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Fagre AC, Soto RA, Magleby R, Cuadera MKQ, Sun A, Cervantes K, Crans SC, Panella NA, Kenney JL, Angelus A, Burkhalter KL, Woell D, Horiuchi K, Biggerstaff BJ, Staples JE, Connelly R, Martin SW, Komar N. Enhancing Eastern Equine Encephalitis Virus Surveillance in New Jersey: Optimized Collection of Culiseta Melanura. J Am Mosq Control Assoc 2024:499851. [PMID: 38587266 DOI: 10.2987/23-7148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Eastern equine encephalitis virus (EEEV) causes the most clinically severe neuroinvasive arboviral disease in the United States. The virus is endemic in eastern and Gulf Coast states and the Great Lakes region, causing cases annually. To detect EEEV circulation in its enzootic cycle before the virus infects humans and other mammals, mosquito control agencies in New Jersey have conducted mosquito surveillance using a series of permanent wooden resting box sites since 1975. We conducted 2 field studies, 1 evaluating resting traps and 1 evaluating efficacy of CO2 lures, to optimize collection of Culiseta melanura, the primary enzootic vector of EEEV. Resulting mosquito samples were subjected to molecular analysis to determine EEEV infection rates. Corrugated plastic boxes trapped more bloodfed Cs. melanura than other resting trap types (resting boxes, Centers for Disease Control and Prevention [CDC] resting traps, or fiber pots) and were similar to resting boxes in total number of female Cs. melanura caught. Further, non-baited CDC light traps were more successful in trapping host-seeking Cs. melanura than those baited with dry ice, a CO2 lure. The EEEV RNA was identified in Cs. melanura, Aedes vexans, Anopheles quadrimaculatus, and Uranotaenia sapphirina. Our findings indicate that corrugated plastic boxes and non-CO2 baited traps could improve detection of Cs. melanura. Mosquito control agencies are encouraged to periodically assess their surveillance strategy for EEEV.
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Taylor ML, Kersh GJ, Salzer JS, Jones ES, Binder AM, Armstrong PA, Choudhary SK, Commins GK, Amelio CL, Biggerstaff BJ, Beard CB, Petersen LR, Commins SP. Intrinsic risk factors for alpha-gal syndrome in a case-control study, 2019 to 2020. Ann Allergy Asthma Immunol 2024:S1081-1206(24)00074-7. [PMID: 38341029 DOI: 10.1016/j.anai.2024.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/24/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Alpha-gal syndrome (AGS) is an allergy to galactose-α-1,3-galactose (alpha-gal), a carbohydrate found in most mammals. Evidence indicates that AGS develops after a tick bite, and in the United States, AGS is most associated with bites from Amblyomma americanum (lone star tick); however, not all persons bitten by ticks develop clinical AGS. OBJECTIVE To investigate intrinsic risk factors associated with the development of AGS. METHODS We performed a case-control study among adults presenting for diagnosis or management of AGS at an allergy clinic in North Carolina during 2019 to 2020 and compared them with controls enrolled from 2 nearby internal medicine clinics. A questionnaire gathered epidemiologic and tick exposure data, and blood was obtained for alpha-gal-specific IgE and other testing. RESULTS The 82 enrolled case patients and 191 controls did not differ significantly by age or sex. Case patients were more likely than controls to have A or O blood types (non B-antigen), have experienced childhood allergies, and have a family history of AGS and other food allergies. Case patients were also more likely to report experiencing long healing times for insect bites or stings and a family history of allergy to stinging or biting insects. CONCLUSION This study suggested that intrinsic factors contribute to risk of developing AGS. Some traits are genetic, but common behaviors among households and family units likely also contribute. Identification of these risk factors can inform personal risk, aid health care providers in understanding susceptible populations, and contribute to ongoing understanding of AGS epidemiology.
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Affiliation(s)
- Marissa L Taylor
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Gilbert J Kersh
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Johanna S Salzer
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Emma S Jones
- Office of the Director, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Alison M Binder
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Paige A Armstrong
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Shailesh K Choudhary
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Grace K Commins
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Claire L Amelio
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Brad J Biggerstaff
- Office of the Director, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Charles B Beard
- Office of the Director, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Lyle R Petersen
- Office of the Director, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Scott P Commins
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
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Powers JA, Boroughs KL, Mikula S, Goodman CH, Davis EH, Thrasher EM, Hughes HR, Biggerstaff BJ, Calvert AE. Characterization of a monoclonal antibody specific to California serogroup orthobunyaviruses and development as a chimeric immunoglobulin M-positive control in human diagnostics. Microbiol Spectr 2023; 11:e0196623. [PMID: 37668403 PMCID: PMC10581219 DOI: 10.1128/spectrum.01966-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 07/18/2023] [Indexed: 09/06/2023] Open
Abstract
California serogroup viruses (CSGVs) of medical importance in the United States include La Crosse virus, Jamestown Canyon virus (JCV), California encephalitis virus, and snowshoe hare virus. Current diagnosis of CSGVs relies heavily on serologic techniques for detecting immunoglobulin M (IgM), an indication of a recent CSGV infection. However, human-positive control sera reactive to viruses in the serogroup are scarce because detection of recent infections is rare. Here, we describe the development of new murine monoclonal antibodies (MAbs) reactive to CSGVs and the engineering of a human-murine chimeric antibody by combining the variable regions of the broadly CSGV cross-reactive murine MAb, 3-3B6/2-3B2 and the constant region of the human IgM. MAb 3-3B6/2-3B2 recognizes a tertiary epitope on the Gn/Gc heterodimer, and epitopes important in JCV neutralization were mapped to the Gc glycoprotein. This engineered human IgM constitutively expressed in a HEK-293 stable cell line can replace human-positive control sera in diagnostic serological techniques such as IgM antibody capture enzyme-linked immunosorbent assay (MAC-ELISA). Compared to the parent murine MAbs, the human-chimeric IgM antibody had identical serological activity to CSGVs in ELISA and demonstrated equivalent reactivity compared to human immune sera in the MAC-ELISA.IMPORTANCEOrthobunyaviruses in the California serogroup cause severe neurological disease in children and adults. While these viruses are known to circulate widely in North America, their occurrence is rare. Serological testing for CSGVs is hindered by the limited availability and volumes of human-positive specimens needed as controls in serologic assays. Here, we described the development of a murine monoclonal antibody cross-reactive to CSGVs engineered to contain the variable regions of the murine antibody on the backbone of human IgM. The chimeric IgM produced from the stably expressing HEK293 cell line was evaluated for use as a surrogate human-positive control in a serologic diagnostic test.
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Affiliation(s)
- Jordan A. Powers
- Division of Vector-Borne Diseases, U.S. Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Karen L. Boroughs
- Division of Vector-Borne Diseases, U.S. Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Sierra Mikula
- Division of Vector-Borne Diseases, U.S. Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Christin H. Goodman
- Division of Vector-Borne Diseases, U.S. Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Emily H. Davis
- Division of Vector-Borne Diseases, U.S. Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Elisa M. Thrasher
- Division of Vector-Borne Diseases, U.S. Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Holly R. Hughes
- Division of Vector-Borne Diseases, U.S. Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Brad J. Biggerstaff
- Division of Vector-Borne Diseases, U.S. Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Amanda E. Calvert
- Division of Vector-Borne Diseases, U.S. Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
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Sulaeman H, Grebe E, Dave H, McCann L, Di Germanio C, Sanghavi A, Sclar V, Bougie DW, Chatelain G, Biggerstaff BJ, Jones JM, Thornburg NJ, Kleinman S, Stone M, Busch MP. Evaluation of Ortho VITROS and Roche Elecsys S and NC Immunoassays for SARS-CoV-2 Serosurveillance Applications. Microbiol Spectr 2023; 11:e0323422. [PMID: 37347180 PMCID: PMC10434072 DOI: 10.1128/spectrum.03234-22] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/04/2023] [Indexed: 06/23/2023] Open
Abstract
SARS-CoV-2 seroprevalence studies are instrumental in monitoring epidemic activity and require well-characterized, high-throughput assays, and appropriate testing algorithms. The U.S. Nationwide Blood Donor Seroprevalence Study performed monthly cross-sectional serological testing from July 2020 to December 2021, implementing evolving testing algorithms in response to changes in pandemic activity. With high vaccine uptake, anti-Spike (S) reactivity rates reached >80% by May 2021, and the study pivoted from reflex Roche anti-nucleocapsid (NC) testing of Ortho S-reactive specimens to parallel Ortho S/NC testing. We evaluated the performance of the Ortho NC assay as a replacement for the Roche NC assay and compared performance of parallel S/NC testing on both platforms. Qualitative and quantitative agreement of Ortho NC with Roche NC assays was evaluated on preselected S/NC concordant and discordant specimens. All 190 Ortho S+/Roche NC+ specimens were reactive on the Ortho NC assay; 34% of 367 Ortho S+/Roche NC- specimens collected prior to vaccine availability and 43% of 37 Ortho S-/Roche NC+ specimens were reactive on the Ortho NC assay. Performance of parallel S/NC testing using Ortho and Roche platforms was evaluated on 200 specimens collected in 2019 and 3,903 study specimens collected in 2021. All 200 pre-COVID-19 specimens tested negative on the four assays. Cross-platform agreement between Roche and Ortho platforms was 96.4% (3,769/3,903); most discordant results had reactivity close to the cutoffs on the alternate assays. These findings, and higher efficiency and throughput, support the use of parallel S/NC testing on either Roche or Ortho platforms for large serosurveillance studies. IMPORTANCE Seroprevalence studies like the U.S. Nationwide Blood Donor Seroprevalence Study (NBDS) have been critical in monitoring SARS-CoV-2 epidemic activity. These studies rely on serological assays to detect antibodies indicating prior infection. It is critical that the assays and testing algorithms used in seroprevalence studies have adequate performance (high sensitivity, high specificity, ability to discriminate vaccine-induced and infection-induced antibodies, etc.), as well as appropriate characteristics to support large-scale studies, such as high throughput and low cost. In this study we evaluated the performance of Ortho's anti-nucleocapsid assay as a replacement for the Roche anti-nucleocapsid assay and compared performance of parallel anti-spike and anti-nucleocapsid testing on both platforms. These data demonstrate similar performance of the Ortho and Roche anti-nucleocapsid assays and that parallel anti-spike and anti-nucleocapsid testing on either platform could be used for serosurveillance applications.
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Affiliation(s)
- Hasan Sulaeman
- Vitalant Research Institute, San Francisco, California, USA
| | - Eduard Grebe
- Vitalant Research Institute, San Francisco, California, USA
- SACEMA, Stellenbosch University, Stellenbosch, South Africa
| | - Honey Dave
- Vitalant Research Institute, San Francisco, California, USA
| | - Lily McCann
- Vitalant Research Institute, San Francisco, California, USA
| | | | - Aditi Sanghavi
- Vitalant Research Institute, San Francisco, California, USA
| | - Victoria Sclar
- Vitalant Research Institute, San Francisco, California, USA
| | | | | | | | - Jefferson M. Jones
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Natalie J. Thornburg
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Steve Kleinman
- University of British Columbia, Victoria, British Columbia, Canada
| | - Mars Stone
- Vitalant Research Institute, San Francisco, California, USA
- Department of Laboratory Medicine, University of California, San Francisco, California, USA
| | - Michael P. Busch
- Vitalant Research Institute, San Francisco, California, USA
- Department of Laboratory Medicine, University of California, San Francisco, California, USA
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Mac VV, Wong JM, Volkman HR, Perez-Padilla J, Wakeman B, Delorey M, Biggerstaff BJ, Fagre A, Gumbs A, Drummond A, Zimmerman B, Lettsome B, Medina FA, Paz-Bailey G, Lawrence M, Ellis B, Rosenblum HG, Carroll J, Roth J, Rossington J, Meeker JR, Joseph J, Janssen J, Ekpo LL, Carrillo M, Hernandez N, Charles P, Tosado R, Soto R, Battle S, Bart SM, Wanga V, Valentin W, Powell W, Battiste Z, Ellis EM, Adams LE. Notes From the Field: Prevalence of Previous Dengue Virus Infection Among Children and Adolescents - U.S. Virgin Islands, 2022. MMWR Morb Mortal Wkly Rep 2023; 72:288-289. [PMID: 36927833 PMCID: PMC10027406 DOI: 10.15585/mmwr.mm7211a4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
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Soto RA, Baldry E, Vahey GM, Lehman J, Silver M, Panella A, Brault AC, Hughes HR, Fitzpatrick KA, Velez J, Biggerstaff BJ, Wolff B, Randolph J, Ruth LJ, Staples JE, Gould CV. Increase in Colorado Tick Fever Virus Disease Cases and Effect of COVID-19 Pandemic on Behaviors and Testing Practices, Montana, 2020. Emerg Infect Dis 2023; 29:561-568. [PMID: 36732081 PMCID: PMC9973673 DOI: 10.3201/eid2903.221240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
In 2020, Montana, USA, reported a large increase in Colorado tick fever (CTF) cases. To investigate potential causes of the increase, we conducted a case-control study of Montana residents who tested positive or negative for CTF during 2020, assessed healthcare providers' CTF awareness and testing practices, and reviewed CTF testing methods. Case-patients reported more time recreating outdoors on weekends, and all reported finding a tick on themselves before illness. No consistent changes were identified in provider practices. Previously, only CTF serologic testing was used in Montana. In 2020, because of SARS-CoV-2 testing needs, the state laboratory sent specimens for CTF testing to the Centers for Disease Control and Prevention, where more sensitive molecular methods are used. This change in testing probably increased the number of CTF cases detected. Molecular testing is optimal for CTF diagnosis during acute illness. Tick bite prevention measures should continue to be advised for persons doing outdoor activities.
