Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-8 (of 8 Records) |
Query Trace: Slutsker JS[original query] |
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Shigellosis cases with bacterial sexually transmitted infections: Population-based data from 6 US jurisdictions, 2007-2016
Ridpath AD , Vanden Esschert KL , Bragg S , Campbell S , Convery C , Cope A , Devinney K , Diesel JC , Kikuchi N , Lee N , Lewis FMT , Matthias J , Pathela P , Pugsley R , Slutsker JS , Schillinger JA , Thompson C , Tingey C , Wilson J , Newman DR , Marsh ZA , Garcia-Williams AG , Kirkcaldy RD . Sex Transm Dis 2022 49 (8) 576-581 BACKGROUND: Shigella species, which cause acute diarrheal disease, are transmitted via fecal-oral and sexual contact. To better understand the overlapping populations affected by Shigella infections and sexually transmitted infections (STIs) in the United States, we examined the occurrence of reported STIs within 24 months among shigellosis case-patients. METHODS: Culture-confirmed Shigella cases diagnosed during 2007-2016 among residents of six U.S. jurisdictions were matched to reports of STIs (chlamydia, gonorrhea, and all stages of syphilis) diagnosed 12 months before or after the shigellosis case. We examined epidemiologic characteristics and reported temporal trends of Shigella cases by sex and species. RESULTS: During 2007-2016, 10,430 shigellosis cases were reported. The annual number of reported shigellosis cases across jurisdictions increased 70%, from 821 cases in 2007 to 1,398 cases in 2016; males saw a larger increase compared to females. Twenty percent of male shigellosis case-patients had an STI reported in the reference period, versus 4% of female case-patients. The percentage of male shigellosis case-patients with an STI increased from 11% (2007) to 28% (2016); the overall percentage among females remained low. CONCLUSIONS: We highlight the substantial proportion of males with shigellosis who were diagnosed with STIs within 24 months and the benefit of matching data across programs. STI screening may be warranted for male shigellosis case-patients. |
Effectiveness of a serogroup B outer membrane vesicle meningococcal vaccine against gonorrhoea: a retrospective observational study
Abara WE , Bernstein KT , Lewis FMT , Schillinger JA , Feemster K , Pathela P , Hariri S , Islam A , Eberhart M , Cheng I , Ternier A , Slutsker JS , Mbaeyi S , Madera R , Kirkcaldy RD . Lancet Infect Dis 2022 22 (7) 1021-1029 BACKGROUND: Declining antimicrobial susceptibility to current gonorrhoea antibiotic treatment and inadequate treatment options have raised the possibility of untreatable gonorrhoea. New prevention approaches, such as vaccination, are needed. Outer membrane vesicle meningococcal serogroup B vaccines might be protective against gonorrhoea. We evaluated the effectiveness of a serogroup B meningococcal outer membrane vesicle vaccine (MenB-4C) against gonorrhoea in individuals aged 16-23 years in two US cities. METHODS: We identified laboratory-confirmed gonorrhoea and chlamydia infections among individuals aged 16-23 years from sexually transmitted infection surveillance records in New York City and Philadelphia from 2016 to 2018. We linked gonorrhoea and chlamydia case records to immunisation registry records to determine MenB-4C vaccination status at infection, defined as complete vaccination (two MenB-4C doses administered 30-180 days apart), partial vaccination (single MenB-4C vaccine dose), or no vaccination (serogroup B meningococcal vaccine naive). Using log-binomial regression with generalised estimating equations to account for correlations between multiple infections per patient, we calculated adjusted prevalence ratios (APR) and 95% CIs to determine if vaccination was protective against gonorrhoea. We used individual-level data for descriptive analyses and infection-level data for regression analyses. FINDINGS: Between Jan 1, 2016, and Dec 31, 2018, we identified 167 706 infections (18 099 gonococcal infections, 124 876 chlamydial infections, and 24 731 gonococcal and chlamydial co-infections) among 109 737 individuals linked to the immunisation registries. 7692 individuals were vaccinated, of whom 4032 (52·4%) had received one dose, 3596 (46·7%) two doses, and 64 (<1·0%) at least three doses. Compared with no vaccination, complete vaccination series (APR 0·60, 95% CI 0·47-0·77; p<0·0001) and partial vaccination series (0·74, 0·63-0·88; p=0·0012) were protective against gonorrhoea. Complete MenB-4C vaccination series was 40% (95% CI 23-53) effective against gonorrhoea and partial MenB-4C vaccination series was 26% (12-37) effective. INTERPRETATION: MenB-4C vaccination was associated with a reduced gonorrhoea prevalence. MenB-4C could offer cross-protection against Neisseria gonorrhoeae. Development of an effective gonococcal vaccine might be feasible with implications for gonorrhoea prevention and control. FUNDING: None. |
Epidemiology of reported HIV and other sexually transmitted infections during the COVID-19 pandemic, New York City.
