Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-21 (of 21 Records) |
Query Trace: Newsome K[original query] |
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Mental health in undergraduate students several months into the COVID-19 pandemic compared to before the pandemic
Jacobs EJ , Spiker S , Newsome KB , Danielson ML , Bhupalam S , Leeb RT . J Am Coll Health 2023 1-10 OBJECTIVE: To compare mental health indicators among undergraduates in Fall 2019, before the COVID-19 pandemic, and Fall 2020, when many students returned to campus amidst restrictions on in-person contact. PARTICIPANTS: Analyses included 26,881 undergraduate students, aged 18-24, from 70 U.S. institutions. METHODS: Students completed the National College Health Assessment-III survey in Fall 2019 or Fall 2020. RESULTS: The prevalences of high stress, loneliness, a low flourishing score, and serious psychological distress increased in 2020 compared to 2019. Serious psychological distress increased substantially in 2020 among students not living with family (adjusted prevalence ratio (aPR)=1.36, 95% CI 1.29-1.45) but not among students living with family (aPR = 1.09, 95% CI 0.95-1.26). CONCLUSIONS: These results suggest prevalences of several indicators of poor mental health were elevated among U.S. undergraduates several months into the pandemic. The pandemic may have had greater impact on mental health among students not living with family. |
Trends in stimulant prescription fills among commercially insured children and adults - United States, 2016-2021
Danielson ML , Bohm MK , Newsome K , Claussen AH , Kaminski JW , Grosse SD , Siwakoti L , Arifkhanova A , Bitsko RH , Robinson LR . MMWR Morb Mortal Wkly Rep 2023 72 (13) 327-332 Prescription stimulant use, primarily for the treatment of attention-deficit/hyperactivity disorder (ADHD), has increased among adults in the United States during recent decades, while remaining stable or declining among children and adolescents (1,2). MarketScan commercial claims data were analyzed to describe trends in prescription stimulant fills before and during the COVID-19 pandemic (2016-2021) by calculating annual percentages of enrollees aged 5-64 years in employer-sponsored health plans who had one or more prescription stimulant fills overall and by sex and age group. Overall, the percentage of enrollees with one or more prescription stimulant fills increased from 3.6% in 2016 to 4.1% in 2021. The percentages of females aged 15-44 years and males aged 25-44 years with prescription stimulant fills increased by more than 10% during 2020-2021. Future evaluation could determine if policy and health system reimbursement changes enacted during the pandemic contributed to the increase in stimulant prescriptions. Stimulants can offer substantial benefits for persons with ADHD, but also pose potential harms, including adverse effects, medication interactions, diversion and misuse, and overdoses. Well-established clinical guidelines exist for ADHD care, but only for children and adolescents* (3); clinical practice guidelines for adult ADHD could help adults also receive accurate diagnoses and appropriate treatment. |
Prevalence of mental, behavioral, and developmental disorders among children and adolescents with diabetes, United States (2016-2019)
Barrett CE , Zhou X , Mendez I , Park J , Koyama AK , Claussen AH , Newsome K , McKeever Bullard K . J Pediatr 2022 253 25-32 OBJECTIVE: To assess the association of diabetes and mental, behavioral, and developmental disorders in youth, we examined the magnitude of overlap between these disorders in children and adolescents. STUDY DESIGN: In this cross-sectional study, we calculated prevalence estimates using the 2016-2019 National Survey of Children's Health. Parents reported whether their child was currently diagnosed with diabetes or with any of the following mental, behavioral, or developmental disorders: attention-deficit/hyperactivity disorder, autism spectrum disorder, learning disability, intellectual disability, developmental delay, anxiety, depression, behavioral problems, Tourette syndrome, or speech/language disorder. We present crude prevalence estimates weighted to be representative of the U.S. child population and prevalence ratios (aPR) adjusted for age, sex, and race/ethnicity. RESULTS: Among children and adolescents (aged 2-17 years; N=121,312), prevalence of mental, behavioral, and developmental disorders varied by diabetes status (diabetes: 39.9% [30.2-50.4]; no diabetes: 20.3% [19.8-20.8]). Compared with children and adolescents without diabetes, those with diabetes had a nearly two-fold higher prevalence of mental, behavioral, and developmental disorders (aPR: 1.72 [1.31-2.27]); mental, emotional, and behavioral disorders (aPR: 1.90 [1.38-2.61]); and developmental, learning, and language disorders (aPR: 1.89 [1.35-2.66]). CONCLUSIONS: These results suggest that approximately 2 in 5 children and adolescents with diabetes have a mental, behavioral, or developmental disorder. Understanding potential causal pathways may ultimately lead to future preventative strategies for mental, behavioral, and developmental disorders and diabetes in children and adolescents. |
Estimating the number of people with Tourette syndrome and persistent tic disorder in the United States
Tinker SC , Bitsko RH , Danielson ML , Newsome K , Kaminski JW . Psychiatry Res 2022 314 114684 Estimates of the number of people in the U.S. with Tourette syndrome or other persistent tic disorders can inform service provision planning. Based on available prevalence estimates applied to 2020 population data from the U.S. Census, we estimated that 350,000-450,000 U.S. children and adults have Tourette syndrome and about one million have other persistent tic disorders. Variation across studies makes estimating the total number of people in the United States affected by these disorders challenging. More precise measurement could ensure that prevalence estimates accurately reflect all who are impacted by these disorders and who could benefit from evidence-based services. |
Answering the Call: The Response of Centers for Disease Control and Prevention's Federal Public Health Nursing Workforce to the COVID-19 Pandemic.
