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Braunstein SL, Wahnich A, Lazar R. COVID-19 Outcomes Among People With HIV and COVID-19 in New York City. J Infect Dis 2023; 228:1571-1582. [PMID: 37534822 DOI: 10.1093/infdis/jiad311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/28/2023] [Accepted: 08/02/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Literature on the impact of human immunodeficiency virus (HIV) on coronavirus disease 2019 (COVID-19)-related outcomes remains mixed. Few studies have evaluated COVID-19 outcomes by HIV status using population-based data. METHODS Using data from New York City COVID-19 surveillance and HIV surveillance systems prior to the widespread availability of COVID-19 vaccines, we conducted a retrospective cohort study comparing the risk of COVID-19 hospitalization and mortality by HIV status among severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnoses from 29 February to 17 October 2020. RESULTS Risk of hospitalization and death among people with HIV (PWH) withCOVID-19 were both nearly 30% higher compared with people without HIV. In crude models, incidence of adverse COVID-19 outcomes among PWH compared to people without HIV was elevated in certain groups, including women, and black, Hispanic/Latino, Native American, and multiracial people. CD4 cell count at SARS-CoV-2 diagnosis and presence of an underlying, non-HIV-related condition were independently and strongly associated with risk for COVID-19 hospitalization and death among PWH. CONCLUSIONS New Yorkers with HIV experienced elevated risk for poor COVID-19 outcomes compared to those without HIV during 2020. PWH, particularly those with low CD4 counts or underlying conditions, should be an ongoing focus for COVID-19 vaccination and rigorous identification and treatment of SARS-CoV-2 infections to prevent adverse outcomes.
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Affiliation(s)
- Sarah L Braunstein
- Bureau of Hepatitis, HIV, and Sexually Transmitted Infections, New York City Department of Health and Mental Hygiene, Long Island City, New York, USA
| | - Amanda Wahnich
- Bureau of Hepatitis, HIV, and Sexually Transmitted Infections, New York City Department of Health and Mental Hygiene, Long Island City, New York, USA
| | - Rachael Lazar
- Bureau of Hepatitis, HIV, and Sexually Transmitted Infections, New York City Department of Health and Mental Hygiene, Long Island City, New York, USA
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Rathakrishnan D, Purpura LJ, Salcuni PM, Myers JE, Wahnich A, Daskalakis DC, Edelstein ZR. PrEP Use and Correlates of Use Among a Large, Urban Sample of Men and Transgender Persons Who Have Sex with Men. AIDS Behav 2022; 26:1017-1025. [PMID: 34599419 DOI: 10.1007/s10461-021-03456-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2021] [Indexed: 11/26/2022]
Abstract
We examined recent pre-exposure prophylaxis (PrEP) use (past 6 months) and its correlates among a large sample of men who have sex with men and transgender and gender non-conforming persons participating in a home HIV self-testing program conducted by the New York City Health Department between 11/2016 and 1/2017. Correlates examined included demographic characteristics and HIV-related behaviors in the past 6 months. Associations with recent PrEP use were assessed using log-binomial regression. 400 (22.5%) of 1776 participants reported recent PrEP use. In adjusted models, recent PrEP use was associated with Manhattan residence [adjusted prevalence ratio (aPR) 1.26; 95% confidence interval (CI) (1.04, 1.53)], higher income [aPR 1.29; 95% CI (1.03, 1.62)], and having insurance [aPR 1.89; 95% CI (1.33, 2.69)]. All HIV-related behaviors, except for injection drug use, were individually associated with PrEP use. More research is needed to better understand barriers to PrEP use among patients who are low income and/or uninsured as this may help improve current public health efforts to increase PrEP uptake among disproportionately impacted populations.
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Affiliation(s)
- Dinesh Rathakrishnan
- New York City Department of Health and Mental Hygiene, Queens, NY, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Lawrence J Purpura
- New York City Department of Health and Mental Hygiene, Queens, NY, USA.