Braunstein SL , Slutsker JS , Lazar R , Shah D , Hennessy RR , Chen S , Pathela P , Daskalakis DC , Schillinger JA . J Infect Dis 2021 224 (5) 798-803 Early in the COVID-19 crisis, a statewide executive order ("PAUSE") severely restricted the movement of New Yorkers from March 23-June 7, 2020. We used NYC surveillance data for HIV, chlamydia, gonorrhea, and syphilis to describe trends in diagnosis and reporting surrounding PAUSE. During PAUSE, the volume of positive HIV/STI tests, and diagnoses of HIV, chlamydia, gonorrhea, and syphilis declined substantially, reaching a nadir in April before rebounding. Some shifts in characteristics of reported cases were identified. |
Assessing the Burden of Infant Deaths due to Herpes Simplex Virus, Human Immunodeficiency Virus, and Congenital Syphilis - United States, 1995-2017
Slutsker JS , Schillinger JA . Sex Transm Dis 2021 48 S4-S10 BACKGROUND: Despite advances in diagnosis and treatment, neonatal infection with herpes simplex virus (HSV) has a high case fatality rate. The national burden of neonatal HSV, and associated deaths, is unknown because this condition is not nationally notifiable. We investigated trends in HSV-related infant deaths, compared to infant deaths from congenital syphilis (CS) and human immunodeficiency virus (HIV). METHODS: Linked birth-death files for infant deaths during 1995-2017 were obtained from the National Center for Health Statistics. These files include infants who were born alive and died in the first 365 days of life and exclude stillbirths. We searched death certificates for disease codes indicating HSV, CS, or HIV, and calculated the frequency and rate of deaths for each infection, overall, by infant sex, and birthing parent age and race/ethnicity. RESULTS: Nationally, 1,591 deaths related to the infections of interest were identified: 1,271 related to HSV (79.9%), 234 HIV (14.7%), and 86 CS (5.4%). HSV-related deaths increased significantly from 0.83/100,000 live-births (95% CI:0.57-1.17) in 1995 to 1.77 (95% CI:1.37-2.24) in 2017. In contrast, HIV-related deaths declined: 1.64/100,000 (95% CI:1.27-2.10) in 1995 to 0.00 in 2017. There was a median of 3 CS-related deaths/year, with elevated frequencies in 1995-1996 and 2017 (n=8). HSV-related death rates were elevated among infants born to birthing parents aged <20 years (4.17/100,000; 95% CI:3.75-4.59) and to Black parents (2.86/100,000; 95% CI:2.58-3.15). CONCLUSIONS: Nationally, HSV-related infant deaths exceeded those caused by HIV and CS and appear to be increasing. Our findings underscore the need for an effective HSV vaccine, test technologies enabling rapid identification of infants exposed to HSV at delivery, and a focus on equity in prevention efforts. |
Do prescriptions for expedited partner therapy for chlamydia get filled Findings from a multi-jurisdictional evaluation, United States, 2017-2019
Slutsker JS , Tsang LB , Schillinger JA . Sex Transm Dis 2020 47 (6) 376-382 BACKGROUND: Expedited partner therapy (EPT) is commonly provided by prescription, however, the efficacy of this modality is unknown. We examined whether EPT prescriptions are filled when the cost barrier is removed. METHODS: To track EPT prescription fill rates, we used single-use pharmacy vouchers that covered the cost of azithromycin, 1-gram (chlamydia treatment). We recruited clinical sites to distribute vouchers to patients with chlamydia who would receive an EPT prescription under clinic policies. When distributing vouchers, sites recorded and retained: voucher unique identifier, sex and age of index patient, distribution date, and whether partner name was written on the EPT prescription. Pharmacists receiving vouchers entered the identifier, sex and age of presenting person, and redemption date into a standard pharmacy claim transmission system. Data for redeemed vouchers were retrieved from an industry portal and linked with data retained at clinical sites. RESULTS: Thirty-two clinical sites distributed 931 vouchers during 9/2017-01/2019; 382 (41%) were redeemed. Vouchers distributed to patients </=18 years (49/163; 30%) were less likely to be redeemed compared to those distributed to patients >18 years (322/736; 44%; p=0.001). Just over half of vouchers were redeemed the same day (195/351; 56%) and </=1 mile from the clinical site (188/349; 54%). After excluding an outlier site, vouchers accompanied by EPT prescriptions including a partner name (15/27; 56%) were more likely to be redeemed than those lacking a name (83/244; 34%; p=0.03). CONCLUSIONS: Less than half of EPT prescriptions were filled, even when medication was free. Whenever possible, EPT should be provided as drug-in-hand. |
Factors contributing to congenital syphilis cases - New York City, 2010-2016