Zauche LH , Pomeroy M , Demeke HB , MetteeZarecki SL , Williams JL , Newsome K , Hill L , Dooyema CA . Am J Public Health 2022 112 S226-s230 Many public health challenges face our world today, including systemic racism, the opioid epidemic, and the COVID-19 pandemic. Nurses are well-qualified and well-positioned to respond to these challenges, as nurses represent 50% of the global health workforce and are leaders not only in clinical settings but also in public health.1 The professions of nursing and public health have been closely intertwined since the founding of the modern-day nursing profession by Florence Nightingale, a pioneer in the field of epidemiology.2 |
State-level estimates of the prevalence of parent-reported ADHD diagnosis and treatment among U.S. children and adolescents, 2016 to 2019
Danielson ML , Holbrook JR , Bitsko RH , Newsome K , Charania SN , McCord RF , Kogan MD , Blumberg SJ . J Atten Disord 2022 26 (13) 10870547221099961 OBJECTIVE: To provide state-level estimates of diagnosed ADHD and associated treatment among children in the United States in 2016 to 2019. METHOD: This study used the National Survey of Children's Health to produce national and state-level estimates of lifetime diagnosis and current ADHD among all children aged 3 to 17 years (n=114,476), and national and state-level estimates of medication and behavioral treatment use among children with current ADHD. RESULTS: The state-level estimates of diagnosed ADHD ranged from 6.1% to 16.3%. Among children with current ADHD, state-level estimates of ADHD medication usage ranged from 37.8% to 81.4%, and state-level estimates of behavioral treatment ranged from 38.8% to 61.8%. CONCLUSION: There was substantial state-level variation for indicators of ADHD diagnosis and associated treatment. These state-level results can be used by policymakers, public health practitioners, health care providers, and other stakeholders to help address the service needs of children with ADHD in their states. |
Evidence base review of couple- and family-based psychosocial interventions to promote infant and early childhood mental health, 2010-2019
Kaminski JW , Robinson LR , Hutchins HJ , Newsome KB , Barry CM . J Marital Fam Ther 2021 48 (1) 23-55 Infant and early childhood mental health (IECMH) has been defined as the capacity of infants and young children to regulate their emotions, form secure relationships, and explore their environments. For this special issue, we conducted a review of IECMH outcomes from evaluations of couple- and family-based psychosocial interventions not explicitly designed for trauma exposure published from 2010 through 2019, following Evidence Base Update criteria and the current convention of classifying general categories of intervention approaches rather than the former practice of evaluating specific brand-name packaged programs. Full-text review of 695 articles resulted in 39 articles eligible for categorization into intervention approaches, taking into consideration the theoretical orientation of the treatment, the population served, the intervention participants, the target outcomes, the treatment theory of change, and the degree to which the intervention was standardized across participants. Four intervention approaches were identified in this review as Probably Efficacious: Behavioral Interventions to Support Parents of Toddlers, Interventions to Support Adolescent Mothers, Tiered Interventions to Provide Support Based on Assessed Risk, and Home Visiting Interventions to Provide Individualized Support to Parents. Other intervention approaches were classified as Possibly Efficacious, Experimental, or did not have sufficient evidence in this time period to classify under these criteria. Further research could explore how to ensure that all families who need support can receive it, such as by increasing the reach of effective programs and by decreasing the number of families needing additional support. |
Incidence of urinary tract infections in newborns with spina bifida: Is antibiotic prophylaxis necessary
Wallis MC , Paramsothy P , Newsome K , Williams T , Routh JC , Joseph DB , Cheng E , Tu D , Austin JC , Tanaka ST , Walker WO , Smith KA , Baum MA , Wiener JS . J Urol 2021 206 (1) 101097ju0000000000001690 PURPOSE: Urinary tract infections (UTI) commonly occur in patients with spina bifida (SB) and pose a risk for renal scarring. Routine antibiotic prophylaxis has been utilized in newborns with SB to prevent UTI. We hypothesized that prophylaxis can safely be withheld in newborns with SB until clinical assessment allows for risk stratification. MATERIALS AND METHODS: Newborns with myelomeningocele at nine institutions were prospectively enrolled in the UMPIRE study and managed by a standardized protocol with a strict definition for UTI. Patient data were collected regarding details of reported UTI, baseline renal ultrasound findings, vesicoureteral reflux, use of clean intermittent catheterization (CIC), and circumcision status in boys. Risk Ratios (RRs) and corresponding 95% confidence intervals (CIs) were calculated using log-binomial models. RESULTS: From 2/2015 through 8/2019, data were available on 299 newborns (50.5% male). During the first four months of life, 48 (16.1%) newborns were treated for UTI with 23 (7.7%) having positive cultures; however, only 12 (4.0%) met the strict UTI definition. Infants with grade 3-4 hydronephrosis had an increased risk of UTI compared to infants with no hydronephrosis (RR=10.1; 95%CI=2.8, 36.3). Infants on CIC also had an increased risk of UTI (RR=3.3; 95%CI=1.0, 10.5). CONCLUSIONS: The incidence of a culture-positive, symptomatic UTI among newborns with SB in the first 4 months of life was low. Patients with high grades of hydronephrosis or those on CIC had a significantly greater incidence of UTI. Our findings suggest that routine antibiotic prophylaxis may not be necessary for most newborns with SB. |
