1
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Oltean HN, Allen KJ, Frisbie L, Lunn SM, Torres LM, Manahan L, Painter I, Russell D, Singh A, Peterson JM, Grant K, Peter C, Cao R, Garcia K, Mackellar D, Jones L, Halstead H, Gray H, Melly G, Nickerson D, Starita L, Frazar C, Greninger AL, Roychoudhury P, Mathias PC, Kalnoski MH, Ting CN, Lykken M, Rice T, Gonzalez-Robles D, Bina D, Johnson K, Wiley CL, Magnuson SC, Parsons CM, Chapman ED, Valencia CA, Fortna RR, Wolgamot G, Hughes JP, Baseman JG, Bedford T, Lindquist S. Sentinel Surveillance System Implementation and Evaluation for SARS-CoV-2 Genomic Data, Washington, USA, 2020-2021. Emerg Infect Dis 2023; 29:242-251. [PMID: 36596565 PMCID: PMC9881772 DOI: 10.3201/eid2902.221482] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Genomic data provides useful information for public health practice, particularly when combined with epidemiologic data. However, sampling bias is a concern because inferences from nonrandom data can be misleading. In March 2021, the Washington State Department of Health, USA, partnered with submitting and sequencing laboratories to establish sentinel surveillance for SARS-CoV-2 genomic data. We analyzed available genomic and epidemiologic data during presentinel and sentinel periods to assess representativeness and timeliness of availability. Genomic data during the presentinel period was largely unrepresentative of all COVID-19 cases. Data available during the sentinel period improved representativeness for age, death from COVID-19, outbreak association, long-term care facility-affiliated status, and geographic coverage; timeliness of data availability and captured viral diversity also improved. Hospitalized cases were underrepresented, indicating a need to increase inpatient sampling. Our analysis emphasizes the need to understand and quantify sampling bias in phylogenetic studies and continue evaluation and improvement of public health surveillance systems.
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Lim E, Reeves J, Gandhi S, Spigel D, Arrowsmith E, George D, Karlix J, Pouliot G, Hattersley M, Gangl E, James G, Thompson J, Russell D, Patel B, Kumar R, Falchook G. 1396P Phase II study of AZD4635 in combination with durvalumab or oleclumab in patients (pts) with metastatic castrate-resistant prostate cancer (mCRPC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1882] [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] [Indexed: 11/26/2022] Open
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3
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Ross A, Iwata K, Elsouda D, Hairston J, Russell D, Davicioni E, Proudfoot J, Shore N, Cooperberg M, Schaeffer E. 1385P Transcriptome-based prognostic and predictive biomarker analysis of ENACT: A randomized controlled trial of enzalutamide (ENZA) in men undergoing active surveillance (AS). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1517] [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] [Indexed: 11/29/2022] Open
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4
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Ratajczak-Tretel B, Tancin Lambert A, Hoie GA, Al-Ani R, Russell D, Atar D, Aamodt AH. Detection of atrial fibrillation in patients with cryptogenic stroke: The Nordic Atrial Fibrillation and Stroke (NOR-FIB) study - topline results. Europace 2022. [DOI: 10.1093/europace/euac053.280] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Other. Main funding source(s): NOR-FIB is an investigator driven academic study. 100 of 259 devices are supported by Medtronic.
BRT and ATL are recipients of a PhD grants from the South-Eastern Norway Regional Health Authority.
The study is supported by the research infrastructure of the European Cerebrovascular Research Infrastructure (ECRI).
Background
Cardioembolism due to occult atrial fibrillation (AF) is one of the common causes often identified by additional investigations in patients with cryptogenic stroke (CS). A large proportion of recurrent cerebral infarctions caused by AF can probably be prevented if more patients receive optimal cardiac monitoring after CS and TIA.
Purpose
The aim of the prospective observational multi-center NOR-FIB study was to detect and quantify AF in patients with cryptogenic stroke or TIA under continuous 12 months cardiac rhythm monitoring with an implantable cardiac monitor (ICM) and to possibly identify biomarkers predicting incident AF.
Methods
Patients with cryptogenic stroke and TIA diagnosed after state-of-the-art work-up had their ICM implanted by a stroke physician within 14 days after symptom onset. All patients were followed clinically and by rhythm monitoring for 12 months. AF was defined by detected atrial arrhythmia episodes ≥ 2 min, and these patients were considered for a change of their secondary prevention from antiplatelet drugs to oral anticoagulants (OAC).
Results
A total of 259 patients with cryptogenic stroke or TIA from 18 hospitals in Norway, Sweden and Denmark were included. After 12 months follow-up 74 (28.6 %) patients were diagnosed with paroxysmal AF, of which 91.9% were asymptomatic. Patients with AF had significantly higher mean age (72.6 vs 62.2, p<0.001), more severe stroke (median National Institute Stroke Scale Score on admission 2 vs 1, p 0.002) and higher pre-stroke median CHA2DS2-VASc score (3 vs 2, p<0.001) than patients without AF. Both hypertension and hyperlipidemia was more common in patients with AF. In 64 (86.5%) cases AF was detected early after index stroke, i.e., within the first two months of monitoring (mean 47.7 days + 52,1). Recurrent AF episodes were detected in 68 (91.9%) cases. Of the 74 AF patients, 72 (97.3%) were switched to OAC. Recurrent strokes during follow-up occurred in 2 AF patients (2.7 %) and in 9 non-AF patients (4.9 %).
Conclusion
AF was detected in 29% of all cryptogenic stroke/TIA patients. Most of the patients were asymptomatic for their arrhythmia, and would have gone undiagnosed without a continuous monitoring approach. Since most of the patients with detected AF were switched to OAC, the 12 months risk of recurrent stroke in this group was low. Prolonged cardiac rhythm monitoring with ICMs is an effective tool for diagnosing underlying asymptomatic AF in a patient population typically confined to a stroke unit.
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Affiliation(s)
| | - A Tancin Lambert
- Sykehuset Ostfold Kalnes, Department of Neurology, Sarpsborg, Norway
| | - GA Hoie
- Sykehuset Ostfold Kalnes, Department of Cardiology, Sarpsborg, Norway
| | - R Al-Ani
- Sykehuset Ostfold Kalnes, Department of Cardiology, Sarpsborg, Norway
| | - D Russell
- Oslo University Hospital Rikshospitalet, Department of Neurology, Oslo, Norway
| | - D Atar
- Oslo University Hospital Ulleval, Department of Cardiology, Oslo, Norway
| | - AH Aamodt
- Oslo University Hospital Rikshospitalet, Department of Neurology, Oslo, Norway
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5
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Paredes MI, Lunn SM, Famulare M, Frisbie LA, Painter I, Burstein R, Roychoudhury P, Xie H, Mohamed Bakhash SA, Perez R, Lukes M, Ellis S, Sathees S, Mathias PC, Greninger A, Starita LM, Frazar CD, Ryke E, Zhong W, Gamboa L, Threlkeld M, Lee J, McDermot E, Truong M, Nickerson DA, Bates DL, Hartman ME, Haugen E, Nguyen TN, Richards JD, Rodriguez JL, Stamatoyannopoulos JA, Thorland E, Melly G, Dykema PE, MacKellar DC, Gray HK, Singh A, Peterson JM, Russell D, Marcela Torres L, Lindquist S, Bedford T, Allen KJ, Oltean HN. Associations between SARS-CoV-2 variants and risk of COVID-19 hospitalization among confirmed cases in Washington State: a retrospective cohort study. Clin Infect Dis 2022; 75:e536-e544. [PMID: 35412591 PMCID: PMC9047245 DOI: 10.1093/cid/ciac279] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Indexed: 12/22/2022] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic is dominated by variant viruses; the resulting impact on disease severity remains unclear. Using a retrospective cohort study, we assessed the hospitalization risk following infection with 7 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants. Methods Our study includes individuals with positive SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) in the Washington Disease Reporting System with available viral genome data, from 1 December 2020 to 14 January 2022. The analysis was restricted to cases with specimens collected through sentinel surveillance. Using a Cox proportional hazards model with mixed effects, we estimated hazard ratios (HR) for hospitalization risk following infection with a variant, adjusting for age, sex, calendar week, and vaccination. Results In total, 58 848 cases were sequenced through sentinel surveillance, of which 1705 (2.9%) were hospitalized due to COVID-19. Higher hospitalization risk was found for infections with Gamma (HR 3.20, 95% confidence interval [CI] 2.40–4.26), Beta (HR 2.85, 95% CI 1.56–5.23), Delta (HR 2.28 95% CI 1.56–3.34), or Alpha (HR 1.64, 95% CI 1.29–2.07) compared to infections with ancestral lineages; Omicron (HR 0.92, 95% CI .56–1.52) showed no significant difference in risk. Following Alpha, Gamma, or Delta infection, unvaccinated patients show higher hospitalization risk, while vaccinated patients show no significant difference in risk, both compared to unvaccinated, ancestral lineage cases. Hospitalization risk following Omicron infection is lower with vaccination. Conclusions Infection with Alpha, Gamma, or Delta results in a higher hospitalization risk, with vaccination attenuating that risk. Our findings support hospital preparedness, vaccination, and genomic surveillance.
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Affiliation(s)
- Miguel I Paredes
- Department of Epidemiology, University of Washington, Seattle, WA, USA.,Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | | | - Michael Famulare
- Institute for Disease Modeling, Bill and Melinda Gates Foundation, Seattle, WA USA
| | | | - Ian Painter
- Washington State Department of Health, Shoreline, WA USA
| | - Roy Burstein
- Institute for Disease Modeling, Bill and Melinda Gates Foundation, Seattle, WA USA
| | - Pavitra Roychoudhury
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.,Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Hong Xie
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Shah A Mohamed Bakhash
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Ricardo Perez
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Maria Lukes
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Sean Ellis
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Saraswathi Sathees
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Patrick C Mathias
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Alexander Greninger
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.,Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Lea M Starita
- Department of Genome Sciences, University of Washington, Seattle, WA, USA.,Brotman Baty Institute for Precision Medicine, Seattle, WA USA
| | - Chris D Frazar
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | - Erica Ryke
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | - Weizhi Zhong
- Brotman Baty Institute for Precision Medicine, Seattle, WA USA
| | - Luis Gamboa
- Brotman Baty Institute for Precision Medicine, Seattle, WA USA
| | - Machiko Threlkeld
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | - Jover Lee
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Evan McDermot
- Brotman Baty Institute for Precision Medicine, Seattle, WA USA
| | - Melissa Truong
- Brotman Baty Institute for Precision Medicine, Seattle, WA USA
| | - Deborah A Nickerson
- Department of Genome Sciences, University of Washington, Seattle, WA, USA.,Brotman Baty Institute for Precision Medicine, Seattle, WA USA
| | - Daniel L Bates
- Altius Institute for Biomedical Sciences, Seattle, WA USA
| | - Matthew E Hartman
- Altius Institute for Biomedical Sciences, Seattle, WA USA.,Department of Cardiovascular Services, Swedish Medical Center, Seattle, WA USA
| | - Eric Haugen
- Altius Institute for Biomedical Sciences, Seattle, WA USA
| | | | | | | | | | - Eric Thorland
- Altius Institute for Biomedical Sciences, Seattle, WA USA
| | - Geoff Melly
- Washington State Department of Health, Shoreline, WA USA
| | | | | | - Hannah K Gray
- Washington State Department of Health, Shoreline, WA USA
| | - Avi Singh
- Washington State Department of Health, Shoreline, WA USA
| | | | - Denny Russell
- Washington State Department of Health, Shoreline, WA USA
| | | | | | - Trevor Bedford
- Department of Epidemiology, University of Washington, Seattle, WA, USA.,Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.,Department of Genome Sciences, University of Washington, Seattle, WA, USA.,Howard Hughes Medical Institute, Seattle, WA USA
| | | | - Hanna N Oltean
- Washington State Department of Health, Shoreline, WA USA
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6
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Siddle H, Bonner R, Leighton P, McGinnis E, Rahma S, Stubbs N, Hinchcliff R, Wright-Hughes A, Nixon J, Richards S, Russell D. 652 Fate of The Contralateral Limb Following Major Lower Limb Amputation in Patients with Peripheral Arterial Disease And/Or Diabetes: Case Series from Two Regional Vascular Centres. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.1119] [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] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
This is the first clinical case series to report time to ulceration, minor and major amputation of the contralateral limb (CLL) in the first 12 months following major lower limb amputation (LLA) in patients with peripheral arterial disease (PAD) and/or diabetes.
Method
Consecutive patient samples at two regional UK vascular centres were included; from 2010 to 2017 (site 1) and 2014 to 2016 (site 2). Data were extracted from electronic records for 12 months following index major LLA. Survival analyses are presented for the event of mortality in the total study population, plus major amputation-free survival, and complication-free survival in site 1 only; results are stratified by diabetes status.
Results
Of 381 patients reviewed (n = 197 site 1; n = 184 site 2), 208 (54.6%) were diagnosed with diabetes at the time of their index major LLA. The mean survival time of patients was lower in those without diabetes (HR: 0.64 [95% CI, 0.43 to 0.95], p=.03). The mean time to major amputation of the CLL or death in patients was lower in those without diabetes (HR: 0.65 [95% CI, 224 0.40 to 1.06]; p=.08). The median time to any complication of the CLL or death was greater in those without diabetes (HR: 1.25 [95% CI, 227 0.88 to 1.78]; p=.21).
Conclusions
Death rates were higher in patients without diabetes, whilst those with diabetes had high levels of CLL complications. Optimisation of care to protect the CLL following major LLA and guidance for carers, patients, and clinicians is required.
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Affiliation(s)
- H Siddle
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom
- Podiatry Department, Leeds Teaching Hospitals NHS Trust, St James University Hospital, Leeds, United Kingdom
| | - R Bonner
- Leeds Institute for Health Sciences, University of Leeds, Leeds, United Kingdom
| | - P Leighton
- Department of Vascular Surgery, North Bristol NHS Trust, Bristol, United Kingdom
| | - E McGinnis
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, United Kingdom
| | - S Rahma
- Leeds Vascular Institute, Leeds Teaching Hospitals NHS Trust, Leeds General 25 Infirmary, Leeds, United Kingdom
| | - N Stubbs
- Leeds Community Healthcare NHS Trust, Leeds, United Kingdom
| | - R Hinchcliff
- Department of Vascular Surgery, North Bristol NHS Trust, Bristol, United Kingdom
- Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - A Wright-Hughes
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, United Kingdom
| | - J Nixon
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, United Kingdom
| | - S Richards
- Leeds Institute for Health Sciences, University of Leeds, Leeds, United Kingdom
| | - D Russell
- Leeds Vascular Institute, Leeds Teaching Hospitals NHS Trust, Leeds General 25 Infirmary, Leeds, United Kingdom
- Leeds Institute of Cardiovascular and Metabolic Medicine, LIGHT Laboratories, University of Leeds, Leeds, United Kingdom
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7
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George D, Agarwal N, Ramaswamy K, Sandin R, Russell D, Hong A, Yang H, Gao W, Hagan K, Freedland S. 616P Real-world utilization of advanced therapies by metastatic site and age among patients with metastatic castration-sensitive prostate cancer (mCSPC): A Medicare database analysis. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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8
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McLaughlin HP, Hiatt BC, Russell D, Carlson CM, Jacobs JR, Perez-Osorio AC, Holshue ML, Choi SW, Gautom RK. COVID-19 Response Efforts of Washington State Public Health Laboratory: Lessons Learned. Am J Public Health 2021; 111:867-875. [PMID: 33734847 PMCID: PMC8034017 DOI: 10.2105/ajph.2021.306212] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Laboratory diagnostics play an essential role in pandemic preparedness. In January 2020, the first US case of COVID-19 was confirmed in Washington State. At the same time, the Washington State Public Health Laboratory (WA PHL) was in the process of building upon and initiating innovative preparedness activities to strengthen laboratory testing capabilities, operations, and logistics. The response efforts of WA PHL, in conjunction with the Centers for Disease Control and Prevention, to the COVID-19 outbreak in Washington are described herein-from the initial detection of severe acute respiratory syndrome coronavirus 2 through the subsequent 2 months.Factors that contributed to an effective laboratory response are described, including preparing early to establish testing capacity, instituting dynamic workforce solutions, advancing information management systems, refining laboratory operations, and leveraging laboratory partnerships. We also report on the challenges faced, successful steps taken, and lessons learned by WA PHL to respond to COVID-19.The actions taken by WA PHL to mount an effective public health response may be useful for US laboratories as they continue to respond to the COVID-19 pandemic and may help inform current and future laboratory pandemic preparedness activities.
