1
|
Shi Y, Bennion E, Ward C, Nolen LD. Circumstances of unintentional fall-related adult deaths: Utah, 2010-2020. Inj Prev 2024:ip-2023-045063. [PMID: 38355294 DOI: 10.1136/ip-2023-045063] [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: 07/31/2023] [Accepted: 01/18/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVE Fall-related deaths have been on the rise nationwide. Our objective was to characterise the trend in unintentional fall-related adult deaths in Utah and evaluate the underlying and contributing causes associated with these deaths. METHODS We used 2010-2020 Utah death certificate data and included all Utah deaths aged 18 and older with a fall listed on their death records as the underlying or contributing cause of death in the analysis. RESULTS From 2010 to 2020, the overall age-adjusted unintentional fall death rate increased 70% from 15.7 to 26.8 per 100 000 person-years, while the overall age-adjusted death rate increase was 12% at the time. On average, the group with falls as one of the contributing causes had 4.9 other contributing causes, while the group with falls as an underlying cause had 3.3; the two averages were statistically different. Incidence of death increased 60% (12.1-19.4 per 100 000) for falls classified as the underlying cause of death and 103% (3.6-7.3 per 100 000) for those with fall as a contributing cause. Coding for the type of fall became more specific with a 30% decrease in unspecified fall (International Classification of Diseases, 10th revision code W19) (5.9-4.1 per 100 000). CONCLUSION There was an increasing trend of unintentional fall-related adult deaths in Utah from 2010 to 2020. This increase is consistent with national trends. Our data supports there is more specific reporting of fall deaths, but better reporting alone cannot explain the uptrend. Furthermore, the deaths with falls as contributing causes increased the most, and these individuals have more comorbidities.
Collapse
Affiliation(s)
- Yanling Shi
- Utah Department of Health and Human Services, Office of Vital Records and Statistics, State of Utah, Salt Lake City, Utah, USA
| | - Erica Bennion
- Utah Department of Health and Human Services, Division of Family Health, State of Utah, Salt Lake City, Utah, USA
| | - Chuck Ward
- Utah Department of Health and Human Services, Office of Vital Records and Statistics, State of Utah, Salt Lake City, Utah, USA
| | - Leisha D Nolen
- Utah Department of Health and Human Services, Division of Population Health, State of Utah, Salt Lake City, Utah, USA
| |
Collapse
|
2
|
Almendares OM, Ruffin JD, Collingwood AH, Nolen LD, Lanier WA, Dash SR, Ciesla AA, Wiegand R, Tate JE, Kirking HL. Previous Infection and Effectiveness of COVID-19 Vaccination in Middle- and High-School Students. Pediatrics 2023; 152:e2023062422. [PMID: 37960897 DOI: 10.1542/peds.2023-062422] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/16/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Understanding the real-world impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mitigation measures, particularly vaccination, in children and adolescents in congregate settings remains important. We evaluated protection against SARS-CoV-2 infection using school-based testing data. METHODS Using data from Utah middle- and high-school students participating in school-wide antigen testing in January 2022 during omicron (BA.1) variant predominance, log binomial models were fit to estimate the protection of previous SARS-CoV-2 infection and coronavirus disease 2019 vaccination against SARS-CoV-2 infection. RESULTS Among 17 910 students, median age was 16 years (range: 12-19), 16.7% had documented previous SARS-CoV-2 infection; 55.6% received 2 vaccine doses with 211 median days since the second dose; and 8.6% of students aged 16 to 19 years received 3 vaccine doses with 21 median days since the third dose. Protection from previous infection alone was 35.9% (95% confidence interval [CI]: 12.9%-52.8%) and 23.8% (95% CI: 2.1%-40.7%) for students aged 12 to 15 and 16 to 19 years, respectively. Protection from 2-dose hybrid immunity (previous SARS-CoV-2 infection and vaccination) with <180 days since the second dose was 58.7% (95% CI: 33.2%-74.4%) for students aged 12 to 15 and 54.7% (95% CI: 31.0%-70.3%) for students aged 16 to 19 years. Protection was highest (70.0%, 95% CI: 42.3%-84.5%) among students with 3-dose hybrid immunity, although confidence intervals overlap with 2-dose vaccination. CONCLUSIONS The estimated protection against infection was strongest for those with hybrid immunity from previous infection and recent vaccination with a third dose.
Collapse
Affiliation(s)
| | | | | | - Leisha D Nolen
- Utah Department of Health and Human Services, Salt Lake City, UT
| | - William A Lanier
- Center for Preparedness and Response, Division of State and Local Readiness, Career Epidemiology Field Officer Program, Centers for Disease Control and Prevention, Atlanta, Georgia
- Utah Department of Health and Human Services, Salt Lake City, UT
- US Public Health Service, Rockville, Maryland
| | | | | | | | | | | |
Collapse
|
3
|
Payne JR, Bose S, Kubiak RW, Nolen LD. Evaluation of mortality risk after COVID-19 vaccination, Utah 2021. Vaccine 2023; 41:2996-3002. [PMID: 37037710 PMCID: PMC10073592 DOI: 10.1016/j.vaccine.2023.03.072] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/23/2023] [Accepted: 03/29/2023] [Indexed: 04/08/2023]
Abstract
Introduction In order to evaluate trends in death after COVID-19 vaccination we analyzed the timing of death relative to vaccination date and the causes of death in vaccinated Utahns in 2021. Methods We matched people in the Utah immunization registry with documented COVID-19 vaccinations between December 18, 2020 and December 31, 2021 to Utah’s 2021 vital statistics death records. Vaccinated people were categorized as having one, two, or ≥three COVID-19 vaccine doses in a time-updated metric. We examined crude mortality rates by dosing groups in two-week intervals for all deaths, and by COVID-19 versus non-COVID-19 causes, within the 44 weeks following receipt of the most recent vaccine. Results We identified 2,072,908 individuals who received at least one dose of COVID-19 vaccine of whom 10,997 died in 2021. Only 17.5% of the total vaccinated population was age 65+, while 80.9% of those who died were over 65. In the four weeks following the first or second vaccination, all-cause mortality was low and then stabilized for the remainder of the evaluation period at a bi-weekly average of 33.0 and 39.0 deaths/100,000 people for one and two doses, respectively. Typical seasonal variation in death was observed among those with two doses. Small sample size precluded analysis of those with ≥three doses, but trends were similar. Conclusions Mortality rates in the 44 weeks following the COVID-19 vaccination did not show trends suggesting an increase in mortality related to COVID-19 vaccination, reinforcing the safety of COVID-19 vaccines. This represents an accessible approach for local evaluation.
Collapse
Affiliation(s)
- Jessica R Payne
- Utah Department of Health and Human Services, Salt Lake City, UT, USA.
| | - Srimoyee Bose
- Utah Department of Health and Human Services, Salt Lake City, UT, USA
| | - Rachel W Kubiak
- Utah Department of Health and Human Services, Salt Lake City, UT, USA; CDC Foundation, Atlanta, GA, USA
| | - Leisha D Nolen
- Utah Department of Health and Human Services, Salt Lake City, UT, USA
| |
Collapse
|
4
|
Lanier WA, Palmer DK, Willmore DK, Oakeson KF, Young EL, Nolen LD. Investigation of SARS-CoV-2 Transmission in The Tabernacle Choir at Temple Square in the Context of Prevention Protocols, Utah, September-November 2021. Public Health Rep 2023:333549231152198. [PMID: 36734220 PMCID: PMC9899664 DOI: 10.1177/00333549231152198] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Group singing and playing of wind instruments increase COVID-19 transmission risk. After a pause during the initial period of the COVID-19 pandemic, The Tabernacle Choir at Temple Square organization (hereinafter, Choir) resumed musical events in September 2021 with prevention protocols, including required vaccination and pre-event rapid antigen testing. We investigated potential SARS-CoV-2 transmission at Choir events during September 21-November 7, 2021. We interviewed COVID-19-positive members (hereinafter, case-members) and identified members exposed when a case-member attended a Choir event during his or her infectious period. We compared whole genome sequencing results to assess the genetic relatedness of available SARS-CoV-2 specimens obtained from case-members. We identified 30 case-members through pre-event testing (n = 10), self-reported positive test results (n = 18), and a review of Utah's disease surveillance system (n = 2). All 30 case-members reported symptoms; 21 (70%) were women and 23 (77%) received a positive test result by nucleic acid amplification test. No hospitalizations or deaths were reported. We identified 176 test-eligible exposed members from 14 instances of case-members attending events during their infectious periods. All were tested at least once 2 to 14 days after exposure: 74 (42%) by rapid antigen test only (all negative) and 102 (58%) by nucleic acid amplification test (4 positive, 97 negative, and 1 equivocal). Among viral sequences available from 15 case-members, the smallest single-nucleotide polymorphism distance between 2 sequences was 2, and the next-smallest distance was 10. The lack of disease detected in most exposed members suggests that minimal, if any, transmission occurred at Choir events. When community COVID-19 incidence is high, prevention protocols might help limit SARS-CoV-2 transmission during group musical activities.