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Binder AM, Cherry-Brown D, Biggerstaff BJ, Jones ES, Amelio CL, Beard CB, Petersen LR, Kersh GJ, Commins SP, Armstrong PA. Clinical and laboratory features of patients diagnosed with alpha-gal syndrome-2010-2019. Allergy 2023; 78:477-487. [PMID: 36178236 PMCID: PMC10092820 DOI: 10.1111/all.15539] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 08/26/2022] [Accepted: 08/29/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Alpha-gal syndrome (AGS) is an IgE-mediated allergy to galactose-alpha-1,3-galactose. Clinical presentation ranges from hives to anaphylaxis; episodes typically occur 2-6 h after exposure to alpha-gal-containing products. In the United States, lone star tick bites are associated with the development of AGS. To characterize features of AGS, we evaluated a cohort of patients presenting for care at the University of North Carolina, focusing on symptoms, severity, and identifying features unique to specific alpha-gal-containing product exposures. METHODS We performed a chart review and descriptive analysis of 100 randomly selected patients with AGS during 2010-2019. RESULTS Median age at onset was 53 years, 56% were female, 95% reported White race, 86% reported a history of tick bite, and 75% met the criteria for anaphylaxis based on the involvement of ≥2 organ systems. Those reporting dairy reactions were significantly less likely to report isolated mucocutaneous symptoms (3% vs. 24%; ratio [95% CI]: 0.1 [0.1, 0.3]) than those who tolerated dairy, and were more likely to report gastrointestinal symptoms (79% vs. 59%; ratio [95% CI]: 1.3 [0.7, 2.6]), although this difference was not statistically significant. Dairy-tolerant patients demonstrated higher alpha-gal sIgE titers (as a percentage of total IgE) than dairy-reactive patients (GM 4.1 [95% CI: 2.7, 6.1] vs. GM 2.5 [95% CI: 1.3, 4.8], respectively; ratio -1.6 [95% CI: -1.0, 3.9]). CONCLUSION While tick exposure is common in the southern United States, nearly all AGS patients reported a tick bite. Gastrointestinal symptoms were prominent among those reporting reactions to dairy. Anaphylaxis was common, underscoring the severity and need to raise awareness of AGS among patients and providers.
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Affiliation(s)
- Alison M Binder
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Dena Cherry-Brown
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Brad J Biggerstaff
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Emma S Jones
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Claire L Amelio
- University of North Carolina, Chapel Hill, North Carolina, USA
| | - Charles B Beard
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Lyle R Petersen
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Gilbert J Kersh
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Scott P Commins
- University of North Carolina, Chapel Hill, North Carolina, USA
| | - Paige A Armstrong
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
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Kersh GJ, Salzer J, Jones ES, Binder AM, Armstrong PA, Choudhary SK, Commins GK, Amelio CL, Kato CY, Singleton J, Biggerstaff BJ, Beard CB, Petersen LR, Commins SP. Tick bite as a risk factor for alpha-gal specific IgE antibodies and development of alpha-gal syndrome. Ann Allergy Asthma Immunol 2022; 130:472-478. [PMID: 36574585 PMCID: PMC10148555 DOI: 10.1016/j.anai.2022.11.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND The disaccharide galactose-α-1,3-galactose (alpha-gal) is expressed in mammals other than humans, apes, and old-world monkeys. In humans, elevated immunoglobulin-E (IgE) antibodies specific for alpha-gal can result in allergic hypersensitivity known as alpha-gal syndrome (AGS). Case reports and series suggest that tick bites can induce alpha-gal specific IgE antibodies. OBJECTIVE Evaluate tick exposure as a risk factor for AGS and elevated alpha-gal specific IgE (sIgE). METHODS We conducted a case-control study comparing AGS patients from a North Carolina allergy clinic with controls who were patients at a nearby internal medicine clinic. Cases and controls were administered a questionnaire to obtain information about demographics, home environment, outdoor activities, and recollection of tick bite. Serum samples taken at the time of enrollment were tested for total IgE, alpha-gal sIgE, and antibodies to other tickborne pathogens. RESULTS AGS patients were more likely to recall finding a tick on themselves (OR=11.20, 95% CI 4.97-25.15), live near wooded forest (OR=2.27, 95% CI 0.92-5.55), and spend 17 or more hours per week outdoors in wooded areas (OR=5.58, 95% CI 2.56-12.19). AGS patients were also more likely to report 4 or more tick bites (OR=33.05, 95% CI 9.92-155.12) and reactions at the site of tick bites (OR=7.93, 95% CI 3.74-16.80). Elevated alpha-gal sIgE was also observed in 33% of controls and was also associated with tick exposure in the controls (OR=4.25, 95% CI 2.21-8.18). CONCLUSION The results define tick bite as a risk factor for AGS and elevated alpha-gal sIgE.
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Affiliation(s)
- Gilbert J Kersh
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329.
| | - Johanna Salzer
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329
| | - Emma S Jones
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, 80521
| | - Alison M Binder
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329
| | - Paige A Armstrong
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329
| | - Shailesh K Choudhary
- Division of Allergy, Immunology and Rheumatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Grace K Commins
- Division of Allergy, Immunology and Rheumatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Claire L Amelio
- Division of Allergy, Immunology and Rheumatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Cecilia Y Kato
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329
| | - Joseph Singleton
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329
| | - Brad J Biggerstaff
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, 80521
| | - Charles B Beard
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, 80521
| | - Lyle R Petersen
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, 80521
| | - Scott P Commins
- Division of Allergy, Immunology and Rheumatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC
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Condit ME, Jones E, Biggerstaff BJ, Kato CY. Procedure for spotted fever group Rickettsia isolation from limited clinical blood specimens. PLoS Negl Trop Dis 2022; 16:e0010781. [PMID: 36240222 PMCID: PMC9605293 DOI: 10.1371/journal.pntd.0010781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 10/26/2022] [Accepted: 08/30/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Current isolation techniques for spotted fever group Rickettsia from clinical samples are laborious and are limited to tissue, blood and blood derivatives with volumes ideally greater than 1 mL. We validated the use of simplified methodologies for spotted fever group Rickettsia culture isolation that overcome sample volume limitations and provide utility in clinical diagnostics and research studies. METHODOLOGY/PRINCIPAL FINDINGS A modified cell culture method is evaluated for the isolation of Rickettsia ssp. from human diagnostic samples. Culture sampling method, culture platform, and growth phase analysis were evaluated to determine best practices for optimal culture isolation conditions. Rickettsial isolates (R. conorii, R. rickettsii, and R. parkeri) were grown in Vero E6 cells over a course of 5 to 7 days at low inoculum treatments (~40 bacterial copies) to standardize the sampling strategy at a copy number reflective of the bacteremia in acute diagnostic samples. This methodology was verified using small volumes (50 μL) of 25 unprocessed clinical whole blood, plasma, and serum samples from acute samples of patients suspected of having Rocky Mountain Spotted Fever, of which 10 were previously confirmed positive via the PanR8 qPCR assay, 13 had no detectable Rickettsia DNA by the PanR8 qPCR assay, and 2 were not previously tested; these samples resulted in the cultivation of 7 new R. rickettsii isolates. CONCLUSIONS/SIGNIFICANCE We observed that rickettsial isolate growth in culture is reproducibly identified by real-time PCR testing of culture media within 72 hours after inoculation. Additionally, specimen sedimentation prior to isolation to remove red blood cells was found to decrease the amount of total organism available in the inoculum. A small volume culture method was established focusing on comparative qPCR detection rather than bacterial visualization, taking significantly shorter time to detect, and requiring less manipulation compared to traditional clinical isolate culture methods.
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Affiliation(s)
- Marah E. Condit
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Emma Jones
- Office of the Director, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, United States of America
| | - Brad J. Biggerstaff
- Office of the Director, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, United States of America
| | - Cecilia Y. Kato
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America,* E-mail:
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Busch MP, Stramer SL, Stone M, Yu EA, Grebe E, Notari E, Saa P, Ferg R, Manrique IM, Weil N, Fink RV, Levy M, Green V, Cyrus S, Williamson PC, Haynes J, Groves J, Krysztof D, Custer B, Kleinman S, Biggerstaff BJ, Opsomer JD, Jones JM. Population-Weighted Seroprevalence From Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection, Vaccination, and Hybrid Immunity Among US Blood Donations From January to December 2021. Clin Infect Dis 2022; 75:S254-S263. [PMID: 35684973 PMCID: PMC9214177 DOI: 10.1093/cid/ciac470] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Previous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19) vaccination, independently and combined ("hybrid immunity"), result in partial protection from subsequent infection and strong protection from severe disease. Proportions of the US population who have been infected, vaccinated, or have hybrid immunity remain unclear, posing a challenge for assessing effective pandemic mitigation strategies. METHODS In this serial cross-sectional study, nationwide blood donor specimens collected during January-December 2021 were tested for anti-spike and anti-nucleocapsid antibodies, and donor COVID-19 vaccination history of ≥1 dose was collected. Monthly seroprevalence induced from SARS-CoV-2 infection, COVID-19 vaccination, or both, were estimated. Estimates were weighted to account for demographic differences from the general population and were compared temporally and by demographic factors. RESULTS Overall, 1 123 855 blood samples were assayed. From January to December 2021, the weighted percentage of donations with seropositivity changed as follows: seropositivity due to vaccination without previous infection, increase from 3.5% (95% confidence interval, 3.4%-3.7%) to 64.0%, (63.5%-64.5%); seropositivity due to previous infection without vaccination, decrease from 15.6% (15.2%-16.0%) to 11.7% (11.4%-12.0%); and seropositivity due to hybrid immunity, increase from 0.7% (0.6%-0.7%) to 18.9% (18.5%-19.3%). Combined seroprevalence from infection, vaccination, or both increased from 19.8% (19.3%-20.2%) to 94.5% (93.5%-94.0%). Infection- and vaccination-induced antibody responses varied significantly by age, race-ethnicity, and region, but not by sex. CONCLUSIONS Our results indicate substantial increases in population humoral immunity from SARS-CoV-2 infection, COVID-19 vaccination, and hybrid immunity during 2021. These findings are important to consider in future COVID-19 studies and long-term pandemic mitigation efforts.
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Affiliation(s)
- Michael P. Busch
- Corresponding authors Michael P. Busch, MD. PhD Vitalant Research Institute 270 Masonic Avenue San Francisco, CA 94118
| | - Susan L. Stramer
- American Red Cross, Scientific Affairs, Gaithersburg and Rockville, Maryland, USA
| | - Mars Stone
- Vitalant Research Institute, San Francisco, California, USA,University of California San Francisco, San Francisco, California, USA
| | - Elaine A. Yu
- Vitalant Research Institute, San Francisco, California, USA,University of California San Francisco, San Francisco, California, USA
| | - Eduard Grebe
- Vitalant Research Institute, San Francisco, California, USA,University of California San Francisco, San Francisco, California, USA
| | - Edward Notari
- American Red Cross, Scientific Affairs, Gaithersburg and Rockville, Maryland, USA
| | - Paula Saa
- American Red Cross, Scientific Affairs, Gaithersburg and Rockville, Maryland, USA
| | | | | | | | | | | | | | | | | | - James Haynes
- American Red Cross, Scientific Affairs, Gaithersburg and Rockville, Maryland, USA
| | - Jamel Groves
- American Red Cross, Scientific Affairs, Gaithersburg and Rockville, Maryland, USA
| | - David Krysztof
- American Red Cross, Scientific Affairs, Gaithersburg and Rockville, Maryland, USA
| | - Brian Custer
- Vitalant Research Institute, San Francisco, California, USA,University of California San Francisco, San Francisco, California, USA
| | - Steve Kleinman
- Vitalant Research Institute, San Francisco, California, USA
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11
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Beck A, Bjork J, Biggerstaff BJ, Eisen L, Eisen R, Foster E, Signs K, Tsao JI, Kough E, Peterson M, Schiffman E, Muganda CP, Osborn R, Wozniak R, Bron GM, Phaneuf D, Smith D, Bartholomay L, Paskewitz S, Hinckley AF. Knowledge, attitudes, and behaviors regarding tick-borne disease prevention in Lyme disease-endemic areas of the Upper Midwest, United States. Ticks Tick Borne Dis 2022; 13:101925. [PMID: 35255349 PMCID: PMC10947721 DOI: 10.1016/j.ttbdis.2022.101925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 02/04/2022] [Accepted: 02/13/2022] [Indexed: 11/19/2022]
Abstract
Lyme disease and other tick-borne diseases are a major public health threat in the Upper Midwestern United States, including Michigan, Minnesota, and Wisconsin. To prevent tick bites and tick-borne diseases, public health officials commonly recommend personal protective measures and property management techniques. Adoption of tick-borne disease prevention behaviors and practices by individuals are, however, highly variable. We aimed to characterize current tick-borne disease knowledge, attitudes, and prevention behaviors (KAB) practiced by the public in these states, as well as their willingness to use specific tick control methods. We conducted a population-based survey in summer 2019 in 48 high-risk counties (those having a five-year average (2013-2017) Lyme disease incidence of ≥ 10 cases per 100,000 persons per year), in Michigan, Minnesota, and Wisconsin. A total of 2713 surveys were analyzed; survey weights were used to account for household selection probability and post-stratified to match county-level joint age and sex population distributions in population-level inference. An estimated 98% of the population had heard of Lyme disease, with most perceiving it as very or extremely serious (91%); however, only an estimated 25% perceived tick-borne diseases as very or extremely common in their community. Among those who spent time in places with ticks from April through October, an estimated 68% check themselves thoroughly for ticks most of the time or always and 43% use bug repellent on skin or clothing most of the time or always. An estimated 13% of the population had ever treated their property with a pesticide to kill ticks, and 3% had ever used devices that apply pesticide to rodents to kill ticks on their property. Willingness to practice tick bite prevention behaviors, however, was estimated to be much higher; with 82% being willing to perform tick checks at least once a day, and more than 60% willing to use bug repellent, tick control products on pets, or to bathe within two hours of being outdoors. We found that residents would likely be willing to support a county-wide tick control program to reduce the risk of tick-borne disease in their community (81%) or to apply tick control products to their property to reduce the risk of tick-borne disease in their household (79%). Tick checks were more likely to be practiced among participants who perceived tick-borne diseases to be highly prevalent in their community, if they or a household member had been previously diagnosed with a tick-borne disease?, or if they perceived tick exposure to be likely around their home, cabin, or vacation home. In addition, property-based tick control methods were associated with perceived risk of encountering ticks around the home, cabin, or vacation home. Participants who had seen information from state health departments were also more likely to practice preventive measures. The most common reported barriers to using any of these methods were forgetfulness, safety concerns, and lack of awareness. Our survey findings shed light on how residents from these Upper Midwest states may adopt tick control and tick bite prevention measures and how public health outreach may be most effective for this population.