- Division of Infectious Diseases, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, 630 West 168th Street, New York, NY, 10032, USA.
- ICAP, Columbia University Mailman School of Public Health, New York, NY, USA.
| | - Paul M Salcuni
- New York City Department of Health and Mental Hygiene, Queens, NY, USA
| | - Julie E Myers
- New York City Department of Health and Mental Hygiene, Queens, NY, USA
- Division of Infectious Diseases, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, 630 West 168th Street, New York, NY, 10032, USA
| | - Amanda Wahnich
- New York City Department of Health and Mental Hygiene, Queens, NY, USA
| | | | - Zoe R Edelstein
- New York City Department of Health and Mental Hygiene, Queens, NY, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
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3
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Krakower DS, Naja-Riese GM, Edelstein ZR, Gandhi AD, Wahnich A, Fischer MA. Academic Detailing to Increase Prescribing of HIV Pre-exposure Prophylaxis. Am J Prev Med 2021; 61:S87-S97. [PMID: 34686295 DOI: 10.1016/j.amepre.2021.05.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/27/2021] [Accepted: 05/10/2021] [Indexed: 10/20/2022]
Abstract
Although HIV pre-exposure prophylaxis can decrease new cases of HIV by up to 99%, many patients who could benefit from pre-exposure prophylaxis never receive prescriptions for it. Because pre-exposure prophylaxis is indicated for patients who do not have an infectious disease, increasing pre-exposure prophylaxis prescribing by primary care and generalist clinicians represents a key element of the Ending the HIV Epidemic in the U.S. initiative. This review provides an overview of academic detailing and how it is currently being used to increase pre-exposure prophylaxis prescribing. Academic detailing is outreach education that engages with clinicians in 1-to-1 or small group interactions focused on identifying and addressing an individual clinician's needs to increase their use of evidence-based practices. Academic detailing has been proven in multiple previous research studies, and the principles required for successful implementation include interactivity, clinical relevance of content, and focus on defined behavior change objectives. Clinician barriers to pre-exposure prophylaxis prescribing may occur in the domains of knowledge, attitudes, or behavior, and academic detailing has the potential to address all of these areas. State and local health departments have developed academic detailing programs focused on pre-exposure prophylaxis prescribing and other elements of HIV prevention-sometimes describing the approach as public health detailing. Few studies of academic detailing for pre-exposure prophylaxis have been published to date; rigorous evaluation of HIV-specific adaptations and innovations of the approach would represent an important contribution. In the setting of the COVID-19 pandemic, interest in virtual delivery of academic detailing has grown, which could inform efforts to implement academic detailing in rural communities and other underserved areas. Increasing this capacity could make an important contribution to Ending the HIV Epidemic in the U.S. and other HIV prevention efforts.
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Affiliation(s)
- Douglas S Krakower
- Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Beth Israel Lahey Health, Boston, Massachusetts; The Fenway Institute, Boston, Massachusetts; Department of Population Medicine, Harvard Medical School, Boston, Massachusetts
| | - Gary M Naja-Riese
- San Francisco Department of Public Health, Population Health Division, Center for Learning and Innovation, San Francisco, California
| | - Zoe R Edelstein
- Prevention Program, Bureau of HIV, New York City Department of Health and Mental Hygiene, New York, New York
| | - Anisha D Gandhi
- Prevention Program, Bureau of HIV, New York City Department of Health and Mental Hygiene, New York, New York
| | - Amanda Wahnich
- Prevention Program, Bureau of HIV, New York City Department of Health and Mental Hygiene, New York, New York
| | - Michael A Fischer
- National Resource Center for Academic Detailing, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Boston, Massachusetts.