Collapse
Affiliation(s)
- William A. Lanier
- Utah Department of Health and Human
Services, Salt Lake City, UT, USA,Career Epidemiology Field Officer
Program, Division of State and Local Readiness, Center for Preparedness and
Response, Centers for Disease Control and Prevention, Atlanta, GA, USA,US Public Health Service, Rockville,
MD, USA,The Tabernacle Choir at Temple Square,
Salt Lake City, UT, USA,William A. Lanier, DVM, MPH, Utah
Department of Health and Human Services, 288 N 1460 W, Salt Lake City, UT 84116,
USA.
| | - David K. Palmer
- The Tabernacle Choir at Temple Square,
Salt Lake City, UT, USA
| | - D. Keith Willmore
- The Tabernacle Choir at Temple Square,
Salt Lake City, UT, USA,Brigham Young University Health Center,
Provo, UT, USA
| | - Kelly F. Oakeson
- Utah Department of Health and Human
Services, Salt Lake City, UT, USA
| | - Erin L. Young
- Utah Department of Health and Human
Services, Salt Lake City, UT, USA
| | - Leisha D. Nolen
- Utah Department of Health and Human
Services, Salt Lake City, UT, USA
| |
Collapse
|
5
|
Sadigh KS, Kugeler KJ, Bressler S, Massay SC, Schmoll E, Milroy L, Cavanaugh AM, Sierocki A, Fischer M, Nolen LD. Evaluating risk factors associated with COVID-19 infections among vaccinated people early in the U.S. vaccination campaign: an observational study of five states, January-March 2021. BMC Infect Dis 2022; 22:718. [PMID: 36050630 PMCID: PMC9434543 DOI: 10.1186/s12879-022-07702-x] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 08/23/2022] [Indexed: 11/18/2022] Open
Abstract
Background COVID-19 vaccines are an effective tool to prevent illness due to SARS-CoV-2 infection. However, infection after vaccination still occurs. We evaluated all infections identified among recipients of either the Pfizer-BioNTech or Moderna COVID-19 vaccine in five U.S. states during January–March 2021. Methods Using observational data reported to CDC, we compared the incidence of SARS-CoV-2 infection among vaccinated and unvaccinated persons, and the sex, age, and vaccine product received for individuals with vaccine breakthrough infections to those of the vaccinated population using Poisson regression models. We also compared the proportion of vaccine breakthrough cases due to a SARS-CoV-2 variant of concern to data reported to CDC’s national genomic surveillance program. Results The age-adjusted incidence of reported SARS-CoV-2 infection was 97% lower among vaccinated as compared to unvaccinated persons aged ≥ 16 years (68 vs 2252 cases per 100,000 people). Vaccinated adults aged ≥ 85 years were 1.6 times (95% CI 1.3–1.9) as likely to become infected with SARS-CoV-2 than vaccinated adults aged < 65 years. Pfizer-BioNTech COVID-19 vaccine recipients were 1.4 times (95% CI 1.3–1.6) as likely to experience infection compared to Moderna COVID-19 recipients. The proportion of infections among vaccinated persons caused by SARS-CoV-2 variants of concern was similar to the proportion of circulating viruses identified as variants of concern in the five states during the same time. Conclusions Vaccinated persons had a substantially lower incidence of SARS-CoV-2 infection compared to unvaccinated persons. Adults aged ≥ 85 years and Pfizer-BioNTech vaccine recipients had a higher risk of infection following vaccination. We provide an analytic framework for ongoing evaluation of patterns associated with SARS-CoV-2 infection among vaccinated persons using observational surveillance and immunization data. Our findings reinforce the effectiveness of COVID-19 vaccines in preventing infection in real-world settings. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07702-x.
Collapse
Affiliation(s)
- Katrin S Sadigh
- Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, 30329, USA.,Epidemic Intelligence Service, Center for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, 30329, USA
| | - Kiersten J Kugeler
- Centers for Disease Control and Prevention, 3156 Rampart Rd, Fort Collins, CO, 80521, USA.
| | - Sara Bressler
- Centers for Disease Control and Prevention, 4055 Tudor Centre Dr, Anchorage, AK, 99508, USA
| | - Stephanie C Massay
- Alaska Department of Health and Social Services, 3601 C St, Anchorage, AK, 99503, USA
| | - Emma Schmoll
- Colorado Department of Public Health and Environment, 4300 Cherry Creek South Dr, Denver, CO, 80246, USA
| | - Lauren Milroy
- Indiana Department of Health, 2 N. Meridian St, Indianapolis, IN, 46204, USA
| | - Alyson M Cavanaugh
- Epidemic Intelligence Service, Center for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, 30329, USA.,Kentucky Department for Public Health, 275 E Main St, Frankfort, KY, 40601, USA
| | - Allison Sierocki
- Tennessee Department of Health, 710 James Robertson Parkway, Nashville, TN, 37243, USA
| | | | - Marc Fischer
- Centers for Disease Control and Prevention, 4055 Tudor Centre Dr, Anchorage, AK, 99508, USA
| | - Leisha D Nolen
- Centers for Disease Control and Prevention, 4055 Tudor Centre Dr, Anchorage, AK, 99508, USA
| |
Collapse
|
6
|
Pfeiffer JA, Collingwood A, Rider LE, Minhaj FS, Matheny AM, Kling C, McCollum AM, Nolen LD, Morgan CN. High-Contact Object and Surface Contamination in a Household of Persons with Monkeypox Virus Infection — Utah, June 2022. MMWR Morb Mortal Wkly Rep 2022; 71:1092-1094. [PMID: 36006842 PMCID: PMC9422960 DOI: 10.15585/mmwr.mm7134e1] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
7
|
Nolen LD, Topaz N, Miernyk K, Bressler S, Massay SC, Geist M, Zulz T, Singleton R. Evaluating a Cluster and the Overall Trend of Invasive Haemophilus influenzae Serotype b in Alaska 2005-2019. Pediatr Infect Dis J 2022; 41:e120-e125. [PMID: 35067639 DOI: 10.1097/inf.0000000000003470] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND In 2019, 5 cases of invasive Haemophilus influenzae serotype b (Hib) occurred in the Anchorage region of Alaska over a period of 16 days. No cases had occurred in Alaska in the preceding 26 months. METHODS Alaska Hib isolates from 2005 through 2019 were analyzed using whole-genome sequencing (WGS). Rates were compared with the CDC's Active Bacterial Core surveillance (ABCs) data. RESULTS A total of 33 cases of invasive Hib occurred in Alaska from 2005 through 2019. Of the 5 cases associated with the cluster, 2 (40%) occurred in adults and all occurred in the Anchorage region. In contrast, only 14% (4/28) of the noncluster cases occurred in this region (P < 0.01). Two cluster cases were linked epidemiologically and the bacteria were nearly identical. The other 3 cluster cases were caused by 3 genetically distinct bacteria. When the full period was evaluated, the unadjusted rate of invasive Hib disease in Alaska was 15.5 times higher in Alaska Native (AN) people than non-AN people [1.3/100,000 vs. 0.07/100,000, 95% confidence intervals (CI): 10.2-22.5). The age-adjusted rate of invasive Hib disease in Alaska was 9.4 times higher than the ABCs rate (95% CI: 6.3-14.1). CONCLUSIONS While clustered in time and space, the 5 cases in 2019 were not due to a single bacterial strain. AN people continue to have elevated rates of invasive Hib infection compared with both non-AN people in Alaska and the ABCs population.
Collapse
Affiliation(s)
- Leisha D Nolen
- From the Arctic Investigations Program, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Nadav Topaz
- Meningitis and Vaccine Preventable Disease Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Karen Miernyk
- From the Arctic Investigations Program, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Sara Bressler
- From the Arctic Investigations Program, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Stephanie C Massay
- Section of Epidemiology, Alaska Department of Health and Social Services, Anchorage, Alaska
| | - Mary Geist
- University of Washington School of Medicine, Seattle, Washington
| | - Tammy Zulz
- From the Arctic Investigations Program, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Rosalyn Singleton
- From the Arctic Investigations Program, Centers for Disease Control and Prevention, Anchorage, Alaska
| |
Collapse
|
8
|
Kugeler KJ, Williamson J, Curns AT, Healy JM, Nolen LD, Clark TA, Martin SW, Fischer M. Estimating the number of symptomatic SARS-CoV-2 infections among vaccinated individuals in the United States—January–July, 2021. PLoS One 2022; 17:e0264179. [PMID: 35263352 PMCID: PMC8906607 DOI: 10.1371/journal.pone.0264179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 05/28/2021] [Accepted: 02/04/2022] [Indexed: 11/18/2022] Open
Abstract
As of March 2021, three COVID-19 vaccines had been authorized by the U.S. Food and Drug Administration (FDA) for use in the United States. Each has substantial efficacy in preventing COVID-19. However, as efficacy from trials was <100% for all three vaccines, disease in vaccinated people is expected to occur. We created a spreadsheet-based tool to estimate the number of symptomatic COVID-19 cases among vaccinated people (vaccine breakthrough infections) based on published vaccine efficacy (VE) data, percent of the population that has been fully vaccinated, and average number of COVID-19 cases reported per day. We estimate that approximately 199,000 symptomatic vaccine breakthrough infections (95% CI: ~183,000–214,000 cases) occurred in the United States during January–July 2021 among >156 million fully vaccinated people. With high SARS-CoV-2 transmission and increasing numbers of people vaccinated in the United States, vaccine breakthrough infections will continue to accumulate. Understanding expectations regarding number of vaccine breakthrough infections enables accurate public health messaging to help ensure that the occurrence of such cases does not negatively affect vaccine perceptions, confidence, and uptake.
