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LI, JOHN, GULZAR H. SHAH, and CRAIG HEDBERG. "Complaint-Based Surveillance for Foodborne Illness in the United States: A Survey of Local Health Departments." Journal of Food Protection 74, no. 3 (March 1, 2011): 432–37. http://dx.doi.org/10.4315/0362-028x.jfp-10-353.
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Foodborne illnesses are an important public health problem in the United States in terms of both the burden of illness and cost to the health care system. Strengthening foodborne illness surveillance helps address the growing issues of food safety in the United States. Very little is known about the use of consumer complaint surveillance systems for foodborne illness. This study evaluates the use of these surveillance systems by local health departments (LHDs) in the United States and their practices and policies for investigating complaints. Data for this study were collected through two Web-based surveys based on a representative sample of LHDs in the United States; 81% of LHDs use complaint-based surveillance. Of those that did not have a complaint system, 64% reported that the state health department or another agency ran their complaint system. Health departments collect a wide variety of information from callers through their complaint systems, including food intake history. Most of the LHDs, however, do not store the information in an electronic database. Outbreak rates and complaint rates were found to be positively correlated, with a Pearson's correlation coefficient of 0.38. Complaints were the most common outbreak detection mechanism reported by respondents, with a median of 69% of outbreaks during the previous year found through complaints. Complaint systems are commonly used in the United States. Increasing the rate at which illnesses are reported by the public and improving investigation practices could help increase the number of outbreaks detected through complaint surveillance.
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Midgley, Claire, Brian Rha, Joana Y. Lively, Angela P. Campbell, Julie A. Boom, Parvin H. Azimi, Geoffrey A. Weinberg, et al. "2639. Respiratory Virus Detections in Asthma-Related Pediatric Hospitalizations: New Vaccine Surveillance Network, United States." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S922—S923. http://dx.doi.org/10.1093/ofid/ofz360.2317.
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Abstract Background Respiratory viruses are associated with most asthma exacerbations (AEx) in children; however, the role of different viruses in AEx is unclear. We describe respiratory virus detections among pediatric inpatients with AEx (AEx-inpatients). Methods Through active, prospective surveillance at 7 US medical centers, we enrolled inpatients (<18 years) with acute respiratory illness (ARI) during November 1, 2015–June 30, 2016. We defined an AEx-inpatient as an inpatient with a principal admission or discharge diagnosis of asthma (ICD-10-CM, J45.xx). Mid-turbinate nasal and/or throat swabs were tested by molecular assays for influenza A or B, respiratory syncytial virus (RSV), parainfluenza virus 1–3, rhinovirus or enterovirus (RV/EV), human metapneumovirus and adenovirus. We assessed virus detections among AEx-inpatients throughout the surveillance period or by season (winter: December–February; spring: March–May), and by patient age and history of asthma/reactive airway disease (asthma/RAD). Results We tested 3,897 inpatients with ARI; of whom, 954 were AEx-inpatients. Most AEx-inpatients (741/954 [78%]) reported an asthma/RAD history. Viruses were more frequently detected among AEx-inpatients <5 years (350/458 [76%]) than 5–17 years (305/496 [61%], P < 0.001). Most (615/655 [94%]) detections were of single viruses. The most frequent single virus detections were RV/EV (474/954 [50%]) and RSV (76/954 [8%]) but the frequency of each virus varied by season and age group (figure). Single RV/EVs were the most common virus detections in both seasons and all groups. Single RSV detections were prominent among <5 year olds in winter (40/185 [22%]). Among those with single RV/EV or RSV detections, 285/474 (60%) and 49/76 (64%) required supplemental oxygen, respectively (P = 0.676); median length of stay was 1 day (range: 0–45; IQR: 1–2) and 2 days (range: 0–6; IQR: 1–2.5), respectively (P < 0.001). Conclusion AEx-inpatients <5 years were more likely to have respiratory virus detections than those 5–17 years. Single RV/EVs formed the majority of virus detections throughout the surveillance period, regardless of age. RSV played a notable role in winter among patients <5 years. These findings could inform prevention or treatment strategies for virus-associated AEx. Disclosures All authors: No reported disclosures.
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Peterson, Kelly S., Julia Lewis, Olga V. Patterson, Alec B. Chapman, Daniel W. Denhalter, Patricia A. Lye, Vanessa W. Stevens, et al. "Automated Travel History Extraction From Clinical Notes for Informing the Detection of Emergent Infectious Disease Events: Algorithm Development and Validation." JMIR Public Health and Surveillance 7, no. 3 (March 24, 2021): e26719. http://dx.doi.org/10.2196/26719.
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Background Patient travel history can be crucial in evaluating evolving infectious disease events. Such information can be challenging to acquire in electronic health records, as it is often available only in unstructured text. Objective This study aims to assess the feasibility of annotating and automatically extracting travel history mentions from unstructured clinical documents in the Department of Veterans Affairs across disparate health care facilities and among millions of patients. Information about travel exposure augments existing surveillance applications for increased preparedness in responding quickly to public health threats. Methods Clinical documents related to arboviral disease were annotated following selection using a semiautomated bootstrapping process. Using annotated instances as training data, models were developed to extract from unstructured clinical text any mention of affirmed travel locations outside of the continental United States. Automated text processing models were evaluated, involving machine learning and neural language models for extraction accuracy. Results Among 4584 annotated instances, 2659 (58%) contained an affirmed mention of travel history, while 347 (7.6%) were negated. Interannotator agreement resulted in a document-level Cohen kappa of 0.776. Automated text processing accuracy (F1 85.6, 95% CI 82.5-87.9) and computational burden were acceptable such that the system can provide a rapid screen for public health events. Conclusions Automated extraction of patient travel history from clinical documents is feasible for enhanced passive surveillance public health systems. Without such a system, it would usually be necessary to manually review charts to identify recent travel or lack of travel, use an electronic health record that enforces travel history documentation, or ignore this potential source of information altogether. The development of this tool was initially motivated by emergent arboviral diseases. More recently, this system was used in the early phases of response to COVID-19 in the United States, although its utility was limited to a relatively brief window due to the rapid domestic spread of the virus. Such systems may aid future efforts to prevent and contain the spread of infectious diseases.
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SEYS, S. A., F. SAMPEDRO, and C. W. HEDBERG. "Factors associated with recovery of meat products following recalls due to Shiga toxin-producing Escherichia coli." Epidemiology and Infection 144, no. 14 (June 17, 2016): 2940–47. http://dx.doi.org/10.1017/s0950268816001266.
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SUMMARYFood-product recall data for recalls due to Shiga toxin-producing Escherichia coli (STEC) from 2000 to 2012 were obtained for establishments regulated by the United States Department of Agriculture, Food Safety and Inspection Service (FSIS). Statistical tests were used to assess the factors associated with recovery of product following STEC recalls along with the relationship between cluster detection and jurisdictions. Our results indicated that the percentage of recalled product recovered following a recall action due to STEC was dependent on the complexity of distribution, type of distribution, amount of time between production and recall dates, and the number of pounds of product recalled. Illness-related STEC recalls were associated with a lower percentage of product recovery which was probably impacted by larger amounts of product recalled, broader production scope, and delays from epidemiological and traceback investigations. Further, detection of illnesses related to STEC recalls seemed to be enhanced in states with additional resources and a history of successful foodborne investigations. This makes an argument for additional resources dedicated to public health agencies specifically for the surveillance of foodborne illnesses.
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Zhang, Yan, James A. Smith, Alexandros A. Ntelekos, Mary Lynn Baeck, Witold F. Krajewski, and Fred Moshary. "Structure and Evolution of Precipitation along a Cold Front in the Northeastern United States." Journal of Hydrometeorology 10, no. 5 (October 1, 2009): 1243–56. http://dx.doi.org/10.1175/2009jhm1046.1.
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Abstract Heavy precipitation in the northeastern United States is examined through observational and numerical modeling analyses for a weather system that produced extreme rainfall rates and urban flash flooding over the New York–New Jersey region on 4–5 October 2006. Hydrometeorological analyses combine observations from Weather Surveillance Radar-1988 Doppler (WSR-88D) weather radars, the National Lightning Detection Network, surface observing stations in the northeastern United States, a vertically pointing lidar system, and a Joss–Waldvogel disdrometer with simulations from the Weather Research and Forecasting Model (WRF). Rainfall analyses from the Hydro-Next Generation Weather Radar (NEXRAD) system, based on observations from WSR-88D radars in State College, Pennsylvania, and Fort Dix, New Jersey, and WRF model simulations show that heavy rainfall was organized into long-lived lines of convective precipitation, with associated regions of stratiform precipitation, that develop along a frontal zone. Structure and evolution of convective storm elements that produced extreme rainfall rates over the New York–New Jersey urban corridor were influenced by the complex terrain of the central Appalachians, the diurnal cycle of convection, and the history of convective evolution in the frontal zone. Extreme rainfall rates and flash flooding were produced by a “leading line–trailing stratiform” system that was rapidly dissipating as it passed over the New York–New Jersey region. Radar, disdrometer, and lidar observations are used in combination with model analyses to examine the dynamical and cloud microphysical processes that control the spatial and temporal structure of heavy rainfall. The study illustrates key elements of the spatial and temporal distribution of rainfall that can be used to characterize flash flood hazards in the urban corridor of the northeastern United States.
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Chhatwal, Jagpreet, Sumeyye Samur, Ju Dong Yang, Lewis R. Roberts, Mindie Nguyen, A. Burak Ozbay, Turgay Ayer, Neehar Parikh, and Amit G. Singal. "Multi-target blood test to improve the performance of hepatocellular carcinoma surveillance programs: A modeling-based virtual trial." Journal of Clinical Oncology 40, no. 4_suppl (February 1, 2022): 405. http://dx.doi.org/10.1200/jco.2022.40.4_suppl.405.