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Affiliation(s)
- Alyssa Beck
- Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, 3156 Rampart Road, Fort Collins, CO 80521, United States; Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN, United States
| | - Jenna Bjork
- Minnesota Department of Health, 625 Robert Street North, Saint Paul, MN 55155, United States
| | - Brad J Biggerstaff
- Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, 3156 Rampart Road, Fort Collins, CO 80521, United States
| | - Lars Eisen
- Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, 3156 Rampart Road, Fort Collins, CO 80521, United States
| | - Rebecca Eisen
- Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, 3156 Rampart Road, Fort Collins, CO 80521, United States
| | - Erik Foster
- Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, 3156 Rampart Road, Fort Collins, CO 80521, United States
| | - Kimberly Signs
- Michigan Department of Health and Human Services, 333 South Grand Avenue, South Grand Building, Lansing, MI 48933, United States
| | - Jean I Tsao
- Michigan State University, Department of Fisheries and Wildlife and Department of Large Animal Clinical Sciences, 480 Wilson Road, Natural Resources Building, East Lansing, MI 48824, United States
| | - Erin Kough
- Minnesota Department of Health, 625 Robert Street North, Saint Paul, MN 55155, United States
| | - Molly Peterson
- Minnesota Department of Health, 625 Robert Street North, Saint Paul, MN 55155, United States
| | - Elizabeth Schiffman
- Minnesota Department of Health, 625 Robert Street North, Saint Paul, MN 55155, United States
| | - Christine P Muganda
- Wisconsin Department of Health Services, 1 West Wilson Street, Madison, WI 53703, United States
| | - Rebecca Osborn
- Wisconsin Department of Health Services, 1 West Wilson Street, Madison, WI 53703, United States
| | - Ryan Wozniak
- Wisconsin Department of Health Services, 1 West Wilson Street, Madison, WI 53703, United States
| | - Gebbiena M Bron
- University of Wisconsin-Madison, 1656 Linden Drive, Madison, WI 53706, United States
| | - Daniel Phaneuf
- University of Wisconsin-Madison, 1656 Linden Drive, Madison, WI 53706, United States
| | - Danielle Smith
- University of Wisconsin-Madison, 1656 Linden Drive, Madison, WI 53706, United States
| | - Lyric Bartholomay
- University of Wisconsin-Madison, 1656 Linden Drive, Madison, WI 53706, United States
| | - Susan Paskewitz
- University of Wisconsin-Madison, 1656 Linden Drive, Madison, WI 53706, United States
| | - Alison F Hinckley
- Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, 3156 Rampart Road, Fort Collins, CO 80521, United States.
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12
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Stone M, Grebe E, Sulaeman H, Di Germanio C, Dave H, Kelly K, Biggerstaff BJ, Crews BO, Tran N, Jerome KR, Denny TN, Hogema B, Destree M, Jones JM, Thornburg N, Simmons G, Krajden M, Kleinman S, Dumont LJ, Busch MP. Evaluation of Commercially Available High-Throughput SARS-CoV-2 Serologic Assays for Serosurveillance and Related Applications. Emerg Infect Dis 2022; 28:672-683. [PMID: 35202525 PMCID: PMC8888213 DOI: 10.3201/eid2803.211885] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serosurveys can estimate cumulative incidence for monitoring epidemics, requiring assessment of serologic assays to inform testing algorithm development and interpretation of results. We conducted a multilaboratory evaluation of 21 commercial high-throughput SARS-CoV-2 serologic assays using blinded panels of 1,000 highly characterized specimens. Assays demonstrated a range of sensitivities (96%–63%), specificities (99%–96%), and precision (intraclass correlation coefficient 0.55–0.99). Durability of antibody detection was dependent on antigen and immunoglobulin targets; antispike and total Ig assays demonstrated more stable longitudinal reactivity than antinucleocapsid and IgG assays. Assays with high sensitivity, specificity, and durable antibody detection are ideal for serosurveillance, but assays demonstrating waning reactivity are appropriate for other applications, including correlation with neutralizing activity and detection of anamnestic boosting by reinfections. Assay performance must be evaluated in context of intended use, particularly in the context of widespread vaccination and circulation of SARS-CoV-2 variants.
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13
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Hook SA, Hansen AP, Niesobecki SA, Meek JI, Bjork JKH, Kough EM, Peterson MS, Schiffman EK, Rutz HJ, Rowe AJ, White JL, Peel JL, Biggerstaff BJ, Hinckley AF. Evaluating public acceptability of a potential Lyme disease vaccine using a population-based, cross-sectional survey in high incidence areas of the United States. Vaccine 2021; 40:298-305. [PMID: 34895785 DOI: 10.1016/j.vaccine.2021.11.065] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 11/09/2021] [Accepted: 11/22/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Lyme disease incidence is increasing, despite current prevention options. New Lyme disease vaccine candidates are in development, however, investigation of the acceptability of a Lyme disease vaccine among potential consumers is needed prior to any vaccine coming to market. We conducted a population-based, cross-sectional study to estimate willingness to receive a potential Lyme disease vaccine and factors associated with willingness. METHODS The web-based survey was administered to a random sample of Connecticut, Maryland, Minnesota, and New York residents June-July 2018. Survey-weighted descriptive statistics were conducted to estimate the proportion willing to receive a potential Lyme disease vaccine. Multivariable multinomial logistic regression models were used to quantify the association of sociodemographic characteristics and Lyme disease vaccine attitudes with willingness to be vaccinated. RESULTS Surveys were completed by 3313 respondents (6% response rate). We estimated that 64% of residents were willing to receive a Lyme disease vaccine, while 30% were uncertain and 7% were unwilling. Compared to those who were willing, those who were uncertain were more likely to be parents, adults 45-65 years old, non-White, have less than a bachelor's degree, or have safety concerns about a potential Lyme disease vaccine. Those who were unwilling were also more likely to be non-White, have less than a bachelor's degree, or have safety concerns about a potential Lyme disease vaccine. In addition, the unwilling had low confidence in vaccines in general, had low perceived risk of contracting Lyme disease, and said they would not be influenced by a positive recommendation from a healthcare provider. DISCUSSION Overall, willingness to receive a Lyme disease vaccine was high. Effective communication by clinicians regarding safety and other vaccine parameters to those groups who are uncertain will be critical for increasing vaccine uptake and reducing Lyme disease incidence.
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Affiliation(s)
- Sarah A Hook
- Centers for Disease Control and Prevention, Division of Vector-borne Diseases, 3156 Rampart Rd., Fort Collins, CO 80521, USA.
| | - AmberJean P Hansen
- Connecticut Emerging Infections Program, Yale School of Public Health, One Church Street, 7th Floor, New Haven, CT 06510, USA.
| | - Sara A Niesobecki
- Connecticut Emerging Infections Program, Yale School of Public Health, One Church Street, 7th Floor, New Haven, CT 06510, USA.
| | - James I Meek
- Connecticut Emerging Infections Program, Yale School of Public Health, One Church Street, 7th Floor, New Haven, CT 06510, USA.
| | - Jenna K H Bjork
- Minnesota Department of Health, 625 Robert St N, St Paul, MN 55164, USA.
| | - Erin M Kough
- Minnesota Department of Health, 625 Robert St N, St Paul, MN 55164, USA.
| | - Molly S Peterson
- Minnesota Department of Health, 625 Robert St N, St Paul, MN 55164, USA.
| | | | - Heather J Rutz
- Maryland Department of Health, 201 W. Preston Street, 3rd Floor, Baltimore, MD 21201, USA.
| | - Adam J Rowe
- New York State Department of Health, Empire Plaza, Corning Tower, State St, Albany, NY 12203, USA.
| | - Jennifer L White
- New York State Department of Health, Empire Plaza, Corning Tower, State St, Albany, NY 12203, USA.
| | - Jennifer L Peel
- Colorado State University, Environmental Health Building, 350 W. Lake St., Fort Collins, CO 80523, USA.
| | - Brad J Biggerstaff
- Centers for Disease Control and Prevention, Division of Vector-borne Diseases, 3156 Rampart Rd., Fort Collins, CO 80521, USA.
| | - Alison F Hinckley
- Centers for Disease Control and Prevention, Division of Vector-borne Diseases, 3156 Rampart Rd., Fort Collins, CO 80521, USA.
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14
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Biggerstaff BJ, Akinbami LJ, Hales C, Chan PA, Petersen LR. Duration of Viral Nucleic Acid Shedding and Early Reinfection With Severe Respiratory Syndrome Coronavirus 2 in Healthcare Workers and First Responders. J Infect Dis 2021; 224:1873-1877. [PMID: 34610137 PMCID: PMC8522438 DOI: 10.1093/infdis/jiab504] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 09/30/2021] [Indexed: 11/25/2022] Open
Abstract
We estimated the distributions of duration of SARS-CoV-2 nucleic acid shedding and time to reinfection among 137 persons with at least two positive nucleic acid amplification test (NAAT) results from March to September 2020. We analyzed gaps of varying length between subsequent positive and negative NAAT results and estimated a mean duration of nucleic acid shedding of 30.1 (95% CI 26.3, 34.5) days. The mean time to reinfection was 89.1 (95% CI 75.3, 103.5) days. Together, these indicate that a 90-day period between positive NAAT results can reliably define reinfection in immunocompetent persons although reinfection can occur at shorter intervals.
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Affiliation(s)
- Brad J Biggerstaff
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Lara J Akinbami
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland, USA.,US Public Health Service, Rockville, Maryland, USA
| | - Craig Hales
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland, USA.,US Public Health Service, Rockville, Maryland, USA
| | - Philip A Chan
- Rhode Island Department of Health, Providence, Rhode Island, USA
| | - Lyle R Petersen
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
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15
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Major CG, Paz-Bailey G, Hills SL, Rodriguez DM, Biggerstaff BJ, Johansson M. Risk Estimation of Sexual Transmission of Zika Virus-United States, 2016-2017. J Infect Dis 2021; 224:1756-1764. [PMID: 33822107 PMCID: PMC10015296 DOI: 10.1093/infdis/jiab173] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 03/31/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Zika virus (ZIKV) can be transmitted sexually but the risk of sexual transmission remains unknown. Most evidence of sexual transmission is from partners of infected travelers returning from areas with ZIKV circulation. METHODS We used data from the US national arboviral disease surveillance system on travel- and sexually acquired ZIKV disease cases during 2016-2017 to develop individual-level simulations for estimating risk of male-to-female, male-to-male, and female-to-male sexual transmission of ZIKV via vaginal and/or anal intercourse. We specified parametric distributions to characterize individual-level variability of parameters for ZIKV persistence and sexual behaviors. RESULTS Using ZIKV RNA persistence in semen/vaginal fluids to approximate infectiousness duration, male-to-male transmission had the highest estimated probability (1.3% [95% confidence interval, CI, .4%-6.0%] per anal sex act), followed by male-to-female and female-to-male transmission (0.4% [95% CI, .3%-.6%] per vaginal/anal sex act and 0.1% [95% CI, 0%-.8%] per vaginal sex act, respectively). Models using viral isolation in semen vs RNA detection to approximate infectiousness duration predicted greater risk of sexual transmission. CONCLUSIONS While likely insufficient to maintain sustained transmission, the estimated risk of ZIKV transmission through unprotected sex is not trivial and is especially important for pregnant women, as ZIKV infection can cause severe congenital disorders.
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Affiliation(s)
- Chelsea G Major
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico, USA
| | - Gabriela Paz-Bailey
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico, USA
| | - Susan L Hills
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Dania M Rodriguez
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico, USA
| | - Brad J Biggerstaff
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Michael Johansson
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico, USA
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16
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Akinbami LJ, Biggerstaff BJ, Chan PA, McGibbon E, Pathela P, Petersen LR. Reinfection with SARS-CoV-2 among previously infected healthcare personnel and first responders. Clin Infect Dis 2021; 75:e201-e207. [PMID: 34791108 PMCID: PMC8767877 DOI: 10.1093/cid/ciab952] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Indexed: 12/22/2022] Open
Abstract
Background SARS-CoV-2 virus testing among first responders and healthcare personnel who participated in a May-August 2020 serosurvey which assessed spike protein antibodies (S1 region) provided an opportunity to assess reinfection. Methods Serology survey data were merged with virus testing results from Rhode Island (March 1, 2020-February 17, 2021) and New York City (March 10-December 14, 2020). Participants with a positive virus test ≥14 days before their serology test were included. Reinfection was defined as a second positive SARS-CoV-2 test result ≥90 days after the first positive test. The association between serostatus and reinfection was assessed with a proportional hazards model adjusting for demographics, exposures, and virus testing frequency. Results Among 1,572 previously infected persons, 40 (2.5%) were reinfected. Reinfection differed by serostatus: 8.4% among seronegative versus 1.9% among seropositive participants (p<0.0001). Most reinfections occurred among Rhode Island nursing home and corrections (RINHC) personnel (n=30) who were most frequently tested (mean 30.3 tests versus 4.6 for other Rhode Island and 2.3 for New York City participants). The adjusted hazard ratio (aHR) for reinfection in seropositive versus seronegative persons was 0.41 (95% CI 0.20, 0.81). Exposure to a household member with COVID-19 before the serosurvey was also protective (aHR 0.34, 95% CI 0.13, 0.89). Conclusions Reinfections were uncommon among previously infected persons over a 9-month period that preceded widespread variant circulation. Seropositivity decreased reinfection risk. Lower reinfection risk associated with exposure to a household member with COVID-19 before the serosurvey may reflect subsequently reduced household transmission among members of previously infected households.