Rates of hospitalization for urinary tract infections among Medicaid-insured individuals by spina bifida status, Tennessee 2005-2013
Gebretsadik T , Cooper WO , Ouyang L , Thibadeau J , Markus T , Cook J , Tesfaye S , Mitchel EF , Newsome K , Carroll KN . Disabil Health J 2020 13 (4) 100920 BACKGROUND: Individuals with spina bifida are at increased risk for urinary tract infection (UTI), however there are few population-based investigations of the burden of UTI hospitalizations. OBJECTIVE: We assessed rates and risk factors for UTI hospitalization in individuals with and without spina bifida. METHODS: We conducted a retrospective cohort study to estimate rates of UTI hospitalization by spina bifida status. We included individuals enrolled in Tennessee Medicaid who lived in one of the Emerging Infections Program's Active Bacterial Surveillance counties between 2005 and 2013. Spina bifida was primarily defined and UTI hospitalizations were identified using International Classification of Diseases, Ninth Revision diagnoses. We also studied a subset without specific health conditions potentially associated with UTI. We used Poisson regression to calculate rate ratios (RR) of UTIs for individuals with versus without spina bifida, adjusting for race, sex and age group. RESULTS: Over the 9-years, 1,239,362 individuals were included and 2,493 met criteria for spina bifida. Individuals with spina bifida had over a four-fold increased rate of UTI hospitalization than those without spina bifida-in the overall study population and in the subset without specific, high-risk conditions (adjusted rate ratios: 4.41, 95% confidence intervals: 3.03, 6.43) and (4.87, 95% CI: 2.99, 7.92), respectively. We detected differences in rates of UTI hospitalization by race and sex in individuals without spina bifida that were not seen among individuals with spina bifida. CONCLUSIONS: Individuals with spina bifida had increased rates of UTI hospitalizations, and associated demographic patterns differed from those without spina bifida. |
Outcomes of infants born to women with influenza A(H1N1)pdm09
Newsome K , Alverson CJ , Williams J , McIntyre AF , Fine AD , Wasserman C , Lofy KH , Acosta M , Louie JK , Jones-Vessey K , Stanfield V , Yeung A , Rasmussen SA . Birth Defects Res 2019 111 (2) 88-95 BACKGROUND: Pregnant women with influenza are more likely to have complications, but information on infant outcomes is limited. METHODS: Five state/local health departments collected data on outcomes of infants born to pregnant women with 2009 H1N1 influenza reported to the Centers for Disease Control and Prevention from April to December 2009. Collaborating sites linked information on pregnant women with confirmed 2009 H1N1 influenza, many who were severely ill, to their infants' birth certificates. Collaborators also collected birth certificate data from two comparison groups that were matched with H1N1-affected pregnancies on month of conception, sex, and county of residence. RESULTS: 490 pregnant women with influenza, 1,451 women without reported influenza with pregnancies in the same year, and 1,446 pregnant women without reported influenza with prior year pregnancies were included. Women with 2009 H1N1 influenza admitted to an intensive care unit (ICU; n = 64) were more likely to deliver preterm infants (<37 weeks), low birth weight infants, and infants with Apgar scores <=6 at 5 min than women in comparison groups (adjusted relative risk, aRR = 3.9 [2.7, 5.6], aRR = 4.6 [2.9, 7.5], and aRR = 8.7 [3.6, 21.2], for same year comparisons, respectively). Women with influenza who were not hospitalized and hospitalized women not admitted to the ICU did not have significantly elevated risks for adverse infant outcomes. CONCLUSIONS: Severely ill women with 2009 H1N1 influenza during pregnancy were more likely to have adverse birth outcomes than women without influenza, providing more support for influenza vaccination during pregnancy. |
Public health approach to addressing the needs of children affected by congenital Zika syndrome