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Affiliation(s)
- Heather P McLaughlin
- Heather P. McLaughlin is with the Division of Preparedness and Emerging Infections, Centers for Disease Control and Prevention, Atlanta, GA. Brian C. Hiatt, Denny Russell, Ailyn C. Perez-Osorio, Sung W. Choi, and Romesh K. Gautom are with the Washington State Public Health Laboratories, Washington State Department of Health, Shoreline. Christina M. Carlson and Jesica R. Jacobs are with the Laboratory Leadership Service, Centers for Disease Control and Prevention. Michelle L. Holshue is a Career Epidemiology Field Officer, Centers for Disease Control and Prevention.,Note. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Use of trade names is for identification only and does not imply endorsement by the Centers for Disease Control and Prevention
| | - Brian C Hiatt
- Heather P. McLaughlin is with the Division of Preparedness and Emerging Infections, Centers for Disease Control and Prevention, Atlanta, GA. Brian C. Hiatt, Denny Russell, Ailyn C. Perez-Osorio, Sung W. Choi, and Romesh K. Gautom are with the Washington State Public Health Laboratories, Washington State Department of Health, Shoreline. Christina M. Carlson and Jesica R. Jacobs are with the Laboratory Leadership Service, Centers for Disease Control and Prevention. Michelle L. Holshue is a Career Epidemiology Field Officer, Centers for Disease Control and Prevention.,Note. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Use of trade names is for identification only and does not imply endorsement by the Centers for Disease Control and Prevention
| | - Denny Russell
- Heather P. McLaughlin is with the Division of Preparedness and Emerging Infections, Centers for Disease Control and Prevention, Atlanta, GA. Brian C. Hiatt, Denny Russell, Ailyn C. Perez-Osorio, Sung W. Choi, and Romesh K. Gautom are with the Washington State Public Health Laboratories, Washington State Department of Health, Shoreline. Christina M. Carlson and Jesica R. Jacobs are with the Laboratory Leadership Service, Centers for Disease Control and Prevention. Michelle L. Holshue is a Career Epidemiology Field Officer, Centers for Disease Control and Prevention.,Note. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Use of trade names is for identification only and does not imply endorsement by the Centers for Disease Control and Prevention
| | - Christina M Carlson
- Heather P. McLaughlin is with the Division of Preparedness and Emerging Infections, Centers for Disease Control and Prevention, Atlanta, GA. Brian C. Hiatt, Denny Russell, Ailyn C. Perez-Osorio, Sung W. Choi, and Romesh K. Gautom are with the Washington State Public Health Laboratories, Washington State Department of Health, Shoreline. Christina M. Carlson and Jesica R. Jacobs are with the Laboratory Leadership Service, Centers for Disease Control and Prevention. Michelle L. Holshue is a Career Epidemiology Field Officer, Centers for Disease Control and Prevention.,Note. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Use of trade names is for identification only and does not imply endorsement by the Centers for Disease Control and Prevention
| | - Jesica R Jacobs
- Heather P. McLaughlin is with the Division of Preparedness and Emerging Infections, Centers for Disease Control and Prevention, Atlanta, GA. Brian C. Hiatt, Denny Russell, Ailyn C. Perez-Osorio, Sung W. Choi, and Romesh K. Gautom are with the Washington State Public Health Laboratories, Washington State Department of Health, Shoreline. Christina M. Carlson and Jesica R. Jacobs are with the Laboratory Leadership Service, Centers for Disease Control and Prevention. Michelle L. Holshue is a Career Epidemiology Field Officer, Centers for Disease Control and Prevention.,Note. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Use of trade names is for identification only and does not imply endorsement by the Centers for Disease Control and Prevention
| | - Ailyn C Perez-Osorio
- Heather P. McLaughlin is with the Division of Preparedness and Emerging Infections, Centers for Disease Control and Prevention, Atlanta, GA. Brian C. Hiatt, Denny Russell, Ailyn C. Perez-Osorio, Sung W. Choi, and Romesh K. Gautom are with the Washington State Public Health Laboratories, Washington State Department of Health, Shoreline. Christina M. Carlson and Jesica R. Jacobs are with the Laboratory Leadership Service, Centers for Disease Control and Prevention. Michelle L. Holshue is a Career Epidemiology Field Officer, Centers for Disease Control and Prevention.,Note. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Use of trade names is for identification only and does not imply endorsement by the Centers for Disease Control and Prevention
| | - Michelle L Holshue
- Heather P. McLaughlin is with the Division of Preparedness and Emerging Infections, Centers for Disease Control and Prevention, Atlanta, GA. Brian C. Hiatt, Denny Russell, Ailyn C. Perez-Osorio, Sung W. Choi, and Romesh K. Gautom are with the Washington State Public Health Laboratories, Washington State Department of Health, Shoreline. Christina M. Carlson and Jesica R. Jacobs are with the Laboratory Leadership Service, Centers for Disease Control and Prevention. Michelle L. Holshue is a Career Epidemiology Field Officer, Centers for Disease Control and Prevention.,Note. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Use of trade names is for identification only and does not imply endorsement by the Centers for Disease Control and Prevention
| | - Sung W Choi
- Heather P. McLaughlin is with the Division of Preparedness and Emerging Infections, Centers for Disease Control and Prevention, Atlanta, GA. Brian C. Hiatt, Denny Russell, Ailyn C. Perez-Osorio, Sung W. Choi, and Romesh K. Gautom are with the Washington State Public Health Laboratories, Washington State Department of Health, Shoreline. Christina M. Carlson and Jesica R. Jacobs are with the Laboratory Leadership Service, Centers for Disease Control and Prevention. Michelle L. Holshue is a Career Epidemiology Field Officer, Centers for Disease Control and Prevention.,Note. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Use of trade names is for identification only and does not imply endorsement by the Centers for Disease Control and Prevention
| | - Romesh K Gautom
- Heather P. McLaughlin is with the Division of Preparedness and Emerging Infections, Centers for Disease Control and Prevention, Atlanta, GA. Brian C. Hiatt, Denny Russell, Ailyn C. Perez-Osorio, Sung W. Choi, and Romesh K. Gautom are with the Washington State Public Health Laboratories, Washington State Department of Health, Shoreline. Christina M. Carlson and Jesica R. Jacobs are with the Laboratory Leadership Service, Centers for Disease Control and Prevention. Michelle L. Holshue is a Career Epidemiology Field Officer, Centers for Disease Control and Prevention.,Note. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Use of trade names is for identification only and does not imply endorsement by the Centers for Disease Control and Prevention
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9
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Wilson‐Barnes S, Gymnopoulos LP, Dimitropoulos K, Solachidis V, Rouskas K, Russell D, Oikonomidis Y, Hadjidimitriou S, María Botana J, Brkic B, Mantovani E, Gravina S, Telo G, Lalama E, Buys R, Hassapidou M, Balula Dias S, Batista A, Perone L, Bryant S, Maas S, Cobello S, Bacelar P, Lanham‐New SA, Hart K. PeRsOnalised nutriTion for hEalthy livINg: The PROTEIN project. NUTR BULL 2021. [DOI: 10.1111/nbu.12482] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- S. Wilson‐Barnes
- School of Biosciences and Medicine, Faculty of Health and Medical Sciences University of Surrey Guildford UK
| | | | | | - V. Solachidis
- Centre for Research and Technology Hellas Thessaloniki Greece
| | - K. Rouskas
- Centre for Research and Technology Hellas Thessaloniki Greece
| | | | | | - S. Hadjidimitriou
- Department of Electrical and Computer Engineering Aristotle University of Thessaloniki Thessaloniki Greece
| | | | - B. Brkic
- BioSense Institute, Research and Development Institute for Information Technology Vojvodina Serbia
| | - E. Mantovani
- Research Group on Law, Science, Technology and Society Vrije Universiteit Brussel Brussels Belgium
| | | | - G. Telo
- PLUX Wireless Biosignals Lisbon Portugal
| | - E. Lalama
- Department of Endocrinology and Metabolic Diseases Charité Universitätsmedizin Berlin Germany
| | - R. Buys
- Department of Rehabilitation Sciences Katholieke Universiteit Leuven Leuven Belgium
| | - M. Hassapidou
- Department of Nutrition and Dietetics Alexander Technological Educational Institute of Thessaloniki Thessaloniki Greece
| | - S. Balula Dias
- Faculdade de Motricidade Humana Universidade de Lisboa Lisbon Portugal
| | | | | | - S. Bryant
- European Association for the Study of Obesity (EASO) Middlesex UK
| | - S. Maas
- AgriFood Capital BV Hertogenbosch Netherlands
| | - S. Cobello
- Polo Europeo della Conoscenza Verona Italy
| | - P. Bacelar
- Healthium/Nutrium Software Porto e Região Portugal
| | - S. A. Lanham‐New
- School of Biosciences and Medicine, Faculty of Health and Medical Sciences University of Surrey Guildford UK
| | - K. Hart
- School of Biosciences and Medicine, Faculty of Health and Medical Sciences University of Surrey Guildford UK
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10
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Burke RM, Balter S, Barnes E, Barry V, Bartlett K, Beer KD, Benowitz I, Biggs HM, Bruce H, Bryant-Genevier J, Cates J, Chatham-Stephens K, Chea N, Chiou H, Christiansen D, Chu VT, Clark S, Cody SH, Cohen M, Conners EE, Dasari V, Dawson P, DeSalvo T, Donahue M, Dratch A, Duca L, Duchin J, Dyal JW, Feldstein LR, Fenstersheib M, Fischer M, Fisher R, Foo C, Freeman-Ponder B, Fry AM, Gant J, Gautom R, Ghinai I, Gounder P, Grigg CT, Gunzenhauser J, Hall AJ, Han GS, Haupt T, Holshue M, Hunter J, Ibrahim MB, Jacobs MW, Jarashow MC, Joshi K, Kamali T, Kawakami V, Kim M, Kirking HL, Kita-Yarbro A, Klos R, Kobayashi M, Kocharian A, Lang M, Layden J, Leidman E, Lindquist S, Lindstrom S, Link-Gelles R, Marlow M, Mattison CP, McClung N, McPherson TD, Mello L, Midgley CM, Novosad S, Patel MT, Pettrone K, Pillai SK, Pray IW, Reese HE, Rhodes H, Robinson S, Rolfes M, Routh J, Rubin R, Rudman SL, Russell D, Scott S, Shetty V, Smith-Jeffcoat SE, Soda EA, Spitters C, Stierman B, Sunenshine R, Terashita D, Traub E, Vahey GM, Verani JR, Wallace M, Westercamp M, Wortham J, Xie A, Yousaf A, Zahn M. Enhanced contact investigations for nine early travel-related cases of SARS-CoV-2 in the United States. PLoS One 2020; 15:e0238342. [PMID: 32877446 DOI: 10.1101/2020.04.27.20081901] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 08/15/2020] [Indexed: 05/24/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19), the respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first identified in Wuhan, China and has since become pandemic. In response to the first cases identified in the United States, close contacts of confirmed COVID-19 cases were investigated to enable early identification and isolation of additional cases and to learn more about risk factors for transmission. Close contacts of nine early travel-related cases in the United States were identified and monitored daily for development of symptoms (active monitoring). Selected close contacts (including those with exposures categorized as higher risk) were targeted for collection of additional exposure information and respiratory samples. Respiratory samples were tested for SARS-CoV-2 by real-time reverse transcription polymerase chain reaction at the Centers for Disease Control and Prevention. Four hundred four close contacts were actively monitored in the jurisdictions that managed the travel-related cases. Three hundred thirty-eight of the 404 close contacts provided at least basic exposure information, of whom 159 close contacts had ≥1 set of respiratory samples collected and tested. Across all actively monitored close contacts, two additional symptomatic COVID-19 cases (i.e., secondary cases) were identified; both secondary cases were in spouses of travel-associated case patients. When considering only household members, all of whom had ≥1 respiratory sample tested for SARS-CoV-2, the secondary attack rate (i.e., the number of secondary cases as a proportion of total close contacts) was 13% (95% CI: 4-38%). The results from these contact tracing investigations suggest that household members, especially significant others, of COVID-19 cases are at highest risk of becoming infected. The importance of personal protective equipment for healthcare workers is also underlined. Isolation of persons with COVID-19, in combination with quarantine of exposed close contacts and practice of everyday preventive behaviors, is important to mitigate spread of COVID-19.
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Affiliation(s)
- Rachel M Burke
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Sharon Balter
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Emily Barnes
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Vaughn Barry
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Karri Bartlett
- The COVID-19 Close Contact Investigation Team, United States of America
- Public Health Madison & Dane County, Madison, Wisconsin, United States of America
| | - Karlyn D Beer
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Isaac Benowitz
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Holly M Biggs
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Hollianne Bruce
- The COVID-19 Close Contact Investigation Team, United States of America
- Snohomish Health District, Everett, Washington, United States of America
| | - Jonathan Bryant-Genevier
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jordan Cates
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Kevin Chatham-Stephens
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Nora Chea
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Howard Chiou
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Demian Christiansen
- The COVID-19 Close Contact Investigation Team, United States of America
- Cook County Department of Public Health, Oak Forest, Illinois, United States of America
| | - Victoria T Chu
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Shauna Clark
- The COVID-19 Close Contact Investigation Team, United States of America
- Public Health Seattle-King County, Seattle, Washington, United States of America
| | - Sara H Cody
- The COVID-19 Close Contact Investigation Team, United States of America
- County of Santa Clara, Public Health Department, San Jose, California, United States of America
| | - Max Cohen
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Erin E Conners
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Vishal Dasari
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Patrick Dawson
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Traci DeSalvo
- The COVID-19 Close Contact Investigation Team, United States of America
- Wisconsin Department of Health Services, Madison, Wisconsin, United States of America
| | - Matthew Donahue
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Alissa Dratch
- The COVID-19 Close Contact Investigation Team, United States of America
- Orange County Healthcare Agency, Santa Ana, California, United States of America
| | - Lindsey Duca
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jeffrey Duchin
- The COVID-19 Close Contact Investigation Team, United States of America
- Public Health Seattle-King County, Seattle, Washington, United States of America
| | - Jonathan W Dyal
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Leora R Feldstein
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Marty Fenstersheib
- The COVID-19 Close Contact Investigation Team, United States of America
- San Benito County Public Health Services, Hollister, California, United States of America
| | - Marc Fischer
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Rebecca Fisher
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Chelsea Foo
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Brandi Freeman-Ponder
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Alicia M Fry
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jessica Gant
- The COVID-19 Close Contact Investigation Team, United States of America
- Washington State Public Health Laboratories, Shoreline, Washington, United States of America
| | - Romesh Gautom
- The COVID-19 Close Contact Investigation Team, United States of America
- Washington State Department of Health, Shoreline, Washington, United States of America
| | - Isaac Ghinai
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Chicago Department of Public Health, Chicago, Illinois, United States of America
| | - Prabhu Gounder
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Cheri T Grigg
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jeffrey Gunzenhauser
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Aron J Hall
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - George S Han
- The COVID-19 Close Contact Investigation Team, United States of America
- County of Santa Clara, Public Health Department, San Jose, California, United States of America
| | - Thomas Haupt
- The COVID-19 Close Contact Investigation Team, United States of America
- Wisconsin Department of Health Services, Madison, Wisconsin, United States of America
| | - Michelle Holshue
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Washington State Department of Health, Shoreline, Washington, United States of America
| | - Jennifer Hunter
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Mireille B Ibrahim
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Max W Jacobs
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - M Claire Jarashow
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Kiran Joshi
- The COVID-19 Close Contact Investigation Team, United States of America
- Cook County Department of Public Health, Oak Forest, Illinois, United States of America
| | - Talar Kamali
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Vance Kawakami
- The COVID-19 Close Contact Investigation Team, United States of America
- Public Health Seattle-King County, Seattle, Washington, United States of America
| | - Moon Kim
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Hannah L Kirking
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Amanda Kita-Yarbro
- The COVID-19 Close Contact Investigation Team, United States of America
- Public Health Madison & Dane County, Madison, Wisconsin, United States of America
| | - Rachel Klos
- The COVID-19 Close Contact Investigation Team, United States of America
- Wisconsin Department of Health Services, Madison, Wisconsin, United States of America
| | - Miwako Kobayashi
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Anna Kocharian
- The COVID-19 Close Contact Investigation Team, United States of America
- Wisconsin Department of Health Services, Madison, Wisconsin, United States of America
| | - Misty Lang
- The COVID-19 Close Contact Investigation Team, United States of America
- Washington State Public Health Laboratories, Shoreline, Washington, United States of America
| | - Jennifer Layden
- The COVID-19 Close Contact Investigation Team, United States of America
- Chicago Department of Public Health, Chicago, Illinois, United States of America
| | - Eva Leidman
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Scott Lindquist
- The COVID-19 Close Contact Investigation Team, United States of America
- Washington State Department of Health, Shoreline, Washington, United States of America
| | - Stephen Lindstrom
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Ruth Link-Gelles
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Mariel Marlow
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Claire P Mattison
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, United States of America
| | - Nancy McClung
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Tristan D McPherson
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Chicago Department of Public Health, Chicago, Illinois, United States of America
| | - Lynn Mello
- The COVID-19 Close Contact Investigation Team, United States of America
- San Benito County Public Health Services, Hollister, California, United States of America
| | - Claire M Midgley
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Shannon Novosad
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Megan T Patel
- The COVID-19 Close Contact Investigation Team, United States of America
- Illinois Department of Public Health, Chicago, Illinois, United States of America
| | - Kristen Pettrone
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Satish K Pillai
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Ian W Pray
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Wisconsin Department of Health Services, Madison, Wisconsin, United States of America
| | - Heather E Reese
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Heather Rhodes
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Wyoming Department of Health, Cheyenne, Wyoming, United States of America
| | - Susan Robinson
- The COVID-19 Close Contact Investigation Team, United States of America
- Arizona Department of Health Services, Phoenix, Arizona, United States of America
| | - Melissa Rolfes
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Janell Routh
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Rachel Rubin
- The COVID-19 Close Contact Investigation Team, United States of America
- Cook County Department of Public Health, Oak Forest, Illinois, United States of America
| | - Sarah L Rudman
- The COVID-19 Close Contact Investigation Team, United States of America
- County of Santa Clara, Public Health Department, San Jose, California, United States of America
| | - Denny Russell
- The COVID-19 Close Contact Investigation Team, United States of America
- Washington State Public Health Laboratories, Shoreline, Washington, United States of America
| | - Sarah Scott
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Maricopa County Department of Public Health, Phoenix, Arizona, United States of America
| | - Varun Shetty
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Sarah E Smith-Jeffcoat
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Elizabeth A Soda
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Christopher Spitters
- The COVID-19 Close Contact Investigation Team, United States of America
- Snohomish Health District, Everett, Washington, United States of America
| | - Bryan Stierman
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Rebecca Sunenshine
- The COVID-19 Close Contact Investigation Team, United States of America
- Maricopa County Department of Public Health, Phoenix, Arizona, United States of America
| | - Dawn Terashita
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Elizabeth Traub
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Grace M Vahey
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jennifer R Verani
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Megan Wallace
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Matthew Westercamp
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jonathan Wortham
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Amy Xie
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Anna Yousaf
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Matthew Zahn
- The COVID-19 Close Contact Investigation Team, United States of America
- Orange County Healthcare Agency, Santa Ana, California, United States of America
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11
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Burke RM, Balter S, Barnes E, Barry V, Bartlett K, Beer KD, Benowitz I, Biggs HM, Bruce H, Bryant-Genevier J, Cates J, Chatham-Stephens K, Chea N, Chiou H, Christiansen D, Chu VT, Clark S, Cody SH, Cohen M, Conners EE, Dasari V, Dawson P, DeSalvo T, Donahue M, Dratch A, Duca L, Duchin J, Dyal JW, Feldstein LR, Fenstersheib M, Fischer M, Fisher R, Foo C, Freeman-Ponder B, Fry AM, Gant J, Gautom R, Ghinai I, Gounder P, Grigg CT, Gunzenhauser J, Hall AJ, Han GS, Haupt T, Holshue M, Hunter J, Ibrahim MB, Jacobs MW, Jarashow MC, Joshi K, Kamali T, Kawakami V, Kim M, Kirking HL, Kita-Yarbro A, Klos R, Kobayashi M, Kocharian A, Lang M, Layden J, Leidman E, Lindquist S, Lindstrom S, Link-Gelles R, Marlow M, Mattison CP, McClung N, McPherson TD, Mello L, Midgley CM, Novosad S, Patel MT, Pettrone K, Pillai SK, Pray IW, Reese HE, Rhodes H, Robinson S, Rolfes M, Routh J, Rubin R, Rudman SL, Russell D, Scott S, Shetty V, Smith-Jeffcoat SE, Soda EA, Spitters C, Stierman B, Sunenshine R, Terashita D, Traub E, Vahey GM, Verani JR, Wallace M, Westercamp M, Wortham J, Xie A, Yousaf A, Zahn M. Enhanced contact investigations for nine early travel-related cases of SARS-CoV-2 in the United States. PLoS One 2020; 15:e0238342. [PMID: 32877446 PMCID: PMC7467265 DOI: 10.1371/journal.pone.0238342] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 05/19/2020] [Accepted: 08/15/2020] [Indexed: 12/20/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19), the respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first identified in Wuhan, China and has since become pandemic. In response to the first cases identified in the United States, close contacts of confirmed COVID-19 cases were investigated to enable early identification and isolation of additional cases and to learn more about risk factors for transmission. Close contacts of nine early travel-related cases in the United States were identified and monitored daily for development of symptoms (active monitoring). Selected close contacts (including those with exposures categorized as higher risk) were targeted for collection of additional exposure information and respiratory samples. Respiratory samples were tested for SARS-CoV-2 by real-time reverse transcription polymerase chain reaction at the Centers for Disease Control and Prevention. Four hundred four close contacts were actively monitored in the jurisdictions that managed the travel-related cases. Three hundred thirty-eight of the 404 close contacts provided at least basic exposure information, of whom 159 close contacts had ≥1 set of respiratory samples collected and tested. Across all actively monitored close contacts, two additional symptomatic COVID-19 cases (i.e., secondary cases) were identified; both secondary cases were in spouses of travel-associated case patients. When considering only household members, all of whom had ≥1 respiratory sample tested for SARS-CoV-2, the secondary attack rate (i.e., the number of secondary cases as a proportion of total close contacts) was 13% (95% CI: 4-38%). The results from these contact tracing investigations suggest that household members, especially significant others, of COVID-19 cases are at highest risk of becoming infected. The importance of personal protective equipment for healthcare workers is also underlined. Isolation of persons with COVID-19, in combination with quarantine of exposed close contacts and practice of everyday preventive behaviors, is important to mitigate spread of COVID-19.