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405 Background: Hepatocellular carcinoma (HCC) is the fastest rising cause of cancer mortality in the United States. Although clinical guidelines recommend ultrasound (U/S), with or without the serum biomarker alpha fetoprotein (AFP) for HCC surveillance in at-risk patients, only 24% of patients adhere to surveillance and only one-third of HCCs are detected before developing symptoms. A multi-target HCC blood-based test (mt-HBT) was recently shown to have promising sensitivity for early HCC detection and may help improve surveillance adherence given its blood-based nature. Our objective was to evaluate the comparative clinical effectiveness of mt-HBT with the current standard-of-care surveillance strategy in patients with cirrhosis. Methods: We simulated a virtual trial by developing a microsimulation model of the natural history of HCC in patients with compensated (Child Pugh A) cirrhosis over a 30-year horizon. To inform model parameters, we used published data on tumor progression, competing risks of mortality, and real-world HCC surveillance adherence. Test performance characteristics were informed by a network meta-analysis. We simulated the life course of 51-year-old patients with cirrhosis and compared no surveillance with biannual surveillance using (1) AFP only, (2) U/S only, (3) U/S+AFP, (4) mt-HBT, and (5) mt-HBT with improved adherence. We assumed a blood-based test—without U/S—would improve surveillance adherence by 10% compared with current adherence (̃4% absolute improvement). Results: Per 100,000 cirrhosis patients, mt-HBT detected 6,220 more early-stage HCC than no surveillance, 2,250 (+57%) more than AFP, 1080 (+21%) more than U/S, and 200 (-3%) less than U/S+AFP. mt-HBT with improved adherence detected 210 (+3%) more early-stage HCC than U/S+AFP (Table). The remaining HCC cases were either symptomatic or the patients died per other competing causes prior to detection. The number of screening tests needed to detect one HCC were 296 for AFP, 287 for U/S, 253 for U/S+AFP, 254 for mt-HBT and 262 for mt-HBT with improved adherence. The number of diagnostic MRI/CT needed to detect one HCC were 40 for AFP, 38 for U/S, 45 for U/S+AFP, 37 for mt-HBT, and 38 for mt-HBT with improved adherence. Conclusions: mt-HBT detects more early-HCC cases than U/S and similar number of early-HCC cases with U/S+AFP. By decreasing surveillance barriers and increasing adherence, mt-HBT could improve early HCC detection and could be promising option for HCC surveillance in patients with cirrhosis. [Table: see text]
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Zahariadis, George, Ari R. Joffe, James Talbot, Albert deVilliers, Patricia Campbell, Kanti Pabbaraju, Sallene Wong, et al. "Identification and Epidemiology of Severe Respiratory Disease due to Novel Swine-Origin Influenza A (H1N1) Virus Infection in Alberta." Canadian Journal of Infectious Diseases and Medical Microbiology 21, no. 4 (2010): e151-e157. http://dx.doi.org/10.1155/2010/293098.
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BACKGROUND: In March 2009, global surveillance started detecting cases of influenza-like illness in Mexico. By mid-April 2009, two pediatric patients were identified in the United States who were confirmed to be infected by a novel influenza A (H1N1) strain. The present article describes the first identified severe respiratory infection and the first death associated with pandemic H1N1 (pH1N1) in Canada.METHODS: Enhanced public health and laboratory surveillance for pH1N1 was implemented throughout Alberta on April 24, 2009. Respiratory specimens from all patients with a respiratory illness and travel history or those presenting with a severe respiratory infection requiring hospitalization underwent screening for respiratory viruses using molecular methods. For the first severe case identified and the first death due to pH1N1, histocompatibility leukocyte antigens were compared by molecular methods.RESULTS: The first death (a 39-year-old woman) occurred on April 28, 2009, and on May 1, 2009, a 10-year-old child presented with severe respiratory distress due to pH1N1. Both patients had no travel or contact with anyone who had travelled to Mexico; the cases were not linked. Histocompatibility antigen comparison of both patients did not identify any notable similarity. pH1N1 strains identified in Alberta did not differ from the Mexican strain.CONCLUSION: Rapid transmission of pH1N1 continued to occur in Alberta following the first death and the first severe respiratory infection in Canada, which were identified without any apparent connection to Mexico or the United States. Contact tracing follow-up suggested that oseltamivir may have prevented ongoing transmission of pH1N1.
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Kahsay, Ruth, Maria A. Gómez-Morales, Hilda N. Rivera, Isabel McAuliffe, Edoardo Pozio, and Sukwan Handali. "A Bead-Based Assay for the Detection of Antibodies against Trichinella spp. Infection in Humans." American Journal of Tropical Medicine and Hygiene 104, no. 5 (May 5, 2021): 1858–62. http://dx.doi.org/10.4269/ajtmh.20-1569.
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ABSTRACTHuman trichinellosis can be diagnosed by a combination of medical history, clinical presentation, and laboratory findings, and through detection of anti–Trichinella IgG in the patient’s sera. ELISA using excretory–secretory (E/S) antigens of Trichinella spiralis larvae is currently the most used assay to detect Trichinella spp. antibodies. Bead-based assay can detect antibodies to multiple antigens concurrently; the ability to detect antibody to T. spiralis using a bead assay could be useful for diagnosis and surveillance. We developed and evaluated a bead assay to detect and quantify total IgG or IgG4 Trichinella spp. antibodies in human serum using T. spiralis E/S antigens. The sensitivity and specificity of the assay were determined using serum from 110 subjects with a confirmed diagnosis of trichinellosis, 140 subjects with confirmed infections with other tissue-dwelling parasites, 98 human serum samples from residents of the United States with no known history of parasitic infection, and nine human serum samples from residents of Egypt with negative microscopy for intestinal parasites. Sensitivity and specificity were 93.6% and 94.3% for total IgG and 89.2% and 99.2% for IgG4, respectively. Twelve percent of sera from patients with confirmed schistosomiasis reacted with the IgG Trichinella bead assay, as did 11% of sera from patients with neurocysticercosis. The Trichinella spp. bead assay to detect IgG total antibody responses has a similar performance as the Trichinella E/S ELISA. The Trichinella spp. bead assay shows promise as a method to detect trichinellosis with a possibility to be used in multiplex applications.
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Sande, Christopher M., Amanda B. Payne, Christine L. Kempton, Marilyn J. Manco-Johnson, and Anjali Sharathkumar. "Epidemiology of Inhibitors in Persons with Severe Hemophilia a in the United States: Analyses of a National Database." Blood 132, Supplement 1 (November 29, 2018): 2470. http://dx.doi.org/10.1182/blood-2018-99-109978.
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Abstract Background: Development of inhibitory alloantibodies, commonly known as "inhibitors," against exogenously infused factor VIII (FVIII) is the most significant complication of hemophilia therapy. The aim of this study was to understand the epidemiology of inhibitors in persons with severe hemophilia A (PWHA) in the United States using a national database, the Community Counts Registry for Bleeding Disorders Surveillance. Methods: The Community Counts Registry collects detailed medical information on patients with bleeding disorders who receive treatment within the US Hemophilia Treatment Center Network (USHTCN). Patients with severe hemophilia A with (PWHA-I) and without an inhibitor (PWHA-NI) enrolled in the registry between 12/1/2013 and 7/9/2018 were included in this cross-sectional exploratory analysis. PWHA designated as having an unknown history of inhibitor were excluded. Data elements included basic demographics (age, sex/gender, race, ethnicity, employment, insurance status), clinical characteristics (age of diagnosis, treatment characteristics), inhibitor characteristics (age at detection, inhibitor-specific treatments, titers, status), and outcome data (bleeding events, joint disease and procedures, intracranial hemorrhage, ED visits, hospitalizations, chronic pain, opioid use, and days missed from school/work). Data were categorized with reported frequencies, and comparisons between PWHA-I and PWHA-NI were made using Chi-square tests. Results: Of 4375 patients with severe hemophilia A, 1142 (26.1%) had a reported history of inhibitor. Among the cohort were 13 (0.30%) female and 7 (0.16%) transgender patients. PWHA-I and PWHA-NI were similarly distributed among sex/gender categories. PWHA-I were more frequently Hispanic, Latino/a, or Spanish origin or black or African American and less frequently white. Nearly all patients were insured, although PWHA-I more frequently utilized public insurance as opposed to commercial insurance as primary insurance, which may align with the lower rate of employment among PWHA-I (Table 1). PWHA-I more frequently reported a history of intracranial hemorrhage. Notably, no association was identified between inhibitor history and history of joint bleed, history of invasive joint procedure, or limitations of activity level at the time of assessment. During the 12 months prior to assessment, a lower percentage of PWHA-I reported hemophilia-related chronic pain, but those PWHA-I with chronic pain reported opioid use at a modestly increased rate. PWHA-I were more frequently seen in the emergency department and hospitalized than PWHA-NI during the 12 months prior to reporting, and PWHA-I reported more days missed from work or school (Table 1). Within the PWHA-I cohort, 45.7% of patients had inhibitors detected prior to age 2 years. The majority (64.8%) of PWHA-I had a history of immune tolerance induction and 56.3% reported using routine doses of FVIII concentrates to treat bleeding events. Bypassing agents and increased FVIII concentrates were each used for ~20% of PWHA-I (Table 2). Conclusions: This study provides an estimate of the burden of inhibitors in persons with severe hemophilia A in the US, representing approximately 52.9% of all severe hemophilia A patients treated in the USHTCN (CDC, unpublished data). History of an inhibitor reduced patient productivity and increased ED and hospital utilization. Future efforts will focus on a longitudinal analysis of this cohort to better understand the natural history and outcome of inhibitors and their impact on patient quality of life and health care utilization. Acknowledgments: This study was performed with the advice of the Community Counts Inhibitor Interest Group and was supported by funds from an ASH HONORS Award for Mr. Sande. Disclosures Payne: Shire: Other: treatment product donation; Genentech: Membership on an entity's Board of Directors or advisory committees; Bayer: Other: treatment product donation; Bioverativ: Other: treatment product donation; Novo Nordisk: Other: treatment product donation. Kempton:Novo Nordisk: Research Funding; Genetech, Inc: Honoraria, Research Funding; Shire: Honoraria; Bayer AG: Honoraria; Spark Therapeutics: Honoraria; Grifols: Honoraria; Catalyst Biosciences: Honoraria. Manco-Johnson:CSL Behring: Honoraria; Novo Nordisk: Honoraria; Biogentek: Honoraria; Bayer AG: Honoraria, Research Funding; Baxalta, now part of Shire: Honoraria. Sharathkumar:CSL Behring: Honoraria; Shire: Honoraria; Bayer: Honoraria.
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Khalifeh, Yara, Amir F. Beirat, Razan Aljaras, Dana Alhaffar, Ahmad Karkash, Adel Hajj Ali, Nasser H. Hanna, and Ali Ajrouch. "Empowering women’s health: Opportunity to bridge breast cancer screening to lung cancer screening." JCO Oncology Practice 19, no. 11_suppl (November 2023): 121. http://dx.doi.org/10.1200/op.2023.19.11_suppl.121.
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121 Background: Lung cancer (LC) is the leading cause of cancer-related death for women in the United States (US). It surpasses the combined mortality rate of breast, cervical and ovarian cancers. Early detection of LC at stage I increases the 5-year survival rate to 80%. Lung Cancer Screening (LCS) is an effective tool for early detection. However, while 78% of women over 50 in the US undergo Breast Cancer Screening (BCS), only 6% of eligible women receive LCS. Methods: This is a retrospective study of all women diagnosed with primary LC presenting to Indiana University Simon Comprehensive Cancer Center from January 2019 to December 2020. We collected sociodemographic characteristics and information related to smoking history, LCS and BCS. We excluded patients with a prior history of lung or breast cancer who were under surveillance, and those with unknown smoking history. We assessed the BCS and LCS eligibility and utilization according to the U.S. Preventive Services Task Force latest recommendations. We also determined the utilization of LCS in women who have received BCS. Results: Among the 307 women who met the eligibility criteria, 87.6% were white, 51.8% had a Medicare insurance, 41.7% were ever-smoker, and 64.5% had advanced stages of LC (Stage II-Stage IV). Approximately half of our cohort was eligible for LCS, but only 20% received LCS. On the other hand, 72% were eligible for BCS and 58% of them underwent BCS. Among women who received BCS and were eligible for LCS, only25% underwent LCS. The median time from BCS to LC diagnosis was approximately 2.2 years. Among the 178 women who received BCS within one year prior to LC diagnosis, 27% underwent LCS. Among the remaining women who did not have LCS,66.7% of women were already in a later stage (Stage II-IV) at the time of LC diagnosis. Conclusions: Our study demonstrates that majority of women, who met the eligibility criteria for BCS and LCS, received BCS but not LCS prior to their LC diagnosis. This shows that despite the potential mortality benefit, LCS is still underutilized. Receiving LCS at the time of BCS can provide a valuable opportunity to increase LCS participation among eligible women and the potential of diagnosing LC at earlier stages.
