Last data update: Jan 27, 2025. (Total: 48650 publications since 2009)
Records 1-16 (of 16 Records) |
Query Trace: Park SY[original query] |
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Fatal borealpox in an immunosuppressed patient treated with antivirals and vaccinia immunoglobulin - Alaska, 2023
Rogers JH , Westley B , Mego T , Newell KG , Laurance J , Smith L , Parker J , Park SY , Venkatasubrahmanyam S , Noll N , Bercovici S , Rao AK , McCollum AM , Davidson W , Carson WC , Townsend MB , Doty JB , Hutson C , Li Y , Wilkins K , Deng J , Gigante CM , Satheshkumar PS , Tuttle A , Villalba JA , Bhatnagar J , Reagan-Steiner S , Castrodale LJ , McLaughlin JB . Clin Infect Dis 2024 BACKGROUND: Borealpox virus (BRPV, formerly known as Alaskapox virus) is a zoonotic member of the Orthopoxvirus genus first identified in a person in 2015. In the six patients with infection previously observed BRPV involved mild, self-limiting illness. We report the first fatal BRPV infection in an immunosuppressed patient. METHODS: A man aged 69 years from Alaska's Kenai Peninsula was receiving anti-CD20 therapy for chronic lymphocytic leukemia. He presented to care for a tender, red papule in his right axilla with increasing induration and pain. The patient failed to respond to multiple prescribed antibiotic regimens and was hospitalized 65 days postsymptom onset for progression of presumed infectious cellulitis. BRPV was eventually detected through orthopoxvirus real-time polymerase chain reaction testing of mucosal swabs. He received combination antiviral therapy, including 21 days of intravenous tecovirimat, intravenous vaccinia immunoglobulin, and oral brincidofovir. Serial serology was conducted on specimens obtained posttreatment initiation. FINDINGS: The patient's condition initially improved with plaque recession, reduced erythema, and epithelization around the axillary lesion beginning one-week post-therapy. He later exhibited delayed wound healing, malnutrition, acute renal failure, and respiratory failure. He died 138 days postsymptom onset. Serologic testing revealed no evidence the patient generated a humoral immune response. No secondary cases were detected. CONCLUSION: This report demonstrates that BRPV can cause overwhelming disseminated infection in certain immunocompromised patients. Based on the patient's initial response, early BRPV identification and antiviral therapies might have been beneficial. These therapies, in combination with optimized immune function, should be considered for patients at risk for manifestations of BRPV. |
Outbreak of human trichinellosis - Arizona, Minnesota, and South Dakota, 2022
Cash-Goldwasser S , Ortbahn D , Narayan M , Fitzgerald C , Maldonado K , Currie J , Straily A , Sapp S , Bishop HS , Watson B , Neja M , Qvarnstrom Y , Berman DM , Park SY , Smith K , Holzbauer S . MMWR Morb Mortal Wkly Rep 2024 73 (20) 456-459 Trichinellosis is a parasitic zoonotic disease transmitted through the consumption of meat from animals infected with Trichinella spp. nematodes. In North America, human trichinellosis is rare and is most commonly acquired through consumption of wild game meat. In July 2022, a hospitalized patient with suspected trichinellosis was reported to the Minnesota Department of Health. One week before symptom onset, the patient and eight other persons shared a meal that included bear meat that had been frozen for 45 days before being grilled and served rare with vegetables that had been cooked with the meat. Investigation identified six trichinellosis cases, including two in persons who consumed only the vegetables. Motile Trichinella larvae were found in remaining bear meat that had been frozen for >15 weeks. Molecular testing identified larvae from the bear meat as Trichinella nativa, a freeze-resistant species. Persons who consume meat from wild game animals should be aware that that adequate cooking is the only reliable way to kill Trichinella parasites and that infected meat can cross-contaminate other foods. |
Borrelia miyamotoi infection in immunocompromised man, California, USA, 2021
Rubio LA , Kjemtrup AM , Marx GE , Cronan S , Kilonzo C , Saunders MEM , Choat JL , Dietrich EA , Liebman KA , Park SY . Emerg Infect Dis 2023 29 (5) 1011-1014 Infection with Borrelia miyamotoi in California, USA, has been suggested by serologic studies. We diagnosed B. miyamotoi infection in an immunocompromised man in California. Diagnosis was aided by plasma microbial cell-free DNA sequencing. We conclude that the infection was acquired in California. |
