Last data update: Jan 27, 2025. (Total: 48650 publications since 2009)
Records 1-30 (of 1739 Records) |
Query Trace: Smith M[original query] |
---|
High rates of potentially unnecessary topical antifungal prescribing in a large commercial health insurance claims database, United States
Gold JAW , Benedict K , Caplan AS , Lipner SR , Smith DJ . J Am Acad Dermatol 2025 ![]() |
An observational study to determine the prevalence of COVID-19 among hospitalized patients with multidrug-resistant enterobacterales infections and clinical outcomes, 10 US sites, 2020--2022
Grass JE , Bulens SN , Ansari UA , Duffy N , Jacob JT , Smith G , Rebolledo PA , Restrepo AM , Vaeth E , Dumyati G , Tsay R , Looi HC , Phipps E , Flores KG , Wilson C , Muleta D , Czaja CA , Driscoll J , Johnston H , Lynfield R , O'Malley S , Maloney M , Stabach N , Nadle J , Pierce R , Hertzel H , Guh AY . Open Forum Infect Dis 2025 12 (1) ofae745 ![]() BACKGROUND: We investigated hospitalized carbapenem-resistant Enterobacterales (CRE) and extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) cases with and without COVID-19, as identified through Emerging Infections Program surveillance in 10 sites from 2020 to 2022. METHODS: We defined a CRE case as the first isolation of Escherichia coli, Enterobacter cloacae complex, Klebsiella aerogenes, K oxytoca, K pneumoniae, or K variicola resistant to any carbapenem. We defined an ESBL-E case as the first isolation of E coli, K pneumoniae, or K oxytoca resistant to any third-generation cephalosporin and nonresistant to all carbapenems tested. Specimens were drawn from a normally sterile site or urine among hospitalized residents of the surveillance area in a 30-day period. We defined COVID-19 as a positive SARS-CoV-2 test result (SC2(+)) within 14 days before CRE or ESBL-E specimen collection and performed multivariable logistic regression analyses. RESULTS: Of 1595 CRE and 1866 ESBL-E hospitalized cases, 38 (2.4%) and 60 (3.2%), respectively, had a SC2(+). Among these cases, a SC2(+) was associated with intensive care unit admission (adjusted odds ratio [aOR], 1.69 [95% CI, 1.14-2.50]; aOR, 1.48 [95% CI, 1.03-2.12]) and 30-day mortality (aOR, 1.79 [95% CI, 1.22-2.64]; aOR, 1.94 [95% CI, 1.39-2.70]). CONCLUSIONS: CRE and ESBL-E infections among hospitalized patients with preceding COVID-19 were uncommon but had worse outcomes when compared with cases without COVID-19. COVID-19 prevention in patients at risk of CRE and ESBL-E infections is needed, as well as continued infection control measures and antibiotic stewardship for patients with COVID-19. |
A unified approach to health data exchange: A Report From the US DHHS
Abbasi AB , Layden J , Gordon W , Gregurick S , DeLew N , Grossman J , Bierman AS , Monarez S , Curtis LH , Viall AH , Rocca M , Rivera DR , Marston H , Mugge A , Smith SR , Bent K , Macrae J , Sheehy A , Wegrzyn RD , Valdez RB , Johnson C , Bush L , Blum J , Cohen MK , Bertagnolli MM , Califf RM , Tripathi M . Jama 2025 ![]() ![]() IMPORTANCE: Health information technology, such as electronic health records (EHRs), has been widely adopted, yet accessing and exchanging data in the fragmented US health care system remains challenging. To unlock the potential of EHR data to improve patient health, public health, and health care, it is essential to streamline the exchange of health data. As leaders across the US Department of Health and Human Services (DHHS), we describe how DHHS has implemented fundamental building blocks to achieve this vision. OBSERVATIONS: Across DHHS, we have implemented 3 foundational building blocks called for by the 2016 21st Century Cures Act to create a unified approach for secure, high-quality, and timely exchange of health data across the health care system. The United States Core Data for Interoperability provides a minimum baseline for data elements that must be available in federally regulated health information technology systems such as certified EHRs. These data elements now must be accessible using Fast Healthcare Interoperability Resources-a secure, flexible, and open-industry standard for health data exchange. The Trusted Exchange Framework and Common Agreement provides a network to securely exchange health data across the country. The 3 building blocks of United States Core Data for Interoperability, Fast Healthcare Interoperability Resources, and Trusted Exchange Framework and Common Agreement are now in place thanks to diligent public and private sector work over 2 administrations. Across DHHS, we are working to refine these building blocks and increase their adoption through regulatory authorities, grants, and public-private partnerships. CONCLUSIONS AND RELEVANCE: The technological building blocks described in this article are creating a unified approach to health data exchange for patient access, clinical care, quality improvement, scientific research, public health, and other uses of health data. Collaborations between the public, nonprofit, and private sectors are needed to maximize their potential. By unlocking the potential of health data, these building blocks are the foundation of a 21st-century digital health care system that will improve the experience of patients and clinicians and result in better health outcomes. |
State laws on intimate partner violence witnessed by children in the United States