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Affiliation(s)
- Rachel M. Burke
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Sharon Balter
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Emily Barnes
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Vaughn Barry
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Karri Bartlett
- The COVID-19 Close Contact Investigation Team, United States of America
- Public Health Madison & Dane County, Madison, Wisconsin, United States of America
| | - Karlyn D. Beer
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Isaac Benowitz
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Holly M. Biggs
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Hollianne Bruce
- The COVID-19 Close Contact Investigation Team, United States of America
- Snohomish Health District, Everett, Washington, United States of America
| | - Jonathan Bryant-Genevier
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jordan Cates
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Kevin Chatham-Stephens
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Nora Chea
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Howard Chiou
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Demian Christiansen
- The COVID-19 Close Contact Investigation Team, United States of America
- Cook County Department of Public Health, Oak Forest, Illinois, United States of America
| | - Victoria T. Chu
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Shauna Clark
- The COVID-19 Close Contact Investigation Team, United States of America
- Public Health Seattle–King County, Seattle, Washington, United States of America
| | - Sara H. Cody
- The COVID-19 Close Contact Investigation Team, United States of America
- County of Santa Clara, Public Health Department, San Jose, California, United States of America
| | - Max Cohen
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Erin E. Conners
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Vishal Dasari
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Patrick Dawson
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Traci DeSalvo
- The COVID-19 Close Contact Investigation Team, United States of America
- Wisconsin Department of Health Services, Madison, Wisconsin, United States of America
| | - Matthew Donahue
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Alissa Dratch
- The COVID-19 Close Contact Investigation Team, United States of America
- Orange County Healthcare Agency, Santa Ana, California, United States of America
| | - Lindsey Duca
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jeffrey Duchin
- The COVID-19 Close Contact Investigation Team, United States of America
- Public Health Seattle–King County, Seattle, Washington, United States of America
| | - Jonathan W. Dyal
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Leora R. Feldstein
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Marty Fenstersheib
- The COVID-19 Close Contact Investigation Team, United States of America
- San Benito County Public Health Services, Hollister, California, United States of America
| | - Marc Fischer
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Rebecca Fisher
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Chelsea Foo
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Brandi Freeman-Ponder
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Alicia M. Fry
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jessica Gant
- The COVID-19 Close Contact Investigation Team, United States of America
- Washington State Public Health Laboratories, Shoreline, Washington, United States of America
| | - Romesh Gautom
- The COVID-19 Close Contact Investigation Team, United States of America
- Washington State Department of Health, Shoreline, Washington, United States of America
| | - Isaac Ghinai
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Chicago Department of Public Health, Chicago, Illinois, United States of America
| | - Prabhu Gounder
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Cheri T. Grigg
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jeffrey Gunzenhauser
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Aron J. Hall
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - George S. Han
- The COVID-19 Close Contact Investigation Team, United States of America
- County of Santa Clara, Public Health Department, San Jose, California, United States of America
| | - Thomas Haupt
- The COVID-19 Close Contact Investigation Team, United States of America
- Wisconsin Department of Health Services, Madison, Wisconsin, United States of America
| | - Michelle Holshue
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Washington State Department of Health, Shoreline, Washington, United States of America
| | - Jennifer Hunter
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Mireille B. Ibrahim
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Max W. Jacobs
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - M. Claire Jarashow
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Kiran Joshi
- The COVID-19 Close Contact Investigation Team, United States of America
- Cook County Department of Public Health, Oak Forest, Illinois, United States of America
| | - Talar Kamali
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Vance Kawakami
- The COVID-19 Close Contact Investigation Team, United States of America
- Public Health Seattle–King County, Seattle, Washington, United States of America
| | - Moon Kim
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Hannah L. Kirking
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Amanda Kita-Yarbro
- The COVID-19 Close Contact Investigation Team, United States of America
- Public Health Madison & Dane County, Madison, Wisconsin, United States of America
| | - Rachel Klos
- The COVID-19 Close Contact Investigation Team, United States of America
- Wisconsin Department of Health Services, Madison, Wisconsin, United States of America
| | - Miwako Kobayashi
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Anna Kocharian
- The COVID-19 Close Contact Investigation Team, United States of America
- Wisconsin Department of Health Services, Madison, Wisconsin, United States of America
| | - Misty Lang
- The COVID-19 Close Contact Investigation Team, United States of America
- Washington State Public Health Laboratories, Shoreline, Washington, United States of America
| | - Jennifer Layden
- The COVID-19 Close Contact Investigation Team, United States of America
- Chicago Department of Public Health, Chicago, Illinois, United States of America
| | - Eva Leidman
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Scott Lindquist
- The COVID-19 Close Contact Investigation Team, United States of America
- Washington State Department of Health, Shoreline, Washington, United States of America
| | - Stephen Lindstrom
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Ruth Link-Gelles
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Mariel Marlow
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Claire P. Mattison
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, United States of America
| | - Nancy McClung
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Tristan D. McPherson
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Chicago Department of Public Health, Chicago, Illinois, United States of America
| | - Lynn Mello
- The COVID-19 Close Contact Investigation Team, United States of America
- San Benito County Public Health Services, Hollister, California, United States of America
| | - Claire M. Midgley
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Shannon Novosad
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Megan T. Patel
- The COVID-19 Close Contact Investigation Team, United States of America
- Illinois Department of Public Health, Chicago, Illinois, United States of America
| | - Kristen Pettrone
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Satish K. Pillai
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Ian W. Pray
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Wisconsin Department of Health Services, Madison, Wisconsin, United States of America
| | - Heather E. Reese
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Heather Rhodes
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Wyoming Department of Health, Cheyenne, Wyoming, United States of America
| | - Susan Robinson
- The COVID-19 Close Contact Investigation Team, United States of America
- Arizona Department of Health Services, Phoenix, Arizona, United States of America
| | - Melissa Rolfes
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Janell Routh
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Rachel Rubin
- The COVID-19 Close Contact Investigation Team, United States of America
- Cook County Department of Public Health, Oak Forest, Illinois, United States of America
| | - Sarah L. Rudman
- The COVID-19 Close Contact Investigation Team, United States of America
- County of Santa Clara, Public Health Department, San Jose, California, United States of America
| | - Denny Russell
- The COVID-19 Close Contact Investigation Team, United States of America
- Washington State Public Health Laboratories, Shoreline, Washington, United States of America
| | - Sarah Scott
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Maricopa County Department of Public Health, Phoenix, Arizona, United States of America
| | - Varun Shetty
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Sarah E. Smith-Jeffcoat
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Elizabeth A. Soda
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Christopher Spitters
- The COVID-19 Close Contact Investigation Team, United States of America
- Snohomish Health District, Everett, Washington, United States of America
| | - Bryan Stierman
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Rebecca Sunenshine
- The COVID-19 Close Contact Investigation Team, United States of America
- Maricopa County Department of Public Health, Phoenix, Arizona, United States of America
| | - Dawn Terashita
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Elizabeth Traub
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Grace M. Vahey
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jennifer R. Verani
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Megan Wallace
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Matthew Westercamp
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jonathan Wortham
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Amy Xie
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Anna Yousaf
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Matthew Zahn
- The COVID-19 Close Contact Investigation Team, United States of America
- Orange County Healthcare Agency, Santa Ana, California, United States of America
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McMichael TM, Currie DW, Clark S, Pogosjans S, Kay M, Schwartz NG, Lewis J, Baer A, Kawakami V, Lukoff MD, Ferro J, Brostrom-Smith C, Rea TD, Sayre MR, Riedo FX, Russell D, Hiatt B, Montgomery P, Rao AK, Chow EJ, Tobolowsky F, Hughes MJ, Bardossy AC, Oakley LP, Jacobs JR, Stone ND, Reddy SC, Jernigan JA, Honein MA, Clark TA, Duchin JS. Epidemiology of Covid-19 in a Long-Term Care Facility in King County, Washington. N Engl J Med 2020; 382:2005-2011. [PMID: 32220208 PMCID: PMC7121761 DOI: 10.1056/nejmoa2005412] [Citation(s) in RCA: 885] [Impact Index Per Article: 221.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Long-term care facilities are high-risk settings for severe outcomes from outbreaks of Covid-19, owing to both the advanced age and frequent chronic underlying health conditions of the residents and the movement of health care personnel among facilities in a region. METHODS After identification on February 28, 2020, of a confirmed case of Covid-19 in a skilled nursing facility in King County, Washington, Public Health-Seattle and King County, aided by the Centers for Disease Control and Prevention, launched a case investigation, contact tracing, quarantine of exposed persons, isolation of confirmed and suspected cases, and on-site enhancement of infection prevention and control. RESULTS As of March 18, a total of 167 confirmed cases of Covid-19 affecting 101 residents, 50 health care personnel, and 16 visitors were found to be epidemiologically linked to the facility. Most cases among residents included respiratory illness consistent with Covid-19; however, in 7 residents no symptoms were documented. Hospitalization rates for facility residents, visitors, and staff were 54.5%, 50.0%, and 6.0%, respectively. The case fatality rate for residents was 33.7% (34 of 101). As of March 18, a total of 30 long-term care facilities with at least one confirmed case of Covid-19 had been identified in King County. CONCLUSIONS In the context of rapidly escalating Covid-19 outbreaks, proactive steps by long-term care facilities to identify and exclude potentially infected staff and visitors, actively monitor for potentially infected patients, and implement appropriate infection prevention and control measures are needed to prevent the introduction of Covid-19.
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Affiliation(s)
- Temet M McMichael
- From Public Health-Seattle and King County (T.M.M., S.C., S.P., M.K., J.L., A.B., V.K., M.D.L., J.F., C.B.-S., J.S.D.), University of Washington, Seattle (T.D.R., M.R.S., J.S.D.), EvergreenHealth, Kirkland (F.X.R.), Washington State Public Health Laboratory, Shoreline (D.R., B.H.), and Washington State Department of Health, Tumwater (P.M.) - all in Washington; and the Epidemic Intelligence Service (T.M.M., D.W.C., N.G.S., E.J.C., F.T., A.C.B., L.P.O.), COVID-19 Emergency Response (T.M.M., D.W.C., N.G.S., A.K.R., E.J.C., F.T., M.J.H., A.C.B., L.P.O., J.R.J., N.D.S., S.C.R., J.A.J., M.A.H., T.A.C.), and Laboratory Leadership Service (J.R.J.), Centers for Disease Control and Prevention, Atlanta
| | - Dustin W Currie
- From Public Health-Seattle and King County (T.M.M., S.C., S.P., M.K., J.L., A.B., V.K., M.D.L., J.F., C.B.-S., J.S.D.), University of Washington, Seattle (T.D.R., M.R.S., J.S.D.), EvergreenHealth, Kirkland (F.X.R.), Washington State Public Health Laboratory, Shoreline (D.R., B.H.), and Washington State Department of Health, Tumwater (P.M.) - all in Washington; and the Epidemic Intelligence Service (T.M.M., D.W.C., N.G.S., E.J.C., F.T., A.C.B., L.P.O.), COVID-19 Emergency Response (T.M.M., D.W.C., N.G.S., A.K.R., E.J.C., F.T., M.J.H., A.C.B., L.P.O., J.R.J., N.D.S., S.C.R., J.A.J., M.A.H., T.A.C.), and Laboratory Leadership Service (J.R.J.), Centers for Disease Control and Prevention, Atlanta
| | - Shauna Clark
- From Public Health-Seattle and King County (T.M.M., S.C., S.P., M.K., J.L., A.B., V.K., M.D.L., J.F., C.B.-S., J.S.D.), University of Washington, Seattle (T.D.R., M.R.S., J.S.D.), EvergreenHealth, Kirkland (F.X.R.), Washington State Public Health Laboratory, Shoreline (D.R., B.H.), and Washington State Department of Health, Tumwater (P.M.) - all in Washington; and the Epidemic Intelligence Service (T.M.M., D.W.C., N.G.S., E.J.C., F.T., A.C.B., L.P.O.), COVID-19 Emergency Response (T.M.M., D.W.C., N.G.S., A.K.R., E.J.C., F.T., M.J.H., A.C.B., L.P.O., J.R.J., N.D.S., S.C.R., J.A.J., M.A.H., T.A.C.), and Laboratory Leadership Service (J.R.J.), Centers for Disease Control and Prevention, Atlanta
| | - Sargis Pogosjans
- From Public Health-Seattle and King County (T.M.M., S.C., S.P., M.K., J.L., A.B., V.K., M.D.L., J.F., C.B.-S., J.S.D.), University of Washington, Seattle (T.D.R., M.R.S., J.S.D.), EvergreenHealth, Kirkland (F.X.R.), Washington State Public Health Laboratory, Shoreline (D.R., B.H.), and Washington State Department of Health, Tumwater (P.M.) - all in Washington; and the Epidemic Intelligence Service (T.M.M., D.W.C., N.G.S., E.J.C., F.T., A.C.B., L.P.O.), COVID-19 Emergency Response (T.M.M., D.W.C., N.G.S., A.K.R., E.J.C., F.T., M.J.H., A.C.B., L.P.O., J.R.J., N.D.S., S.C.R., J.A.J., M.A.H., T.A.C.), and Laboratory Leadership Service (J.R.J.), Centers for Disease Control and Prevention, Atlanta
| | - Meagan Kay
- From Public Health-Seattle and King County (T.M.M., S.C., S.P., M.K., J.L., A.B., V.K., M.D.L., J.F., C.B.-S., J.S.D.), University of Washington, Seattle (T.D.R., M.R.S., J.S.D.), EvergreenHealth, Kirkland (F.X.R.), Washington State Public Health Laboratory, Shoreline (D.R., B.H.), and Washington State Department of Health, Tumwater (P.M.) - all in Washington; and the Epidemic Intelligence Service (T.M.M., D.W.C., N.G.S., E.J.C., F.T., A.C.B., L.P.O.), COVID-19 Emergency Response (T.M.M., D.W.C., N.G.S., A.K.R., E.J.C., F.T., M.J.H., A.C.B., L.P.O., J.R.J., N.D.S., S.C.R., J.A.J., M.A.H., T.A.C.), and Laboratory Leadership Service (J.R.J.), Centers for Disease Control and Prevention, Atlanta
| | - Noah G Schwartz
