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Castro L, Ridpath A, Mace K, Gutman JR. Have You Heard the News? Artemether-lumefantrine is Now Recommended for ALL Uncomplicated Malaria in the United States, Including in Pregnancy. Clin Infect Dis 2024; 78:245-247. [PMID: 37847222 DOI: 10.1093/cid/ciad638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/29/2023] [Accepted: 10/13/2023] [Indexed: 10/18/2023] Open
Affiliation(s)
- Laura Castro
- Malaria Branch, Division of Parasitic Diseases and Malaria, Global Health Center, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Epidemic Intelligence Service, Center for Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Alison Ridpath
- Malaria Branch, Division of Parasitic Diseases and Malaria, Global Health Center, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kimberly Mace
- Malaria Branch, Division of Parasitic Diseases and Malaria, Global Health Center, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Julie R Gutman
- Malaria Branch, Division of Parasitic Diseases and Malaria, Global Health Center, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Quilter LA, Tang EC, Johnson KA, Jacobson K, Ridpath A, Cohen S, Rajagopalan S, Munoz MD, Holderman JL, Kent JB, Bachmann LH, Bernstein K. 1520. Mind the Clap: Reported Disseminated Gonococcal Infections in the United States, 2020–2022. Open Forum Infect Dis 2022. [PMCID: PMC9751791 DOI: 10.1093/ofid/ofac492.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background Disseminated gonococcal infections (DGI) are estimated to occur in 0.5% to 3% of untreated Neisseria gonorrhoeae (GC) infections; however, surveillance and population-based studies to estimate DGI burden and describe recent DGI epidemiology and clinical manifestations are limited. In response to increased reports of DGI cases and clusters in the U.S., the Centers for Disease Control and Prevention (CDC) developed a surveillance system in 2020. We analyzed data captured by the initial two years of surveillance. Methods During 1/1/2020–3/31/2022, U.S. state/local health jurisdictions reported DGI cases to CDC utilizing a standardized case report form that collects demographic, sociobehavioral, and clinical information. A confirmed case was defined as isolation or detection of GC from a disseminated site of infection by culture or nucleic acid amplification test (NAAT); a probable case was defined as clinical manifestations of DGI and isolation or detection of GC from a mucosal site by culture or NAAT. Results In total, 274 DGI cases were reported to CDC from 13 U.S. states (65.7% from California): 215 (78.5%) confirmed cases and 59 (21.5%) probable cases. Among DGI cases, 51.1% were cisgender male, 33.2% were ≥ 45 years old, and 26.6% reported methamphetamine use in the past 12 months. Most patients (87.6%) did not have documented underlying immunosuppression or predisposing medical conditions. Among patients with DGI, 85.8% were hospitalized, 41.2% underwent related surgeries, and 2.2% died. Among confirmed cases, the most common disseminated sites of infection were synovial fluid (50.2%) and blood (45.1%). Among 184 (67.2%) patients with DGI who were tested for GC at a mucosal site, 115 (62.5%) were diagnosed with a mucosal GC infection (69.6% urogenital, 27.0% pharyngeal, 12.2% rectal); however, 85.5% of those not diagnosed with mucosal GC were only tested at urogenital sites. Only 89 patients (32.5%) reported mucosal symptoms present at the time of or within the month prior to DGI presentation. Conclusion Health care providers should maintain a high degree of suspicion for patients presenting with DGI symptoms given the potential for significant associated morbidity and the low proportion of patients who present with concurrent GC mucosal symptoms. Disclosures Alison Ridpath, MD, MPH, 3M company: Stocks/Bonds|Abbott Laboratories: Stocks/Bonds|Abbvie Inc.: Stocks/Bonds|Allogene Theraputics: Stocks/Bonds|Amarin Corperation PLC: Stocks/Bonds|infinity Pharmaceutical Companies: Stocks/Bonds|IQVIA Holdings Inc: Stocks/Bonds|Johnson and Johnson: Stocks/Bonds|Medtronic: Stocks/Bonds|pfizer: Stocks/Bonds|Thermo Fisher Scientific: Stocks/Bonds.