Reott EC , Hulkower R , Lancaster C , Frey MT , Smith RC , Thomas C , Godoshian V . J Public Health Policy 2025 ![]() Intimate partner violence (IPV) is common, and almost half of all IPV takes place in relationships with children in the home. We inventoried laws in the 50 states and the District of Columbia in the United States of America (USA) focused on addressing IPV committed in the presence of children, as these laws could help prevent or remediate this critical health and social issue. Using WestLaw, a web-based legal research service, we identified over 1,200 statutes and 500 regulations. We documented the laws' key attributes and heterogeneities and coded 557 laws from 31 states. We determined that the most commonly prescribed penalty was stricter sentencing, followed by mandates to pay for counseling for any child witnesses, separate additional criminal charges, mandated receipt of counseling or intervention services, and a period of supervised parenting. Future research could assess the possible impacts of these laws on children's short- and long-term wellbeing. |
Comparison of a non-invasive point-of-care measurement of anemia to conventionally used HemoCue devices in Gambella refugee camp, Ethiopia, 2022
Smith F , Woldeyohannes M , Lusigi M , Samson KLI , Mureverwi BT , Gazarwa D , Mohmand N , Theuri T , Leidman E . PLoS One 2025 20 (1) e0313319 Annual surveys of refugees in Gambella, Ethiopia suggest that anemia is a persistent public health problem among non-pregnant women of reproductive age (NP-WRA, 15-49 years). Measurement of anemia in most refugee camp settings is conducted using an invasive HemoCue 301. We assessed the accuracy and precision of a non-invasive, pulse CO-oximeter in measuring anemia among NP-WRA in four Gambella refugee camps. We conducted a population-representative household survey between November 7 and December 4, 2022. Hemoglobin (Hb) concentration was measured by HemoCue 301, using capillary blood, and Rad-67, a novel non-invasive device. We collected four measurements per participant: two per device. We calculated Rad-67 bias and precision of Hb measurements and sensitivity and specificity of detecting anemia. Of the 812 NP-WRAs selected, 807 (99%) participated in the study. Anemia was detected in 39% of NP-WRA as classified by the Rad-67 compared with 47% of NP-WRA as classified by the HemoCue 301. Average bias of Rad-67 measurements was 1.1 ± 1.0 SD g/dL, using HemoCue 301 as a comparator. Absolute mean difference between the first and second measurements was 0.9 g/dL (95% CI 0.8, 0.9) using the Rad-67, compared with 0.6 g/dL (95% CI 0.5, 0.6) using the HemoCue 301. The Rad-67 had 49% sensitivity and 70% specificity for detecting anemia, compared with the HemoCue 301. The Rad-67 can be a useful tool for anemia screening; however, lower accuracy and precision, and poor sensitivity suggest it cannot immediately replace the HemoCue 301 in the study area. |
Human health surveillance during animal disease emergencies: Minnesota Department of Health response to highly pathogenic avian influenza outbreaks, 2015 and 2022-2023
Scheftel JM , Schenk KE , Bauck LJ , Bye ML , Ireland MJ , Klumb CA , Kollmann LM , Smith KE , Voss SJ , Hoefs BL , Hunt LJ , Holzbauer SM . J Agromedicine 2025 1-12 OBJECTIVES: Highly pathogenic avian influenza (HPAI) poses an occupational risk for poultry workers, responders, and others in contact with infected birds. The objective of this analysis was to describe HPAI surveillance methods and outcomes, and highlight the challenges, successes, and lessons learned during the Minnesota Department of Health's (MDH's) public health response to HPAI outbreaks in Minnesota poultry flocks in the years 2015 and 2022-2023. METHODS: During both outbreaks, MDH staff attempted to contact all potentially exposed people and conduct a standardized interview. People were considered exposed and at risk if they had entered a barn with poultry on any HPAI test-positive premises. With their consent, exposed persons were entered into illness monitoring until 10 days from their last exposure. In 2015, MDH monitored the health of poultry workers only. In the 2022-2023 response, MDH monitored the health of poultry workers, backyard flock owners, responders, and private contract workers. In 2022-2023, interview responses were entered into a REDCap (Research Electronic Data Capture) database in real time, which automatically entered the person into monitoring if they consented. Through REDCap, they received an automated email with a unique link to a short survey asking about any symptom development. Where appropriate, interview responses from poultry workers collected in 2015 were compared to interview responses from poultry workers collected in 2022-2023. RESULTS: From March 3 to June 5, 2015, MDH epidemiologists interviewed and evaluated 375 (86%) of 435 poultry workers from 110 HPAI-infected flocks. From March 25, 2022 through December 31, 2023, MDH epidemiologists interviewed and evaluated 649 (65%) of 992 poultry workers, responders, contractors, and backyard flock owners associated with 151 HPAI-infected flocks. Among poultry workers, self-reported personal protective equipment (PPE) usage declined significantly from 2015 to 2022-2023 (full PPE usage 51.8% vs. 23.9%, p < .01). CONCLUSION: MDH's long standing relationships with animal health officials and the poultry industry resulted in strong poultry worker participation rates in surveillance efforts during HPAI outbreaks in 2015 and 2022-2023. Self-reported PPE usage was low, particularly in 2022-2023. Improvements in PPE accessibility and technology are needed to protect workers and responders in the on-going HPAI outbreak. |
Effectiveness of mRNA COVID-19 vaccines and hybrid immunity in preventing SARS-CoV-2 infection and symptomatic COVID-19 among adults in the United States