Broussard CS , Shapiro-Mendoza CK , Peacock G , Rasmussen SA , Mai CT , Petersen EE , Galang RR , Newsome K , Reynolds MR , Gilboa SM , Boyle CA , Moore CA . Pediatrics 2018 141 S146-s153 We have learned much about the short-term sequelae of congenital Zika virus (ZIKV) infection since the Centers for Disease Control and Prevention activated its ZIKV emergency response in January 2016. Nevertheless, gaps remain in our understanding of the full spectrum of adverse health outcomes related to congenital ZIKV infection and how to optimize health in those who are affected. To address the remaining knowledge gaps, support affected children so they can reach their full potential, and make the best use of available resources, a carefully planned public health approach in partnership with pediatric health care providers is needed. An essential step is to use population-based data captured through surveillance systems to describe congenital Zika syndrome. Another key step is using collected data to investigate why some children exhibit certain sequelae during infancy and beyond, whereas others do not, and to describe the clustering of anomalies and the timing of when these anomalies occur, among other research questions. The final critical step in the public health framework for congenital Zika syndrome is an intervention strategy with evidence-based best practices for longer-term monitoring and care. Adherence to recommended evaluation and management procedures for infants with possible congenital ZIKV infection, including for those with less obvious developmental and medical needs at birth, is essential. It will take many years to fully understand the effects of ZIKV on those who are congenitally infected; however, the lifetime medical and educational costs as well as the emotional impact on affected children and families are likely to be substantial. |
Pregnancy outcomes after maternal Zika virus infection during pregnancy - U.S. territories, January 1, 2016-April 25, 2017
Shapiro-Mendoza CK , Rice ME , Galang RR , Fulton AC , VanMaldeghem K , Prado MV , Ellis E , Anesi MS , Simeone RM , Petersen EE , Ellington SR , Jones AM , Williams T , Reagan-Steiner S , Perez-Padilla J , Deseda CC , Beron A , Tufa AJ , Rosinger A , Roth NM , Green C , Martin S , Lopez CD , deWilde L , Goodwin M , Pagano HP , Mai CT , Gould C , Zaki S , Ferrer LN , Davis MS , Lathrop E , Polen K , Cragan JD , Reynolds M , Newsome KB , Huertas MM , Bhatangar J , Quinones AM , Nahabedian JF , Adams L , Sharp TM , Hancock WT , Rasmussen SA , Moore CA , Jamieson DJ , Munoz-Jordan JL , Garstang H , Kambui A , Masao C , Honein MA , Meaney-Delman D . MMWR Morb Mortal Wkly Rep 2017 66 (23) 615-621 Pregnant women living in or traveling to areas with local mosquito-borne Zika virus transmission are at risk for Zika virus infection, which can lead to severe fetal and infant brain abnormalities and microcephaly (1). In February 2016, CDC recommended 1) routine testing for Zika virus infection of asymptomatic pregnant women living in areas with ongoing local Zika virus transmission at the first prenatal care visit, 2) retesting during the second trimester for women who initially test negative, and 3) testing of pregnant women with signs or symptoms consistent with Zika virus disease (e.g., fever, rash, arthralgia, or conjunctivitis) at any time during pregnancy (2). To collect information about pregnant women with laboratory evidence of recent possible Zika virus infection* and outcomes in their fetuses and infants, CDC established pregnancy and infant registries (3). During January 1, 2016-April 25, 2017, U.S. territoriesdagger with local transmission of Zika virus reported 2,549 completed pregnancies section sign (live births and pregnancy losses at any gestational age) with laboratory evidence of recent possible Zika virus infection; 5% of fetuses or infants resulting from these pregnancies had birth defects potentially associated with Zika virus infection paragraph sign (4,5). Among completed pregnancies with positive nucleic acid tests confirming Zika infection identified in the first, second, and third trimesters, the percentage of fetuses or infants with possible Zika-associated birth defects was 8%, 5%, and 4%, respectively. Among liveborn infants, 59% had Zika laboratory testing results reported to the pregnancy and infant registries. Identification and follow-up of infants born to women with laboratory evidence of recent possible Zika virus infection during pregnancy permits timely and appropriate clinical intervention services (6). |
Vital Signs: Update on Zika virus-associated birth defects and evaluation of all U.S. Infants with congenital Zika virus exposure - U.S. Zika Pregnancy Registry, 2016
Reynolds MR , Jones AM , Petersen EE , Lee EH , Rice ME , Bingham A , Ellington SR , Evert N , Reagan-Steiner S , Oduyebo T , Brown CM , Martin S , Ahmad N , Bhatnagar J , Macdonald J , Gould C , Fine AD , Polen KD , Lake-Burger H , Hillard CL , Hall N , Yazdy MM , Slaughter K , Sommer JN , Adamski A , Raycraft M , Fleck-Derderian S , Gupta J , Newsome K , Baez-Santiago M , Slavinski S , White JL , Moore CA , Shapiro-Mendoza CK , Petersen L , Boyle C , Jamieson DJ , Meaney-Delman D , Honein MA . MMWR Morb Mortal Wkly Rep 2017 66 (13) 366-373 BACKGROUND: In collaboration with state, tribal, local, and territorial health departments, CDC established the U.S. Zika Pregnancy Registry (USZPR) in early 2016 to monitor pregnant women with laboratory evidence of possible recent Zika virus infection and their infants. METHODS: This report includes an analysis of completed pregnancies (which include live births and pregnancy losses, regardless of gestational age) in the 50 U.S. states and the District of Columbia (DC) with laboratory evidence of possible recent Zika virus infection reported to the USZPR from January 15 to December 27, 2016. Birth defects potentially associated