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Affiliation(s)
| | - Eric C Tang
- Sexually Transmitted Diseases Control Branch, Richmond, California
| | - Kelly A Johnson
- California Department of Public Health & University of California San Francisco, San Francisco, California
| | | | | | - Stephanie Cohen
- San Francisco Department of Public Health, San Francisco, California
| | | | - Monica D Munoz
- Division of HIV & STD Programs(DHSP), Los Angeles, California
| | | | - James B Kent
- Michigan Department Health and Human Services, Lansing, Michigan
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Schlanger K, Black JM, Smith M, Ridpath A, Crause C, Holderman JL, Henderson K, Hardrick H, Pham CD, Howard G, Kirkcaldy RD. Enhancing U.S. Local, State, and Federal Preparedness Through Simulated Interactive Tabletop Exercises of a Mock Antibiotic-Resistant Gonorrhea Outbreak, 2018-2019. Sex Transm Dis 2021; 48:S174-S179. [PMID: 34433792 PMCID: PMC10261998 DOI: 10.1097/olq.0000000000001536] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Responding effectively to outbreaks of antibiotic-resistant gonorrhea (ARGC) in the future will likely prove challenging. Tabletop exercises (TTXs) may assist local, state, and federal public health officials evaluate existing ARGC outbreak response plans, strengthen preparedness and response effectiveness, and identify critical gaps to address before an outbreak. METHODS In 2018 to 2019, Centers for Disease Control and Prevention (CDC) collaborated with state partners to develop and implement TTXs to simulate a public health emergency involving an ARGC outbreak. Before the TTXs, 2 state-local health department pairs developed ARGC outbreak response plans. During each 1-day exercise (in Indiana and Illinois), participants discussed roles, clinical management, public health response, and communication based on predeveloped response plans. Observers identified outbreak response strengths and gaps, and participants completed feedback forms. RESULTS Forty-one (Illinois) and 48 people (Indiana) participated in each TTX, including sexually transmitted disease clinical staff, laboratorians, public health infectious disease program staff, and CDC observers. Strengths and gaps varied by jurisdiction, but identified gaps included: (1) local access to gonorrhea culture and timely antimicrobial susceptibility testing, (2) protocols for clinical management of suspected treatment failures, (3) communication plans, and (4) clarity regarding state and local responsibilities. The CDC observers identified opportunities to provide national-level technical assistance, foster local antimicrobial susceptibility testing, and develop further response guidance. Tabletop exercises summary reports were used to guide modifications to local response plans to address gaps. CONCLUSIONS The TTXs allowed participants to practice responding to a simulated public health emergency and may have enhanced local response capacity. Centers for Disease Control and Prevention made TTX implementation materials publicly available.
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Affiliation(s)
| | | | | | | | - Candi Crause
- Champaign-Urbana Public Health District, Champaign, IL
| | - Justin L. Holderman
- Centers for Disease Control and Prevention, Atlanta, GA
- Indiana Department of Health, Indianapolis, IN
| | - Kyle Henderson
- Marion County Public Health Department, Indianapolis, IN
| | | | - Cau D. Pham
- Centers for Disease Control and Prevention, Atlanta, GA
| | - George Howard
- Centers for Disease Control and Prevention, Atlanta, GA
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McClung RP, Atkins AD, Kilkenny M, Bernstein KT, Willenburg KS, Weimer M, Robilotto S, Panneer N, Thomasson E, Adkins E, Lyss SB, Balleydier S, Edwards A, Chen M, Wilson S, Handanagic S, Hogan V, Watson M, Eubank S, Wright C, Thompson A, DiNenno E, Fanfair RN, Ridpath A, Oster AM. Response to a Large HIV Outbreak, Cabell County, West Virginia, 2018-2019. Am J Prev Med 2021; 61:S143-S150. [PMID: 34686283 DOI: 10.1016/j.amepre.2021.05.039] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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: 03/09/2021] [Revised: 05/04/2021] [Accepted: 05/06/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION In January 2019, the West Virginia Bureau for Public Health detected increased HIV diagnoses among people who inject drugs in Cabell County. Responding to HIV clusters and outbreaks is 1 of the 4 pillars of the Ending the HIV Epidemic in the U.S. initiative and requires activities from the Diagnose, Treat, and Prevent pillars. This article describes the design and implementation of a comprehensive response, featuring interventions from all pillars. METHODS This study used West Virginia Bureau for Public Health data to identify HIV diagnoses during January 1, 2018-October 9, 2019 among (1) people who inject drugs linked to Cabell County, (2) their sex or injecting partners, or (3) others with an HIV sequence linked to Cabell County people who inject drugs. Surveillance data, including HIV-1 polymerase sequences, were analyzed to estimate the transmission rate and timing of infections using molecular clock phylogenetic analysis. Federal, state, and local partners designed and implemented a comprehensive response during January 2019-October 2019. RESULTS Of 82 people identified in the outbreak, most were male (60%), were White (91%), and reported unstable housing (80%). In a large molecular cluster containing 56 of 60 (93%) available sequences, 93% of inferred transmissions occurred after January 1, 2018. HIV testing, HIV pre-exposure prophylaxis, and syringe services were rapidly expanded, leading to improved linkage to HIV care and viral suppression. CONCLUSIONS Evidence of rapid transmission in this outbreak galvanized robust collaboration among federal, state, and local partners, leading to critical improvements in HIV prevention and care services. HIV outbreak response requires increased coordination and creativity to improve service delivery to people affected by rapid HIV transmission.