Collapse
Affiliation(s)
- Kiersten J. Kugeler
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Fort Collins, Colorado, United States of America
- * E-mail:
| | - John Williamson
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Fort Collins, Colorado, United States of America
| | - Aaron T. Curns
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Fort Collins, Colorado, United States of America
| | - Jessica M. Healy
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Fort Collins, Colorado, United States of America
| | - Leisha D. Nolen
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Fort Collins, Colorado, United States of America
| | - Thomas A. Clark
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Fort Collins, Colorado, United States of America
| | - Stacey W. Martin
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Fort Collins, Colorado, United States of America
| | - Marc Fischer
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Fort Collins, Colorado, United States of America
| |
Collapse
|
9
|
Bressler SS, Bruden D, Nolen LD, Bruce MG, Towshend-Bulson L, Spradling P, McMahon BJ. Mortality among Alaska Native Adults with Confirmed Hepatitis C Virus Infection Compared with the General Population in Alaska, 1995-2016. Can J Gastroenterol Hepatol 2022; 2022:2573545. [PMID: 35178364 PMCID: PMC8847038 DOI: 10.1155/2022/2573545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Received: 10/19/2021] [Revised: 01/06/2022] [Accepted: 01/07/2022] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND Hepatitis C virus (HCV) infection incidence rates in the United States have increased since 2010 as a byproduct of the opioid crisis despite the introduction of direct-acting antiviral agents in 2013. HCV infection is associated with higher rates of liver-related and nonhepatic causes of death. METHODS This study compared demographic characteristics and age-adjusted death rates from 1995 to 2016 among Alaska Native (AN) adults infected with HCV (AK-HepC) to rates among the AN and non-AN adult populations living in Alaska. Liver-related disease (LRD) and other disease-specific age-adjusted death rates were compared between the populations. RESULTS The all-cause death rate among the AK-HepC cohort was 2.2- and 3.4-fold higher than AN and non-AN adults, respectively, and remained stable over time in all populations. The LRD death rate among the AK-HepC cohort was 18- and 11-fold higher than the non-AN and AN, respectively. The liver cancer rate among the AK-HepC cohort was 26-fold higher compared to the Alaska statewide population. The AK-HepC cohort had elevated rates of death associated with nonhepatic diseases with circulatory disease having the highest rate in all populations. Among liver cancer deaths in the AK-HepC cohort, 32% had HCV listed as a contributing cause of death on the death certificate. CONCLUSIONS Death rates in the AK-HepC cohort remained stable since 1995 and higher compared to the general population. People with HCV infection had an elevated risk for all-cause, liver-related, and nonhepatic causes of death. Hepatitis C infection may be underrepresented as a cause of mortality in the United States.
Collapse
Affiliation(s)
- Sara S. Bressler
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, AK, USA
| | - Dana Bruden
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, AK, USA
| | - Leisha D. Nolen
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, AK, USA
| | - Michael G. Bruce
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, AK, USA
| | - Lisa Towshend-Bulson
- Liver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Philip Spradling
- Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control, Atlanta, GA, USA
| | - Brian J. McMahon
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, AK, USA
- Liver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| |
Collapse
|
10
|
Watkins LKF, Mitruka K, Dorough L, Bressler SS, Kugeler KJ, Sadigh KS, Birhane MG, Nolen LD, Fischer M. Characteristics of Reported Deaths Among Fully Vaccinated Persons with COVID-19 -United States, January-April 2021. Clin Infect Dis 2022; 75:e645-e652. [PMID: 35092677 PMCID: PMC8807315 DOI: 10.1093/cid/ciac066] [Citation(s) in RCA: 4] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Indexed: 12/19/2022] Open
Abstract
Background COVID-19 vaccines are highly efficacious, but SARS-CoV-2 infections post-vaccination occur. We characterized COVID-19 cases among fully vaccinated persons with an outcome of death. Methods We analyzed COVID-19 cases voluntarily reported to CDC by US health departments during January 1, 2021–April 30, 2021. We included cases among U.S. residents with a positive SARS-CoV-2 test ≥14 days after completion of an authorized primary vaccine series and who had a known outcome (alive or death) as of May 31, 2021. When available, specimens were sequenced for viral lineage and death certificates were reviewed for cause(s) of death. Results Of 8,084 reported COVID-19 cases among fully vaccinated persons during the surveillance period, 245 (3.0%) died. Compared with patients who remained alive, those who died were older (median age 82 years vs. 57 years, P <0.01), more likely to reside in a long-term care facility (51% vs. 18%, P <0.01), and more likely to have at least one underlying health condition associated with risk for severe disease (64% vs. 24%, P <0.01). Among 245 deaths, 191 (78%) were classified as COVID-19-related. Of 106 deaths with available death certificates, COVID-19 was listed on 81 (77%). There were no differences in the type of vaccine administered or the most common viral lineage (B.1.1.7). Conclusions COVID-19 deaths are rare in fully vaccinated persons, occurring most commonly in those with risk factors for severe disease, including older age and underlying health conditions. All eligible persons should be fully vaccinated against COVID-19 and follow other prevention measures to mitigate exposure risk.
Collapse
Affiliation(s)
| | - Kiren Mitruka
- COVID-19 Emergency Response, Centers for Disease Control and Prevention, Atlanta, GA
| | - Layne Dorough
- COVID-19 Emergency Response, Centers for Disease Control and Prevention, Atlanta, GA; ORISE fellow, Oak Ridge Institute for Science and Education, Oak Ridge, TN
| | - Sara S Bressler
- COVID-19 Emergency Response, Centers for Disease Control and Prevention, Atlanta, GA
| | - Kiersten J Kugeler
- COVID-19 Emergency Response, Centers for Disease Control and Prevention, Atlanta, GA
| | - Katrin S Sadigh
- COVID-19 Emergency Response, Centers for Disease Control and Prevention, Atlanta, GA; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA.,COVID-19 Emergency Response, Centers for Disease Control and Prevention, Atlanta, GA; ORISE fellow, Oak Ridge Institute for Science and Education, Oak Ridge, TN
| | - Meseret G Birhane
- COVID-19 Emergency Response, Centers for Disease Control and Prevention, Atlanta, GA
| | - Leisha D Nolen
- COVID-19 Emergency Response, Centers for Disease Control and Prevention, Atlanta, GA
| | - Marc Fischer
- COVID-19 Emergency Response, Centers for Disease Control and Prevention, Atlanta, GA
| |
Collapse
|
11
|
McMahon BJ, Nolen LD, Snowball M, Homan C, Negus S, Roik E, Spradling PR, Bruden D. HBV Genotype: A Significant Risk Factor in Determining Which Patients With Chronic HBV Infection Should Undergo Surveillance for HCC: The Hepatitis B Alaska Study. Hepatology 2021; 74:2965-2973. [PMID: 34292609 PMCID: PMC10929546 DOI: 10.1002/hep.32065] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 06/03/2021] [Accepted: 06/25/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND AIMS Information is limited regarding HBV genotype and the outcome of chronic HBV (CHB) infection. We examined the effect of HBV genotype on HCC occurrence in Alaska Native (AN) persons with CHB, where five HBV genotypes are found: A2, B6, C2, D, and F1. APPROACH AND RESULTS We calculated HCC incidence per 1,000 person-years of follow-up to determine which groups by age, sex, and genotype met current American Association for the Study of Liver Diseases (AASLD) HCC surveillance criteria. We used Poisson regression to compare HCC risk by genotype, age, sex, and Alaska region. Incidence of HCC was calculated using the sex-specific AASLD cutoff recommended for the Asian population of 50 years for women and 40 years for men. HCC screening was conducted semiannually using alpha-fetoprotein levels and abdominal ultrasound. Among 1,185 AN persons, median follow-up was 35.1 years; 667 (63%) were male. The HBV genotype distribution was 49% D, 18% F, 13% A, 6% C, 3% B, 0.1% H, and 12% undetermined. Sixty-three cases of HCC occurred. HCC incidence for genotype F was 5.73 per 1,000 person-years of follow-up, followed by 4.77 for C, 1.28 for A, 0.47 for D, and 0.00 for B. The HCC risk was higher for genotypes F (relative rate [RR], 12.7; 95% CI, 6.1-26.4), C (RR, 10.6; 95% CI, 4.3-26.0), and A (RR, 2.9; 95% CI, 1.0-8.0) compared to genotypes B and D. Among men < 40 years of age and women < 50 years of age, genotype F had the highest incidence (4.79/1,000 person-years). CONCLUSIONS HBV genotype was strongly associated with HCC. HBV genotype should be considered in risk factor stratification.
Collapse
Affiliation(s)
- Brian J. McMahon
- Liver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
- Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Arctic Investigations Program, Anchorage, AK, USA
- Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Leisha D. Nolen
- Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Arctic Investigations Program, Anchorage, AK, USA
- Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mary Snowball
- Liver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
- Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Arctic Investigations Program, Anchorage, AK, USA
- Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Chriss Homan
- Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Arctic Investigations Program, Anchorage, AK, USA
- Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Susan Negus
- Liver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
- Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Arctic Investigations Program, Anchorage, AK, USA
- Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Elena Roik
- Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Arctic Investigations Program, Anchorage, AK, USA
- Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Philip R. Spradling
- Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Arctic Investigations Program, Anchorage, AK, USA
- Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Dana Bruden
- Liver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
- Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Arctic Investigations Program, Anchorage, AK, USA
- Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| |
Collapse
|
12
|
McClure M, Miernyk K, Bruden D, Rudolph K, Hennessy TW, Bruce MG, Nolen LD. Presence of Antibodies Against Haemophilus influenzae Serotype a in Alaska Before and After the Emergence of Invasive Infections. J Infect Dis 2021; 223:326-332. [PMID: 32594132 DOI: 10.1093/infdis/jiaa369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 06/19/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Haemophilus influenzae bacteria can cause asymptomatic carriage and invasive disease. Haemophilus influenzae serotype a (Hia) is an emerging cause of invasive disease in Alaska, with greatest burden occurring among rural Alaska Native (AN) children. The first case of invasive Hia (iHia) in Alaska was reported in 2002; however, it is unclear how long the pathogen has been in Alaska. METHODS We quantified immunoglobulin G antibodies against Hia (anti-Hia) in 839 banked serum samples from Alaska residents, comparing antibody concentrations in samples drawn in the decades before (1980s and 1990s) and after (2000s) the emergence of iHia. We also assessed serum antibody concentration by age group, region of residence, and race. RESULTS The anti-Hia was >0.1 µg/mL in 88.1% (348 of 395) and 91.0% (404 of 444) of samples from the decades prior and after the emergence of Hia, respectively (P = .17). No significant differences in antibody levels were detected between people from rural and urban regions (1.55 vs 2.08 µg/mL, P = .91 for age ≥5) or between AN and non-AN people (2.50 vs 2.60 µg/mL, P = .26). CONCLUSIONS Our results are consistent with widespread Hia exposure in Alaska predating the first iHia case. No difference in Hia antibody prevalence was detected between populations with differing levels of invasive disease.