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Affiliation(s)
- Lara J Akinbami
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland, USA.,U.S. Public Health Service, Rockville, Maryland, USA
| | - Brad J Biggerstaff
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Philip A Chan
- Rhode Island Department of Health, Providence, Rhode Island, USA
| | - Emily McGibbon
- New York City Department of Health and Mental Hygiene, Queens, New York, USA
| | - Preeti Pathela
- New York City Department of Health and Mental Hygiene, Queens, New York, USA
| | - Lyle R Petersen
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
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17
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Kugeler KJ, Podewils LJ, Alden NB, Burket TL, Kawasaki B, Biggerstaff BJ, Biggs HM, Zacks R, Foster MA, Lim T, McDonald E, Tate JE, Herlihy RK, Drobeniuc J, Cortese MM. Assessment of SARS-CoV-2 Seroprevalence by Community Survey and Residual Specimens, Denver, Colorado, July-August 2020. Public Health Rep 2021; 137:128-136. [PMID: 34752156 PMCID: PMC8721766 DOI: 10.1177/00333549211055137] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES The number of SARS-CoV-2 infections is underestimated in surveillance data. Various approaches to assess the seroprevalence of antibodies to SARS-CoV-2 have different resource requirements and generalizability. We estimated the seroprevalence of antibodies to SARS-CoV-2 in Denver County, Colorado, via a cluster-sampled community survey. METHODS We estimated the overall seroprevalence of antibodies to SARS-CoV-2 via a community seroprevalence survey in Denver County in July 2020, described patterns associated with seroprevalence, and compared results with cumulative COVID-19 incidence as reported to the health department during the same period. In addition, we compared seroprevalence as assessed with a temporally and geographically concordant convenience sample of residual clinical specimens from a commercial laboratory. RESULTS Based on 404 specimens collected through the community survey, 8.0% (95% CI, 3.9%-15.7%) of Denver County residents had antibodies to SARS-CoV-2, an infection rate of about 7 times that of the 1.1% cumulative reported COVID-19 incidence during this period. The estimated infection-to-reported case ratio was highest among children (34.7; 95% CI, 11.1-91.2) and males (10.8; 95% CI, 5.7-19.3). Seroprevalence was highest among males of Black race or Hispanic ethnicity and was associated with previous COVID-19-compatible illness, a previous positive SARS-CoV-2 test result, and close contact with someone who had confirmed SARS-CoV-2 infection. Testing of 1598 residual clinical specimens yielded a seroprevalence of 6.8% (95% CI, 5.0%-9.2%); the difference between the 2 estimates was 1.2 percentage points (95% CI, -3.6 to 12.2 percentage points). CONCLUSIONS Testing residual clinical specimens provided a similar seroprevalence estimate yet yielded limited insight into the local epidemiology of COVID-19 and might be less representative of the source population than a cluster-sampled community survey. Awareness of the limitations of various sampling strategies is necessary when interpreting findings from seroprevalence assessments.
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Affiliation(s)
- Kiersten J. Kugeler
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Nisha B. Alden
- Colorado Department of Public Health and Environment, Denver, CO, USA
| | | | - Breanna Kawasaki
- Colorado Department of Public Health and Environment, Denver, CO, USA
| | - Brad J. Biggerstaff
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Holly M. Biggs
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Rachael Zacks
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Monique A. Foster
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Travis Lim
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Emily McDonald
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jacqueline E. Tate
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Rachel K. Herlihy
- Colorado Department of Public Health and Environment, Denver, CO, USA
| | - Jan Drobeniuc
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Margaret M. Cortese
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA,Margaret M. Cortese, MD, Centers for Disease Control and Prevention, COVID-19 Response Team, 1600 Clifton Rd NE, MS H24-5, Atlanta, GA 30333, USA.
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18
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Jones JM, Stone M, Sulaeman H, Fink RV, Dave H, Levy ME, Di Germanio C, Green V, Notari E, Saa P, Biggerstaff BJ, Strauss D, Kessler D, Vassallo R, Reik R, Rossmann S, Destree M, Nguyen KA, Sayers M, Lough C, Bougie DW, Ritter M, Latoni G, Weales B, Sime S, Gorlin J, Brown NE, Gould CV, Berney K, Benoit TJ, Miller MJ, Freeman D, Kartik D, Fry AM, Azziz-Baumgartner E, Hall AJ, MacNeil A, Gundlapalli AV, Basavaraju SV, Gerber SI, Patton ME, Custer B, Williamson P, Simmons G, Thornburg NJ, Kleinman S, Stramer SL, Opsomer J, Busch MP. Estimated US Infection- and Vaccine-Induced SARS-CoV-2 Seroprevalence Based on Blood Donations, July 2020-May 2021. JAMA 2021; 326:1400-1409. [PMID: 34473201 PMCID: PMC8414359 DOI: 10.1001/jama.2021.15161] [Citation(s) in RCA: 127] [Impact Index Per Article: 42.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
IMPORTANCE People who have been infected with or vaccinated against SARS-CoV-2 have reduced risk of subsequent infection, but the proportion of people in the US with SARS-CoV-2 antibodies from infection or vaccination is uncertain. OBJECTIVE To estimate trends in SARS-CoV-2 seroprevalence related to infection and vaccination in the US population. DESIGN, SETTING, AND PARTICIPANTS In a repeated cross-sectional study conducted each month during July 2020 through May 2021, 17 blood collection organizations with blood donations from all 50 US states; Washington, DC; and Puerto Rico were organized into 66 study-specific regions, representing a catchment of 74% of the US population. For each study region, specimens from a median of approximately 2000 blood donors were selected and tested each month; a total of 1 594 363 specimens were initially selected and tested. The final date of blood donation collection was May 31, 2021. EXPOSURE Calendar time. MAIN OUTCOMES AND MEASURES Proportion of persons with detectable SARS-CoV-2 spike and nucleocapsid antibodies. Seroprevalence was weighted for demographic differences between the blood donor sample and general population. Infection-induced seroprevalence was defined as the prevalence of the population with both spike and nucleocapsid antibodies. Combined infection- and vaccination-induced seroprevalence was defined as the prevalence of the population with spike antibodies. The seroprevalence estimates were compared with cumulative COVID-19 case report incidence rates. RESULTS Among 1 443 519 specimens included, 733 052 (50.8%) were from women, 174 842 (12.1%) were from persons aged 16 to 29 years, 292 258 (20.2%) were from persons aged 65 years and older, 36 654 (2.5%) were from non-Hispanic Black persons, and 88 773 (6.1%) were from Hispanic persons. The overall infection-induced SARS-CoV-2 seroprevalence estimate increased from 3.5% (95% CI, 3.2%-3.8%) in July 2020 to 20.2% (95% CI, 19.9%-20.6%) in May 2021; the combined infection- and vaccination-induced seroprevalence estimate in May 2021 was 83.3% (95% CI, 82.9%-83.7%). By May 2021, 2.1 SARS-CoV-2 infections (95% CI, 2.0-2.1) per reported COVID-19 case were estimated to have occurred. CONCLUSIONS AND RELEVANCE Based on a sample of blood donations in the US from July 2020 through May 2021, vaccine- and infection-induced SARS-CoV-2 seroprevalence increased over time and varied by age, race and ethnicity, and geographic region. Despite weighting to adjust for demographic differences, these findings from a national sample of blood donors may not be representative of the entire US population.
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Affiliation(s)
- Jefferson M. Jones
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mars Stone
- Vitalant Research Institute, San Francisco, California
| | | | | | - Honey Dave
- Vitalant Research Institute, San Francisco, California
| | | | | | | | - Edward Notari
- Scientific Affairs, American Red Cross, Rockville, Maryland
| | - Paula Saa
- Scientific Affairs, American Red Cross, Gaithersburg, Maryland
| | - Brad J. Biggerstaff
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | | | | | | | | | | | | | - Chris Lough
- LifeSouth Community Blood Centers, Gainesville, Florida
| | | | | | - Gerardo Latoni
- Banco de Sangre de Servicios Mutuos, San Juan, Puerto Rico
| | | | | | - Jed Gorlin
- Innovative Blood Resources, St Paul, Minnesota
| | - Nicole E. Brown
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Carolyn V. Gould
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kevin Berney
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Tina J. Benoit
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Maureen J. Miller
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Alicia M. Fry
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Aron J. Hall
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Adam MacNeil
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Adi V. Gundlapalli
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sridhar V. Basavaraju
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Susan I. Gerber
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Monica E. Patton
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brian Custer
- Vitalant Research Institute, San Francisco, California
| | | | | | - Natalie J. Thornburg
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Steven Kleinman
- University of British Columbia, Vancouver, British Columbia, Canada
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19
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Hinckley AF, Niesobecki SA, Connally NP, Hook SA, Biggerstaff BJ, Horiuchi KA, Hojgaard A, Mead PS, Meek JI. Prevention of Lyme and other tickborne diseases using a rodent-targeted approach: A randomized controlled trial in Connecticut. Zoonoses Public Health 2021; 68:578-587. [PMID: 34050628 PMCID: PMC10898493 DOI: 10.1111/zph.12844] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 04/22/2021] [Indexed: 11/27/2022]
Abstract
Tickborne diseases are an increasing public health problem in the northeastern USA. Bait boxes that apply acaricide to rodents have been shown in small field studies to significantly reduce abundance of Ixodes scapularis ticks as well as their pathogen infection rates in treated areas. The effectiveness of this intervention for preventing human tickborne diseases (TBDs) has not been demonstrated. During 2012-2016, TickNET collaborators conducted a randomized, blinded, placebo-controlled trial among 622 Connecticut households. Each household received active (containing fipronil wick) or placebo (empty) bait boxes in their yards over two consecutive years. Information on tick encounters and TBDs among household members was collected through biannual surveys. Nymphal ticks were collected from a subset of 100 properties during spring at baseline, during treatment, and in the year post-intervention. Demographic and property characteristics did not differ between treatment groups. There were no significant differences post-intervention between treatment groups with respect to tick density or pathogen infection rates, nor for tick encounters or TBDs among household members. We found no evidence that rodent-targeted bait boxes disrupt pathogen transmission cycles or significantly reduce household risk of tick exposure or TBDs. The effectiveness of this intervention may depend on scale of use or local enzootic cycles.
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Affiliation(s)
- Alison F Hinckley
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Sara A Niesobecki
- Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, CT, USA
| | - Neeta P Connally
- Department of Biological & Environmental Sciences, Western Connecticut State University, Danbury, CT, USA
| | - Sarah A Hook
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Brad J Biggerstaff
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Kalanthe A Horiuchi
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Andrias Hojgaard
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Paul S Mead
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - James I Meek
- Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, CT, USA
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20
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Biggerstaff BJ. Discussion of "Is group testing ready for prime-time in disease Identification?" by Haber, Malinovsky, and Albert, Statistics in Medicine, 2021. Stat Med 2021; 40:3887-3888. [PMID: 34251037 PMCID: PMC8441781 DOI: 10.1002/sim.8989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 03/25/2021] [Indexed: 11/22/2022]
Affiliation(s)
- Brad J. Biggerstaff
- Division of Vector‐Borne DiseasesCenters for Disease Control and PreventionFort CollinsColoradoUSA
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21
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Hills SL, Laven J, Biggerstaff BJ, Kosoy O, Staples JE, Panella A. Frequency of Zika Virus Immunoglobulin M Antibody in Persons with West Nile Virus Infection. Vector Borne Zoonotic Dis 2021; 21:817-821. [PMID: 34292777 DOI: 10.1089/vbz.2021.0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
West Nile virus (WNV) and Zika virus (ZIKV) are mosquito-borne viruses in the family Flaviviridae. Residents in, and travelers to, areas where the viruses are circulating are at risk for infection, and both viruses can cause an acute febrile illness. Given known cross-reactivity in flavivirus serologic assays, it is possible a patient with acute WNV infection could be misdiagnosed as having ZIKV infection if appropriate testing is not conducted. To understand how frequently persons with WNV infection have detectable cross-reactive ZIKV immunoglobulin M (IgM) antibody, we used archived serum samples from patients in the United States with recent WNV infection confirmed by a microsphere-based immunoassay test for IgM antibody and neutralizing antibody testing. Samples were tested for ZIKV IgM antibody with the Centers for Disease Control and Prevention (CDC) ZIKV IgM antibody capture enzyme-linked immunosorbent assay. Among 153 sera from patients with acute WNV infection, the ZIKV IgM antibody result was positive in 56 (37%; 95% confidence interval [CI] 29-44%) and equivocal in 28 (18%; 95% CI 13-25%). With 55% of samples having cross-reactive antibodies, it is important for health care providers to request appropriate testing based on the most likely cause of a patient's possible arboviral infection considering their clinical symptoms and signs, travel history, and place of residence. For cases where the epidemiology does not support the preliminary IgM findings, confirmatory neutralizing antibody testing should be performed. These measures will avoid an incorrect diagnosis of ZIKV infection, based on cross-reactive antibodies, in a person truly infected with WNV.
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Affiliation(s)
- Susan L Hills
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Janeen Laven
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Brad J Biggerstaff
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Olga Kosoy
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - J Erin Staples
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Amanda Panella
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
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22
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Marx GE, Biggerstaff BJ, Nawrocki CC, Totten SE, Travanty EA, Burakoff AW, Scott T, De Hey JCV, Carlson JJ, Wendel KA, Harcourt JL, Tamin A, Thomas JD, Rowan SE. Detection of Severe Acute Respiratory Syndrome Coronavirus 2 on Self-Collected Saliva or Anterior Nasal Specimens Compared With Healthcare Personnel-Collected Nasopharyngeal Specimens. Clin Infect Dis 2021; 73:S65-S73. [PMID: 33912930 PMCID: PMC8135412 DOI: 10.1093/cid/ciab330] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Nasopharyngeal specimens (NPS) are commonly used for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing but can be uncomfortable for patients. Self-collected saliva specimens (SS) or anterior nasal specimens (ANS) for SARS-CoV-2 detection are less invasive, but the sensitivity of these specimen types has not been thoroughly evaluated. METHODS During September-November 2020, 730 adults undergoing SARS-CoV-2 testing at community testing events and homeless shelters in Denver provided self-collected SS and ANS before NPS collection and answered a short survey about symptoms and specimen preference. Specimens were tested for SARS-CoV-2 by means of real-time reverse-transcription polymerase chain reaction (rRT-PCR); viral culture was performed on a subset of specimens positive by rRT-PCR. The sensitivity of SS and ANS for SARS-CoV-2 detection by rRT-PCR was measured against that of NPS. Subgroup analyses included test outcomes by symptom status and culture results. RESULTS Sensitivity for SARS-CoV-2 detection by rRT-PCR appeared higher for SS than for ANS (85% vs 80%) and higher among symptomatic participants than among those without symptoms (94% vs 29% for SS; 87% vs 50% for ANS). Among participants with culture-positive SARS-CoV-2 by any specimen type, the sensitivities of SS and ANS by rRT-PCR were 94% and 100%, respectively. SS and ANS were equally preferred by participants; most would undergo NPS collection again despite this method's being the least preferred. CONCLUSIONS SS were slightly more sensitive than ANS for SARS-CoV-2 detection with rRT-PCR. With both SS and ANS, SARS-CoV-2 was reliably detected among participants with symptoms. Self-collected SS and ANS offer practical advantages, are preferred by patients, and might be most useful for testing people with coronavirus disease 2019 symptoms.
