1
|
Faherty EAG, Holly T, Ogale YP, Spencer H, Becht AM, Crisler G, Wasz M, Stonehouse P, Barbian HJ, Zelinski C, Kittner A, Foulkes D, Anderson KW, Evans T, Nicolae L, Staton A, Hardnett C, Townsend MB, Carson WC, Panayampalli SS, Hutson CL, Gigante CM, Quilter LAS, Gorman S, Borah B, Black SR, Pacilli M, Kern D, Kerins J, McCollum AM, Rao AK, Tabidze I. Investigation of an mpox outbreak affecting many vaccinated persons in Chicago, IL-March 2023-June 2023. Clin Infect Dis 2024:ciae181. [PMID: 38567460 DOI: 10.1093/cid/ciae181] [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: 01/02/2024] [Revised: 02/29/2024] [Accepted: 04/01/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND After months of few mpox cases, an increased number of cases were reported in Chicago during May 2023; predominantly among fully vaccinated patients. We investigated the outbreak scope, differences between vaccinated and unvaccinated patients, and hypotheses for monkeypox virus (MPXV) infection after vaccination. METHODS We interviewed patients and reviewed medical records to assess demographic, behavioral, and clinical characteristics, mpox vaccine status, and vaccine administration routes. We evaluated serum antibody levels after infection and compared patient viral genomes with MPXV sequences in available databases. We discussed potential vaccine compromise with partners who manufactured, handled, and administered vaccine associated with breakthrough infections. RESULTS During March 18-June 27, 2023, we identified 49 mpox cases; 57% of these mpox patients were fully vaccinated (FV). FV patients received both JYNNEOS doses subcutaneously (57%), intradermally (7%), or via heterologous administration (36%). FV patients had more median sex partners (3, IQR=1-4) versus not fully vaccinated (NFV) patients (1, IQR=1-2). Thirty-six of 37 sequenced specimens belonged to lineage B.1.20 of clade IIb MPXV, which did not demonstrate any amino acid changes relative to B.1, the predominant lineage from May 2022. Vaccinated patients demonstrated expected humoral antibody responses; none were hospitalized. No vaccine storage excursions were identified. Approximately 63% of people at risk for mpox in Chicago were FV during this period. CONCLUSIONS Our investigation indicated cases were likely due to frequent behaviors associated with mpox transmission, even with relatively high vaccine effectiveness and vaccine coverage. Cases after vaccination might occur in similar populations.
Collapse
Affiliation(s)
- Emily A G Faherty
- Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, United States of America
- Chicago Department of Public Health, 1340 South Damen Avenue, Chicago, Illinois, 60646, United States of America
| | - Taylor Holly
- Chicago Department of Public Health, 1340 South Damen Avenue, Chicago, Illinois, 60646, United States of America
| | - Yasmin P Ogale
- Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, United States of America
| | - Hillary Spencer
- Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, United States of America
- Chicago Department of Public Health, 1340 South Damen Avenue, Chicago, Illinois, 60646, United States of America
| | - Ashley M Becht
- Chicago Department of Public Health, 1340 South Damen Avenue, Chicago, Illinois, 60646, United States of America
| | - Gordon Crisler
- Chicago Department of Public Health, 1340 South Damen Avenue, Chicago, Illinois, 60646, United States of America
| | - Michael Wasz
- Chicago Department of Public Health, 1340 South Damen Avenue, Chicago, Illinois, 60646, United States of America
| | - Patrick Stonehouse
- Chicago Department of Public Health, 1340 South Damen Avenue, Chicago, Illinois, 60646, United States of America
| | - Hannah J Barbian
- Rush University Medical Center, 1620 W Harrison St, Chicago, IL 60612, United States of America
| | - Christy Zelinski
- Chicago Department of Public Health, 1340 South Damen Avenue, Chicago, Illinois, 60646, United States of America
| | - Alyse Kittner
- Chicago Department of Public Health, 1340 South Damen Avenue, Chicago, Illinois, 60646, United States of America
| | - Dorothy Foulkes
- Chicago Department of Public Health, 1340 South Damen Avenue, Chicago, Illinois, 60646, United States of America
| | - Kendall W Anderson
- Chicago Department of Public Health, 1340 South Damen Avenue, Chicago, Illinois, 60646, United States of America
| | - Tiffany Evans
- Chicago Department of Public Health, 1340 South Damen Avenue, Chicago, Illinois, 60646, United States of America
| | - Lavinia Nicolae
- Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, United States of America
| | - Amber Staton
- Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, United States of America
| | - Carla Hardnett
- Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, United States of America