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Huang, Xuelin, Yisheng Li, Juhee Song, and Donald A. Berry. "A Bayesian Simulation Model for Breast Cancer Screening, Incidence, Treatment, and Mortality." Medical Decision Making 38, no. 1_suppl (June 19, 2017): 78S—88S. http://dx.doi.org/10.1177/0272989x17714473.
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Background. The important but complicated research questions regarding the optimization of mammography screening for the detection of breast cancer are unable to be answered through any single trial or a simple meta-analysis of related trials. The Cancer Intervention and Surveillance Network (CISNET) breast groups provide answers using complex statistical models to simulate population dynamics. Among them, the MD Anderson Cancer Center (Model M) takes a unique approach by not making any assumptions on the natural history of breast cancer, such as the distribution of the indolent time before detection, but simulating only the observable part of a woman’s disease and life. Methods. The simulations start with 4 million women in the age distribution found in the year 1975, and follow them over several years. Input parameters are used to describe their breast cancer incidence rates, treatment efficacy, and survival. With these parameters, each woman’s history of breast cancer diagnosis, treatment, and survival are generated and recorded each year. Research questions can then be answered by comparing the outcomes of interest, such as mortality rates, quality-adjusted life years, number of false positives, differences between hypothetical scenarios, such as different combinations of screening and treatment strategies. We use our model to estimate the relative contributions of screening and treatments on the mortality reduction in the United States, for both overall and different molecular (ER, HER2) subtypes of breast cancer. Results. We estimate and compare the benefits (life-years gained) and harm (false-positives, over-diagnoses) of mammography screening strategies with different frequencies (annual, biennial, triennial, mixed) and different starting (40 and 50 years) and end ages (70 and 80 years). Conclusions. We will extend our model in future studies to account for local, regional, and distant disease recurrences.
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Gudina, Abdi T., Lee A. Kehoe, Sara Hardy, Charles S. Kamen, and Paula Cupertino. "Abstract C113: Geographic variation in low-dose computed tomography scanning for lung cancer screening in the United States." Cancer Epidemiology, Biomarkers & Prevention 32, no. 12_Supplement (December 1, 2023): C113. http://dx.doi.org/10.1158/1538-7755.disp23-c113.
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Abstract Background: Early detection using low-dose computed tomography scanning reduces lung cancer specific mortality by 20%. Despite its efficacy and its recommendation by the United States Preventive Services Task Force, the uptake of lung cancer screening (LCS) among high-risk individuals (aged 55–80 years with a >30-pack-year smoking history and who currently smoke or have quit within the previous 15 years) remains low. The purpose of this study was to assess whether LCS uptake varies by geographic location. Methods: Data for this study were obtained from the 2019 Behavioral Risk Factor Surveillance System. After excluding ineligible subjects, 10,242 subjects were included in the final analysis. Multivariable logistic regression models were used to model the associations between the predictor and the outcome variable, adjusting for potential confounders. Results: In metropolitan statistical areas, individuals who reside outside the center city are less likely to receive LCS than those who reside in the center city (OR: 0.65; 95% CI: 0.43 – 0.98). Stratifying the data by race/ethnicity, we found a non-significant difference between Whites who reside in the center city and those outside the center city in LCS uptake (OR: 0.69; 95% CI: 0.45 – 1.06). Among Blacks (OR:0.10; 95% CI: 0.02 – 0.59) and other minorities (OR:0.10; 95% CI: 0.02 – 0.63), individuals who reside outside the center city are less likely to receive LCS than their respective counterparts residing in the center city. Nevertheless, we found a non-significant difference in LCS uptake between urban and rural counties (OR: 1.06; 95% CI: 0.76-1.48).Conclusions: LCS uptake is related to metropolitan statistical area (residents in the center city vs. outside the center city), but it is modified by race/ethnicity. This finding has important implications for policy makers and program planners in helping them design more effective interventions to promote LCS targeting racial/ethnic minorities residing outside the center city. Citation Format: Abdi T. Gudina, Lee A. Kehoe, Sara Hardy, Charles S. Kamen, Paula Cupertino. Geographic variation in low-dose computed tomography scanning for lung cancer screening in the United States [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C113.
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Gill, Gurmat, Avnish Sandhu, Jordan Polistico, Reda Awali, Sara McNamara, and Teena Chopra. "Epidemiology of NDM-Producing Enterobacteriaceae in Michigan." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s217—s218. http://dx.doi.org/10.1017/ice.2020.761.
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Background: Carbapenem-resistant Enterobacteriaceae (CRE) are classified as an urgent antibiotic-resistant threat by the CDC, and they are listed on the critical priority list by the World Health Organization due to the lack of antibiotic treatment options. New-Delhi metallo-β-lactamase (NDM) is an emerging mechanism of carbapenem resistance in the United States. We sought to understand the risk factors and clinical characteristics of patients with NDM CRE in Michigan to improve surveillance. Methods:A retrospective descriptive study was conducted in collaboration with the Michigan Department of Health and Human Services (MDHHS). CRE isolates submitted to MDHHS between April 2014 and July 2019 were tested for the presence of NDM using CDC PCR protocols. Additional information on case demographics, laboratory results, healthcare and antibiotic exposure history, and travel history were collected. Results: In total, 30 NDM cases were identified in Michigan during the study period. Of these 30 cases, 15 (50%) were men, and the median age was 73.5 years (range, 20–88 20). Also, 2 of these patients (6.6%) were immunocompromised; 2 patients (6.6%) had had extensive abdominal surgery, and 2 patients (6.6%) had recurrent hospitalization. Furthermore, 12 case isolates (40%) were collected in outpatient settings, whereas 16 (53%) were collected from inpatient settings. In addition, 13 (43%) patients were admitted from home and 4 (13%) presented from an extended-care facility. Urine was the most common site of isolation in 19 of 30 (63%) cases, followed by blood and tissue culture in 4 of 30 (13%) each. Escherichia coli was the most common organism (17 of 30, 57%), followed by Klebsiella pneumoniae (9 of 30, 30%). Also, 15 of 30 cases (50%) had a recent history of international travel, and of these, 9 of 15 (60%) reported travel to India. Among these 15 cases, 12 (80%) sought medical care in the countries they visited. Two cases (6.6%) had a documented history of multidrug-resistant organism colonization or infection. The mortality rate was 6.6% (2 of 30). The mean time from admission to implementation of contact precautions was 7.3 days (range, 0–20). Conclusions: Suspicion of NDM CRE strains should remain high in patients with a travel history from areas known as major reservoirs of NDM. Delay in implementing contact precautions, as noted in the present study, can lead to a greater risk of transmission. Early detection and subsequent isolation of NDM patients are essential strategies for preventing transmission within healthcare facilities. Future efforts include performing whole-genome sequencing of these isolates to assist in identifying potential epidemiological links among the affected patients.Funding: NoneDisclosures: None
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Negley, Jeanne, Elizabeth Smith, Maroya Walters, Tonia Parrott, Richard Stanton, David Ham, Jacobs Slifka Kara, et al. "Transmission of Carbapenemase-Producing Hypervirulent Klebsiella pneumoniae in Georgia, 2018–2019." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s414—s415. http://dx.doi.org/10.1017/ice.2020.1070.
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Background: In April 2019, the Georgia Department of Public Health (DPH) initiated whole-genome sequencing (WGS) on NDM-producing Enterobacteriaceae identified since January 2018. The WGS data analyzed at CDC identified related Klebsiella pneumoniae isolates with hypervirulence markers from 2 patients. Carbapenemase-producing hypervirulent K. pneumoniae (CP-hvKP) are rarely reported in the United States, but they can to cause serious, highly resistant, invasive infections. We conducted an investigation to identify cases and prevent spread. Methods: We defined a case as NDM-producing K. pneumoniae with ≥4 hypervirulence markers identified by WGS, isolated from any specimen source from a Georgia patient. We reviewed the case patient’s medical history to identify potentially affected facilities. We also performed PCR-based colonization screening and retrospective and prospective laboratory-based surveillance. Finally, we assessed facility infection control practices. Results: Overall, 7 cases from 3 case patients (A, B, and C) were identified (Fig. 1). The index case specimen was collected from case-patient A at ventilator-capable skilled nursing facility 1 (vSNF1) in May 2018. Case-patient A had been hospitalized for 1 month in India before transfer to the United States. Case-patient B’s initial isolate was collected in January 2019 on admission to vSNF2 from a critical access hospital (CAH). The CAH laboratory retrospectively identified case-patient C, who overlapped with case-patient B at the CAH in October 2018. The CAH and the vSNF2 are geographically distant from vSNF1. Case-patients B and C had no known epidemiologic links to case-patient A. Colonization screening occurred at vSNF1 in May 2018, following detection of NDM-producing K. pneumoniae from case-patient A ∼1 year before determining that the isolate carried hypervirulence markers. Among 30 residents screened, 1 had NDM and several had other carbapenemases. Subsequent screening did not identify additional NDM. Colonization screening of 112 vSNF2 residents and 13 CAH patients in 2019 did not reveal additional case patients; case-patient B resided at vSNF2 at the time of screening and remained colonized. At all 3 facilities, the DPH assessed infection control practices, issued recommendations to resolve lapses, and monitored implementation. The DPH sequenced all 27 Georgia NDM–K. pneumoniae isolates identified since January 2018; all were different multilocus sequence types from the CP-hvKP isolates, and none possessed hypervirulence markers. Conclusions: We hypothesize that CP-hvKP was imported by a patient hospitalized in India and spread to 3 Georgia facilities in 2 distinct geographic regions through indirect patient transfers. Although a response to contain NDM at vSNF1 in 2018 likely limited CP-hvKP transmission, WGS identified hvKP and established the relatedness of isolates from distinct regions, thereby directing the DPH’s additional containment activities to halt transmission.Funding: NoneDisclosures: None
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Whittaker, Meredith, Kiah Farr, Preethika Potluri, Nova Foster, Jennifer Erdrich, Jennifer Segar, Sima Ehsani, Sao Jiralerspong, Denise Roe, and Pavani Chalasani. "Abstract P1-05-04: Physician Practice Patterns of Breast Imaging After Treatment: Survey of Real-World Practice." Cancer Research 83, no. 5_Supplement (March 1, 2023): P1–05–04—P1–05–04. http://dx.doi.org/10.1158/1538-7445.sabcs22-p1-05-04.