with Zika virus infection during pregnancy include brain abnormalities and/or microcephaly, eye abnormalities, other consequences of central nervous system dysfunction, and neural tube defects and other early brain malformations. RESULTS: During the analysis period, 1,297 pregnant women in 44 states were reported to the USZPR. Zika virus-associated birth defects were reported for 51 (5%) of the 972 fetuses/infants from completed pregnancies with laboratory evidence of possible recent Zika virus infection (95% confidence interval [CI] = 4%-7%); the proportion was higher when restricted to pregnancies with laboratory-confirmed Zika virus infection (24/250 completed pregnancies [10%, 95% CI = 7%-14%]). Birth defects were reported in 15% (95% CI = 8%-26%) of fetuses/infants of completed pregnancies with confirmed Zika virus infection in the first trimester. Among 895 liveborn infants from pregnancies with possible recent Zika virus infection, postnatal neuroimaging was reported for 221 (25%), and Zika virus testing of at least one infant specimen was reported for 585 (65%). CONCLUSIONS AND IMPLICATIONS FOR PUBLIC HEALTH PRACTICE: These findings highlight why pregnant women should avoid Zika virus exposure. Because the full clinical spectrum of congenital Zika virus infection is not yet known, all infants born to women with laboratory evidence of possible recent Zika virus infection during pregnancy should receive postnatal neuroimaging and Zika virus testing in addition to a comprehensive newborn physical exam and hearing screen. Identification and follow-up care of infants born to women with laboratory evidence of possible recent Zika virus infection during pregnancy and infants with possible congenital Zika virus infection can ensure that appropriate clinical services are available. |
Baseline prevalence of birth defects associated with congenital Zika virus infection - Massachusetts, North Carolina, and Atlanta, Georgia, 2013-2014
Cragan JD , Mai CT , Petersen EE , Liberman RF , Forestieri NE , Stevens AC , Delaney A , Dawson AL , Ellington SR , Shapiro-Mendoza CK , Dunn JE , Higgins CA , Meyer RE , Williams T , Polen KN , Newsome K , Reynolds M , Isenburg J , Gilboa SM , Meaney-Delman DM , Moore CA , Boyle CA , Honein MA . MMWR Morb Mortal Wkly Rep 2017 66 (8) 219-222 Zika virus infection during pregnancy can cause serious brain abnormalities, but the full range of adverse outcomes is unknown (1). To better understand the impact of birth defects resulting from Zika virus infection, the CDC surveillance case definition established in 2016 for birth defects potentially related to Zika virus infection* (2) was retrospectively applied to population-based birth defects surveillance data collected during 2013-2014 in three areas before the introduction of Zika virus (the pre-Zika years) into the World Health Organization's Region of the Americas (Americas) (3). These data, from Massachusetts (2013), North Carolina (2013), and Atlanta, Georgia (2013-2014), included 747 infants and fetuses with one or more of the birth defects meeting the case definition (pre-Zika prevalence = 2.86 per 1,000 live births). Brain abnormalities or microcephaly were the most frequently recorded (1.50 per 1,000), followed by neural tube defects and other early brain malformationsdagger (0.88), eye abnormalities without mention of a brain abnormality (0.31), and other consequences of central nervous system (CNS) dysfunction without mention of brain or eye abnormalities (0.17). During January 15-September 22, 2016, the U.S. Zika Pregnancy Registry (USZPR) reported 26 infants and fetuses with these same defects among 442 completed pregnancies (58.8 per 1,000) born to mothers with laboratory evidence of possible Zika virus infection during pregnancy (2). Although the ascertainment methods differed, this finding was approximately 20 times higher than the proportion of one or more of the same birth defects among pregnancies during the pre-Zika years. These data demonstrate the importance of population-based surveillance for interpreting data about birth defects potentially related to Zika virus infection. |
Update: interim guidance for health care providers caring for pregnant women with possible Zika virus exposure - United States, July 2016
Oduyebo T , Igbinosa I , Petersen EE , Polen KN , Pillai SK , Ailes EC , Villanueva JM , Newsome K , Fischer M , Gupta PM , Powers AM , Lampe M , Hills S , Arnold KE , Rose LE , Shapiro-Mendoza CK , Beard CB , Munoz JL , Rao CY , Meaney-Delman D , Jamieson DJ , Honein MA . MMWR Morb Mortal Wkly Rep 2016 65 (29) 739-44 CDC has updated its interim guidance for U.S. health care providers caring for pregnant women with possible Zika virus exposure, to include the emerging data indicating that Zika virus RNA can be detected for prolonged periods in some pregnant women. To increase the proportion of pregnant women with Zika virus infection who receive a definitive diagnosis, CDC recommends expanding real-time reverse transcription-polymerase chain reaction (rRT-PCR) testing. Possible exposures to Zika virus include travel to or residence in an area with active Zika virus transmission, or sex* with a partner who has traveled to or resides in an area with active Zika virus transmission without using condoms or other barrier methods to prevent infection.