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Falade-Nwulia O, Lesko CR, Fojo AT, Keruly JC, Moore RD, Sutcliffe CG, Mehta SH, Chander G, Thomas DL, Sulkowski M. Hepatitis C Treatment in People With HIV: Potential to Eliminate Disease and Disparity. J Infect Dis 2024; 229:775-779. [PMID: 37793170 PMCID: PMC10938212 DOI: 10.1093/infdis/jiad433] [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: 05/21/2023] [Revised: 09/20/2023] [Accepted: 10/02/2023] [Indexed: 10/06/2023] Open
Abstract
Access to direct acting antivirals (DAAs) may be associated with reductions in hepatitis C virus (HCV) viremia prevalence among people with human immunodeficiency virus (PWH). Among 3755 PWH, estimated HCV viremia prevalence decreased by 94.0% from 36% (95% confidence interval [CI], 27%-46%) in 2009 (pre-DAA era) to 2% (95% CI, 0%-4%) in 2021 (DAA era). Male sex, black race, and older age were associated with HCV viremia in 2009 but not in 2021. Injection drug use remained associated with HCV viremia in 2009 and 2021. Targeted interventions are needed to meet the HCV care needs of PWH who use drugs.
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Affiliation(s)
- Oluwaseun Falade-Nwulia
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Catherine R Lesko
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Anthony T Fojo
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jeanne C Keruly
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Richard D Moore
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Catherine G Sutcliffe
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Shruti H Mehta
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Geetanjali Chander
- Division of General Internal Medicine, University of Washington, Seattle, Washington, USA
| | - David L Thomas
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Mark Sulkowski
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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2
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Park HS, Yin A, Barranta C, Lee JS, Caputo CA, Sachithanandham J, Li M, Yoon S, Sitaras I, Jedlicka A, Eby Y, Ram M, Fernandez RE, Baker OR, Shenoy AG, Mosnaim GS, Fukuta Y, Patel B, Heath SL, Levine AC, Meisenberg BR, Spivak ES, Anjan S, Huaman MA, Blair JE, Currier JS, Paxton JH, Gerber JM, Petrini JR, Broderick PB, Rausch W, Cordisco ME, Hammel J, Greenblatt B, Cluzet VC, Cruser D, Oei K, Abinante M, Hammitt LL, Sutcliffe CG, Forthal DN, Zand MS, Cachay ER, Raval JS, Kassaye SG, Marshall CE, Yarava A, Lane K, McBee NA, Gawad AL, Karlen N, Singh A, Ford DE, Jabs DA, Appel LJ, Shade DM, Lau B, Ehrhardt S, Baksh SN, Shapiro JR, Ou J, Na YB, Knoll MD, Ornelas-Gatdula E, Arroyo-Curras N, Gniadek TJ, Caturegli P, Wu J, Ndahiro N, Betenbaugh MJ, Ziman A, Hanley DF, Casadevall A, Shoham S, Bloch EM, Gebo KA, Tobian AA, Laeyendecker O, Pekosz A, Klein SL, Sullivan DJ. Outpatient COVID-19 convalescent plasma recipient antibody thresholds correlated to reduced hospitalizations within a randomized trial. JCI Insight 2024; 9:e178460. [PMID: 38483534 DOI: 10.1172/jci.insight.178460] [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: 12/14/2023] [Accepted: 03/06/2024] [Indexed: 03/26/2024] Open
Abstract
BACKGROUNDCOVID-19 convalescent plasma (CCP) virus-specific antibody levels that translate into recipient posttransfusion antibody levels sufficient to prevent disease progression are not defined.METHODSThis secondary analysis correlated donor and recipient antibody levels to hospitalization risk among unvaccinated, seronegative CCP recipients within the outpatient, double-blind, randomized clinical trial that compared CCP to control plasma. The majority of COVID-19 CCP arm hospitalizations (15/17, 88%) occurred in this unvaccinated, seronegative subgroup. A functional cutoff to delineate recipient high versus low posttransfusion antibody levels was established by 2 methods: (i) analyzing virus neutralization-equivalent anti-Spike receptor-binding domain immunoglobulin G (anti-S-RBD IgG) responses in donors or (ii) receiver operating characteristic (ROC) curve analysis.RESULTSSARS-CoV-2 anti-S-RBD IgG antibody was volume diluted 21.3-fold into posttransfusion seronegative recipients from matched donor units. Virus-specific antibody delivered was approximately 1.2 mg. The high-antibody recipients transfused early (symptom onset within 5 days) had no hospitalizations. A CCP-recipient analysis for antibody thresholds correlated to reduced hospitalizations found a statistical significant association between early transfusion and high antibodies versus all other