- From Public Health-Seattle and King County (T.M.M., S.C., S.P., M.K., J.L., A.B., V.K., M.D.L., J.F., C.B.-S., J.S.D.), University of Washington, Seattle (T.D.R., M.R.S., J.S.D.), EvergreenHealth, Kirkland (F.X.R.), Washington State Public Health Laboratory, Shoreline (D.R., B.H.), and Washington State Department of Health, Tumwater (P.M.) - all in Washington; and the Epidemic Intelligence Service (T.M.M., D.W.C., N.G.S., E.J.C., F.T., A.C.B., L.P.O.), COVID-19 Emergency Response (T.M.M., D.W.C., N.G.S., A.K.R., E.J.C., F.T., M.J.H., A.C.B., L.P.O., J.R.J., N.D.S., S.C.R., J.A.J., M.A.H., T.A.C.), and Laboratory Leadership Service (J.R.J.), Centers for Disease Control and Prevention, Atlanta
| | - James Lewis
- From Public Health-Seattle and King County (T.M.M., S.C., S.P., M.K., J.L., A.B., V.K., M.D.L., J.F., C.B.-S., J.S.D.), University of Washington, Seattle (T.D.R., M.R.S., J.S.D.), EvergreenHealth, Kirkland (F.X.R.), Washington State Public Health Laboratory, Shoreline (D.R., B.H.), and Washington State Department of Health, Tumwater (P.M.) - all in Washington; and the Epidemic Intelligence Service (T.M.M., D.W.C., N.G.S., E.J.C., F.T., A.C.B., L.P.O.), COVID-19 Emergency Response (T.M.M., D.W.C., N.G.S., A.K.R., E.J.C., F.T., M.J.H., A.C.B., L.P.O., J.R.J., N.D.S., S.C.R., J.A.J., M.A.H., T.A.C.), and Laboratory Leadership Service (J.R.J.), Centers for Disease Control and Prevention, Atlanta
| | - Atar Baer
- From Public Health-Seattle and King County (T.M.M., S.C., S.P., M.K., J.L., A.B., V.K., M.D.L., J.F., C.B.-S., J.S.D.), University of Washington, Seattle (T.D.R., M.R.S., J.S.D.), EvergreenHealth, Kirkland (F.X.R.), Washington State Public Health Laboratory, Shoreline (D.R., B.H.), and Washington State Department of Health, Tumwater (P.M.) - all in Washington; and the Epidemic Intelligence Service (T.M.M., D.W.C., N.G.S., E.J.C., F.T., A.C.B., L.P.O.), COVID-19 Emergency Response (T.M.M., D.W.C., N.G.S., A.K.R., E.J.C., F.T., M.J.H., A.C.B., L.P.O., J.R.J., N.D.S., S.C.R., J.A.J., M.A.H., T.A.C.), and Laboratory Leadership Service (J.R.J.), Centers for Disease Control and Prevention, Atlanta
| | - Vance Kawakami
- From Public Health-Seattle and King County (T.M.M., S.C., S.P., M.K., J.L., A.B., V.K., M.D.L., J.F., C.B.-S., J.S.D.), University of Washington, Seattle (T.D.R., M.R.S., J.S.D.), EvergreenHealth, Kirkland (F.X.R.), Washington State Public Health Laboratory, Shoreline (D.R., B.H.), and Washington State Department of Health, Tumwater (P.M.) - all in Washington; and the Epidemic Intelligence Service (T.M.M., D.W.C., N.G.S., E.J.C., F.T., A.C.B., L.P.O.), COVID-19 Emergency Response (T.M.M., D.W.C., N.G.S., A.K.R., E.J.C., F.T., M.J.H., A.C.B., L.P.O., J.R.J., N.D.S., S.C.R., J.A.J., M.A.H., T.A.C.), and Laboratory Leadership Service (J.R.J.), Centers for Disease Control and Prevention, Atlanta
| | - Margaret D Lukoff
- From Public Health-Seattle and King County (T.M.M., S.C., S.P., M.K., J.L., A.B., V.K., M.D.L., J.F., C.B.-S., J.S.D.), University of Washington, Seattle (T.D.R., M.R.S., J.S.D.), EvergreenHealth, Kirkland (F.X.R.), Washington State Public Health Laboratory, Shoreline (D.R., B.H.), and Washington State Department of Health, Tumwater (P.M.) - all in Washington; and the Epidemic Intelligence Service (T.M.M., D.W.C., N.G.S., E.J.C., F.T., A.C.B., L.P.O.), COVID-19 Emergency Response (T.M.M., D.W.C., N.G.S., A.K.R., E.J.C., F.T., M.J.H., A.C.B., L.P.O., J.R.J., N.D.S., S.C.R., J.A.J., M.A.H., T.A.C.), and Laboratory Leadership Service (J.R.J.), Centers for Disease Control and Prevention, Atlanta
| | - Jessica Ferro
- From Public Health-Seattle and King County (T.M.M., S.C., S.P., M.K., J.L., A.B., V.K., M.D.L., J.F., C.B.-S., J.S.D.), University of Washington, Seattle (T.D.R., M.R.S., J.S.D.), EvergreenHealth, Kirkland (F.X.R.), Washington State Public Health Laboratory, Shoreline (D.R., B.H.), and Washington State Department of Health, Tumwater (P.M.) - all in Washington; and the Epidemic Intelligence Service (T.M.M., D.W.C., N.G.S., E.J.C., F.T., A.C.B., L.P.O.), COVID-19 Emergency Response (T.M.M., D.W.C., N.G.S., A.K.R., E.J.C., F.T., M.J.H., A.C.B., L.P.O., J.R.J., N.D.S., S.C.R., J.A.J., M.A.H., T.A.C.), and Laboratory Leadership Service (J.R.J.), Centers for Disease Control and Prevention, Atlanta
| | - Claire Brostrom-Smith
- From Public Health-Seattle and King County (T.M.M., S.C., S.P., M.K., J.L., A.B., V.K., M.D.L., J.F., C.B.-S., J.S.D.), University of Washington, Seattle (T.D.R., M.R.S., J.S.D.), EvergreenHealth, Kirkland (F.X.R.), Washington State Public Health Laboratory, Shoreline (D.R., B.H.), and Washington State Department of Health, Tumwater (P.M.) - all in Washington; and the Epidemic Intelligence Service (T.M.M., D.W.C., N.G.S., E.J.C., F.T., A.C.B., L.P.O.), COVID-19 Emergency Response (T.M.M., D.W.C., N.G.S., A.K.R., E.J.C., F.T., M.J.H., A.C.B., L.P.O., J.R.J., N.D.S., S.C.R., J.A.J., M.A.H., T.A.C.), and Laboratory Leadership Service (J.R.J.), Centers for Disease Control and Prevention, Atlanta
| | - Thomas D Rea
- From Public Health-Seattle and King County (T.M.M., S.C., S.P., M.K., J.L., A.B., V.K., M.D.L., J.F., C.B.-S., J.S.D.), University of Washington, Seattle (T.D.R., M.R.S., J.S.D.), EvergreenHealth, Kirkland (F.X.R.), Washington State Public Health Laboratory, Shoreline (D.R., B.H.), and Washington State Department of Health, Tumwater (P.M.) - all in Washington; and the Epidemic Intelligence Service (T.M.M., D.W.C., N.G.S., E.J.C., F.T., A.C.B., L.P.O.), COVID-19 Emergency Response (T.M.M., D.W.C., N.G.S., A.K.R., E.J.C., F.T., M.J.H., A.C.B., L.P.O., J.R.J., N.D.S., S.C.R., J.A.J., M.A.H., T.A.C.), and Laboratory Leadership Service (J.R.J.), Centers for Disease Control and Prevention, Atlanta
| | - Michael R Sayre
- From Public Health-Seattle and King County (T.M.M., S.C., S.P., M.K., J.L., A.B., V.K., M.D.L., J.F., C.B.-S., J.S.D.), University of Washington, Seattle (T.D.R., M.R.S., J.S.D.), EvergreenHealth, Kirkland (F.X.R.), Washington State Public Health Laboratory, Shoreline (D.R., B.H.), and Washington State Department of Health, Tumwater (P.M.) - all in Washington; and the Epidemic Intelligence Service (T.M.M., D.W.C., N.G.S., E.J.C., F.T., A.C.B., L.P.O.), COVID-19 Emergency Response (T.M.M., D.W.C., N.G.S., A.K.R., E.J.C., F.T., M.J.H., A.C.B., L.P.O., J.R.J., N.D.S., S.C.R., J.A.J., M.A.H., T.A.C.), and Laboratory Leadership Service (J.R.J.), Centers for Disease Control and Prevention, Atlanta
| | - Francis X Riedo
- From Public Health-Seattle and King County (T.M.M., S.C., S.P., M.K., J.L., A.B., V.K., M.D.L., J.F., C.B.-S., J.S.D.), University of Washington, Seattle (T.D.R., M.R.S., J.S.D.), EvergreenHealth, Kirkland (F.X.R.), Washington State Public Health Laboratory, Shoreline (D.R., B.H.), and Washington State Department of Health, Tumwater (P.M.) - all in Washington; and the Epidemic Intelligence Service (T.M.M., D.W.C., N.G.S., E.J.C., F.T., A.C.B., L.P.O.), COVID-19 Emergency Response (T.M.M., D.W.C., N.G.S., A.K.R., E.J.C., F.T., M.J.H., A.C.B., L.P.O., J.R.J., N.D.S., S.C.R., J.A.J., M.A.H., T.A.C.), and Laboratory Leadership Service (J.R.J.), Centers for Disease Control and Prevention, Atlanta
| | - Denny Russell
- From Public Health-Seattle and King County (T.M.M., S.C., S.P., M.K., J.L., A.B., V.K., M.D.L., J.F., C.B.-S., J.S.D.), University of Washington, Seattle (T.D.R., M.R.S., J.S.D.), EvergreenHealth, Kirkland (F.X.R.), Washington State Public Health Laboratory, Shoreline (D.R., B.H.), and Washington State Department of Health, Tumwater (P.M.) - all in Washington; and the Epidemic Intelligence Service (T.M.M., D.W.C., N.G.S., E.J.C., F.T., A.C.B., L.P.O.), COVID-19 Emergency Response (T.M.M., D.W.C., N.G.S., A.K.R., E.J.C., F.T., M.J.H., A.C.B., L.P.O., J.R.J., N.D.S., S.C.R., J.A.J., M.A.H., T.A.C.), and Laboratory Leadership Service (J.R.J.), Centers for Disease Control and Prevention, Atlanta
| | - Brian Hiatt
- From Public Health-Seattle and King County (T.M.M., S.C., S.P., M.K., J.L., A.B., V.K., M.D.L., J.F., C.B.-S., J.S.D.), University of Washington, Seattle (T.D.R., M.R.S., J.S.D.), EvergreenHealth, Kirkland (F.X.R.), Washington State Public Health Laboratory, Shoreline (D.R., B.H.), and Washington State Department of Health, Tumwater (P.M.) - all in Washington; and the Epidemic Intelligence Service (T.M.M., D.W.C., N.G.S., E.J.C., F.T., A.C.B., L.P.O.), COVID-19 Emergency Response (T.M.M., D.W.C., N.G.S., A.K.R., E.J.C., F.T., M.J.H., A.C.B., L.P.O., J.R.J., N.D.S., S.C.R., J.A.J., M.A.H., T.A.C.), and Laboratory Leadership Service (J.R.J.), Centers for Disease Control and Prevention, Atlanta
| | - Patricia Montgomery
- From Public Health-Seattle and King County (T.M.M., S.C., S.P., M.K., J.L., A.B., V.K., M.D.L., J.F., C.B.-S., J.S.D.), University of Washington, Seattle (T.D.R., M.R.S., J.S.D.), EvergreenHealth, Kirkland (F.X.R.), Washington State Public Health Laboratory, Shoreline (D.R., B.H.), and Washington State Department of Health, Tumwater (P.M.) - all in Washington; and the Epidemic Intelligence Service (T.M.M., D.W.C., N.G.S., E.J.C., F.T., A.C.B., L.P.O.), COVID-19 Emergency Response (T.M.M., D.W.C., N.G.S., A.K.R., E.J.C., F.T., M.J.H., A.C.B., L.P.O., J.R.J., N.D.S., S.C.R., J.A.J., M.A.H., T.A.C.), and Laboratory Leadership Service (J.R.J.), Centers for Disease Control and Prevention, Atlanta
| | - Agam K Rao
- From Public Health-Seattle and King County (T.M.M., S.C., S.P., M.K., J.L., A.B., V.K., M.D.L., J.F., C.B.-S., J.S.D.), University of Washington, Seattle (T.D.R., M.R.S., J.S.D.), EvergreenHealth, Kirkland (F.X.R.), Washington State Public Health Laboratory, Shoreline (D.R., B.H.), and Washington State Department of Health, Tumwater (P.M.) - all in Washington; and the Epidemic Intelligence Service (T.M.M., D.W.C., N.G.S., E.J.C., F.T., A.C.B., L.P.O.), COVID-19 Emergency Response (T.M.M., D.W.C., N.G.S., A.K.R., E.J.C., F.T., M.J.H., A.C.B., L.P.O., J.R.J., N.D.S., S.C.R., J.A.J., M.A.H., T.A.C.), and Laboratory Leadership Service (J.R.J.), Centers for Disease Control and Prevention, Atlanta
| | - Eric J Chow
- From Public Health-Seattle and King County (T.M.M., S.C., S.P., M.K., J.L., A.B., V.K., M.D.L., J.F., C.B.-S., J.S.D.), University of Washington, Seattle (T.D.R., M.R.S., J.S.D.), EvergreenHealth, Kirkland (F.X.R.), Washington State Public Health Laboratory, Shoreline (D.R., B.H.), and Washington State Department of Health, Tumwater (P.M.) - all in Washington; and the Epidemic Intelligence Service (T.M.M., D.W.C., N.G.S., E.J.C., F.T., A.C.B., L.P.O.), COVID-19 Emergency Response (T.M.M., D.W.C., N.G.S., A.K.R., E.J.C., F.T., M.J.H., A.C.B., L.P.O., J.R.J., N.D.S., S.C.R., J.A.J., M.A.H., T.A.C.), and Laboratory Leadership Service (J.R.J.), Centers for Disease Control and Prevention, Atlanta
| | - Farrell Tobolowsky
- From Public Health-Seattle and King County (T.M.M., S.C., S.P., M.K., J.L., A.B., V.K., M.D.L., J.F., C.B.-S., J.S.D.), University of Washington, Seattle (T.D.R., M.R.S., J.S.D.), EvergreenHealth, Kirkland (F.X.R.), Washington State Public Health Laboratory, Shoreline (D.R., B.H.), and Washington State Department of Health, Tumwater (P.M.) - all in Washington; and the Epidemic Intelligence Service (T.M.M., D.W.C., N.G.S., E.J.C., F.T., A.C.B., L.P.O.), COVID-19 Emergency Response (T.M.M., D.W.C., N.G.S., A.K.R., E.J.C., F.T., M.J.H., A.C.B., L.P.O., J.R.J., N.D.S., S.C.R., J.A.J., M.A.H., T.A.C.), and Laboratory Leadership Service (J.R.J.), Centers for Disease Control and Prevention, Atlanta
| | - Michael J Hughes
- From Public Health-Seattle and King County (T.M.M., S.C., S.P., M.K., J.L., A.B., V.K., M.D.L., J.F., C.B.-S., J.S.D.), University of Washington, Seattle (T.D.R., M.R.S., J.S.D.), EvergreenHealth, Kirkland (F.X.R.), Washington State Public Health Laboratory, Shoreline (D.R., B.H.), and Washington State Department of Health, Tumwater (P.M.) - all in Washington; and the Epidemic Intelligence Service (T.M.M., D.W.C., N.G.S., E.J.C., F.T., A.C.B., L.P.O.), COVID-19 Emergency Response (T.M.M., D.W.C., N.G.S., A.K.R., E.J.C., F.T., M.J.H., A.C.B., L.P.O., J.R.J., N.D.S., S.C.R., J.A.J., M.A.H., T.A.C.), and Laboratory Leadership Service (J.R.J.), Centers for Disease Control and Prevention, Atlanta
| | - Ana C Bardossy
- From Public Health-Seattle and King County (T.M.M., S.C., S.P., M.K., J.L., A.B., V.K., M.D.L., J.F., C.B.-S., J.S.D.), University of Washington, Seattle (T.D.R., M.R.S., J.S.D.), EvergreenHealth, Kirkland (F.X.R.), Washington State Public Health Laboratory, Shoreline (D.R., B.H.), and Washington State Department of Health, Tumwater (P.M.) - all in Washington; and the Epidemic Intelligence Service (T.M.M., D.W.C., N.G.S., E.J.C., F.T., A.C.B., L.P.O.), COVID-19 Emergency Response (T.M.M., D.W.C., N.G.S., A.K.R., E.J.C., F.T., M.J.H., A.C.B., L.P.O., J.R.J., N.D.S., S.C.R., J.A.J., M.A.H., T.A.C.), and Laboratory Leadership Service (J.R.J.), Centers for Disease Control and Prevention, Atlanta
| | - Lisa P Oakley
- From Public Health-Seattle and King County (T.M.M., S.C., S.P., M.K., J.L., A.B., V.K., M.D.L., J.F., C.B.-S., J.S.D.), University of Washington, Seattle (T.D.R., M.R.S., J.S.D.), EvergreenHealth, Kirkland (F.X.R.), Washington State Public Health Laboratory, Shoreline (D.R., B.H.), and Washington State Department of Health, Tumwater (P.M.) - all in Washington; and the Epidemic Intelligence Service (T.M.M., D.W.C., N.G.S., E.J.C., F.T., A.C.B., L.P.O.), COVID-19 Emergency Response (T.M.M., D.W.C., N.G.S., A.K.R., E.J.C., F.T., M.J.H., A.C.B., L.P.O., J.R.J., N.D.S., S.C.R., J.A.J., M.A.H., T.A.C.), and Laboratory Leadership Service (J.R.J.), Centers for Disease Control and Prevention, Atlanta
| | - Jesica R Jacobs
- From Public Health-Seattle and King County (T.M.M., S.C., S.P., M.K., J.L., A.B., V.K., M.D.L., J.F., C.B.-S., J.S.D.), University of Washington, Seattle (T.D.R., M.R.S., J.S.D.), EvergreenHealth, Kirkland (F.X.R.), Washington State Public Health Laboratory, Shoreline (D.R., B.H.), and Washington State Department of Health, Tumwater (P.M.) - all in Washington; and the Epidemic Intelligence Service (T.M.M., D.W.C., N.G.S., E.J.C., F.T., A.C.B., L.P.O.), COVID-19 Emergency Response (T.M.M., D.W.C., N.G.S., A.K.R., E.J.C., F.T., M.J.H., A.C.B., L.P.O., J.R.J., N.D.S., S.C.R., J.A.J., M.A.H., T.A.C.), and Laboratory Leadership Service (J.R.J.), Centers for Disease Control and Prevention, Atlanta
| | - Nimalie D Stone
- From Public Health-Seattle and King County (T.M.M., S.C., S.P., M.K., J.L., A.B., V.K., M.D.L., J.F., C.B.-S., J.S.D.), University of Washington, Seattle (T.D.R., M.R.S., J.S.D.), EvergreenHealth, Kirkland (F.X.R.), Washington State Public Health Laboratory, Shoreline (D.R., B.H.), and Washington State Department of Health, Tumwater (P.M.) - all in Washington; and the Epidemic Intelligence Service (T.M.M., D.W.C., N.G.S., E.J.C., F.T., A.C.B., L.P.O.), COVID-19 Emergency Response (T.M.M., D.W.C., N.G.S., A.K.R., E.J.C., F.T., M.J.H., A.C.B., L.P.O., J.R.J., N.D.S., S.C.R., J.A.J., M.A.H., T.A.C.), and Laboratory Leadership Service (J.R.J.), Centers for Disease Control and Prevention, Atlanta
| | - Sujan C Reddy
- From Public Health-Seattle and King County (T.M.M., S.C., S.P., M.K., J.L., A.B., V.K., M.D.L., J.F., C.B.-S., J.S.D.), University of Washington, Seattle (T.D.R., M.R.S., J.S.D.), EvergreenHealth, Kirkland (F.X.R.), Washington State Public Health Laboratory, Shoreline (D.R., B.H.), and Washington State Department of Health, Tumwater (P.M.) - all in Washington; and the Epidemic Intelligence Service (T.M.M., D.W.C., N.G.S., E.J.C., F.T., A.C.B., L.P.O.), COVID-19 Emergency Response (T.M.M., D.W.C., N.G.S., A.K.R., E.J.C., F.T., M.J.H., A.C.B., L.P.O., J.R.J., N.D.S., S.C.R., J.A.J., M.A.H., T.A.C.), and Laboratory Leadership Service (J.R.J.), Centers for Disease Control and Prevention, Atlanta
| | - John A Jernigan
- From Public Health-Seattle and King County (T.M.M., S.C., S.P., M.K., J.L., A.B., V.K., M.D.L., J.F., C.B.-S., J.S.D.), University of Washington, Seattle (T.D.R., M.R.S., J.S.D.), EvergreenHealth, Kirkland (F.X.R.), Washington State Public Health Laboratory, Shoreline (D.R., B.H.), and Washington State Department of Health, Tumwater (P.M.) - all in Washington; and the Epidemic Intelligence Service (T.M.M., D.W.C., N.G.S., E.J.C., F.T., A.C.B., L.P.O.), COVID-19 Emergency Response (T.M.M., D.W.C., N.G.S., A.K.R., E.J.C., F.T., M.J.H., A.C.B., L.P.O., J.R.J., N.D.S., S.C.R., J.A.J., M.A.H., T.A.C.), and Laboratory Leadership Service (J.R.J.), Centers for Disease Control and Prevention, Atlanta
| | - Margaret A Honein
- From Public Health-Seattle and King County (T.M.M., S.C., S.P., M.K., J.L., A.B., V.K., M.D.L., J.F., C.B.-S., J.S.D.), University of Washington, Seattle (T.D.R., M.R.S., J.S.D.), EvergreenHealth, Kirkland (F.X.R.), Washington State Public Health Laboratory, Shoreline (D.R., B.H.), and Washington State Department of Health, Tumwater (P.M.) - all in Washington; and the Epidemic Intelligence Service (T.M.M., D.W.C., N.G.S., E.J.C., F.T., A.C.B., L.P.O.), COVID-19 Emergency Response (T.M.M., D.W.C., N.G.S., A.K.R., E.J.C., F.T., M.J.H., A.C.B., L.P.O., J.R.J., N.D.S., S.C.R., J.A.J., M.A.H., T.A.C.), and Laboratory Leadership Service (J.R.J.), Centers for Disease Control and Prevention, Atlanta
| | - Thomas A Clark