Collapse
Affiliation(s)
- Max McClure
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| | - Karen Miernyk
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Dana Bruden
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Karen Rudolph
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Thomas W Hennessy
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Michael G Bruce
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Leisha D Nolen
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
| |
Collapse
|
13
|
Nolen LD, Tiffany A, DeByle C, Bruden D, Thompson G, Reasonover A, Hurlburt D, Mosites E, Simons BC, Klejka J, Castrodale L, McLaughlin J, Bruce MG. Haemophilus influenzae Serotype a (Hia) Carriage in a Small Alaska Community After a Cluster of Invasive Hia Disease, 2018. Clin Infect Dis 2021; 73:e280-e286. [PMID: 32531017 DOI: 10.1093/cid/ciaa750] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 06/05/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Between May and July 2018, 4 Haemophilus influenzae serotype a (Hia) infections occurred in a remote Alaska community. We performed a public health response to prevent further illness and understand Hia carriage. METHODS We collected oropharyngeal samples community-wide to evaluate baseline carriage. Risk factors were evaluated by interview. We offered prophylactic rifampin to individuals in contact with invasive Hia patients (contacts) and to all children aged <10 years. Oropharyngeal samples were collected again 8 weeks after rifampin distribution. Samples were tested using real-time polymerase chain reaction and culture. RESULTS At baseline, 4 of 27 (14.8%) contacts and 7 of 364 (1.9%) noncontacts (P < .01) carried Hia. Contacts aged <10 years were more likely to carry Hia at any timepoint (11/18 [61%]) compared to contacts aged ≥10 years (3/34 [8.8%]), noncontacts aged <10 years (2/139 [1.4%]), and noncontacts ≥10 years (6/276 [2.2%]) (P < .001 for all). Hia carriers were clustered in 9 households (7% of total households). At the household level, carriage was associated with households with ≥1 contact (prevalence ratio [PR], 5.6 [95% confidence interval {CI}, 1.3-21.6]), crowding (PR, 7.7 [95% CI, 1.1-199.5]), and ≥3 tobacco users (PR, 5.0 [95% CI, 1.2-19.6]). Elevated carriage prevalence persisted in contacts compared to noncontacts 8 weeks after rifampin distribution (6/25 [24%] contacts, 2/114 [1.8%] noncontacts; P < .001). CONCLUSIONS Hia carriage prevalence was significantly higher among contacts than noncontacts. Rifampin prophylaxis did not result in a reduction of Hia carriage prevalence in this community.
Collapse
Affiliation(s)
- Leisha D Nolen
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska, USA
| | - Amanda Tiffany
- Section of Epidemiology, Department of Health and Social Services, State of Alaska, Anchorage, Alaska, USA.,Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Carolynn DeByle
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska, USA
| | - Dana Bruden
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska, USA
| | - Gail Thompson
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska, USA
| | - Alisa Reasonover
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska, USA
| | - Debby Hurlburt
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska, USA
| | - Emily Mosites
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska, USA
| | - Brenna C Simons
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska, USA
| | - Joe Klejka
- Yukon Kuskokwim Health Corporation, Bethel, Alaska, USA
| | - Louisa Castrodale
- Section of Epidemiology, Department of Health and Social Services, State of Alaska, Anchorage, Alaska, USA
| | - Joseph McLaughlin
- Section of Epidemiology, Department of Health and Social Services, State of Alaska, Anchorage, Alaska, USA
| | - Michael G Bruce
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska, USA
| |
Collapse
|
14
|
Nolen LD, DeByle C, Topaz N, Simons BC, Tiffany A, Reasonover A, Castrodale L, McLaughlin J, Klejka J, Wang X, Bruce M. Genomic Diversity of Haemophilus influenzae Serotype a in an Outbreak Community, Alaska 2018. J Infect Dis 2021; 225:520-524. [PMID: 34270748 DOI: 10.1093/infdis/jiab376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 07/15/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Haemophilus influenzae serotype a (Hia) can cause severe invasive disease, especially in young children. In 2018, four invasive Hia cases occurred in an Alaska community. We used whole-genome sequencing (WGS) to evaluate the relationship of the bacteria from this community and other Alaska patients with invasive Hia. METHODS All carriage (15) and invasive (4) Hia isolates from the outbreak community, together with 15 non-outbreak Alaska invasive Hia surveillance isolates from 2018, were tested for antimicrobial susceptibility and characterized using WGS. RESULTS Phylogenetic analysis of both invasive and carriage Hia isolates revealed two major clades that differed by an average of 300 core single nucleotide polymorphisms (SNPs). All isolates from the outbreak community were clustered in one subclade, within a larger clade containing 3 non-outbreak invasive Hia isolates. Comparative genomics did not reveal any genetic mutations that distinguished carriage from invasive isolates. Three (20%) community isolates were rifampin-resistant and had a previously unreported mutation in the rpoB gene. CONCLUSIONS In the outbreak community, Hia isolates from carriers were indistinguishable from the invasive Hia isolates. Overall, invasive Hia isolates from Alaska in 2018 were genetically similar. The rifampin resistance mutation is concerning as rifampin is the first-line medication for Hia prophylaxis.
Collapse
Affiliation(s)
- Leisha D Nolen
- Arctic Investigations Program, Centers for Disease Control and Prevention, Anchorage, Alaska, USA
| | - Carolynn DeByle
- Arctic Investigations Program, Centers for Disease Control and Prevention, Anchorage, Alaska, USA
| | - Nadav Topaz
- Meningitis and Vaccine Preventable Disease Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Brenna C Simons
- Arctic Investigations Program, Centers for Disease Control and Prevention, Anchorage, Alaska, USA
| | - Amanda Tiffany
- Section of Epidemiology, Alaska Department of Health and Social Services, Anchorage, Alaska, USA.,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Alisa Reasonover
- Arctic Investigations Program, Centers for Disease Control and Prevention, Anchorage, Alaska, USA
| | - Louisa Castrodale
- Section of Epidemiology, Alaska Department of Health and Social Services, Anchorage, Alaska, USA
| | - Joseph McLaughlin
- Section of Epidemiology, Alaska Department of Health and Social Services, Anchorage, Alaska, USA
| | - Joe Klejka
- Yukon Kuskokwim Health Corporation, Bethel, Alaska, USA
| | - Xin Wang
- Meningitis and Vaccine Preventable Disease Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Michael Bruce
- Arctic Investigations Program, Centers for Disease Control and Prevention, Anchorage, Alaska, USA
| |
Collapse
|
15
|
Nolen LD, Seeman S, Bruden D, Klejka J, Desnoyers C, Tiesinga J, Singleton R. Impact of Social Distancing and Travel Restrictions on Non-Coronavirus Disease 2019 (Non-COVID-19) Respiratory Hospital Admissions in Young Children in Rural Alaska. Clin Infect Dis 2021; 72:2196-2198. [PMID: 32888007 PMCID: PMC7499549 DOI: 10.1093/cid/ciaa1328] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [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: 08/18/2020] [Accepted: 09/01/2020] [Indexed: 11/23/2022] Open
Abstract
Hospitalizations due to non-COVID-19 respiratory illnesses decreased dramatically after social distancing was implemented in a high-risk population in rural Alaska. Our data from the past ten respiratory seasons show that this decline is unprecedented. This demonstrates the potential secondary benefits of implementing social distancing and travel restrictions on respiratory illnesses.
Collapse
Affiliation(s)
- Leisha D Nolen
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska, USA
| | - Sara Seeman
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska, USA
| | - Dana Bruden
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska, USA
| | - Joe Klejka
- Yukon Kuskokwim Health Corporation, Bethel, Alaska, USA
| | | | - James Tiesinga
- Alaska Native Tribal Health Consortium, Anchorage, Alaska, USA
| | - Rosalyn Singleton
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska, USA.,Alaska Native Tribal Health Consortium, Anchorage, Alaska, USA
| |
Collapse
|
16
|
Nolen LD, Bressler S, Vindigni SM, Miller K, Nash S. Gastric Cancer in Alaska Native and American Indian People Living in Alaska, 1990-2017. Clin Transl Gastroenterol 2021; 12:e00374. [PMID: 34158461 PMCID: PMC8221803 DOI: 10.14309/ctg.0000000000000374] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/20/2021] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Alaska Native (AN) people experience a high burden of gastric cancer compared with other US Native and non-Native populations. Previous reports have suggested that gastric cancer in AN people occurs at a younger age and is a more aggressive pathologic type. We evaluated all cases of gastric cancer in AN people from 1990 to 2017 and compared the epidemiologic and pathologic characteristics with the gastric cancers that occurred in the same time in the US white (USW) population. METHODS Cancer data were collected by the Alaska Native Tumor Registry and National Cancer Institute's Surveillance, Epidemiology, and End Results Program. Comparisons were performed looking at the age and sex distribution of the affected AN and USW people, as well as the cancer characteristics, including the location, stage, and pathology. RESULTS The age distribution was significantly different between AN and USW patients (P < 0.001), with a greater proportion of AN people diagnosed younger than 40 years (11% vs 3%, P < 0.0001) and 40-59 years (37% vs 20%, P < 0.0001). In addition, a greater proportion of AN people were diagnosed with distant stage cancer (AN: 48% and USW: 35%, P < 0.0001). The age-adjusted rate of gastric cancer in the AN population was significantly higher than the USW population (20.8 vs 6.7 per 100,000 persons, P < 0.0001). Although there has been a significant decrease in the gastric cancer incidence rate in the USW population, no significant change in incidence was seen in the AN population. DISCUSSION This study highlights the disproportionate burden of gastric cancer in the AN population. Further work is needed to address and understand this disparity.