CCP recipients (or control plasma), with antibody cutoffs established by both methods-donor-based virus neutralization cutoffs in posttransfusion recipients (0/85 [0%] versus 15/276 [5.6%]; P = 0.03) or ROC-based cutoff (0/94 [0%] versus 15/267 [5.4%]; P = 0.01).CONCLUSIONIn unvaccinated, seronegative CCP recipients, early transfusion of plasma units in the upper 30% of study donors' antibody levels reduced outpatient hospitalizations. High antibody level plasma units, given early, should be reserved for therapeutic use.TRIAL REGISTRATIONClinicalTrials.gov NCT04373460.FUNDINGDepartment of Defense (W911QY2090012); Defense Health Agency; Bloomberg Philanthropies; the State of Maryland; NIH (3R01AI152078-01S1, U24TR001609-S3, 1K23HL151826NIH); the Mental Wellness Foundation; the Moriah Fund; Octapharma; the Healthnetwork Foundation; the Shear Family Foundation; the NorthShore Research Institute; and the Rice Foundation.
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Affiliation(s)
- Han-Sol Park
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Anna Yin
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Caelan Barranta
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - John S Lee
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Christopher A Caputo
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jaiprasath Sachithanandham
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Maggie Li
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Steve Yoon
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ioannis Sitaras
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Anne Jedlicka
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Yolanda Eby
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Malathi Ram
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Reinaldo E Fernandez
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Owen R Baker
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Aarthi G Shenoy
- Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center, Washington DC, USA
| | - Giselle S Mosnaim
- Division of Allergy and Immunology, Department of Medicine, NorthShore University Health System, Evanston, Illinois, USA
| | - Yuriko Fukuta
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA
| | - Bela Patel
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, Texas, USA
| | - Sonya L Heath
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Adam C Levine
- Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, Rhode Island, USA
| | | | - Emily S Spivak
- Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Shweta Anjan
- Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Moises A Huaman
- Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati, Ohio, USA
| | - Janis E Blair
- Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, Arizona, USA
| | - Judith S Currier
- Department of Medicine, Division of Infectious Diseases, UCLA, Los Angeles, California, USA
| | - James H Paxton
- Department of Emergency Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Jonathan M Gerber
- Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | | | | | | | | | - Jean Hammel
- Nuvance Health Norwalk Hospital, Norwalk, Connecticut, USA
| | | | - Valerie C Cluzet
- Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, New York, USA
| | - Daniel Cruser
- Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, New York, USA
| | - Kevin Oei
- Ascada Research, Fullerton, California, USA
| | | | - Laura L Hammitt
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Catherine G Sutcliffe
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Donald N Forthal
- Department of Medicine, Division of Infectious Diseases, University of California, Irvine, California, USA
| | - Martin S Zand
- Department of Medicine, University of Rochester Medical Center, Rochester, New York, USA
| | - Edward R Cachay
- Department of Medicine, Division of Infectious Diseases, UCSD, San Diego, California, USA
| | - Jay S Raval
- Department of Pathology, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
| | - Seble G Kassaye
- Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center, Washington DC, USA
| | - Christi E Marshall
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Karen Lane
- Department of Neurology, Brain Injury Outcomes
| | | | - Amy L Gawad
- Department of Neurology, Brain Injury Outcomes
| | | | - Atika Singh
- Department of Neurology, Brain Injury Outcomes
| | - Daniel E Ford
- Institute for Clinical and Translational Research, and
| | - Douglas A Jabs
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Lawrence J Appel
