Last data update: Sep 16, 2024. (Total: 47680 publications since 2009)
Records 1-12 (of 12 Records) |
Query Trace: Moore ZS [original query] |
---|
COVID-19 Contact Tracing in Two Counties - North Carolina, June-July 2020.
Lash RR , Donovan CV , Fleischauer AT , Moore ZS , Harris G , Hayes S , Sullivan M , Wilburn A , Ong J , Wright D , Washington R , Pulliam A , Byers B , McLaughlin HP , Dirlikov E , Rose DA , Walke HT , Honein MA , Moonan PK , Oeltmann JE . MMWR Morb Mortal Wkly Rep 2020 69 (38) 1360-1363 Contact tracing is a strategy implemented to minimize the spread of communicable diseases (1,2). Prompt contact tracing, testing, and self-quarantine can reduce the transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19) (3,4). Community engagement is important to encourage participation in and cooperation with SARS-CoV-2 contact tracing (5). Substantial investments have been made to scale up contact tracing for COVID-19 in the United States. During June 1-July 12, 2020, the incidence of COVID-19 cases in North Carolina increased 183%, from seven to 19 per 100,000 persons per day* (6). To assess local COVID-19 contact tracing implementation, data from two counties in North Carolina were analyzed during a period of high incidence. Health department staff members investigated 5,514 (77%) persons with COVID-19 in Mecklenburg County and 584 (99%) in Randolph Counties. No contacts were reported for 48% of cases in Mecklenburg and for 35% in Randolph. Among contacts provided, 25% in Mecklenburg and 48% in Randolph could not be reached by telephone and were classified as nonresponsive after at least one attempt on 3 consecutive days of failed attempts. The median interval from specimen collection from the index patient to notification of identified contacts was 6 days in both counties. Despite aggressive efforts by health department staff members to perform case investigations and contact tracing, many persons with COVID-19 did not report contacts, and many contacts were not reached. These findings indicate that improved timeliness of contact tracing, community engagement, and increased use of community-wide mitigation are needed to interrupt SARS-CoV-2 transmission. |
Trends in Number and Distribution of COVID-19 Hotspot Counties - United States, March 8-July 15, 2020.
Oster AM , Kang GJ , Cha AE , Beresovsky V , Rose CE , Rainisch G , Porter L , Valverde EE , Peterson EB , Driscoll AK , Norris T , Wilson N , Ritchey M , Walke HT , Rose DA , Oussayef NL , Parise ME , Moore ZS , Fleischauer AT , Honein MA , Dirlikov E , Villanueva J . MMWR Morb Mortal Wkly Rep 2020 69 (33) 1127-1132 The geographic areas in the United States most affected by the coronavirus disease 2019 (COVID-19) pandemic have changed over time. On May 7, 2020, CDC, with other federal agencies, began identifying counties with increasing COVID-19 incidence (hotspots) to better understand transmission dynamics and offer targeted support to health departments in affected communities. Data for January 22-July 15, 2020, were analyzed retrospectively (January 22-May 6) and prospectively (May 7-July 15) to detect hotspot counties. No counties met hotspot criteria during January 22-March 7, 2020. During March 8-July 15, 2020, 818 counties met hotspot criteria for ≥1 day; these counties included 80% of the U.S. population. The daily number of counties meeting hotspot criteria peaked in early April, decreased and stabilized during mid-April-early June, then increased again during late June-early July. The percentage of counties in the South and West Census regions* meeting hotspot criteria increased from 10% and 13%, respectively, during March-April to 28% and 22%, respectively, during June-July. Identification of community transmission as a contributing factor increased over time, whereas identification of outbreaks in long-term care facilities, food processing facilities, correctional facilities, or other workplaces as contributing factors decreased. Identification of hotspot counties and understanding how they change over time can help prioritize and target implementation of U.S. public health response activities. |
Notes from the field: Enteroinvasive Escherichia coli outbreak associated with a potluck party - North Carolina, June-July 2018