| | - Michael B Townsend
- Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, United States of America
| | - William C Carson
- Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, United States of America
| | | | - Christina L Hutson
- Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, United States of America
| | - Crystal M Gigante
- Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, United States of America
| | - Laura A S Quilter
- Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, United States of America
| | - Susan Gorman
- Office of Strategic National Stockpile, Department of Health and Human Services, 1600 Clifton Rd, Atlanta, GA 30333, United States of America
| | - Brian Borah
- Chicago Department of Public Health, 1340 South Damen Avenue, Chicago, Illinois, 60646, United States of America
| | - Stephanie R Black
- Chicago Department of Public Health, 1340 South Damen Avenue, Chicago, Illinois, 60646, United States of America
| | - Massimo Pacilli
- Chicago Department of Public Health, 1340 South Damen Avenue, Chicago, Illinois, 60646, United States of America
| | - David Kern
- Chicago Department of Public Health, 1340 South Damen Avenue, Chicago, Illinois, 60646, United States of America
| | - Janna Kerins
- Chicago Department of Public Health, 1340 South Damen Avenue, Chicago, Illinois, 60646, United States of America
| | - Andrea M McCollum
- Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, United States of America
| | - Agam K Rao
- Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, United States of America
| | - Irina Tabidze
- Chicago Department of Public Health, 1340 South Damen Avenue, Chicago, Illinois, 60646, United States of America
| |
Collapse
|
2
|
Faherty EAG, Holly T, Herrera K, Guidry T, Lyang J, Black S, Tabidze I. Prior Sexually Transmitted Infections and HIV in Patients With Mpox, Chicago, Illinois (June 2022-March 2023). J Infect Dis 2024; 229:S197-S202. [PMID: 37947018 DOI: 10.1093/infdis/jiad491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 11/03/2023] [Accepted: 11/06/2023] [Indexed: 11/12/2023] Open
Abstract
HIV is associated with severe mpox. Sexually transmitted infections (STIs) could facilitate mpox transmission. We estimated HIV and STI frequency among patients with mpox and compared characteristics associated with mpox severity. Mpox cases during 1 June 2022 to 31 March 2023 were matched to Illinois HIV/AIDS surveillance data. Among 1124 patients with mpox, 489 (44%) had HIV and 786 (70%) had prior or concurrent STI; 307 (39%) had ≥3 STI episodes. More patients with mpox who were living with HIV were hospitalized than those without HIV (10.3% vs 4.1%, P < .001). STI screening visits are opportunities to vaccinate against mpox and provide HIV prophylaxis or treatment.
Collapse
Affiliation(s)
- Emily A G Faherty
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA
- Disease Control Bureau, Chicago Department of Public Health, Illinois
| | - Taylor Holly
- Syndemic Infectious Diseases Bureau, Chicago Department of Public Health, Illinois
| | - Kara Herrera
- Syndemic Infectious Diseases Bureau, Chicago Department of Public Health, Illinois
| | - Taylor Guidry
- Syndemic Infectious Diseases Bureau, Chicago Department of Public Health, Illinois
| | - Jeffrey Lyang
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health
| | - Stephanie Black
- Disease Control Bureau, Chicago Department of Public Health, Illinois
| | - Irina Tabidze
- Syndemic Infectious Diseases Bureau, Chicago Department of Public Health, Illinois
| |
Collapse
|
3
|
Faherty EAG, Wilkins KJ, Jones S, Challa A, Qin Q, Chan LE, Olson-Chen C, Tarleton JL, Liebman MN, Mariona F, Hill EL, Patel RC. Pregnancy Outcomes among Pregnant Persons after COVID-19 Vaccination: Assessing Vaccine Safety in Retrospective Cohort Analysis of U.S. National COVID Cohort Collaborative (N3C). Vaccines (Basel) 2024; 12:289. [PMID: 38543923 PMCID: PMC10975285 DOI: 10.3390/vaccines12030289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 03/02/2024] [Accepted: 03/04/2024] [Indexed: 04/07/2024] Open
Abstract