Trends and characteristics of blood pressure prescription fills before and during the COVID-19 pandemic in the United States
Yang PK , Park SY , Jackson SL , Attipoe-Dorcoo S , Gray E , Ritchey MD , Sperling LS . Am J Hypertens 2023 36 (8) 439-445 BACKGROUND: The COVID-19 pandemic disrupted healthcare in the United States and raised concerns about certain antihypertensives, and may have impacted both prescribing practices and access to blood pressure (BP) medications. METHODS: We assessed trends in BP prescription fills before and during the first year of the COVID-19 pandemic, using cross-sectional data for BP fills and tablets in the IQVIA (IMS Health) National Prescription Audit® database. Drugs filled via retail (92% coverage), mail-order (78% coverage), and long-term care (72% coverage) channels from January 2018 through December 2020 were included. Data were projected nationally and by state. RESULTS: Between 2.9 to 3.4 billion BP tablets were dispensed monthly until February 2020, increasing sharply to 3.8 billion in March 2020 and declining to 3.4 billion in April, then increasing at three-month intervals until December 2020. The number of tablets per fill increased slightly over time, with the largest increase (from 66.7 to 68.6) during February-March, 2020. Tablets were dispensed through retail channels (99.7 billion), mail-order (14.7 billion), and long-term care (5.3 billion). Rates of patients initiating new medications decreased during 2020 compared to prior years. Fills did not vary significantly by drug class. CONCLUSIONS: A sharp increase in BP fills occurred with COVID-19 emergence, suggesting patients may have secured medications in preparation for potential access limitations. A decrease in new fills, indicating decreased initiation and/or modification of treatment regimens, suggests need for efforts to re-engage patients in the healthcare system and provide alternative ways to obtain medication refills and adjustments. |
Development of antibody-dependent cellular cytotoxicity in response to recombinant and live-attenuated herpes zoster vaccines
Park SY , Levin MJ , Canniff J , Johnson M , Schmid DS , Weinberg A . NPJ Vaccines 2022 7 (1) 123 Zoster vaccines generate antibody responses against varicella-zoster virus (VZV). We compared antibody-dependent cell cytotoxicity (ADCC) elicited by zoster vaccine live (ZVL) and recombinant zoster vaccine (RZV). ADCC mediated by antibodies against VZV lysate (VZV-ADCC) and recombinant glycoprotein E (gE-ADCC) was measured using plasma from 20 RZV- and 20 ZVL-recipients, including half 50-60-years-old and half 70-years-old. Solid phase-bound anti-VZV antibodies stimulated TNF in NK cells as measured by flow cytometry or ELISA. VZV-ADCC pre- and post-immunization was higher in younger vaccinees. ZVL did not appreciably increase VZV-ADCC, whereas RZV increased VZV-ADCC in older vaccinees. ELISA-measured gE-ADCC was similar across groups pre-immunization; significantly increased after ZVL; and RZV and was higher in younger RZV than ZVL recipients. IgG3 antibodies increased after RZV and ZVL, with greater anti-gE than anti-VZV responses. Moreover, gE-ADCC strongly correlated with anti-gE antibody avidity, but there were no appreciable correlations between VZV-ADCC and avidity. NK cells stimulated by anti-gE antibodies showed increased IFN and CD107a expression, which was not observed with anti-VZV antibodies. In conclusion, anti-gE antibodies generated more robust ADCC than anti-VZV antibodies. RZV induced higher ADCC antibodies than ZVL depending on the antigen and age of vaccinees. Older adults had lower ADCC antibodies before and after vaccination than younger adults. |
Entomological investigation detects dengue virus type 1 in Aedes (Stegomyia) albopictus (Skuse) during the 2015-16 outbreak in Hawaii
Hasty JM , Felix GE , Amador M , Barrera R , Santiago GS , Nakasone L , Park SY , Okoji S , Honda E , Asuncion B , Save M , Munoz-Jordan JL , Martinez-Conde S , Medina FA , Waterman SH , Petersen LR , Johnston DI , Hemme RR . Am J Trop Med Hyg 2020 102 (4) 869-875 A dengue outbreak occurred on Hawaii Island between September 2015 and March 2016. Entomological investigations were undertaken between December 2015 and February 2016 to determine which Aedes mosquito species were responsible for the outbreak. A total of 3,259 mosquitoes were collected using a combination of CDC autocidal gravid ovitraps, Biogents BG-Sentinel traps, and hand-nets; immature mosquitoes were collected during environmental surveys. The composition of species was Aedes albopictus (58%), Aedes aegypti (25%), Wyeomyia mitchelli (7%), Aedes vexans (5%), Culex quinquefasciatus (4%), and Aedes japonicus (1%). Adult mosquitoes were analyzed by real-time reverse transcription polymerase chain reaction (PCR) for the presence of dengue virus (DENV) RNA. Of the 185 pools of female mosquitoes tested, 15 containing Ae. albopictus were positive for the presence of DENV type 1 RNA. No virus was detected in pools of the remaining species. Phylogenetic analysis showed the virus strain belonged to genotype I and was closely related to strains that were circulating in the Pacific between 2008 and 2014. This is the first report of detection of DENV in Ae. albopictus from Hawaii. |