Collapse
Affiliation(s)
- Leisha D. Nolen
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska, USA
| | - Sara Bressler
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska, USA
| | - Stephen M. Vindigni
- Department of Gastroenterology, Alaska Native Tribal Health Consortium, Anchorage, Alaska, USA
- University of Washington, Seattle, Washington, USA
| | - Keri Miller
- Department of Gastroenterology, Alaska Native Tribal Health Consortium, Anchorage, Alaska, USA
| | - Sarah Nash
- Department of Gastroenterology, Alaska Native Tribal Health Consortium, Anchorage, Alaska, USA
| |
Collapse
|
17
|
Plumb ID, Gounder PP, Nolen LD, Massay SC, Castrodale L, McLaughlin J, Snowball M, Homan C, Nelson NP, Singleton R, Bruce MG, McMahon BJ. Vaccination Status of Alaska Native Persons With Hepatitis A Virus Infection-Alaska, 1996-2018. Clin Infect Dis 2021; 72:2212-2214. [PMID: 32968772 PMCID: PMC8496132 DOI: 10.1093/cid/ciaa1102] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 07/27/2020] [Indexed: 11/14/2022] Open
Abstract
Following increases in reported cases of hepatitis A, we assessed the impact of hepatitis A vaccine in Alaska Native persons. During 1996-2018, only 6 cases of hepatitis A were identified, all in unvaccinated adults. Populations can be protected against hepatitis A by achieving sufficient vaccination coverage over time.
Collapse
Affiliation(s)
- Ian D Plumb
- Arctic Investigations Program, Centers for Disease Control and
Prevention, Anchorage, Alaska, USA
| | - Prabhu P Gounder
- Arctic Investigations Program, Centers for Disease Control and
Prevention, Anchorage, Alaska, USA
| | - Leisha D Nolen
- Arctic Investigations Program, Centers for Disease Control and
Prevention, Anchorage, Alaska, USA
| | | | | | | | - Mary Snowball
- Liver Disease and Hepatitis Program, Alaska Native Tribal Health
Consortium, Anchorage, Alaska, USA
| | - Chriss Homan
- Liver Disease and Hepatitis Program, Alaska Native Tribal Health
Consortium, Anchorage, Alaska, USA
| | - Noele P Nelson
- Division of Viral Hepatitis, Centers for Disease Control and
Prevention, Atlanta, Georgia, USA
| | - Rosalyn Singleton
- Arctic Investigations Program, Centers for Disease Control and
Prevention, Anchorage, Alaska, USA
| | - Michael G Bruce
- Arctic Investigations Program, Centers for Disease Control and
Prevention, Anchorage, Alaska, USA
| | - Brian J McMahon
- Arctic Investigations Program, Centers for Disease Control and
Prevention, Anchorage, Alaska, USA
- Liver Disease and Hepatitis Program, Alaska Native Tribal Health
Consortium, Anchorage, Alaska, USA
| |
Collapse
|
18
|
Ramaswamy M, Bruden D, Nolen LD, Mosites E, Snowball M, Nelson NP, Bruce M, McMahon BJ. Hepatitis A vaccine immunogenicity 25 years after vaccination in Alaska. J Med Virol 2021; 93:3991-3994. [PMID: 33448443 PMCID: PMC10851705 DOI: 10.1002/jmv.26327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/18/2020] [Accepted: 07/20/2020] [Indexed: 01/11/2023]
Abstract
The hepatitis A vaccine is recommended for all children greater than or equal to 1 year of age, however, the duration of vaccine protection is unknown and protection through adulthood is crucial to prevent symptomatic hepatitis later in life. We report on 25 years of follow-up of a cohort of Alaska Native individuals who were vaccinated in early childhood. We assessed the duration of vaccine protection by calculating the geometric mean concentration and proportion of participants with protective levels of IgG antibody to hepatitis A virus (anti-HAV) (≥20 mIU/mL) every 2 to 3 years. We estimated the amount of time until the anti-HAV dropped below protective levels using survival analyses. At 25 years, 43 of the original 144 participants were available, mean anti-HAV levels were 91.5 mIU/mL, and 35 (81.4%) had protective levels of anti-HAV. Using data from all persons and all time points, a survival analysis estimated 78.7% of participants had protective levels of anti-HAV at 25 years. The high level of protective antibodies in this cohort indicate that supplemental doses of hepatitis A vaccine are not needed 25 years after completion of the vaccine series.
Collapse
Affiliation(s)
- Maya Ramaswamy
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Dana Bruden
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Leisha D. Nolen
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Emily Mosites
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Mary Snowball
- Liver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, Alaska
| | - Noele P. Nelson
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Michael Bruce
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Brian J. McMahon
- Liver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, Alaska
| |
Collapse
|
19
|
Vindigni SM, Nolen LD, Bruce MG. A High-Risk Subpopulation in the United States Disproportionately Affected by High Rates of Gastric Cancer: The Alaska Native People. Clin Gastroenterol Hepatol 2021; 19:620-621. [PMID: 33248095 DOI: 10.1016/j.cgh.2020.04.087] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 04/26/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Stephen M Vindigni
- Alaska Native Tribal Health Consortium, Alaska Native Medical Center, Anchorage, Alaska
| | - Leisha D Nolen
- Arctic Investigations Program, U.S. Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Michael G Bruce
- Arctic Investigations Program, U.S. Centers for Disease Control and Prevention, Anchorage, Alaska
| |
Collapse
|
20
|
Prince-Guerra JL, Almendares O, Nolen LD, Gunn JKL, Dale AP, Buono SA, Deutsch-Feldman M, Suppiah S, Hao L, Zeng Y, Stevens VA, Knipe K, Pompey J, Atherstone C, Bui DP, Powell T, Tamin A, Harcourt JL, Shewmaker PL, Medrzycki M, Wong P, Jain S, Tejada-Strop A, Rogers S, Emery B, Wang H, Petway M, Bohannon C, Folster JM, MacNeil A, Salerno R, Kuhnert-Tallman W, Tate JE, Thornburg NJ, Kirking HL, Sheiban K, Kudrna J, Cullen T, Komatsu KK, Villanueva JM, Rose DA, Neatherlin JC, Anderson M, Rota PA, Honein MA, Bower WA. Evaluation of Abbott BinaxNOW Rapid Antigen Test for SARS-CoV-2 Infection at Two Community-Based Testing Sites - Pima County, Arizona, November 3-17, 2020. MMWR Morb Mortal Wkly Rep 2021; 70:100-105. [PMID: 33476316 PMCID: PMC7821766 DOI: 10.15585/mmwr.mm7003e3] [Citation(s) in RCA: 159] [Impact Index Per Article: 53.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
21
|
Nolen LD, Seeman S, Desnoyers C, DeByle C, Klejka J, Bruden D, Rudolph K, Gerber SI, Kim L, Langley G, Patel M, Englund J, Chu HY, Tiesinga J, Singleton R. Respiratory syncytial virus and influenza hospitalizations in Alaska native adults. J Clin Virol 2020; 127:104347. [PMID: 32334281 DOI: 10.1016/j.jcv.2020.104347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 03/24/2020] [Accepted: 03/29/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Alaska Native (AN) infants from Yukon Kuskokwim Delta (YKD) have the highest U.S. infant hospitalization rate for respiratory syncytial virus (RSV). RSV can cause significant morbidity and mortality in adult populations, although the RSV burden in AN adults is unknown. Here we investigate RSV, influenza, and human metapneumovirus (hMPV) in hospitalized rural AN adults. METHODS YKD AN adults, hospitalized with acute respiratory illness between November 2016 and October 2018 were enrolled prospectively. Nasopharyngeal (NP) swabs were tested for RSV, influenza and hMPV using polymerase chain reaction. Hospitalization rates were calculated. RESULTS Of 251 patients who had an NP swab, RSV was detected in 8 (3.2 %), influenza in 31 (12.4 %), and hMPV in no patients. Weighted annual rates of lower respiratory tract infection (LRTI), RSV and influenza hospitalization were 192.0 (95 % CI: 176.5-208.4), 9.1 (6.0-13.3), and 42.2 (35.1-50.2) per 10,000. The most common discharge diagnosis was pneumonia (57.0 %), followed by chronic obstructive pulmonary disease (51.4 %). Ninety-eight percent (246/251) had a medical co-morbidity and 49.8 % (125/251) lived in a house with a smoker. Overall, 6.4 % (16/251) required mechanical ventilation, and 3.6 % (9/251) died during hospitalization. Only 35.7 % (66/185) of patients admitted during influenza season had received the annual influenza vaccine. DISCUSSION We examined adult LRTI, influenza, and RSV hospitalization rates in an AN population with high infant RSV hospitalization rates. While we confirmed a high rate of hospitalization from LRTIs and influenza, we did not find a high rate due to RSV or hMPV. Improving influenza vaccination rates, and addressing co-morbidities could reduce respiratory hospitalizations.
Collapse
Affiliation(s)
- Leisha D Nolen
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (CDC), 4055 Tudor Center Rd, Anchorage, AK, 99508, United States.