COVID-19 vaccines have been shown to be effective in preventing severe illness, including among pregnant persons. The vaccines appear to be safe in pregnancy, supporting a continuously favorable overall risk/benefit profile, though supportive data for the U.S. over different periods of variant predominance are lacking. We sought to analyze the association of adverse pregnancy outcomes with COVID-19 vaccinations in the pre-Delta, Delta, and Omicron SARS-CoV-2 variants' dominant periods (constituting 50% or more of each pregnancy) for pregnant persons in a large, nationally sampled electronic health record repository in the U.S. Our overall analysis included 311,057 pregnant persons from December 2020 to October 2023 at a time when there were approximately 3.6 million births per year. We compared rates of preterm births and stillbirths among pregnant persons who were vaccinated before or during pregnancy to persons vaccinated after pregnancy or those who were not vaccinated. We performed a multivariable Poisson regression with generalized estimated equations to address data site heterogeneity for preterm births and unadjusted exact models for stillbirths, stratified by the dominant variant period. We found lower rates of preterm birth in the majority of modeled periods (adjusted incidence rate ratio [aIRR] range: 0.42 to 0.85; p-value range: <0.001 to 0.06) and lower rates of stillbirth (IRR range: 0.53 to 1.82; p-value range: <0.001 to 0.976) in most periods among those who were vaccinated before or during pregnancy compared to those who were vaccinated after pregnancy or not vaccinated. We largely found no adverse associations between COVID-19 vaccination and preterm birth or stillbirth; these findings reinforce the safety of COVID-19 vaccination during pregnancy and bolster confidence for pregnant persons, providers, and policymakers in the importance of COVID-19 vaccination for this group despite the end of the public health emergency.
Collapse
Affiliation(s)
- Emily A. G. Faherty
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN 55455, USA
| | - Kenneth J. Wilkins
- Biostatistics Program, Office of the Director, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892, USA;
| | - Sara Jones
- Office of Data Science and Emerging Technologies, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD 20892, USA;
| | - Anup Challa
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN 37203, USA;
| | - Qiuyuan Qin
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA; (Q.Q.); (E.L.H.)
| | - Lauren E. Chan
- Department of Pediatrics, University of Chicago, Chicago, IL 60637, USA
| | - Courtney Olson-Chen
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY 14620, USA;
| | - Jessica L. Tarleton
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC 29425, USA;
| | | | - Federico Mariona
- Beaumont Hospital, Dearborn, MI 48124, USA;
- School of Medicine, Wayne State University, Detroit, MI 48201, USA
| | - Elaine L. Hill
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA; (Q.Q.); (E.L.H.)
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY 14620, USA;
| | - Rena C. Patel
- Departments of Medicine and Global Health, University of Washington, Seattle, WA 98195, USA;
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35233, USA
| | | |
Collapse
|
4
|
Faherty EAG, Yuce D, Korban C, Bemis K, Kowalski R, Gretsch S, Ramirez E, Poretsky R, Packman A, Leisman KP, Pierce M, Kittner A, Teran R, Pacilli M. Correlation of wastewater surveillance data with traditional influenza surveillance measures in Cook County, Illinois, October 2022-April 2023. Sci Total Environ 2024; 912:169551. [PMID: 38135071 PMCID: PMC10913165 DOI: 10.1016/j.scitotenv.2023.169551] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/18/2023] [Accepted: 12/18/2023] [Indexed: 12/24/2023]
Abstract
Influenza is a respiratory illness that can result in serious outcomes, particularly among persons who are immunocompromised, aged <5 years or aged >65 years. Traditional influenza surveillance approaches rely upon syndromic surveillance of emergency departments and public health reporting from clinicians and laboratories. Wastewater surveillance infrastructure developed to monitor SARS-CoV-2 is being used for influenza surveillance in the Chicago area. The goal was to evaluate timeliness and correlations between influenza virus detected through wastewater surveillance and traditional influenza surveillance measures to assess utility of wastewater surveillance for influenza at the county level. Specifically, we measured correlations between influenza virus gene copies in wastewater samples and 1) the number of intensive care unit admissions associated with a diagnosis of influenza, 2) the percentage emergency department (ED) visits for influenza-like-illness, and 3) the percentage of ED visits with influenza diagnosis at discharge2 in Cook County. Influenza concentrations in wastewater were strongly correlated with traditional influenza surveillance measures, particularly for catchment areas serving >100,000 residents. Wastewater indicators lagged traditional influenza surveillance measures by approximately one week when analyzed in cross-correlations. Although wastewater data lagged traditional influenza surveillance measures in this analysis, it can serve as a useful surveillance tool as a complement to syndromic surveillance; it is a form of influenza surveillance that does not rely on healthcare-seeking behavior or reporting by healthcare providers.