(dagger) Testing recommendations for pregnant women with possible Zika virus exposure who report clinical illness consistent with Zika virus disease( section sign) (symptomatic pregnant women) are the same, regardless of their level of exposure (i.e., women with ongoing risk for possible exposure, including residence in or frequent travel to an area with active Zika virus transmission, as well as women living in areas without Zika virus transmission who travel to an area with active Zika virus transmission, or have unprotected sex with a partner who traveled to or resides in an area with active Zika virus transmission). Symptomatic pregnant women who are evaluated <2 weeks after symptom onset should receive serum and urine Zika virus rRT-PCR testing. Symptomatic pregnant women who are evaluated 2-12 weeks after symptom onset should first receive a Zika virus immunoglobulin (IgM) antibody test; if the IgM antibody test result is positive or equivocal, serum and urine rRT-PCR testing should be performed. Testing recommendations for pregnant women with possible Zika virus exposure who do not report clinical illness consistent with Zika virus disease (asymptomatic pregnant women) differ based on the circumstances of possible exposure. For asymptomatic pregnant women who live in areas without active Zika virus transmission and who are evaluated <2 weeks after last possible exposure, rRT-PCR testing should be performed. If the rRT-PCR result is negative, a Zika virus IgM antibody test should be performed 2-12 weeks after the exposure. Asymptomatic pregnant women who do not live in an area with active Zika virus transmission, who are first evaluated 2-12 weeks after their last possible exposure should first receive a Zika virus IgM antibody test; if the IgM antibody test result is positive or equivocal, serum and urine rRT-PCR should be performed. Asymptomatic pregnant women with ongoing risk for exposure to Zika virus should receive Zika virus IgM antibody testing as part of routine obstetric care during the first and second trimesters; immediate rRT-PCR testing should be performed when IgM antibody test results are positive or equivocal. This guidance also provides updated recommendations for the clinical management of pregnant women with confirmed or possible Zika virus infection. These recommendations will be updated when additional data become available. |
Possible Zika virus infection among pregnant women - United States and Territories, May 2016
Simeone RM , Shapiro-Mendoza CK , Meaney-Delman D , Petersen EE , Galang RR , Oduyebo T , Rivera-Garcia B , Valencia-Prado M , Newsome KB , Perez-Padilla J , Williams TR , Biggerstaff M , Jamieson DJ , Honein MA , Ahmed F , Anesi S , Arnold KE , Barradas D , Barter D , Bertolli J , Bingham AM , Bollock J , Bosse T , Bradley KK , Brady D , Brown CM , Bryan K , Buchanan V , Bullard PD , Carrigan A , Clouse M , Cook S , Cooper M , Davidson S , DeBarr A , Dobbs T , Dunams T , Eason J , Eckert A , Eggers P , Ellington SR , Feldpausch A , Fredette CR , Gabel J , Glover M , Gosciminski M , Gay M , Haddock R , Hand S , Hardy J , Hartel ME , Hennenfent AK , Hills SL , House J , Igbinosa I , Im L , Jeff H , Khan S , Kightlinger L , Ko JY , Koirala S , Korhonen L , Krishnasamy V , Kurkjian K , Lampe M , Larson S , Lee EH , Lind L , Lindquist S , Long J , Macdonald J , MacFarquhar J , Mackie DP , Mark-Carew M , Martin B , Martinez-Quinones A , Matthews-Greer J , McGee SA , McLaughlin J , Mock V , Muna E , Oltean H , O'Mallan J , Pagano HP , Park SY , Peterson D , Polen KN , Porse CC , Rao CY , Ropri A , Rinsky J , Robinson S , Rosinger AY , Ruberto I , Schiffman E , Scott-Waldron C , Semple S , Sharp T , Short K , Signs K , Slavinski SA , Stevens T , Sweatlock J , Talbot EA , Tonzel J , Traxler R , Tubach S , Van Houten C , VinHatton E , Viray M , Virginie D , Warren MD , Waters C , White P , Williams T , Winters AI , Wood S , Zaganjor I . MMWR Morb Mortal Wkly Rep 2016 65 (20) 514-9 Zika virus is a cause of microcephaly and brain abnormalities (1), and it is the first known mosquito-borne infection to cause congenital anomalies in humans. The establishment of a comprehensive surveillance system to monitor pregnant women with Zika virus infection will provide data to further elucidate the full range of potential outcomes for fetuses and infants of mothers with asymptomatic and symptomatic Zika virus infection during pregnancy. In February 2016, Zika virus disease and congenital Zika virus infections became nationally notifiable conditions in the United States (2). Cases in pregnant women with laboratory evidence of Zika virus infection who have either 1) symptomatic infection or 2) asymptomatic infection with diagnosed complications of pregnancy can be reported as cases of Zika virus disease to ArboNET* (2), CDC's national arboviral diseases surveillance system. Under existing interim guidelines from the Council for State and Territorial Epidemiologists (CSTE), asymptomatic Zika virus infections in pregnant women who do not have known pregnancy complications are not reportable. ArboNET does not currently include pregnancy surveillance information (e.g., gestational age or pregnancy exposures) or pregnancy outcomes. To understand the full impact of infection on the