- From Public Health-Seattle and King County (T.M.M., S.C., S.P., M.K., J.L., A.B., V.K., M.D.L., J.F., C.B.-S., J.S.D.), University of Washington, Seattle (T.D.R., M.R.S., J.S.D.), EvergreenHealth, Kirkland (F.X.R.), Washington State Public Health Laboratory, Shoreline (D.R., B.H.), and Washington State Department of Health, Tumwater (P.M.) - all in Washington; and the Epidemic Intelligence Service (T.M.M., D.W.C., N.G.S., E.J.C., F.T., A.C.B., L.P.O.), COVID-19 Emergency Response (T.M.M., D.W.C., N.G.S., A.K.R., E.J.C., F.T., M.J.H., A.C.B., L.P.O., J.R.J., N.D.S., S.C.R., J.A.J., M.A.H., T.A.C.), and Laboratory Leadership Service (J.R.J.), Centers for Disease Control and Prevention, Atlanta
| | - Jeffrey S Duchin
- From Public Health-Seattle and King County (T.M.M., S.C., S.P., M.K., J.L., A.B., V.K., M.D.L., J.F., C.B.-S., J.S.D.), University of Washington, Seattle (T.D.R., M.R.S., J.S.D.), EvergreenHealth, Kirkland (F.X.R.), Washington State Public Health Laboratory, Shoreline (D.R., B.H.), and Washington State Department of Health, Tumwater (P.M.) - all in Washington; and the Epidemic Intelligence Service (T.M.M., D.W.C., N.G.S., E.J.C., F.T., A.C.B., L.P.O.), COVID-19 Emergency Response (T.M.M., D.W.C., N.G.S., A.K.R., E.J.C., F.T., M.J.H., A.C.B., L.P.O., J.R.J., N.D.S., S.C.R., J.A.J., M.A.H., T.A.C.), and Laboratory Leadership Service (J.R.J.), Centers for Disease Control and Prevention, Atlanta
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Kimball A, Hatfield KM, Arons M, James A, Taylor J, Spicer K, Bardossy AC, Oakley LP, Tanwar S, Chisty Z, Bell JM, Methner M, Harney J, Jacobs JR, Carlson CM, McLaughlin HP, Stone N, Clark S, Brostrom-Smith C, Page LC, Kay M, Lewis J, Russell D, Hiatt B, Gant J, Duchin JS, Clark TA, Honein MA, Reddy SC, Jernigan JA. Asymptomatic and Presymptomatic SARS-CoV-2 Infections in Residents of a Long-Term Care Skilled Nursing Facility - King County, Washington, March 2020. MMWR Morb Mortal Wkly Rep 2020; 69:377-381. [PMID: 32240128 PMCID: PMC7119514 DOI: 10.15585/mmwr.mm6913e1] [Citation(s) in RCA: 740] [Impact Index Per Article: 185.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Older adults are susceptible to severe coronavirus disease 2019 (COVID-19) outcomes as a consequence of their age and, in some cases, underlying health conditions (1). A COVID-19 outbreak in a long-term care skilled nursing facility (SNF) in King County, Washington that was first identified on February 28, 2020, highlighted the potential for rapid spread among residents of these types of facilities (2). On March 1, a health care provider at a second long-term care skilled nursing facility (facility A) in King County, Washington, had a positive test result for SARS-CoV-2, the novel coronavirus that causes COVID-19, after working while symptomatic on February 26 and 28. By March 6, seven residents of this second facility were symptomatic and had positive test results for SARS-CoV-2. On March 13, CDC performed symptom assessments and SARS-CoV-2 testing for 76 (93%) of the 82 facility A residents to evaluate the utility of symptom screening for identification of COVID-19 in SNF residents. Residents were categorized as asymptomatic or symptomatic at the time of testing, based on the absence or presence of fever, cough, shortness of breath, or other symptoms on the day of testing or during the preceding 14 days. Among 23 (30%) residents with positive test results, 10 (43%) had symptoms on the date of testing, and 13 (57%) were asymptomatic. Seven days after testing, 10 of these 13 previously asymptomatic residents had developed symptoms and were recategorized as presymptomatic at the time of testing. The reverse transcription-polymerase chain reaction (RT-PCR) testing cycle threshold (Ct) values indicated large quantities of viral RNA in asymptomatic, presymptomatic, and symptomatic residents, suggesting the potential for transmission regardless of symptoms. Symptom-based screening in SNFs could fail to identify approximately half of residents with COVID-19. Long-term care facilities should take proactive steps to prevent introduction of SARS-CoV-2 (3). Once a confirmed case is identified in an SNF, all residents should be placed on isolation precautions if possible (3), with considerations for extended use or reuse of personal protective equipment (PPE) as needed (4).
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Kimball A, Hatfield KM, Arons M, James A, Taylor J, Spicer K, Bardossy AC, Oakley LP, Tanwar S, Chisty Z, Bell JM, Methner M, Harney J, Jacobs JR, Carlson CM, McLaughlin HP, Stone N, Clark S, Brostrom-Smith C, Page LC, Kay M, Lewis J, Russell D, Hiatt B, Gant J, Duchin JS, Clark TA, Honein MA, Reddy SC, Jernigan JA. Asymptomatic and Presymptomatic SARS-CoV-2 Infections in Residents of a Long-Term Care Skilled Nursing Facility - King County, Washington, March 2020. MMWR Morb Mortal Wkly Rep 2020. [PMID: 32240128 DOI: 10.15585/mmwr.mm6913e] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
Older adults are susceptible to severe coronavirus disease 2019 (COVID-19) outcomes as a consequence of their age and, in some cases, underlying health conditions (1). A COVID-19 outbreak in a long-term care skilled nursing facility (SNF) in King County, Washington that was first identified on February 28, 2020, highlighted the potential for rapid spread among residents of these types of facilities (2). On March 1, a health care provider at a second long-term care skilled nursing facility (facility A) in King County, Washington, had a positive test result for SARS-CoV-2, the novel coronavirus that causes COVID-19, after working while symptomatic on February 26 and 28. By March 6, seven residents of this second facility were symptomatic and had positive test results for SARS-CoV-2. On March 13, CDC performed symptom assessments and SARS-CoV-2 testing for 76 (93%) of the 82 facility A residents to evaluate the utility of symptom screening for identification of COVID-19 in SNF residents. Residents were categorized as asymptomatic or symptomatic at the time of testing, based on the absence or presence of fever, cough, shortness of breath, or other symptoms on the day of testing or during the preceding 14 days. Among 23 (30%) residents with positive test results, 10 (43%) had symptoms on the date of testing, and 13 (57%) were asymptomatic. Seven days after testing, 10 of these 13 previously asymptomatic residents had developed symptoms and were recategorized as presymptomatic at the time of testing. The reverse transcription-polymerase chain reaction (RT-PCR) testing cycle threshold (Ct) values indicated large quantities of viral RNA in asymptomatic, presymptomatic, and symptomatic residents, suggesting the potential for transmission regardless of symptoms. Symptom-based screening in SNFs could fail to identify approximately half of residents with COVID-19. Long-term care facilities should take proactive steps to prevent introduction of SARS-CoV-2 (3). Once a confirmed case is identified in an SNF, all residents should be placed on isolation precautions if possible (3), with considerations for extended use or reuse of personal protective equipment (PPE) as needed (4).
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Russell D, Higgins D, Posso A. Preventing child sexual abuse: A systematic review of interventions and their efficacy in developing countries. Child Abuse Negl 2020; 102:104395. [PMID: 32062425 DOI: 10.1016/j.chiabu.2020.104395] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [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: 08/30/2019] [Revised: 01/20/2020] [Accepted: 01/28/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Research on prevalence, risk factors, and prevention interventions for child sexual abuse has continued to focus on western and developed countries. Where country-level prevalence data or large-scale research exists, rates of child sexual abuse are consistently higher in developing and non-western countries than their western and developed counterparts. OBJECTIVE We systematically reviewed research on the nature of child sexual abuse interventions in developing countries, the settings and populations included to identify types of child sexual abuse prevention initiatives being implemented in developing countries and their effectiveness. METHODS Following PRISMA guidelines, we conducted a systematic search of six databases and identified eight studies to include in our analysis. RESULTS Most empirically evaluated interventions in developing countries have focused on preschool and primary school-aged children. Most have focused on interventions delivered in educational settings, with a lack of focus on population-level interventions to prevent child sexual abuse. Researchers have used outcomes measuring knowledge or skills for young people in self-protection and help-seeking, not deployment of those skills, actual reduction in prevalence of CSA, or improvements in conditions of safety in organizational contexts. CONCLUSIONS If the focus on school-based strategies to prevent child sexual abuse continues in developing countries, a significant gap in knowledge of the efficacy of population-level interventions outside of school contexts, and consistency across the application of interventions will remain. Evaluations are needed that address the efficacy of broader government-led or whole-of-community prevention interventions to reduce actual prevalence of child sexual abuse, or that can link increased knowledge and skill with reduced victimization.
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Affiliation(s)
- D Russell
- Institute of Child Protection Studies, Australian Catholic University, Australia.
| | - D Higgins
- Institute of Child Protection Studies, Australian Catholic University, Australia
| | - A Posso
- Royal Melbourne Institute of Technology, Australia
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McMichael TM, Clark S, Pogosjans S, Kay M, Lewis J, Baer A, Kawakami V, Lukoff MD, Ferro J, Brostrom-Smith C, Riedo FX, Russell D, Hiatt B, Montgomery P, Rao AK, Currie DW, Chow EJ, Tobolowsky F, Bardossy AC, Oakley LP, Jacobs JR, Schwartz NG, Stone N, Reddy SC, Jernigan JA, Honein MA, Clark TA, Duchin JS. COVID-19 in a Long-Term Care Facility - King County, Washington, February 27-March 9, 2020. MMWR Morb Mortal Wkly Rep 2020; 69:339-342. [PMID: 32214083 PMCID: PMC7725515 DOI: 10.15585/mmwr.mm6912e1] [Citation(s) in RCA: 269] [Impact Index Per Article: 67.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
On February 28, 2020, a case of coronavirus disease (COVID-19) was identified in a woman resident of a long-term care skilled nursing facility (facility A) in King County, Washington.* Epidemiologic investigation of facility A identified 129 cases of COVID-19 associated with facility A, including 81 of the residents, 34 staff members, and 14 visitors; 23 persons died. Limitations in effective infection control and prevention and staff members working in multiple facilities contributed to intra- and interfacility spread. COVID-19 can spread rapidly in long-term residential care facilities, and persons with chronic underlying medical conditions are at greater risk for COVID-19-associated severe disease and death. Long-term care facilities should take proactive steps to protect the health of residents and preserve the health care workforce by identifying and excluding potentially infected staff members and visitors, ensuring early recognition of potentially infected patients, and implementing appropriate infection control measures.
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Russell D, Cole W, Yheulon C, Wren S, Kellicut D, Lim R. USA Department of Defense audit of surgical antibiotic prophylaxis prescribing patterns in inguinal hernia repair. Hernia 2020; 25:159-164. [PMID: 32107656 DOI: 10.1007/s10029-020-02145-2] [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: 11/22/2019] [Accepted: 02/11/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE Antibiotic prophylaxis in inguinal hernia repair (IHR) is contentious in literature and practice. In low-risk patients, for whom evidence suggests antibiotic prophylaxis is unnecessary, many surgeons still advocate for its routine use. This study surveys prescription patterns of Department of Defense (DoD) general surgeons. METHODS An anonymous survey was sent electronically to approximately 350 DoD general surgeons. The survey asked multiple-choice and free text answers about prescribing patterns and knowledge of current evidence for low-risk patients undergoing elective open inguinal hernia repair without mesh (OIHRWOM), open inguinal hernia repair with mesh (OIHRWM), or laparoscopic inguinal hernia repair (LIHR). RESULTS 110 DoD general surgeons consented to participate. 58.6, 95 and 84.2% of surgeons always administer antibiotic prophylaxis in OIHRWOM, OIHRWM, and LIHR, respectively. 37.9, 70.9, and 63.2% of surgeons believe that it reduces rates of surgical site infection in OIHRWOM, OIHRWM, and LIHR, respectively. The most common reasons for empirically prescribing antibiotic prophylaxis include "I think the evidence supports it" (27 of 72 responses), "I would rather be conservative and safe" (15 of 72 responses), and "I am following my hospital/department guidelines" (9 of 72 responses). 11.8, 40.8, and 32.9% of surgeons believe current evidence supports antibiotic prophylaxis use in OIHRWM, OIHRWOM, and LIHR, respectively. 50, 18.4, and 22.4% of surgeons believe current evidence refutes antibiotic prophylaxis use in OIHRWM, OIHRWOM, and LIHR, respectively. CONCLUSION The survey results indicate that the majority of practicing DoD general surgeons still empirically prescribe surgical antibiotic prophylaxis in IHR despite more conflicting opinions that it has no meaningful effect or that current evidence does not supports its use.
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Affiliation(s)
- D Russell
- Tripler Army Medical Center, Honolulu, HI, 96815, USA.
| | - W Cole
- Tripler Army Medical Center, Honolulu, HI, 96815, USA
| | - C Yheulon
- Tripler Army Medical Center, Honolulu, HI, 96815, USA
| | - S Wren
- Stanford University, Stanford, CA, 94305, USA
| | - D Kellicut
- Tripler Army Medical Center, Honolulu, HI, 96815, USA
| | - R Lim
- University of Oklahoma, Tulsa, OK, 74104, USA
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18
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Zamani M, Skagen K, Scott H, Russell D, Skjelland M. Advanced ultrasound methods in assessment of carotid plaque instability: a prospective multimodal study. BMC Neurol 2020; 20:39. [PMID: 31996153 PMCID: PMC6990506 DOI: 10.1186/s12883-020-1620-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 02/19/2019] [Accepted: 01/16/2020] [Indexed: 12/20/2022] Open
Abstract
Background A significant proportion of ischemic strokes are caused by emboli from atherosclerotic, unstable carotid artery plaques. The selection of patients for endarterectomy in current clinical practice is primarily based on the degree of carotid artery stenosis and clinical symptoms. However, the content of the plaque is known to be more important for stroke risk. Intraplaque neovascularization (IPN) has recently emerged as a possible surrogate marker for plaque instability. Neo-microvessels from the adventitial vasa vasorum grow into the full thickness of the vessel wall in an adaptive response to hypoxia, causing subsequent intraplaque haemorrhage and plaque rupture. Conventional ultrasound cannot detect IPN. Contrast-enhanced ultrasound and Superb Microvascular Imaging (SMI), have, however, shown promise in IPN assessment. Recent research using Shear Wave Elastography (SWE) has also reported reduced tissue stiffness in the artery wall (reduced mean Young’s modulus) in unstable compared to stable plaques. The purpose of this study is to identify unstable carotid artery plaques at risk of rupture and future ischemic stroke risk using multimodal assessments. Methods Forty five symptomatic and 45 asymptomatic patients > 18 years, with > 50% carotid stenosis referred to Oslo University Hospital ultrasound lab will be included in this on-going project. Patients will undergo contrast enhanced ultrasound, SMI, carotid-MRI and PET-(18F-FDG). Contrast enhanced ultrasound will be analyzed semi-quantitatively (5-levels visual classification) and quantitatively by plotting time-intensity curve analyses to obtain plaque peak contrast enhancement intensity. Plaques removed at carotid endarterectomy will be assessed histologically and the number of microvessels, areas of inflammation, granulation, calcification, lipid and fibrosis will be measured. Discussion This multimodality study will primarily provide information on the clinical value of advanced ultrasound methods (SMI, SWE) for the detection of unstable carotid artery plaque in comparison with other methods including contrast-enhanced ultrasound, carotid-MRI and PET-(18F-FDG) using histology as the gold standard. Secondly, findings from the methods mentioned above will be related to cerebrovascular symptoms, blood tests (leukocytes, CRP, ESR, lipoproteins and inflammatory markers) and cardiovascular risk factors at inclusion and at 1-year follow-up. The overall aim is to optimize detection of plaque instability which can lead to better preventive decisions and reduced stroke rate.