Public health investigation and response to a hepatitis A outbreak from imported scallops consumed raw - Hawaii, 2016
Viray MA , Hofmeister MG , Johnston DI , Krishnasamy VP , Nichols C , Foster MA , Balajadia R , Wise ME , Manuzak A , Lin Y , Xia G , Basler C , Nsubuga J , Woods J , Park SY . Epidemiol Infect 2018 147 1-8 ![]() ![]() During the summer of 2016, the Hawaii Department of Health responded to the second-largest domestic foodborne hepatitis A virus (HAV) outbreak in the post-vaccine era. The epidemiological investigation included case finding and investigation, sequencing of RNA positive clinical specimens, product trace-back and virologic testing and sequencing of HAV RNA from the product. Additionally, an online survey open to all Hawaii residents was conducted to estimate baseline commercial food consumption. We identified 292 confirmed HAV cases, of whom 11 (4%) were possible secondary cases. Seventy-four (25%) were hospitalised and there were two deaths. Among all cases, 94% reported eating at Oahu or Kauai Island branches of Restaurant Chain A, with 86% of those cases reporting raw scallop consumption. In contrast, a food consumption survey conducted during the outbreak indicated 25% of Oahu residents patronised Restaurant Chain A in the 7 weeks before the survey. Product trace-back revealed a single distributor that supplied scallops imported from the Philippines to Restaurant Chain A. Recovery, amplification and sequence comparison of HAV recovered from scallops revealed viral sequences matching those from case-patients. Removal of product from implicated restaurants and vaccination of those potentially exposed led to the cessation of the outbreak. This outbreak further highlights the need for improved imported food safety. |
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. |
Hepatotoxicity associated with the dietary supplement OxyELITE Pro - Hawaii, 2013
Johnston DI , Chang A , Viray M , Chatham-Stephens K , He H , Taylor E , Wong LL , Schier J , Martin C , Fabricant D , Salter M , Lewis L , Park SY . Drug Test Anal 2015 8 319-27 Dietary supplements are increasingly marketed to and consumed by the American public for a variety of purported health benefits. On 9 September 2013, the Hawaii Department of Health (HDOH) was notified of a cluster of acute hepatitis and fulminant hepatic failure among individuals with exposure to the dietary supplement OxyELITE Pro (OEP). HDOH conducted an outbreak investigation in collaboration with federal partners. Physicians were asked to report cases, defined as individuals with acute onset hepatitis of unknown etiology on or after 1 April 2013, a history of weight-loss/muscle-building dietary supplement use during the 60 days before illness onset, and residence in Hawaii during the period of exposure. Reported cases' medical records were reviewed, questionnaires were administered, and a product investigation, including chemical analyses and traceback, was conducted. Of 76 reports, 44 (58%) met case definition; of these, 36 (82%) reported OEP exposure during the two months before illness. No other common supplements or exposures were observed. Within the OEP-exposed subset, two patients required liver transplantation, and a third patient died. Excessive product dosing was not reported. No unique lot numbers were identified; there were multiple mainland distribution points, and lot numbers common to cases in Hawaii were also identified in continental states. Product analysis found consumed products were consistent with labeled ingredients; the mechanism of hepatotoxicity was not identified. We report one of the largest statewide outbreaks of dietary supplement-associated hepatotoxicity. The implicated product was OEP. The increasing popularity of dietary supplements raises the potential for additional clusters of dietary supplement-related adverse events. |
Real-Time Polymerase Chain Reaction Detection of Angiostrongylus cantonensis DNA in Cerebrospinal Fluid from Patients with Eosinophilic Meningitis.