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4
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Braunstein SL, Lazar R, Wahnich A, Daskalakis DC, Blackstock OJ. Coronavirus Disease 2019 (COVID-19) Infection Among People With Human Immunodeficiency Virus in New York City: A Population-Level Analysis of Linked Surveillance Data. Clin Infect Dis 2021; 72:e1021-e1029. [PMID: 33252620 PMCID: PMC7799250 DOI: 10.1093/cid/ciaa1793] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Indexed: 12/31/2022] Open
Abstract
Background New York City (NYC) was hard-hit by the SARS-CoV-2 pandemic and is also home to a large population of people with HIV (PWH). Methods We matched lab-confirmed COVID-19 case and death data reported to the NYC Health Department as of June 2, 2020, against the NYC HIV surveillance registry. We describe and compare the characteristics and COVID-19-related outcomes of PWH diagnosed with COVID-19 with all NYC PWH and with all New Yorkers diagnosed with COVID-19. Results Through June 2, 204,583 NYC COVID-19 cases were reported. The registry match identified 2,410 PWH with diagnosed COVID-19 eligible for analysis (1.06% of all COVID-19 cases). Compared with all NYC PWH and all New Yorkers diagnosed with COVID-19, a higher proportion of PWH with COVID-19 were older, male, Black or Latino, and living in high-poverty neighborhoods. At least one underlying condition was reported for 58.9% of PWH with COVID-19. Compared with all NYC COVID-19 cases, a higher proportion of PWH with COVID-19 experienced hospitalization, intensive care unit admission and/or death; most PWH who experienced poor COVID-19-related outcomes had CD4 <500 cells/µL. Conclusions Given NYC HIV prevalence is 1.5%, PWH were not overrepresented among COVID-19 cases. However, compared with NYC COVID-19 cases overall, a greater proportion of PWH had adverse COVID-19-related outcomes, perhaps because of a higher prevalence of factors associated with poor COVID-19 outcomes. Given the pandemic’s exacerbating effects on health inequities, HIV public health and clinical communities must strengthen services and support for people living with and affected by HIV.
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Affiliation(s)
- Sarah L Braunstein
- Bureau of HIV, New York City Department of Health and Mental Hygiene, Long Island City, New York, USA
| | - Rachael Lazar
- Bureau of HIV, New York City Department of Health and Mental Hygiene, Long Island City, New York, USA
| | - Amanda Wahnich
- Bureau of HIV, New York City Department of Health and Mental Hygiene, Long Island City, New York, USA
| | - Demetre C Daskalakis
- Division of Disease Control, New York City Department of Health and Mental Hygiene, Long Island City, New York, USA
| | - Oni J Blackstock
- Bureau of HIV, New York City Department of Health and Mental Hygiene, Long Island City, New York, USA
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5
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Thompson CN, Baumgartner J, Pichardo C, Toro B, Li L, Arciuolo R, Chan PY, Chen J, Culp G, Davidson A, Devinney K, Dorsinville A, Eddy M, English M, Fireteanu AM, Graf L, Geevarughese A, Greene SK, Guerra K, Huynh M, Hwang C, Iqbal M, Jessup J, Knorr J, Lall R, Latash J, Lee E, Lee K, Li W, Mathes R, McGibbon E, McIntosh N, Montesano M, Moore MS, Murray K, Ngai S, Paladini M, Paneth-Pollak R, Parton H, Peterson E, Pouchet R, Ramachandran J, Reilly K, Sanderson Slutsker J, Van Wye G, Wahnich A, Winters A, Layton M, Jones L, Reddy V, Fine A. COVID-19 Outbreak - New York City, February 29-June 1, 2020. MMWR Morb Mortal Wkly Rep 2020; 69:1725-1729. [PMID: 33211680 PMCID: PMC7676643 DOI: 10.15585/mmwr.mm6946a2] [Citation(s) in RCA: 153] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
New York City (NYC) was an epicenter of the coronavirus disease 2019 (COVID-19) outbreak in the United States during spring 2020 (1). During March-May 2020, approximately 203,000 laboratory-confirmed COVID-19 cases were reported to the NYC Department of Health and Mental Hygiene (DOHMH). To obtain more complete data, DOHMH used supplementary information sources and relied on direct data importation and matching of patient identifiers for data on hospitalization status, the occurrence of death, race/ethnicity, and presence of underlying medical conditions. The highest rates of cases, hospitalizations, and deaths were concentrated in communities of color, high-poverty areas, and among persons aged ≥75 years or with underlying conditions. The crude fatality rate was 9.2% overall and 32.1% among hospitalized patients. Using these data to prevent additional infections among NYC residents during subsequent waves of the pandemic, particularly among those at highest risk for hospitalization and death, is critical. Mitigating COVID-19 transmission among vulnerable groups at high risk for hospitalization and death is an urgent priority. Similar to NYC, other jurisdictions might find the use of supplementary information sources valuable in their efforts to prevent COVID-19 infections.