Slutsker JS , Hennessy RR , Schillinger JA . MMWR Morb Mortal Wkly Rep 2018 67 (39) 1088-1093 Congenital syphilis occurs when syphilis is transmitted from a pregnant woman to her fetus; congenital syphilis can be prevented through screening and treatment during pregnancy. Transmission to the fetus can occur at any stage of maternal infection, but is more likely during primary and secondary syphilis, with rates of transmission up to 100% at these stages (1). Untreated syphilis during pregnancy can cause spontaneous abortion, stillbirth, and early infant death. During 2013-2017, national rates of congenital syphilis increased from 9.2 to 23.3 cases per 100,000 live births (2), coinciding with increasing rates of primary and secondary syphilis among women of reproductive age (3). In New York City (NYC), cases of primary and secondary syphilis among women aged 15-44 years increased 147% during 2015-2016. To evaluate measures to prevent congenital syphilis, the NYC Department of Health and Mental Hygiene (DOHMH) reviewed data for congenital syphilis cases reported during 2010-2016 and identified patient-, provider-, and systems-level factors that contributed to these cases. During this period, 578 syphilis cases among pregnant women aged 15-44 years were reported to DOHMH; a congenital syphilis case was averted or otherwise failed to occur in 510 (88.2%) of these pregnancies, and in 68, a case of congenital syphilis occurred (eight cases per 100,000 live births).* Among the 68 pregnant women associated with these congenital syphilis cases, 21 (30.9%) did not receive timely (>/=45 days before delivery) prenatal care. Among the 47 pregnant women who did access timely prenatal care, four (8.5%) did not receive an initial syphilis test until <45 days before delivery, and 22 (46.8%) acquired syphilis after an initial nonreactive syphilis test. These findings support recommendations that health care providers screen all pregnant women for syphilis at the first prenatal care visit and then rescreen women at risk in the early third trimester. |
Using reports of latent tuberculosis infection among young children to identify tuberculosis transmission in New York City, 2006-2012
Slutsker JS , Trieu L , Crossa A , Ahuja SD . Am J Epidemiol 2018 187 (6) 1303-1310 The presence of latent tuberculosis infection (LTBI) in young children indicates recent tuberculosis (TB) transmission. We reviewed surveillance reports of children with LTBI to assess whether more follow-up is needed to prevent TB in this high-risk population. Data on all children under 5 years of age who were reported by health-care providers or laboratories to the New York City Department of Health during 2006-2012 were abstracted from the TB surveillance and case management system, and those with LTBI were identified. Potential source cases, defined as any infectious TB case diagnosed in the 2 years before a child was reported and whose residence was within 0.5 miles (0.8 km) of the child's residence, were identified. Neighborhood risk factors for TB transmission were examined. Among 3,511 reports of children under age 5 years, 1,722 (49%) had LTBI. The children were aged 2.9 years, on average, and most (64%) had been born in the United States. A potential source case was identified for 92% of the children; 27 children lived in the same building as a TB patient. Children with potential source cases were more likely to reside in neighborhoods with high TB incidence, poverty, and population density. The high proportion of children born in the United States and the young average age of the cases imply that undetected TB transmission occurred. Monitoring reports could be used to identify places where transmission occurred, and additional investigation is needed to prevent TB disease. |
The epidemiology of syphilis in New York City; historic trends and the current outbreak among men who have sex with men, 2016
Schillinger JA , Slutsker JS , Pathela P , Klingler E , Hennessy RR , Toro B , Blank S . Sex Transm Dis 2018 45 S48-S54 BACKGROUND: Male primary and secondary (P&S) and early latent (EL) syphilis cases have increased markedly in New York City (NYC) after a historic nadir in 1998. The majority of cases are among men-who-have-sex-with-men (MSM). We describe the epidemiology of syphilis among NYC males to provide a model of how one jurisdiction collects, analyzes, interprets, uses, and disseminates local data to guide programmatic activities directed at syphilis control. METHODS: We analyzed trends in reported infectious syphilis cases using routinely collected surveillance and case investigation data. HIV co-infection status was ascertained by routine deterministic match between sexually transmitted infection and HIV surveillance registries, and self-report. We mapped diagnosing facilities to display the relative contribution of different public/private facilities. Characteristics of male syphilis cases diagnosed in public sexual health (SH) clinics were compared to those diagnosed elsewhere. RESULTS: During 2012-2016, male P&S syphilis case rates increased 81%, from 24.8 to 44.8/100,000 (1832 cases); the highest rates were among black non-Hispanic men. Overall, 87.6% (902/1030) of interviewed men in 2016 disclosed >1 male partner. HIV co-infection rates are high among MSM with P&S syphilis (43.4%; 394/907 in 2016), but appear to be decreasing (from 54.1% in 2012). Maps highlighted SH clinics' contribution to diagnosing P&S syphilis cases among men of color. HIV co-infection rates were lower among men with P&S syphilis diagnosed in SH clinics than among those diagnosed elsewhere (34%, SH clinics versus 49%, other settings, p<0.0001). CONCLUSIONS: Syphilis infections continue to increase among MSM in NYC. Novel interventions responsive to the drivers of the current outbreak are needed. |
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