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Affiliation(s)
- M Zamani
- Department of Neurology, Oslo University Hospital, Rikshospitalet, Postboks 4950 Nydalen 0424, Oslo, Norway. .,Department of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - K Skagen
- Department of Neurology, Oslo University Hospital, Rikshospitalet, Postboks 4950 Nydalen 0424, Oslo, Norway.,Department of Clinical Medicine, University of Oslo, Oslo, Norway
| | - H Scott
- Department of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Pathology, Oslo University Hospital, Rikshospitalet, Norway
| | - D Russell
- Department of Neurology, Oslo University Hospital, Rikshospitalet, Postboks 4950 Nydalen 0424, Oslo, Norway.,Department of Clinical Medicine, University of Oslo, Oslo, Norway
| | - M Skjelland
- Department of Neurology, Oslo University Hospital, Rikshospitalet, Postboks 4950 Nydalen 0424, Oslo, Norway.,Department of Clinical Medicine, University of Oslo, Oslo, Norway
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19
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Scott R, Ellis L, Khanom A, Rhydderch M, Richardson G, Russell D, Russell I, Snooks H. Health experiences of asylum seekers and refugees in Wales. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.039] [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] [Indexed: 11/12/2022] Open
Abstract
Abstract
There are concerns that people seeking sanctuary (asylum seekers and refugees) in Wales, UK, have unmet health needs and face difficulties accessing services, but little collated evidence. This study addressed this gap to inform policy and practice in reducing health inequities. It aimed to: investigate the health, wellbeing and healthcare experiences of adults seeking sanctuary in Wales, including the views of healthcare recipients and providers; and establish what helped or hindered the healthcare experiences of those seeking sanctuary. It is the most comprehensive study of this population in Wales.
A mixed-method approach was taken, including a literature search, a cross-sectional survey of 210 adults seeking sanctuary, telephone interviews with 32 health professionals and third sector support workers, and 8 focus groups including 57 people seeking sanctuary and those supporting them.
Eight trained volunteer peer researchers, themselves asylum seekers or refugees, administered the surveys. Interviews were digitally recorded, transcribed and analysed using a standard framework.
The literature search identified 5 themes that help or hinder people seeking sanctuary to access healthcare. The survey found 79% of respondents attended an initial health assessment on arriving in Wales, with 94% currently registered with Primary healthcare. 64% reported difficulties in accessing health services. Awareness of services was mixed, with 66% having used healthcare in working hours (planned) and 28% out of hours (unplanned).
Mainstream health professionals felt they lack capacity to deliver care effectively due to time and other pressures on the healthcare system and the need for appropriate translation/interpretation services.
This study triangulates the experiences of people seeking sanctuary with those providing healthcare and general support. Peer researchers maximised sanctuary seekers’ participation. Many of its methods and findings have relevance to other countries in Europe.
Key messages
Improving health equity is key to realising Wales’ ambition to become a Nation of Sanctuary. Peer Researchers enabled participation by sanctuary seekers and revealed useful findings to steer future policy and practice.
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Affiliation(s)
- R Scott
- Policy & International Health, Public Health Wales, Cardiff, UK
| | - L Ellis
- Policy & International Health, Public Health Wales, Cardiff, UK
| | - A Khanom
- Patient and Population Health and Informatics, Swansea University, Swansea, UK
| | - M Rhydderch
- Displaced People in Action, Displaced People in Action, Cardiff, UK
| | - G Richardson
- Policy & International Health, Public Health Wales, Cardiff, UK
| | - D Russell
- Patient and Population Health and Informatics, Swansea University, Swansea, UK
| | - I Russell
- Patient and Population Health and Informatics, Swansea University, Swansea, UK
| | - H Snooks
- Patient and Population Health and Informatics, Swansea University, Swansea, UK
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20
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Carlsson AM, Curry P, Elkin B, Russell D, Veitch A, Branigan M, Campbell M, Croft B, Cuyler C, Côté SD, Leclerc LM, Tryland M, Nymo IH, Kutz SJ. Multi-pathogen serological survey of migratory caribou herds: A snapshot in time. PLoS One 2019; 14:e0219838. [PMID: 31365561 PMCID: PMC6668789 DOI: 10.1371/journal.pone.0219838] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 07/02/2019] [Indexed: 11/19/2022] Open
Abstract
Pathogens can impact host survival, fecundity, and population dynamics even when no obvious disease is observed. Few baseline data on pathogen prevalence and diversity of caribou are available, which hampers our ability to track changes over time and evaluate impacts on caribou health. Archived blood samples collected from ten migratory caribou herds in Canada and two in Greenland were used to test for exposure to pathogens that have the potential to effect population productivity, are zoonotic or are emerging. Relationships between seroprevalence and individual, population, and other health parameters were also examined. For adult caribou, the highest overall seroprevalence was for alphaherpesvirus (49%, n = 722), pestivirus (49%, n = 572) and Neospora caninum (27%, n = 452). Lower seroprevalence was found for parainfluenza virus type 3 (9%, n = 708), Brucella suis (2%, n = 758), and Toxoplasma gondii (2%, n = 706). No animal tested positive for antibodies against West Nile virus (n = 418) or bovine respiratory syncytial virus (n = 417). This extensive multi-pathogen survey of migratory caribou herds provides evidence that caribou are exposed to pathogens that may have impacts on herd health and revealed potential interactions between pathogens as well as geographical differences in pathogen exposure that could be linked to the bio-geographical history of caribou. Caribou are a keystone species and the socio-economic cornerstone of many indigenous cultures across the North. The results from this study highlight the urgent need for a better understanding of pathogen diversity and the impact of pathogens on caribou health.
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Affiliation(s)
- A. M. Carlsson
- Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada
- * E-mail:
| | - P. Curry
- Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada
| | - B. Elkin
- Environment and Natural Resources, Government of the Northwest Territories, Yellowknife, Alberta, Canada
| | - D. Russell
- CircumArctic Rangifer Monitoring and Assessment Network, Whitehorse, Yukon, Canada
| | - A. Veitch
- Environment and Natural Resources, Government of the Northwest Territories, Yellowknife, Alberta, Canada
| | - M. Branigan
- Environment and Natural Resources, Government of the Northwest Territories, Yellowknife, Alberta, Canada
| | - M. Campbell
- Department of Environment, Government of Nunavut, Iqaluit, Nunavut, Canada
| | - B. Croft
- Environment and Natural Resources, Government of the Northwest Territories, Yellowknife, Alberta, Canada
| | - C. Cuyler
- Greenland Institute of Natural Resources, Nuuk, Greenland
| | - S. D. Côté
- Caribou Ungava, Département de Biologie and Centre d’études nordiques, Université Laval, Québec, Québec, Canada
| | - L-M Leclerc
- Department of Environment, Government of Nunavut, Iqaluit, Nunavut, Canada
| | - M. Tryland
- Department of Arctic and Marine Biology, UiT - The Arctic University of Norway, Tromso, Norway
| | - I. H. Nymo
- Department of Arctic and Marine Biology, UiT - The Arctic University of Norway, Tromso, Norway
| | - S. J. Kutz
- Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada
- Canadian Wildlife Health Cooperative, Calgary, Alberta, Canada
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21
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Giles ML, MacPhail A, Bell C, Bradshaw CS, Furner V, Gunathilake M, John M, Krishnaswamy S, Martin SJ, Ooi C, Owen L, Russell D, Street A, Post JJ. The barriers to linkage and retention in care for women living with HIV in an high income setting where they comprise a minority group. AIDS Care 2019; 31:730-736. [PMID: 30754996 DOI: 10.1080/09540121.2019.1576843] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Women comprise a minority population of individuals living with HIV in Australia, and are often poorly represented in research and clinical trials so their needs remain largely unknown. Data suggests that they are diagnosed later than men and start antiretroviral therapy at a lower CD4 cell count. This raises the question whether there are sex specific barriers to linkage and retention in care. This study analyzed 484 surveys received from clinicians collecting demographic, virological, and reproductive health data along with perceived barriers to linkage and retention in care. Most women (67%) were estimated to have been linked into care within 28 days of diagnosis. For women who were not linked into care for more than 28 days, the most commonly reason cited was fear of disclosure to others, followed by fear of disclosure to their partner. The main reasons given for non-retention in care were related to transport, carer responsibilities, financial pressure, health beliefs and concern about stigma or disclosure.
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Affiliation(s)
- M L Giles
- a Department of Infectious Diseases , Alfred Health , Melbourne , Australia.,b Department of Obstetrics and Gynecology , Monash University , Melbourne , Australia
| | - A MacPhail
- a Department of Infectious Diseases , Alfred Health , Melbourne , Australia
| | - C Bell
- c Royal Adelaide Hospital , Adelaide , Australia
| | - C S Bradshaw
- d Melbourne Sexual Health Centre , Melbourne , Australia.,e Central Clinical School , Monash University , Melbourne , Australia
| | - V Furner
- f The Albion Centre , Sydney , Australia
| | - M Gunathilake
- g Sexual Health and Blood Borne Virus Unit, Centre for Disease Control , Northern Territory , Darwin , Australia.,h Kirby Institute , University of New South Wales , Sydney , Australia
| | - M John
- i Department of Immunology , Royal Perth Hospital , Perth , Australia
| | - S Krishnaswamy
- j Alice Springs Hospital , Alice Springs , Australia.,k Monash Infectious Diseases , Monash Health , Melbourne , Australia
| | - S J Martin
- l Canberra Sexual Health Service , Canberra Hospital , Canberra , Australia.,m Australian National University , Canberra , Australia
| | - C Ooi
- n Western Sydney Sexual Health Centre , Sydney , Australia
| | - L Owen
- o Statewide Sexual Health Service , Tasmania , Australia
| | - D Russell
- p Cairns Sexual Health Service , Cairns , Australia
| | - A Street
- q Victorian Infectious Diseases Service , Royal Melbourne Hospital , Melbourne , Australia
| | - J J Post
- f The Albion Centre , Sydney , Australia.,r Department of Infectious Diseases, Prince of Wales Hospital , Sydney , Australia.,s Prince of Wales Clinical School , University of New South Wales , Sydney , Australia
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22
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Puhr R, Petoumenos K, Huang R, Templeton DJ, Woolley I, Bloch M, Russell D, Law MG, Cooper DA. Cardiovascular disease and diabetes in HIV-positive and HIV-negative gay and bisexual men over the age of 55 years in Australia: insights from the Australian Positive & Peers Longevity Evaluation Study. HIV Med 2018; 20:121-130. [PMID: 30474916 DOI: 10.1111/hiv.12689] [Citation(s) in RCA: 6] [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] [Accepted: 10/01/2018] [Indexed: 01/19/2023]
Abstract
OBJECTIVES As HIV-positive people age, diagnosis and management of comorbidities associated with ageing are of increasing concern. In this study, we aimed to compare the self-reported prevalences of heart disease, stroke, thrombosis and diabetes in older Australian HIV-positive and HIV-negative gay and bisexual men (GBM). METHODS We analysed data from the Australian Positive & Peers Longevity Evaluation Study (APPLES), a study of a prospectively recruited cross-sectional sample of 228 (51.1%) HIV-positive and 218 (48.9%) HIV-negative GBM, aged ≥ 55 years. Regression methods were used to assess the association of HIV status with self-reported comorbidities. RESULTS Of 446 patients, 389 [200 (51.4%) HIV-positive] reported their disease history. The reported prevalence of comorbidities was higher in the HIV-positive group than in the HIV-negative group: heart disease, 19.5 versus 12.2%; stroke, 7.5 versus 4.2%; thrombosis, 10.5 versus 4.2%; and diabetes, 15.0 versus 9.0%, respectively. In adjusted analyses, HIV-positive GBM had significantly increased odds of reporting heart disease [adjusted odds ratio (aOR) 1.99; P = 0.03] and thrombosis (aOR 2.87; P = 0.01). In our analysis, HIV status was not significantly associated with either age at diagnosis of heart disease (median 53 years for HIV-positive GBM versus 55 years for HIV-negative GBM; P = 0.64) or 5-year cardiovascular disease (CVD) risk estimated using the Framingham risk score. CONCLUSIONS HIV-positive GBM more commonly reported heart disease and thrombosis compared with their HIV-negative peers. These results further highlight the need to understand the impact of HIV on age-related comorbidities in GBM, to guide optimal screening and treatment strategies to reduce the risk of these comorbidities among the HIV-positive population.
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Affiliation(s)
- R Puhr
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - K Petoumenos
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - R Huang
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - D J Templeton
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia.,RPA Sexual Health, Sydney Local Health District, Camperdown, NSW, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - I Woolley
- Monash Infectious Diseases, Monash Health and Monash University, Clayton, Vic, Australia
| | - M Bloch
- Holdsworth House Medical Practice, Sydney, NSW, Australia
| | - D Russell
- Cairns Sexual Health Service, Cairns North, QLD, Australia.,James Cook University, Cairns, QLD, Australia
| | - M G Law
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - D A Cooper
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
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23
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Kim J, Jasper A, Martin P, Russell D. LATENT PROFILES OF HEALTH PERSONALITY. Innov Aging 2018. [DOI: 10.1093/geroni/igy031.3577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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24
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Baik D, Russell D, Jordan L, Dooley F, Bowles K, Masterson Creber R. End-of-Life Issues. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | - L Jordan
- Visiting Nurse Service of New York
| | - F Dooley
- Visiting Nurse Service of New York
| | - K Bowles
- University of Pennsylvania School of Nursing
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Obhi H, Margrett J, Russell D, Kohut M. INFLAMMATION AND COGNITION: THE IMPACT OF EXERCISE INTERVENTION FITNESS IMPROVEMENT. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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26
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Barr DB, McFadzean RM, Hadley D, Ramsay A, Houston CA, Russell D. Acquired Bilateral Superior Oblique Palsy: A Localising Sign in the Dorsal Midbrain. Eur J Ophthalmol 2018; 7:271-6. [PMID: 9352282 DOI: 10.1177/112067219700700312] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Bilateral superior oblique palsy is an uncommon ocular motility problem, the commonest cause being closed head trauma. Two cases, both adults, are presented in whom bilateral superior oblique palsy occurred as a result of neoplastic infiltration of the dorsal midbrain in the region of the anterior medullary velum. In the absence of a history of head trauma, the presence of an acquired bilateral superior oblique palsy is a definite sign of a single lesion in the region of the decussation of the trochlear nerves and appropriate imaging is indicated.
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Affiliation(s)
- D B Barr
- Tennent Institute of Ophthalmology, Glasgow, United Kingdom
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27
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Kobayashi A, Czlonkowska A, Ford GA, Fonseca AC, Luijckx GJ, Korv J, de la Ossa NP, Price C, Russell D, Tsiskaridze A, Messmer-Wullen M, De Keyser J. European Academy of Neurology and European Stroke Organization consensus statement and practical guidance for pre-hospital management of stroke. Eur J Neurol 2018; 25:425-433. [PMID: 29218822 DOI: 10.1111/ene.13539] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [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: 09/28/2017] [Accepted: 12/01/2017] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND PURPOSE The reduction of delay between onset and hospital arrival and adequate pre-hospital care of persons with acute stroke are important for improving the chances of a favourable outcome. The objective is to recommend evidence-based practices for the management of patients with suspected stroke in the pre-hospital setting. METHODS The GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology was used to define the key clinical questions. An expert panel then reviewed the literature, established the quality of the evidence, and made recommendations. RESULTS Despite very low quality of evidence educational campaigns to increase the awareness of immediately calling emergency medical services are strongly recommended. Moderate quality evidence was found to support strong recommendations for the training of emergency medical personnel in recognizing the symptoms of a stroke and in implementation of a pre-hospital 'code stroke' including highest priority dispatch, pre-hospital notification and rapid transfer to the closest 'stroke-ready' centre. Insufficient evidence was found to recommend a pre-hospital stroke scale to predict large vessel occlusion. Despite the very low quality of evidence, restoring normoxia in patients with hypoxia is recommended, and blood pressure lowering drugs and treating hyperglycaemia with insulin should be avoided. There is insufficient evidence to recommend the routine use of mobile stroke units delivering intravenous thrombolysis at the scene. Because only feasibility studies have been reported, no recommendations can be provided for pre-hospital telemedicine during ambulance transport. CONCLUSIONS These guidelines inform on the contemporary approach to patients with suspected stroke in the pre-hospital setting. Further studies, preferably randomized controlled trials, are required to examine the impact of particular interventions on quality parameters and outcome.