| | - Sara Seeman
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (CDC), 4055 Tudor Center Rd, Anchorage, AK, 99508, United States
| | - Christine Desnoyers
- Yukon Kuskokwim Health Corporation, Box 528, Bethel, AK, 99559, United States
| | - Carolynn DeByle
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (CDC), 4055 Tudor Center Rd, Anchorage, AK, 99508, United States
| | - Joseph Klejka
- Yukon Kuskokwim Health Corporation, Box 528, Bethel, AK, 99559, United States
| | - Dana Bruden
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (CDC), 4055 Tudor Center Rd, Anchorage, AK, 99508, United States
| | - Karen Rudolph
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (CDC), 4055 Tudor Center Rd, Anchorage, AK, 99508, United States
| | - Susan I Gerber
- Division of Viral Diseases, National Center for Infectious and Respiratory Disease (NCIRD), CDC, 1600 Clifton Rd, Atlanta, GA, 30329, United States
| | - Lindsay Kim
- Division of Viral Diseases, National Center for Infectious and Respiratory Disease (NCIRD), CDC, 1600 Clifton Rd, Atlanta, GA, 30329, United States
| | - Gayle Langley
- Division of Viral Diseases, National Center for Infectious and Respiratory Disease (NCIRD), CDC, 1600 Clifton Rd, Atlanta, GA, 30329, United States
| | - Manish Patel
- Influenza Division, National Center for Infectious and Respiratory Disease (NCIRD), CDC, 1600 Clifton Rd, Atlanta, GA, 30329, United States
| | - Janet Englund
- University of Washington, Seattle, WA, 98195, United States
| | - Helen Y Chu
- University of Washington, Seattle, WA, 98195, United States
| | - James Tiesinga
- Alaska Native Tribal Health Consortium, 4000 Ambassador Dr, Anchorage, AK, 99508, United States
| | - Rosalyn Singleton
- Alaska Native Tribal Health Consortium, 4000 Ambassador Dr, Anchorage, AK, 99508, United States
| |
Collapse
|
22
|
Nolen LD, Vindigni SM, Parsonnet J. Combating Gastric Cancer in Alaska Native People: An Expert and Community Symposium. Gastroenterology 2020; 158:1197-1201. [PMID: 31836529 PMCID: PMC7103478 DOI: 10.1053/j.gastro.2019.11.299] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 11/18/2019] [Indexed: 12/13/2022]
Abstract
Alaska Native (AN) people experience higher incidence of, and mortality from, gastric cancer compared to other U.S. populations1 , 2 . Compared to the general U.S. population, gastric cancer in AN people occurs at a younger age, is diagnosed at later stages, is more evenly distributed between the sexes, and is more frequently signet-ring or diffuse histology3 . It is known that the prevalence of Helicobacter pylori (Hp ) infection, a risk factor for gastric cancer, is high in AN people4 ; however, high antimicrobial resistance combined with high reinfection rates in Alaska make treatment at the population level complex5 . In addition, health issues in AN people are uniquely challenging due to the extremely remote locations of many residents. A multiagency workgroup hosted a symposium in Anchorage that brought internationally-recognized experts and local leaders together to evaluate issues around gastric cancer in the AN population. The overall goal of this symposium was to identify the best strategies to combat gastric cancer in the AN population through prevention and early diagnosis.
Collapse
Affiliation(s)
- Leisha D Nolen
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska.
| | - Stephen M Vindigni
- Alaska Native Tribal Health Consortium, Anchorage, Alaska; University of Washington, Seattle, Washington
| | - Julie Parsonnet
- Departments of Medicine and of Epidemiology and Population Health, Stanford University, Stanford, California
| |
Collapse
|
23
|
Nolen LD, Lirow E, Gee JE, Elrod MG, Kolton CB, Liu L, Bower WA, Person MK, Marfel M, Blaney DD. Differentiating New from Newly Detected: Melioidosis in Yap, Federated States of Micronesia. Am J Trop Med Hyg 2020; 101:323-327. [PMID: 31264560 DOI: 10.4269/ajtmh.19-0253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Melioidosis is a bacterial infection caused by exposure to water or soil that contains Burkholderia pseudomallei (Bp). Burkholderia pseudomallei is endemic to many tropical and subtropical areas of the world. In 2013, the first case of melioidosis was recognized in Yap, the Federated States of Micronesia. Six additional cases were identified in the subsequent 3 years. An investigation was initiated to understand the epidemiology of melioidosis in Yap. Serum from family and community members of the identified cases were tested for antibodies to Bp. Archived serum from a 2007 Zika serosurvey were also tested for antibodies to Bp. Sequencing of bacterial isolates was performed to understand bacterial phylogeny. Soil and water were tested for the presence of Bp in the environment by culture and PCR. None of the affected patients had a history of travel to melioidosis-endemic countries. Two of the 34 (5.8%) samples from the field investigation and 67 (11.7%) of the historical samples demonstrated serologic evidence of prior Bp exposure. No Bp were detected from 30 soil or water samples. Genotype analysis showed highly related Bp isolates that were unique to Yap. Melioidosis is likely to be endemic to Yap; however, it has only recently been recognized by the clinical community in country. Further investigation is needed to understand the local sites that harbor Bp and represent the highest risk to the community.
Collapse
Affiliation(s)
- Leisha D Nolen
- Bacterial Special Pathogens Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.,Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Eric Lirow
- Yap Memorial Hospital, FSM Department of Health and Social Affairs, Yap, Federated States of Micronesia
| | - Jay E Gee
- Bacterial Special Pathogens Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mindy G Elrod
- Bacterial Special Pathogens Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cari B Kolton
- Bacterial Special Pathogens Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lindy Liu
- Bacterial Special Pathogens Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - William A Bower
- Bacterial Special Pathogens Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Marissa K Person
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Maria Marfel
- Yap Memorial Hospital, FSM Department of Health and Social Affairs, Yap, Federated States of Micronesia
| | - David D Blaney
- Bacterial Special Pathogens Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| |
Collapse
|
24
|
Nolen LD, O’Malley JC, Seeman SS, Bruden DJT, Apostolou A, McMahon BJ, Bruce MG. Hepatitis C in pregnant American Indian and Alaska native women; 2003-2015. Int J Circumpolar Health 2019; 78:1608139. [PMID: 31025610 PMCID: PMC6493225 DOI: 10.1080/22423982.2019.1608139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 03/06/2019] [Accepted: 04/12/2019] [Indexed: 01/04/2023] Open
Abstract
Recent reports have found a rise in Hepatitis C virus (HCV) infection in reproductive age women in the USA. Surveillance data suggests one group that is at increased risk of HCV infection is the American Indian and Alaska Native population (AI/AN). Using the National Center for Health Statistics (NCHS) birth certificate and the Indian Health Services, Tribal, and Urban Indian (IHS) databases, we evaluated reported cases of HCV infection in pregnant women between 2003 and 2015. In the NCHS database, 38 regions consistently reported HCV infection. The percentage of mothers who were known to have HCV infection increased between 2011 and 2015 in both the AI/AN population (0.57% to 1.19%, p < 0.001) and the non-AI/AN population (0.21% to 0.36%, p < 0.001). The IHS database confirmed these results. Individuals with hepatitis B infection or intravenous drug use (IDU) had significantly higher odds of HCV infection (OR 16.4 and 17.6, respectively). In total, 62% of HCV-positive women did not have IDU recorded. This study demonstrates a significant increase in the proportion of pregnant women infected with HCV between 2003 and 2015. This increase was greater in AI/AN women than non-AI/AN women. This highlights the need for HCV screening and prevention in pregnant AI/AN women.
Collapse
Affiliation(s)
- Leisha D. Nolen
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, AK, USA
| | - John C. O’Malley
- University of Washington School of Medicine, Seattle, Washington, USA
| | - Sara S. Seeman
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, AK, USA
| | - Dana J. T. Bruden
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, AK, USA
| | - Andria Apostolou
- Office of Public Health Support, Division of Epidemiology and Disease Prevention, Indian Health Service, Rockville, MD, USA
- SciMetrika, LLC, Durham, NC, USA
| | - Brian J. McMahon
- Liver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Michael G. Bruce
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, AK, USA
| |
Collapse
|
25
|
Vora NM, Grober A, Goodwin BP, Davis MS, McGee C, Luckhaupt SE, Cockrill JA, Ready S, Bluemle LN, Brewer L, Brown A, Brown C, Clement J, Downie DL, Garner MR, Lerner R, Mahool M, Mojica SA, Nolen LD, Pedersen MR, Chappell-Reed MJ, Richards E, Smith J, Weekes KC, Dickinson J, Weir C, Bowman TI, Eckes J. Challenges of service coordination for evacuees of Hurricane Maria through the National Disaster Medical System. J Emerg Manag 2018; 16:203-206. [PMID: 30044493 DOI: 10.5055/jem.2018.0369] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To describe the challenges of service coordination through the National Disaster Medical System (NDMS) for Hurricane Maria evacuees, particularly those on dialysis. DESIGN Public health report. SETTING Georgia. REPORT On November 25, 2017, there were 208 patients evacuated to Georgia in response to Hurricane Maria receiving NDMS support. Most were evacuated from the US Virgin Islands (97 percent) and the remaining from Puerto Rico (3 percent); 73 percent of these patients were on dialysis, all from the US Virgin Islands. From the beginning of the evacuation response through November 25, 2017, there were 282 patients evacuated to Georgia via NDMS, with a median length of coverage through NDMS for those on and not on dialysis of 60 and 16 days, respectively. CONCLUSION The limited capacity and capability of dialysis centers currently in the US Virgin Islands are delaying the return to home of many Hurricane Maria evacuees who are on dialysis.
Collapse
Affiliation(s)
- Neil M Vora
- Centers for Disease Control and Prevention; New York City Department of Health and Mental Hygiene
| | - Aaron Grober
- Agency for Toxic Substances and Disease Registry
| | | | | | | | | | | | | | | | | | | | | | | | | | - Michael R Garner
- Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response
| | | | | | - Shirley A Mojica
- Department of Health and Human Services, Administration for Children and Families
| | | | | | | | | | | | | | - Jeanette Dickinson
- Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response
| | - Charles Weir
- Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response
| | - Thomas I Bowman
- Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response
| | - Jeanne Eckes
- Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response
| |
Collapse
|
26
|
Hofmeister MG, McCready JA, Link-Gelles R, Cramer BG, Nolen LD, Garstang H, Foster MA. Notes from the Field: Increase in Hepatitis A Virus Infections — Marshall Islands, 2016–2017. MMWR Morb Mortal Wkly Rep 2018; 67:504-505. [PMID: 29723167 PMCID: PMC5933866 DOI: 10.15585/mmwr.mm6717a5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
|
27
|
Cui X, Nolen LD, Sun J, Booth M, Donaldson L, Quinn CP, Boyer AE, Hendricks K, Shadomy S, Bothma P, Judd O, McConnell P, Bower WA, Eichacker PQ. Analysis of Anthrax Immune Globulin Intravenous with Antimicrobial Treatment in Injection Drug Users, Scotland, 2009-2010. Emerg Infect Dis 2018; 23:56-65. [PMID: 27983504 PMCID: PMC5176236 DOI: 10.3201/eid2301.160608] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We studied anthrax immune globulin intravenous (AIG-IV) use from a 2009-2010 outbreak of Bacillus anthracis soft tissue infection in injection drug users in Scotland, UK, and we compared findings from 15 AIG-IV recipients with findings from 28 nonrecipients. Death rates did not differ significantly between recipients and nonrecipients (33% vs. 21%). However, whereas only 8 (27%) of 30 patients at low risk for death (admission sequential organ failure assessment score of 0-5) received AIG-IV, 7 (54%) of the 13 patients at high risk for death (sequential organ failure assessment score of 6-11) received treatment. AIG-IV recipients had surgery more often and, among survivors, had longer hospital stays than did nonrecipients. AIG-IV recipients were sicker than nonrecipients. This difference and the small number of higher risk patients confound assessment of AIG-IV effectiveness in this outbreak.