Feldstein LR , Ruffin J , Wiegand RE , Borkowf CB , James-Gist J , Babu TM , Briggs-Hagen M , Chappell J , Chu HY , Englund JA , Kuntz JL , Lauring AS , Lo N , Carone M , Lockwood C , Martin ET , Midgley CM , Monto AS , Naleway AL , Ogilvie T , Saydah S , Schmidt MA , Schmitz JE , Smith N , Sohn I , Starita L , Talbot HK , Weil AA , Grijalva CG . J Infect Dis 2025 ![]() BACKGROUND: Understanding protection against SARS-CoV-2 infection by vaccine and hybrid immunity is important for informing public health strategies as new variants emerge. METHODS: We analyzed data from three cohort studies spanning September 1, 2022-July 31, 2023, to estimate COVID-19 vaccine effectiveness (VE) against SARS-CoV-2 infection and symptomatic COVID-19 among adults with and without prior infection in the United States. Participants collected weekly nasal swabs, irrespective of symptoms, annual blood draws, and completed periodic surveys, which included vaccination status and prior infection history. Swabs were tested molecularly for SARS-CoV-2. VE was estimated using Cox proportional hazards models for the hazard ratios of infections, adjusting for covariates. VE was calculated considering prior infection and recency of vaccination. RESULTS: Among 3,344 adults, adjusted VE of bivalent vaccine against infection was 37.2% (95% CI: 12.3-55.7%) within 7-59 days of vaccination and 21.1% (95% CI: -0.5-37.1%) within 60-179 days of vaccination compared to participants who were unvaccinated/received an original monovalent vaccine dose ≥180 days prior. Overall, adjusted VE of bivalent vaccine against infection, in conjunction with prior infection, was 62.2% (95% CI: 46.0-74.5%) within 7-179 days of vaccination and 39.4% (95% CI: 12.5-61.6%) ≥180 days compared to naïve participants who were unvaccinated/received a monovalent vaccine dose ≥180 days prior. CONCLUSIONS: Adults with both prior infection and recent vaccination had high protection against infection and symptomatic illness. Recent vaccination alone provided moderate protection. |
Evaluating the ingress of total polycyclic aromatic hydrocarbons (PAHs) specifically naphthalene through firefighter hoods and base layers
Kander MC , Wilkinson AF , Chen IC , Bertke S , Kesler RM , Smith DL , Horn GP , Fent KW . J Occup Environ Hyg 2025 1-9 Structural firefighters are exposed to an array of polycyclic aromatic hydrocarbons (PAHs) as a result of incomplete combustion of both synthetic and natural materials. PAHs are found in both the particulate and vapor phases in the firefighting environment and are significantly associated with acute and chronic diseases, including cancer. Using a fireground exposure simulator (FES) and standing mannequins dressed in four different firefighter personal protective equipment (PPE) conditions, each with varying levels of protective hood interface and particulate-blocking features, the efficacy of the hoods was assessed against the ingress of PAHs (specifically, naphthalene). The authors also explored the effectiveness of a 100% cotton turtleneck at further attenuating the amount of naphthalene reaching the surface of the mannequin's neck. Air samples were collected at the breathing zone, abdomen, and thigh heights from the 6 ft-2 in mannequins used in this study. Naphthalene was the most abundant PAH (55% of the total PAH concentrations) in the FES and existed primarily in the vapor phase (92% vapor in the breathing zone). Additionally, bulk base layer and under the base layer polytetrafluoroethylene (PTFE) filter samples (used as skin surrogates) were collected from the neck region of the mannequins and analyzed for PAHs. A larger percentage of naphthalene was collected on the filter under the traditional knit hoods than on the cotton base layer, suggesting a small protective effect of the base layer against solid-phase naphthalene. Previous studies investigating naphthalene by employing air sampling under PPE have found a larger protective effect of base layers against the ingress of naphthalene vapor. PAHs that exist primarily as particulate in the fire environment were largely not detected on the base layers or PTFE filters under the gear. Further research is needed that involves more sensitive methods and non-static human subjects. |
Cluster of legionellosis cases associated with manufacturing process, South Carolina, USA, 2022
Mohamed HM , Zielinski L , Diedhiou A , Clemmons N , Smith JC , Rinsky JL , Ritter T , Willby M , Burton N , Feldmann K , Dunn K , Whisenhunt R , Greer V , Acosta AM , Garber M , Lucas CE , Henderson KC , Edens C , Bell L . Emerg Infect Dis 2025 31 (1) 41-49 Evolving technology and the development of new devices that can aerosolize water present a risk for new sources of Legionella bacteria growth and spread within industrial settings. We investigated a cluster of legionellosis among employees of a manufacturing facility in South Carolina, USA, and found 2 unique equipment sources of Legionella bacteria. The cluster of cases took place during August-November 2022; a total of 34 cases of legionellosis, including 15 hospitalizations and 2 deaths, were reported. Legionella pneumophila was isolated from 3 devices: 2 water jet cutters and 1 floor scrubber. L. pneumophila sequence type 36 was identified in environmental isolates and 1 patient specimen, indicating that those devices were the likely source of infection. Remediation was ultimately achieved through the development and implementation of a device-specific water management program. Manufacturing facilities that use aerosol-generating devices should consider maintaining updated Legionella water management programs to prevent Legionella bacterial infections. |