fetus and neonate, other systems are needed for reporting and active monitoring of pregnant women with laboratory evidence of possible Zika virus infection during pregnancy. Thus, in collaboration with state, local, tribal, and territorial health departments, CDC established two surveillance systems to monitor pregnancies and congenital outcomes among women with laboratory evidence of Zika virus infection(dagger) in the United States and territories: 1) the U.S. Zika Pregnancy Registry (USZPR),( section sign) which monitors pregnant women residing in U.S. states and all U.S. territories except Puerto Rico, and 2) the Zika Active Pregnancy Surveillance System (ZAPSS), which monitors pregnant women residing in Puerto Rico. As of May 12, 2016, the surveillance systems were monitoring 157 and 122 pregnant women with laboratory evidence of possible Zika virus infection from participating U.S. states and territories, respectively. Tracking and monitoring clinical presentation of Zika virus infection, all prenatal testing, and adverse consequences of Zika virus infection during pregnancy are critical to better characterize the risk for congenital infection, the performance of prenatal diagnostic testing, and the spectrum of adverse congenital outcomes. These data will improve clinical guidance, inform counseling messages for pregnant women, and facilitate planning for clinical and public health services for affected families. |
The National Birth Defects Prevention Study: a review of the methods
Reefhuis J , Gilboa SM , Anderka M , Browne ML , Feldkamp ML , Hobbs CA , Jenkins MM , Langlois PH , Newsome KB , Olshan AF , Romitti PA , Shapira SK , Shaw GM , Tinker SC , Honein MA . Birth Defects Res A Clin Mol Teratol 2015 103 (8) 656-69 BACKGROUND: The National Birth Defects Prevention Study (NBDPS) is a large population-based multicenter case-control study of major birth defects in the United States. METHODS: Data collection took place from 1998 through 2013 on pregnancies ending between October 1997 and December 2011. Cases could be live born, stillborn, or induced terminations, and were identified from birth defects surveillance programs in Arkansas, California, Georgia, Iowa, Massachusetts, New Jersey, New York, North Carolina, Texas, and Utah. Controls were live born infants without major birth defects identified from the same geographical regions and time periods as cases by means of either vital records or birth hospitals. Computer-assisted telephone interviews were completed with women between 6 weeks and 24 months after the estimated date of delivery. After completion of interviews, families received buccal cell collection kits for the mother, father, and infant (if living). RESULTS: There were 47,832 eligible cases and 18,272 eligible controls. Among these, 32,187 (67%) and 11,814 (65%), respectively, provided interview information about their pregnancies. Buccal cell collection kits with a cytobrush for at least one family member were returned by 19,065 case and 6,211 control families (65% and 59% of those who were sent a kit). More than 500 projects have been proposed by the collaborators and over 200 manuscripts published using data from the NBDPS through December 2014. CONCLUSION: The NBDPS has made substantial contributions to the field of birth defects epidemiology through its rigorous design, including case classification, detailed questionnaire and specimen collection, large study population, and collaborative activities across Centers. |
Public health response to commercial airline travel of a person with Ebola virus infection - United States, 2014
Regan JJ , Jungerman R , Montiel SH , Newsome K , Objio T , Washburn F , Roland E , Petersen E , Twentyman E , Olaiya O , Naughton M , Alvarado-Ramy F , Lippold SA , Tabony L , McCarty CL , Kinsey CB , Barnes M , Black S , Azzam I , Stanek D , Sweitzer J , Valiani A , Kohl KS , Brown C , Pesik N . MMWR Morb Mortal Wkly Rep 2015 64 (3) 63-6 Before the current Ebola epidemic in West Africa, there were few documented cases of symptomatic Ebola patients traveling by commercial airline, and no evidence of transmission to passengers or crew members during airline travel. In July 2014 two persons with confirmed Ebola virus infection who were infected early in the Nigeria outbreak traveled by commercial airline while symptomatic, involving a total of four flights (two international flights and two Nigeria domestic flights). It is not clear what symptoms either of these two passengers experienced during flight; however, one collapsed in the airport shortly after landing, and the other was documented to have fever, vomiting, and diarrhea on the day the flight arrived. Neither infected passenger transmitted Ebola to other passengers or crew on these flights. In October 2014, another airline passenger, a U.S. health care worker who had traveled domestically on two commercial flights, was confirmed to have Ebola virus infection. Given that the time of onset of symptoms was uncertain, an Ebola airline contact investigation in the United States was conducted. In total, follow-up was conducted for 268 contacts in nine states, including all 247 passengers from both flights, 12 flight crew members, eight cleaning crew members, and one federal airport worker (81 of these contacts were documented in a report published previously). All contacts were accounted for by state and local jurisdictions and followed until completion of their 21-day incubation periods. No secondary cases of Ebola were identified in this investigation, confirming that transmission of Ebola during commercial air travel did not occur. |
