Last data update: Sep 23, 2024. (Total: 47723 publications since 2009)
Records 1-13 (of 13 Records) |
Query Trace: Nemhauser J [original query] |
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Travel history among persons infected with SARS-CoV-2 variants of concern in the United States, December 2020-February 2021.
Dunajcik A , Haire K , Thomas JD , Moriarty LF , Springer Y , Villanueva JM , MacNeil A , Silk B , Nemhauser JB , Byrkit R , Taylor M , Queen K , Tong S , Lee J , Batra D , Paden C , Henderson T , Kunkes A , Ojo M , Firestone M , Martin Webb L , Freeland M , Brown CM , Williams T , Allen K , Kauerauf J , Wilson E , Jain S , McDonald E , Silver E , Stous S , Wadford D , Radcliffe R , Marriott C , Owes JP , Bart SM , Sosa LE , Oakeson K , Wodniak N , Shaffner J , Brown Q , Westergaard R , Salinas A , Hallyburton S , Ogale Y , Offutt-Powell T , Bonner K , Tubach S , Van Houten C , Hughes V , Reeb V , Galeazzi C , Khuntia S , McGee S , Hicks JT , Dinesh Patel D , Krueger A , Hughes S , Jeanty F , Wang JC , Lee EH , Assanah-Deane T , Tompkins M , Dougherty K , Naqvi O , Donahue M , Frederick J , Abdalhamid B , Powers AM , Anderson M . PLOS Glob Public Health 2023 3 (3) e0001252 The first three SARS-CoV-2 phylogenetic lineages classified as variants of concern (VOCs) in the United States (U.S.) from December 15, 2020 to February 28, 2021, Alpha (B.1.1.7), Beta (B.1.351), and Gamma (P.1) lineages, were initially detected internationally. This investigation examined available travel history of coronavirus disease 2019 (COVID-19) cases reported in the U.S. in whom laboratory testing showed one of these initial VOCs. Travel history, demographics, and health outcomes for a convenience sample of persons infected with a SARS-CoV-2 VOC from December 15, 2020 through February 28, 2021 were provided by 35 state and city health departments, and proportion reporting travel was calculated. Of 1,761 confirmed VOC cases analyzed, 1,368 had available data on travel history. Of those with data on travel history, 1,168 (85%) reported no travel preceding laboratory confirmation of SARS-CoV-2 and only 105 (8%) reported international travel during the 30 days preceding a positive SARS-CoV-2 test or symptom onset. International travel was reported by 92/1,304 (7%) of persons infected with the Alpha variant, 7/55 (22%) with Beta, and 5/9 (56%) with Gamma. Of the first three SARS-CoV-2 lineages designated as VOCs in the U.S., international travel was common only among the few Gamma cases. Most persons infected with Alpha and Beta variant reported no travel history, therefore, community transmission of these VOCs was likely common in the U.S. by March 2021. These findings underscore the importance of global surveillance using whole genome sequencing to detect and inform mitigation strategies for emerging SARS-CoV-2 VOCs. |
Heritage and Genealogy Travel Health Concerns in the Era of In-home DNA Testing.