Qvarnstrom Y , Xayavong M , Aramburu da Silva AC , Park SY , Whelen AC , Calimlim PS , Sciulli RH , Honda SA , Higa K , Kitsutani P , Chea N , Heng S , Johnson S , Graeff-Teixeira C , Fox LM , da Silva AJ . Am J Trop Med Hyg 2015 94 (1) 176-81 ![]() ![]() Angiostrongylus cantonensis is the most common infectious cause of eosinophilic meningitis. Timely diagnosis of these infections is difficult, partly because reliable laboratory diagnostic methods are unavailable. The aim of this study was to evaluate the usefulness of a real-time polymerase chain reaction (PCR) assay for the detection of A. cantonensis DNA in human cerebrospinal fluid (CSF) specimens. A total of 49 CSF specimens from 33 patients with eosinophilic meningitis were included: A. cantonensis DNA was detected in 32 CSF specimens, from 22 patients. Four patients had intermittently positive and negative real-time PCR results on subsequent samples, indicating that the level of A. cantonensis DNA present in CSF may fluctuate during the course of the illness. Immunodiagnosis and/or supplemental PCR testing supported the real-time PCR findings for 30 patients. On the basis of these observations, this real-time PCR assay can be useful to detect A. cantonensis in the CSF from patients with eosinophilic meningitis. |
Outbreak of hepatitis A in the USA associated with frozen pomegranate arils imported from Turkey: an epidemiological case study.
Collier MG , Khudyakov YE , Selvage D , Adams-Cameron M , Epson E , Cronquist A , Jervis RH , Lamba K , Kimura AC , Sowadsky R , Hassan R , Park SY , Garza E , Elliott AJ , Rotstein DS , Beal J , Kuntz T , Lance SE , Dreisch R , Wise ME , Nelson NP , Suryaprasad A , Drobeniuc J , Holmberg SD , Xu F . Lancet Infect Dis 2014 14 (10) 976-81 ![]() ![]() BACKGROUND: In May, 2013, an outbreak of symptomatic hepatitis A virus infections occurred in the USA. Federal, state, and local public health officials investigated the cause of the outbreak and instituted actions to control its spread. We investigated the source of the outbreak and assessed the public health measures used. METHODS: We interviewed patients, obtained their shopping information, and did genetic analysis of hepatitis A virus recovered from patients' serum and stool samples. We tested products for the virus and traced supply chains. FINDINGS: Of 165 patients identified from ten states, 69 (42%) were admitted to hospital, two developed fulminant hepatitis, and one needed a liver transplant; none died. Illness onset occurred from March 31 to Aug 12, 2013. The median age of patients was 47 years (IQR 35-58) and 91 (55%) were women. 153 patients (93%) reported consuming product B from retailer A. 40 patients (24%) had product B in their freezers, and 113 (68%) bought it according to data from retailer A. Hepatitis A virus genotype IB, uncommon in the Americas, was recovered from specimens from 117 people with hepatitis A virus illness. Pomegranate arils that were imported from Turkey-where genotype IB is common-were identified in product B. No hepatitis A virus was detected in product B. INTERPRETATION: Imported frozen pomegranate arils were identified as the vehicle early in the investigation by combining epidemiology-with data from several sources-genetic analysis of patient samples, and product tracing. Product B was removed from store shelves, the public were warned not to eat product B, product recalls took place, and postexposure prophylaxis with both hepatitis A virus vaccine and immunoglobulin was provided. Our findings show that modern public health actions can help rapidly detect and control hepatitis A virus illness caused by imported food. Our findings show that postexposure prophylaxis can successfully prevent hepatitis A illness when a specific product is identified. Imported food products combined with waning immunity in some adult populations might make this type of intervention necessary in the future. |
Outbreak of variant influenza A(H3N2) virus in the United States