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Affiliation(s)
- Corinne N Thompson
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Jennifer Baumgartner
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Carolina Pichardo
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Brian Toro
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Lan Li
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Robert Arciuolo
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Pui Ying Chan
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Judy Chen
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Gretchen Culp
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Alexander Davidson
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Katelynn Devinney
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Alan Dorsinville
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Meredith Eddy
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Michele English
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Ana Maria Fireteanu
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Laura Graf
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Anita Geevarughese
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Sharon K Greene
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Kevin Guerra
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Mary Huynh
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Christina Hwang
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Maryam Iqbal
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Jillian Jessup
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Jillian Knorr
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Ramona Lall
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Julia Latash
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Ellen Lee
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Kristen Lee
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Wenhui Li
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Robert Mathes
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Emily McGibbon
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Natasha McIntosh
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Matthew Montesano
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Miranda S Moore
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Kenya Murray
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Stephanie Ngai
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Marc Paladini
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Rachel Paneth-Pollak
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Hilary Parton
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Eric Peterson
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Renee Pouchet
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Jyotsna Ramachandran
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Kathleen Reilly
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | | | - Gretchen Van Wye
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Amanda Wahnich
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Ann Winters
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Marcelle Layton
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Lucretia Jones
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Vasudha Reddy
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Anne Fine
- New York City Department of Health and Mental Hygiene, Long Island City, New York
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6
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Bushman D, Alroy KA, Greene SK, Keating P, Wahnich A, Weiss D, Pathela P, Harrison C, Rakeman J, Langley G, Tong S, Tao Y, Uehara A, Queen K, Paden CR, Szymczak W, Orner EP, Nori P, Lai PA, Jacobson JL, Singh HK, Calfee DP, Westblade LF, Vasovic LV, Rand JH, Liu D, Singh V, Burns J, Prasad N, Sell J. Detection and genetic characterization of community‐based SARS‐CoV‐2 infections – New York City, March 2020. Am J Transplant 2020. [DOI: 10.1111/ajt.16377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Dena Bushman
- Incident Command System Surveillance and Epidemiology Section New York City Department of Health and Mental Hygiene
- Epidemic Intelligence Service CDC
| | - Karen A. Alroy
- Incident Command System Surveillance and Epidemiology Section New York City Department of Health and Mental Hygiene
- Epidemic Intelligence Service CDC
| | - Sharon K. Greene
- Incident Command System Surveillance and Epidemiology Section New York City Department of Health and Mental Hygiene
| | - Page Keating
- Incident Command System Surveillance and Epidemiology Section New York City Department of Health and Mental Hygiene
| | - Amanda Wahnich
- Incident Command System Surveillance and Epidemiology Section New York City Department of Health and Mental Hygiene
| | - Don Weiss