Angelo KM , Breiman J , Wu HM , Nemhauser J , Walker AT . J Travel Med 2020 27 (4) Over 1000 companies offer in-home DNA testing kits. These kits enable customers to learn about their genetic history simply by submitting a saliva sample or cheek swab. Customers typically receive an electronic copy of DNA results in 6–8 weeks.1 The most affordable in-home DNA testing kits are for ancestry and genealogy only, providing a geographically based percentage of genealogy, relatedness to other individuals and possible links to ancestors and family members through testing autosomal DNA genetic variants.2 These tests are not without their limitations, however, as they cannot correctly identify distant ancestors for some populations, there are associated cost and privacy issues and emotional or social consequences.3 A secondary effect of in-home ancestry DNA testing is a novel trend in ancestry or genealogy travel (also known as heritage travel) inspired by in home DNA testing results.4 |
Spread of measles in Europe and implications for US travelers
Angelo KM , Gastanaduy PA , Walker AT , Patel M , Reef S , Lee CV , Nemhauser J . Pediatrics 2019 144 (1) From January 2018 to June 2018, World Health Organization (WHO) European Region countries reported >41 000 measles cases, including 37 deaths, a record high since the 1990s. Low vaccination coverage in previous years is the biggest contributing factor to the increase in cases. The Ukraine reported the majority of cases, but France, Georgia, Greece, Italy, the Russian Federation, and Serbia also reported high case counts. Europe is the most common travel destination worldwide and is widely perceived as being without substantial infectious disease risks. For this reason, travelers may not consider the relevance of a pretravel health consultation, including vaccination, in their predeparture plans. Measles is highly contagious, and the record number of measles cases in the WHO European Region not only puts unvaccinated and inadequately vaccinated travelers at risk but also increases the risk for nontraveling US residents who come into close contact with returned travelers who are ill. The US Centers for Disease Control and Prevention encourage US travelers to be aware of measles virus transmission in Europe and receive all recommended vaccinations, including for measles, before traveling abroad. Health care providers must maintain a high degree of suspicion for measles among travelers returning from Europe or people with close contact with international travelers who present with a febrile rash illness. The current WHO European Region outbreak should serve to remind health care providers to stay current with the epidemiology of highly transmissible diseases, such as measles, through media, WHO, and Centers for Disease Control and Prevention reports and encourage measles vaccination for international travelers. |
Update: Interim guidance for health care providers caring for pregnant women with possible Zika virus exposure - United States (including U.S. territories), July 2017
Oduyebo T , Polen KD , Walke HT , Reagan-Steiner S , Lathrop E , Rabe IB , Kuhnert-Tallman WL , Martin SW , Walker AT , Gregory CJ , Ades EW , Carroll DS , Rivera M , Perez-Padilla J , Gould C , Nemhauser JB , Ben Beard C , Harcourt JL , Viens L , Johansson M , Ellington SR , Petersen E , Smith LA , Reichard J , Munoz-Jordan J , Beach MJ , Rose DA , Barzilay E , Noonan-Smith M , Jamieson DJ , Zaki SR , Petersen LR , Honein MA , Meaney-Delman D . MMWR Morb Mortal Wkly Rep 2017 66 (29) 781-793 CDC has updated the interim guidance for U.S. health care providers caring for pregnant women with possible Zika virus exposure in response to 1) declining prevalence of Zika virus disease in the World Health Organization's Region of the Americas (Americas) and 2) emerging evidence indicating prolonged detection of Zika virus immunoglobulin M (IgM) antibodies. Zika virus cases were first reported in the Americas during 2015-2016; however, the incidence of Zika virus disease has since declined. As the prevalence of Zika virus disease declines, the likelihood of false-positive test results increases. In addition, emerging epidemiologic and laboratory data indicate that, as is the case with other flaviviruses, Zika virus IgM antibodies can persist beyond 12 weeks after infection. Therefore, IgM test results cannot always reliably distinguish between an infection that occurred during the current pregnancy and one that occurred before the current pregnancy, particularly for women with possible Zika virus exposure before the current pregnancy. These limitations should be considered when counseling pregnant women about the risks and benefits of testing for Zika virus infection during pregnancy. This updated guidance emphasizes a shared decision-making model for testing and screening pregnant women, one in which patients and providers work together to make decisions about testing and care plans based on patient preferences and values, clinical judgment, and a balanced assessment of risks and expected outcomes. |
Safe and effective deployment of personnel to support the Ebola response - West Africa