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Affiliation(s)
- Grace E Marx
- Centers for Disease Control and Prevention, Fort Collins, Colorado, USA.,Denver Public Health, Denver Health and Hospital Authority, Denver, Colorado, USA.,University of Colorado Denver, Aurora, Colorado, USA
| | | | - Courtney C Nawrocki
- Centers for Disease Control and Prevention, Fort Collins, Colorado, USA.,Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA
| | - Sarah E Totten
- Colorado Department of Public Health and Environment, Denver, Colorado, USA
| | - Emily A Travanty
- Colorado Department of Public Health and Environment, Denver, Colorado, USA
| | - Alexis W Burakoff
- Colorado Department of Public Health and Environment, Denver, Colorado, USA
| | - Tracy Scott
- Denver Public Health, Denver Health and Hospital Authority, Denver, Colorado, USA
| | | | - Jesse J Carlson
- Denver Public Health, Denver Health and Hospital Authority, Denver, Colorado, USA
| | - Karen A Wendel
- Denver Public Health, Denver Health and Hospital Authority, Denver, Colorado, USA.,University of Colorado Denver, Aurora, Colorado, USA
| | | | - Azaibi Tamin
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Sarah E Rowan
- Denver Public Health, Denver Health and Hospital Authority, Denver, Colorado, USA.,University of Colorado Denver, Aurora, Colorado, USA
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23
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Binder AM, Commins SP, Altrich ML, Wachs T, Biggerstaff BJ, Beard CB, Petersen LR, Kersh GJ, Armstrong PA. Diagnostic testing for galactose-alpha-1,3-galactose, United States, 2010 to 2018. Ann Allergy Asthma Immunol 2021; 126:411-416.e1. [PMID: 33422649 PMCID: PMC10961706 DOI: 10.1016/j.anai.2020.12.019] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 12/13/2020] [Accepted: 12/28/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Alpha-gal syndrome (AGS) is an emerging immunoglobulin E (IgE)-mediated allergy to galactose-alpha-1,3-galactose (alpha-gal). The geographic distribution and burden of AGS in the United States are unknown. OBJECTIVE To characterize alpha-gal IgE testing patterns and describe the trends and distribution from 2010 to 2018 in the United States. METHODS This retrospective analysis included all persons tested for alpha-gal IgE antibodies by Viracor-IBT Laboratories (Lee's Summit, Missouri), the primary site of testing in the United States. Data included age and sex of person tested, specimen state of origin, collection date, and result value; persons with at least 1 positive test result (≥0.1 kU/L) were compared with negatives. Proportions tested and with positive test results were calculated using the US Census population estimates. RESULTS Overall, 122,068 specimens from 105,674 persons were tested for alpha-gal IgE during July 1, 2010, to December 31, 2018. Nearly one-third (34,256, 32.4%) had at least 1 positive result. The number of persons receiving positive test results increased 6-fold from 1110 in 2011 to 7798 in 2018. Of those receiving positive test results, mean [SD] age was 46.9 (19.8) years; men were more likely to test positive than women (43.3% vs 26.0%). Arkansas, Virginia, Kentucky, Oklahoma, and Missouri had the highest number of persons who were tested and had a positive result per 100,000 population. CONCLUSION More than 34,000 persons, most presumably symptomatic, have received positive test results for IgE antibodies to alpha-gal, suggesting AGS is an increasingly recognized public health problem. The geographic distribution of persons who tested positive is consistent with exposure to Amblyomma americanum ticks.
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Affiliation(s)
- Alison M Binder
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado.
| | - Scott P Commins
- Division of Rheumatology, Allergy, and Immunology, University of North Carolina, Chapel Hill, North Carolina
| | | | | | - Brad J Biggerstaff
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Charles B Beard
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Lyle R Petersen
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Gilbert J Kersh
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Paige A Armstrong
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
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24
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Quandelacy TM, Healy JM, Greening B, Rodriguez DM, Chung KW, Kuehnert MJ, Biggerstaff BJ, Dirlikov E, Mier-y-Teran-Romero L, Sharp TM, Waterman S, Johansson MA. Estimating incidence of infection from diverse data sources: Zika virus in Puerto Rico, 2016. PLoS Comput Biol 2021; 17:e1008812. [PMID: 33784311 PMCID: PMC8034731 DOI: 10.1371/journal.pcbi.1008812] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 04/09/2021] [Accepted: 02/17/2021] [Indexed: 01/25/2023] Open
Abstract
Emerging epidemics are challenging to track. Only a subset of cases is recognized and reported, as seen with the Zika virus (ZIKV) epidemic where large proportions of infection were asymptomatic. However, multiple imperfect indicators of infection provide an opportunity to estimate the underlying incidence of infection. We developed a modeling approach that integrates a generic Time-series Susceptible-Infected-Recovered epidemic model with assumptions about reporting biases in a Bayesian framework and applied it to the 2016 Zika epidemic in Puerto Rico using three indicators: suspected arboviral cases, suspected Zika-associated Guillain-Barré Syndrome cases, and blood bank data. Using this combination of surveillance data, we estimated the peak of the epidemic occurred during the week of August 15, 2016 (the 33rd week of year), and 120 to 140 (50% credible interval [CrI], 95% CrI: 97 to 170) weekly infections per 10,000 population occurred at the peak. By the end of 2016, we estimated that approximately 890,000 (95% CrI: 660,000 to 1,100,000) individuals were infected in 2016 (26%, 95% CrI: 19% to 33%, of the population infected). Utilizing multiple indicators offers the opportunity for real-time and retrospective situational awareness to support epidemic preparedness and response. Zika virus (ZIKV) infections, like many infections, are generally underreported due to asymptomatic, mild, or unrecognized cases. Using available surveillance indicators reflecting imperfect proxies of infection, we developed a modeling approach to estimate the weekly incidence of infection by combining independent surveillance indicators and assumptions about system-specific reporting biases in a Bayesian framework. Using our approach, we estimated that approximately 890,000 people in the population were infected with Zika in Puerto Rico in 2016, much higher than the 36,316 reported confirmed infections. Our framework has broad application to other diseases where cases may be underreported through traditional disease surveillance and can provide near real-time changes in incidences.
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Affiliation(s)
- Talia M. Quandelacy
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico, United States of America
- * E-mail:
| | - Jessica M. Healy
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Bradford Greening
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Dania M. Rodriguez
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico, United States of America
| | - Koo-Whang Chung
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Matthew J. Kuehnert
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Brad J. Biggerstaff
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, United States of America
| | - Emilio Dirlikov
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Luis Mier-y-Teran-Romero
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico, United States of America
| | - Tyler M. Sharp
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico, United States of America
- United States Public Health Service, Silver Springs, Maryland, United States of America
| | - Stephen Waterman
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico, United States of America
- United States Public Health Service, Silver Springs, Maryland, United States of America
| | - Michael A. Johansson
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico, United States of America
- Harvard TH Chan School of Public Health, Boston, Massachusetts, United States of America
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25
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Hepworth G, Biggerstaff BJ. Bias Correction in Estimating Proportions by Imperfect Pooled Testing. J Agric Biol Environ Stat 2021; 26:90-104. [PMID: 38618153 PMCID: PMC11010583 DOI: 10.1007/s13253-020-00411-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 07/08/2020] [Indexed: 11/25/2022]
Abstract
In the estimation of proportions by pooled testing, the MLE is biased. Hepworth and Biggerstaff (JABES, 22:602-614, 2017) proposed an estimator based on the bias correction method of Firth (Biometrika 80:27-38, 1993) and showed that it is almost unbiased across a range of pooled testing problems involving no misclassification. We now extend their work to allow for imperfect testing. We derive the estimator, provide a Newton-Raphson iterative formula for its computation and test it in situations involving equal or unequal pool sizes, drawing on problems encountered in plant disease assessment and prevalence estimation of mosquito-borne viruses. Our estimator is highly effective at reducing the bias for prevalences consistent with the pooled testing procedure employed.
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Affiliation(s)
- Graham Hepworth
- School of Mathematics and Statistics, The University of Melbourne, Melbourne, VIC 3010, Australia
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26
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Allerdice MEJ, Snellgrove AN, Hecht JA, Hartzer K, Jones ES, Biggerstaff BJ, Ford SL, Karpathy SE, Delgado-de la Mora J, Delgado-de la Mora D, Licona-Enriquez JD, Goddard J, Levin ML, Paddock CD. Reproductive incompatibility between Amblyomma maculatum (Acari: Ixodidae) group ticks from two disjunct geographical regions within the USA. Exp Appl Acarol 2020; 82:543-557. [PMID: 33091146 PMCID: PMC11008682 DOI: 10.1007/s10493-020-00557-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 10/05/2020] [Indexed: 06/11/2023]
Abstract
The Amblyomma maculatum Koch group of ixodid ticks consists of three species: A. maculatum, A. triste, and A. tigrinum. However, since Koch described this group in 1844, the systematics of its members has been the subject of ongoing debate. This is especially true of A. maculatum and A. triste; recent molecular analyses reveal insufficient genetic divergence to separate these as distinct species. Further confounding this issue is the discovery in 2014 of A. maculatum group ticks in southern Arizona (AZ), USA, that share morphological characteristics with both A. triste and A. maculatum. To biologically evaluate the identity of A. maculatum group ticks from southern Arizona, we analyzed the reproductive compatibility between specimens of A. maculatum group ticks collected from Georgia (GA), USA, and southern Arizona. Female ticks from both Arizona and Georgia were mated with males from both the Georgia and Arizona Amblyomma populations, creating two homologous and two heterologous F1 cohorts of ticks: GA ♀/GA ♂, AZ ♀/AZ ♂, GA ♀/AZ ♂, and AZ ♀/GA ♂. Each cohort was maintained separately into the F2 generation with F1 females mating only with F1 males from their same cohort. Survival and fecundity parameters were measured for all developmental stages. The observed survival parameters for heterologous cohorts were comparable to those of the homologous cohorts through the F1 generation. However, the F1 heterologous females produced F2 egg clutches that did not hatch, thus indicating that the Arizona and Georgia populations of A. maculatum group ticks tested here represent different biological species.
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Affiliation(s)
- Michelle E J Allerdice
- Division of Vector-Borne Diseases, Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA.
- Department of Biochemistry, Molecular Biology, Entomology, and Plant Pathology, Mississippi State University, Starkville, MS, USA.
| | - Alyssa N Snellgrove
- Division of Vector-Borne Diseases, Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Joy A Hecht
- Division of Vector-Borne Diseases, Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kris Hartzer
- Division of Vector-Borne Diseases, Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Emma S Jones
- Division of Vector-Borne Diseases, Office of the Director, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Brad J Biggerstaff
- Division of Vector-Borne Diseases, Office of the Director, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Shelby L Ford
- Division of Vector-Borne Diseases, Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Division of Vector-Borne Diseases, Bacterial Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Sandor E Karpathy
- Division of Vector-Borne Diseases, Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jesus Delgado-de la Mora
- Departamento de Anatomía Patológica, Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Mexico, Mexico
| | - David Delgado-de la Mora
- Departamento de Anatomía Patológica, Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Mexico, Mexico
| | | | - Jerome Goddard
- Department of Biochemistry, Molecular Biology, Entomology, and Plant Pathology, Mississippi State University, Starkville, MS, USA
| | - Michael L Levin
- Division of Vector-Borne Diseases, Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Christopher D Paddock
- Division of Vector-Borne Diseases, Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Williamson PC, Biggerstaff BJ, Simmons G, Stone M, Winkelman V, Latoni G, Alsina J, Bakkour S, Newman C, Pate LL, Galel SA, Kleinman S, Busch MP. Evolving viral and serological stages of Zika virus RNA-positive blood donors and estimation of incidence of infection during the 2016 Puerto Rican Zika epidemic: an observational cohort study. Lancet Infect Dis 2020; 20:1437-1445. [PMID: 32673594 DOI: 10.1016/s1473-3099(19)30706-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 08/31/2019] [Accepted: 11/14/2019] [Indexed: 01/11/2023]
Abstract
BACKGROUND Puerto Rico began screening blood donations for Zika virus RNA with nucleic acid amplification tests (NAATs) on April 3, 2016, because of an emerging Zika virus outbreak. We followed up positive donors to assess the dynamics of viral and serological markers during the early stages of Zika virus infection and update the estimate of infection incidence in the Puerto Rican population during the outbreak. METHODS Blood donations from volunteer donors in Puerto Rico were screened for the presence of Zika virus RNA using the cobas Zika NAAT. Positive donations were further tested to confirm infection, estimate viral load, and identify Zika virus-specific IgM antibodies. Individuals with positive blood donations were invited to attend follow-up visits. Donations with confirmed infection (defined as detection of Zika virus RNA or IgM on additional testing of index or follow-up samples) were assessed for stage of infection according to Zika virus RNA detectability in simulated minipools, viral load, and Zika virus IgM status. A three-step process was used to estimate the mean duration of NAAT reactivity of Zika virus in human plasma from individuals identified pre-seroconversion with at least one follow up visit and to update the 2016 incidence estimate of Zika virus infection. FINDINGS Between April 3 and Dec 31, 2016, 53 112 blood donations were screened for Zika virus, of which 351 tested positive, 339 had confirmed infections, and 319 could be staged. Compared with IgM-positive index donations (n=110), IgM-negative index donations (n=209) had higher mean viral loads (1·1 × 106vs 8·3 × 104 international units per mL) and were more likely to be detected in simulated minipools (93% [n=194] vs 26% [n=29]). The proportions of donations with confirmed infections that had viral RNA detected only in individual-donation NAATs (ie, not in simulated minipools) and were IgM positive increased as the epidemic evolved. The estimated mean duration of NAAT detectability in the 140 donors included in the follow-up study was 11·70 days (95% CI 10·06-14·36). Applying this detection period to the observed proportion of donations that were confirmed NAAT positive yielded a Zika virus seasonal incidence estimate of 21·1% (95% CI 18·1-24·1); 768 101 infections in a population of 3 638 773 in 2016. INTERPRETATION Characterisation of early Zika virus infection has implications for blood safety because infectivity of blood donations and utility of screening methods likely correlate with viral load and serological stage of infection. Our findings also have implications for diagnostic testing, public health surveillance, and epidemiology, and we estimate that around 21% of the Puerto Rican population was infected during the 2016 outbreak. FUNDING Biomedical Advanced Research and Development Authority, National Heart, Lung, and Blood Institute.