- Incident Command System Surveillance and Epidemiology Section New York City Department of Health and Mental Hygiene
| | - Preeti Pathela
- Incident Command System Surveillance and Epidemiology Section New York City Department of Health and Mental Hygiene
| | - Christy Harrison
- Public Health Laboratory New York City Department of Health and Mental Hygiene
| | - Jennifer Rakeman
- Public Health Laboratory New York City Department of Health and Mental Hygiene
| | - Gayle Langley
- Division of Viral Diseases National Center for Immunization and Respiratory Diseases CDC
| | - Suxiang Tong
- Division of Viral Diseases National Center for Immunization and Respiratory Diseases CDC
| | - Ying Tao
- Division of Viral Diseases National Center for Immunization and Respiratory Diseases CDC
| | - Anna Uehara
- Division of Viral Diseases National Center for Immunization and Respiratory Diseases CDC
| | - Krista Queen
- Division of Viral Diseases National Center for Immunization and Respiratory Diseases CDC
| | - Clinton R. Paden
- Division of Viral Diseases National Center for Immunization and Respiratory Diseases CDC
| | - Wendy Szymczak
- Department of Pathology Montefiore Medical Center Albert Einstein College of Medicine Bronx New York
| | - Erika P. Orner
- Department of Pathology Montefiore Medical Center Albert Einstein College of Medicine Bronx New York
| | - Priya Nori
- Department of Pathology Montefiore Medical Center Albert Einstein College of Medicine Bronx New York
- Division of Infectious Diseases Department of Medicine Montefiore Medical Center Albert Einstein College of Medicine Bronx New York
| | - Phi A. Lai
- Department of Pathology and Laboratory Medicine NYU Langone Hospital Brooklyn New York
| | | | - Harjot K. Singh
- Division of Infectious Diseases Department of Medicine Weill Cornell Medicine New York New York
| | - David P. Calfee
- Division of Infectious Diseases Department of Medicine Weill Cornell Medicine New York New York
| | - Lars F. Westblade
- Division of Infectious Diseases Department of Medicine Weill Cornell Medicine New York New York
- Department of Pathology and Laboratory Medicine Weill Cornell Medicine New York New York
| | - Ljiljana V. Vasovic
- Department of Pathology and Laboratory Medicine Weill Cornell Medicine New York New York
| | - Jacob H. Rand
- Department of Pathology and Laboratory Medicine Weill Cornell Medicine New York New York
| | - Dakai Liu
- New York‐Presbyterian Queens Flushing New York
| | | | | | | | - Jessica Sell
- Incident Command System Surveillance and Epidemiology Section New York City Department of Health and Mental Hygiene
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7
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Bushman D, Alroy KA, Greene SK, Keating P, Wahnich A, Weiss D, Pathela P, Harrison C, Rakeman J, Langley G, Tong S, Tao Y, Uehara A, Queen K, Paden CR, Szymczak W, Orner EP, Nori P, Lai PA, Jacobson JL, Singh HK, Calfee DP, Westblade LF, Vasovic LV, Rand JH, Liu D, Singh V, Burns J, Prasad N, Sell J. Detection and Genetic Characterization of Community-Based SARS-CoV-2 Infections - New York City, March 2020. MMWR Morb Mortal Wkly Rep 2020; 69:918-922. [PMID: 32678072 PMCID: PMC7366849 DOI: 10.15585/mmwr.mm6928a5] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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8
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Wahnich A, Clark S, Bloch D, Kubinson H, Hrusa G, Liu D, Rakeman JL, Deocharan B, Jones L, Slavinski S, Stoute A, Mathes R, Weiss D, Conners EE. Surveillance for Mosquitoborne Transmission of Zika Virus, New York City, NY, USA, 2016. Emerg Infect Dis 2019; 24:827-834. [PMID: 29664375 PMCID: PMC5938798 DOI: 10.3201/eid2405.170764] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Sentinel, enhanced passive, and syndromic surveillance in 2016 did not identify any evidence of transmission. A large number of imported cases of Zika virus infection and the potential for transmission by Aedes albopictus mosquitoes prompted the New York City Department of Health and Mental Hygiene to conduct sentinel, enhanced passive, and syndromic surveillance for locally acquired mosquitoborne Zika virus infections in New York City, NY, USA, during June–October 2016. Suspected case-patients were those >5 years of age without a travel history or sexual exposure who had >3 compatible signs/symptoms (arthralgia, fever, conjunctivitis, or rash). We identified 15 suspected cases and tested urine samples for Zika virus by using real-time reverse transcription PCR; all results were negative. We identified 308 emergency department visits for Zika-like illness, 40,073 visits for fever, and 17 unique spatiotemporal clusters of visits for fever. We identified no evidence of local transmission. Our experience offers possible surveillance tools for jurisdictions concerned about local mosquitoborne Zika virus or other arboviral transmission.