CDC Pregnancy Flu Line: monitoring severe illness among pregnant women with influenza
Ailes EC , Newsome K , Williams JL , McIntyre AF , Jamieson DJ , Finelli L , Honein MA . Matern Child Health J 2013 18 (7) 1578-82 The Centers for Disease Control and Prevention implemented the Pregnancy Flu Line (PFL) during the influenza A(H1N1)pdm09 (pH1N1) pandemic and continued operation through the 2010-2011 influenza season to collect reports of intensive care unit (ICU) admissions and deaths among pregnant women with influenza. The system documented the severe impact of influenza on pregnant women during both seasons with 181 ICU/survivals and 37 deaths reported during the 2009 fall pandemic wave and 69 ICU/survivals and ten deaths reported in the subsequent influenza season (2010-2011). A health department survey suggests PFL participants perceived public health benefits and minimum time burdens. |
Seasonal and 2009 pandemic influenza A (H1N1) virus infection during pregnancy: a population-based study of hospitalized cases
Creanga AA , Kamimoto L , Newsome K , D'Mello T , Jamieson DJ , Zotti ME , Arnold KE , Baumbach J , Bennett NM , Farley MM , Gershman K , Kirschke D , Lynfield R , Meek J , Morin C , Reingold A , Ryan P , Schaffner W , Thomas A , Zansky S , Finelli L , Honein MA . Am J Obstet Gynecol 2011 204 S38-45 We sought to describe characteristics of hospitalized reproductive-aged (15-44 years) women with seasonal (2005/2006 through 2008/2009) and 2009 pandemic influenza A (H1N1) virus infection. We used population-based data from the Emerging Infections Program in 10 US states, and compared characteristics of pregnant (n = 150) and nonpregnant (n = 489) seasonal, and pregnant (n = 489) and nonpregnant (n = 1088) pandemic influenza cases using chi(2) and Fisher's exact tests. Pregnant women represented 23.5% and 31.0% of all reproductive-aged women hospitalized for seasonal and pandemic influenza, respectively. Significantly more nonpregnant than pregnant women with seasonal (71.2% vs 36.0%) and pandemic (69.7% vs 31.9%) influenza had an underlying medical condition other than pregnancy. Antiviral treatment was significantly more common with pandemic than seasonal influenza for both pregnant (86.5% vs 24.0%) and nonpregnant (82.0% vs 55.2%) women. Pregnant women comprised a significant proportion of influenza-hospitalized reproductive-aged women, underscoring the importance of influenza vaccination during pregnancy. |
Pandemic 2009 influenza A(H1N1) virus illness among pregnant women in the United States
Siston AM , Rasmussen SA , Honein MA , Fry AM , Seib K , Callaghan WM , Louie J , Doyle TJ , Crockett M , Lynfield R , Moore Z , Wiedeman C , Anand M , Tabony L , Nielsen CF , Waller K , Page S , Thompson JM , Avery C , Springs CB , Jones T , Williams JL , Newsome K , Finelli L , Jamieson DJ . JAMA 2010 303 (15) 1517-25 CONTEXT: Early data on pandemic 2009 influenza A(H1N1) suggest pregnant women are at increased risk of hospitalization and death. OBJECTIVE: To describe the severity of 2009 influenza A(H1N1) illness and the association with early antiviral treatment among pregnant women in the United States. DESIGN, SETTING, AND PATIENTS: Surveillance of 2009 influenza A(H1N1) in pregnant women reported to the Centers for Disease Control and Prevention (CDC) with symptom onset from April through December 2009. MAIN OUTCOME MEASURES: Severity of illness (hospitalizations, intensive care unit [ICU] admissions, and deaths) due to 2009 influenza A(H1N1) among pregnant women, stratified by timing of antiviral treatment and pregnancy trimester at symptom onset. RESULTS: We received reports on 788 pregnant women in the United States with 2009 influenza A(H1N1) with symptom onset from April through August 2009. Among those, 30 died (5% of all reported 2009 influenza A[H1N1] influenza deaths in this period). Among 509 hospitalized women, 115 (22.6%) were admitted to an ICU. Pregnant women with treatment more than 4 days after symptom onset were more likely to be admitted to an ICU (56.9% vs 9.4%; relative risk [RR], 6.0; 95% confidence interval [CI], 3.5-10.6) than those treated within 2 days after symptom onset. Only 1 death occurred in a patient who received treatment within 2 days of symptom onset. Updating these data with the CDC's continued surveillance of ICU admissions and deaths among pregnant women with symptom onset through December 31, 2009, identified an additional 165 women for a total of 280 women who were admitted to ICUs, 56 of whom died. Among the deaths, 4 occurred in the first trimester (7.1%), 15 in the second (26.8%), and 36 in the third (64.3%); CONCLUSIONS: Pregnant women had a disproportionately high risk of mortality due to 2009 influenza A(H1N1). Among pregnant women with 2009 influenza A(H1N1) influenza reported to the CDC, early antiviral treatment appeared to be associated with fewer admissions to an ICU and fewer deaths. |
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