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Affiliation(s)
- Laura E Adams
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Steve Waterman
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Gabriela Paz-Bailey
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
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2
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Medina FA, Vila F, Premkumar L, Lorenzi O, Paz-Bailey G, Alvarado LI, Rivera-Amill V, de Silva A, Waterman S, Muñoz-Jordán J. Capacity of a Multiplex IgM Antibody Capture ELISA to Differentiate Zika and Dengue Virus Infections in Areas of Concurrent Endemic Transmission. Am J Trop Med Hyg 2022; 106:585-592. [PMID: 34929668 PMCID: PMC8832915 DOI: 10.4269/ajtmh.20-1651] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 06/28/2021] [Indexed: 11/21/2022] Open
Abstract
Serological cross-reactivity has proved to be a challenge to diagnose Zika virus (ZIKV) infections in dengue virus (DENV) endemic countries. Confirmatory testing of ZIKV IgM positive results by plaque reduction neutralization tests (PRNTs) provides clarification in only a minority of cases because most individuals infected with ZIKV were previously exposed to DENV. The goal of this study was to evaluate the performance of a ZIKV/DENV DUO IgM antibody capture ELISA (MAC-ELISA) for discriminating between DENV and ZIKV infections in endemic regions. Our performance evaluation included acute and convalescent specimens from patients with real-time reverse transcription polymerase chain reaction (RT-PCR)-confirmed DENV or ZIKV from the Sentinel Enhanced Dengue Surveillance System in Ponce, Puerto Rico. The ZIKV/DENV DUO MAC-ELISA specificity was 100% for DENV (N = 127) and 98.4% for ZIKV (N = 275) when specimens were tested during the optimal testing window (days post-onset of illness [DPO] 6-120). The ZIKV/DENV DUO MAC-ELISA sensitivity of RT-PCR confirmed specimens reached 100% for DENV by DPO 6 and for ZIKV by DPO 9. Our new ZIKV/DENV DUO MAC-ELISA was also able to distinguish ZIKV and DENV regardless of previous DENV exposure. We conclude this novel serologic diagnostic assay can accurately discriminate ZIKV and DENV infections. This can potentially be useful considering that the more labor-intensive and expensive PRNT assay may not be an option for confirmatory diagnosis in areas that lack PRNT capacity, but experience circulation of both DENV and ZIKV.
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Affiliation(s)
- Freddy A. Medina
- Surveillance and Research Laboratory, Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Frances Vila
- Surveillance and Research Laboratory, Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Lakshmanane Premkumar
- Department of Microbiology and Immunology University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Olga Lorenzi
- Surveillance and Research Laboratory, Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Gabriela Paz-Bailey
- Surveillance and Research Laboratory, Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | | | | | - Aravinda de Silva
- Department of Microbiology and Immunology University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Steve Waterman
- Surveillance and Research Laboratory, Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Jorge Muñoz-Jordán
- Surveillance and Research Laboratory, Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico;,Address correspondence to Jorge Muñoz-Jordán, Surveillance and Research Laboratory, Dengue Branch, Centers for Disease Control and Prevention, 1324 Calle Cañada, San Juan, Puerto Rico 00920. E-mail:
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Cole CL, Waterman S, Stott J, Saunders R, Buckman JEJ, Pilling S, Wheatley J. Adapting IAPT services to support frontline NHS staff during the Covid-19 pandemic: the Homerton Covid Psychological Support (HCPS) pathway. Cogn Behav Therap 2020; 13:e12. [PMID: 32454891 PMCID: PMC7235312 DOI: 10.1017/s1754470x20000148] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 11/07/2022]
Abstract
The Coronavirus (Covid-19) pandemic is exerting unprecedented pressure on NHS Health and Social Care provisions, with frontline staff, such as those of critical care units, encountering vast practical and emotional challenges on a daily basis. Although staff are being supported through organisational provisions, facilitated by those in leadership roles, the emergence of mental health difficulties or the exacerbation of existing ones amongst these members of staff is a cause for concern. Acknowledging this, academics and healthcare professionals alike are calling for psychological support for frontline staff, which not only addresses distress during the initial phases of the outbreak but also over the months, if not years, that follow. Fortunately, mental health services and psychology professional bodies across the United Kingdom have issued guidance to meet these needs. An attempt has been made to translate these sets of guidance into clinical provisions via the recently established Homerton Covid Psychological Support (HCPS) pathway delivered by Talk Changes (Hackney & City IAPT). This article describes the phased, stepped-care and evidence-based approach that has been adopted by the service to support local frontline NHS staff. We wish to share our service design and pathway of care with other Improving Access to Psychological Therapies (IAPT) services who may also seek to support hospital frontline staff within their associated NHS Trusts and in doing so, lay the foundations of a coordinated response. KEY LEARNING AIMS (1)To understand the ways staff can be psychologically and emotionally impacted by working on the frontline of disease outbreaks.(2)To understand the ways in which IAPT services have previously supported populations exposed to crises.(3)To learn ways of delivering psychological support and interventions during a pandemic context based on existing guidance and research.