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - David M Shade
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Bryan Lau
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Stephan Ehrhardt
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Sheriza N Baksh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Janna R Shapiro
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jiangda Ou
- Department of Neurology, Brain Injury Outcomes
| | - Yu Bin Na
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Maria D Knoll
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Elysse Ornelas-Gatdula
- Chemistry-Biology Interface Program, Zanvyl Krieger School of Arts & Sciences, Johns Hopkins University, Baltimore, Maryland, USA
| | - Netzahualcoyotl Arroyo-Curras
- Chemistry-Biology Interface Program, Zanvyl Krieger School of Arts & Sciences, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Thomas J Gniadek
- Department of Pathology and Laboratory Medicine, Northshore University Health System, Evanston, Illinois, USA
| | - Patrizio Caturegli
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jinke Wu
- Advanced Mammalian Biomanufacturing Innovation Center, Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Nelson Ndahiro
- Advanced Mammalian Biomanufacturing Innovation Center, Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Michael J Betenbaugh
- Advanced Mammalian Biomanufacturing Innovation Center, Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Alyssa Ziman
- Department of Pathology and Laboratory Medicine, Wing-Kwai and Alice Lee-Tsing Chung Transfusion Service, David Geffen School of Medicine, UCLA, Los Angeles, California, USA
| | | | - Arturo Casadevall
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Shmuel Shoham
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Evan M Bloch
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Kelly A Gebo
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Aaron Ar Tobian
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Oliver Laeyendecker
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases (NIAID), Baltimore, Maryland, USA
| | - Andrew Pekosz
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Sabra L Klein
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - David J Sullivan
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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3
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Cella E, Sutcliffe CG, Grant LR, Tso C, Weatherholtz RC, Littlepage S, Becenti L, Jubair M, Simons BC, Harker-Jones M, Reid R, Yazzie D, Santosham M, O'Brien KL, Hammitt LL, Azarian T. Streptococcus pneumoniae serotype 3 population structure in the era of conjugate vaccines, 2001-2018. Microb Genom 2024; 10. [PMID: 38498591 DOI: 10.1099/mgen.0.001196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024] Open
Abstract
Background. Despite use of highly effective conjugate vaccines, invasive pneumococcal disease (IPD) remains a leading cause of morbidity and mortality and disproportionately affects Indigenous populations. Although included in the 13-valent pneumococcal conjugate vaccine (PCV13), which was introduced in 2010, serotype 3 continues to cause disease among Indigenous communities in the Southwest USA. In the Navajo Nation, serotype 3 IPD incidence increased among adults (3.8/100 000 in 2001-2009 and 6.2/100 000 in 2011-2019); in children the disease persisted although the rates dropped from 5.8/100 000 to 2.3/100 000.Methods. We analysed the genomic epidemiology of serotype 3 isolates collected from 129 adults and 63 children with pneumococcal carriage (n=61) or IPD (n=131) from 2001 to 2018 of the Navajo Nation. Using whole-genome sequencing data, we determined clade membership and assessed changes in serotype 3 population structure over time.Results. The serotype 3 population structure was characterized by three dominant subpopulations: clade II (n=90, 46.9 %) and clade Iα (n=59, 30.7 %), which fall into Clonal Complex (CC) 180, and a non-CC180 clade (n=43, 22.4 %). The proportion of clade II-associated IPD cases increased significantly from 2001 to 2010 to 2011-2018 among adults (23.1-71.8 %; P<0.001) but not in children (27.3-33.3 %; P=0.84). Over the same period, the proportion of clade II-associated carriage increased; this was statistically significant among children (23.3-52.6 %; P=0.04) but not adults (0-50.0 %, P=0.08).Conclusions. In this setting with persistent serotype 3 IPD and carriage, clade II has increased since 2010. Genomic changes may be contributing to the observed trends in serotype 3 carriage and disease over time.