Jhung MA , Epperson S , Biggerstaff M , Allen D , Balish A , Barnes N , Beaudoin A , Berman L , Bidol S , Blanton L , Blythe D , Brammer L , D'Mello T , Danila R , Davis W , de Fijter S , Diorio M , Durand LO , Emery S , Fowler B , Garten R , Grant Y , Greenbaum A , Gubareva L , Havers F , Haupt T , House J , Ibrahim S , Jiang V , Jain S , Jernigan D , Kazmierczak J , Klimov A , Lindstrom S , Longenberger A , Lucas P , Lynfield R , McMorrow M , Moll M , Morin C , Ostroff S , Page SL , Park SY , Peters S , Quinn C , Reed C , Richards S , Scheftel J , Simwale O , Shu B , Soyemi K , Stauffer J , Steffens C , Su S , Torso L , Uyeki TM , Vetter S , Villanueva J , Wong KK , Shaw M , Bresee JS , Cox N , Finelli L . Clin Infect Dis 2013 57 (12) 1703-12 BACKGROUND: Variant influenza virus infections are rare but may have pandemic potential if person-to-person transmission is efficient. We describe the epidemiology of a multistate outbreak of an influenza A(H3N2) variant virus (H3N2v) first identified in 2011. METHODS: We identified laboratory-confirmed cases of H3N2v and used a standard case report form to characterize illness and exposures. We considered illness to result from person-to-person H3N2v transmission if swine contact was not identified within 4 days prior to illness onset. RESULTS: From 9 July to 7 September 2012, we identified 306 cases of H3N2v in 10 states. The median age of all patients was 7 years. Commonly reported signs and symptoms included fever (98%), cough (85%), and fatigue (83%). Sixteen patients (5.2%) were hospitalized, and 1 fatal case was identified. The majority of those infected reported agricultural fair attendance (93%) and/or contact with swine (95%) prior to illness. We identified 15 cases of possible person-to-person transmission of H3N2v. Viruses recovered from patients were 93%-100% identical and similar to viruses recovered from previous cases of H3N2v. All H3N2v viruses examined were susceptible to oseltamivir and zanamivir and resistant to adamantane antiviral medications. CONCLUSIONS: In a large outbreak of variant influenza, the majority of infected persons reported exposures, suggesting that swine contact at an agricultural fair was a risk for H3N2v infection. We identified limited person-to-person H3N2v virus transmission, but found no evidence of efficient or sustained person-to-person transmission. Fair managers and attendees should be aware of the risk of swine-to-human transmission of influenza viruses in these settings. |
Self-reported academic grades and other correlates of sugar-sweetened soda intake among US adolescents
Park SY , Sherry B , Foti K , Blanck HM . J Acad Nutr Diet 2012 112 (1) 125-131 High consumption of sugar-sweetened drinks has been associated with obesity and other adverse health consequences. This cross-sectional study examined the association of demographic characteristics, weight status, self-reported academic grades, and behavioral factors with sugar-sweetened soda intake among a nationally representative sample of US high school students. Analysis was based on the 2009 national Youth Risk Behavior Survey and included 16,188 students in grades 9 through 12. The main outcome measure was daily sugar-sweetened soda intake (eg, drank a can, bottle, or glass of soda [excluding diet soda] at least one time per day during the 7 days before the survey). Nationally, 29.2% of students reported drinking sugar-sweetened soda at least one time per day. Logistic regression analyses showed factors significantly associated with sugar-sweetened soda intake at least one time per day included male sex (adjusted odds ratio [OR]=1.47), Hispanic ethnicity (vs whites; OR=0.81), earning mostly B, C, and D/F grades (vs mostly As; OR=1.26, 1.66, and 2.19, respectively), eating vegetables fewer than three times per day (OR=0.72), trying to lose weight (OR=0.72), sleeping 8 hours (OR=1.18), watching television >2 hours/day (OR=1.71), playing video or computer games or using a computer for other than school work >2 hours/day (OR=1.53), being physically active at least 60 minutes/day on 5 days during the 7 days before the survey (OR=1.19), and current cigarette use (OR=2.01). The significant associations with poor self-reported academic grades, inadequate sleep, sedentary behaviors, and cigarette smoking suggest research should examine why soda consumption is associated with these behaviors to inform the design of future nutrition interventions. |
Eosinophilic meningitis attributable to Angiostrongylus cantonensis infection in Hawaii: clinical characteristics and potential exposures