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Affiliation(s)
- C L Cole
- Centre for Outcomes Research and Effectiveness (CORE), University College London - Research Department of Clinical, Educational and Health Psychology, Gower Street, London, UK
- Talk Changes (City & Hackney IAPT), Homerton University Hospital Foundation Trust, London, UK
| | - S Waterman
- Department of Psychology, Royal Holloway, University of London, Surrey, UK
| | - J Stott
- Centre for Outcomes Research and Effectiveness (CORE), University College London - Research Department of Clinical, Educational and Health Psychology, Gower Street, London, UK
| | - R Saunders
- Centre for Outcomes Research and Effectiveness (CORE), University College London - Research Department of Clinical, Educational and Health Psychology, Gower Street, London, UK
| | - J E J Buckman
- Centre for Outcomes Research and Effectiveness (CORE), University College London - Research Department of Clinical, Educational and Health Psychology, Gower Street, London, UK
- iCope - Camden and Islington Psychological Therapies Services, Camden & Islington NHS Foundation Trust, London, UK
| | - S Pilling
- Centre for Outcomes Research and Effectiveness (CORE), University College London - Research Department of Clinical, Educational and Health Psychology, Gower Street, London, UK
- iCope - Camden and Islington Psychological Therapies Services, Camden & Islington NHS Foundation Trust, London, UK
| | - J Wheatley
- Talk Changes (City & Hackney IAPT), Homerton University Hospital Foundation Trust, London, UK
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Abstract
OBJECTIVES Research registers using Consent for Contact (C4C) can facilitate recruitment into mental health research studies, allowing investigators to contact patients based on clinical records information. We investigated whether such a register was useful for mental health research, seeking the perspectives of patients and research investigators. SETTING AND DESIGN In 2012, a C4C register was developed in a large secondary mental health provider within the UK; almost 9000 patients have joined. This mixed-method study audited the effectiveness of the register. PARTICIPANTS A 'mystery shopper' exercise was conducted, and patients (n=21) were recruited to ask clinicians about the availability of research opportunities. Structured interviews were conducted with patients (n=52) about their experiences of being on the register. Similar interviews were conducted with 18 investigators from 19 studies, who had attempted to use the register to recruit participants. OUTCOME MEASURES The impact of C4C on study recruitment, and whether it helped patients learn about research. RESULTS So far, the register has provided 928 individuals with 1085 research opportunities (in 60% of cases, the individual agreed to participate in the study). Clinicians were willing to link patients to research opportunities, but often lacked information about studies. For patients, the register provided opportunities which they may not otherwise have; 27 of 52 had participated in studies since joining the register (18 participating for the first time). Most investigators used the register to supplement recruitment to their studies, but described problems in prescreening potential participants from a clinical record for complex studies. CONCLUSIONS Although the register helped investigators recruit for studies, and provided patients with research opportunities, clinicians' input is still useful for identifying suitable participants. C4C registers should be adapted to provide clinicians with automatically updated information on local studies allowing them to match patients on their caseload with active studies.
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Affiliation(s)
- D Robotham
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - S Waterman
- South London and Maudsley NHS Foundation Trust, London, UK
| | - S Oduola
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - C Papoulias
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - T Craig
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - T Wykes
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Jones JM, Lopez B, Adams L, Gálvez FJN, Núñez AS, Santillán NAH, Plante L, Hemme RR, Casal M, Hunsperger EA, Muñoz-Jordan J, Acevedo V, Ernst K, Hayden M, Waterman S, Gomez D, Sharp TM, Komatsu KK. Binational Dengue Outbreak Along the United States-Mexico Border - Yuma County, Arizona, and Sonora, Mexico, 2014. MMWR Morb Mortal Wkly Rep 2016; 65:495-9. [PMID: 27196619 DOI: 10.15585/mmwr.mm6519a3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Dengue is an acute febrile illness caused by any of four dengue virus types (DENV-1-4). DENVs are transmitted by mosquitos of the genus Aedes (1) and are endemic throughout the tropics (2). In 2010, an estimated 390 million DENV infections occurred worldwide (2). During 2007-2013, a total of three to 10 dengue cases were reported annually in Arizona and all were travel-associated. During September-December 2014, coincident with a dengue outbreak in Sonora, Mexico, 93 travel-associated dengue cases were reported in Arizona residents; 70 (75%) cases were among residents of Yuma County, which borders San Luis Río Colorado, Sonora, Mexico. San Luis Río Colorado reported its first case of locally acquired dengue in September 2014. To investigate the temporal relationship of the dengue outbreaks in Yuma County and San Luis Río Colorado and compare patient characteristics and signs and symptoms, passive surveillance data from both locations were analyzed. In addition, household-based cluster investigations were conducted near the residences of reported dengue cases in Yuma County to identify unreported cases and assess risk for local transmission. Surveillance data identified 52 locally acquired cases (21% hospitalized) in San Luis Río Colorado and 70 travel-associated cases (66% hospitalized) in Yuma County with illness onset during September-December 2014. Among 194 persons who participated in the cluster investigations in Yuma County, 152 (78%) traveled to Mexico at least monthly during the preceding 3 months. Four (2%) of 161 Yuma County residents who provided serum samples for diagnostic testing during cluster investigations had detectable DENV immunoglobulin M (IgM); one reported a recent febrile illness, and all four had traveled to Mexico during the preceding 3 months. Entomologic assessments among 105 households revealed 24 water containers per 100 houses colonized by Ae. aegypti. Frequent travel to Mexico and Ae. aegypti colonization indicate risk for local transmission of DENV in Yuma County. Public health officials in Sonora and Arizona should continue to collaborate on dengue surveillance and educate the public regarding mosquito abatement and avoidance practices. Clinicians evaluating patients from the U.S.-Mexico border region should consider dengue in patients with acute febrile illness and report suspected cases to public health authorities.
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Dirlikov E, Ryff KR, Torres-Aponte J, Thomas DL, Perez-Padilla J, Munoz-Jordan J, Caraballo EV, Garcia M, Segarra MO, Malave G, Simeone RM, Shapiro-Mendoza CK, Reyes LR, Alvarado-Ramy F, Harris AF, Rivera A, Major CG, Mayshack M, Alvarado LI, Lenhart A, Valencia-Prado M, Waterman S, Sharp TM, Rivera-Garcia B. Update: Ongoing Zika Virus Transmission - Puerto Rico, November 1, 2015-April 14, 2016. MMWR Morb Mortal Wkly Rep 2016; 65:451-5. [PMID: 27149205 DOI: 10.15585/mmwr.mm6517e2] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Zika virus is a flavivirus transmitted primarily by Aedes species mosquitoes, and symptoms of infection can include rash, fever, arthralgia, and conjunctivitis (1).* Zika virus infection during pregnancy is a cause of microcephaly and other severe brain defects (2). Infection has also been associated with Guillain-Barré syndrome (3). In December 2015, Puerto Rico became the first U.S. jurisdiction to report local transmission of Zika virus, with the index patient reporting symptom onset on November 23, 2015 (4). This report provides an update to the epidemiology of and public health response to ongoing Zika virus transmission in Puerto Rico. During November 1, 2015-April 14, 2016, a total of 6,157 specimens from suspected Zika virus-infected patients were evaluated by the Puerto Rico Department of Health (PRDH) and CDC Dengue Branch (which is located in San Juan, Puerto Rico), and 683 (11%) had laboratory evidence of current or recent Zika virus infection by one or more tests: reverse transcription-polymerase chain reaction (RT-PCR) or immunoglobulin M (IgM) enzyme-linked immunosorbent assay (ELISA). Zika virus-infected patients resided in 50 (64%) of 78 municipalities in Puerto Rico. Median age was 34 years (range = 35 days-89 years). The most frequently reported signs and symptoms were rash (74%), myalgia (68%), headache (63%), fever (63%), and arthralgia (63%). There were 65 (10%) symptomatic pregnant women who tested positive by RT-PCR or IgM ELISA. A total of 17 (2%) patients required hospitalization, including 5 (1%) patients with suspected Guillain-Barré syndrome. One (<1%) patient died after developing severe thrombocytopenia. The public health response to the outbreak has included increased laboratory capacity to test for Zika virus infection (including blood donor screening), implementation of enhanced surveillance systems, and prevention activities focused on pregnant women. Vector control activities include indoor and outdoor residual spraying and reduction of mosquito breeding environments focused around pregnant women's homes. Residents of and travelers to Puerto Rico should continue to employ mosquito bite avoidance behaviors, take precautions to reduce the risk for sexual transmission (5), and seek medical care for any acute illness with rash or fever.