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Affiliation(s)
- R Paul McClung
- Division of HIV Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention, Atlanta, Georgia; U.S. Public Health Service Commissioned Corps, Atlanta, Georgia.
| | - Amy D Atkins
- West Virginia Department of Health & Human Resources, West Virginia Bureau for Public Health, Charleston, West Virginia
| | | | - Kyle T Bernstein
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kara S Willenburg
- Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia
| | | | - Susan Robilotto
- HIV/AIDS Bureau, Health Resources & Services Administration, Rockville, Maryland
| | - Nivedha Panneer
- Division of HIV Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Erica Thomasson
- West Virginia Department of Health & Human Resources, West Virginia Bureau for Public Health, Charleston, West Virginia; Division of State and Local Readiness, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Sheryl B Lyss
- Division of HIV Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention, Atlanta, Georgia; U.S. Public Health Service Commissioned Corps, Atlanta, Georgia
| | - Shawn Balleydier
- West Virginia Department of Health & Human Resources, West Virginia Bureau for Public Health, Charleston, West Virginia
| | - Anita Edwards
- U.S. Public Health Service Commissioned Corps, Atlanta, Georgia; HIV/AIDS Bureau, Health Resources & Services Administration, Rockville, Maryland
| | - Mi Chen
- Division of HIV Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Suzanne Wilson
- West Virginia Department of Health & Human Resources, West Virginia Bureau for Public Health, Charleston, West Virginia
| | - Senad Handanagic
- Division of HIV Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Vicki Hogan
- West Virginia Department of Health & Human Resources, West Virginia Bureau for Public Health, Charleston, West Virginia
| | - Meg Watson
- Division of HIV Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Scott Eubank
- West Virginia Department of Health & Human Resources, West Virginia Bureau for Public Health, Charleston, West Virginia
| | - Carolyn Wright
- Division of HIV Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Antoine Thompson
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Elizabeth DiNenno
- Division of HIV Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Robyn Neblett Fanfair
- Division of HIV Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention, Atlanta, Georgia; U.S. Public Health Service Commissioned Corps, Atlanta, Georgia
| | - Alison Ridpath
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Alexandra M Oster
- Division of HIV Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention, Atlanta, Georgia; U.S. Public Health Service Commissioned Corps, Atlanta, Georgia
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Quilter LAS, Agnew-Brune C, Broussard D, Salmon M, Bradley H, Hogan V, Ridpath A, Burton K, Rose BC, Kirk N, Reynolds P, Varella L, Granado M, Gerard A, Thompson A, De La Garza G, Lee C, Bernstein K. Establishing Best Practices in a Response to an HIV Cluster: An Example From a Surge Response in West Virginia. Sex Transm Dis 2021; 48:e35-e40. [PMID: 32890333 DOI: 10.1097/olq.0000000000001279] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | | | | | | | - Heather Bradley
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Vicki Hogan
- Bureau for Public Health, West Virginia Department of Health and Human Resources, Charleston, WV
| | | | - Kenya Burton
- Bureau for Public Health, West Virginia Department of Health and Human Resources, Charleston, WV
| | - Bridget Connard Rose
- Bureau for Public Health, West Virginia Department of Health and Human Resources, Charleston, WV
| | - Nathan Kirk
- Bureau for Public Health, West Virginia Department of Health and Human Resources, Charleston, WV
| | - Pamela Reynolds
- Bureau for Public Health, West Virginia Department of Health and Human Resources, Charleston, WV