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Affiliation(s)
- A Kobayashi
- Institute of Psychiatry and Neurology, Interventional Stroke and Cerebrovascular Diseases Treatment Centre, Warsaw, Poland.,Department of Neuroradiology, Institute of Psychiatry and Neurology, Warsaw, Poland.,Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - A Czlonkowska
- Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland.,Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland
| | - G A Ford
- Division of Medical Sciences, Oxford University, Oxford, UK
| | - A C Fonseca
- Department of Neurology, Hospital de Santa Maria, University of Lisbon, Lisbon, Portugal
| | - G J Luijckx
- Department of Neurology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - J Korv
- Department of Neurology, Estonia Department of Neurology and Neurosurgery, Neurology Clinic, Tartu University Hospital, University of Tartu, Tartu, Estonia
| | - N Pérez de la Ossa
- Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
| | - C Price
- Institute of Neuroscience (Stroke Research Group), Newcastle University, Newcastle upon Tyne, UK
| | - D Russell
- Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - A Tsiskaridze
- Department of Neurology, Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia
| | - M Messmer-Wullen
- Austrian Stroke Selfhelp Association, Lochau, Austria.,European Federation of Neurological Associations (EFNA) and Stroke Alliance for Europe (SAFE), Brussels, Belgium
| | - J De Keyser
- Department of Neurology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.,Department of Neurology, Centre for Neurosciences, UZ Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
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28
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Conte S, Lovell J, Russell D, Whitbourn R, Palmer S. Improvement in Diastolic Function After Transcatheter Aortic Valve Insertion. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.933] [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] [Indexed: 11/26/2022]
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Judd A, Zangerle R, Touloumi G, Warszawski J, Meyer L, Dabis F, Mary Krause M, Ghosn J, Leport C, Wittkop L, Reiss P, Wit F, Prins M, Bucher H, Gibb D, Fätkenheuer G, Julia DA, Obel N, Thorne C, Mocroft A, Kirk O, Stephan C, Pérez-Hoyos S, Hamouda O, Bartmeyer B, Chkhartishvili N, Noguera-Julian A, Antinori A, d’Arminio Monforte A, Brockmeyer N, Prieto L, Rojo Conejo P, Soriano-Arandes A, Battegay M, Kouyos R, Mussini C, Tookey P, Casabona J, Miró JM, Castagna A, Konopnick D, Goetghebuer T, Sönnerborg A, Quiros-Roldan E, Sabin C, Teira R, Garrido M, Haerry D, de Wit S, Miró JM, Costagliola D, d’Arminio-Monforte A, Castagna A, del Amo J, Mocroft A, Raben D, Chêne G, Judd A, Pablo Rojo C, Barger D, Schwimmer C, Termote M, Wittkop L, Campbell M, Frederiksen CM, Friis-Møller N, Kjaer J, Raben D, Salbøl Brandt R, Berenguer J, Bohlius J, Bouteloup V, Bucher H, Cozzi-Lepri A, Dabis F, d’Arminio Monforte A, Davies MA, del Amo J, Dorrucci M, Dunn D, Egger M, Furrer H, Grabar S, Guiguet M, Judd A, Kirk O, Lambotte O, Leroy V, Lodi S, Matheron S, Meyer L, Miro JM, Mocroft A, Monge S, Nakagawa F, Paredes R, Phillips A, Puoti M, Rohner E, Schomaker M, Smit C, Sterne J, Thiebaut R, Thorne C, Torti C, van der Valk M, Wittkop L, Tanser F, Vinikoor M, Macete E, Wood R, Stinson K, Garone D, Fatti G, Giddy J, Malisita K, Eley B, Fritz C, Hobbins M, Kamenova K, Fox M, Prozesky H, Technau K, Sawry S, Benson CA, Bosch RJ, Kirk GD, Boswell S, Mayer KH, Grasso C, Hogg RS, Richard Harrigan P, Montaner JSG, Yip B, Zhu J, Salters K, Gabler K, Buchacz K, Brooks JT, Gebo KA, Moore RD, Moore RD, Rodriguez B, Horberg MA, Silverberg MJ, Thorne JE, Rabkin C, Margolick JB, Jacobson LP, D’Souza G, Klein MB, Rourke SB, Rachlis AR, Cupido P, Hunter-Mellado RF, Mayor AM, John Gill M, Deeks SG, Martin JN, Patel P, Brooks JT, Saag MS, Mugavero MJ, Willig J, Eron JJ, Napravnik S, Kitahata MM, Crane HM, Drozd DR, Sterling TR, Haas D, Rebeiro P, Turner M, Bebawy S, Rogers B, Justice AC, Dubrow R, Fiellin D, Gange SJ, Anastos K, Moore RD, Saag MS, Gange SJ, Kitahata MM, Althoff KN, Horberg MA, Klein MB, McKaig RG, Freeman AM, Moore RD, Freeman AM, Lent C, Kitahata MM, Van Rompaey SE, Crane HM, Drozd DR, Morton L, McReynolds J, Lober WB, Gange SJ, Althoff KN, Abraham AG, Lau B, Zhang J, Jing J, Modur S, Wong C, Hogan B, Desir F, Liu B, You B, Cahn P, Cesar C, Fink V, Sued O, Dell’Isola E, Perez H, Valiente J, Yamamoto C, Grinsztejn B, Veloso V, Luz P, de Boni R, Cardoso Wagner S, Friedman R, Moreira R, Pinto J, Ferreira F, Maia M, Célia de Menezes Succi R, Maria Machado D, de Fátima Barbosa Gouvêa A, Wolff M, Cortes C, Fernanda Rodriguez M, Allendes G, William Pape J, Rouzier V, Marcelin A, Perodin C, Tulio Luque M, Padgett D, Sierra Madero J, Crabtree Ramirez B, Belaunzaran P, Caro Vega Y, Gotuzzo E, Mejia F, Carriquiry G, McGowan CC, Shepherd BE, Sterling T, Jayathilake K, Person AK, Rebeiro PF, Giganti M, Castilho J, Duda SN, Maruri F, Vansell H, Ly PS, Khol V, Zhang FJ, Zhao HX, Han N, Lee MP, Li PCK, Lam W, Chan YT, Kumarasamy N, Saghayam S, Ezhilarasi C, Pujari S, Joshi K, Gaikwad S, Chitalikar A, Merati TP, Wirawan DN, Yuliana F, Yunihastuti E, Imran D, Widhani A, Tanuma J, Oka S, Nishijima T, Na S, Choi JY, Kim JM, Sim BLH, Gani YM, David R, Kamarulzaman A, Syed Omar SF, Ponnampalavanar S, Azwa I, Ditangco R, Uy E, Bantique R, Wong WW, Ku WW, Wu PC, Ng OT, Lim PL, Lee LS, Ohnmar PS, Avihingsanon A, Gatechompol S, Phanuphak P, Phadungphon C, Kiertiburanakul S, Sungkanuparph S, Chumla L, Sanmeema N, Chaiwarith R, Sirisanthana T, Kotarathititum W, Praparattanapan J, Kantipong P, Kambua P, Ratanasuwan W, Sriondee R, Nguyen KV, Bui HV, Nguyen DTH, Nguyen DT, Cuong DD, An NV, Luan NT, Sohn AH, Ross JL, Petersen B, Cooper DA, Law MG, Jiamsakul A, Boettiger DC, Ellis D, Bloch M, Agrawal S, Vincent T, Allen D, Smith D, Rankin A, Baker D, Templeton DJ, O’Connor CC, Thackeray O, Jackson E, McCallum K, Ryder N, Sweeney G, Cooper D, Carr A, Macrae K, Hesse K, Finlayson R, Gupta S, Langton-Lockton J, Shakeshaft J, Brown K, Idle S, Arvela N, Varma R, Lu H, Couldwell D, Eswarappa S, Smith DE, Furner V, Smith D, Cabrera G, Fernando S, Cogle A, Lawrence C, Mulhall B, Boyd M, Law M, Petoumenos K, Puhr R, Huang R, Han A, Gunathilake M, Payne R, O’Sullivan M, Croydon A, Russell D, Cashman C, Roberts C, Sowden D, Taing K, Marshall P, Orth D, Youds D, Rowling D, Latch N, Warzywoda E, Dickson B, Donohue W, Moore R, Edwards S, Boyd S, Roth NJ, Lau H, Read T, Silvers J, Zeng W, Hoy J, Watson K, Bryant M, Price S, Woolley I, Giles M, Korman T, Williams J, Nolan D, Allen A, Guelfi G, Mills G, Wharry C, Raymond N, Bargh K, Templeton D, Giles M, Brown K, Hoy J. Comparison of Kaposi Sarcoma Risk in Human Immunodeficiency Virus-Positive Adults Across 5 Continents: A Multiregional Multicohort Study. Clin Infect Dis 2017; 65:1316-1326. [PMID: 28531260 PMCID: PMC5850623 DOI: 10.1093/cid/cix480] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 05/19/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND We compared Kaposi sarcoma (KS) risk in adults who started antiretroviral therapy (ART) across the Asia-Pacific, South Africa, Europe, Latin, and North America. METHODS We included cohort data of human immunodeficiency virus (HIV)-positive adults who started ART after 1995 within the framework of 2 large collaborations of observational HIV cohorts. We present incidence rates and adjusted hazard ratios (aHRs). RESULTS We included 208140 patients from 57 countries. Over a period of 1066572 person-years, 2046 KS cases were diagnosed. KS incidence rates per 100000 person-years were 52 in the Asia-Pacific and ranged between 180 and 280 in the other regions. KS risk was 5 times higher in South African women (aHR, 4.56; 95% confidence intervals [CI], 2.73-7.62) than in their European counterparts, and 2 times higher in South African men (2.21; 1.34-3.63). In Europe, Latin, and North America KS risk was 6 times higher in men who have sex with men (aHR, 5.95; 95% CI, 5.09-6.96) than in women. Comparing patients with current CD4 cell counts ≥700 cells/µL with those whose counts were <50 cells/µL, the KS risk was halved in South Africa (aHR, 0.53; 95% CI, .17-1.63) but reduced by ≥95% in other regions. CONCLUSIONS Despite important ART-related declines in KS incidence, men and women in South Africa and men who have sex with men remain at increased KS risk, likely due to high human herpesvirus 8 coinfection rates. Early ART initiation and maintenance of high CD4 cell counts are essential to further reducing KS incidence worldwide, but additional measures might be needed, especially in Southern Africa.
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Huynh A, Leong K, Jones N, Crump N, Russell D, Anderson M, Steinfort D, Johnson DF. Outcomes of exertional rhabdomyolysis following high-intensity resistance training. Intern Med J 2017; 46:602-8. [PMID: 26949203 DOI: 10.1111/imj.13055] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 10/04/2015] [Revised: 02/17/2016] [Accepted: 02/26/2016] [Indexed: 12/29/2022]
Abstract
BACKGROUND High-intensity resistance training (HIRT) programmes are increasingly popular amongst personal trainers and those attending gymnasiums. We report the experience of exertional rhabdomyolysis (ER) at two tertiary hospitals in Melbourne, Australia. AIMS To compare the clinical outcomes of ER with other causes of rhabdomyolysis. METHODS Retrospective cross-sectional study of patients presenting with a serum creatine kinase (CK) of greater than 25 000 units/L from 1 September 2013 to 31 August 2014 at two tertiary referral hospitals in Melbourne, Australia. Records were examined to identify care measures implemented during hospital stay, clinical outcomes during admission and on subsequent follow up. RESULTS Thirty four cases of rhabdomyolysis with a CK of greater than 25 000 units/L (normal range: 20-180 units/L) were identified during the 12-month study period. Twelve of the 34 cases (35%) had ER with 10 of 12 related to HIRT. No acute kidney injury, intensive care admission or death were seen among those with ER. All cases were managed conservatively, with 11 admitted and 9 receiving intravenous fluids only. In contrast, patients with rhabdomyolysis from other causes experienced significantly higher rates of intensive care admission (64%, P = 0.0002), acute kidney injury (82%, P = 0.0001) and death (27%, P = 0.069). CONCLUSION ER resulting from HIRT appears to have a benign course compared with rhabdomyolysis of other aetiologies in patients with a serum CK greater than 25 000 units/L. Conservative management of ER appears to be adequate, although this requires confirmation in future prospective studies.
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Affiliation(s)
- A Huynh
- Department of General Medicine, Austin Health, Melbourne, Victoria, Australia
| | - K Leong
- Department of General Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - N Jones
- Department of General Medicine, Austin Health, Melbourne, Victoria, Australia
| | - N Crump
- Department of Neurology, Austin Health, Melbourne, Victoria, Australia
| | - D Russell
- Department of General Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - M Anderson
- Shinbone Medical Centre, Melbourne, Victoria, Australia
| | - D Steinfort
- Department of Respiratory Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - D F Johnson
- Department of General Medicine, Austin Health, Melbourne, Victoria, Australia
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Zhao F, Hong G, Russell D. WIDOWHOOD AND DEPRESSION TRAJECTORIES OF OLDER ADULTS IN THE HEALTH AND RETIREMENT STUDY. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- F. Zhao
- Iowa State University, Ames, Iowa
| | - G. Hong
- Iowa State University, Ames, Iowa
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Yoo J, Karraker A, Russell D. CARING FOR GRANDCHILDREN AND GRANDPARENTS’ PHYSICAL AND MENTAL HEALTH CHANGE. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J. Yoo
- Iowa State University, Ames, Iowa,
| | - A. Karraker
- National Institute on Aging, Bethesda, Maryland
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Russell D, Szanton S, Feinberg J, Bowles K. A PILOT STUDY ASSESSING IN-HOME ACTIVITY PERFORMANCE AMONG VULNERABLE OLDER ADULTS IN NEW YORK CITY. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- D. Russell
- Visiting Nurse Service of New York, New York, New York,
| | - S.L. Szanton
- Johns Hopkins University School of Nursing,
New York, New York
| | - J.L. Feinberg
- Visiting Nurse Service of New York, New York, New York,
| | - K.H. Bowles
- Visiting Nurse Service of New York, New York, New York,
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Chase J, Huang L, Russell D, Hanlon A, O’Connor M, Robinson K, Bowles K. RACIAL AND ETHNIC DISPARITIES IN ADL DISABILITY AFTER HOSPITALIZATION AMONG OLDER HOME CARE RECIPIENTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.3853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- J. Chase
- University of Missouri, Columbia, Missouri,
- University of Pennsylvania, Philadelphia, Pennsylvania,
| | - L. Huang
- University of Pennsylvania, Philadelphia, Pennsylvania,
| | - D. Russell
- Visiting Nurse Service of New York, Manhattan, New York,
| | - A. Hanlon
- University of Pennsylvania, Philadelphia, Pennsylvania,
| | - M. O’Connor
- Villanova University, Villanova, Pennsylvania
| | - K. Robinson
- University of Pennsylvania, Philadelphia, Pennsylvania,
| | - K.H. Bowles
- University of Pennsylvania, Philadelphia, Pennsylvania,
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Al-kaisey A, Jones N, Russell D, Hare D, Kearney L, Srivastava P, Mark H, Oliver L. When the Pathologist Makes the Diagnosis. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.256] [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] [Indexed: 11/24/2022]
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Peat R, Furlong J, Spencer E, Russell D, Ledson M, Walshaw MJ. P250 Real flight spo2 compares with hypoxic challenge testing in adults with cystic fibrosis. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.393] [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] [Indexed: 11/04/2022]
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37
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Peat R, Szymczyk P, Russell D, Nazareth D, Shaw M, Walshaw MJ. P254 Validation of telemedicine spirometry. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.397] [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] [Indexed: 11/04/2022]
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Peat R, Furlong J, Byrne T, Young R, Kangombe A, Elkin T, Renwick S, Russell D, Oelbaum S, Burhan H, Walker PP. P198 Anchoring copd screening to drug services in heroin and crack smokers to improve diagnosis. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.341] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Hussein H, Dulin J, Smanik L, Drost WT, Russell D, Wellman M, Bertone A. Repeated oral administration of a cathepsin K inhibitor significantly suppresses bone resorption in exercising horses with evidence of increased bone formation and maintained bone turnover. J Vet Pharmacol Ther 2016; 40:327-334. [DOI: 10.1111/jvp.12368] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Accepted: 09/12/2016] [Indexed: 12/19/2022]
Affiliation(s)
- H. Hussein
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; The Ohio State University; Columbus OH USA
| | - J. Dulin
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; The Ohio State University; Columbus OH USA
| | - L. Smanik
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; The Ohio State University; Columbus OH USA
| | - W. T. Drost
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; The Ohio State University; Columbus OH USA
| | - D. Russell
- Department of Veterinary Biosciences; College of Veterinary Medicine; The Ohio State University; Columbus OH USA
| | - M. Wellman
- Department of Veterinary Biosciences; College of Veterinary Medicine; The Ohio State University; Columbus OH USA
| | - A. Bertone
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; The Ohio State University; Columbus OH USA
- Department of Veterinary Biosciences; College of Veterinary Medicine; The Ohio State University; Columbus OH USA
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Affiliation(s)
- A. Dahl
- Department of Neurology, Rikshospitalet, The University of Oslo, Oslo, Norway
| | - D. Russell
- Department of Neurology, Rikshospitalet, The University of Oslo, Oslo, Norway
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Affiliation(s)
- A. Dahl
- Department of Neurology, Rikshospitalet, The University of Oslo, Oslo, Norway
| | - D. Russell
- Department of Neurology, Rikshospitalet, The University of Oslo, Oslo, Norway
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Russell D, Gludish D, Jambo K, Mwandumba H. 15 Is the lung a site of productive HIV infection that persists through ART? J Virus Erad 2016. [DOI: 10.1016/s2055-6640(20)30960-2] [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] [Indexed: 10/23/2022] Open
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Dunlop O, Rootwelt K, Rklund R, Bruun JN, Russell D, Nyberg-Hansen R. Reduced Global Cerebral Blood Flow in Non-Demented HIV Positive Patients. ACTA ACUST UNITED AC 2016; 1:71-8. [PMID: 16873180 DOI: 10.1300/j128v01n04_07] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Twelve non-demented HIV positive men with different degrees of immunodeficiency were examined with single photon emission computed tomography (SPECT). Reduction in relative global cerebral blood flow was found in HIV positive patients compared to healthy HIV negative controls (p = 0.014). In the patients there was also a change in cerebral flow distribution, with lower global flow compared to central flow (p = 0.01), most pronounced in patients with early disease. In the patients with advanced HIV disease the relative cerebral blood flow was lower than in the controls in 108 of 116 (93%) regions investigated.
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Roof SR, Boslett J, Russell D, del Rio C, Alecusan J, Zweier JL, Ziolo MT, Hamlin R, Mohler PJ, Curran J. Insulin-like growth factor 1 prevents diastolic and systolic dysfunction associated with cardiomyopathy and preserves adrenergic sensitivity. Acta Physiol (Oxf) 2016; 216:421-34. [PMID: 26399932 DOI: 10.1111/apha.12607] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [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: 05/04/2015] [Revised: 06/03/2015] [Accepted: 09/15/2015] [Indexed: 12/11/2022]
Abstract
AIMS Insulin-like growth factor 1 (IGF-1)-dependent signalling promotes exercise-induced physiological cardiac hypertrophy. However, the in vivo therapeutic potential of IGF-1 for heart disease is not well established. Here, we test the potential therapeutic benefits of IGF-1 on cardiac function using an in vivo model of chronic catecholamine-induced cardiomyopathy. METHODS Rats were perfused with isoproterenol via osmotic pump (1 mg kg(-1) per day) and treated with 2 mg kg(-1) IGF-1 (2 mg kg(-1) per day, 6 days a week) for 2 or 4 weeks. Echocardiography, ECG, and blood pressure were assessed. In vivo pressure-volume loop studies were conducted at 4 weeks. Heart sections were analysed for fibrosis and apoptosis, and relevant biochemical signalling cascades were assessed. RESULTS After 4 weeks, diastolic function (EDPVR, EDP, tau, E/A ratio), systolic function (PRSW, ESPVR, dP/dtmax) and structural remodelling (LV chamber diameter, wall thickness) were all adversely affected in isoproterenol-treated rats. All these detrimental effects were attenuated in rats treated with Iso+IGF-1. Isoproterenol-dependent effects on BP were attenuated by IGF-1 treatment. Adrenergic sensitivity was blunted in isoproterenol-treated rats but was preserved by IGF-1 treatment. Immunoblots indicate that cardioprotective p110α signalling and activated Akt are selectively upregulated in Iso+IGF-1-treated hearts. Expression of iNOS was significantly increased in both the Iso and Iso+IGF-1 groups; however, tetrahydrobiopterin (BH4) levels were decreased in the Iso group and maintained by IGF-1 treatment. CONCLUSION IGF-1 treatment attenuates diastolic and systolic dysfunction associated with chronic catecholamine-induced cardiomyopathy while preserving adrenergic sensitivity and promoting BH4 production. These data support the potential use of IGF-1 therapy for clinical applications for cardiomyopathies.