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Thomas DL, Sharp TM, Torres J, Armstrong PA, Munoz-Jordan J, Ryff KR, Martinez-Quiñones A, Arias-Berríos J, Mayshack M, Garayalde GJ, Saavedra S, Luciano CA, Valencia-Prado M, Waterman S, Rivera-García B. Local Transmission of Zika Virus--Puerto Rico, November 23, 2015-January 28, 2016. MMWR Morb Mortal Wkly Rep 2016; 65:154-8. [PMID: 26890470 DOI: 10.15585/mmwr.mm6506e2] [Citation(s) in RCA: 100] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Zika virus, a mosquito-borne flavivirus, spread to the Region of the Americas (Americas) in mid-2015, and appears to be related to congenital microcephaly and Guillain-Barré syndrome (1,2). On February 1, 2016, the World Health Organization (WHO) declared the occurrence of microcephaly cases in association with Zika virus infection to be a Public Health Emergency of International Concern.* On December 31, 2015, Puerto Rico Department of Health (PRDH) reported the first locally acquired (index) case of Zika virus disease in a jurisdiction of the United States in a patient from southeastern Puerto Rico. During November 23, 2015-January 28, 2016, passive and enhanced surveillance for Zika virus disease identified 30 laboratory-confirmed cases. Most (93%) patients resided in eastern Puerto Rico or the San Juan metropolitan area. The most frequently reported signs and symptoms were rash (77%), myalgia (77%), arthralgia (73%), and fever (73%). Three (10%) patients were hospitalized. One case occurred in a patient hospitalized for Guillain-Barré syndrome, and one occurred in a pregnant woman. Because the most common mosquito vector of Zika virus, Aedes aegypti, is present throughout Puerto Rico, Zika virus is expected to continue to spread across the island. The public health response in Puerto Rico is being coordinated by PRDH with assistance from CDC. Clinicians in Puerto Rico should report all cases of microcephaly, Guillain-Barré syndrome, and suspected Zika virus disease to PRDH. Other adverse reproductive outcomes, including fetal demise associated with Zika virus infection, should be reported to PRDH. To avoid infection with Zika virus, residents of and visitors to Puerto Rico, particularly pregnant women, should strictly follow steps to avoid mosquito bites, including wearing pants and long-sleeved shirts, using permethrin-treated clothing and gear, using an Environmental Protection Agency (EPA)-registered insect repellent, and ensuring that windows and doors have intact screens.
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Thomas DL, Sharp TM, Torres J, Armstrong PA, Munoz-Jordan J, Ryff KR, Martinez-Quiñones A, Arias-Berríos J, Mayshack M, Garayalde GJ, Saavedra S, Luciano CA, Valencia-Prado M, Waterman S, Rivera-García B. Local Transmission of Zika Virus — Puerto Rico, November 23, 2015–January 28, 2016. MMWR Morb Mortal Wkly Rep 2016. [DOI: 10.15585/mmwr.mm6506e2er] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Wallace RM, Bhavnani D, Russell J, Zaki S, Muehlenbachs A, Hayden-Pinneri K, Aplícano RM, Peruski L, Vora NM, Elson D, Lederman E, Leeson B, McLaughlin T, Waterman S, Fonseca-Ford M, Blanton J, Franka R, Velasco-Villa A, Niezgoda M, Orciari L, Recuenco S, Damon I, Hanlon C, Jackson F, Dyer J, Wadhwa A, Robinson L. Rabies death attributed to exposure in Central America with symptom onset in a U.S. detention facility - Texas, 2013. MMWR Morb Mortal Wkly Rep 2014; 63:446-9. [PMID: 24848216 PMCID: PMC4584916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
On June 7, 2013, a man was diagnosed in a Texas hospital with rabies. He had been detained in a U.S. detention facility during his infectious period. To identify persons exposed to rabies who might require rabies postexposure prophylaxis (PEP), CDC and the Texas Department of State Health Services (DSHS) conducted investigations at four detention facilities, one medical clinic, and two hospitals. In all, 25 of 742 persons assessed for rabies exposure were advised to receive PEP. Early diagnosis of rabies is essential for implementation of appropriate hospital infection control measures and for rapid assessment of potential contacts for PEP recommendations.