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Affiliation(s)
- Eleonora Cella
- Burnett School of Biomedical Sciences, University of Central Florida, Orlando, Florida
| | - Catherine G Sutcliffe
- Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Lindsay R Grant
- Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Carol Tso
- Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Robert C Weatherholtz
- Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Shea Littlepage
- Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Ladonna Becenti
- Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Mohammad Jubair
- Burnett School of Biomedical Sciences, University of Central Florida, Orlando, Florida
| | - Brenna C Simons
- Arctic Investigations Program, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Marcella Harker-Jones
- Arctic Investigations Program, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Raymond Reid
- Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Del Yazzie
- Navajo Epidemiology Center, Window Rock, Arizona
| | - Mathuram Santosham
- Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Katherine L O'Brien
- Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Laura L Hammitt
- Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Taj Azarian
- Burnett School of Biomedical Sciences, University of Central Florida, Orlando, Florida
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4
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Gebo KA, Heath SL, Fukuta Y, Zhu X, Baksh S, Abraham AG, Habtehyimer F, Shade D, Ruff J, Ram M, Laeyendecker O, Fernandez RE, Patel EU, Baker OR, Shoham S, Cachay ER, Currier JS, Gerber JM, Meisenberg B, Forthal DN, Hammitt LL, Huaman MA, Levine A, Mosnaim GS, Patel B, Paxton JH, Raval JS, Sutcliffe CG, Anjan S, Gniadek T, Kassaye S, Blair JE, Lane K, McBee NA, Gawad AL, Das P, Klein SL, Pekosz A, Bloch EM, Hanley D, Casadevall A, Tobian AAR, Sullivan DJ. Erratum for Gebo et al., "Early antibody treatment, inflammation, and risk of post-COVID conditions". mBio 2024; 15:e0297923. [PMID: 38095433 PMCID: PMC10790766 DOI: 10.1128/mbio.02979-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024] Open
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5
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Habtehyimer F, Zhu X, Redd AD, Gebo KA, Abraham AG, Patel EU, Laeyendecker O, Gniadek TJ, Fernandez RE, Baker OR, Ram M, Cachay ER, Currier JS, Fukuta Y, Gerber JM, Heath SL, Meisenberg B, Huaman MA, Levine AC, Shenoy A, Anjan S, Blair JE, Cruser D, Forthal DN, Hammitt LL, Kassaye S, Mosnaim GS, Patel B, Paxton JH, Raval JS, Sutcliffe CG, Abinante M, Oei KS, Cluzet V, Cordisco ME, Greenblatt B, Rausch W, Shade D, Gawad AL, Klein SL, Pekosz A, Shoham S, Casadevall A, Bloch EM, Hanley D, Tobian AAR, Sullivan DJ. COVID-19 convalescent plasma therapy decreases inflammatory cytokines: a randomized controlled trial. Microbiol Spectr 2024; 12:e0328623. [PMID: 38009954 PMCID: PMC10783116 DOI: 10.1128/spectrum.03286-23] [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: 09/11/2023] [Accepted: 10/25/2023] [Indexed: 11/29/2023] Open
Abstract
IMPORTANCE This study examined the role that cytokines may have played in the beneficial outcomes found when outpatient individuals infected with SARS-CoV-2 were transfused with COVID-19 convalescent plasma (CCP) early in their infection. We found that the pro-inflammatory cytokine IL-6 decreased significantly faster in patients treated early with CCP. Participants with COVID-19 treated with CCP later in the infection did not have the same effect. This decrease in IL-6 levels after early CCP treatment suggests a possible role of inflammation in COVID-19 progression. The evidence of IL-6 involvement brings insight into the possible mechanisms involved in CCP treatment mitigating SARS-CoV-2 severity.
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Affiliation(s)
- Feben Habtehyimer
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Xianming Zhu
- Department of Pathology, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Andrew D. Redd
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Baltimore, Maryland, USA
| | - Kelly A. Gebo
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Alison G. Abraham
- Department of Epidemiology, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Eshan U. Patel
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Oliver Laeyendecker
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Baltimore, Maryland, USA
| | - Thomas J. Gniadek
- Department of Pathology and Laboratory Medicine, Northshore University Health System, Evanston, Illinois, USA
| | - Reinaldo E. Fernandez
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Owen R. Baker
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Malathi Ram
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Edward R. Cachay
- Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, California, USA
| | - Judith S. Currier
- Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, California, USA
| | - Yuriko Fukuta
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA
| | - Jonathan M. Gerber
- Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Sonya L. Heath
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Barry Meisenberg
- Department of Medicine and Research Institute of Luminis Health, Annapolis, Maryland, USA
| | - Moises A. Huaman
- Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati, Ohio, USA
| | - Adam C. Levine
- Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Aarthi Shenoy
- Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Shweta Anjan
- Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, Florida, USA
| | - Janis E. Blair
- Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, Arizona, USA
| | - Daniel Cruser
- Department of Pathology, Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, New York, USA
| | - Donald N. Forthal
- Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, California, USA
| | - Laura L. Hammitt
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Seble Kassaye