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Abstract Introduction: Mammography is the cornerstone of breast cancer screening, diagnosis, and surveillance. After definitive treatment for breast cancer, mammograms are continued for surveillance. The current recommendations regarding surveillance after definitive treatment (surgery and radiation) lack consensus amongst various societies. There are no clear guidelines in regards to the type of mammogram recommended: diagnostic or screening mammogram or if a diagnostic mammogram is used, when to return to routine screening protocols. Current practice patterns are driven by physician’s preference. We conducted a survey to evaluate physicians’ preferences in ordering breast imaging post- breast cancer diagnosis and treatment. Methods: This survey was approved by University of Arizona institutional review board. This survey was conducted through American Society of Clinical Oncology (ASCO) voluntary opt-in Research Survey Pool (RSP). ASCO sent out this survey to 1000 randomly selected members between 10/19/2021-11/22/2021. Weekly reminders to participate were sent through the ASCO RSP for 5 weeks. Participants clicked the link to the survey platform where upon consent they completed the survey. Results: The survey was completed by 244 healthcare professionals through the ASCO RSP. Most respondents were physicians (n=228), primarily medical oncologists (n=174) and practiced in an academic environment in the United States (n=132). After definitive treatment, majority (58%) ordered first imaging at 6 months post-surgery/radiation, and it was primarily a diagnostic mammogram (68%). Interestingly, for patients at age 80 or above, screening mammogram was used for surveillance after definitive treatment by most respondents (59%). After first post-surgery/radiation mammogram there is an almost even spilt (50%) on continuing with diagnostic versus screening mammograms for follow up. Of those who order diagnostic mammograms, majority (38%) do it for 3-5 years with an additional 30% continuing it beyond 5 years. Almost 65% of respondents reported they do not stop screening mammograms at any age for patients with a history of early-stage breast cancer as long as they are healthy. Conclusions: The practice patterns of healthcare professionals as it relates to the type and frequency of breast imaging varies significantly. Despite having the same imaging quality there is a significant difference in the cost of screening and diagnostic mammograms. In addition, in clinical practice, most routine screening care is covered by insurances without co-pays or out of pocket costs for patients. Diagnostic imaging does not fall under routine screening care and frequently requires out of pocket expenses for patients. As insurance companies start to decline certain imaging modalities used for cancer detection due to lack of data supporting the use of these expensive studies, specific imaging guidelines for follow up in post-treatment setting for patients with breast cancer are needed. Citation Format: Meredith Whittaker, Kiah Farr, Preethika Potluri, Nova Foster, Jennifer Erdrich, Jennifer Segar, Sima Ehsani, Sao Jiralerspong, Denise Roe, Pavani Chalasani. Physician Practice Patterns of Breast Imaging After Treatment: Survey of Real-World Practice [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P1-05-04.
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White, Lindsey J., Antarpreet Kaur, Raechel T. Lapel, Gilbert E Boswell, Robert E. Luceri, John Scott Parrish, and Gilbert Seda. "Lung Cancer Screening at a Military Treatment Facility: A Retrospective Review." Military Medicine 185, no. 5-6 (January 11, 2020): e864-e869. http://dx.doi.org/10.1093/milmed/usz386.
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Abstract Introduction Lung cancer is the leading cause of cancer death among men and women, accounting for more fatalities than colon, breast, and prostate cancers combined. Smoking causes about 85% of all lung cancers in the United States and is the single greatest risk factor. In 2013, the US Preventive Services Task Force (USPSTF) published initial guidelines for low-dose computed tomography lung cancer screening (LCS) among patients 55–80 years old, with a 30-pack-year history, who are current smokers or who quit within the previous 15 years. Smoking prevalence is higher among military personnel compared to the civilian population, demonstrating a need for vigilant screening. Materials and Methods A retrospective review of Naval Medical Center San Diego’s (NMCSD) LCS data was conducted to examine screening numbers, lung cancer rates, and initial analysis of screening results. Patients were referred for screening if they met the USPSTF criteria. Between September 2013 and September 2018, 962 patients underwent LCS. A total of 1758 examinations were performed, including follow-up and annual surveillance examinations. The American College of Radiology’s Lung CT Screening Reporting and Data System (Lung-RADS) was used to classify lung nodules’ risk for malignancy. Results On this initial analysis, 42 enrolled patients received the diagnosis of lung cancer detected by screening. The initial calculated lung cancer rate is 4.4% (42/962) over the 5-year reporting period. The lung cancer rate among those patients with a Lung-RADS score of 3 or 4 was 31% (42/135). Thirty-seven patients were classified as having non-small cell lung cancer (NSCLC), while five were classified as having small cell lung cancer. Of the 37 NSCLC patients, 76% (28/37) were diagnosed at stage I and II, 11% (4/37) were diagnosed at stage III, and 13% (5/37) were diagnosed at stage IV. The total number of years a person smoked was a significant risk factor (P = 0.004), but not pack-years a person smoked (P = 0.052). Conclusions These preliminary results demonstrate the success of a Military Treatment Facility (MTF)-based LCS Program in the detection of early stage lung cancer. Earlier stage detection may result in better health outcomes for affected patients. In the population studied, duration of smoking proved to be more significant than pack-years in predicting lung cancer risk. These results validate the newly dedicated resources and continued efforts to strengthen the LCS program at NMCSD and across MTFs.
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Li, Shi, Caixia Chen, Hua Zhu, Qi Lin, and Zhixian Yu. "Risk Evaluation of Bone Metastases and a Simple Tool for Detecting Bone Metastases in Prostate Cancer: A Population-Based Study." Computational and Mathematical Methods in Medicine 2023 (February 14, 2023): 1–13. http://dx.doi.org/10.1155/2023/9161763.
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Introduction. Population-based estimates of the incidence and prognosis of bone metastases in prostate cancer (PC) are lacking. We aimed to characterize the incidence and risk of bone metastases and develop a simple tool for the prediction of bone metastases among patients with PC. Methods. Data were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. A total of 75698 patients with PC with confirmed presence or absence of bone metastases at diagnosis between 1975 and 2019 in the United States were used for analysis. Data were stratified by age, race, residence, median income, prostate-specific antigen (PSA) values, tumor size, distant metastatic history, and positive lymph node scores. Multivariable logistic and Cox regressions were performed to identify predictors of bone metastases and factors correlated with all-cause mortality. Classification tree analysis was performed to establish a model. Results. After patients with PC with missing data were excluded, 75698 cases remained. Among these, 3835 patients had bone metastases. Incidence proportions were highest in patients with a high prostate-specific antigen (PSA) value (odds ratio (OR), 2.49; 95% confidence interval (CI), 1.35-4.35; p < 0.002 ). Multivariable Cox regression and risk analyses indicated that high PSA values (hazards ratio (HR), 19.8; 95% CI, 18.5-21.2; p < 0.001 ) and high positive lymph node scores (vs. score 0; HR, 8.65; 95% CI, 7.89-9.49; p < 0.001 ) were significant risk factors for mortality. Meanwhile, in the predication tree analysis, PSA values and lymph node scores were the most significant determining factors in two models. Median survival among the patients with PC was 78 months, but only 31 months among those with bone metastases. Conclusion. Patients with PC with high PSA values or high positive lymph node scores were at a significantly higher risk of bone metastases. Our study may provide a simple and accurate tool to identify patients with PC at high risk of bone metastases based on population-based estimates.
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Cox, Hannah, Deborah Hartzfeld, Shawn Gessy, Christina Zaleski, and Jerry Machado. "Abstract PO1-08-08: Hereditary cancer genetic testing in Puerto Rican females." Cancer Research 84, no. 9_Supplement (May 2, 2024): PO1–08–08—PO1–08–08. http://dx.doi.org/10.1158/1538-7445.sabcs23-po1-08-08.
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Abstract Background: Puerto Rico is a Caribbean Island and unincorporated United States territory with a population of approximately 3.2 million. The incidence of breast cancer in Puerto Rico is estimated at 57.5 per 100,000 females with a mortality rate of 13.0 per 100,000 females. A recent study of hereditary breast and ovarian cancer syndrome across countries in the Caribbean reported a combined positive detection rate of 14.2% using a similar multi-gene panel to the one described here. Positive rates ranged from 5.5% to 28.3% per country, but sample sizes were limited, ranged from 61 to 298 participants per country, and did not include Puerto Rico. To provide insight into the incidence of inherited tumor predisposition syndromes in less studied populations, we analyzed the demographics and germline genetic findings for a cohort of Puerto Rican females largely ascertained based on a personal and/or family history of breast cancer. Methods: This retrospective study includes 949 consecutive female individuals who underwent genetic testing at a single clinical laboratory (PreventionGenetics LLC) using a multi-gene panel test of 29 genes associated with hereditary cancer. Clinical information was obtained from health care provider-completed test requisition forms. Next Generation Sequencing (NGS) with copy number variant (CNV) detection was performed on patient-derived DNA using the Illumina NovaSeq 6000 platform (Illumina, San Diego, CA, USA) and Sanger sequencing as necessary. Results: The median age at testing was 55.5 years and ranged from 19.1 to 90.0 years of age. Of the total cohort, 713 (75.1%) individuals had a personal history of breast cancer with or without additional cancer types; 43 (4.5%) individuals had non-cancerous breast findings, and 49 (5.2%) individuals had a personal history of other types of cancer(s). The remaining 144 (15.2%) individuals did not specify a personal history, but the vast majority did indicate a family history of cancer (n=133; 93.8%). Comparably, 572 (60.3%) of the individuals with a personal history of cancer or of non-cancerous breast findings reported a family history of cancer. The median age at onset for breast cancer was 53 years (n=472; range=24-89 years). A total of 90 (9.5%) individuals had a pathogenic (P) or likely pathogenic (LP) and 3 (0.3%) of individuals harbored the APC I1307K risk variant. Of the 90 individuals with positive findings, 31.1% had a P/LP variant in BRCA2, 28.0% in MUTYH, 11.8% in CHEK2, 7.5% in BRCA1, in 6.5% BRIP1, and 11.8% in ATM, CDKN2A, MSH6, NBN, PALB2, RAD51C, RAD51D, and RET. The most frequently reported pathogenic variants were MUTYH p.Gly396Asp (n=20), BRCA2 p.Glu1308* (n=16), and BRCA2 p.Asn1933Lysfs*29 (n=6). A recurrent pathogenic deletion of the upstream and exon 2 region of BRCA1 was also identified in three individuals. The indeterminate and negative rates were 36.5% (n=346) and 53.7% (n=510), respectively. Conclusion: Although the present study was limited to biological females and included individuals with broader personal and family cancer histories, the positive rate is within range of those reported for other countries in the Caribbean. Interestingly, P/LP variants have been reported to be enriched in BRCA1, BRCA2, and PALB2 across other Caribbean countries; however, this was not mirrored in the pattern of positive findings for this cohort of Puerto Rican females and may suggest a distinct background for hereditary cancer predisposition in this population. Further studies are needed to understand the landscape of germline variants in this population to ensure proper surveillance and risk mitigation is applied. Citation Format: Hannah Cox, Deborah Hartzfeld, Shawn Gessy, Christina Zaleski, Jerry Machado. Hereditary cancer genetic testing in Puerto Rican females [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-08-08.