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Affiliation(s)
- Ryan M. Wallace
- EIS officer, CDC,Corresponding author: Ryan M. Wallace, , 404-639-2018
| | - Darlene Bhavnani
- Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - John Russell
- Texas A&M Health Science Center, Christus Spohn Hospital, Corpus Christi, Texas
| | - Sherif Zaki
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Atis Muehlenbachs
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | | | | | - Leonard Peruski
- Division of Global Health Protection, Center for Global Health, CDC
| | | | - Diana Elson
- Public Health, Safety, and Preparedness Unit, Immigrations and Customs Enforcement
| | - Edith Lederman
- Public Health, Safety, and Preparedness Unit, Immigrations and Customs Enforcement
| | - Ben Leeson
- Texas A&M Health Science Center, Christus Spohn Hospital, Corpus Christi, Texas
| | - Thomas McLaughlin
- Texas A&M Health Science Center, Christus Spohn Hospital, Corpus Christi, Texas
| | - Steve Waterman
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Maureen Fonseca-Ford
- Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Jesse Blanton
- Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Richard Franka
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Andres Velasco-Villa
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Michael Niezgoda
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Lillian Orciari
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Sergio Recuenco
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Inger Damon
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Cathleen Hanlon
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Felix Jackson
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Jessie Dyer
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Ashutosh Wadhwa
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC
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Vaughan G, Forbi JC, Xia GL, Fonseca-Ford M, Vazquez R, Khudyakov YE, Montiel S, Waterman S, Alpuche C, Gonçalves Rossi LM, Luna N. Full-length genome characterization and genetic relatedness analysis of hepatitis A virus outbreak strains associated with acute liver failure among children. J Med Virol 2013; 86:202-8. [DOI: 10.1002/jmv.23843] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2013] [Indexed: 11/08/2022]
Affiliation(s)
- Gilberto Vaughan
- Division of Viral Hepatitis; Centers for Diseases Control and Prevention; Atlanta Georgia
| | - Joseph C. Forbi
- Division of Viral Hepatitis; Centers for Diseases Control and Prevention; Atlanta Georgia
| | - Guo-Liang Xia
- Division of Viral Hepatitis; Centers for Diseases Control and Prevention; Atlanta Georgia
| | - Maureen Fonseca-Ford
- Division of Global Migration and Quarantine; Centers for Disease Control and Prevention; Atlanta Georgia
| | - Roberto Vazquez
- National Institute for Epidemiologic Diagnosis and Reference; Mexico City Mexico
| | - Yury E. Khudyakov
- Division of Viral Hepatitis; Centers for Diseases Control and Prevention; Atlanta Georgia
| | - Sonia Montiel
- Division of Global Migration and Quarantine; Centers for Disease Control and Prevention; Atlanta Georgia
| | - Steve Waterman
- Division of Global Migration and Quarantine; Centers for Disease Control and Prevention; Atlanta Georgia
| | - Celia Alpuche
- National Institute for Epidemiologic Diagnosis and Reference; Mexico City Mexico
| | | | - Norma Luna
- General Directorate of Epidemiology; Mexico City Mexico
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Rodriguez-Noriega E, Gonzalez-Diaz E, Morfin-Otero R, Gomez-Abundis GF, Briseño-Ramirez J, Perez-Gomez HR, Lopez-Gatell H, Alpuche-Aranda CM, Ramírez E, López I, Iguala M, Chapela IB, Zavala EP, Hernández M, Stuart TL, Villarino ME, Widdowson MA, Waterman S, Uyeki T, Azziz-Baumgartner E. Hospital triage system for adult patients using an influenza-like illness scoring system during the 2009 pandemic--Mexico. PLoS One 2010; 5:e10658. [PMID: 20498718 PMCID: PMC2871038 DOI: 10.1371/journal.pone.0010658] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [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: 12/14/2009] [Accepted: 04/12/2010] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Pandemic influenza A (H1N1) virus emerged during 2009. To help clinicians triage adults with acute respiratory illness, a scoring system for influenza-like illness (ILI) was implemented at Hospital Civil de Guadalajara, Mexico. METHODS A medical history, laboratory and radiology results were collected on emergency room (ER) patients with acute respiratory illness to calculate an ILI-score. Patients were evaluated for admission by their ILI-score and clinicians' assessment of risk for developing complications. Nasal and throat swabs were collected from intermediate and high-risk patients for influenza testing by RT-PCR. The disposition and ILI-score of those oseltamivir-treated versus untreated, clinical characteristics of 2009 pandemic influenza A (H1N1) patients versus test-negative patients were compared by Pearson's Chi(2), Fisher's Exact, and Wilcoxon rank-sum tests. RESULTS Of 1840 ER patients, 230 were initially hospitalized (mean ILI-score = 15), and the rest were discharged, including 286 ambulatory patients given oseltamivir (median ILI-score = 11), and 1324 untreated (median ILI-score = 5). Fourteen (1%) untreated patients returned, and 3 were hospitalized on oseltamivir (median ILI-score = 19). Of 371 patients tested by RT-PCR, 104 (28%) had pandemic influenza and 42 (11%) had seasonal influenza A detected. Twenty (91%) of 22 imaged hospitalized pandemic influenza patients had bilateral infiltrates compared to 23 (38%) of 61 imaged hospital test-negative patients (p<0.001). One patient with confirmed pandemic influenza presented 6 days after symptom onset, required mechanical ventilation, and died. CONCLUSIONS The triaging system that used an ILI-score complimented clinicians' judgment of who needed oseltamivir and inpatient care and helped hospital staff manage a surge in demand for services.
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Affiliation(s)
- Eduardo Rodriguez-Noriega
- Hospital Civil de Guadalajara, Fray Antonio Alcalde, Guadalajara, Jalisco, México
- Instituto de Patología Infecciosa y Experimental, Centro Universitario Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México
| | | | - Rayo Morfin-Otero
- Hospital Civil de Guadalajara, Fray Antonio Alcalde, Guadalajara, Jalisco, México
- Instituto de Patología Infecciosa y Experimental, Centro Universitario Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México
| | - Gerardo F. Gomez-Abundis
- Instituto de Patología Infecciosa y Experimental, Centro Universitario Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México
| | - Jaime Briseño-Ramirez
- Hospital Civil de Guadalajara, Fray Antonio Alcalde, Guadalajara, Jalisco, México
- Instituto de Patología Infecciosa y Experimental, Centro Universitario Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México
| | - Hector Raul Perez-Gomez
- Hospital Civil de Guadalajara, Fray Antonio Alcalde, Guadalajara, Jalisco, México
- Instituto de Patología Infecciosa y Experimental, Centro Universitario Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México
| | - Hugo Lopez-Gatell
- Dirección General de Epidemiología, México Ministry of Health, México City, Distrito Federal, México
| | | | - Ernesto Ramírez
- National Public Health Laboratory, México City, Distrito Federal, México
| | - Irma López
- National Public Health Laboratory, México City, Distrito Federal, México
| | - Miguel Iguala
- National Public Health Laboratory, México City, Distrito Federal, México
| | - Ietza Bojórquez Chapela
- Dirección General de Epidemiología, México Ministry of Health, México City, Distrito Federal, México
| | - Ethel Palacios Zavala
- Dirección General de Epidemiología, México Ministry of Health, México City, Distrito Federal, México
| | - Mauricio Hernández
- Dirección General de Epidemiología, México Ministry of Health, México City, Distrito Federal, México
| | | | - Margarita Elsa Villarino
- United States Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Marc-Alain Widdowson
- United States Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Steve Waterman
- United States Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Timothy Uyeki
- United States Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Eduardo Azziz-Baumgartner
- United States Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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12
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Whittembury A, Ramirez G, Hernández H, Ropero AM, Waterman S, Ticona M, Brinton M, Uchuya J, Gershman M, Toledo W, Staples E, Campos C, Martínez M, Chang GJJ, Cabezas C, Lanciotti R, Zaki S, Montgomery JM, Monath T, Hayes E. Viscerotropic disease following yellow fever vaccination in Peru. Vaccine 2009; 27:5974-81. [PMID: 19679215 DOI: 10.1016/j.vaccine.2009.07.082] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2009] [Revised: 07/16/2009] [Accepted: 07/22/2009] [Indexed: 11/29/2022]
Abstract
Five suspected cases of yellow fever vaccine-associated viscerotropic disease (YEL-AVD) clustered in space and time following a vaccination campaign in Ica, Peru in 2007. All five people received the same lot of 17DD live attenuated yellow fever vaccine before their illness; four of the five died of confirmed YEL-AVD. The surviving case was classified as probable YEL-AVD. Intensive investigation yielded no abnormalities of the implicated vaccine lot and no common risk factors. This is the first described space-time cluster of yellow fever viscerotropic disease involving more than two cases. Mass yellow fever vaccination should be avoided in areas that present extremely low risk of yellow fever.