Rouse EN , Zarecki SM , Flowers D , Robinson ST , Sheridan RJ , Goolsby GD , Nemhauser J , Kuwabara S . MMWR Suppl 2016 65 (3) 90-7 From the initial task of getting "50 deployers within 30 days" into the field to support the 2014-2016 Ebola virus disease (Ebola) epidemic response in West Africa to maintaining well over 200 staff per day in the most affected countries (Guinea, Liberia, and Sierra Leone) during the peak of the response, ensuring the safe and effective deployment of international responders was an unprecedented accomplishment by CDC. Response experiences shared by CDC deployed staff returning from West Africa were quickly incorporated into lessons learned and resulted in new activities to better protect the health, safety, security, and resiliency of responding personnel. Enhanced screening of personnel to better match skill sets and experience with deployment needs was developed as a staffing strategy. The mandatory predeployment briefings were periodically updated with these lessons to ensure that staff were aware of what to expect before, during, and after their deployments. Medical clearance, security awareness, and resiliency programs became a standard part of both predeployment and postdeployment activities. Response experience also led to the identification and provision of more appropriate equipment for the environment. Supporting the social and emotional needs of deployed staff and their families also became an agency focus for care and communication. These enhancements set a precedent as a new standard for future CDC responses, regardless of size or complexity.The activities summarized in this report would not have been possible without collaboration with many U.S and international partners (http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/partners.html). |
US screening of international travelers for radioactive contamination after the Japanese nuclear plant disaster in March 2011
Wilson T , Chang A , Berro A , Still A , Brown C , Demma A , Nemhauser J , Martin C , Salame-Alfie A , Fisher-Tyler F , Smith L , Grady-Erickson O , Alvarado-Ramy F , Brunette G , Ansari A , McAdam D , Marano N . Disaster Med Public Health Prep 2012 6 (3) 291-6 On March 11, 2011, a magnitude 9.0 earthquake and subsequent tsunami damaged nuclear reactors at the Fukushima Daiichi complex in Japan, resulting in radionuclide release. In response, US officials augmented existing radiological screening at its ports of entry (POEs) to detect and decontaminate travelers contaminated with radioactive materials. During March 12 to 16, radiation screening protocols detected 3 travelers from Japan with external radioactive material contamination at 2 air POEs. Beginning March 23, federal officials collaborated with state and local public health and radiation control authorities to enhance screening and decontamination protocols at POEs. Approximately 543 000 (99%) travelers arriving directly from Japan at 25 US airports were screened for radiation contamination from March 17 to April 30, and no traveler was detected with contamination sufficient to require a large-scale public health response. The response highlighted synergistic collaboration across government levels and leveraged screening methods already in place at POEs, leading to rapid protocol implementation. Policy development, planning, training, and exercising response protocols and the establishment of federal authority to compel decontamination of travelers are needed for future radiological responses. Comparison of resource-intensive screening costs with the public health yield should guide policy decisions, given the historically low frequency of contaminated travelers arriving during radiological disasters. |
Murder by radiation poisoning: implications for public health
Miller CW , Whitcomb RC , Ansari A , McCurley C , Nemhauser JB , Jones R . J Environ Health 2012 74 (10) 8-13 On November 23, 2006, former Russian military intelligence officer Alexander Litvinenko died in a London hospital. Authorities determined he was deliberately poisoned with the radionuclide Polonium-210 (210Po). Police subsequently discovered that those involved in this crime had--apparently inadvertently--spread 210Po over many locations in London. The United Kingdom Health Protection Agency (HPA) contacted many persons who might have been exposed to 210Po and provided voluntary urine testing. Some of those identified as potentially exposed were U.S. citizens, whom the HPA requested that the Centers for Disease Control and Prevention (CDC) assist in contacting. CDC also provided health care professionals and state and local public health officials with guidance as to how they might respond should a Litvinenko-like incident occur in the U.S. This guidance has resulted in the identification of a number of lessons that can be useful to public health and medical authorities in planning for radiological incidents. Eight such lessons are discussed in this article. |
Literature review and global consensus on management of acute radiation syndrome affecting nonhematopoietic organ systems