Genome characterization of a simian foamy virus from a human bitten by an African green monkey
Shankar A , Smith JM , Switzer WM . Microbiol Resour Announc 2024 e0083224 ![]() ![]() We obtained the near-complete simian foamy virus (SFV) genome from an infected human bitten by an African green monkey (Chlorocebus aethiops; SFVcae_hu501). The genome is 13,062 nucleotides long with the classical SFV genome structure. Phylogenetically, SFVcae_hu501 clustered closely with SFV from Ch. aethiops (SFVagm_LK3). |
Protection from COVID-19 vaccination and prior SARS-CoV-2 infection among children aged 6 months - 4 years, United States, September 2022-April 2023
Feldstein LR , Ruffin J , Wiegand R , Grant L , Babu TM , Briggs-Hagen M , Burgess JL , Caban-Martinez AJ , Chu HY , Ellingson KD , Englund JA , Hegmann KT , Jeddy Z , Kuntz J , Lauring AS , Lutrick K , Martin ET , Mathenge C , Meece J , Midgley CM , Monto AS , Naleway AL , Newes-Adeyi G , Odame-Bamfo L , Olsho LE , Phillips AL , Rai RP , Saydah S , Smith N , Tyner H , Vaughan M , Weil AA , Yoon SK , Britton A , Gaglani M . J Pediatric Infect Dis Soc 2024 To understand how COVID-19 vaccines impact infection risk in children <5 years, we assessed risk of SARS-CoV-2 infection from Sept 2022-April 2023 in three cohort studies. There was no difference in risk by vaccination status. While vaccines reduce severe disease, they may not reduce SARS-CoV-2 infections in young children. |
An update on fungal disease outbreaks of public health concern
Smith DJ , Gold JAW , Williams SL , Hennessee I , Jones S , Chiller T . Infect Dis Clin North Am 2024 For this narrative review, we describe recent high-profile and severe outbreaks of emerging fungal infections, emphasizing lessons learned and opportunities to improve future prevention and response efforts. Several themes and challenges remain consistent across a diverse array of fungal outbreaks, including the multidisciplinary need for improved diagnostic testing to determine species and perform antifungal susceptibility testing, clinical awareness, and optimization of antifungal use. Recent outbreaks exemplify the growing promise of non-culture-based tools in identifying fungal outbreaks and improving responses, although access remains limited. Culture-based tools remain critical for performing antifungal-susceptibility to guide therapy. |
The Brief Case: Hidden in plain sight-Exophiala jeanselmei subcutaneous phaeohyphomycosis of hand masquerading as a hematoma
Heath CP , Sharma PC , Sontakke S , Smith DJ , Jhaveri TA . J Clin Microbiol 2024 62 (12) e0106824 |
Perceptions and barriers to outpatient antiviral therapy for COVID-19 and influenza as observed by infectious disease specialists in North America: Results of an Emerging Infections Network (EIN) Survey, February 2024
Singleton JB , Wang D , Louis S , Smith DJ , Lambrou AS , Beekmann SE , Midgley CM , Polgreen P , Garg S , Ricaldi JN , Uyeki TM , Santibañez S , Patel P . Open Forum Infect Dis 2024 11 (12) ofae666 Antiviral therapy is underutilized for outpatients at increased risk for severe COVID-19 or influenza. Results from this survey offer insights into treatment barriers from the infectious disease specialist perspective. Further education is needed about the benefits of early antiviral therapy. |
Spatiotemporal evolution and transmission dynamics of Alpha and Delta SARS-CoV-2 variants contributing to sequential outbreaks in Cambodia during 2021
Su YCF , Zeller MA , Ou TP , Ma J , Pum L , Zhang R , Rath S , Heang V , Kol S , Lim R , Chea KL , Khun L , Heng L , Krang S , Raftery P , Kinzer MH , Ieng V , Kab V , Patel S , Sar B , Horm VS , Yann S , Auerswald H , Siegers JY , Troupin C , Boukli N , Vandelannoote K , Wong FY , Ng GGK , Chan M , Sorn S , Sengdoeurn Y , Heng S , Darapheak C , Savuth C , Khalakdina A , Ly S , Baril L , Spiegel A , Duong V , Ly S , Smith GJD , Karlsson EA . Commun Med (Lond) 2024 4 (1) 252 ![]() ![]() ![]() BACKGROUND: Tracking the emergence, introduction and spread of SARS-CoV-2 variants of concern are essential for informing public health strategies. In 2021, Cambodia faced two major epidemic waves of SARS-CoV-2 triggered by the successive rise of the Alpha and Delta variants. METHODS: Phylodynamic analysis of 1,163 complete SARS-CoV-2 genomes from Cambodia, along with global sequences, were conducted between February and September 2021 to infer viral introductions, molecular epidemiology and population dynamics. The relationship between epidemic trends and control strategies were evaluated. Bayesian phylogeographic reconstruction was employed to estimate and contrast the spatiotemporal dynamics of the Alpha and Delta variants over time. RESULTS: Here we reveal that the Alpha variant displays rapid lineage diversification, accompanied by the acquisition of a spike E484K mutation that coincides with the national implementation of mass COVID-19 vaccination. Despite nationwide control strategies and increased vaccination coverage, the Alpha variant was quickly displaced by Delta variants that exhibits a higher effective reproductive number. Phylogeographic inference indicates that the Alpha variant was introduced through south-central region of Cambodia, with strong diffusion rates from the capital of Phnom Penh to other provinces, while the Delta variant likely entered the country via the northern border provinces. CONCLUSIONS: Continual genomic surveillance and sequencing efforts, in combination with public health strategies, play a vital role in effectively tracking and responding to the emergence, evolution and dissemination of future emerging variants. | Tracking how SARS-CoV-2, the virus that causes COVID-19, changes over time is important for public health. In Cambodia, there were two major COVID-19 waves in 2021, driven by the Alpha and Delta variants. We analyzed 1,163 virus samples from Cambodia, plus samples from other places, to understand how these variants spread. We found that the Alpha variant quickly spread and changed as Cambodia started a mass vaccination campaign. Despite efforts to control it, the Delta variant, which spreads more easily, soon took over. The Alpha variant likely came into Cambodia from the south, while the Delta variant probably entered from the north. Monitoring these changes helps us respond better to future outbreaks. | eng |