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Chang A, Ridpath A, Carpenter J, Kieszak S, Sircar K, Espinosa-Bode A, Nelson D, Martin C. Urine Bisphenol A and Arsenic Levels in Residents of the Cheyenne River Sioux Tribe, South Dakota, with and without Diabetes. J Med Toxicol 2019; 16:276-283. [PMID: 31848906 DOI: 10.1007/s13181-019-00748-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 10/25/2019] [Accepted: 11/07/2019] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Diabetes disproportionately affects American Indians/Alaskan Natives (AI/AN). Bisphenol A (BPA) and arsenic (As), environmental toxicants which may be associated with diabetes, have not been well studied in this population. Our objectives were to determine if urinary BPA and As are associated with diabetes among adults in the Cheyenne River Sioux Tribe (CRST), and to compare their urinary levels with the general US population. METHODS We performed a case-control study among 276 volunteers. We matched our cases (persons with diabetes) and controls (persons without diabetes) using age. We collected questionnaire data and urine samples which were tested for BPA and speciated As analytes. We used paired t tests and McNemar's chi-square test to compare continuous and categorical variables, respectively, between cases and controls and linear regression to assess the association between self-reported exposures and BPA and As levels. We used conditional logistic regression to investigate the association between case status and BPA and As levels. BPA and As levels among participants were compared with those from the 2011-2012 National Health and Nutrition Examination Survey (NHANES). RESULTS The average age of participants was 46 years. The majority identified as AI/AN race (97%) and 58% were female. The geometric means from CRST participant urine specimens were 1.83 ug/L for BPA and 3.89 ug/L for total As. BPA geometric means of CRST participants were higher than NHANES participants while total As geometric means were lower. BPA and As were not associated with case status. CONCLUSION The results of this study are consistent with others that have reported no association between diabetes and exposure to BPA or As.
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Affiliation(s)
- Arthur Chang
- Division of Environmental Health Science and Practice, National Center for Environmental Health (NCEH), Centers for Disease Control and Prevention (CDC), 4770 Buford Highway NE, MS S106-6, Chamblee, GA, 30341, USA.
| | - Alison Ridpath
- Division of Sexually Transmitted Disease Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention (NCHHSTP), CDC, Atlanta, GA, USA
| | - Joseph Carpenter
- Division of Environmental Health Science and Practice, National Center for Environmental Health (NCEH), Centers for Disease Control and Prevention (CDC), 4770 Buford Highway NE, MS S106-6, Chamblee, GA, 30341, USA
| | - Stephanie Kieszak
- Division of Environmental Health Science and Practice, National Center for Environmental Health (NCEH), Centers for Disease Control and Prevention (CDC), 4770 Buford Highway NE, MS S106-6, Chamblee, GA, 30341, USA
| | - Kanta Sircar
- Division of Environmental Health Science and Practice, NCEH, CDC, Chamblee, GA, USA
| | - Andres Espinosa-Bode
- Division of Global Health Protection, Center for Global Health (CGH), CDC, Atlanta, GA, USA
| | - David Nelson
- Department of Environmental and Natural Resources, Cheyenne River Sioux Tribe, Eagle Butte, SD, USA
| | - Colleen Martin
- Division of Environmental Health Science and Practice, National Center for Environmental Health (NCEH), Centers for Disease Control and Prevention (CDC), 4770 Buford Highway NE, MS S106-6, Chamblee, GA, 30341, USA
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Ridpath A, Chesson H, Marcus JL, Kirkcaldy RD, Torrone E, Aral SO, Bernstein KT. Screening Peter to Save Paul: The Population-Level Effects of Screening Men Who Have Sex With Men for Gonorrhea and Chlamydia. Sex Transm Dis 2018; 45:623-625. [PMID: 29994935 PMCID: PMC6086737 DOI: 10.1097/olq.0000000000000892] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Alison Ridpath
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Harrell Chesson
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Julia L Marcus
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA
| | - Robert D Kirkcaldy
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Elizabeth Torrone
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Sevgi O Aral
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Kyle T Bernstein
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