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13
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Garten RJ, Davis CT, Russell CA, Shu B, Lindstrom S, Balish A, Sessions WM, Xu X, Skepner E, Deyde V, Okomo-Adhiambo M, Gubareva L, Barnes J, Smith CB, Emery SL, Hillman MJ, Rivailler P, Smagala J, de Graaf M, Burke DF, Fouchier RAM, Pappas C, Alpuche-Aranda CM, López-Gatell H, Olivera H, López I, Myers CA, Faix D, Blair PJ, Yu C, Keene KM, Dotson PD, Boxrud D, Sambol AR, Abid SH, St George K, Bannerman T, Moore AL, Stringer DJ, Blevins P, Demmler-Harrison GJ, Ginsberg M, Kriner P, Waterman S, Smole S, Guevara HF, Belongia EA, Clark PA, Beatrice ST, Donis R, Katz J, Finelli L, Bridges CB, Shaw M, Jernigan DB, Uyeki TM, Smith DJ, Klimov AI, Cox NJ. Antigenic and genetic characteristics of swine-origin 2009 A(H1N1) influenza viruses circulating in humans. Science 2009; 325:197-201. [PMID: 19465683 PMCID: PMC3250984 DOI: 10.1126/science.1176225] [Citation(s) in RCA: 1771] [Impact Index Per Article: 118.1] [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: 12/16/2022]
Abstract
Since its identification in April 2009, an A(H1N1) virus containing a unique combination of gene segments from both North American and Eurasian swine lineages has continued to circulate in humans. The lack of similarity between the 2009 A(H1N1) virus and its nearest relatives indicates that its gene segments have been circulating undetected for an extended period. Its low genetic diversity suggests that the introduction into humans was a single event or multiple events of similar viruses. Molecular markers predictive of adaptation to humans are not currently present in 2009 A(H1N1) viruses, suggesting that previously unrecognized molecular determinants could be responsible for the transmission among humans. Antigenically the viruses are homogeneous and similar to North American swine A(H1N1) viruses but distinct from seasonal human A(H1N1).
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MESH Headings
- Animals
- Antibodies, Viral/immunology
- Antigens, Viral/genetics
- Antigens, Viral/immunology
- Disease Outbreaks
- Evolution, Molecular
- Genes, Viral
- Genetic Variation
- Genome, Viral
- Hemagglutination Inhibition Tests
- Hemagglutinin Glycoproteins, Influenza Virus/chemistry
- Hemagglutinin Glycoproteins, Influenza Virus/genetics
- Hemagglutinin Glycoproteins, Influenza Virus/immunology
- Humans
- Influenza A Virus, H1N1 Subtype/classification
- Influenza A Virus, H1N1 Subtype/genetics
- Influenza A Virus, H1N1 Subtype/immunology
- Influenza A Virus, H1N1 Subtype/isolation & purification
- Influenza A Virus, H3N2 Subtype/genetics
- Influenza A virus/genetics
- Influenza, Human/epidemiology
- Influenza, Human/immunology
- Influenza, Human/virology
- Mutation
- Neuraminidase/genetics
- Orthomyxoviridae Infections/veterinary
- Orthomyxoviridae Infections/virology
- Phylogeny
- Reassortant Viruses/genetics
- Swine
- Swine Diseases/virology
- Viral Matrix Proteins/genetics
- Viral Nonstructural Proteins/genetics
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Affiliation(s)
- Rebecca J Garten
- WHO Collaborating Center for Influenza, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30333, USA
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14
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Kinde H, Mikolon A, Rodriguez-Lainz A, Adams C, Walker RL, Cernek-Hoskins S, Treviso S, Ginsberg M, Rast R, Harris B, Payeur JB, Waterman S, Ardans A. Recovery of Salmonella, Listeria monocytogenes, and Mycobacterium bovis from cheese entering the United States through a noncommercial land port of entry. J Food Prot 2007; 70:47-52. [PMID: 17265859 DOI: 10.4315/0362-028x-70.1.47] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [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: 11/11/2022]
Abstract
A joint multiagency project was initiated in response to a Salmonella outbreak in San Diego County, California, in 2004. Samples of cheese were collected during four 1-day operations at the San Ysidro port of entry, along the United States-Mexico border. Surveyed participants were persons crossing the border as pedestrians or in vehicles who had a minimum of 2.27 kg of cheese, which may suggest a potential diversion to illegal marketing. In addition, data were collected about the cheese to identify risk factors for cheese contamination. Two hundred four cheese samples were submitted to the California Animal Health and Food Safety Laboratory System-San Bernardino Branch and analyzed for potential food pathogens. Ninety-four percent (190 of 203) of the samples tested positive for alkaline phosphatase. Salmonella was detected from 13% (27 of 204) of the samples comprising 11 serogroups and 28 serotypes. Pulsed-field gel electrophoresis DNA fingerprinting analysis, performed following standardized methods, determined that an isolate obtained from this study had an indistinguishable pattern from a recent Salmonella enterica serovar Typhimurium var. Copenhagen epidemic in the San Diego County that was linked to 14 illnesses. Listeria spp. were detected from 4% (8 of 204) of the samples, and of these, half were identified as L. monocytogenes. Escherichia coli O157:H7 was not detected from any of the samples. Mycobacterium bovis was detected from one panela-style cheese sample. Nine additional samples yielded Mycobacterium spp.
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Affiliation(s)
- Hailu Kinde
- California Animal Health and Food Safety Laboratory System, San Bernardino Branch, 105 West Central Avenue, San Bernardino, California 92408, USA.