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Weldon, Emily, Naveen Patil, Jan Voyles, Sandra Chai, Marsha Majors, and Leonard Mukasa. "770. Multi-Drug-Resistant Tuberculosis Cases in Arkansas in 2017: A Tale of Two Threats." Open Forum Infectious Diseases 5, suppl_1 (November 2018): S276. http://dx.doi.org/10.1093/ofid/ofy210.777.
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Abstract Background Multi-drug-resistant tuberculosis (MDR-TB) is a threat to TB elimination strategies worldwide. From 1998 to 2016, six cases of MDR-TB were reported in Arkansas. In 2017 alone, three cases were detected. We sought to describe the characteristics of these cases to inform our MDR-TB prevention strategy in AR. Methods The surveillance database identified three MDR-TB cases in 2017. A detailed review was done to define the demographics, clinical presentation, and laboratory reports relating to drug susceptibility testing (DST), including molecular detection of drug resistance (MDDR). A search was done in the Genotyping database for genotype patterns of the patient isolates. Results All three cases were born outside the United States and developed active disease after arrival in AR. Case 1, age 52, was born in the Marshall Islands, arrived in 2016, and had a history of Type 2 diabetes. He developed MDR-TB in February 2017. Case 2, age 42, was born in Mexico, arrived over 20 years ago, and was HIV positive. He developed TB in July 2016 with a pan-sensitive organism and completed an intermittent treatment regimen. A second TB episode with matching genotype but different drug sensitivities occurred in April 2017, less than 4 months after treatment completion, and was considered treatment failure. Case 3, age 56, was born in the Philippines, arrived in 1990, and was reportedly treated for latent TB infection in 1993 with 6 months of isoniazid. She visited the Philippines April–May 2017 and developed MDR-TB in October 2017. Her isolate was in cluster with a case in Oklahoma who came from Mexico in 2006 and was admitted in an AR hospital with a pan-sensitive organism. There are no epidemiological links between the two cases; only one isolate in each case. Because both isolates were identified in AR State TB laboratory, a complex contamination has been considered with no definite resolution at this time. Conclusion MDR-TB, due to both primary and secondary drug resistance, remains a threat in AR. Cooperation and communication between all levels of healthcare are crucial to avoid delayed diagnosis of MDR-TB. Timely DST via technologies like GeneXpert and MDDR service at CDC is critical. Consultation from Centers of Excellence is vital in the treatment of MDR-TB complicated by diabetes and HIV. Whole-genome sequencing could provide clarity in the cluster with discordant DST patterns. Disclosures All authors: No reported disclosures.
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Cawcutt, Kelly, Mark Rupp, and Lauren Musil. "COVID-19 and Ventilator-Associated Event Discordance." Antimicrobial Stewardship & Healthcare Epidemiology 1, S1 (July 2021): s45. http://dx.doi.org/10.1017/ash.2021.82.
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Background: The COVID-19 pandemic has challenged healthcare facilities since its discovery in late 2019. Notably, the subsequent COVID-19 pandemic has led to an increase in healthcare-acquired infections such as ventilator associated events (VAEs). Many hospitals in the United States perform surveillance for the NHSN for VAEs by monitoring mechanically ventilated patients for metrics that are generally considered to be objective and preventable and that lead to poor patient outcomes. The VAE definition is met in a stepwise manner. Initially, a ventilator-associated condition (VAC) is met when there an increase in ventilator requirements after a period of stability or improvement. An IVAC is then met when there is evidence of an infectious process such as leukocytosis or fever and a new antimicrobial agent is started. Finally, possible ventilator-associated pneumonia (PVAP) is met when there is evidence of microbial growth or viral detection. Since the beginning of the COVID-19 pandemic, our hospital has seen an increase in VAEs, which is, perhaps, not unexpected during a respiratory illness pandemic. However, the NSHN definitions of VAE, and PVAP in particular, do not account for the novelty and nuances of COVID-19. Methods: We performed a chart review of 144 patients who had a VAE reported to the NHSN between March 1 and December 31, 2020. Results: Of the 144 patients with a VAE reported to NHSN, 39 were SARS-CoV-2 positive. Of the 39 patients, 4 patients (10.25%) met the NHSN PVAP definition due to a positive SARS-CoV-2 PCR that was collected in the prolonged viral shedding period of their illness (< 90 days). One of the four patients also had a bacterial infection in addition to their subsequent positive COVID-19 result. All these patients were admitted to the hospital with a COVID-19 diagnosis and their initial PCR swab was performed upon admission. Conclusions: We believe that the PVAP definition was inappropriately triggered by patients who were decompensating on the ventilator due to a novel respiratory virus that was present on admission. Early in the pandemic, frequent swabbing of these patients was performed to try and understand the duration of viral shedding and to determine when it would be safe to transfer patients from isolation after prolonged hospitalization. The NSHN definition should take into consideration the prolonged viral shedding period of COVID-19 and natural history of the illness, and subsequent COVID-19 testing within 90 days of an initial positive should not require classification as a hospital-acquired PVAP.Funding: NoDisclosures: None
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BOKMA, BOB H., CHERYL HALL, LYNNE M. SIEGFRIED, and J. TODD WEAVER. "Surveillance for Avian Influenza in the United States." Annals of the New York Academy of Sciences 1081, no. 1 (October 2006): 163–68. http://dx.doi.org/10.1196/annals.1373.018.
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Patel, Sajan, Siran Koroukian, Johnie Rose, Long Vu, and Holly Hartman. "Abstract C125: Prostate specific antigen testing patterns and prostate cancer stage at diagnosis in Ohio cancer patients." Cancer Epidemiology, Biomarkers & Prevention 32, no. 12_Supplement (December 1, 2023): C125. http://dx.doi.org/10.1158/1538-7755.disp23-c125.
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Abstract Summary Statement This study aims to: 1) examine patterns of prostate specific antigen (PSA) testing — diagnostic or screening — across subgroups of prostate cancer (PCa) patients; and 2) analyze patterns of PSA testing in relation to PCa stage at diagnosis. Background Recommendations for PSA tests, blood-based screenings used for PCa detection, are issued by the United States Preventive Services Task Force. Changes in national recommendations, as well as demographic and clinical information can influence the likelihood of an individual receiving a PSA test, and the subsequent PCa diagnosis. Methods Using data from the 2014-2016 linked Ohio Cancer Incidence Surveillance System (OCISS) and Medicare database, we categorized PSA testing as diagnostic or screening, based on diagnosis and procedure codes. Bivariate analyses were conducted on several factors, including patient demographics, claims-based frailty measures, and certain social determinants of health, to evaluate their association with receipt of screening PSA and stage of PCa diagnosis. Two multivariable logistic regression models were created to identify factors associated with receipt of screening PSA test, and subsequently, of being diagnosed with distant stage PCa. Results After excluding individuals identified without any PSA testing in the three years prior to diagnosis (n = 964) and those with unknown staged cancer (n = 446), our final study population included 3034 Ohio men diagnosed with PCa between 2014-2016. The median age was 73 years. Being of older age at the time of PCa diagnosis (adjusted odds ratio (aOR): 0.95 [95% confidence interval: 0.94, 0.97]) was associated with significantly lower odds of being screened. Compared to non-frail men, pre-frail patients (aOR: 0.69 [0.57, 0.84]) and patients with mild to severe frailty (aOR: 0.54 [0.39, 0.75]) also had decreased odds of being screened. History of receipt of screening PSA tests was associated with lower odds of being diagnosed with distant stage disease (aOR: 0.55 [0.42, 0.72]). On the other hand, being of older age at the time of PCa diagnosis (aOR: 1.14 [1.12, 1.17]), having moderate to severe frailty (compared to non-frailty) (aOR: 4.30 [2.38, 8.02]), and being separated or divorced (compared to being married) (aOR: 1.75 [1.06, 2.78]), were associated with increased odds of being diagnosed with distant stage disease. Conclusions Younger age and lower gradients of frailty were strongly associated with receipt of screening PSA. In turn, receipt of screening PSA was associated with early stage PCa, while being older, having higher degrees of frailty, and being divorced or separated from a spouse, were associated with elevated odds of distant stage PCa. This study adds to existing evidence suggesting that PSA-based screening may promote earlier detection of prostate cancer in a real-world setting and challenges preexisting beliefs on the usefulness of PSA testing in older populations. Citation Format: Sajan Patel, Siran Koroukian, Johnie Rose, Long Vu, Holly Hartman. Prostate specific antigen testing patterns and prostate cancer stage at diagnosis in Ohio cancer patients [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C125.
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Omura, John D., Geoffrey P. Whitfield, Tiffany J. Chen, Eric T. Hyde, Emily N. Ussery, Kathleen B. Watson, and Susan A. Carlson. "Surveillance of Physical Activity and Sedentary Behavior Among Youth and Adults in the United States: History and Opportunities." Journal of Physical Activity and Health 18, S1 (August 1, 2021): S6—S24. http://dx.doi.org/10.1123/jpah.2021-0179.
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Background: Surveillance is a core function of public health, and approaches to national surveillance of physical activity and sedentary behavior have evolved over the past 2 decades. The purpose of this paper is to provide an overview of surveillance of physical activity and sedentary behavior in the United States over the past 2 decades, along with related challenges and emerging opportunities. Methods: The authors reviewed key national surveillance systems for the assessment of physical activity and sedentary behavior among youth and adults in the United States between 2000 and 2019. Results: Over the past 20 years, 8 surveillance systems have assessed physical activity, and 5 of those have assessed sedentary behavior. Three of the 8 originated in nonpublic health agencies. Most systems have assessed physical activity and sedentary behavior via surveys. However, survey questions varied over time within and also across systems, resulting in a wide array of available data. Conclusion: The evolving nature of physical activity surveillance in the United States has resulted in both broad challenges (eg, balancing content with survey space; providing data at the national, state, and local level; adapting traditional physical activity measures and survey designs; and addressing variation across surveillance systems) and related opportunities.
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Silverman, Justin D., Nathaniel Hupert, and Alex D. Washburne. "Using influenza surveillance networks to estimate state-specific prevalence of SARS-CoV-2 in the United States." Science Translational Medicine 12, no. 554 (June 22, 2020): eabc1126. http://dx.doi.org/10.1126/scitranslmed.abc1126.
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Detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections to date has relied heavily on reverse transcription polymerase chain reaction testing. However, limited test availability, high false-negative rates, and the existence of asymptomatic or subclinical infections have resulted in an undercounting of the true prevalence of SARS-CoV-2. Here, we show how influenza-like illness (ILI) outpatient surveillance data can be used to estimate the prevalence of SARS-CoV-2. We found a surge of non-influenza ILI above the seasonal average in March 2020 and showed that this surge correlated with coronavirus disease 2019 (COVID-19) case counts across states. If one-third of patients infected with SARS-CoV-2 in the United States sought care, this ILI surge would have corresponded to more than 8.7 million new SARS-CoV-2 infections across the United States during the 3-week period from 8 to 28 March 2020. Combining excess ILI counts with the date of onset of community transmission in the United States, we also show that the early epidemic in the United States was unlikely to have been doubling slower than every 4 days. Together, these results suggest a conceptual model for the COVID-19 epidemic in the United States characterized by rapid spread across the United States with more than 80% infected individuals remaining undetected. We emphasize the importance of testing these findings with seroprevalence data and discuss the broader potential to use syndromic surveillance for early detection and understanding of emerging infectious diseases.
