Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-3 (of 3 Records) |
Query Trace: Nelson GE[original query] |
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Epidemiology of Invasive Group A Streptococcal Infections in the United States, 2005-2012
Nelson GE , Pondo T , Toews KA , Farley MM , Lindegren ML , Lynfield R , Aragon D , Zansky SM , Watt JP , Cieslak PR , Angeles K , Harrison LH , Petit S , Beall B , Van Beneden CA . Clin Infect Dis 2016 63 (4) 478-86 BACKGROUND: Invasive group A Streptococcus (GAS) infections cause significant morbidity and mortality. We report the epidemiology and trends of invasive GAS over 8 years of surveillance. METHODS: From January 2005 through December 2012, we collected data from the Centers for Disease Control and Prevention's Active Bacterial Core surveillance (ABCs), a population-based network of 10 geographically diverse U.S. sites (2012 population, 32.8 million). We defined invasive GAS as isolation of GAS from a normally sterile site or from a wound in a patient with necrotizing fasciitis (NF) or streptococcal toxic shock syndrome (STSS). Available isolates were emm typed. We calculated rates and made age- and race-adjusted national projections using census data. RESULTS: We identified 9557 cases (3.8 cases per 100,000 persons per year) with 1116 deaths (case-fatality ratio [CFR]: 11.7%). CFRs for septic shock, STSS and NF were 45%, 38%, and 29%, respectively. Annual incidence was highest among persons aged ≥65 years (9.4 per 100,000), persons aged <1 year (5.3), and blacks (4.7). National rates remained steady over 8 years of surveillance. Factors independently associated with death included increasing age, residence in a nursing home, recent surgery, septic shock, NF, meningitis, isolated bacteremia, pneumonia, emm type 1 or 3, and underlying chronic illness or immunosuppression. An estimated 10,649-13,434 cases of invasive GAS infections occur in the U.S. annually, resulting in 1,136-1,607 deaths. emm types in a 30-valent M-protein vaccine accounted for 91% of isolates. CONCLUSIONS: The burden of invasive GAS infection in the U.S. remains substantial. Vaccines under development could have a considerable public health impact. |
Epidemiology of a mumps outbreak in a highly vaccinated island population and use of a third dose of measles-mumps-rubella vaccine for outbreak control- Guam 2009-2010
Nelson GE , Aguon A , Valencia E , Oliva R , Guerrero ML , Reyes R , Lizama A , Diras D , Mathew A , Camacho EJ , Monforte MN , Chen TH , Mahamud A , Kutty PK , Hickman C , Bellini WJ , Seward JF , Gallagher K , Fiebelkorn AP . Pediatr Infect Dis J 2012 32 (4) 374-80 BACKGROUND: Despite high two-dose measles-mumps-rubella (MMR) vaccine coverage, a large mumps outbreak occurred on the U.S. Territory of Guam during 2009-2010, primarily in school-aged children. METHODS: We implemented active surveillance in April 2010 during the outbreak peak and characterized the outbreak epidemiology. We administered third doses of MMR vaccine to eligible students aged 9-14 years in 7 schools with the highest attack rates (ARs) between 5/18/2010-5/21/2010. Baseline surveys, follow-up surveys, and case-reports were used to determine mumps vaccine ARs. Adverse events post-vaccination were monitored. RESULTS: Between 12/1/2009-12/31/2010, 505 mumps cases were reported. Self-reported Pohnpeians and Chuukese had the highest relative risks (54.7 and 19.7, respectively) and highest crowding indices (mean: 3.1 and 3.0 persons/bedroom, respectively). Among 287 (57%) school-aged case-patients, 270 (93%) had ≥2 MMR doses. A third MMR dose was administered to 1068 (33%) eligible students. Three-dose vaccinated students had an AR of 0.9/1000 compared with 2.4/1000 among students vaccinated with ≤2 doses more than1 incubation period pos-intervention, but the difference was not significant (p= 0.67). No serious adverse events were reported. CONCLUSIONS: This mumps outbreak occurred in a highly vaccinated population. The highest ARs occurred in ethnic minority populations with the highest household crowding indices. After the third dose MMR intervention in highly affected schools, three-dose recipients had an AR 60% lower than students with ≤2 doses, but the difference was not statistically significant and the intervention occurred after the outbreak peaked. This outbreak may have persisted due to crowding at home and high student contact rates. |
Invasive pneumococcal disease and pandemic (H1N1) 2009, Denver, Colorado, USA
Nelson GE , Gershman KA , Swerdlow DL , Beall BW , Moore MR . Emerg Infect Dis 2012 18 (2) 208-16 Pneumococcal pneumonia was a complication during previous influenza pandemics but was not evident initially during pandemic (H1N1) 2009. During October 2009 in Denver, Colorado, USA, invasive pneumococcal disease (IPD) and pandemic (H1N1) 2009 peaked simultaneously, which suggests a link. We compared cases of IPD in October 2009 with cases in February 2009, the most recent peak month of seasonal influenza. During October 2009, we observed 58 IPD cases, which was 3x the average number of IPD cases that usually occur in October in Denver. Patients with IPD in October 2009 were younger and more likely to have chronic lung disease than patients who had IPD in February 2009; a total of 10/47 patients had influenza, and 33/53 patients had influenza-like illness. Thus, approximately 17%-62% cases of IPD may have been associated with pandemic (H1N1) 2009. Pneumococcal disease prevention strategies should be emphasized during future influenza pandemics. |
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