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Affiliation(s)
| | | | | | - Mars Stone
- Vitalant Research Institute, San Francisco, CA, USA
| | | | | | - Jose Alsina
- Banco de Sangre Servicios Mutuos, Guaynabo, PR, USA
| | | | - Christina Newman
- Department of Pathology and Laboratory Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - Lisa L Pate
- Roche Molecular Systems, Pleasanton, CA, USA
| | | | - Steven Kleinman
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
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Lindsey NP, Perry L, Fischer M, Woolpert T, Biggerstaff BJ, Brice G, Fitzpatrick K, Kosoy OI, Laven JJ, Myers CA, Hollis EM, Staples JE. Duration of seropositivity following yellow fever vaccination in U.S. military service members. Vaccine 2020; 38:8286-8291. [PMID: 33239225 DOI: 10.1016/j.vaccine.2020.11.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/06/2020] [Accepted: 11/08/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND The United States military regularly deploys thousands of service members throughout areas of South America and Africa that are endemic for yellow fever (YF) virus. To determine if booster doses might be needed for service members who are repetitively or continually deployed to YF endemic areas, we evaluated seropositivity among US military personnel receiving a single dose of YF vaccine based on time post-vaccination. METHODS Serum antibodies were measured using a plaque reduction neutralization test with 50% cutoff in 682 military personnel at 5-39 years post-vaccination. We determined noninferiority of immune response by comparing the proportion seropositive among those vaccinated 10-14 years previously with those vaccinated 5-9 years previously. Noninferiority was supported if the lower-bound of the 2-tailed 95% CI for p10-14years - p5-9years was ≥-0.10. Additionally, the geometric mean antibody titer (GMT) at various timepoints following vaccination were compared to the GMT at 5-9 years. RESULTS The proportion of military service members with detectable neutralizing antibodies 10-14 years after a single dose of YF vaccine (95.8%, 95% CI 91.2-98.1%) was non-inferior to the proportion 5-9 years after vaccination (97.8%, 95% CI 93.7-99.3%). Additionally, GMT among vaccine recipients at 10-14 years post vaccination (99, 95% CI 82-121) was non-inferior to GMT in YF vaccine recipients at 5-9 years post vaccination (115, 95% CI 96-139). The proportion of vaccinees with neutralizing antibodies remained high, and non-inferior, among those vaccinated 15-19 years prior (98.5%, 95%CI 95.5-99.7%). Although the proportion seropositive decreased among vaccinees ≥ 20 years post vaccination, >90% remained seropositive. CONCLUSIONS Neutralizing antibodies were present in > 95% of vaccine recipients for at least 19 years after vaccination, suggesting that booster doses every 10 years are not essential for most U.S. military personnel.
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Affiliation(s)
- Nicole P Lindsey
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, United States.
| | - Lori Perry
- Operational Infectious Diseases Directorate, Naval Health Research Center, San Diego, CA, United States
| | - Marc Fischer
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, United States
| | - Tabitha Woolpert
- Operational Infectious Diseases Directorate, Naval Health Research Center, San Diego, CA, United States
| | - Brad J Biggerstaff
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, United States
| | - Gary Brice
- Operational Infectious Diseases Directorate, Naval Health Research Center, San Diego, CA, United States
| | - Kelly Fitzpatrick
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, United States
| | - Olga I Kosoy
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, United States
| | - Janeen J Laven
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, United States
| | - Christopher A Myers
- Operational Infectious Diseases Directorate, Naval Health Research Center, San Diego, CA, United States
| | - Ewell M Hollis
- Operational Infectious Diseases Directorate, Naval Health Research Center, San Diego, CA, United States
| | - J Erin Staples
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, United States
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Biggerstaff BJ. Estimation of time-dependent arbovirus infection risk in blood and tissue donations. Stat Commun Infect Dis 2020; 12:10.1515/scid-2020-0001. [PMID: 38618187 PMCID: PMC11010585 DOI: 10.1515/scid-2020-0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
West Nile virus (WNV) outbreaks raise the concern of WNV infection in donated blood and blood products destined for transfusion. We describe methods we developed to estimate time-dependent risk of WNV infection in donated blood, including improvements not previously detailed. The methods are then extended for use in estimation of the risk of WNV infection in donated cadaveric tissues by introducing stratification and stratum-specific weighting to address novel aspects of this application. Data from the WNV outbreak in Colorado in 2003 are used to estimate risk for donated cardiac tissue.
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Affiliation(s)
- Brad J. Biggerstaff
- Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, Fort Collins, Colorado, USA
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Curren EJ, Tufa AJ, Hancock WT, Biggerstaff BJ, Vaifanua-Leo JS, Montalbo CA, Sharp TM, Fischer M, Hills SL, Gould CV. Reverse Transcription-Polymerase Chain Reaction Testing on Filter Paper-Dried Serum for Laboratory-Based Dengue Surveillance-American Samoa, 2018. Am J Trop Med Hyg 2020; 102:622-624. [PMID: 31933466 DOI: 10.4269/ajtmh.19-0800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Laboratory-based surveillance for arboviral diseases is challenging in resource-limited settings. We evaluated the use of filter paper-dried sera for detection of dengue virus (DENV) RNA during an outbreak in American Samoa. Matched liquid and filter paper-dried sera were collected from patients with suspected dengue and shipped to a reference laboratory for diagnostic testing. RNA was extracted from each sample and tested for DENV RNA by real-time reverse transcription-polymerase chain reaction (RT-PCR). Of 18 RT-PCR-positive liquid specimens, 14 matched filter paper-dried specimens were positive for a sensitivity of 78% (95% CI, 55-91%). Of 82 RT-PCR-negative liquid specimens, all filter paper-dried specimens were negative for a specificity of 100% (95% CI, 96-100%). Shipping of filter paper-dried specimens was similarly timely but less expensive than shipping liquid sera. Using filter paper-dried serum or blood can be a cost-effective and sustainable approach to surveillance of dengue and other arboviral diseases in resource-limited settings.
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Affiliation(s)
- Emily J Curren
- Epidemic Intelligence Service, CDC, Atlanta, Georgia.,Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado
| | | | | | - Brad J Biggerstaff
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado
| | | | | | - Tyler M Sharp
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado
| | - Marc Fischer
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado
| | - Susan L Hills
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado
| | - Carolyn V Gould
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado
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Hills SL, Fischer M, Biggerstaff BJ. Perceptions among the U.S. population of value of Japanese encephalitis (JE) vaccination for travel to JE-endemic countries. Vaccine 2020; 38:2117-2121. [DOI: 10.1016/j.vaccine.2020.01.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 01/08/2020] [Accepted: 01/16/2020] [Indexed: 11/25/2022]
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32
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Brandt KS, Horiuchi K, Biggerstaff BJ, Gilmore RD. Evaluation of Patient IgM and IgG Reactivity Against Multiple Antigens for Improvement of Serodiagnostic Testing for Early Lyme Disease. Front Public Health 2019; 7:370. [PMID: 31867303 PMCID: PMC6906137 DOI: 10.3389/fpubh.2019.00370] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 11/20/2019] [Indexed: 01/22/2023] Open
Abstract
Serologic testing is the standard for laboratory diagnosis and confirmation of Lyme disease. Serodiagnostic assays to detect antibodies against Borrelia burgdorferi, the agent of Lyme borreliosis, are used for detection of infection. However, serologic testing within the first month of infection is less sensitive as patients' antibody responses continue to develop. Previously, we screened several B. burgdorferi in vivo expressed antigens for candidates that elicit early antibody responses in patients with Stage 1 and 2 Lyme disease. We evaluated patient IgM seroreactivity against 6 antigens and found an increase in sensitivity without compromising specificity when compared to current IgM second-tier immunoblot scoring. In this study, we continued the evaluation using a multi-antigen panel to measure IgM plus IgG seroreactivity in these early Lyme disease patients' serum samples. Using two statistical methods for calculating positivity cutoff values, sensitivity was 70 and 84-87%, for early acute and early convalescent Lyme disease patients, respectively. Specificity was 98-100% for healthy non-endemic control patients, and 96-100% for healthy endemic controls depending on the statistical analysis. We conclude that improved serologic testing for early Lyme disease may be achieved by the addition of multiple borrelial antigens that elicit IgM and IgG antibodies early in infection.
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Affiliation(s)
- Kevin S Brandt
- Division of Vector Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, United States
| | - Kalanthe Horiuchi
- Division of Vector Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, United States
| | - Brad J Biggerstaff
- Division of Vector Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, United States
| | - Robert D Gilmore
- Division of Vector Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, United States
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Hennessey MJ, Ellis EM, Delorey MJ, Panella AJ, Kosoy OI, Kirking HL, Appiah GD, Qin J, Basile AJ, Feldstein LR, Biggerstaff BJ, Lanciotti RS, Fischer M, Staples JE. Seroprevalence and Symptomatic Attack Rate of Chikungunya Virus Infection, United States Virgin Islands, 2014-2015. Am J Trop Med Hyg 2019; 99:1321-1326. [PMID: 30226143 DOI: 10.4269/ajtmh.18-0437] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
When introduced into a naïve population, chikungunya virus generally spreads rapidly, causing large outbreaks of fever and severe polyarthralgia. We randomly selected households in the U.S. Virgin Islands (USVI) to estimate seroprevalence and symptomatic attack rate for chikungunya virus infection at approximately 1 year following the introduction of the virus. Eligible household members were administered a questionnaire and tested for chikungunya virus antibodies. Estimated proportions were calibrated to age and gender of the population. We enrolled 509 participants. The weighted infection rate was 31% (95% confidence interval [CI]: 26-36%). Among those with evidence of chikungunya virus infection, 72% (95% CI: 65-80%) reported symptomatic illness and 31% (95% CI: 23-38%) reported joint pain at least once per week approximately 1 year following the introduction of the virus to USVI. Comparing rates from infected and noninfected study participants, 70% (95% CI: 62-79%) of fever and polyarthralgia and 23% (95% CI: 9-37%) of continuing joint pain in patients infected with chikungunya virus were due to their infection. Overall, an estimated 43% (95% CI: 33-52%) of the febrile illness and polyarthralgia in the USVI population during the outbreak was attributable to chikungunya virus and only 12% (95% CI: 7-17%) of longer term joint pains were attributed to chikungunya virus. Although the rates of infection, symptomatic disease, and longer term joint symptoms identified in USVI are similar to other outbreaks of the disease, a lower proportion of acute fever and joint pain was found to be attributable to chikungunya virus.
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Affiliation(s)
- Morgan J Hennessey
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia.,Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado
| | - Esther M Ellis
- United States Virgin Islands Department of Health, St. Croix U.S. Virgin Islands
| | - Mark J Delorey
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado
| | - Amanda J Panella
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado
| | - Olga I Kosoy
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado
| | - Hannah L Kirking
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Grace D Appiah
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jin Qin
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Alison J Basile
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado
| | - Leora R Feldstein
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Brad J Biggerstaff
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado
| | - Robert S Lanciotti
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado
| | - Marc Fischer
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado
| | - J Erin Staples
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado
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Sharp TM, Lorenzi O, Torres-Velásquez B, Acevedo V, Pérez-Padilla J, Rivera A, Muñoz-Jordán J, Margolis HS, Waterman SH, Biggerstaff BJ, Paz-Bailey G, Barrera R. Autocidal gravid ovitraps protect humans from chikungunya virus infection by reducing Aedes aegypti mosquito populations. PLoS Negl Trop Dis 2019; 13:e0007538. [PMID: 31344040 PMCID: PMC6657827 DOI: 10.1371/journal.pntd.0007538] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 06/10/2019] [Indexed: 12/12/2022] Open
Abstract
Background Public health responses to outbreaks of dengue, chikungunya, and Zika virus have been stymied by the inability to control the primary vector, Aedes aegypti mosquitos. Consequently, the need for novel approaches to Aedes vector control is urgent. Placement of three autocidal gravid ovitraps (AGO traps) in ~85% of homes in a community was previously shown to sustainably reduce the density of female Ae. aegypti by >80%. Following the introduction of chikungunya virus (CHIKV) to Puerto Rico, we conducted a seroprevalence survey to estimate the prevalence of CHIKV infection in communities with and without AGO traps and evaluate their effect on reducing CHIKV transmission. Methods and findings Multivariate models that calculated adjusted prevalence ratios (aPR) showed that among 175 and 152 residents of communities with and without AGO traps, respectively, an estimated 26.1% and 43.8% had been infected with CHIKV (aPR = 0.50, 95% CI: 0.37–0.91). After stratification by time spent in their community, protection from CHIKV infection was strongest among residents who reported spending many or all weekly daytime hours in their community:10.3% seropositive in communities with AGO traps vs. 48.7% in communities without (PR = 0.21, 95% CI: 0.11–0.41). The age-adjusted rate of fever with arthralgia attributable to CHIKV infection was 58% (95% CI: 46–66%). The monthly number of CHIKV-infected mosquitos and symptomatic residents were diminished in communities with AGO traps compared to those without. Conclusions These findings indicate that AGO traps are an effective tool that protects humans from infection with a virus transmitted by Ae. aegypti mosquitos. Future studies should evaluate their protective effectiveness in large, urban communities. Aedes species mosquitos transmit pathogens of public health importance, including dengue, Zika, and chikungunya viruses. No tools exist to control these mosquitos that sustainably and effectively prevent human infections. Autocidal gravid ovitraps (AGO traps) have been shown to sustainably reduce Aedes populations by >80%. After chikungunya virus was introduced into Puerto Rico, we conducted serosurveys in communities with and without AGO traps. We observed a two-fold lower prevalence of chikungunya virus infection among residents of communities with AGO traps compared to communities without. Among infected residents of communities with traps, a significant proportion likely had been infected while outside their community. These findings indicate that AGO traps are an effective tool that protects humans from infection with pathogens transmitted by Aedes mosquitos.