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Manangan, Lilia Ponce, Cheryl Tryon, Elvin Magee, and Roque Miramontes. "Innovative Quality-Assurance Strategies for Tuberculosis Surveillance in the United States." Tuberculosis Research and Treatment 2012 (2012): 1–11. http://dx.doi.org/10.1155/2012/481230.
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Introduction. The Centers for Disease Control and Prevention (CDC)’s National Tuberculosis Surveillance System (NTSS) is the national repository of tuberculosis (TB) data in the United States. Jurisdictions report to NTSS through the Report of Verified Case of Tuberculosis (RVCT) form that transitioned to a web-based system in 2009.Materials and Methods. To improve RVCT data quality, CDC conducted a quality assurance (QA) needs assessment to develop QA strategies. These include QA components (case detection, data accuracy, completeness, timeliness, data security, and confidentiality); sample tools such as National TB Indicators Project (NTIP) to identify TB case reporting discrepancies; comprehensive training course; resource guide and toolkit.Results and Discussion. During July–September 2011, 73 staff from 34 (57%) of 60 reporting jurisdictions participated in QA training. Participants stated usefulness of sharing jurisdictions’ QA methods; 66 (93%) wrote that the QA tools will be effective for their activities. Several jurisdictions reported implementation of QA tools pertinent to their programs. Data showed >8% increase in NTSS and NTIP enrollment through Secure Access Management Services, which monitors system usage, from August 2011–February 2012.Conclusions. Despite challenges imposed by web-based surveillance systems, QA strategies can be developed with innovation and collaboration. These strategies can also be used by other disease programs to ensure high data quality.
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Rowan, Sean, Nazleen Mohseni, Mariann Chang, Hannah Burger, Mykah Peters, and Sheema Mir. "From Tick to Test: A Comprehensive Review of Tick-Borne Disease Diagnostics and Surveillance Methods in the United States." Life 13, no. 10 (October 13, 2023): 2048. http://dx.doi.org/10.3390/life13102048.
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Tick-borne diseases (TBDs) have become a significant public health concern in the United States over the past few decades. The increasing incidence and geographical spread of these diseases have prompted the implementation of robust surveillance systems to monitor their prevalence, distribution, and impact on human health. This comprehensive review describes key disease features with the geographical distribution of all known tick-borne pathogens in the United States, along with examining disease surveillance efforts, focusing on strategies, challenges, and advancements. Surveillance methods include passive and active surveillance, laboratory-based surveillance, sentinel surveillance, and a One Health approach. Key surveillance systems, such as the National Notifiable Diseases Surveillance System (NNDSS), TickNET, and the Tick-Borne Disease Laboratory Network (TBDLN), are discussed. Data collection and reporting challenges, such as underreporting and misdiagnosis, are highlighted. The review addresses challenges, including lack of standardization, surveillance in non-human hosts, and data integration. Innovations encompass molecular techniques, syndromic surveillance, and tick surveillance programs. Implications for public health cover prevention strategies, early detection, treatment, and public education. Future directions emphasize enhanced surveillance networks, integrated vector management, research priorities, and policy implications. This review enhances understanding of TBD surveillance, aiding in informed decision-making for effective disease prevention and control. By understanding the current surveillance landscape, public health officials, researchers, and policymakers can make informed decisions to mitigate the burden of (TBDs).
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Olumuyiwa Tolulope Ojeyinka and Toritsemogba Tosanbami Omaghomi. "Integrative strategies for zoonotic disease surveillance: A review of one health implementation in the United States." World Journal of Biology Pharmacy and Health Sciences 17, no. 3 (March 30, 2024): 075–86. http://dx.doi.org/10.30574/wjbphs.2024.17.3.0124.
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Zoonotic diseases pose significant public health threats worldwide, highlighting the need for effective surveillance strategies. The One Health approach, which recognizes the interconnection between human, animal, and environmental health, has gained traction as a comprehensive framework for addressing zoonotic disease surveillance. This review explores integrative strategies for zoonotic disease surveillance in the United States, focusing on the implementation of One Health principles. The review examines the collaborative efforts between human and animal health sectors, environmental agencies, and other relevant stakeholders in implementing One Health surveillance strategies. It highlights the importance of data sharing, communication, and coordination among these sectors to enhance early detection, rapid response, and effective control of zoonotic diseases. Key findings include the establishment of cross-sectoral surveillance systems, such as the National Notifiable Diseases Surveillance System (NNDSS) and the National Animal Health Monitoring System (NAHMS), which facilitate the collection and analysis of zoonotic disease data. These systems enable the identification of emerging zoonotic threats and the implementation of targeted interventions to mitigate risks. The review also discusses the role of technology, such as geographic information systems (GIS) and molecular epidemiology, in enhancing zoonotic disease surveillance. These tools enable the visualization of disease patterns and the tracking of disease transmission pathways, aiding in the development of effective control strategies. Challenges in implementing One Health surveillance strategies include limited resources, fragmented data systems, and regulatory barriers. Addressing these challenges requires increased investment in infrastructure, capacity building, and policy development to support integrated surveillance approaches. Overall, this review highlights the importance of One Health implementation in zoonotic disease surveillance and underscores the need for continued collaboration and innovation to enhance the effectiveness of surveillance efforts in the United States.
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Walchak, Robert C., Seanne P. Buckwalter, Nicole M. Zinsmaster, Katrina M. Henn, Katelyn M. Johnson, Jolene M. Koelsch, Senait A. Herring, et al. "Candida auris Direct Detection from Surveillance Swabs, Blood, and Urine Using a Laboratory-Developed PCR Method." Journal of Fungi 6, no. 4 (October 15, 2020): 224. http://dx.doi.org/10.3390/jof6040224.
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Candida auris is an emerging fungal pathogen with cases reported in countries around the world and in 19 states within the United States as of August 2020. The CDC has recommended that hospitals perform active surveillance upon admission for patients with the appropriate risk factors. Currently, active surveillance requires that local hospitals send surveillance swabs to a public health laboratory for analysis. In this work, a real-time PCR assay was developed for the specific detection of C. auris from surveillance swabs, blood, and urine to enable rapid detection of this pathogen. The assay uses commercially available primers and reporter probes and it was verified on the LightCycler 480 PCR platform. Contrived specimens and prospectively collected composite groin/axilla surveillance swabs were used to validate the assay. The performance of the PCR assay on surveillance swabs was also compared to a second PCR assay targeting C. auris that was performed at the Minnesota Department of Health–Public Health Laboratory (MDH-PHL). Our PCR assay is able to detect and differentiate C. auris from closely related Candida species such as C. duobushaemulonii, C. haemulonii, and C. pseudohaemulonii on the basis of melting curve temperature differences.
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Shah, Melisa, Amber K. Haynes, Rebecca M. Dahl, Krista Kniss, Benjamin Silk, and Marie E. Killerby. "1331. Seasonality of Common Human Coronaviruses in the United States, 2014-2021." Open Forum Infectious Diseases 8, Supplement_1 (November 1, 2021): S753—S754. http://dx.doi.org/10.1093/ofid/ofab466.1523.
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Abstract Background The four common human coronavirus (HCoV) types, including two alpha (NL63 and 229E) and two beta (HKU1 and OC43) coronaviruses, generally cause mild, upper respiratory illness. Common HCoV seroprevalence increases rapidly during the first five years of life and remains high throughout adulthood. HCoVs are known to have seasonal patterns, with variation in predominant types each year, but more defined measures of seasonality are needed. Methods We describe laboratory detection, percent positivity, and seasonality of the four common HCoVs during July 2014 to May 2021 in the United States reported to the National Respiratory and Enteric Virus Surveillance System (NREVSS). We also describe age, sex, and co-detection with other respiratory viruses for a subset of specimens available through the Public Health Laboratory Interoperability Project (PHLIP). We used a method previously validated for respiratory syncytial virus, characterized by a centered 5-week moving average and normalization to peak, to define seasonal inflections, including season onset, peak, and offset. Results Any HCoV type was detected in 96,336 (3.4%) of 2,487,736 specimens. Predominant common HCoV types fluctuated by surveillance year (Figure 1) and were generally consistent across geographic regions. In a subset of 4,576 specimens with a common HCoV detection, those with type 229E had a higher median age compared to other HCoV types (30.8 versus 24.8 years, p< 0.001), but there were no differences by sex. Influenza was the most commonly co-detected virus. In the last six complete HCoV seasons, onsets ranged from October to November, peaks from January to February, and offsets from April to June; >95% of all HCoV detections occurred within these ranges. The 2020-2021 common HCoV season onset, dominated by types NL63 and OC43, was delayed by approximately two months compared to prior seasons. Figure 1. The top panel represents total specimens tested and the bottom panel shows percent positivity of the four common human coronavirus (HCoV) types by week starting July 5, 2014 through May 8, 2021. Data are from the National Respiratory and Enteric Virus Surveillance System (NREVSS). Conclusion Common HCoVs demonstrate relatively consistent seasonal patterns. The delayed onset of the 2020-2021 season may be attributable to mitigation measures implemented across the US including masking, improved hand hygiene, and social distancing. Better defining HCoV seasonality can inform clinical preparedness and testing practices and may provide insights into the behavior of emerging coronaviruses. Disclosures All Authors: No reported disclosures
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Ericson, Richard V., and William G. Staples. "The Culture of Surveillance: Discipline and Social Control in the United States." Social Forces 76, no. 3 (March 1998): 1154. http://dx.doi.org/10.2307/3005718.
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Smith, Michael M. "The Mexican Secret Service in the United States, 1910-1920." Americas 59, no. 1 (July 2002): 65–85. http://dx.doi.org/10.1353/tam.2002.0091.
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Throughout the era of the Mexican Revolution, the United States provided sanctuary for thousands of political exiles who opposed the regimes of Porfirio Díaz, Francisco Madero, Victoriano Huerta, and Venustiano Carranza. Persecuted enemies of Don Porfirio and losers in the bloody war of factions that followed the ouster of the old regime continued their struggle for power from bases of operation north of the international boundary in such places as San Francisco, Los Angeles, El Paso, San Antonio, New Orleans, and New York. As a consequence, Mexican regimes were compelled not only to combat their enemies on domestic battlefields but also to wage more subtle campaigns against their adversaries north of the Río Bravo. The weapons in this shadowy war included general intelligence gathering, surveillance, espionage, counter-espionage, and propaganda; the agency most responsible for these activities was the Mexican Secret Service.
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Dye, Bruce A., and Gina Thornton-Evans. "A Brief History of National Surveillance Efforts for Periodontal Disease in the United States." Journal of Periodontology 78, no. 7s (July 2007): 1373–79. http://dx.doi.org/10.1902/jop.2007.060210.