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15
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Averhoff F, Zucker J, Vellozzi C, Redd S, Woodfill C, Waterman S, Baggs J, Weinberg M, Rodriquez-Lainz A, Carrion V, Goto C, Reef SE. Adequacy of surveillance to detect endemic rubella transmission in the United States. Clin Infect Dis 2006; 43 Suppl 3:S151-7. [PMID: 16998775 DOI: 10.1086/505948] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [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: 11/04/2022] Open
Abstract
BACKGROUND Reported rubella cases in the United States are at the lowest numbers since the introduction of vaccine, suggesting that endemic transmission may have been interrupted. It is necessary to validate that the observed absence of rubella is due to the disappearance of disease rather than a failure of rubella surveillance. METHODS Adequate rubella surveillance to detect ongoing transmission is characterized by evidence that rubella investigations are being conducted, detection of importations, and lack of spread from confirmed cases. We reviewed rubella surveillance data and activities from 5 sources: (1) data reported to the national surveillance system; (2) a survey of health departments and public health laboratories, including questions regarding any links between measles and rubella surveillance; (3) enhanced rubella surveillance activities in California and in New York City; (4) sentinel surveillance along the US-Mexico border; and (5) case detection in 8 large health maintenance organizations (HMOs). RESULTS During 2002-2004, 35 cases of rubella were reported to the national system, including 12 (34%) imported cases. The 39 programs that responded to our survey reported conducting 1482 investigations for rubella; according to another national survey, 1921 investigations were conducted for measles. Forty-one laboratories responded to our survey and reported conducting 6428 tests for acute rubella. No previously undetected (or unreported) cases of rubella or congenital rubella syndrome were identified by our survey or reviews of surveillance in California, New York, and along the US-Mexico border, and no additional cases were detected in the HMO database. CONCLUSIONS No previously unrecognized spread cases or outbreaks of rubella were detected. Surveillance in the United States is sufficiently sensitive to identify indigenous cases of rubella, if they were occurring, supporting the contention that rubella has been eliminated from the United States.
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Affiliation(s)
- Francisco Averhoff
- National Center for Preparedness, Detection, and Control of Infectious Diseases (proposed), Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
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16
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Cavill D, Waterman S, Gordon TP. Failure to detect antibodies to the second extracellular loop of the serotonin 5-HT4 receptor in systemic lupus erythematosus and primary Sjögren's syndrome. Lupus 2002; 11:197-8. [PMID: 11999887 DOI: 10.1191/0961203302lu169xx] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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17
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Waterman S. British Pharmaceutical Society--138th annual conference. Novel leads to the treatment of cancer. IDrugs 2001; 4:1232-4. [PMID: 15942821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Affiliation(s)
- S Waterman
- KS Biomedix Ltd, 20 Bedford Road, Guildford, Surrey, GU1 4SJ, UK.
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18
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Steiling W, Basketter D, Berthold K, Butler M, Garrigue JL, Kimber I, Lea L, Newsome C, Roggeband R, Stropp G, Waterman S, Wiemann C. Skin sensitisation testing--new perspectives and recommendations. Food Chem Toxicol 2001; 39:293-301. [PMID: 11295477 DOI: 10.1016/s0278-6915(00)00147-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [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: 11/15/2022]
Abstract
Various methodological aspects of skin sensitisation testing have been explored, particularly in the context of animal welfare considerations and reliability and sensitivity of test methods. Recommendations are made for the conduct of current and proposed OECD skin sensitisation tests with respect to appropriate test configurations for the purposes of hazard identification and labelling, and the requirement for positive controls. Specifically, the following aspects of guinea pig sensitisation test methods have been addressed: (1) the number of test and control animals required; (2) the option of using joint positive controls between independent laboratories; (3) the choice of positive control chemicals; (4) the optimal conduct and interpretation of rechallenge; and (5) the requirement for pretreatment with sodium lauryl sulfate. In addition, the use of the murine local lymph node assay (LLNA) has been considered. A number of conclusions have been drawn and recommendations made as follows: In many instances, particularly with the conduct of the guinea pig maximisation test, it is acceptable to halve the number of test and control animals used. An optional scheme for the conduct of joint positive control studies within a co-ordinated group of laboratories is appropriate. Only one positive control chemical (alpha-hexyl cinnamic aldehyde) is necessary for the routine assessment of assay sensitivity. The proper conduct and interpretation of rechallenge can provide valuable information and confirmation of results in guinea pig sensitisation tests. Sodium lauryl sulfate should no longer be used as a pretreatment in the guinea pig maximisation test. The LLNA is a viable and complete alternative to traditional guinea pig test methods for the purposes of skin sensitisation hazard identification. These recommendations provide the opportunity for both animal welfare benefits and improved hazard identification.
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Affiliation(s)
- W Steiling
- Henkel KGaA, Henkelstrasse 67, D-40191, Düsseldorf, Germany
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19
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Kimber I, Basketter DA, Berthold K, Butler M, Garrigue JL, Lea L, Newsome C, Roggeband R, Steiling W, Stropp G, Waterman S, Wiemann C. Skin sensitization testing in potency and risk assessment. Toxicol Sci 2001; 59:198-208. [PMID: 11158712 DOI: 10.1093/toxsci/59.2.198] [Citation(s) in RCA: 133] [Impact Index Per Article: 5.8] [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: 11/14/2022] Open
Abstract
The purpose of this article is to review, and make recommendations for, the use of relevant skin sensitization test methods, for the purposes of determination of relative potency and the threshold dose necessary for the induction of skin sensitization, and for risk assessment. In addressing the first area, the utility of three guinea pig tests (the guinea pig maximization test, the occluded patch test, and the open epicutaneous test) of the local lymph node assay (LLNA) and of human volunteer testing for the assessment of relative potency and identification of thresholds for sensitization were considered. The following conclusions were drawn. (1) Although attempts have been made to modify the guinea pig maximization test for the purposes of deriving dose-response relationships, this method is usually unsuitable for determination of relative sensitizing potency. (2) Guinea pig methods that do not require the use of adjuvant and which employ a relevant route of exposure (the occluded patch test and the open epicutaneous test) are more appropriate for the assessment of relative skin-sensitizing potency. (3) The LLNA is suitable for the determination of relative skin sensitizing potency, and the adaptation of this method for derivation of comparative criteria such as EC3 values (the estimated concentration of test chemical required to induce a stimulation index of 3 in the LLNA) provides an effective and quantitative basis for such measurements. (4) For all the methods identified above, potency is assessed relative to other chemical allergens of known skin sensitizing potential. The estimation of likely threshold concentrations is dependent upon the availability of suitable benchmark chemicals of known potency for human sensitization. (5) Human testing (and specifically, the Human Repeat Insult Patch Test) can provide information of value in confirming the absence of skin sensitizing activity of formulations and products under specific conditions of use and exposure. Based on the above, the following recommendations are made. (1) If results are already available from suitable guinea pig tests, then judicious interpretation of the data may provide information of value in assessing relative skin sensitizing potency. This option should be explored before other analyses are conducted. (2) The LLNA is the recommended method for new assessments of relative potency, and/or for the investigation of the influence of vehicle or formulation on skin sensitizing potency. (3) Whenever available, human skin sensitization data should be incorporated into an assessment of relative potency. With respect to risk assessment, the conclusion drawn is that all the available data on skin-sensitizing activity in animals and man should be integrated into the risk-assessment process. Appropriate interpretation of existing data from suitable guinea pig studies can provide valuable information with respect to potency, as the first step in the development of a risk assessment. However, for de novo investigations, the LLNA is the method favored for providing quantitative estimations of skin-sensitizing potency that are best suited to the risk assessment process. Finally, human testing is of value in the risk assessment process, but is performed only for the purposes of confirming product safety.