Orthopoxvirus purification for high containment laboratories
Hughes L , Wilkins K , Smith S , Olson VA , Satheshkumar PS . Methods Mol Biol 2025 2860 149-156 Purification of large viruses in a high containment laboratory can create unique challenges. Traditional purification methods for large viruses rely on equipment and techniques that are not ideal for high containment work. Poxvirus purification has long relied on the use of Genetron(®), a reagent that is no longer available. Here we describe a purification protocol that is effective for semi-purification of orthopoxviruses and suitable for work in high containment laboratories. |
Bioluminescence imaging to study recombinant orthopoxvirus infection in animal models
Kling C , Smith TG , Baird N , Hutson CL . Methods Mol Biol 2025 2860 175-189 ![]() Bioluminescent images of viral replication in live animals (in vivo) reveal disease dynamics and effects of medical countermeasures over time. After selecting an appropriate orthopoxvirus animal model for the study, a recombinant virus with the firefly luciferase gene inserted in the genome is used to infect the animals. On the day of bioluminescent imaging, the substrate, D-luciferin, is prepared; animals are sedated and injected with the substrate and IVIS imager is utilized; various bioluminescent images are acquired; then animals recover and are able to continue in the study. Ex vivo imaging can also be completed after animals are euthanized at experimental endpoint. This approach allows real-time imaging of viral kinetics within an animal, and analysis of images can provide an additional quantitative measure throughout the study. Bioluminescent imaging not only provides scientific benefits but also benefits to animal welfare. For these reasons, bioluminescent imaging should be considered for any in vivo orthopoxvirus study. |
Endurance exercise training alters lipidomic profiles of plasma and eight tissues in rats: a MoTrPAC study
Ortlund E , Hou Z , Chen CY , Gaul D , Zhang T , Moore S , Liu X , Ivanova A , Maner-Smith K , Newgard C , Bodine S , Savage E , Bennett A , Fernandez F . Res Sq 2024 Endurance exercise training (ExT) induces metabolic, structural, and functional adaptations via lipidomic modifications, yet the systematic elucidation of lipidome alterations in response to ExT remains incomplete. As a part of the Molecular Transducers of Physical Activity Consortium (MoTrPAC), we leveraged non-targeted and targeted lipidomics for the systematic discovery of lipid alterations in the brown adipose tissue, heart, hippocampus, kidney, liver, lung, skeletal muscle gastrocnemius, subcutaneous white adipose tissue, and plasma in response to 1, 2, 4 or 8 weeks of ExT in 6-month-old male and female Fischer-344 rats. This study demonstrates that these tissues, each with distinct lipidomic features, underwent dynamic, sexually dimorphic lipid remodeling. Exercise trained animals showed reduced whole-body adiposity and improved cardiorespiratory fitness, along with enhanced utilization of lipid stores and dynamic triacylglycerol remodeling compared to sedentary controls in all tissues except hippocampus. They also showed modifications in phospholipids, lysophospholipids, oxylipins, and ceramides in several tissues. Coordinated changes across tissues reflect systemic tissue communication, with liver-plasma-heart connection potentially playing a key role in systemic lipid metabolism during ExT. These data will improve our understanding of lipid-associated biological processes underlying the health-promoting benefits of ExT. |
Understanding community resilience during the drinking water contamination event on Oahu, Hawaii, 2021-2022: a mixed mode approach
Parasram V , Smith AR , Bolduc MLF , Rayman J , Poniatowski A , Mintz N , Jarvis M , Troeschel AN , Miko S , Surasi K , Edge C , Gerhardstein B , Felton D , Orr MF . BMC Public Health 2024 24 (1) 3176 BACKGROUND: A petroleum leak into the Joint Base Pearl Harbor-Hickam water system on Oahu, Hawaii in November 2021 contaminated the drinking water of approximately 93,000 users, causing many to relocate for months. Perceptions of health and wellbeing were captured using the Centers for Disease Control/Agency for Toxic Substances and Disease Registry (CDC/ATSDR) Assessment of Chemical Exposures (ACE) cross-sectional survey in collaboration with the Hawaii Department of Health (HDOH). METHODS: Responses from the ACE online survey of community members, businesses, schools, health care and veterinary care organizations during the contamination event, containing quantitative questions and qualitative information from an open text field, were analyzed. Separately, a qualitative key informant questionnaire was administered to community establishments. Thematic content analysis was used to analyze and