Herzig CTA , Fleischauer AT , Lackey B , Lee N , Lawson T , Moore ZS , Hergert J , Mobley V , MacFarquhar J , Morrison T , Strockbine N , Martin H . MMWR Morb Mortal Wkly Rep 2019 68 (7) 183-184 On July 2, 2018, the North Carolina Division of Public Health was notified that approximately three dozen members of an ethnic Nepali refugee community had been transported to area hospitals for severe gastrointestinal illness after attending a potluck party on June 30. The North Carolina Division of Public Health partnered with the local health department and CDC to investigate the outbreak, identify the cause, and prevent further transmission. The investigation included molecular-guided laboratory testing of clinical specimens by CDC, which determined that this was the first confirmed U.S. outbreak of enteroinvasive Escherichia coli (EIEC) in 47 years. |
Previously undiagnosed HIV infections identified through cluster investigation, North Carolina, 2002-2007
Dailey Garnes NJ , Moore ZS , Cadwell BL , Fleischauer AT , Leone P . AIDS Behav 2014 19 (4) 723-31 During cluster investigation, index patients name social contacts that are not sex or drug-sharing partners. The likelihood of identifying new HIV infections among social contacts is unknown. We hypothesized greater odds of identifying new infections among social contacts identified by men who report sex with men (MSM). We reviewed North Carolina HIV diagnoses during 2002-2005 and used logistic regression to compare testing results among social contacts of MSM, men who report sex with women only (MSW) and women. HIV was newly diagnosed among 54/601 (9.0 %) social contacts tested named by MSM, 16/522 (3.1 %) named by MSW, and 23/639 (3.6 %) named by women. Compared with those named by MSW, odds of new HIV diagnosis were greater among MSM social contacts (adjusted odds ratio: 2.5; 95 % confidence interval: 1.3-4.7). Testing social contacts identified previously undiagnosed HIV infections and could provide an opportunity to interrupt transmission. |
Notes from the field: atypical pneumonia in three members of an extended family - South Carolina and north Carolina, July-August 2013
Rhea SK , Cox SW , Moore ZS , Mays ER , Benitez AJ , Diaz MH , Winchell JM . MMWR Morb Mortal Wkly Rep 2014 63 (33) 734-5 On August 5, 2013, the South Carolina Department of Health and Environmental Control was notified of a case of acute respiratory failure in a previously healthy woman. A family interview revealed the patient's uncle and cousin had also been hospitalized with similar symptoms in North Carolina. The South Carolina Department of Health and Environmental Control and the North Carolina Division of Public Health collaborated to identify the cause of the respiratory illness cluster and to prevent additional illnesses. |
Evaluation of the North Carolina Violent Death Reporting System, 2009
Dailey NJ , Norwood T , Moore ZS , Fleischauer AT , Proescholdbell S . N C Med J 2012 73 (4) 257-62 BACKGROUND: Violence is a leading cause of death in North Carolina. The North Carolina Violent Death Reporting System (NC-VDRS) is part of the National Violent Death Reporting System (NVDRS), which monitors violent deaths and collects information about injuries and psychosocial contributors. Our objective was to describe and evaluate the quality, timeliness, and usefulness of the system. METHODS: We used the Centers for Disease Control and Prevention's guidelines for evaluating public health surveillance systems to assess the system. We performed subjective assessment of system attributes by reviewing system documents and interviewing stakeholders. We estimated NC-VDRS's reporting completeness using a capture-recapture method. RESULTS: Stakeholders considered data provided by NC-VDRS to be of high quality. Reporting to the national system has taken place before the specified 6-month and 18-month deadlines, but local stakeholder reports have been delayed up to 36 months. Stakeholders reported using NC-VDRS data for program planning and community education. The system is estimated to capture all NVDRS-defined cases, but law enforcement officers report only 61% of suicides. LIMITATIONS: The law enforcement agencies we interviewed may not be representative of all participating agencies in the state. Data sources used to assess completeness were not independent. CONCLUSION: NC-VDRS is useful and well-accepted. However, completeness of suicide reporting is limited, and reporting to local stakeholders has been delayed. Improving these limitations might improve the usefulness of the system for planning and appropriately targeting violence prevention interventions. |
Clostridium perfringens infections initially attributed to norovirus, North Carolina, USA, 2010