Collapse
|
28
|
Ha NT, Ederer D, Vo VAH, Van Pham A, Mounts A, Nolen LD, Sugerman D. Changes in motorcycle-related injuries and deaths after mandatory motorcycle helmet law in a district of Vietnam. Traffic Inj Prev 2018; 19:75-80. [PMID: 28448166 PMCID: PMC5659950 DOI: 10.1080/15389588.2017.1322203] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [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: 10/22/2016] [Accepted: 04/19/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Our study measured the change in head injuries and deaths among motorcycle users in Cu Chi district, a suburban district of Ho Chi Minh City. METHODS Hospital records for road traffic injuries (RTIs) were collected from the Cu Chi Trauma Centre and motorcycle-related death records were obtained from mortality registries in commune health offices. Head injury severity was categorized using the Abbreviated Injury Score (AIS). Rate ratios (RRs) were used to compare rates pre- and post-law (2005/2006-2009/2010). Cu Chi's population, stratified by year, age, and sex, was used as the denominator. RESULTS Of records identifying the transportation mode at the time of injury, motorcyclists accounted for most injuries (3,035, 87%) and deaths (238, 90%). Head injuries accounted for 70% of motorcycle-related hospitalizations. Helmet use was not recorded in any death records and not in 97% of medical records. Males accounted for most injuries (73%) and deaths (88%). The median age was 28 years and 32 years for injuries and deaths, respectively. Compared to the pre-law period, rates of motorcycle injuries (RR = 0.53; 95% confidence interval [CI], 0.49-0.58), head injuries (RR = 0.35; 95% CI, 0.31-0.39), severe head injuries (RR = 0.47; 95% CI, 0.34-0.63), and deaths (RR = 0.69; 95% CI, 0.53-0.89) significantly decreased in the post-law period. CONCLUSIONS Rates of head injuries and deaths among motorcycle riders decreased significantly after implementation of the mandatory helmet law in Vietnam. To further examine the impact of the motorcycle helmet law, including compliance and helmet quality, further emphasis should be placed on gathering helmet use data from injured motorcyclists.
Collapse
Affiliation(s)
- Ninh Thi Ha
- Institute of Public Health, Ho Chi Minh City, Vietnam
| | - David Ederer
- U.S. Centers of Disease Control, Atlanta, Georgia
| | - Van Anh Ha Vo
- Institute of Public Health, Ho Chi Minh City, Vietnam
| | - An Van Pham
- Cu Chi Regional General Hospital, Ho Chi Minh City, Vietnam
| | | | - Leisha D. Nolen
- Arctic Investigations Program, NCPDCID, Centers for Disease Control and Prevention, Anchorage, Alaska
| | | |
Collapse
|
29
|
Abstract
As of 13 July 2016, 13 countries have reported fetal Zika virus (ZIKV) infection. Here we report a case of fetal ZIKV infection that resulted from an infection originating in Vietnam.
Collapse
Affiliation(s)
| | - Luong Chan Quang
- Department of Prevention and Control Diseases, Pasteur Institute, Ho Chi Minh City, Vietnam
| | - Vu Thi Que Huong
- Microbiology and Immumnology, Pasteur Institute, Ho Chi Minh City, Vietnam
| | | | - Phan Cong Hung
- Department of Prevention and Control Diseases, Pasteur Institute, Ho Chi Minh City, Vietnam
| | | | | | - Nguyen Thi Thanh Thao
- Department of Prevention and Control Diseases, Pasteur Institute, Ho Chi Minh City, Vietnam
| | - Anthony W Mounts
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Leisha D Nolen
- Arctic Investigation Program, Centers for Disease Control and Prevention, Anchorage, Alaska, USA
| |
Collapse
|
30
|
Nolen LD, Traxler RM, Kharod GA, Kache PA, Katharios-Lanwermeyer S, Hendricks KA, Shadomy SV, Bower WA, Meaney-Delman D, Walke HT. Postexposure Prophylaxis After Possible Anthrax Exposure: Adherence and Adverse Events. Health Secur 2016; 14:419-423. [PMID: 27898235 DOI: 10.1089/hs.2016.0060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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] [Indexed: 11/12/2022] Open
Abstract
Anthrax postexposure prophylaxis (PEP) was recommended to 42 people after a laboratory incident that involved potential aerosolization of Bacillus anthracis spores in 2 laboratories at the Centers for Disease Control and Prevention in 2014. At least 31 (74%) individuals who initiated PEP did not complete either the recommended 60 days of antimicrobial therapy or the 3-dose vaccine regimen. Among the 29 that discontinued the antimicrobial component of PEP, most (38%) individuals discontinued PEP because of their low perceived risk of infection; 9 (31%) individuals discontinued prophylaxis due to PEP-related minor adverse events, and 10% cited both low risk and adverse events as their reason for discontinuation. Most minor adverse events reported were gastrointestinal complaints, and none required medical attention. Individuals taking ciprofloxacin were twice as likely (RR = 2.02, 95% CI = 1.1-3.6) to discontinue antimicrobial prophylaxis when compared to those taking doxycycline. In the event anthrax PEP is recommended, public health messages and patient education materials will need to address potential misconceptions regarding exposure risk and provide information about possible adverse events in order to promote PEP adherence.
Collapse
|
31
|
McNamara LA, Schafer IJ, Nolen LD, Gorina Y, Redd JT, Lo T, Ervin E, Henao O, Dahl BA, Morgan O, Hersey S, Knust B. Ebola Surveillance - Guinea, Liberia, and Sierra Leone. MMWR Suppl 2016; 65:35-43. [PMID: 27389614 DOI: 10.15585/mmwr.su6503a6] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Developing a surveillance system during a public health emergency is always challenging but is especially so in countries with limited public health infrastructure. Surveillance for Ebola virus disease (Ebola) in the West African countries heavily affected by Ebola (Guinea, Liberia, and Sierra Leone) faced numerous impediments, including insufficient numbers of trained staff, community reticence to report cases and contacts, limited information technology resources, limited telephone and Internet service, and overwhelming numbers of infected persons. Through the work of CDC and numerous partners, including the countries' ministries of health, the World Health Organization, and other government and nongovernment organizations, functional Ebola surveillance was established and maintained in these countries. CDC staff were heavily involved in implementing case-based surveillance systems, sustaining case surveillance and contact tracing, and interpreting surveillance data. In addition to helping the ministries of health and other partners understand and manage the epidemic, CDC's activities strengthened epidemiologic and data management capacity to improve routine surveillance in the countries affected, even after the Ebola epidemic ended, and enhanced local capacity to respond quickly to future public health emergencies. However, the many obstacles overcome during development of these Ebola surveillance systems highlight the need to have strong public health, surveillance, and information technology infrastructure in place before a public health emergency occurs. Intense, long-term focus on strengthening public health surveillance systems in developing countries, as described in the Global Health Security Agenda, is needed.The activities summarized in this report would not have been possible without collaboration with many U.S and international partners (http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/partners.html).
Collapse
Affiliation(s)
- Lucy A McNamara
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, CDC
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Nolen LD, Boyle S, Ansari M, Pritchard E, Bickmore WA. Regional chromatin decompaction in Cornelia de Lange syndrome associated with NIPBL disruption can be uncoupled from cohesin and CTCF. Hum Mol Genet 2013; 22:4180-93. [PMID: 23760082 PMCID: PMC3781641 DOI: 10.1093/hmg/ddt265] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [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: 04/03/2013] [Accepted: 06/03/2013] [Indexed: 01/09/2023] Open
Abstract
Cornelia de Lange syndrome (CdLS) is a developmental disorder caused by mutations in NIPBL, a protein which has functionally been associated with the cohesin complex. Mutations in core cohesin complex components have also been reported in individuals with CdLS-like phenotypes. In addition to its role in sister chromatid cohesion, cohesin is thought to play a role in regulating gene expression during development. The mechanism of this gene regulation remains unclear, but NIPBL and cohesin have been reported to affect long-range chromosomal interactions, both independently and through interactions with CTCF. We used fluorescence in situ hybridization to investigate whether the disruption of NIPBL affects chromosome architecture. We show that cells from CdLS patients exhibit visible chromatin decompaction, that is most pronounced across gene-rich regions of the genome. Cells carrying mutations predicted to have a more severe effect on NIPBL function show more extensive chromatin decompaction than those carrying milder mutations. This cellular phenotype was reproduced in normal cells depleted for NIPBL with siRNA, but was not seen following the knockdown of either the cohesin component SMC3, or CTCF. We conclude that NIPBL has a function in modulating chromatin architecture, particularly for gene-rich areas of the chromosome, that is not dependent on SMC3/cohesin or CTCF, raising the possibility that the aetiology of disorders associated with the mutation of core cohesin components is distinct from that associated with the disruption of NIPBL itself in classical CdLS.