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Schnabel D, Esposito DH, Gaines J, Ridpath A, Barry MA, Feldman KA, Mullins J, Burns R, Ahmad N, Nyangoma EN, Nguyen DB, Perz JF, Moulton-Meissner HA, Jensen BJ, Lin Y, Posivak-Khouly L, Jani N, Morgan OW, Brunette GW, Pritchard PS, Greenbaum AH, Rhee SM, Blythe D, Sotir M. Multistate US Outbreak of Rapidly Growing Mycobacterial Infections Associated with Medical Tourism to the Dominican Republic, 2013-2014(1). Emerg Infect Dis 2018; 22:1340-1347. [PMID: 27434822 PMCID: PMC4982176 DOI: 10.3201/eid2208.151938] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Infections in 6 states were linked to persons traveling to undergo cosmetic surgical procedures. During 2013, the Maryland Department of Health and Mental Hygiene in Baltimore, MD, USA, received report of 2 Maryland residents whose surgical sites were infected with rapidly growing mycobacteria after cosmetic procedures at a clinic (clinic A) in the Dominican Republic. A multistate investigation was initiated; a probable case was defined as a surgical site infection unresponsive to therapy in a patient who had undergone cosmetic surgery in the Dominican Republic. We identified 21 case-patients in 6 states who had surgery in 1 of 5 Dominican Republic clinics; 13 (62%) had surgery at clinic A. Isolates from 12 (92%) of those patients were culture-positive for Mycobacterium abscessus complex. Of 9 clinic A case-patients with available data, all required therapeutic surgical intervention, 8 (92%) were hospitalized, and 7 (78%) required ≥3 months of antibacterial drug therapy. Healthcare providers should consider infection with rapidly growing mycobacteria in patients who have surgical site infections unresponsive to standard treatment.
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Anwar M, Ridpath A, Berner J, Schier JG. Medical Toxicology and Public Health-Update on Research and Activities at the Centers for Disease Control and Prevention and the Agency for Toxic Substances and Disease Registry : Environmental Exposures among Arctic Populations: The Maternal Organics Monitoring Study in Alaska. J Med Toxicol 2016; 12:315-7. [PMID: 27379884 PMCID: PMC4996793 DOI: 10.1007/s13181-016-0562-8] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 06/03/2016] [Indexed: 10/21/2022] Open
Abstract
Evidence suggests that in-utero exposure to environmental chemicals, such as persistent organic pollutants (POPs), heavy metals, and radionuclides, that might bioaccumulate in the mother may increase a newborn's risk of adverse developmental, neurological, and immunologic effects. Chemical contamination of bodies of water and strong ocean currents worldwide can drive these chemicals from lower latitudes to Arctic waters where they accumulate in common traditional subsistence foods. In response to concerns of the people from Alaska of the effects of bio-accumulated chemicals on their children, the Maternal Organics Monitoring Study(MOMS) was developed. The objective of the study was to assess the risks and benefits associated with the population's subsistence diet. Data analysis of biological samples at the CDC's NCEH laboratory and maternal questionnaires is ongoing. Results will be provided to Alaska Native communities to help support public health actions and inform future interventions and research.
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Affiliation(s)
- Mehruba Anwar
- Health Studies Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health (NCEH), 4770 Buford Highway, Chamblee, GA, 30341, USA.
| | - Alison Ridpath
- Health Studies Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health (NCEH), 4770 Buford Highway, Chamblee, GA, 30341, USA
| | - James Berner
- Alaska Native Tribal Health Consortium (ANTHC), 4000 Ambassador Drive, Anchorage, AK, 99508, USA
| | - Joshua G Schier
- Health Studies Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health (NCEH), 4770 Buford Highway, Chamblee, GA, 30341, USA
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Ridpath A, Greene SK, Robinson BF, Weiss D. Risk Factors for Serogroup C Meningococcal Disease during Outbreak among Men who Have Sex with Men, New York City, New York, USA. Emerg Infect Dis 2016. [PMID: 26196855 PMCID: PMC4517728 DOI: 10.3201/eid2108.141932] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Risk factors for illness during a serogroup C meningococcal disease outbreak among men who have sex with men in New York City, New York, USA, in 2012–2013 included methamphetamine and cocaine use and sexually transmitted infections. Outbreak investigations should consider routinely capturing information regarding drug use and sex-related risk factors.