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Affiliation(s)
- Tyler M. Sharp
- Centers for Disease Control and Prevention, Dengue Branch, San Juan, Puerto Rico, United States of America
- United States Public Health Service, Silver Springs, Maryland, United States of America
- * E-mail:
| | - Olga Lorenzi
- Centers for Disease Control and Prevention, Dengue Branch, San Juan, Puerto Rico, United States of America
| | - Brenda Torres-Velásquez
- Centers for Disease Control and Prevention, Dengue Branch, San Juan, Puerto Rico, United States of America
| | - Veronica Acevedo
- Centers for Disease Control and Prevention, Dengue Branch, San Juan, Puerto Rico, United States of America
| | - Janice Pérez-Padilla
- Centers for Disease Control and Prevention, Dengue Branch, San Juan, Puerto Rico, United States of America
| | - Aidsa Rivera
- Centers for Disease Control and Prevention, Dengue Branch, San Juan, Puerto Rico, United States of America
| | - Jorge Muñoz-Jordán
- Centers for Disease Control and Prevention, Dengue Branch, San Juan, Puerto Rico, United States of America
| | - Harold S. Margolis
- Centers for Disease Control and Prevention, Dengue Branch, San Juan, Puerto Rico, United States of America
| | - Stephen H. Waterman
- Centers for Disease Control and Prevention, Dengue Branch, San Juan, Puerto Rico, United States of America
- United States Public Health Service, Silver Springs, Maryland, United States of America
| | - Brad J. Biggerstaff
- Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, Fort Collins, Colorado, United States of America
| | - Gabriela Paz-Bailey
- Centers for Disease Control and Prevention, Dengue Branch, San Juan, Puerto Rico, United States of America
| | - Roberto Barrera
- Centers for Disease Control and Prevention, Dengue Branch, San Juan, Puerto Rico, United States of America
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Hannon ER, Jackson KC, Biggerstaff BJ, Raman V, Komar N. Bloodmeal Host Selection of Culex quinquefasciatus (Diptera: Culicidae) in Las Vegas, Nevada, United States. J Med Entomol 2019; 56:603-608. [PMID: 30668743 DOI: 10.1093/jme/tjy237] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Indexed: 06/09/2023]
Abstract
St. Louis encephalitis virus (SLEV) and West Nile virus (WNV) have recently emerged in the southwestern United States. Surveillance for arboviruses in Las Vegas, NV, detected a surge of SLEV activity in the southern house mosquito (Culex quinquefasciatus Say) during 2016. To identify candidate avian amplifiers, we assessed the identification, viral infection, and immune status of vertebrate hosts for 195 blood-engorged Cx. quinquefasciatus mosquitoes collected in August and September 2016. Bloodmeals were identified from 164 engorged abdomens, representing 19 species of birds and three species of mammals. No SLEV or WNV viremia was detected, but one mosquito tested positive for Culex flavivirus. House finch (Haemorhous mexicanus) (Muller) was the most common bloodmeal, followed by domestic chicken (Gallus gallus) (Linnaeus), American robin (Turdus migratorius) L., house sparrow (Passer domesticus) (L.), great-tailed grackle (Quiscalus mexicanus) (Gmelin), northern mockingbird (Mimus polyglottos) (L.) and mourning dove (Zenaida macroura) (L.). SLEV-reactive antibodies were detected in six identified bloodmeals and WNV-reactive antibodies were detected in 33. House sparrow and house finch were the most likely hosts to show previous exposure to SLEV and WNV, respectively. Over-utilization by Cx. quinquefasciatus for bloodmeal hosts was observed primarily among robin, finch and sparrow, all species that roost communally. House finch stands out as a candidate important amplifier for both SLEV and WNV because of its preference by mosquito vectors, and high competence for closely related virus strains. While implicated in previous outbreaks as an important mosquito vector, Cx. quinquefasciatus feeds infrequently on mammals in Las Vegas, indicating a low risk for bridge transmission to humans.
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Affiliation(s)
- Emily R Hannon
- Arbovirus Diseases Branch, Division of Vector Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO
| | - Katelin C Jackson
- Arbovirus Diseases Branch, Division of Vector Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO
| | - Brad J Biggerstaff
- Arbovirus Diseases Branch, Division of Vector Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO
| | - Vivek Raman
- Southern Nevada Health District, Las Vegas, NV
| | - Nicholas Komar
- Arbovirus Diseases Branch, Division of Vector Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO
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Lindsey NP, Menitove JE, Biggerstaff BJ, Turabelidze G, Parton P, Peck K, Basile AJ, Kosoy OI, Fischer M, Staples JE. Seroprevalence of Heartland Virus Antibodies in Blood Donors, Northwestern Missouri, USA. Emerg Infect Dis 2019; 25:358-360. [PMID: 30511916 PMCID: PMC6346440 DOI: 10.3201/eid2502.181288] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We estimated the seroprevalence of Heartland virus antibodies to be 0.9% (95% CI 0.4%–4.2%) in a convenience sample of blood donors from northwestern Missouri, USA, where human cases and infected ticks have been identified. Although these findings suggest that some past human infections were undetected, the estimated prevalence is low.
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Mitchell PK, Mier-y-Teran-Romero L, Biggerstaff BJ, Delorey MJ, Aubry M, Cao-Lormeau VM, Lozier MJ, Cauchemez S, Johansson MA. Reassessing Serosurvey-Based Estimates of the Symptomatic Proportion of Zika Virus Infections. Am J Epidemiol 2019; 188:206-213. [PMID: 30165474 DOI: 10.1093/aje/kwy189] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 08/21/2018] [Indexed: 12/22/2022] Open
Abstract
Since the 2007 Zika epidemic in the Micronesian state of Yap, it has been apparent that not all people infected with Zika virus (ZIKV) experience symptoms. However, the proportion of infections that result in symptoms remains unclear. Existing estimates have varied in their interpretation of symptoms due to other causes and the case definition used, and they have assumed perfect test sensitivity and specificity. Using a Bayesian model and data from ZIKV serosurveys in Yap (2007), French Polynesia (2013-2014), and Puerto Rico (2016), we found that assuming perfect sensitivity and specificity generally led to lower estimates of the symptomatic proportion. Incorporating reasonable assumptions for assay sensitivity and specificity, we estimated that 27% (95% credible interval (CrI): 15, 37) (Yap), 44% (95% CrI: 26, 66) (French Polynesia), and 50% (95% CrI: 34, 92) (Puerto Rico) of infections were symptomatic, with variation due to differences in study populations, study designs, and case definitions. The proportion of ZIKV infections causing symptoms is critical for surveillance system design and impact assessment. Here, we accounted for key uncertainties in existing seroprevalence data and found that estimates for the symptomatic proportion ranged from 27% to 50%, suggesting that while the majority of infections are asymptomatic or mildly symptomatic, symptomatic infections might be more common than previously estimated.
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Affiliation(s)
- Patrick K Mitchell
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia
- Pennsylvania Department of Health, Harrisburg, Pennsylvania
| | - Luis Mier-y-Teran-Romero
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Brad J Biggerstaff
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Mark J Delorey
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Maite Aubry
- Unit of Emerging Infectious Diseases, Institut Louis Malardé, Papeete, Tahiti, French Polynesia
| | - Van-Mai Cao-Lormeau
- Unit of Emerging Infectious Diseases, Institut Louis Malardé, Papeete, Tahiti, French Polynesia
| | - Matthew J Lozier
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Simon Cauchemez
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Paris, France
- Centre National de la Recherche Scientifique, URA 3012, Paris, France
- Center of Bioinformatics, Biostatistics and Integrative Biology, Institut Pasteur, Paris, France
| | - Michael A Johansson
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
- Center for Communicable Disease Dynamics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Brandt KS, Ullmann AJ, Molins CR, Horiuchi K, Biggerstaff BJ, Gilmore RD. Evaluation of in vivo expressed Borrelia burgdorferi antigens for improved IgM serodiagnosis of early Lyme disease. Diagn Microbiol Infect Dis 2018; 93:196-202. [PMID: 30344068 DOI: 10.1016/j.diagmicrobio.2018.09.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 09/20/2018] [Accepted: 09/25/2018] [Indexed: 11/27/2022]
Abstract
Improved serologic tests are needed for accurate diagnosis and proper treatment of early stage Lyme disease. We evaluated the 3 antigens currently used for 2-tiered IgM immunoblot testing (FlaB, OspC, and BmpA) in combination with 3 additional antigens (BBA65, BBA70, and BBA73) and measured the sensitivity and specificity against a serum repository of positive and negative controls. Using 3 statistical methods for positivity cutoff determinations and scoring criteria, we found increased sensitivities for early Lyme disease when 2 of 6 antigens were positive as compared with the 2 of 3 antigen IgM criteria currently used for second-tier immunoblot scoring. Specificities for negative controls were comparable or superior to using 2 of 3 antigens. These results indicate that IgM sensitivity and specificity of serological testing for Lyme disease in the early stages of illness can be improved by employing antigens that target the initial host antibody responses.
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Affiliation(s)
- Kevin S Brandt
- Division of Vector Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, United States of America
| | - Amy J Ullmann
- Division of Vector Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, United States of America
| | - Claudia R Molins
- Division of Vector Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, United States of America
| | - Kalanthe Horiuchi
- Division of Vector Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, United States of America
| | - Brad J Biggerstaff
- Division of Vector Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, United States of America
| | - Robert D Gilmore
- Division of Vector Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, United States of America.
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Basile AJ, Goodman C, Horiuchi K, Sloan A, Johnson BW, Kosoy O, Laven J, Panella AJ, Sheets I, Medina F, Mendoza EJ, Epperson M, Maniatis P, Semenova V, Steward-Clark E, Wong E, Biggerstaff BJ, Lanciotti R, Drebot M, Safronetz D, Schiffer J. Multi-laboratory comparison of three commercially available Zika IgM enzyme-linked immunosorbent assays. J Virol Methods 2018; 260:26-33. [PMID: 29964076 PMCID: PMC7176053 DOI: 10.1016/j.jviromet.2018.06.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 06/06/2018] [Accepted: 06/28/2018] [Indexed: 11/17/2022]
Affiliation(s)
- Alison Jane Basile
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, United States.
| | - Christin Goodman
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, United States
| | - Kalanthe Horiuchi
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, United States
| | - Angela Sloan
- Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Barbara W Johnson
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, United States
| | - Olga Kosoy
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, United States
| | - Janeen Laven
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, United States
| | - Amanda J Panella
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, United States
| | - Isabel Sheets
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, United States
| | - Freddy Medina
- Dengue Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico, United States
| | - Emelissa J Mendoza
- Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Monica Epperson
- Microbial Pathogenesis and Immune Response Laboratory, Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Panagiotis Maniatis
- Microbial Pathogenesis and Immune Response Laboratory, Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Vera Semenova
- Microbial Pathogenesis and Immune Response Laboratory, Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Evelene Steward-Clark
- Microbial Pathogenesis and Immune Response Laboratory, Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Emily Wong
- Microbial Pathogenesis and Immune Response Laboratory, Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Brad J Biggerstaff
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, United States
| | - Robert Lanciotti
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, United States
| | - Michael Drebot
- Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - David Safronetz
- Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Jarad Schiffer
- Microbial Pathogenesis and Immune Response Laboratory, Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
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Krow-Lucal ER, Novosad SA, Dunn AC, Brent CR, Savage HM, Faraji A, Peterson D, Dibbs A, Vietor B, Christensen K, Laven JJ, Godsey MS, Christensen B, Beyer B, Cortese MM, Johnson NC, Panella AJ, Biggerstaff BJ, Rubin M, Fridkin SK, Staples JE, Nakashima AK. Zika Virus Infection in Patient with No Known Risk Factors, Utah, USA, 2016. Emerg Infect Dis 2018; 23:1260-1267. [PMID: 28726601 PMCID: PMC5547791 DOI: 10.3201/eid2308.170479] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
In 2016, Zika virus disease developed in a man (patient A) who had no known risk factors beyond caring for a relative who died of this disease (index patient). We investigated the source of infection for patient A by surveying other family contacts, healthcare personnel, and community members, and testing samples for Zika virus. We identified 19 family contacts who had similar exposures to the index patient; 86 healthcare personnel had contact with the index patient, including 57 (66%) who had contact with body fluids. Of 218 community members interviewed, 28 (13%) reported signs/symptoms and 132 (61%) provided a sample. Except for patient A, no other persons tested had laboratory evidence of recent Zika virus infection. Of 5,875 mosquitoes collected, none were known vectors of Zika virus and all were negative for Zika virus. The mechanism of transmission to patient A remains unknown but was likely person-to-person contact with the index patient.
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41
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Krow-Lucal ER, de Andrade MR, Cananéa JNA, Moore CA, Leite PL, Biggerstaff BJ, Cabral CM, Itoh M, Percio J, Wada MY, Powers AM, Barbosa A, Abath RB, Staples JE, Coelho GE, Araújo E, Medeiros ELA, Brant J, Cerroni M, de Barros Moreira Beltrão H, Fantinato FFST, Lise MLZ, Ohara PM, Resende E, Saad E, de St. Maurice A, Dieke A, Harrist A, Kwit N, Marlow M, Soke G, de Arruda Pessoa R, da Silva RC, Diniz RC, de Araújo Ariette MC, Lira CF, Matos S, Wanderley TMM, Silva VOC, da Silva HS, Carmo EH, Carvalho M, Lentini N, Miranda R, Boland E, Burns P, Fischer M, Ledermann J, Coronado F, Dicent-Taillepierre J, Flannery B, Macedo de Oliveira A, Arena JF. Association and birth prevalence of microcephaly attributable to Zika virus infection among infants in Paraíba, Brazil, in 2015–16: a case-control study. The Lancet Child & Adolescent Health 2018; 2:205-213. [DOI: 10.1016/s2352-4642(18)30020-8] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 12/06/2017] [Accepted: 12/12/2017] [Indexed: 12/01/2022]
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42
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Calvert AE, Biggerstaff BJ, Tanner NA, Lauterbach M, Lanciotti RS. Rapid colorimetric detection of Zika virus from serum and urine specimens by reverse transcription loop-mediated isothermal amplification (RT-LAMP). PLoS One 2017; 12:e0185340. [PMID: 28945787 PMCID: PMC5612724 DOI: 10.1371/journal.pone.0185340] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 09/11/2017] [Indexed: 12/22/2022] Open
Abstract
Zika virus (ZIKV) has emerged as a major global public health concern in the last two years due to its link as a causative agent of human birth defects. Its rapid expansion into the Western Hemisphere as well as the ability to be transmitted from mother to fetus, through sexual transmission and possibly through blood transfusions has increased the need for a rapid and expansive public health response to this unprecedented epidemic. A non-invasive and rapid ZIKV diagnostic screening assay that can be performed in a clinical setting throughout pregnancy is vital for prenatal care of women living in areas of the world where exposure to the virus is possible. To meet this need we have developed a sensitive and specific reverse transcriptase loop-mediated isothermal amplification (RT-LAMP) assay to detect ZIKV RNA in urine and serum with a simple visual detection. RT-LAMP results were shown to have a limit of detection 10-fold higher than qRT-PCR. As little as 1.2 RNA copies/μl was detected by RT-LAMP from a panel of 178 diagnostic specimens. The assay was shown to be highly specific for ZIKV RNA when tested with diagnostic specimens positive for dengue virus (DENV) and chikungunya virus (CHIKV). The assay described here illustrates the potential for a fast, reliable, sensitive and specific assay for the detection of ZIKV from urine or serum that can be performed in a clinical or field setting with minimal equipment and technological expertise.