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Wunderlin, Clarence E. "Paradox of Power: Infiltration, Coastal Surveillance, and the United States Navy in Vietnam, 1965-68." Journal of Military History 53, no. 3 (July 1989): 275. http://dx.doi.org/10.2307/1985874.
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Jefferson, Robert F., and Mark Ellis. "Race, War, and Surveillance: African Americans and the United States Government during World War I." Journal of Military History 66, no. 4 (October 2002): 1222. http://dx.doi.org/10.2307/3093302.
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Ramachandran, M., J. R. Gentsch, U. D. Parashar, S. Jin, P. A. Woods, J. L. Holmes, C. D. Kirkwood, et al. "Detection and Characterization of Novel Rotavirus Strains in the United States." Journal of Clinical Microbiology 36, no. 11 (1998): 3223–29. http://dx.doi.org/10.1128/jcm.36.11.3223-3229.1998.
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We recently established a rotavirus strain surveillance system in the United States to monitor the prevalent G serotypes before and after the anticipated implementation of a vaccination program against rotavirus and to identify the emergence of uncommon strains. In this study, we examined 348 rotavirus strains obtained in 1996 to 1997 from children with diarrhea in 10 U.S. cities. Strains were characterized for P and G types, subgroups, and electropherotypes by using a combination of monoclonal antibody immunoassay, reverse transcription-PCR, and hybridization. The four strains most commonly found worldwide comprised 83% of the isolates (P[8]G1, 66.4%; P[4]G2, 8.3%; P[8]G3, 6.9%; P[8]G4, 1.4%), but 9.2% were unusual strains (P[6]G9, 5.5%; P[8]G9, 1.7%; P[6]G1, 1.4%; and P[4]G1 and P[8]G2, 0.3% each). Strains not typeable for P or G type accounted for 5.5% of the total, while 2.3% of the strains had more than one G type (mixed infections). All P[6]G9 strains tested had short electropherotypes and subgroup I specificity and were detected in 4 of 10 cities, while P[8]G9 strains had long electropherotypes and subgroup II VP6 antigens. Both sequence analysis of the VP7 open reading frame (about 94 to 95% amino acid identity with the VP7 gene of G9 prototype strain WI61) and binding to a G9-specific monoclonal antibody strongly suggest that U.S. G9 strains belong to serotype G9. The high detection rates of unusual rotaviruses with G9 (7.2%) or P[6] (6.9%) specificity in multiple U.S. cities suggest the emergence of new strains or inadequate diagnosis in the past. The epidemiologic importance of these strains remains to be determined.
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Tréguer, Félix. "The Virus of Surveillance: How the covid-19 Pandemic Is Fuelling Technologies of Control." Political Anthropological Research on International Social Sciences 2, no. 1 (July 13, 2021): 16–46. http://dx.doi.org/10.1163/25903276-bja10018.
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Abstract While it is too early to provide a definitive analysis of the impact that the covid-19 health crisis will have on digital state surveillance, this article aims to provide a first assessment. It starts by situating states’ response to the crisis in the longer history of epidemics and their connections to what philosopher Michel Foucault called “regimes of power.” By surveying various surveillance discourses and practices in countries like France, Italy, the United Kingdom, the United States or Israel in the Spring of 2020, the article identifies three key trends magnified by the crisis, namely, the crystallisation of new public-private assemblages in the management of health data, a shift towards health-based justification regimes for legitimising controversial surveillance and urban policing technologies, as well as mounting human rights threats and oversight failures in a context marked by a “state of health emergency”.
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Burrell, Kellan, Jennifer Huang, Maria Karlsson, Gillian McAllister, and Allison Brown. "Molecular Landscape of Carbapenemase-Producing Acinetobacter baumanii in the United States." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s320—s321. http://dx.doi.org/10.1017/ice.2020.917.
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Background: Carbapenem-resistant Acinetobacter baumannii (CRAB) are an urgent public health threat because they cause healthcare-associated infections that are difficult to treat and can spread in healthcare environments. Acinetobacter spp may develop resistance to carbapenems through various mechanisms, including decreased permeability, overexpression of efflux pumps, and production of carbapenemases. Carbapenemases found in CRAB commonly belong to the group of carbapenem-hydrolyzing class D β-lactamases, which can be either intrinsic or acquired. The most clinically relevant class D enzymes are the OXA-23-like, OXA-24/40–like, and OXA-58–like because they are commonly plasmid mediated and thereby have the potential for rapid dissemination. We describe the molecular epidemiology of CRAB in the United States using a convenience sample of isolates collected from reference submissions, an isolate-based surveillance system, and the Antibiotic Resistance Laboratory Network (ARLN). Methods: Beginning in August 2017, 7 public health laboratories in the ARLN began testing CRAB isolates submitted by participating sentinel clinical laboratories across their region. Carbapenem-resistant isolates were identified by resistance to imipenem, meropenem, or doripenem. Testing included molecular detection of 4 targeted carbapenemase genes: blaKPC, blaNDM, blaVIM, and blaIMP. Participating labs reported testing results to CDC at least monthly. A separate collection of isolates from CDC reference and surveillance activities between 2013 and 2015 underwent whole-genome sequencing (WGS) to evaluate the presence of acquired carbapenemase genes, including class D OXA-variants. Results: From August 2017 through July 2019, the ARLN tested 2,368 CRAB isolates across 44 states. Only 12 (0.5%) of these harbored a bla- gene: blaKPC (n = 5), blaNDM (n = 5), blaIMP (n = 1), and blaVIM (n = 1). Of 95 reference and surveillance isolates sequenced, none harbored these targeted carbapenemases. However, 69 (73%) harbored at least 1 acquired class D OXA gene; OXA-23 was the most commonly acquired OXA variant (n = 46, 48.4%). Conclusions: Using a multipronged approach, our studies indicate that the presence of class D β-lactamases of the OXA type are common in CRAB among surveillance and reference samples that underwent WGS analysis. Other acquired carbapenemases appear to be rare. To prevent the spread of highly resistant CRAB, particularly those carrying the targeted, emerging carbapenemase genes, continued testing, and rapid infection control are necessary to improve patient safety and maintain situational awareness.Funding: NoneDisclosures: None
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Snyder, Jeffrey C., and Alexander V. Ryzhkov. "Automated Detection of Polarimetric Tornadic Debris Signatures Using a Hydrometeor Classification Algorithm." Journal of Applied Meteorology and Climatology 54, no. 9 (September 2015): 1861–70. http://dx.doi.org/10.1175/jamc-d-15-0138.1.
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AbstractAlthough radial velocity data from Doppler radars can partially resolve some tornadoes, particularly large tornadoes near the radar, most tornadoes are not explicitly resolved by radar owing to inadequate spatiotemporal resolution. In addition, it can be difficult to determine which mesocyclones typically observed on radar are associated with tornadoes. Since debris lofted by tornadoes has scattering characteristics that are distinct from those of hydrometeors, the additional information provided by polarimetric weather radars can aid in identifying debris from tornadoes; the polarimetric tornadic debris signature (TDS) provides what is nearly “ground truth” that a tornado is ongoing (or has recently occurred). This paper outlines a modification to the hydrometeor classification algorithm used with the operational Weather Surveillance Radar-1988 Doppler (WSR-88D) network in the United States to include a TDS category. Examples of automated TDS classification are provided for several recent cases that were observed in the United States.
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Capozzola, Christopher, and Mark Ellis. "Race, War, and Surveillance: African Americans and the United States Government during World War I." Journal of American History 89, no. 3 (December 2002): 1097. http://dx.doi.org/10.2307/3092447.
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Kamali, Sara. "Informants, Provocateurs, and Entrapment: Examining the Histories of the FBI’s PATCON and the NYPD’s Muslim Surveillance Program." Surveillance & Society 15, no. 1 (February 28, 2017): 68–78. http://dx.doi.org/10.24908/ss.v15i1.5254.
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Since September 11, 2001, the U.S. government and police departments across the United States, most notably the New York City Police Department, have been collecting intelligence targeting Muslim American communities. The controversial surveillance practices include the use of confidential informants, undercover operations, and entrapment, and infringing upon civil rights and civil liberties in the name of national security. A decade before 9/11, however, the Federal Bureau of Investigation (FBI) conducted the same practices against a completely different demographic – Christian Right militants, through a program called PATCON, short for Patriot Conspiracy. Building upon the concept of surveillance as social sorting (Lyon 2013) and surveillance and terrorism (Monahan 2013), This article will compare the history of surveillance tactics used by the FBI against Christian Right militants and those used by the NYPD against non-militant Muslim Americans, and assess their implications in the context of civil rights, leaving a legacy of mistrust between these respective groups and the federal government that further undermines the national security interests of the United States.
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Kirn, Thomas J. "Automatic Digital Plate Reading for Surveillance Cultures." Journal of Clinical Microbiology 54, no. 10 (August 10, 2016): 2424–26. http://dx.doi.org/10.1128/jcm.01279-16.
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The automation of specimen processing and culture workup has rapidly emerged in clinical microbiology laboratories throughout the world and more recently in the United States. While many U.S. laboratories have implemented some form of automated specimen processing and some have begun performing digital plate reading, automated colony analysis is just beginning to be utilized clinically. In this issue of theJournal of Clinical Microbiology, M. L. Faron et al. (J Clin Microbiol 54:2470–2475, 2016,http://dx.doi.org/10.1128/JCM.01040-16) report the results of their evaluation of the performance of the WASPLab Chromogenic Detection Module (CDM) for categorizing chromogenic agar plates as negative or “nonnegative” for vancomycin-resistant enterococci (VRE). Their major finding was 100% sensitivity for detection of “nonnegative” specimens using CDM compared to manual methods for specimens plated on two different types of VRE chromogenic agar plates. Additionally, utilization of digital plate reading in conjunction with automated colony analysis was predicted to result in significant savings based on greatly reduced labor costs.
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Sparling, Kennedy, and Pooja Dhupati. "The Association Between Internet Search Patterns and Scabies Incidence Across the United States." SKIN The Journal of Cutaneous Medicine 8, no. 2 (March 18, 2024): 1456–60. http://dx.doi.org/10.25251/skin.8.2.19.
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Background
Scabies, a contagious skin infestation caused by Sarcoptes scabiei, is a significant public health concern [1]. Traditional surveillance methods for scabies suffer from time lag and incomplete data, hindering early detection and response [5]. The widespread use of the internet and search engines, such as GoogleTM, offer new opportunities for alternative surveillance approaches.
Objective
This study aimed to explore the association between scabies search volumes on Google TrendsTM (GTs) and scabies incidence at the state level across the United States.
Methods
GTs data for each U.S. state and scabies incidence from 2011 to 2019 were analyzed for summary statistics and association.
Results
The mean Spearman correlation coefficient for the period of 2011-2019 indicated a strong positive correlation between GTs RSVs for “scabies” and the incidence of scabies in the United States. Using an unpaired t-test, this correlation was found to be statistically significant.