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Kratz MM, Weiss D, Ridpath A, Zucker JR, Geevarughese A, Rakeman J, Varma JK. Community-Based Outbreak of Neisseria meningitidis Serogroup C Infection in Men who Have Sex with Men, New York City, New York, USA, 2010-2013. Emerg Infect Dis 2016. [PMID: 26197087 PMCID: PMC4517726 DOI: 10.3201/eid2108.141837] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [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
Questions about how to protect this at-risk population deserve careful consideration. In September 2012, the New York City Department of Health and Mental Hygiene identified an outbreak of Neisseria meningitidis serogroup C invasive meningococcal disease among men who have sex with men (MSM). Twenty-two case-patients and 7 deaths were identified during August 2010−February 2013. During this period, 7 cases in non-MSM were diagnosed. The slow-moving outbreak was linked to the use of websites and mobile phone applications that connect men with male sexual partners, which complicated the epidemiologic investigation and prevention efforts. We describe the outbreak and steps taken to interrupt transmission, including an innovative and wide-ranging outreach campaign that involved direct, internet-based, and media-based communications; free vaccination events; and engagement of community and government partners. We conclude by discussing the challenges of managing an outbreak affecting a discrete community of MSM and the benefits of using social networking technology to reach this at-risk population.
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Ridpath A, Taylor E, Greenstreet C, Martens M, Wicke H, Martin C. Description of calls from private well owners to a national well water hotline, 2013. Sci Total Environ 2016; 544:601-5. [PMID: 26674689 PMCID: PMC5088433 DOI: 10.1016/j.scitotenv.2015.11.141] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 11/25/2015] [Accepted: 11/26/2015] [Indexed: 05/26/2023]
Abstract
Water Systems Council (WSC) is a national, non-profit organization providing education and resources to private household well owners. Since 2003, WSC has provided wellcare®, a toll-free telephone hotline to answer questions from the public regarding well stewardship. In order to identify knowledge gaps regarding well stewardship among private well owners, we obtained data from WSC and reviewed calls made during 2013 to wellcare®. WSC records data from each wellcare® call-including caller information, primary reason for call, main use of well water, and if they were calling about a cistern, private well, shared well, or spring. We searched for calls with key words indicating specific contaminants of interest and reviewed primary reasons for calls. Calls classified as primarily testing-related were further categorized depending on whether the caller asked about how to test well water or how to interpret testing results. During 2013, wellcare® received 1100 calls from private well owners who were residents of 48 states. Among these calls, 87 (8%) mentioned radon, 83 (8%) coliforms, 51 (5%) chemicals related to fracking, 34 (3%) arsenic, and 32 (3%) nitrates key words. Only 38% of private well owners reported conducting any well maintenance activities, such as inspecting, cleaning, repairing the well, or testing well water, during the previous 12 months. The primary reason for calls were related to well water testing (n=403), general information relating to wells (n=249), contaminants (n=229), and well water treatment (n=97). Among calls related to testing, 319 had questions about how to test their well water, and 33 had questions about how to interpret testing results. Calls from private well owners to the wellcare® Hotline during 2013 identified key knowledge gaps regarding well stewardship; well owners are generally not testing or maintaining their wells, have questions about well water testing treatment, and concerns about well water contaminants.