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Affiliation(s)
- Amanda E. Calvert
- Arboviral Diseases Branch, Division of Vector-Borne Diseases, U.S. Centers for Disease Control and Prevention, Fort Collins, CO, United States of America
- * E-mail:
| | - Brad J. Biggerstaff
- Arboviral Diseases Branch, Division of Vector-Borne Diseases, U.S. Centers for Disease Control and Prevention, Fort Collins, CO, United States of America
| | | | - Molly Lauterbach
- Arboviral Diseases Branch, Division of Vector-Borne Diseases, U.S. Centers for Disease Control and Prevention, Fort Collins, CO, United States of America
| | - Robert S. Lanciotti
- Arboviral Diseases Branch, Division of Vector-Borne Diseases, U.S. Centers for Disease Control and Prevention, Fort Collins, CO, United States of America
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Abstract
In the estimation of proportions by pooled testing, the MLE is biased, and several methods of correcting the bias have been presented in previous studies. We propose a new estimator based on the bias correction method introduced by Firth (Biometrika 80:27-38, 1993), which uses a modification of the score function, and we provide an easily computable, Newton-Raphson iterative formula for its computation. Our proposed estimator is almost unbiased across a range of problems, and superior to existing methods. We show that for equal pool sizes the new estimator is equivalent to the estimator proposed by Burrows (Phytopathology 77:363-365, 1987). The performance of our estimator is examined using pooled testing problems encountered in plant disease assessment and prevalence estimation of mosquito-borne viruses.
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Affiliation(s)
- Graham Hepworth
- School of Mathematics and Statistics, The University of Melbourne, Victoria 3010, Australia,
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44
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Chevalier MS, Biggerstaff BJ, Basavaraju SV, Ocfemia MCB, Alsina JO, Climent-Peris C, Moseley RR, Chung KW, Rivera-García B, Bello-Pagán M, Pate LL, Galel SA, Williamson P, Kuehnert MJ. Use of Blood Donor Screening Data to Estimate Zika Virus Incidence, Puerto Rico, April-August 2016. Emerg Infect Dis 2017; 23:790-795. [PMID: 28263141 PMCID: PMC5403024 DOI: 10.3201/eid2305.161873] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Puerto Rico has been heavily impacted by Zika virus, a mosquitoborne flavivirus that emerged in the Americas during 2015. Although most persons with Zika virus show no symptoms, the virus can cause neurologic and other complications, including fetal microcephaly. Local Zika virus transmission in Puerto Rico has been reported since December 2015. To prevent transfusion-associated transmission, local blood collection ceased in March 2016 but resumed in April 2016 after Zika virus screening of blood donations became available. Using data from screening of blood donations collected by the 2 largest blood centers in Puerto Rico during April 3-August 12, 2016, and assuming a 9.9-day duration of viremia, we estimated that 469,321 persons in Puerto Rico were infected during this period, for an estimated cumulative incidence of 12.9%. Results from blood donation screening during arboviral outbreaks can supplement routine clinical and surveillance data for improved targeting of prevention efforts.
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Abstract
Information about the Zika virus disease incubation period can help identify risk periods and local virus transmission. In 2015-2016, data from 197 symptomatic travelers with recent Zika virus infection indicated an estimated incubation period of 3-14 days. For symptomatic persons with symptoms >2 weeks after travel, transmission might be not travel associated.
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46
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Eisen L, Breuner NE, Hojgaard A, Hoxmeier JC, Pilgard MA, Replogle AJ, Biggerstaff BJ, Dolan MC. Comparison of Vector Efficiency of Ixodes scapularis (Acari: Ixodidae) From the Northeast and Upper Midwest of the United States for the Lyme Disease Spirochete Borrelia mayonii. J Med Entomol 2017; 54:239-242. [PMID: 28082653 PMCID: PMC5777136 DOI: 10.1093/jme/tjw160] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 08/29/2016] [Indexed: 05/20/2023]
Abstract
Borrelia mayonii, a recently recognized species within the Borrelia burgdorferi sensu lato complex, has been detected in host-seeking Ixodes scapularis Say ticks and found to be associated with Lyme disease in the Upper Midwest. This spirochete has, to date, not been documented from the Northeast, but we previously demonstrated that I. scapularis ticks originating from Connecticut are capable of serving as a vector of B. mayonii In this follow-up study, we compared the vector efficiency for B. mayonii (strain MN14-1420) of I. scapularis ticks originating from Minnesota in the Upper Midwest and Connecticut in the Northeast. CD-1 outbred white mice previously infected with B. mayonii via tick bite were exposed to simultaneous feeding by Minnesota and Connecticut larvae contained within separate feeding capsules. We found no difference in the ability of Minnesota and Connecticut larvae to acquire B. mayonii from infected mice and pass spirochetes to the nymphal stage (overall nymphal infection rates of 11.6 and 13.3%, respectively). Moreover, the efficiency of transmission of B. mayonii by single infected nymphs was similar for the Minnesota and Connecticut ticks (33 and 44%, respectively). We conclude that the examined I. scapularis ticks from the Upper Midwest and Northeast did not differ in their efficiency as vectors for B. mayonii.
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Affiliation(s)
- Lars Eisen
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO 80521 (; ; ; ; ; ; ; )
| | - Nicole E Breuner
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO 80521 (; ; ; ; ; ; ; )
| | - Andrias Hojgaard
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO 80521 (; ; ; ; ; ; ; )
| | - J Charles Hoxmeier
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO 80521 (; ; ; ; ; ; ; )
| | - Mark A Pilgard
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO 80521 (; ; ; ; ; ; ; )
| | - Adam J Replogle
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO 80521 (; ; ; ; ; ; ; )
| | - Brad J Biggerstaff
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO 80521 (; ; ; ; ; ; ; )
| | - Marc C Dolan
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO 80521 (; ; ; ; ; ; ; )
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47
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Hemme RR, Poole-Smith BK, Hunsperger EA, Felix GE, Horiuchi K, Biggerstaff BJ, Lopez-Ortiz R, Barrera R. Non-human primate antibody response to mosquito salivary proteins: Implications for dengue virus transmission in Puerto Rico. Acta Trop 2016; 164:369-374. [PMID: 27593498 DOI: 10.1016/j.actatropica.2016.08.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 06/24/2016] [Accepted: 08/31/2016] [Indexed: 01/31/2023]
Abstract
An important step to incriminate a mosquito as a vector of a disease pathogen is finding evidence of direct contact between the mosquito and humans. Typically, this is accomplished through landing/biting catches, or host blood meal analysis in engorged mosquitoes via immunologic assays. An alternate approach is to identify the presence of specific mosquito anti-saliva protein antibodies in the blood of exposed hosts. Following the discovery of dengue infected, free roaming non-human primates in Puerto Rico, we investigated which mosquito species had bitten these primates using a serologic assay. Serum samples from 20 patas monkeys (Erythrocebus patas) and two rhesus macaques (Macaca mulatta) were used to evaluate mosquito bite exposure to Aedes aegypti, Aedes mediovittatus, Aedes taeniorhynchus, and Culex quinquefasciatus mosquitoes. Of 22 non-human primates examined 20 (90%), 17 (77%), 13 (59%), and 7 (31%) were positive for exposure to Ae. mediovittatus, Cx. quinquefasciatus, Ae. taeniorhynchus, and Ae. aegypti, respectively. Our findings indicated that free-roaming primates in Puerto Rico were exposed to the bites of one proven dengue vector, Ae. aegypti and one potential dengue vector, Ae. mediovittatus.
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Affiliation(s)
- Ryan R Hemme
- Dengue Branch, Centers for Disease Control and Prevention, San Juan 00920, Puerto Rico.
| | | | | | - Gilberto E Felix
- Dengue Branch, Centers for Disease Control and Prevention, San Juan 00920, Puerto Rico.
| | - Kalanthe Horiuchi
- Office of the Director (Division of Vector Borne Diseases), Centers for Disease Control and Prevention, Fort Collins, CO 80521, United States.
| | - Brad J Biggerstaff
- Office of the Director (Division of Vector Borne Diseases), Centers for Disease Control and Prevention, Fort Collins, CO 80521, United States.
| | - Ricardo Lopez-Ortiz
- Fish and Wildlife Bureau, Puerto Rico Department of Natural & Environmental Resources, San Juan 00936, Puerto Rico.
| | - Roberto Barrera
- Dengue Branch, Centers for Disease Control and Prevention, San Juan 00920, Puerto Rico.
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Shang G, Biggerstaff BJ, Richardson AM, Gahan ME, Lidbury BA. A simulation model to estimate the risk of transfusion-transmitted arboviral infection. Transfus Apher Sci 2016; 55:233-239. [DOI: 10.1016/j.transci.2016.07.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 07/01/2016] [Accepted: 07/18/2016] [Indexed: 12/25/2022]
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49
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Han GS, Gregory CJ, Biggerstaff BJ, Horiuchi K, Perez-Guerra C, Soto-Gomez E, Matos D, Margolis HS, Tomashek KM. Effect of a Dengue Clinical Case Management Course on Physician Practices in Puerto Rico. Clin Infect Dis 2016; 63:1297-1303. [PMID: 27506689 DOI: 10.1093/cid/ciw511] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 07/21/2016] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Prior to 2010, the clinical management of dengue in Puerto Rico was inconsistent with World Health Organization guidelines. A 4-hour classroom-style course on dengue clinical management was developed in 2009 and mandated for Puerto Rico medical licensure in 2010. Fifty physicians were trained as "master trainers" and gave this course to 7638 physicians. This study evaluated the effect of the course on the clinical management of hospitalized dengue patients. METHODS Pre- and post-course test responses were compared. Changes in physician practices were assessed by reviewing medical records of 430 adult and 1075 pediatric dengue patients at the 12 hospitals in Puerto Rico that reported the most cases during 2008-2009 (pre-intervention) and 2011 (post-intervention). Mixed-effects logistic regression was used to compare key indicators of dengue management. RESULTS Physician test scores increased from 48% to 72% correct. Chart reviews showed that the percentage of adult patients who did not receive corticosteroids increased from 30% to 68% (odds ratio [OR], 5.9; 95% confidence interval [CI], 3.7-9.5) and from 91% to 96% in pediatric patients (OR, 2.7; 95% CI, 1.5-4.9). Usage of isotonic intravenous saline during the critical period increased from 57% to 90% in adult patients (OR, 6.2; 95% CI, 1.9-20.4) and from 25% to 44% in pediatric patients (OR, 3.4; 95% CI, 2.2-5.3). CONCLUSIONS Management of dengue inpatients significantly improved following implementation of a classroom-style course taught by master trainers. An online version of the course was launched in 2014 to expand its reach and sustainability.
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Affiliation(s)
- George S Han
- Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | | | - Brad J Biggerstaff
- Office of the Director, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Kalanthe Horiuchi
- Office of the Director, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Carmen Perez-Guerra
- Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Eunice Soto-Gomez
- Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Desiree Matos
- Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Harold S Margolis
- Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Kay M Tomashek
- Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
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50
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Kersh GJ, Priestley RA, Hornstra HM, Self JS, Fitzpatrick KA, Biggerstaff BJ, Keim P, Pearson T, Massung RF. Genotyping and Axenic Growth of Coxiella burnetii Isolates Found in the United States Environment. Vector Borne Zoonotic Dis 2016; 16:588-94. [PMID: 27304166 DOI: 10.1089/vbz.2016.1972] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Coxiella burnetii is a gram-negative bacterium that is the etiologic agent of the zoonotic disease Q fever. Common reservoirs of C. burnetii include sheep, goats, and cattle. These animals shed C. burnetii into the environment, and humans are infected by inhalation of aerosols. A survey of 1622 environmental samples taken across the United States in 2006-2008 found that 23.8% of the samples contained C. burnetii DNA. To identify the strains circulating in the U.S. environment, DNA from these environmental samples was genotyped using an SNP-based approach to derive sequence types (ST) that are also compatible with multispacer sequence typing methods. Three different sequence types were observed in 31 samples taken from 19 locations. ST8 was associated with goats and ST20 with dairy cattle. ST16/26 was detected in locations with exposure to various animals and also in locations with no direct animal contact. Viable isolates were obtained for all three sequence types, but only the ST20 and ST16/26 isolates grew in acidified citrate cysteine medium (ACCM)-2 axenic media. Examination of a variety of isolates with different sequence types showed that ST8 and closely related isolates did not grow in ACCM-2. These results suggest that a limited number of C. burnetii sequence types are circulating in the U.S. environment and these strains have close associations with specific reservoir species. Growth in ACCM-2 may not be suitable for isolation of many C. burnetii strains.
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Affiliation(s)
- Gilbert J Kersh
- 1 Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Rachael A Priestley
- 1 Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Heidie M Hornstra
- 2 Center for Microbial Genetics and Genomics, Northern Arizona University , Flagstaff, Arizona
| | - Joshua S Self
- 1 Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Kelly A Fitzpatrick
- 1 Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Brad J Biggerstaff
- 3 Division of Vector-Borne Diseases, Centers for Disease Control and Prevention , Ft. Collins, Colorado
| | - Paul Keim
- 2 Center for Microbial Genetics and Genomics, Northern Arizona University , Flagstaff, Arizona
| | - Talima Pearson
- 2 Center for Microbial Genetics and Genomics, Northern Arizona University , Flagstaff, Arizona
| | - Robert F Massung
- 1 Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention , Atlanta, Georgia
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