Conclusions
In resource-scarce environments where access to care is a common barrier, healthcare providers and departments can leverage this information to effectively target populations and employ resources for scabies prevention and treatment. Analyzing search engine term patterns can enhance our understanding of people's behavior when they suspect a scabies infestation.
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McGregor, Bethany L., Paula Rozo-Lopez, Travis M. Davis, and Barbara S. Drolet. "Detection of Vesicular Stomatitis Virus Indiana from Insects Collected during the 2020 Outbreak in Kansas, USA." Pathogens 10, no. 9 (September 2, 2021): 1126. http://dx.doi.org/10.3390/pathogens10091126.
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Vesicular stomatitis (VS) is a reportable viral disease which affects horses, cattle, and pigs in the Americas. Outbreaks of vesicular stomatitis virus New Jersey serotype (VSV-NJ) in the United States typically occur on a 5–10-year cycle, usually affecting western and southwestern states. In 2019–2020, an outbreak of VSV Indiana serotype (VSV-IN) extended eastward into the states of Kansas and Missouri for the first time in several decades, leading to 101 confirmed premises in Kansas and 37 confirmed premises in Missouri. In order to investigate which vector species contributed to the outbreak in Kansas, we conducted insect surveillance at two farms that experienced confirmed VSV-positive cases, one each in Riley County and Franklin County. Centers for Disease Control and Prevention miniature light traps were used to collect biting flies on the premises. Two genera of known VSV vectors, Culicoides biting midges and Simulium black flies, were identified to species, pooled by species, sex, reproductive status, and collection site, and tested for the presence of VSV-IN RNA by RT-qPCR. In total, eight positive pools were detected from Culicoides sonorensis (1), Culicoides stellifer (3), Culicoides variipennis (1), and Simulium meridionale (3). The C. sonorensis- and C. variipennis-positive pools were from nulliparous individuals, possibly indicating transovarial or venereal transmission as the source of virus. This is the first report of VSV-IN in field caught C. stellifer and the first report of either serotype in S. meridionale near outbreak premises. These results improve our understanding of the role midges and black flies play in VSV epidemiology in the United States and broadens the scope of vector species for targeted surveillance and control.
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Trout Fryxell, R. T., and J. T. Vogt. "Collaborative-Tick Surveillance Works: An Academic and Government Partnership for Tick Surveillance in the Southeastern United States (Acari: Ixodidae)." Journal of Medical Entomology 56, no. 5 (May 3, 2019): 1411–19. http://dx.doi.org/10.1093/jme/tjz055.
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Abstract Tick surveillance provides essential information on distributions and encounter frequencies; it is a component of operational activities in public health practice. Our research objectives were a proof-of-concept for collaborative surveillance, which involved establishing an academic and government partnership to enhance tick surveillance efforts. The University of Tennessee (UT) collaborated with United States Department of Agriculture Forest Service, Southern Research Station Forest Inventory Analysis (FIA) in an Occupational Health and Safety partnership. UT provided FIA crews in the southeastern United States with vials containing 80% ethanol (July 2014–November 2017). Crew members were instructed to put all encountered ticks into the vials and return them to FIA headquarters. UT identified all submitted ticks to species and life stage, and screened Amblyomma americanum (L.) for Ehrlichia bacteria using a nested-PCR assay. From the 198 returned vials, 1,180 ticks were submitted, including A. americanum (90.51%; 202 larvae, 503 nymphs, and 363 adults), Dermacentor variabilis Say (7.12%; 1 nymph, 83 adults), Ixodes scapularis (Say) (1.61%; 19 adults), Amblyomma maculatum Koch (0.59%; 1 nymph, 6 adults), and Amblyomma cajennense (Fabricius) (0.17%; 1 nymph, 1 adult). FIA crews encountered A. americanum with Ehrlichia and collection information was used to generate baseline occurrence data of tick encounters. Results indicate that this collaborative-tick surveillance can be improved and used to generate useful data including pathogen detection, and because crews revisit these sites, changes in tick encounters can be monitored.
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Poon, Jessie P. H. "Regulating the global illicit economy: Singapore's role in United States' spatial financial surveillance." Political Geography 91 (November 2021): 102493. http://dx.doi.org/10.1016/j.polgeo.2021.102493.
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Perkins, T. Alex, Sean M. Cavany, Sean M. Moore, Rachel J. Oidtman, Anita Lerch, and Marya Poterek. "Estimating unobserved SARS-CoV-2 infections in the United States." Proceedings of the National Academy of Sciences 117, no. 36 (August 21, 2020): 22597–602. http://dx.doi.org/10.1073/pnas.2005476117.
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By March 2020, COVID-19 led to thousands of deaths and disrupted economic activity worldwide. As a result of narrow case definitions and limited capacity for testing, the number of unobserved severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections during its initial invasion of the United States remains unknown. We developed an approach for estimating the number of unobserved infections based on data that are commonly available shortly after the emergence of a new infectious disease. The logic of our approach is, in essence, that there are bounds on the amount of exponential growth of new infections that can occur during the first few weeks after imported cases start appearing. Applying that logic to data on imported cases and local deaths in the United States through 12 March, we estimated that 108,689 (95% posterior predictive interval [95% PPI]: 1,023 to 14,182,310) infections occurred in the United States by this date. By comparing the model’s predictions of symptomatic infections with local cases reported over time, we obtained daily estimates of the proportion of symptomatic infections detected by surveillance. This revealed that detection of symptomatic infections decreased throughout February as exponential growth of infections outpaced increases in testing. Between 24 February and 12 March, we estimated an increase in detection of symptomatic infections, which was strongly correlated (median: 0.98; 95% PPI: 0.66 to 0.98) with increases in testing. These results suggest that testing was a major limiting factor in assessing the extent of SARS-CoV-2 transmission during its initial invasion of the United States.
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Goldman, GS, and PG King. "Vaccination to prevent varicella." Human & Experimental Toxicology 33, no. 8 (November 25, 2013): 886–93. http://dx.doi.org/10.1177/0960327113512340.
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Background: There is increasing evidence that herpes zoster (HZ) incidence rates among children and adults (aged <60 years) with a history of natural varicella are influenced primarily by the frequency of exogenous exposures, while asymptomatic endogenous reactivations help to cap the rate at approximately 550 cases/100,000 person-years when exogenous boosting becomes rare. The Antelope Valley Varicella Active Surveillance Project was funded by the Centers for Disease Control and Prevention in 1995 to monitor the effects of varicella vaccination in one of the three representative regions of the United States. The stability in the data collection and number of reporting sites under varicella surveillance from 1995–2002 and HZ surveillance during 2000–2001 and 2006–2007 contributed to the robustness of the discerned trends. Discussion: Varicella vaccination may be useful for leukemic children; however, the target population in the United States is all children. Since the varicella vaccine inoculates its recipients with live, attenuated varicella–zoster virus (VZV), clinical varicella cases have dramatically declined. Declining exogenous exposures (boosts) from children shedding natural VZV have caused waning cell-mediated immunity. Thus, the protection provided by varicella vaccination is neither lifelong nor complete. Moreover, dramatic increases in the incidence of adult shingles cases have been observed since HZ was added to the surveillance in 2000. In 2013, this topic is still debated and remains controversial in the United States. Summary: When the costs of the booster dose for varicella and the increased shingles recurrences are included, the universal varicella vaccination program is neither effective nor cost-effective.
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Paulick, Ashley, Michelle Adamczyk, Lauren C. Korhonen, Alice Guh, Amy Gargis, and Maria Karlsson. "2404. Molecular Epidemiology of Clostridioides difficile in the United States, 2017." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S830. http://dx.doi.org/10.1093/ofid/ofz360.2082.
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Abstract Background In 2009, the Centers for Disease Control and Prevention (CDC) implemented Clostridioides difficile infection (CDI) surveillance through the Emerging Infections Program (EIP) to monitor the incidence and evolving epidemiology of CDI in the United States. Since 2012, ribotypes (RTs) 027, 106, 002, 014, and 020 have constituted the top five strain types among both US community- and healthcare-associated isolates. Here we describe the changes in molecular epidemiology of C. difficile isolates collected in the United States in 2017. Methods In 2017, CDI surveillance was conducted at 10 EIP sites (CA, CO, CT, GA, MD, MN, NM, NY, OR, and TN). A convenience sample of clinical laboratories across EIP sites submitted C. difficile-positive stool specimens to the MN Department of Health Public Health Laboratory and Hines VA Hospital (IL) for culture. Isolates were forwarded to CDC and characterized by capillary-based PCR-ribotyping and PCR detection of tcdA, tcdB, cdtA, cdtB, and deletions in tcdC. Results In 2017, 1,051 C. difficile isolates were submitted; the total number of isolates received from each site ranged from 11 to 286 with a median of 85.5. In total, 143 RTs were observed, with the majority of isolates harboring toxin genes tcdA and tcdB (95%) and a wild-type tcdC sequence (71%). Among 556 healthcare-associated isolates, RT 027 was the most prevalent and the top RT at 5 sites (CA, GA, MD, NM, TN). Ribotype 106 was the most prevalent among 495 community-associated CA isolates and the top RT at 6 sites (CO, CT, GA, MD, MN, TN). Ribotype 027 significantly decreased from 2012 to 2017 among both healthcare-associated (21% vs 15%; p = 0.02) and community-associated isolates (17% vs 6%; P < 0.0001). Among healthcare-associated isolates, RT 076, which was observed in 8 EIP sites, increased from 2% in 2016 to 5% in 2017 (p = 0.05) and replaced RT 020 as one of the top 5 healthcare-associated RTs in 2017. Conclusion Despite an overall decline since 2012, RT 027 remained the most prevalent RT among healthcare-associated isolates submitted in 2017. The increased frequency of RT 076 among healthcare-associated isolates submitted in 2017 highlights the evolving molecular epidemiology of C. difficile and the need for continued surveillance to monitor potential emerging strains. Disclosures All authors: No reported disclosures.
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Ford, Nancy Gentile. "Race, War, and Surveillance: African Americans and the United States Government during World War I." Journal of American Ethnic History 22, no. 3 (April 1, 2003): 121–23. http://dx.doi.org/10.2307/27501337.
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Ansaldi, Filippo, Paola Canepa, Daniela de Florentiis, Roberto Bandettini, Paolo Durando, and Giancarlo Icardi. "Increasing Incidence ofStreptococcus pneumoniaeSerotype 19A and Emergence of Two Vaccine Escape Recombinant ST695 Strains in Liguria, Italy, 7 Years after Implementation of the 7-Valent Conjugated Vaccine." Clinical and Vaccine Immunology 18, no. 2 (December 22, 2010): 343–45. http://dx.doi.org/10.1128/cvi.00383-10.
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ABSTRACTTwo serotype 19A (ST695)Streptococcus pneumoniaevaccine escape recombinant strains attributable to capsular switching events were detected by a laboratory surveillance system that is an integral part of a vaccination program begun in Liguria, Italy, in May 2003, an Italian administrative region with long-lasting high coverage, an unusual occurrence in Europe. To our knowledge, this is the first detection of an occurrence of capsular switching outside the United States.