Hochberg NS , Blackburn BG , Park SY , Sejvar JJ , Effler PV , Herwaldt BL . Am J Trop Med Hyg 2011 85 (4) 685-690 The most common infectious cause of eosinophilic meningitis is Angiostrongylus cantonensis, which is transmitted largely by consumption of snails/slugs. We previously identified cases of angiostrongyliasis that occurred in Hawaii from 2001 to 2005; the highest incidence was on the island of Hawaii. We now report symptoms, laboratory parameters, and exposures. Eighteen patients were evaluated; 94% had headache, and 65% had sensory symptoms (paresthesia, hyperesthesia, and/or numbness). These symptoms lasted a median of 17 and 55 days, respectively. Three persons recalled finding a slug in their food/drink. Case-patients on the island of Hawaii were more likely than case-patients on other islands to consume raw homegrown produce in a typical week (89% versus 0%, P < 0.001) and to see snails/slugs on produce (56% versus 0%, P = 0.03). Residents and travelers should be aware of the potential risks of eating uncooked produce in Hawaii, especially if it is from the island of Hawaii and locally grown. |
Epidemiology of 2009 pandemic influenza A (H1N1) deaths in the United States, April-July 2009
Fowlkes AL , Arguin P , Biggerstaff MS , Gindler J , Blau D , Jain S , Dhara R , McLaughlin J , Turnipseed E , Meyer JJ , Louie JK , Siniscalchi A , Hamilton JJ , Reeves A , Park SY , Richter D , Ritchey MD , Cocoros NM , Blythe D , Peters S , Lynfield R , Peterson L , Anderson J , Moore Z , Williams R , McHugh L . Clin Infect Dis 2011 52 S60-S68 During the spring of 2009, pandemic influenza A (H1N1) virus (pH1N1) was recognized and rapidly spread worldwide. To describe the geographic distribution and patient characteristics of pH1N1-associated deaths in the United States, the Centers for Disease Control and Prevention requested information from health departments on all laboratory-confirmed pH1N1 deaths reported from 17 April through 23 July 2009. Data were collected using medical charts, medical examiner reports, and death certificates. A total of 377 pH1N1-associated deaths were identified, for a mortality rate of .12 deaths per 100 000 population. Activity was geographically localized, with the highest mortality rates in Hawaii, New York, and Utah. Seventy-six percent of deaths occurred in persons aged 18-65 years, and 9% occurred in persons aged ≥65 years. Underlying medical conditions were reported for 78% of deaths: chronic lung disease among adults (39%) and neurologic disease among children (54%). Overall mortality associated with pH1N1 was low; however, the majority of deaths occurred in persons aged 65 years with underlying medical conditions. |
Invasive pneumococcal infections among vaccinated children in the United States
Park SY , Van Beneden CA , Pilishvili T , Martin M , Facklam RR , Whitney CG , Active Bacterial Core surveillance team . J Pediatr 2009 156 (3) 478-483.e2 OBJECTIVE: Because 7-valent pneumococcal conjugate vaccine (PCV7) is highly efficacious, pneumococcal infections in vaccinated children raise concerns about immunologic disorders. We characterized a case series of US children in whom invasive pneumococcal infections developed despite vaccination. STUDY DESIGN: We reviewed invasive (sterile site) pneumococcal infections in children aged <5 years who had received ≥1 PCV7 dose as identified from October 2001 to February 2004 through national passive surveillance and the Centers for Disease Control and Prevention's Active Bacterial Core surveillance. Vaccine serotype infections were considered breakthrough cases; the subset of breakthrough cases occurring in children who completed an age-appropriate vaccination series were considered PCV7 failures. RESULTS: We identified 753 invasive infections; 155 infections (21%) were breakthrough cases, predominantly caused by serotypes 6B (n = 50, 32%) and 19F (n = 45, 29%). The proportion of breakthrough cases decreased with the increasing number of PCV7 doses received (P < .001, X(2) for linear trend). Children with co-morbid conditions accounted for 31% of breakthrough infections. Twenty-seven cases (4%) were classified as vaccine failures. Most failures (71%) occurred in children who were vaccinated according to catch-up schedules; 37% had co-morbid conditions. CONCLUSION: Invasive pneumococcal infections identified in vaccinated U.S. children were primarily caused by disease resulting from serotypes not covered with PCV7, rather than failure of the vaccine. Incomplete vaccination and co-morbid conditions likely contribute to breakthrough vaccine-type pneumococcal infections. |
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