Collapse
Affiliation(s)
- Emily A G Faherty
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, United States of America; Chicago Department of Public Health, United States of America.
| | - Deniz Yuce
- Chicago Department of Public Health, United States of America
| | - Colin Korban
- Chicago Department of Public Health, United States of America
| | - Kelley Bemis
- Cook County Department of Public Health, United States of America
| | - Rishi Kowalski
- Cook County Department of Public Health, United States of America
| | | | - Enrique Ramirez
- Chicago Department of Public Health, United States of America
| | | | | | | | - Melissa Pierce
- University of Illinois System, Discovery Partners Institute, United States of America
| | - Alyse Kittner
- Chicago Department of Public Health, United States of America
| | - Richard Teran
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, United States of America; Chicago Department of Public Health, United States of America
| | - Massimo Pacilli
- Chicago Department of Public Health, United States of America
| |
Collapse
|
5
|
Faherty EAG, Holly T, Ogale YP, Crisler G, Becht A, Kern D, Nicolae L, Spencer H, Wasz M, Kerins JL, Kittner A, Staton A, Hardnett C, Hutson C, Gigante CM, Quilter L, Kracalik I, Black S, McCollum AM, Rao AK, Tabidze I. Notes from the Field: Emergence of an Mpox Cluster Primarily Affecting Persons Previously Vaccinated Against Mpox - Chicago, Illinois, March 18-June 12, 2023. Am J Transplant 2023; 23:1268-1270. [PMID: 37573130 DOI: 10.1016/j.ajt.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/14/2023]
Affiliation(s)
- Emily A G Faherty
- Epidemic Intelligence Service, CDC; Chicago Department of Public Health, Chicago, Illinois.
| | - Taylor Holly
- Chicago Department of Public Health, Chicago, Illinois
| | - Yasmin P Ogale
- Epidemic Intelligence Service, CDC; Division of Sexually Transmitted Diseases Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, CDC
| | | | - Ashley Becht
- Chicago Department of Public Health, Chicago, Illinois
| | - David Kern
- Chicago Department of Public Health, Chicago, Illinois
| | - Lavinia Nicolae
- Division of Sexually Transmitted Diseases Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, CDC
| | - Hillary Spencer
- Epidemic Intelligence Service, CDC; Chicago Department of Public Health, Chicago, Illinois
| | - Michael Wasz
- Chicago Department of Public Health, Chicago, Illinois
| | | | - Alyse Kittner
- Chicago Department of Public Health, Chicago, Illinois
| | - Amber Staton
- Division of Sexually Transmitted Diseases Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, CDC
| | - Carla Hardnett
- Division of Sexually Transmitted Diseases Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, CDC
| | - Christina Hutson
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Crystal M Gigante
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Laura Quilter
- Division of Sexually Transmitted Diseases Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, CDC
| | - Ian Kracalik
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | | | - Andrea M McCollum
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Agam K Rao
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Irina Tabidze
- Chicago Department of Public Health, Chicago, Illinois
| |
Collapse
|
6
|
Faherty EAG, Holly T, Ogale YP, Crisler G, Becht A, Kern D, Nicolae L, Spencer H, Wasz M, Kerins JL, Kittner A, Staton A, Hardnett C, Hutson C, Gigante CM, Quilter L, Kracalik I, Black S, McCollum AM, Rao AK, Tabidze I. Notes from the Field: Emergence of an Mpox Cluster Primarily Affecting Persons Previously Vaccinated Against Mpox - Chicago, Illinois, March 18-June 12, 2023. MMWR Morb Mortal Wkly Rep 2023; 72:696-698. [PMID: 37347713 PMCID: PMC10328474 DOI: 10.15585/mmwr.mm7225a6] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
|
7
|
Faherty EAG, Teran RA, Black SR, Chundi V, Smith S, Bernhardt B, Weber E, Brassil B, Ruestow P, Kerins JL. Mpox among Public Festival Attendees, Chicago, Illinois, USA, July-August 2022. Emerg Infect Dis 2023; 29:1059-1061. [PMID: 37044128 PMCID: PMC10124669 DOI: 10.3201/eid2905.221797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
We investigated an mpox outbreak after a 2022 LGBTQ event in Chicago, Illinois, USA. Among case-patients, 38% had received 1 dose of mpox vaccine, none 2 doses; most reported sexual activity during the probable exposure period. Among other preventive measures, persons at risk should complete mpox vaccination 14 days before an event.
Collapse
|