identify prominent themes from the ACE open text field and the key informant responses that were triangulated by the quantitative data when the themes aligned. RESULTS: Six major themes of disruption, communication, trust, stress, support, and ongoing needs were identified. Burdensome logistics from obtaining alternate water, negative financial impacts from relocation or losing business, distrust of information, perceived lack of support from response entities and uncertainty of long-term health impact caused significant disruption, stress and mental health. Individuals reported needing water, shelter, and mental health care while establishments wanted financial reimbursement and a resolution. CONCLUSIONS: The findings show that environmental disasters have significant disruptive and mental health impacts from stress. Identified themes can inform and improve emergency response and communication strategies and increase trust with community members during and after large chemical exposure events. |
Effectiveness of bivalent mrna vaccines in preventing symptomatic SARS-CoV-2 infection-increasing community access to testing program, United States, January-September 2023
Ciesla AA , Mak J , Roper LE , Fleming-Dutra KE , Smith ZR , Wiegand RE , Britton A , Miller J , Link-Gelles R . Influenza Other Respir Viruses 2024 18 (11) e70038 ![]() ![]() BACKGROUND: On September 2, 2022, bivalent COVID-19 mRNA vaccines, were recommended to address reduced effectiveness of COVID-19 monovalent vaccines during SARS-CoV-2 Omicron variant predominance. METHODS: Using national pharmacy-based SARS-CoV-2 testing program data from January 15 to September 11, 2023, this test-negative, case-control design study assessed bivalent COVID-19 vaccine effectiveness (VE) against symptomatic infection. RESULTS: VE against symptomatic infection of a bivalent dose between 2 weeks and 1 month after bivalent vaccination ranged from 46% (95% CI: 38%-52%) for those aged ≥ 65 years to 61% (95% CI 41%-75%) for those aged 12-17 years. CONCLUSION: Bivalent vaccines protected against symptomatic infection. However, effectiveness waned over time, emphasizing the need to stay up to date with COVID-19 vaccination. |
Association of mRNA COVID-19 vaccination and reductions in Post-COVID Conditions following SARS-CoV-2 infection in a US prospective cohort of essential workers
Mak J , Khan S , Britton A , Rose S , Gwynn L , Ellingson KD , Meece J , Feldstein L , Tyner H , Edwards L , Thiese MS , Naleway A , Gaglani M , Solle N , Burgess JL , Lamberte JM , Shea M , Hunt-Smith T , Caban-Martinez A , Porter C , Wiegand R , Rai R , Hegmann KT , Hollister J , Fowlkes A , Wesley M , Philips AL , Rivers P , Bloodworth R , Newes-Adeyi G , Olsho LEW , Yoon SK , Saydah S , Lutrick K . J Infect Dis 2024 ![]() ![]() BACKGROUND: While there is evidence that COVID-19 vaccination protects against development of post-COVID conditions (PCC) after severe infection data are limited on whether vaccination reduces the risk after cases of less-severe non-hospitalized COVID-19 disease with more recent SARS-CoV-2 variant viruses. This study assessed whether COVID-19 vaccination was protective against subsequent development of PCC in persons with predominantly mild initial infections during both Delta and Omicron variant predominance. METHODS: This study utilized a case-control design, nested within the HEROES-RECOVER cohort. Participants aged ≥18 years with PCR-confirmed SARS-CoV-2 infection between 6/28/2021 and 9/14/2022 were surveyed for PCC, defined by symptoms lasting >1 month after initial infection Cases were participants self-reporting PCC and controls were participants that did not self-report PCC. The exposure was mRNA COVID-19 vaccination (2 or 3 monovalent doses) versus no COVID-19 vaccination. Logistic regression was used to compare the odds of PCC among vaccinated and unvaccinated persons; additional analyses evaluating PCC subtypes were also performed. RESULTS: A total of 936 participants with documented SARS-CoV-2 infection were included; of these 23.6% (221) reported PCC and 83.3% (779) were vaccinated. Participants who received a 3rd COVID-19 monovalent mRNA dose prior to infection had lower odds of PCC-related gastrointestinal, neurological, and other symptoms compared to unvaccinated participants (aOR: 0.37; 95% CI: 0.16-0.85; aOR: 0.56; 95% CI: 0.32-0.97; aOR:0.48; 95% CI: 0.25-0.91). CONCLUSIONS: COVID-19 vaccination protected against development of PCC among persons with mild infection during both Delta and Omicron variant predominance, supporting vaccination as an important tool for PCC prevention. |
Changes to virus taxonomy and the ICTV statutes ratified by the International Committee on Taxonomy of Viruses (2024)
Simmonds P , Adriaenssens EM , Lefkowitz EJ , Oksanen HM , Siddell SG , Zerbini FM , Alfenas-Zerbini P , Aylward FO , Dempsey DM , Dutilh BE , Freitas-Astúa J , García ML , Hendrickson RC , Hughes HR , Junglen S , Krupovic M , Kuhn JH , Lambert AJ , Łobocka M , Mushegian AR , Penzes J , Muñoz AR , Robertson DL , Roux S , Rubino L , Sabanadzovic S , Smith DB , Suzuki N , Turner D , Van Doorslaer K , Vandamme AM , Varsani A . Arch Virol 2024 169 (11) 236 ![]() This article reports changes to virus taxonomy and taxon nomenclature that were approved and ratified by the International Committee on Taxonomy of Viruses (ICTV) in April 2024. The entire ICTV membership was invited to vote on 203 taxonomic proposals that had been approved by the ICTV Executive Committee (EC) in July 2023 at the 55th EC meeting in Jena, Germany, or in the second EC vote in November 2023. All proposals were ratified by online vote. Taxonomic additions include one new phylum (Ambiviricota), one new class, nine new orders, three new suborders, 51 new families, 18 new subfamilies, 820 new genera, and 3547 new species (excluding taxa that have been abolished). Proposals to complete the process of species name replacement to the binomial (genus + species epithet) format were ratified. Currently, a total of 14,690 virus species have been established. |