Dailey NJ , Lee N , Fleischauer AT , Moore ZS , Alfano-Sobsey E , Breedlove F , Pierce A , Ledford S , Greene S , Gomez GA , Talkington DF , Sotir MJ , Hall AJ , Sweat D . Clin Infect Dis 2012 55 (4) 568-70 We investigated an outbreak initially attributed to norovirus; however, Clostridium perfringens toxicoinfection was subsequently confirmed. C. perfringens is an underrecognized but frequently observed cause of foodborne disease outbreaks. This investigation illustrates the importance of considering epidemiologic and laboratory data together when evaluating potential etiologies that might require unique control measures. |
Hepatitis B vaccination of susceptible elderly residents of long term care facilities during a hepatitis B outbreak
Williams RE , Sena AC , Moorman AC , Moore ZS , Sharapov UM , Drobenuic J , Hu DJ , Wood HW , Xing J , Spradling PR . Vaccine 2012 30 (21) 3147-50 Protection of older persons, particularly those with diabetes, against hepatitis B virus (HBV) infection is of growing concern because of increased reports of outbreaks among long-term care facility residents receiving assisted blood glucose monitoring. We evaluated hepatitis B vaccine immunogenicity among residents immunized in response to two such outbreaks in skilled nursing facilities during June 2009-July 2010. One hundred forty-eight (71%) of 209 residents were found to be susceptible to HBV infection. Of 105 patients who began a vaccination series with Twinrix((R)) (0-, 1-, 6-month dosing), 86 (82%) completed the series and postvaccination testing. Of these, most were elderly (median age 79.5 years; range 45-101), female (56%), and African-American (51%). Twenty-nine (34%) vaccinated residents had post-vaccination hepatitis B surface antibody levels ≥10mIU/ml. There were no significant differences in vaccine response by age, gender, race, diabetes status, body mass index, or current smoking status. Our findings indicate that a low proportion of skilled nursing facility residents achieved a seroprotective response after hepatitis B vaccination. |
Transmission of hepatitis C virus during myocardial perfusion imaging in an outpatient clinic
Moore ZS , Schaefer MK , Hoffmann KK , Thompson SC , Xia GL , Lin Y , Khudyakov Y , Maillard JM , Engel JP , Perz JF , Patel PR , Thompson ND . Am J Cardiol 2011 108 (1) 126-32 Reports of health care-associated viral hepatitis transmission have been increasing in the United States. Transmission due to poor infection control practices during myocardial perfusion imaging (MPI) has not previously been reported. The aim of this study was to identify the source of incident hepatitis C virus (HCV) infection in a patient without identified risk factors who had undergone MPI 6 weeks before diagnosis. Practices at the cardiology clinic and nuclear pharmacy were evaluated, and HCV testing was performed in patients with shared potential exposures. Clinical and epidemiologic information was obtained for patients with HCV infection, and molecular testing was performed to assess viral relatedness. Evidence of HCV transmission among patients who had undergone MPI at the cardiology clinic on 2 separate dates was found, involving 2 potential source patients and a total of 5 newly infected patients. Molecular testing identified a high degree of genetic homology among viruses from patients with common procedure dates. The nuclear medicine technologist routinely drew up flush from multidose vials of saline solution using the same needle and syringe that had been used to administer radiopharmaceutical doses. Multipatient use of vials was not observed, but a review of purchasing invoices and interviews with staff members suggested that this had occurred. No evidence of transmission via contamination of radiopharmaceuticals at the nuclear pharmacy was found. In conclusion, transmission of HCV occurred because of unsafe injection practices during MPI. Cardiologists should carefully review their infection control practices and the practices of other staff members involved with these procedures. |
Cluster of oseltamivir-resistant 2009 pandemic influenza A (H1N1) virus infections on a hospital ward among immunocompromised patients--North Carolina, 2009