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Affiliation(s)
- I Kimber
- Zeneca Central Toxicology Laboratory, Alderley Park, Macclesfield, Cheshire SK10 4TJ, United Kingdom.
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20
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Waterman S. Growth and development. Web alert. Curr Opin Microbiol 1999; 2:577-8. [PMID: 10644170 DOI: 10.1016/s1369-5274(99)00023-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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21
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Waterman S, Fritz C. New vaccines for infectious diseases. West J Med 1998; 169:370-1. [PMID: 9866435 PMCID: PMC1305406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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22
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Lang B, Waterman S, Pinto A, Jones D, Moss F, Boot J, Brust P, Williams M, Stauderman K, Harpold M, Motomura M, Moll JW, Vincent A, Newsom-Davis J. The role of autoantibodies in Lambert-Eaton myasthenic syndrome. Ann N Y Acad Sci 1998; 841:596-605. [PMID: 9668304 DOI: 10.1111/j.1749-6632.1998.tb10992.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- B Lang
- Institute of Molecular Medicine, University of Oxford, United Kingdom
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23
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Snyder CA, Sellakumar A, Waterman S. An assessment of the tumorigenic properties of a Hudson County soil sample heavily contaminated with hexavalent chromium. Arch Environ Health 1997; 52:220-6. [PMID: 9169633 DOI: 10.1080/00039899709602890] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
During much of this century, Hudson County, New Jersey, was a major center for the processing of chromium ore. Some of the residue from this processing was used in landfills and in construction materials throughout the county and, in some cases, in highly populated areas. Given that it is widely accepted that exposure to hexavalent chromium compounds poses a risk for the development of respiratory-tract cancer, concerns were raised that individuals who worked or resided in chromium-contaminated areas might be at increased risk for the development of respiratory cancer. To address these concerns, we evaluated a Hudson County soil sample-heavily contaminated with chromium ore residue (Cr(+6) concentration at 5 895 mg/kg)-with respect to its carcinogenic potential to the respiratory tract of Sprague-Dawley rats. Groups of animals were given repeated intratracheal exposures to one of four materials: (1) Hudson County chromium-contaminated soil (CCS), (2) CCS augmented with calcium chromate (CaCrO4), (3) CaCrO4 alone, or (4) control soil. Nominal total doses of Cr(+6) for each respective group were 324 microg/kg, 7,975 microg/kg, 8,700 microg/kg, and 0.02 microg/kg. Incidences of malignant tumors and nephritis were not elevated in any group. Four primary lung tumors appeared in animals that received CCS + CaCrO4, and one primary lung tumor appeared in the group treated with CaCrO4 alone. These incidences were not significant statistically, but the rare spontaneous occurrence of these tumors in Sprague-Dawley rats suggested that they were treatment related. No primary lung tumors appeared in the control or CCS-treated groups.
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Affiliation(s)
- C A Snyder
- New York University Institute of Environmental Medicine, Tuxedo, New York 10987, USA
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24
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Kramer T, Iliffe S, Murray E, Waterman S. Which adolescents attend the GP? Br J Gen Pract 1997; 47:327. [PMID: 9219415 PMCID: PMC1313013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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25
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Banerji S, Bellomy AL, Yu ES, Waterman S, Haas EA, Moser KE. Tuberculosis in San Diego county: a border community perspective. Public Health Rep 1996; 111:431-6. [PMID: 8837632 PMCID: PMC1381788] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES To describe the epidemiology of active disease caused by Mycobacterium tuberculosis in San Diego County from 1989 to 1993 and to identify the specific subgroups for whom the impact of the disease was most pronounced. METHOD The authors reviewed all 1860 reports of verified tuberculosis (TB) cases included in the surveillance database maintained by the San Diego County Health Department's TB Control Program. Data were analyzed by age, gender, ethnicity, nativity, HIV co-infection, major site of infection, and drug resistance. RESULTS Between 1989 and 1993. San Diego County witnessed a greater increase (77.7%) in the number of incident TB cases than the state of California as a whole (22.8%) or the United States (9.9%). The local resurgence of TB was reflected in increasing case counts among specific subpopulations--immigrants from countries with high endemic rates of TB (62.5% of the new cases), U.S.-born members of minority groups, the elderly, and young adult males. CONCLUSIONS Tuberculosis cases in San Diego County have increased each year since 1989, with certain population subgroups exhibiting more dramatic increases in case rates than those reported nationally. San Diego County is one of the principal entry points for the western United States and a popular travel destination. These factors have led to a dramatic increase in the incidence of TB in the county. A range of tailored surveillance, treatment, and control strategies--some of which have already been implemented--will be needed to control the spread of the disease.
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Affiliation(s)
- S Banerji
- Department of Public Health, San Bernardino County, CA, USA
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26
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Randhawa S, Nazeran H, Byrnes D, Waterman S, Brookes S, Costa M. Computer modelling of intestinal peristalsis. Australas Phys Eng Sci Med 1995; 18:45-6. [PMID: 7755494] [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] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- S Randhawa
- School of Engineering, Flinders University, Adelaide SA
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27
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González-Block MA, Wishik S, Escalante R, Waterman S, Wheeler I, Simon HJ. [A community referral system for the permanent program of universal vaccination]. Salud Publica Mex 1994; 36:503-12. [PMID: 7892625] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
This article describes a community referral system for the permanent immunization program, tested in Tijuana, Baja California, Mexico, by the Regional Nucleus for Health Systems Development (NUREDESS-Norte). The model was designed to facilitate the participation of the intermediate organizations that make up the community in urban settings. Through appropriate technology, health counselors identify with precision, ease and rapidity the specific immunization needs of pre-school age children. The counselors also help diminish the barriers in the way to service access, and follow-up the children at highest risk.