Notes from the field: Trichophyton mentagrophytes genotype VII - New York City, April-July 2024
Zucker J , Caplan AS , Gunaratne SH , Gallitano SM , Zampella JG , Otto C , Sally R , Chaturvedi S , O'Brien B , Todd GC , Anand P , Quilter LAS , Smith DJ , Chiller T , Lockhart SR , Lyman M , Pathela P , Gold JAW . MMWR Morb Mortal Wkly Rep 2024 73 (43) 985-988 ![]() |
Next-generation 3D printed multipurpose prevention intravaginal ring for prevention of HIV, HSV-2, and unintended pregnancy
Dahl DK , Srinivasan P , Janusziewicz R , King JL , Shrivastava R , Zhang J , Little D , Bachman S , Kelley K , Cottrell ML , Schauer AP , Sykes C , Kashuba ADM , Smith J , Benhabbour SR . J Control Release 2024 Globally, nearly half of all pregnancies are unintended, ~1.3 million new human immunodeficiency virus (HIV) infections are reported every year, and more than 500 million people are estimated to have a genital herpes simplex virus (HSV-2) infection. Here we report the first 3D printed multipurpose prevention technology (MPT) intravaginal ring (IVR) for prevention of HIV, HSV-2, and unintended pregnancy. The IVRs were fabricated using state-of-the-art Continuous Liquid Interface Production (CLIP™) 3D printing technology using a biocompatible silicone-urethane based resin. Anti-HIV drug (Dapivirine, DPV), anti-herpes drug (Pritelivir, PTV) and a contraceptive drug (Levonorgestrel, LNG) were loaded in a macaque size IVR (25 mm outer diameter, OD; 6.0 mm cross-section, CS) allometrically scaled from the human size (54 mm OD; 7.6 mm CS) IVR analogue. All three active pharmaceutical ingredients (APIs) were loaded in the IVR using a single-step drug loading process driven by absorption. DPV, PTV, and LNG elicited zero-order release kinetics in vitro in simulated vaginal fluid (SVF) at pH 4 and pH 8 relevant to human and macaque vaginal pH respectively. CLIP 3D printed MPT IVRs remained stable after 6 months of storage at 4 °C with no change in physical, dimensional, or mechanical properties and no change in drug concentration and absence of drug degradation byproducts. The MPT IVRs elicited sustained release of all three APIs in macaques for 28 days with median plasma concentrations of 138 pg/mL (DPV), 18,700 pg/mL (PTV), and 335 pg/mL (LNG). Safety studies demonstrated that the MPT IVRs were safe and well tolerated in the macaques with no observed change or abnormalities in vaginal pH and no significant changes in any of the 22 mucosal cytokines and chemokines tested including pro-inflammatory (IL-1β, IL-6, IL-8, IFN-γ, TNF-α, IL-17, IL-18) and anti-inflammatory (IL-10, IL-12) cytokines while the MPT IVR was in place or after its removal. Additionally, MPT IVRs elicited no observed alterations in systemic CD4+ and CD8+ T cells during the entire study. Collectively, the proposed MPT IVR has potential to expand preventative choices for young women and girls against unintended pregnancy against two highly prevalent sexually transmitted infections (STIs). |
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. |
Prescribing of clotrimazole-betamethasone dipropionate, a topical combination corticosteroid-antifungal product, for Medicare part D beneficiaries, United States, 2016-2022
Currie DW , Caplan AS , Benedict K , Hatfield KM , Smith DJ , Lipner SR , Gold JAW . Antimicrob Steward Healthc Epidemiol 2024 4 (1) e174 During 2016-2022, Medicare part D beneficiaries filled 8,674,460 clotrimazole-betamethasone dipropionate prescriptions. Annual rates were stable (30.9 prescriptions/1,000 beneficiary-years in 2022, enough for one in every 33 beneficiaries). Diagnostic testing was infrequent, particularly among internal medicine, family medicine, and general practitioners, suggesting potential opportunities to improve diagnostic and prescribing practices. |
Two outbreaks of Legionnaires disease associated with outdoor hot tubs for private use - two cruise ships, November 2022-July 2024
Lee S , Edens C , Ritter T , Rodriguez LO , Tardivel K , Kozak-Muiznieks NA , Willby M , Ortiz N , Cohen AL , Smith JC . MMWR Morb Mortal Wkly Rep 2024 73 (42) 950-954 Legionnaires disease is a serious pneumonia caused by Legionella bacteria. During November 2022-June 2024, CDC was notified of 12 cases of Legionnaires disease among travelers on two cruise ships; eight on cruise ship A and four on cruise ship B. CDC, in collaboration with the cruise lines, initiated investigations to ascertain the potential sources of on-board exposure after notification of the second potentially associated case for each ship. Epidemiologic data collected from patient interviews and environmental assessment and sampling results identified private hot tubs on selected cabin balconies as the most likely exposure source. To minimize Legionella growth, both cruise lines modified the operation and maintenance of these devices by removing the heating elements, draining water between uses, and increasing the frequency of hyperchlorination and cleaning. Hot tubs offer favorable conditions for Legionella growth and transmission when maintained and operated inadequately, regardless of location. Private hot tubs on cruise ships are not subject to the same maintenance requirements as are public hot tubs in common areas. Given the range of hot tub-type devices offered as amenities across the cruise industry, to reduce risk for Legionella growth and transmission, it is important for cruise ship water management program staff members to inventory and assess private balcony hot tubs and adapt public hot tub maintenance and operations protocols for use on private outdoor hot tubs. |