Dainiak N , Gent RN , Carr Z , Schneider R , Bader J , Buglova E , Chao N , Coleman CN , Ganser A , Gorin C , Hauer-Jensen M , Huff LA , Lillis-Hearne P , Maekawa K , Nemhauser J , Powles R , Schunemann H , Shapiro A , Stenke L , Valverde N , Weinstock D , White D , Albanese J , Meineke V . Disaster Med Public Health Prep 2011 5 (3) 183-201 OBJECTIVES: The World Health Organization convened a panel of experts to rank the evidence for medical countermeasures for management of acute radiation syndrome (ARS) in a hypothetical scenario involving the hospitalization of 100 to 200 victims. The goal of this panel was to achieve consensus on optimal management of ARS affecting nonhematopoietic organ systems based upon evidence in the published literature. METHODS: English-language articles were identified in MEDLINE and PubMed. Reference lists of retrieved articles were distributed to conferees in advance of and updated during the meeting. Published case series and case reports of ARS, publications of randomized controlled trials of relevant interventions used to treat nonirradiated individuals, reports of studies in irradiated animals, and prior recommendations of subject matter experts were selected. Studies were extracted using the Grading of Recommendations Assessment Development and Evaluation system. In cases in which data were limited or incomplete, a narrative review of the observations was made. RESULTS: No randomized controlled trials of medical countermeasures have been completed for individuals with ARS. Reports of countermeasures were often incompletely described, making it necessary to rely on data generated in nonirradiated humans and in experimental animals. A strong recommendation is made for the administration of a serotonin-receptor antagonist prophylactically when the suspected exposure is >2 Gy and topical steroids, antibiotics, and antihistamines for radiation burns, ulcers, or blisters; excision and grafting of radiation ulcers or necrosis with intractable pain; provision of supportive care to individuals with neurovascular syndrome; and administration of electrolyte replacement therapy and sedatives to individuals with significant burns, hypovolemia, and/or shock. A strong recommendation is made against the use of systemic steroids in the absence of a specific indication. A weak recommendation is made for the use of fluoroquinolones, bowel decontamination, loperamide, and enteral nutrition, and for selective oropharyngeal/digestive decontamination, blood glucose maintenance, and stress ulcer prophylaxis in critically ill patients. CONCLUSIONS: High-quality studies of therapeutic interventions in humans exposed to nontherapeutic radiation are not available, and because of ethical concerns regarding the conduct of controlled studies in humans, such studies are unlikely to emerge in the near future. |
First global consensus for evidence-based management of the hematopoietic syndrome resulting from exposure to ionizing radiation
Dainiak N , Gent RN , Carr Z , Schneider R , Bader J , Buglova E , Chao N , Coleman CN , Ganser A , Gorin C , Hauer-Jensen M , Huff LA , Lillis-Hearne P , Maekawa K , Nemhauser J , Powles R , Schunemann H , Shapiro A , Stenke L , Valverde N , Weinstock D , White D , Albanese J , Meineke V . Disaster Med Public Health Prep 2011 5 (3) 202-12 OBJECTIVE: Hematopoietic syndrome (HS) is a clinical diagnosis assigned to people who present with ≥1 new-onset cytopenias in the setting of acute radiation exposure. The World Health Organization convened a panel of experts to evaluate the evidence and develop recommendations for medical countermeasures for the management of HS in a hypothetical scenario involving the hospitalization of 100 to 200 individuals exposed to radiation. The objective of this consultancy was to develop recommendations for treatment of the HS based upon the quality of evidence. METHODS: English-language articles were identified in MEDLINE and PubMed. Reference lists of retrieved articles were distributed to panel members before the meeting and updated during the meeting. Published case series and case reports of individuals with HS, published randomized controlled trials of relevant interventions used to treat nonirradiated individuals, reports of studies in irradiated animals, and prior recommendations of subject matter experts were selected. Studies were extracted using the Grading of Recommendations Assessment Development and Evaluation (GRADE) system. In cases in which data were limited or incomplete, a narrative review of the observations was made. No randomized controlled trials of medical countermeasures have been completed for individuals with radiation-associated HS. The use of GRADE analysis of countermeasures for injury to hematopoietic tissue was restricted by the lack of comparator groups in humans. Reliance on data generated in nonirradiated humans and experimental animals was necessary. RESULTS: Based upon GRADE analysis and narrative review, a strong recommendation was made for the administration of granulocyte colony-stimulating factor or granulocyte macrophage colony-stimulating factor and a weak recommendation was made for the use of erythropoiesis-stimulating agents or hematopoietic stem cell transplantation. CONCLUSIONS: Assessment of therapeutic interventions for HS in humans exposed to nontherapeutic radiation is difficult because of the limits of the evidence. |
