Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-5 (of 5 Records) |
Query Trace: Weber IB[original query] |
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Completeness of West Nile virus testing in patients with meningitis and encephalitis during an outbreak in Arizona, USA
Weber IB , Lindsey NP , Bunko-Patterson AM , Briggs G , Wadleigh TJ , Sylvester TL , Levy C , Komatsu KK , Lehman JA , Fischer M , Staples JE . Epidemiol Infect 2012 140 (9) 1632-6 SUMMARY: Accurate data on West Nile virus (WNV) cases help guide public health education and control activities, and impact regional WNV blood product screening procedures. During an outbreak of WNV disease in Arizona, records from patients with meningitis or encephalitis were reviewed to determine the proportion tested for WNV. Of 60 patients identified with meningitis or encephalitis, 24 (40%) were tested for WNV. Only 12 (28%) of 43 patients aged <50 years were tested for WNV compared to 12 (71%) of 17 patients aged 50 years (P<0.01). Patients with clinical signs of weakness or paralysis, elevated CSF protein, admitted to an inpatient facility, or discharged to a rehabilitation facility were also more likely to have WNV testing performed. The lack of testing in younger age groups and in those with less severe disease probably resulted in substantial underestimates of WNV neuroinvasive disease burden. |
Clinical recognition and management of tularemia in Missouri: a retrospective chart review of 121 cases
Weber IB , Turabelidze G , Patrick S , Griffith KS , Mead PS , Kugeler KJ . Clin Infect Dis 2012 55 (10) 1283-90 BACKGROUND: Clinical recognition of tularemia is essential for initiating prompt appropriate antibiotic treatment. Although fluoroquinolones have desirable attributes as a treatment option, there are limited data on efficacy in the U.S. setting. METHODS: To define the epidemiology of tularemia in Missouri, and to evaluate practices and outcomes of tularemia management in general, we conducted a detailed retrospective review and analysis of clinical records for patients reported to the State from 2000-2007. RESULTS: We reviewed records of 121 (64%) of 190 patients reported with tularemia; 79 (65%) were males; the median age was 37 years. Most patients presented with ulceroglandular (37%) and glandular (25%) forms of tularemia, followed by pneumonic (12%), typhoidal (10%), oculoglandular (3%), and oropharyngeal (2%) forms. Most cases (69%) were attributed to tick bites. Median incubation period was 3 days (range 1-9 days), and patients sought care after a median of three days of illness (range 0-44 days). Systemic disease occurred more commonly in older patients. Patients were prescribed tetracyclines (49%), aminoglycosides (47%), and fluoroquinolones (41%). Nine of ten patients treated with ciprofloxacin for ≥ 10 days recovered uneventfully, without accompanying aminoglycosides or tetracyclines. CONCLUSIONS: Tularemia is frequently initially misdiagnosed. A thorough exposure history, particularly for tick bites, and awareness of clinical features may prompt clinicians to consider tularemia and facilitate appropriate testing. Promising success with oral fluoroquinolones could provide an acceptable alternative to intravenous aminoglycosides or long courses of tetracyclines where clinically appropriate. |
Zoonotic infections among employees from Great Smoky Mountains and Rocky Mountain National Parks, 2008-2009
Adjemian J , Weber IB , McQuiston J , Griffith KS , Mead PS , Nicholson W , Roche A , Schriefer M , Fischer M , Kosoy O , Laven JJ , Stoddard RA , Hoffmaster AR , Smith T , Bui D , Wilkins PP , Jones JL , Gupton PN , Quinn CP , Messonnier N , Higgins C , Wong D . Vector Borne Zoonotic Dis 2012 12 (11) 922-31 U.S. National Park Service employees may have prolonged exposure to wildlife and arthropods, placing them at increased risk of infection with endemic zoonoses. To evaluate possible zoonotic risks present at both Great Smoky Mountains (GRSM) and Rocky Mountain (ROMO) National Parks, we assessed park employees for baseline seroprevalence to specific zoonotic pathogens, followed by evaluation of incident infections over a 1-year study period. Park personnel showed evidence of prior infection with a variety of zoonotic agents, including California serogroup bunyaviruses (31.9%), Bartonella henselae (26.7%), spotted fever group rickettsiae (22.2%), Toxoplasma gondii (11.1%), Anaplasma phagocytophilum (8.1%), Brucella spp. (8.9%), flaviviruses (2.2%), and Bacillus anthracis (1.5%). Over a 1-year study period, we detected incident infections with leptospirosis (5.7%), B. henselae (5.7%), spotted fever group rickettsiae (1.5%), T. gondii (1.5%), B. anthracis (1.5%), and La Crosse virus (1.5%) in staff members at GRSM, and with spotted fever group rickettsiae (8.5%) and B. henselae (4.3%) in staff at ROMO. The risk of any incident infection was greater for employees who worked as resource managers (OR 7.4; 95% CI 1.4,37.5; p=0.02), and as law enforcement rangers/rescue crew (OR 6.5; 95% CI 1.1,36.5; p=0.03), relative to those who worked primarily in administration or management. The results of this study increase our understanding of the pathogens circulating within both parks, and can be used to inform the development of effective guidelines and interventions to increase visitor and staff awareness and help prevent exposure to zoonotic agents. |
Lack of interference by zoster vaccine with the immune response to yellow fever vaccine
Stier DM , Weber IB , Staples JE . J Travel Med 2012 19 (2) 122-3 Concerns exist about the serologic response to yellow fever (YF) vaccine when given within 28 days of another live virus vaccine. We report the case of a healthy adult who received 17D YF vaccine 21 days following administration of another live viral vaccine, and developed a protective level of immunity against YF virus. |
Primary pneumonic plague contracted from a mountain lion carcass
Wong D , Wild MA , Walburger MA , Higgins CL , Callahan M , Czarnecki LA , Lawaczeck EW , Levy CE , Patterson JG , Sunenshine R , Adem P , Paddock CD , Zaki SR , Petersen JM , Schriefer ME , Eisen RJ , Gage KL , Griffith KS , Weber IB , Spraker TR , Mead PS . Clin Infect Dis 2009 49 (3) e33-8 BACKGROUND: Primary pneumonic plague is a rare but often fatal form of Yersinia pestis infection that results from direct inhalation of bacteria and is potentially transmissible from person to person. We describe a case of primary pneumonic plague in a wildlife biologist who was found deceased in his residence 1 week after conducting a necropsy on a mountain lion. METHODS: To determine cause of death, a postmortem examination was conducted, and friends and colleagues were interviewed. Physical evidence was reviewed, including specimens from the mountain lion and the biologist's medical chart, camera, and computer. Human and animal tissues were submitted for testing. Persons in close contact (within 2 meters) to the biologist after he had developed symptoms were identified and offered chemoprophylaxis. RESULTS: The biologist conducted the necropsy in his garage without the use of personal protective equipment. Three days later, he developed fever and hemoptysis and died approximately 6 days after exposure. Gross examination showed consolidation and hemorrhagic fluid in the lungs; no buboes were noted. Plague was diagnosed presumptively by polymerase chain reaction and confirmed by culture. Tissues from the mountain lion tested positive for Y. pestis, and isolates from the biologist and mountain lion were indistinguishable by pulsed-field gel electrophoresis. Among 49 contacts who received chemoprophylaxis, none developed symptoms consistent with plague. CONCLUSIONS: The biologist likely acquired pneumonic plague through inhalation of aerosols generated during postmortem examination of an infected mountain lion. Enhanced awareness of zoonotic diseases and appropriate use of personal protective equipment are needed for biologists and others who handle wildlife. |
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