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Affiliation(s)
- Alison Ridpath
- Centers for Disease Control and Prevention, 4770 Buford Hwy, NE, MS-F-60, Chamblee, GA 30341, United States.
| | - Ethel Taylor
- Centers for Disease Control and Prevention, 4770 Buford Hwy, NE, MS-F-60, Chamblee, GA 30341, United States
| | | | - Margaret Martens
- Water Systems Council, 1101 30th St NW, Washington, DC 20007, United States
| | - Heather Wicke
- Water Systems Council, 1101 30th St NW, Washington, DC 20007, United States
| | - Colleen Martin
- Centers for Disease Control and Prevention, 4770 Buford Hwy, NE, MS-F-60, Chamblee, GA 30341, United States
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13
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Ridpath A, Driver CR, Nolan ML, Karpati A, Kass D, Paone D, Jakubowski A, Hoffman RS, Nelson LS, Kunins HV. Illnesses and deaths among persons attending an electronic dance-music festival - New York City, 2013. MMWR Morb Mortal Wkly Rep 2014; 63:1195-8. [PMID: 25522087 PMCID: PMC5779530] [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] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Outdoor electronic dance-music festivals (EDMFs) are typically summer events where attendees can dance for hours in hot temperatures. EDMFs have received increased media attention because of their growing popularity and reports of illness among attendees associated with recreational drug use. MDMA (3,4-methylenedioxymethamphetamine) is one of the drugs often used at EDMFs. MDMA causes euphoria and mental stimulation but also can cause serious adverse effects, including hyperthermia, seizures, hyponatremia, rhabdomyolysis, and multiorgan failure. In this report, MDMA and other synthetic drugs commonly used at dance festivals are referred to as "synthetic club drugs." On September 1, 2013, the New York City (NYC) Department of Health and Mental Hygiene (DOHMH) received reports of two deaths of attendees at an EDMF (festival A) held August 31-September 1 in NYC. DOHMH conducted an investigation to identify and characterize adverse events resulting in emergency department (ED) visits among festival A attendees and to determine what drugs were associated with these adverse events. The investigation identified 22 cases of adverse events; nine cases were severe, including two deaths. Twenty-one (95%) of the 22 patients had used drugs or alcohol. Of 17 patients with toxicology testing, MDMA and other compounds were identified, most frequently methylone, in 11 patients. Public health messages and strategies regarding adverse health events might reduce illnesses and deaths at EDMFs.
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Affiliation(s)
- Alison Ridpath
- New York City Department of Health and Mental Hygiene,Epidemic Intelligence Service, CDC
| | | | | | - Adam Karpati
- New York City Department of Health and Mental Hygiene
| | - Daniel Kass
- New York City Department of Health and Mental Hygiene
| | - Denise Paone
- New York City Department of Health and Mental Hygiene
| | | | | | | | - Hillary V. Kunins
- New York City Department of Health and Mental Hygiene,Corresponding author: Hillary Kunins, , 347-396-7012
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14
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Schnabel D, Gaines J, Nguyen DB, Esposito DH, Ridpath A, Yacisin K, Poy JA, Mullins J, Burns R, Lijewski V, McElroy NP, Ahmad N, Harrison C, Parinelli EJ, Beaudoin AL, Posivak-Khouly L, Pritchard PS, Jensen BJ, Toney NC, Moulton-Meissner HA, Nyangoma EN, Barry MA, Feldman KA, Blythe D, Perz JF, Morgan OW, Kozarsky P, Brunette GW, Sotir M. Notes from the field: rapidly growing nontuberculous Mycobacterium wound infections among medical tourists undergoing cosmetic surgeries in the Dominican Republic--multiple states, March 2013-February 2014. MMWR Morb Mortal Wkly Rep 2014; 63:201-2. [PMID: 24598597 PMCID: PMC4584729] [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: 10/30/2022]
Abstract
In August 2013, the Maryland Department of Health and Mental Hygiene (MDHMH) was notified of two persons with rapidly growing nontuberculous mycobacterial (RG-NTM) surgical-site infections. Both patients had undergone surgical procedures as medical tourists at the same private surgical clinic (clinic A) in the Dominican Republic the previous month. Within 7 days of returning to the United States, both sought care for symptoms that included surgical wound abscesses, clear fluid drainage, pain, and fever. Initial antibiotic therapy was ineffective. Material collected from both patients' wounds grew Mycobacterium abscessus exhibiting a high degree of antibiotic resistance characteristic of this organism.