- Division of Infectious Diseases, Georgetown University Medical Center, Washington, DC, USA
| | - Giselle S. Mosnaim
- Department of Medicine, Division of Allergy and Immunology, Northshore University Health System, Evanston, Illinois, USA
| | - Bela Patel
- Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, Texas, USA
| | - James H. Paxton
- Department of Emergency Medicine, Wayne State University, Detroit, Michigan, USA
| | - Jay S. Raval
- Department of Pathology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Catherine G. Sutcliffe
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | | | | | - Valerie Cluzet
- Department of Infectious Disease, Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, New York, USA
| | | | | | - William Rausch
- Nuvance Health Danbury Hospital, Danbury, Connecticut, USA
| | - David Shade
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Amy L. Gawad
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Sabra L. Klein
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Andrew Pekosz
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Shmuel Shoham
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Arturo Casadevall
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Evan M. Bloch
- Department of Pathology, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Daniel Hanley
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Aaron A. R. Tobian
- Department of Pathology, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - David J. Sullivan
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
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6
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Karimi-Sari H, Piggott DA, Scully EP, Ward K, Sutcliffe CG, Sulkowski M, Falade-Nwulia O. Changes in Inflammatory Cytokines After Chronic Hepatitis C Treatment Among People Living With HIV. Open Forum Infect Dis 2024; 11:ofad623. [PMID: 38192382 PMCID: PMC10773550 DOI: 10.1093/ofid/ofad623] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Indexed: 01/10/2024] Open
Abstract
We aimed to evaluate the effect of hepatitis C virus cure on serum inflammatory markers among people with HIV. Among 127 people with HIV, serum alanine aminotransferase, soluble tumor necrosis factor receptor 1, and inflammatory index score were significantly lower at the 24-week time point in patients who achieved sustained virologic response as compared with those who did not.
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Affiliation(s)
- Hamidreza Karimi-Sari
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Damani A Piggott
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Eileen P Scully
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Kathleen Ward
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Catherine G Sutcliffe
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Mark Sulkowski
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Oluwaseun Falade-Nwulia
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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7
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Park HS, Yin A, Barranta C, Lee JS, Caputo CA, Sachithanandham J, Li M, Yoon S, Sitaras I, Jedlicka A, Eby Y, Ram M, Fernandez RE, Baker OR, Shenoy AG, Mosnaim GS, Fukuta Y, Patel B, Heath SL, Levine AC, Meisenberg BR, Spivak ES, Anjan S, Huaman MA, Blair JE, Currier JS, Paxton JH, Gerber JM, Petrini JR, Broderick PB, Rausch W, Cordisco ME, Hammel J, Greenblatt B, Cluzet VC, Cruser D, Oei K, Abinante M, Hammitt LL, Sutcliffe CG, Forthal DN, Zand MS, Cachay ER, Raval JS, Kassaye SG, Marshall CE, Yarava A, Lane K, McBee NA, Gawad AL, Karlen N, Singh A, Ford DE, Jabs DA, Appel LJ, Shade DM, Lau B, Ehrhardt S, Baksh SN, Shapiro JR, Ou J, Na YB, Knoll MD, Ornelas-Gatdula E, Arroyo-Curras N, Gniadek TJ, Caturegli P, Wu J, Ndahiro N, Betenbaugh MJ, Ziman A, Hanley DF, Casadevall A, Shoham S, Bloch EM, Gebo KA, Tobian AAR, Laeyendecker O, Pekosz A, Klein SL, Sullivan DJ. Outpatient COVID-19 convalescent plasma recipient antibody thresholds correlated to reduced hospitalizations within a randomized trial. medRxiv 2023:2023.04.13.23288353. [PMID: 37131659 PMCID: PMC10153328 DOI: 10.1101/2023.04.13.23288353] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
BACKGROUND The COVID-19 convalescent plasma (CCP) viral specific antibody levels that translate into recipient post-transfusion antibody levels sufficient to prevent disease progression is not defined. METHODS This secondary analysis correlated donor and recipient antibody levels to hospitalization risk among unvaccinated, seronegative CCP recipients within the outpatient, double blind, randomized clinical trial that compared CCP to control plasma. The majority of COVID-19 CCP arm hospitalizations (15/17, 88%) occurred in this unvaccinated, seronegative subgroup. A functional cutoff to delineate recipient high versus low post-transfusion antibody levels was established by two methods: 1) analyzing virus neutralization-equivalent anti-S-RBD IgG responses in donors or 2) receiver operating characteristic (ROC) analysis. RESULTS SARS-CoV-2 anti-S-RBD IgG antibody was diluted by a factor of 21.3 into post-transfusion seronegative recipients from matched donor units. Viral specific antibody delivered approximated 1.2 mg. The high antibody recipients transfused early (symptom onset within 5 days) had no hospitalizations. A CCP recipient analysis for antibody thresholds correlated to reduced hospitalizations found a significant association with Fisher's exact test between early and high antibodies versus all other CCP recipients (or control plasma) with antibody cutoffs established by both methods-donor virus neutralization-based cutoff: (0/85; 0% versus 15/276; 5.6%) p=0.03 or ROC based cutoff: (0/94; 0% versus 15/267; 5.4%) p=0.01. CONCLUSION In unvaccinated, seronegative CCP recipients, early transfusion of plasma units corresponding to the upper 30% of all study donors reduced outpatient hospitalizations. These high antibody level plasma units, given early, should be reserved for therapeutic use.Trial registration: NCT04373460. FUNDING Defense Health Agency and others.