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Affiliation(s)
- M A González-Block
- Instituto Nacional de Salud Pública y de El Colegio de la Frontera Norte, México
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28
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29
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Thomas JC, Bridge J, Waterman S, Vogt J, Kilman L, Hancock G. Transmission and control of methicillin-resistant Staphylococcus aureus in a skilled nursing facility. Infect Control Hosp Epidemiol 1989; 10:106-10. [PMID: 2708797 DOI: 10.1086/645976] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.7] [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: 01/02/2023]
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is increasingly frequent in both acute care facilities (ACFs) and skilled nursing facilities (SNFs). Admissions to SNFs from ACFs with endemic MRSA are one likely source of infection in SNFs. The occurrence of MRSA in SNFs and the relative roles of ACFs and SNFs in MRSA transmission have not been well characterized. We conducted an epidemiologic investigation in an SNF reporting a high incidence of MRSA cases and found that the prevalence of MRSA exceeded that reported in acute care settings. Fifteen (9.1%) of the 164 residents were colonized or infected with MRSA. Risk factors for MRSA identified through a prevalence case-control study were nasogastric intubation (odds ratio = 5.5; 95% confidence interval = 1.2, 26.4), antibiotic therapy (OR = 3.9; CI = 1.2, 13.0), and hospitalization in an acute care facility within the previous six months (OR = 2.9; CI = 0.9, 9.7). During a three-month period, 6 of 100 new admissions were MRSA-positive; all positive patients were from ACFs. Five new cases also emerged from previously MRSA-negative residents. SNF residents are often discharged to ACFs. Transmission of MRSA within the SNF and the transfer of patients to ACFs increases the reservoir of potentially infective patients and the potential for MRSA infections in ACFs. Modest control measures, including targeted surveillance culturing and cohorting of colonized residents, may minimize MRSA transmission in the SNF and decrease the reservoir of MRSA in the community.
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Affiliation(s)
- J C Thomas
- Department of Health Services, Los Angeles County, California
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30
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Moran JS, Bernard KW, Greenberg AE, Patchen L, Waterman S, Bennet HS. Failure of chloroquine treatment to prevent malaria in Americans in West Africa. JAMA 1987; 258:2376-7. [PMID: 3312654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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31
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Waterman S. A note on the migration of Jews from Dublin. Jew J Sociol 1985; 27:23-7. [PMID: 12267047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
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32
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Bernard KW, Fishbein DB, Miller KD, Parker RA, Waterman S, Sumner JW, Reid FL, Johnson BK, Rollins AJ, Oster CN. Pre-exposure rabies immunization with human diploid cell vaccine: decreased antibody responses in persons immunized in developing countries. Am J Trop Med Hyg 1985; 34:633-47. [PMID: 4003672 DOI: 10.4269/ajtmh.1985.34.633] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
In November 1982, a U.S. Peace Corps volunteer in Kenya completed pre-exposure rabies prophylaxis with a standard 3 dose intradermal (ID) series of human diploid cell rabies vaccine (HDCV). In May 1983, she was bitten by a dog and died of rabies 3 months later. An initial investigation revealed that the patient, as well as 9 of 11 others immunized at the same time, had no rabies antibody titers (less than 1:5). We therefore instituted investigations into the immunogenicity of pre-exposure HDCV both in the United States and in developing countries. A serosurvey revealed unexpectedly low rabies titers in both Peace Corps volunteers and others immunized in developing countries. Antibody titers measured 2-3 weeks after ID immunization were compared in 9 groups totaling 271 persons in the United States and Kenya. There was no statistically significant difference in antibody titers in the 6 U.S. groups immunized from 1980-1984 (P greater than 0.15); however, groups immunized in the United States had significantly higher titers than a group of Kenyan nationals (P less than or equal to 0.0001), and the Kenyans had significantly higher titers than 2 Peace Corps groups immunized in Kenya (P less than or equal to 0.0001). No single hypothesis proposed (laboratory error, vaccine potency, vaccination technique, or specific immune suppression) accounted for the observed differences. Although we cannot fully explain the poor response to HDCV, it is probably due to multiple factors. We conclude that persons immunized with ID pre-exposure HDCV in developing countries should have rabies antibody titers determined to ensure their seroconversion; for persons immunized in the United States, such titers need not be routinely determined.
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Abstract
A one session multipurpose intubation method for the investigation of diarrhoea and malabsorption is described. It enables tests for bacterial colonisation, infestations, and luminal cytology of the small intestine to be combined with a pancreatic exocrine function test and a jejunal biopsy during the same intubation. The technique has proved acceptable, reliable, diagnostically valuable, and convenient for use on outpatients.
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Throop FB, DeRosa GP, Reeck C, Waterman S. Correction of equinus in cerebral palsy by the Murphy procedure of tendo calcaneus advancement: a preliminary communication. Dev Med Child Neurol 1975; 17:182-5. [PMID: 1093916 DOI: 10.1111/j.1469-8749.1975.tb03470.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The biomechanics of the Murphy procedure for correction of equinus in cerebral palsy are presented. A series of 79 surgical procedures on 48 patients, with a follow-up period of from one to four years, is reviewed. Correction of equinus was succeswful in 89-9 per cent of the procedures. Using the Murphy procedure the following advantages over other methods of correction are anticipated: (1) no loss on 'push-off' in gait; (2) no loss of correction (recurrence) during longitudinal growth of the child, necessitating repeated surgery; and (3) no need for continual night bracing during the growth period.
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Waterman S. The Effect of Anæsthetics upon the Human System, as Evidenced by Spectroscopic Observations. Am J Dent Sci 1878; 11:481-505. [PMID: 30752898 PMCID: PMC6101786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Waterman S. The Effects of Anæsthetics upon the Human System, as Evidenced by Spectroscopic Observations. Dent Regist 1878; 32:1-23. [PMID: 33699405 PMCID: PMC6924438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
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Waterman S. On the Therapeutical Employment of the Oxide of Zinc. Chic Med Exam 1861; 2:545-547. [PMID: 37472628 PMCID: PMC9981052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
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