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Affiliation(s)
- David Schnabel
- Maryland Department of Health and Mental Hygiene,Corresponding author: David Schnabel, , 410-767-7395
| | - Joanna Gaines
- Division for Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Duc B. Nguyen
- Division of Healthcare Quality and Promotion, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Douglas H. Esposito
- Division for Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Alison Ridpath
- New York City Department of Health and Mental Hygiene, New York, New York
| | - Kari Yacisin
- New York City Department of Health and Mental Hygiene, New York, New York
| | - Jose A. Poy
- New York City Department of Health and Mental Hygiene, New York, New York
| | | | | | | | | | | | | | | | | | | | | | - Bette J. Jensen
- Division of Healthcare Quality and Promotion, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Nadege C. Toney
- Division of Healthcare Quality and Promotion, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Heather A. Moulton-Meissner
- Division of Healthcare Quality and Promotion, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Edith N. Nyangoma
- Division for Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | | | | | - David Blythe
- Maryland Department of Health and Mental Hygiene
| | - Joseph F. Perz
- Division of Healthcare Quality and Promotion, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Oliver W. Morgan
- Dominican Republic Country Office, Center for Global Health, CDC
| | - Phyllis Kozarsky
- Division for Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Gary W. Brunette
- Division for Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Mark Sotir
- Division for Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC
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15
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Patel RB, Stoklosa H, Shitole S, Shitole T, Sawant K, Nanarkar M, Subbaraman R, Ridpath A, Patil-Deshmuk A. The high cost of diarrhoeal illness for urban slum households-a cost-recovery approach: a cohort study. BMJ Open 2013; 3:bmjopen-2012-002251. [PMID: 23558731 PMCID: PMC3641490 DOI: 10.1136/bmjopen-2012-002251] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Rapid urbanisation has often meant that public infrastructure has not kept pace with growth leading to urban slums with poor access to water and sanitation and high rates of diarrhoea with greater household costs due to illness. This study sought to determine the monetary cost of diarrhoea to urban slum households in Kaula Bandar slum in Mumbai, India. The study also tested the hypotheses that the cost of water and sanitation infrastructure may be surpassed by the cumulative costs of diarrhoea for households in an urban slum community. DESIGN A cohort study using a baseline survey of a random sample followed by a systematic longitudinal household survey. The baseline survey was administered to a random sample of households. The systematic longitudinal survey was administered to every available household in the community with a case of diarrhoea for a period of 5 weeks. PARTICIPANTS Every household in Kaula Bandar was approached for the longitudinal survey and all available and consenting adults were included. RESULTS The direct cost of medical care for having at least one person in the household with diarrhoea was 205 rupees. Other direct costs brought total expenses to 291 rupees. Adding an average loss of 55 rupees per household from lost wages and monetising lost productivity from homemakers gave a total loss of 409 rupees per household. During the 5-week study period, this community lost an estimated 163 600 rupees or 3635 US dollars due to diarrhoeal illness. CONCLUSIONS The lack of basic water and sanitation infrastructure is expensive for urban slum households in this community. Financing approaches that transfer that cost to infrastructure development to prevent illness may be feasible. These findings along with the myriad of unmeasured benefits of preventing diarrhoeal illness add to pressing arguments for investment in basic water and sanitation infrastructure.
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Affiliation(s)
- Ronak B Patel
- Departments of Emergency Medicine, Brigham and Women's Hospital and Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Humanitarian Initiative, Cambridge, Massachusetts, USA
| | - Hanni Stoklosa
- Departments of Emergency Medicine, Brigham and Women's Hospital and Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Shrutika Shitole
- Partners for Urban Knowledge Action and Research, Mumbai, Maharashtra, India
| | - Tejal Shitole
- Partners for Urban Knowledge Action and Research, Mumbai, Maharashtra, India
| | - Kiran Sawant
- Partners for Urban Knowledge Action and Research, Mumbai, Maharashtra, India
| | - Mahesh Nanarkar
- Partners for Urban Knowledge Action and Research, Mumbai, Maharashtra, India
| | - Ramnath Subbaraman
- Partners for Urban Knowledge Action and Research, Mumbai, Maharashtra, India
| | - Alison Ridpath
- Harvard Humanitarian Initiative, Cambridge, Massachusetts, USA
| | - Anita Patil-Deshmuk
- Partners for Urban Knowledge Action and Research, Mumbai, Maharashtra, India
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