Chen LF , Dailey NJ , Rao AK , Fleischauer AT , Greenwald I , Deyde VM , Moore ZS , Anderson DJ , Duffy J , Gubareva LV , Sexton DJ , Fry AM , Srinivasan A , Wolfe CR . J Infect Dis 2011 203 (6) 838-46 BACKGROUND: Oseltamivir resistance among 2009 pandemic influenza A (H1N1) viruses (pH1N1) is rare. We investigated a cluster of oseltamivir-resistant pH1N1 infections in a hospital ward. METHODS: We reviewed patient records and infection control measures and interviewed health care personnel (HCP) and visitors. Oseltamivir-resistant pH1N1 infections were found with real-time reverse-transcription polymerase chain reaction and pyrosequencing for the H275Y neuraminidase (NA) mutation. We compared hemagglutinin (HA) sequences from clinical samples from the outbreak with those of other surveillance viruses. RESULTS: During the period 6-11 October 2009, 4 immunocompromised patients within a hematology-oncology ward exhibited symptoms of pH1N1 infection. The likely index patient became febrile 8 days after completing a course of oseltamivir; isolation was instituted 9 days after symptom onset. Three other case patients developed symptoms 1, 3, and 5 days after the index patient. Three case patients were located in adjacent rooms. HA and NA sequences from case patients were identical. Twelve HCP and 6 visitors reported influenza symptoms during the study period. No other pH1N1 isolates from the hospital or from throughout the state carried the H275Y mutation. CONCLUSIONS: Geographic proximity, temporal clustering, presence of H275Y mutation, and viral sequence homology confirmed nosocomial transmission of oseltamivir-resistant pH1N1. Diagnostic vigilance and prompt isolation may prevent nosocomial transmission of influenza. |
Fatal apophysomyces elegans infection transmitted by deceased donor renal allografts
Alexander BD , Schell WA , Siston AM , Rao CY , Bower WA , Balajee SA , Howell DN , Moore ZS , Noble-Wang J , Rhyne JA , Fleischauer AT , Maillard JM , Kuehnert M , Vikraman D , Collins BH , Marroquin CE , Park BJ . Am J Transplant 2010 10 (9) 2161-7 Two patients developed renal mucormycosis following transplantation of kidneys from the same donor, a near-drowning victim in a motor vehicle crash. Genotypically, indistinguishable strains of Apophysomyces elegans were recovered from both recipients. We investigated the source of the infection including review of medical records, environmental sampling at possible locations of contamination and query for additional cases at other centers. Histopathology of the explanted kidneys revealed extensive vascular invasion by aseptate, fungal hyphae with relative sparing of the renal capsules suggesting a vascular route of contamination. Disseminated infection in the donor could not be definitively established. A. elegans was not recovered from the same lots of reagents used for organ recovery or environmental samples and no other organ transplant-related cases were identified. This investigation suggests either isolated contamination of the organs during recovery or undiagnosed disseminated donor infection following a near-drowning event. Although no changes to current organ recovery or transplant procedures are recommended, public health officials and transplant physicians should consider the possibility of mucormycosis transmitted via organs in the future, particularly for near-drowning events. Attention to aseptic technique during organ recovery and processing is re-emphasized. |
Number of named partners and number of partners newly diagnosed with HIV infection identified by persons with acute versus established HIV infection
Moore ZS , McCoy S , Kuruc J , Hilton M , Leone P . J Acquir Immune Defic Syndr 2009 52 (4) 509-13 BACKGROUND: Acute infections with HIV account for a disproportionate share of forward transmission in certain populations. We hypothesized that persons with acute HIV infection (AHI) would identify more named partners than those with established HIV infection (EHI). METHODS: We reviewed North Carolina surveillance databases to identify all persons aged > or =18 years in whom HIV was diagnosed during November 1, 2002 to October 31, 2007. We compared the number of named partners identified by persons with AHI versus EHI (based on nucleic acid amplification plus serologic testing) using a multivariable model and also compared information regarding HIV testing among partners identified by these groups. RESULTS: EHI was diagnosed in 9044 persons and AHI in 120 persons during the study period. Persons with AHI named 2.5 times more partners per index patient [95% confidence interval: 2.1 to 3.0] and 1.9 times more partners newly diagnosed with HIV infection per index patient (95% confidence interval: 1.1 to 3.5) as did persons with EHI. DISCUSSION: In North Carolina, persons with AHI identified proportionately more named partners and more partners newly diagnosed with HIV infections than persons with EHI. Improved detection of AHI offers critical opportunities to intervene and potentially reduce transmission of HIV. |
- Page last reviewed:Feb 1, 2024
- Page last updated:Sep 16, 2024
- Content source:
- Powered by CDC PHGKB Infrastructure