Collapse
Affiliation(s)
| | | | | | | | - Wendy A. Bickmore
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Crewe Road, Edinburgh EH4 2XU, UK
| |
Collapse
|
33
|
Kind J, Pagie L, Ortabozkoyun H, Boyle S, de Vries SS, Janssen H, Amendola M, Nolen LD, Bickmore WA, van Steensel B. Single-cell dynamics of genome-nuclear lamina interactions. Cell 2013; 153:178-92. [PMID: 23523135 DOI: 10.1016/j.cell.2013.02.028] [Citation(s) in RCA: 473] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 12/17/2012] [Accepted: 02/05/2013] [Indexed: 12/15/2022]
Abstract
The nuclear lamina (NL) interacts with hundreds of large genomic regions termed lamina associated domains (LADs). The dynamics of these interactions and the relation to epigenetic modifications are poorly understood. We visualized the fate of LADs in single cells using a "molecular contact memory" approach. In each nucleus, only ~30% of LADs are positioned at the periphery; these LADs are in intermittent molecular contact with the NL but remain constrained to the periphery. Upon mitosis, LAD positioning is not detectably inherited but instead is stochastically reshuffled. Contact of individual LADs with the NL is linked to transcriptional repression and H3K9 dimethylation in single cells. Furthermore, we identify the H3K9 methyltransferase G9a as a regulator of NL contacts. Collectively, these results highlight principles of the dynamic spatial architecture of chromosomes in relation to gene regulation.
Collapse
Affiliation(s)
- Jop Kind
- Division of Gene Regulation, Netherlands Cancer Institute, Amsterdam, 1066 CX, The Netherlands.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Nolen LD, Amor D, Haywood A, St Heaps L, Willcock C, Mihelec M, Tam P, Billson F, Grigg J, Peters G, Jamieson RV. Deletion at 14q22-23 indicates a contiguous gene syndrome comprising anophthalmia, pituitary hypoplasia, and ear anomalies. Am J Med Genet A 2006; 140:1711-8. [PMID: 16835935 DOI: 10.1002/ajmg.a.31335] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.0] [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: 11/09/2022]
Abstract
Anophthalmia and pituitary gland hypoplasia are both debilitating conditions where the underlying genetic defect is unknown in the majority of cases. We identified a patient with bilateral anophthalmia and absence of the optic nerves, chiasm and tracts, as well as pituitary gland hypoplasia and ear anomalies with a de novo apparently balanced chromosomal translocation, 46,XY,t(3;14)(q28;q23.2). Translocation breakpoint analysis using FISH and high-resolution microarray comparative genomic hybridization (CGH) has identified a 9.66 Mb deleted region on the long arm of chromosome 14 which includes the genes BMP4, OTX2, RTN1, SIX6, SIX1, and SIX4. Three other patients with interstitial deletions involving 14q22-23 have been described, all with bilateral anophthalmia, pituitary abnormalities, ear anomalies, and a facial phenotype similar to our patient. OTX2 is involved in ocular developmental defects, and the severity of the ocular phenotype in our patient and the other 14q22-23 deletion patients, suggests this genomic region harbors other gene/s involved in ocular development. BMP4 haploinsufficiency is predicted to contribute to the ocular phenotype on the basis of its expression pattern and observed murine mutant phenotypes. In addition, deletion of BMP4 and SIX6 is likely to contribute to the abnormal pituitary development, and SIX1 deletion may contribute to the ear and other craniofacial features. This indicates that contiguous gene deletion may contribute to the phenotypic features in the 14q22-23 deletion patients.
Collapse
Affiliation(s)
- Leisha D Nolen
- Eye Genetics Research Group, Children's Medical Research Institute, The Children's Hospital at Westmead and Save Sight Institute, Sydney, New South Wales, Australia
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Loebel DAF, Lewis SL, Rao RS, Nolen LD. New developments in developmental biology. Genome Biol 2006; 6:364. [PMID: 16420677 PMCID: PMC1414102 DOI: 10.1186/gb-2005-6-13-364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
A report on the 15th International Society of Developmental Biologists Congress, Sydney, Australia, 3-7 September 2005.
Collapse
Affiliation(s)
- David A F Loebel
- Embryology Unit, Children's Medical Research Institute, Westmead NSW 2145, Australia.
| | | | | | | |
Collapse
|
36
|
Nolen LD, Gao S, Han Z, Mann MRW, Gie Chung Y, Otte AP, Bartolomei MS, Latham KE. X chromosome reactivation and regulation in cloned embryos. Dev Biol 2005; 279:525-40. [PMID: 15733677 DOI: 10.1016/j.ydbio.2005.01.016] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2004] [Revised: 01/10/2005] [Accepted: 01/11/2005] [Indexed: 10/25/2022]
Abstract
Somatic cell nuclear transfer embryos exhibit extensive epigenetic abnormalities, including aberrant methylation and abnormal imprinted gene expression. In this study, a thorough analysis of X chromosome inactivation (XCI) was performed in both preimplantation and postimplantation nuclear transfer embryos. Cloned blastocysts reactivated the inactive somatic X chromosome, possibly in a gradient fashion. Analysis of XCI by Xist RNA and Eed protein localization revealed heterogeneity within cloned embryos, with some cells successfully inactivating an X chromosome and others failing to do so. Additionally, a significant proportion of cells contained more than two X chromosomes, which correlated with an increased incidence of tetraploidy. Imprinted XCI, normally found in preimplantation embryos and extraembryonic tissues, was not observed in blastocysts or placentae from later stage clones, although fetuses recapitulated the Xce effect. We conclude that, although SCNT embryos can reactivate, count, and inactivate X chromosomes, they are not able to regulate XCI consistently. These results illustrate the heterogeneity of epigenetic changes found in cloned embryos.
Collapse
MESH Headings
- Animals
- Biomarkers
- Blastocyst/physiology
- Cell Lineage
- Chromosomal Proteins, Non-Histone/genetics
- Chromosomal Proteins, Non-Histone/metabolism
- Cloning, Organism
- Cyclin-Dependent Kinases/genetics
- Cyclin-Dependent Kinases/metabolism
- DNA Methylation
- DNA-Binding Proteins/genetics
- DNA-Binding Proteins/metabolism
- Dosage Compensation, Genetic
- Embryo Implantation
- Embryo, Mammalian/physiology
- Epigenesis, Genetic
- Female
- Gene Expression Regulation
- Gene Expression Regulation, Developmental
- Male
- Methyl-CpG-Binding Protein 2
- Mice
- Mice, Inbred C57BL
- Nuclear Transfer Techniques
- Polycomb-Group Proteins
- Promoter Regions, Genetic
- Protein Serine-Threonine Kinases/genetics
- Protein Serine-Threonine Kinases/metabolism
- RNA, Long Noncoding
- RNA, Untranslated/genetics
- RNA, Untranslated/metabolism
- Repressor Proteins/genetics
- Repressor Proteins/metabolism
- X Chromosome/genetics
- X Chromosome/metabolism
Collapse
Affiliation(s)
- Leisha D Nolen
- Department of Cell and Developmental Biology, Howard Hughes Medical Institute, University of Pennsylvania School of Medicine, 415 Curie Boulevard, Philadelphia, PA 19104-6148, USA
| | | | | | | | | | | | | | | |
Collapse
|
37
|
Mann MRW, Lee SS, Doherty AS, Verona RI, Nolen LD, Schultz RM, Bartolomei MS. Selective loss of imprinting in the placenta following preimplantation development in culture. Development 2004; 131:3727-35. [PMID: 15240554 DOI: 10.1242/dev.01241] [Citation(s) in RCA: 330] [Impact Index Per Article: 16.5] [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: 12/17/2022]
Abstract
Preimplantation development is a period of dynamic epigenetic change that begins with remodeling of egg and sperm genomes, and ends with implantation. During this time, parental-specific imprinting marks are maintained to direct appropriate imprinted gene expression. We previously demonstrated that H19 imprinting could be lost during preimplantation development under certain culture conditions. To define the lability of genomic imprints during this dynamic period and to determine whether loss of imprinting continues at later stages of development, imprinted gene expression and methylation were examined after in vitro preimplantation culture. Following culture in Whitten's medium, the normally silent paternal H19 allele was aberrantly expressed and undermethylated. However, only a subset of individual cultured blastocysts (∼65%) exhibited biallelic expression, while others maintained imprinted H19 expression. Loss of H19 imprinting persisted in mid-gestation conceptuses. Placental tissues displayed activation of the normally silent allele for H19, Ascl2, Snrpn, Peg3 and Xist while in the embryo proper imprinted expression for the most part was preserved. Loss of imprinted expression was associated with a decrease in methylation at the H19 and Snrpn imprinting control regions. These results indicate that tissues of trophectoderm origin are unable to restore genomic imprints and suggest that mechanisms that safeguard imprinting might be more robust in the embryo than in the placenta.
Collapse
Affiliation(s)
- Mellissa R W Mann
- Howard Hughes Medical Institute and Department of Cell and Developmental Biology, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
| | | | | | | | | | | | | |
Collapse
|
38
|
Mann MRW, Chung YG, Nolen LD, Verona RI, Latham KE, Bartolomei MS. Disruption of imprinted gene methylation and expression in cloned preimplantation stage mouse embryos. Biol Reprod 2003; 69:902-14. [PMID: 12748125 DOI: 10.1095/biolreprod.103.017293] [Citation(s) in RCA: 257] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Cloning by somatic cell nuclear transfer requires that epigenetic information possessed by the donor nucleus be reprogrammed to an embryonic state. Little is known, however, about this remodeling process, including when it occurs, its efficiency, and how well epigenetic markings characteristic of normal development are maintained. Examining the fate of epigenetic information associated with imprinted genes during clonal development offers one means of addressing these questions. We examined transcript abundance, allele specificity of imprinted gene expression, and parental allele-specific DNA methylation in cloned mouse blastocysts. Striking disruptions were seen in total transcript abundance and allele specificity of expression for five imprinted genes. Only 4% of clones recapitulated a blastocyst mode of expression for all five genes. Cloned embryos also exhibited extensive loss of allele-specific DNA methylation at the imprinting control regions of the H19 and Snprn genes. Thus, epigenetic errors arise very early in clonal development in the majority of embryos, indicating that reprogramming is inefficient and that some epigenetic information may be lost.
Collapse
Affiliation(s)
- Mellissa R W Mann
- Howard Hughes Medical Institute and Department of Cell and Developmental Biology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA
| | | | | | | | | | | |
Collapse
|