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9
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Minen MT, Boubour A, Wahnich A, Grudzen C, Friedman BW. A Retrospective Nested Cohort Study of Emergency Department Revisits for Migraine in New York City. Headache 2017; 58:399-406. [DOI: 10.1111/head.13216] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Revised: 09/06/2017] [Accepted: 09/06/2017] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - Amanda Wahnich
- New York City Department of Health and Mental Hygiene; New York NY USA
| | - Corita Grudzen
- Department of Emergency Medicine; NYU Langone Medical Center; New York NY USA (C. Grudzen)
| | - Benjamin W. Friedman
- Department of Emergency Medicine; Albert Einstein College of Medicine; New York NY USA
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10
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Lall R, Abdelnabi J, Ngai S, Parton HB, Saunders K, Sell J, Wahnich A, Weiss D, Mathes RW. Advancing the Use of Emergency Department Syndromic Surveillance Data, New York City, 2012-2016. Public Health Rep 2017; 132:23S-30S. [PMID: 28692384 DOI: 10.1177/0033354917711183] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION The use of syndromic surveillance has expanded from its initial purpose of bioterrorism detection. We present 6 use cases from New York City that demonstrate the value of syndromic surveillance for public health response and decision making across a broad range of health outcomes: synthetic cannabinoid drug use, heat-related illness, suspected meningococcal disease, medical needs after severe weather, asthma exacerbation after a building collapse, and Ebola-like illness in travelers returning from West Africa. MATERIALS AND METHODS The New York City syndromic surveillance system receives data on patient visits from all emergency departments (EDs) in the city. The data are used to assign syndrome categories based on the chief complaint and discharge diagnosis, and analytic methods are used to monitor geographic and temporal trends and detect clusters. RESULTS For all 6 use cases, syndromic surveillance using ED data provided actionable information. Syndromic surveillance helped detect a rise in synthetic cannabinoid-related ED visits, prompting a public health investigation and action. Surveillance of heat-related illness indicated increasing health effects of severe weather and led to more urgent public health messaging. Surveillance of meningitis-related ED visits helped identify unreported cases of culture-negative meningococcal disease. Syndromic surveillance also proved useful for assessing a surge of methadone-related ED visits after Superstorm Sandy, provided reassurance of no localized increases in asthma after a building collapse, and augmented traditional disease reporting during the West African Ebola outbreak. PRACTICE IMPLICATIONS Sharing syndromic surveillance use cases can foster new ideas and build capacity for public health preparedness and response.