Acute radiation syndrome: assessment and management
Donnelly EH , Nemhauser JB , Smith JM , Kazzi ZN , Farfan EB , Chang AS , Naeem SF . South Med J 2010 103 (6) 541-546 Primary care physicians may be unprepared to diagnose and treat rare, yet potentially fatal, illnesses such as acute radiation syndrome (ARS). ARS, also known as radiation sickness, is caused by exposure to a high dose of penetrating, ionizing radiation over a short period of time. The time to onset of ARS is dependent on the dose received, but even at the lowest doses capable of causing illness, this will occur within a matter of hours to days. This article describes the clinical manifestations of ARS, provides guidelines for assessing its severity, and makes recommendations for managing ARS victims. Copyright copyright 2010 by The Southern Medical Association. |
The polonium-210 public health assessment: the need for medical toxicology expertise in radiation terrorism events
Nemhauser JB . J Med Toxicol 2010 6 (3) 355-9 In 1989, the Centers for Disease Control and Prevention | (CDC) brought together a group of subject matter experts to | form the Radiation Studies Branch (RSB). CDC tasked the | RSB staff with assessing potential environmental health | impacts of radiation released from US Department of | Energy nuclear weapons production facilities. Shortly | after the September 11, 2001 attacks, however, the | mission of the RSB expanded to include (and to focus | on) preparing the nation’s public health community, | healthcare providers and citizens for intentional (i.e., | terrorism-related) radiological incidents, accidents involving exposures to radiation, and unintentional environmental releases of radioactive materials. | In late 2006, an event occurred in the UK for which the | RSB was uniquely suited to respond. The radioactive | isotope polonium-210 (210Po) was deliberately used as a | weapon against one person and, perhaps accidentally, | released into the environment. Initially, it was unclear | how many bystanders might have been unintended victims | of the radioactive chemical. Some of those bystanders | included American citizens travelling abroad at the time |
Medical toxicology and public health: update on research and activities at the Centers for Disease Control and Prevention and the Agency for Toxic Substances and Disease Registry : introduction to activities at the Radiation Studies Branch
Kazzi ZN , Nemhauser JB , Ansari A , McCurley C , Whitcomb R , Miller C . J Med Toxicol 2010 6 (2) 230-3 The Radiation Studies Branch (RSB) was formed in 1989 | as part of the Division of Environmental Hazards and | Health Effects in the Centers for Disease Control and | Prevention’s National Center for Environmental Health | (NCEH) [Fig. 1]. At that time, branch staff focused | primarily on assessing the potential environmental health | effect of radiation released from Department of Energy | Nuclear Weapons Production Facilities. After the events of | September 11, 2001, however, the RSB assumed additional | responsibilities in public health preparedness. This effort is | largely directed toward preparing the nation’s public health | community, healthcare providers, and citizens for various | scenarios. These include intentional (i.e., terrorism-related) | radiological incidents, accidents involving radiation exposure, and unintentional environmental releases of radioactive materials. |
Medical response to a major radiologic emergency: a primer for medical and public health practitioners
Wolbarst AB , Wiley AL Jr , Nemhauser JB , Christensen DM , Hendee WR . Radiology 2010 254 (3) 660-77 There are several types of serious nuclear or radiologic emergencies that would require a specialized medical response. Four scenarios of great public health, economic, and psychologic impact are the detonation of a nuclear weapon, the meltdown of a nuclear reactor, the explosion of a large radiologic dispersal device ("dirty bomb"), or the surreptitious placement of a radiation exposure device in a public area of high population density. With any of these, medical facilities that remain functional may have to deal with large numbers of ill, wounded, and probably contaminated people. Special care and/or handling will be needed for those with trauma, blast injuries, or thermal burns as well as significant radiation exposures or contamination. In addition, radiologists, nuclear medicine specialists, and radiation oncologists will be called on to perform a number of diverse and critically important tasks, including advising political and public health leaders, interfacing with the media, managing essential resources, and, of course, providing medical care. This article describes the medical responses needed following a radiologic or nuclear incident, including the symptoms of and specific treatments for acute radiation syndrome and other early health effects. (c) RSNA, 2010 Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.09090330/-/DC1. |
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