Genomic surveillance for SARS-CoV-2 variants: Circulation of Omicron XBB and JN.1 lineages - United States, May 2023-September 2024
Ma KC , Castro J , Lambrou AS , Rose EB , Cook PW , Batra D , Cubenas C , Hughes LJ , MacCannell DR , Mandal P , Mittal N , Sheth M , Smith C , Winn A , Hall AJ , Wentworth DE , Silk BJ , Thornburg NJ , Paden CR . MMWR Morb Mortal Wkly Rep 2024 73 (42) 938-945 ![]() ![]() CDC continues to track the evolution of SARS-CoV-2, including the Omicron variant and its descendants, using national genomic surveillance. This report summarizes U.S. trends in variant proportion estimates during May 2023-September 2024, a period when SARS-CoV-2 lineages primarily comprised descendants of Omicron variants XBB and JN.1. During summer and fall 2023, multiple descendants of XBB with immune escape substitutions emerged and reached >10% prevalence, including EG.5-like lineages by June 24, FL.1.5.1-like lineages by August 5, HV.1 lineage by September 30, and HK.3-like lineages by November 11. In winter 2023, the JN.1 variant emerged in the United States and rapidly attained predominance nationwide, representing a substantial genetic shift (>30 spike protein amino acid differences) from XBB lineages. Descendants of JN.1 subsequently circulated and reached >10% prevalence, including KQ.1-like and KP.2-like lineages by April 13, KP.3 and LB.1-like lineages by May 25, and KP.3.1.1 by July 20. Surges in COVID-19 cases occurred in winter 2024 during the shift to JN.1 predominance, as well as in summer 2023 and 2024 during circulation of multiple XBB and JN.1 descendants, respectively. The ongoing evolution of the Omicron variant highlights the importance of continued genomic surveillance to guide medical countermeasure development, including the selection of antigens for updated COVID-19 vaccines. |
The trajectory of antibody responses one year following SARS-CoV-2 infection among indigenous individuals in the Southwest United States
Smith CP , Hartman RM , Kugler AM , Little V , Baker OR , Fairlie TA , Fernandez RE , Hagen MB , Honie E , Laeyendecker O , Midgley CM , Parker D , Sandoval M , Takahashi S , Hammitt LL , Sutcliffe CG . Viruses 2024 16 (10) SARS-CoV-2 antibody kinetics based on immunologic history is not fully understood. We analyzed anti-spike and anti-nucleocapsid antibody responses following acute infection in a cohort of Indigenous persons. The models of peak concentrations and decay rates estimated that one year after infection, participants would serorevert for anti-nucleocapsid antibodies and remain seropositive for anti-spike antibodies. The peak anti-spike concentrations were higher for individuals vaccinated prior to infection, but the decay rates were similar across immunologic status groups. Children had significantly lower peak anti-spike concentrations than adults. This study affirms the importance of continued vaccination to maintain high levels of immunity in the face of waning immunity. |
Locally acquired (autochthonous) mosquito-transmitted plasmodium vivax malaria - Saline County, Arkansas, September 2023
Courtney AP , Boyanton BL Jr , Strebeck PV , Blount K , Ledford S , Ridpath AD , Mace KE , Smith C , Garner K , Waters C , Cima MJ , Patil N , McElroy PD , Raphael BH , Sapp SGH , Qvarnstrom Y , Lenhart A , Sutcliffe A , Dulski TM , Rothfeldt L . MMWR Morb Mortal Wkly Rep 2024 73 (42) 646-649 ![]() ![]() A case of locally acquired (autochthonous) mosquito-transmitted Plasmodium vivax malaria was diagnosed in Arkansas in September 2023. This represents the 10th autochthonous case identified nationally in 2023, after 20 years without recorded local mosquitoborne malaria transmission in the United States. The public health response included case investigation, active case surveillance, mosquito surveillance and control, assessment of medical countermeasures, and clinical and public outreach. Prompt diagnosis and appropriate treatment of malaria can improve clinical outcomes and, in addition to vector control, minimize risk for local transmission. Clinicians should consider malaria among patients who have traveled to countries where malaria is endemic, or with unexplained fever regardless of travel history. Although the risk for autochthonous malaria in the United States remains very low, its reemergence highlights the importance of vectorborne disease preparedness and response. Examples of such efforts include improving awareness among clinicians, access to diagnostics and antimalarial medications, and capacity for mosquito surveillance and control. Collaboration and communication among CDC, health departments, local jurisdictions, clinicians, hospitals, laboratories, and the public can support rapid malaria diagnosis, prevention, and control. Before traveling internationally to areas where malaria is endemic, travelers should consult with their health care provider regarding recommended malaria prevention measures, including chemoprophylaxis and precautions to avoid mosquito bites, to reduce both personal and community risk. |
- Page last reviewed:Feb 1, 2024
- Page last updated:Jan 27, 2025
- Content source:
- Powered by CDC PHGKB Infrastructure