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Affiliation(s)
- Ramona Lall
- 1 Bureau of Communicable Diseases, New York City Department of Health and Mental Hygiene, Queens, NY, USA
| | - Jasmine Abdelnabi
- 1 Bureau of Communicable Diseases, New York City Department of Health and Mental Hygiene, Queens, NY, USA
| | - Stephanie Ngai
- 1 Bureau of Communicable Diseases, New York City Department of Health and Mental Hygiene, Queens, NY, USA
| | - Hilary B Parton
- 1 Bureau of Communicable Diseases, New York City Department of Health and Mental Hygiene, Queens, NY, USA
| | - Kelly Saunders
- 1 Bureau of Communicable Diseases, New York City Department of Health and Mental Hygiene, Queens, NY, USA
| | - Jessica Sell
- 1 Bureau of Communicable Diseases, New York City Department of Health and Mental Hygiene, Queens, NY, USA
| | - Amanda Wahnich
- 1 Bureau of Communicable Diseases, New York City Department of Health and Mental Hygiene, Queens, NY, USA
| | - Don Weiss
- 1 Bureau of Communicable Diseases, New York City Department of Health and Mental Hygiene, Queens, NY, USA
| | - Robert W Mathes
- 1 Bureau of Communicable Diseases, New York City Department of Health and Mental Hygiene, Queens, NY, USA
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Fogel BL, Cho E, Wahnich A, Gao F, Becherel OJ, Wang X, Fike F, Chen L, Criscuolo C, De Michele G, Filla A, Collins A, Hahn AF, Gatti RA, Konopka G, Perlman S, Lavin MF, Geschwind DH, Coppola G. Mutation of senataxin alters disease-specific transcriptional networks in patients with ataxia with oculomotor apraxia type 2. Hum Mol Genet 2014; 23:4758-69. [PMID: 24760770 DOI: 10.1093/hmg/ddu190] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Senataxin, encoded by the SETX gene, contributes to multiple aspects of gene expression, including transcription and RNA processing. Mutations in SETX cause the recessive disorder ataxia with oculomotor apraxia type 2 (AOA2) and a dominant juvenile form of amyotrophic lateral sclerosis (ALS4). To assess the functional role of senataxin in disease, we examined differential gene expression in AOA2 patient fibroblasts, identifying a core set of genes showing altered expression by microarray and RNA-sequencing. To determine whether AOA2 and ALS4 mutations differentially affect gene expression, we overexpressed disease-specific SETX mutations in senataxin-haploinsufficient fibroblasts and observed changes in distinct sets of genes. This implicates mutation-specific alterations of senataxin function in disease pathogenesis and provides a novel example of allelic neurogenetic disorders with differing gene expression profiles. Weighted gene co-expression network analysis (WGCNA) demonstrated these senataxin-associated genes to be involved in both mutation-specific and shared functional gene networks. To assess this in vivo, we performed gene expression analysis on peripheral blood from members of 12 different AOA2 families and identified an AOA2-specific transcriptional signature. WGCNA identified two gene modules highly enriched for this transcriptional signature in the peripheral blood of all AOA2 patients studied. These modules were disease-specific and preserved in patient fibroblasts and in the cerebellum of Setx knockout mice demonstrating conservation across species and cell types, including neurons. These results identify novel genes and cellular pathways related to senataxin function in normal and disease states, and implicate alterations in gene expression as underlying the phenotypic differences between AOA2 and ALS4.
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Affiliation(s)
- Brent L Fogel
- Program in Neurogenetics, Department of Neurology and
| | - Ellen Cho
- Program in Neurogenetics, Department of Neurology and
| | | | - Fuying Gao
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA
| | - Olivier J Becherel
- Radiation Biology and Oncology Laboratory, University of Queensland, UQ Centre for Clinical Research, Herston, Australia
| | - Xizhe Wang
- Program in Neurogenetics, Department of Neurology and
| | | | - Leslie Chen
- Program in Neurogenetics, Department of Neurology and
| | - Chiara Criscuolo
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, Federico II University, Napoli, Italy
| | - Giuseppe De Michele
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, Federico II University, Napoli, Italy
| | - Alessandro Filla
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, Federico II University, Napoli, Italy
| | - Abigail Collins
- Department of Pediatrics and Department of Neurology, Children's Hospital Colorado, University of Colorado, Denver, School of Medicine, Aurora, CO, USA
| | - Angelika F Hahn
- Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada and
| | - Richard A Gatti