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Affiliation(s)
| | - J. Boslett
- The Dorothy M. Davis Heart and Lung Research Institute; The Ohio State University Wexner Medical Center; Columbus OH USA
| | - D. Russell
- Department of Veterinary Clinical Sciences; College of Veterinarian Medicine; The Ohio State University; Columbus OH USA
| | | | - J. Alecusan
- The Dorothy M. Davis Heart and Lung Research Institute; The Ohio State University Wexner Medical Center; Columbus OH USA
| | - J. L. Zweier
- The Dorothy M. Davis Heart and Lung Research Institute; The Ohio State University Wexner Medical Center; Columbus OH USA
| | - M. T. Ziolo
- The Dorothy M. Davis Heart and Lung Research Institute; The Ohio State University Wexner Medical Center; Columbus OH USA
- Department of Physiology and Cell Biology; The Ohio State University Wexner Medical Center; Columbus OH USA
| | | | - P. J. Mohler
- The Dorothy M. Davis Heart and Lung Research Institute; The Ohio State University Wexner Medical Center; Columbus OH USA
- Department of Internal Medicine; The Ohio State University Wexner Medical Center; Columbus OH USA
- Department of Physiology and Cell Biology; The Ohio State University Wexner Medical Center; Columbus OH USA
| | - J. Curran
- The Dorothy M. Davis Heart and Lung Research Institute; The Ohio State University Wexner Medical Center; Columbus OH USA
- Department of Internal Medicine; The Ohio State University Wexner Medical Center; Columbus OH USA
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Mulhall BP, Wright ST, De La Mata N, Allen D, Brown K, Dickson B, Grotowski M, Jackson E, Petoumenos K, Foster R, Read T, Russell D, Smith DJ, Templeton DJ, Fairley CK, Law MG. Risk factors associated with incident sexually transmitted infections in HIV-positive patients in the Australian HIV Observational Database: a prospective cohort study. HIV Med 2016; 17:623-30. [PMID: 27019207 DOI: 10.1111/hiv.12371] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVES We established a subcohort of HIV-positive individuals from 10 sexual health clinics within the Australian HIV Observational Database (AHOD). The aim of this study was to assess demographic and other factors that might be associated with an incident sexually transmitted infection (STI). METHODS The cohort follow-up was from March 2010 to March 2013, and included patients screened at least once for an STI. We used survival methods to determine time to first new and confirmed incident STI infection (chlamydia, gonorrhoea, syphilis or genital warts). Factors evaluated included sex, age, mode of HIV exposure, year of AHOD enrolment, hepatitis B or C coinfection, time-updated CD4 cell count, time-updated HIV RNA viral load, and prior STI diagnosis. RESULTS There were 110 first incident STI diagnoses observed over 1015 person-years of follow-up, a crude rate of 10.8 [95% confidence interval (CI) 9.0-13.0] per 100 person-years. Factors independently associated with increased risk of incident STI included younger age [≥ 50 vs. 30-39 years old, adjusted hazards ratio (aHR) 0.4; 95% CI 0.2-0.8; P < 0.0001]; prior STI infection (aHR 2.5; 95% CI 1.6-3.8; P < 0.001), and heterosexual vs. men who have sex with men (MSM) as the likely route of exposure (aHR 0.2; 95% CI 0.1-0.6; P < 0.001). CONCLUSIONS In this cohort of individualsbeing treated with antiretroviral drugs, those who were MSM, who were 30-39 years old, and who had a prior history of STI, were at highest risk of a further STI diagnosis.
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Affiliation(s)
- B P Mulhall
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia.,University of Sydney, Camperdown, NSW, Australia
| | - S T Wright
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - N De La Mata
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - D Allen
- Holden Street Sexual Health Clinic, Gosford, NSW, Australia
| | - K Brown
- University of Sydney, Camperdown, NSW, Australia.,Illawarra Sexual Health Services, Warrawong, NSW, Australia.,University of Wollongong, Wollongong, NSW, Australia
| | - B Dickson
- Caradata, Arundel DC, Qld, Australia
| | - M Grotowski
- Tamworth Sexual Health, Clinic 468, HNEAHS, NSW, Australia
| | - E Jackson
- Nepean/Blue Mountains Sexual Health, Nepean Hospital, Kingswood, NSW, Australia
| | - K Petoumenos
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - R Foster
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia.,Sydney Sexual Health Centre, Sydney, NSW, Australia
| | - T Read
- Melbourne Sexual Health Centre, Alfred Hospital, Prahran, Vic., Australia
| | - D Russell
- Cairns Sexual Health Service, Cairns, Qld, Australia.,Central Clinical School Monash University, Alfred Hospital, Melbourne, Vic., NSW, Australia
| | - D J Smith
- Lismore Sexual Health Services, Lismore, NSW, Australia
| | - D J Templeton
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia.,RPA Sexual Health, Camperdown, NSW, Australia
| | - C K Fairley
- Melbourne Sexual Health Centre, Alfred Hospital, Prahran, Vic., Australia.,Central Clinical School Monash University, Alfred Hospital, Melbourne, Vic., NSW, Australia
| | - M G Law
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
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Politis J, Lau S, Yeoh J, Brand C, Russell D, Liew D. Overview of shorthand medical glossary (OMG) study. Intern Med J 2016; 45:423-7. [PMID: 25827509 DOI: 10.1111/imj.12668] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 11/27/2014] [Accepted: 12/10/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Shorthand is commonplace in clinical notation. While many abbreviations are standard and widely accepted, an increasing number are non-standard and/or unrecognisable. AIM We sought to describe the frequency of inappropriate and ambiguous shorthand in discharge summaries. METHODS Eighty electronic discharge summaries from the four General Medical Units at the Royal Melbourne Hospital were randomly extracted from the hospital's electronic records. Extraction was stratified by the four units and by the four quarters between July 2012 and June 2013. All abbreviations were assigned into one of four categories according to appropriateness: 1. 'Universally accepted and understood even without context'; 2. 'Understood when in context'; 3. 'Understood but inappropriate and/or ambiguous'; and 4. 'Unknown'. These categories were determined by the authors, which included junior and senior medical staff. RESULTS The 80 discharge summaries contained 840 different abbreviations used on 6269 occasions. Of all words, 20.1% were abbreviations. Of the 6269 occasions of shorthand, 6.8% were categorised as 'Understood but inappropriate and/or ambiguous' or 'Unknown' (category 3 or 4), equating to 1.4% of all words, and an average of 5.4 words per discharge summary. CONCLUSION Abbreviations are common in electronic discharge summaries, occurring at a frequency of one in five words. While the majority of shorthand used seems to be appropriate, the use of inappropriate, ambiguous or unknown shorthand is still frequent. This has implications for safe and effective patient care and highlights the need for better awareness and education regarding use of shorthand in clinical notation.
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Affiliation(s)
- J Politis
- The Royal Melbourne Hospital, Melbourne, Victoria, Australia
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Lee LK, Goren A, Zou KH, Odell K, Russell D, Araiza AL, Luo X. Potential benefits of diagnosis and treatment on health outcomes among elderly people with symptoms of overactive bladder. Int J Clin Pract 2016; 70:66-81. [PMID: 26662296 PMCID: PMC4738527 DOI: 10.1111/ijcp.12758] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES This study examined potential benefits of diagnosing and treating elderly adults with overactive bladder (OAB) symptoms. METHODS Data were analysed from the OAB Re-Contact Study (N = 2750), a cross-sectional, self-reported Internet survey. Elderly respondents (65+ years old) with OAB were identified according to current medication use to control OAB symptoms or by scores > 14 (men) or > 16 (women) on the OAB Awareness Tool. Treated were those currently using prescription medication and never treated were those who never used prescription medication for OAB. Outcome measures included health-related quality of life, activity impairment, OAB-related severity and symptoms, and healthcare resource use (e.g. hospitalisations). Generalised linear models predicted health outcomes as a function of diagnosis or treatment, adjusting for covariates. RESULTS Diagnosed vs. not diagnosed elderly respondents had higher mental component summary (MCS) scores and SF-6D health utilities, and less activity impairment. Treated vs. never treated elderly respondents had higher MCS and SF-6D health utilities, less activity impairment, fewer OAB symptoms, lower OAB Awareness Tool scores, and lower odds of having bladder problems or incontinence. There were no significant differences in healthcare resource use. Further analysis by age group (middle-aged vs. elderly respondents) revealed significantly greater diagnosis- and treatment-related benefits on MCS (2.93 and 4.49 points more, respectively) and activity impairment (1.24 and 1.37 times as much, respectively) among elderly respondents. CONCLUSIONS Diagnosis and treatment were each associated with a lower health burden for elderly adults with OAB symptoms. These findings highlighted the importance of diagnosis and treatment in alleviating OAB symptoms and their impact on health outcomes.
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Affiliation(s)
- L K Lee
- Kantar Health, New York, NY, USA
| | - A Goren
- Kantar Health, New York, NY, USA
| | - K H Zou
- Pfizer Inc, New York, NY, USA
| | - K Odell
- Pfizer Inc, New York, NY, USA
| | | | | | - X Luo
- Pfizer Inc, Groton, CT, USA
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Harvey JJ, Chester S, Burke SA, Ansbro M, Aden T, Gose R, Sciulli R, Bai J, DesJardin L, Benfer JL, Hall J, Smole S, Doan K, Popowich MD, St George K, Quinlan T, Halse TA, Li Z, Pérez-Osorio AC, Glover WA, Russell D, Reisdorf E, Whyte T, Whitaker B, Hatcher C, Srinivasan V, Tatti K, Tondella ML, Wang X, Winchell JM, Mayer LW, Jernigan D, Mawle AC. Comparative analytical evaluation of the respiratory TaqMan Array Card with real-time PCR and commercial multi-pathogen assays. J Virol Methods 2015; 228:151-7. [PMID: 26640122 PMCID: PMC7113746 DOI: 10.1016/j.jviromet.2015.11.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 11/19/2015] [Accepted: 11/25/2015] [Indexed: 12/24/2022]
Abstract
Viral and bacterial real-time PCR oligonucleotides were spotted on TaqMan Array Cards. Analytical sensitivity was compared with standalone laboratory PCR assays. TaqMan Array Card sensitivity was generally one log lower. Reproducibility across six independent testing sites was within one log.
In this study, a multicenter evaluation of the Life Technologies TaqMan® Array Card (TAC) with 21 custom viral and bacterial respiratory assays was performed on the Applied Biosystems ViiA™ 7 Real-Time PCR System. The goal of the study was to demonstrate the analytical performance of this platform when compared to identical individual pathogen specific laboratory developed tests (LDTs) designed at the Centers for Disease Control and Prevention (CDC), equivalent LDTs provided by state public health laboratories, or to three different commercial multi-respiratory panels. CDC and Association of Public Health Laboratories (APHL) LDTs had similar analytical sensitivities for viral pathogens, while several of the bacterial pathogen APHL LDTs demonstrated sensitivities one log higher than the corresponding CDC LDT. When compared to CDC LDTs, TAC assays were generally one to two logs less sensitive depending on the site performing the analysis. Finally, TAC assays were generally more sensitive than their counterparts in three different commercial multi-respiratory panels. TAC technology allows users to spot customized assays and design TAC layout, simplify assay setup, conserve specimen, dramatically reduce contamination potential, and as demonstrated in this study, analyze multiple samples in parallel with good reproducibility between instruments and operators.
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Affiliation(s)
- John J Harvey
- Battelle Technical On-Site Professional Services, Atlanta, GA, 30329 USA; Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, 30329-4027 USA.
| | - Stephanie Chester
- Association of Public Health Laboratories, Silver Spring, MD, 20904 USA
| | - Stephen A Burke
- Battelle Technical On-Site Professional Services, Atlanta, GA, 30329 USA; Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, 30329-4027 USA
| | - Marisela Ansbro
- Battelle Technical On-Site Professional Services, Atlanta, GA, 30329 USA; Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, 30329-4027 USA
| | - Tricia Aden
- Battelle Technical On-Site Professional Services, Atlanta, GA, 30329 USA; Association of Public Health Laboratories, Silver Spring, MD, 20904 USA
| | - Remedios Gose
- Hawaii Department of Health State Laboratories, Pearl City, HI, 96782 USA
| | - Rebecca Sciulli
- Hawaii Department of Health State Laboratories, Pearl City, HI, 96782 USA
| | - Jing Bai
- Iowa State Hygienic Laboratory, Coralville, IA, 52241 USA
| | - Lucy DesJardin
- Iowa State Hygienic Laboratory, Coralville, IA, 52241 USA
| | | | - Joshua Hall
- William A. Hinton State Laboratory Institute, Jamaica Plain, MA, 02130 USA
| | - Sandra Smole
- William A. Hinton State Laboratory Institute, Jamaica Plain, MA, 02130 USA
| | - Kimberly Doan
- William A. Hinton State Laboratory Institute, Jamaica Plain, MA, 02130 USA
| | - Michael D Popowich
- Wadsworth Center, New York State Department of Health, Albany, NY, 12201-0509 USA
| | - Kirsten St George
- Wadsworth Center, New York State Department of Health, Albany, NY, 12201-0509 USA
| | - Tammy Quinlan
- Wadsworth Center, New York State Department of Health, Albany, NY, 12201-0509 USA
| | - Tanya A Halse
- Wadsworth Center, New York State Department of Health, Albany, NY, 12201-0509 USA
| | - Zhen Li
- Washington State Public Health Laboratories, Shoreline, WA, 98155-7224 USA
| | | | - William A Glover
- Washington State Public Health Laboratories, Shoreline, WA, 98155-7224 USA
| | - Denny Russell
- Washington State Public Health Laboratories, Shoreline, WA, 98155-7224 USA
| | - Erik Reisdorf
- Wisconsin State Laboratory of Hygiene, Madison, WI, USA
| | - Thomas Whyte
- Wisconsin State Laboratory of Hygiene, Madison, WI, USA
| | - Brett Whitaker
- Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, 30329-4027 USA
| | - Cynthia Hatcher
- Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, 30329-4027 USA
| | - Velusamy Srinivasan
- Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, 30329-4027 USA
| | - Kathleen Tatti
- Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, 30329-4027 USA
| | - Maria Lucia Tondella
- Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, 30329-4027 USA
| | - Xin Wang
- Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, 30329-4027 USA
| | - Jonas M Winchell
- Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, 30329-4027 USA
| | - Leonard W Mayer
- Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, 30329-4027 USA
| | - Daniel Jernigan
- Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, 30329-4027 USA
| | - Alison C Mawle
- Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, 30329-4027 USA
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Bosanquet D, Ansell J, Abdelrahman T, Cornish J, Harries R, Stimpson A, Davies L, Glasbey J, Frewer K, Frewer N, Russell D, Russell I, Torkington J. Systematic review and meta regression of factors affecting midline incisional hernia rates: An analysis of 14,618 patients. Int J Surg 2015. [DOI: 10.1016/j.ijsu.2015.07.307] [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] [Indexed: 10/22/2022]
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Hov MR, Nome T, Zakariassen E, Russell D, Røislien J, Lossius HM, Lund CG. Assessment of acute stroke cerebral CT examinations by anaesthesiologists. Acta Anaesthesiol Scand 2015; 59:1179-86. [PMID: 25976840 PMCID: PMC5029598 DOI: 10.1111/aas.12542] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [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: 11/07/2014] [Revised: 01/21/2015] [Accepted: 03/21/2015] [Indexed: 12/31/2022]
Abstract
Background and purpose It is essential to diagnose ischaemic stroke as soon as possible after symptom onset, so that thrombolytic treatment can be initiated as quickly as possible. This might be greatly facilitated if cerebral CT could be carried out in a pre‐hospital setting. The aim of this study was to evaluate if anaesthesiologists, who in Norway provide pre‐hospital medical care, could be trained to assess cerebral CT scans to exclude radiological contraindications for thrombolytic stroke treatment. Methods Thirteen anaesthesiologists attended an 8‐h course in acute stroke assessment, including a 2‐h introduction to the neuroradiology of acute stroke. Each participant then assessed 12 non‐contrast cerebral CT examinations of acute stroke patients with specific regard to radiological contraindications for thrombolytic therapy. Test results were compared with those of three experienced neuroradiologists. Inter‐rater agreement between anaesthesiologists and neuroradiologists was calculated using Cohen's Kappa statistics. Robustness of the results was assessed using the non‐parametric bootstrap. Results Among the neuroradiologists, Kappa was 1 for detecting radiological contraindications for thrombolytic therapy. Twelve of the 13 anaesthesiologists showed good or excellent agreement (Kappa > 0.60) with the neuroradiologists. The anaesthesiologists spent a median time of 2 min and 18 s on each CT scan. Conclusions This study suggests that anaesthesiologists who are experienced in pre‐hospital care may be quickly trained to assess cerebral CT examinations in acute stroke patients with regard to radiological contraindications for thrombolytic therapy.
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Affiliation(s)
- M. R. Hov
- Department of Research and Development The Norwegian Air Ambulance Foundation Drøbak Norway
| | - T. Nome
- Department of Neuroradiology Oslo Norway Oslo University Hospital Oslo Norway
| | - E. Zakariassen
- Department of Research and Development The Norwegian Air Ambulance Foundation Drøbak Norway
| | - D. Russell
- Department of Neurology Oslo University Hospital Oslo Norway
| | - J. Røislien
- Department of Health Sciences University of Stavanger Oslo Norway
- Department of Biostatistics University of Oslo Oslo Norway
| | - H. M. Lossius
- Department of Research and Development The Norwegian Air Ambulance Foundation Drøbak Norway
- Department of Biostatistics University of Oslo Oslo Norway
| | - C. G. Lund
- Department of Research and Development The Norwegian Air Ambulance Foundation Drøbak Norway
- Department of Neurology Oslo University Hospital Oslo Norway
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