Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-2 (of 2 Records) |
Query Trace: Stern EJ[original query] |
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Meningococcal carriage among Georgia and Maryland high school students
Harrison LH , Shutt KA , Arnold KE , Stern EJ , Pondo T , Kiehlbauch JA , Myers RA , Hollick RA , Schmink S , Vello M , Stephens DS , Messonnier NE , Mayer L , Clark TA . J Infect Dis 2014 211 (11) 1761-8 BACKGROUND: Meningococcal disease incidence in the U.S. is at an all-time low. In a previous study of Georgia high school students, meningococcal carriage prevalence was 7%. The purpose of this study was to measure the impact of a meningococcal conjugate vaccine on serogroup Y meningococcal carriage and to define the dynamics of carriage in high school students. METHODS: This was a prospective cohort study at 8 high schools, 4 each in Maryland and Georgia during a school year. In each state, 2 high schools were randomized for participating students to receive MCV4-DT at the beginning of the study and 2 at the end. Oropharyngeal swab cultures for meningococcal carriage were performed three times during the school year. RESULTS: Among 3,311 students, prevalence of meningococcal carriage was 3.21%- 4.01%. Phenotypically non-groupable strains accounted for 88% of carriage isolates. There were only 5 observed acquisitions of serogroup Y strains during the study; therefore, the impact of MCV4-DT on meningococcal carriage could not be determined. CONCLUSIONS: Meningococcal carriage rates in U.S. high school students were lower than expected and the vast majority of strains did not express capsule. These findings may help explain the historically low incidence of meningococcal disease in the U.S. |
Outbreak of leptospirosis among adventure race participants in Florida, 2005
Stern EJ , Galloway R , Shadomy SV , Wannemuehler K , Atrubin D , Blackmore C , Wofford T , Wilkins PP , Ari MD , Harris L , Clark TA . Clin Infect Dis 2010 50 (6) 843-9 BACKGROUND: On 21 November 2005, a 32-year-old male resident of New York was hospitalized with suspected leptospirosis. He had participated in an endurance-length swamp race on 4-5 November 2005 outside of Tampa, Florida. METHODS: We interviewed racers to assess illness, medical care, and race activities. A suspected case was defined as fever plus 2 signs or symptoms of leptospirosis occurring in a racer after 4 November 2005. Individuals with suspected cases were referred for treatment as needed and were asked to submit serum samples for microscopic agglutination testing (MAT) and for rapid testing by the dot enzyme-linked immunosorbent assay dipstick immunoglobulin M immunoassay. RESULTS: The Centers for Disease Control and Prevention and participating state health departments interviewed 192 (96%) of 200 racers from 32 states and Canada. Forty-four (23%) of 192 racers met the definition for a suspected case. The median age of the patients was 37 years (range, 19-66 years), and 128 (66.7%) were male. Fourteen (45%) of the 31 patients with suspected cases who were tested had their cases confirmed by serological testing (a single sample with MAT titer 400), including the index case patient. Organisms of a potential novel serovar (species Leptospira noguchii) were isolated in culture from 1 case patient. Factors associated with increased risk of leptospirosis included swallowing river water (odds ratio [OR], 3.4; 95% confidence interval [CI], 1.6-7.0), swallowing swamp water (OR, 2.4; 95% CI, 1.1-5.2), and being submerged in any water (OR, 2.3; 95% CI, 1.1-4.7). CONCLUSIONS: This report describes a leptospirosis outbreak that resulted in a high rate of symptomatic infection among adventure racers in Florida. The growing popularity of adventure sports may put more people at risk for leptospirosis, even in areas that have not previously been considered areas of leptospirosis endemicity. |
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