- Department of Pathology and Laboratory Medicine and Department of Human Genetics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Genevieve Konopka
- Department of Neuroscience, University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA
| | - Susan Perlman
- Program in Neurogenetics, Department of Neurology and
| | - Martin F Lavin
- Radiation Biology and Oncology Laboratory, University of Queensland, UQ Centre for Clinical Research, Herston, Australia
| | - Daniel H Geschwind
- Program in Neurogenetics, Department of Neurology and Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA Department of Human Genetics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Giovanni Coppola
- Program in Neurogenetics, Department of Neurology and Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA
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Fogel BL, Wexler E, Wahnich A, Friedrich T, Vijayendran C, Gao F, Parikshak N, Konopka G, Geschwind DH. RBFOX1 regulates both splicing and transcriptional networks in human neuronal development. Hum Mol Genet 2012; 21:4171-86. [PMID: 22730494 DOI: 10.1093/hmg/dds240] [Citation(s) in RCA: 149] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
RNA splicing plays a critical role in the programming of neuronal differentiation and, consequently, normal human neurodevelopment, and its disruption may underlie neurodevelopmental and neuropsychiatric disorders. The RNA-binding protein, fox-1 homolog (RBFOX1; also termed A2BP1 or FOX1), is a neuron-specific splicing factor predicted to regulate neuronal splicing networks clinically implicated in neurodevelopmental disease, including autism spectrum disorder (ASD), but only a few targets have been experimentally identified. We used RNA sequencing to identify the RBFOX1 splicing network at a genome-wide level in primary human neural stem cells during differentiation. We observe that RBFOX1 regulates a wide range of alternative splicing events implicated in neuronal development and maturation, including transcription factors, other splicing factors and synaptic proteins. Downstream alterations in gene expression define an additional transcriptional network regulated by RBFOX1 involved in neurodevelopmental pathways remarkably parallel to those affected by splicing. Several of these differentially expressed genes are further implicated in ASD and related neurodevelopmental diseases. Weighted gene co-expression network analysis demonstrates a high degree of connectivity among these disease-related genes, highlighting RBFOX1 as a key factor coordinating the regulation of both neurodevelopmentally important alternative splicing events and clinically relevant neuronal transcriptional programs in the development of human neurons.
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Affiliation(s)
- Brent L Fogel
- Program in Neurogenetics, Department of Neurology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90095, USA.
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Fogel BL, Lee JY, Lane J, Wahnich A, Chan S, Huang A, Osborn GE, Klein E, Mamah C, Perlman S, Geschwind DH, Coppola G. Mutations in rare ataxia genes are uncommon causes of sporadic cerebellar ataxia. Mov Disord 2012; 27:442-6. [PMID: 22287014 PMCID: PMC3323119 DOI: 10.1002/mds.24064] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Revised: 11/11/2011] [Accepted: 11/14/2011] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Sporadic-onset ataxia is common in a tertiary care setting but a significant percentage remains unidentified despite extensive evaluation. Rare genetic ataxias, reported only in specific populations or families, may contribute to a percentage of sporadic ataxia. METHODS Patients with adult-onset sporadic ataxia, who tested negative for common genetic ataxias (SCA1, SCA2, SCA3, SCA6, SCA7, and/or Friedreich ataxia), were evaluated using a stratified screening approach for variants in 7 rare ataxia genes. RESULTS We screened patients for published mutations in SYNE1 (n = 80) and TGM6 (n = 118), copy number variations in LMNB1 (n = 40) and SETX (n = 11), sequence variants in SACS (n = 39) and PDYN (n = 119), and the pentanucleotide insertion of spinocerebellar ataxia type 31 (n = 101). Overall, we identified 1 patient with a LMNB1 duplication, 1 patient with a PDYN variant, and 1 compound SACS heterozygote, including a novel variant. CONCLUSIONS The rare genetic ataxias examined here do not significantly contribute to sporadic cerebellar ataxia in our tertiary care population.
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Affiliation(s)
- Brent L Fogel
- Program in Neurogenetics, Department of Neurology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California 90095, USA.
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