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Affiliation(s)
- Han-Sol Park
- W. Harry Feinstone Department of Molecular Microbiology and Immunology; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Anna Yin
- W. Harry Feinstone Department of Molecular Microbiology and Immunology; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Caelan Barranta
- W. Harry Feinstone Department of Molecular Microbiology and Immunology; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - John S Lee
- W. Harry Feinstone Department of Molecular Microbiology and Immunology; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Christopher A Caputo
- W. Harry Feinstone Department of Molecular Microbiology and Immunology; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jaiprasath Sachithanandham
- W. Harry Feinstone Department of Molecular Microbiology and Immunology; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Maggie Li
- W. Harry Feinstone Department of Molecular Microbiology and Immunology; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Steve Yoon
- W. Harry Feinstone Department of Molecular Microbiology and Immunology; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ioannis Sitaras
- W. Harry Feinstone Department of Molecular Microbiology and Immunology; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Anne Jedlicka
- W. Harry Feinstone Department of Molecular Microbiology and Immunology; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Yolanda Eby
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Malathi Ram
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Reinaldo E Fernandez
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Owen R Baker
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Aarthi G Shenoy
- Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center, Washington DC, USA
| | - Giselle S Mosnaim
- Division of Allergy and Immunology, Department of Medicine, NorthShore University Health System, Evanston, IL, USA
| | - Yuriko Fukuta
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX, USA
| | - Bela Patel
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX, USA
| | - Sonya L Heath
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Adam C Levine
- Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI, USA
| | | | - Emily S Spivak
- Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Shweta Anjan
- Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Moises A Huaman
- Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati, OH, USA
| | - Janis E Blair
- Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ, USA
| | - Judith S Currier
- Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, CA, USA
| | - James H Paxton
- Department of Emergency Medicine, Wayne State University School of Medicine, Detroit, MI, USA
| | - Jonathan M Gerber
- Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | | | | | | | | | - Jean Hammel
- Nuvance Health Norwalk Hospital, Norwalk, CT, USA
| | | | - Valerie C Cluzet
- Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY, USA
| | - Daniel Cruser
- Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY, USA
| | | | | | - Laura L Hammitt
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Catherine G Sutcliffe
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Donald N Forthal
- Department of Medicine, Division of Infectious Diseases, University of California, Irvine, CA, USA
| | - Martin S Zand
- Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Edward R Cachay
- Department of Medicine, Division of Infectious Diseases, University of California, San Diego, CA, USA
| | - Jay S Raval
- Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Seble G Kassaye
- Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center Washington DC, USA
| | - Christi E Marshall
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Anusha Yarava
- Department of Neurology, Brain Injury Outcomes, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Karen Lane
- Department of Neurology, Brain Injury Outcomes, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nichol A McBee
- Department of Neurology, Brain Injury Outcomes, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Amy L Gawad
- Department of Neurology, Brain Injury Outcomes, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nicky Karlen
- Department of Neurology, Brain Injury Outcomes, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Atika Singh
- Department of Neurology, Brain Injury Outcomes, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Daniel E Ford
- Institute for Clinical and Translational Research Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Douglas A Jabs
- Department of Ophthalmology Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lawrence J Appel
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - David M Shade
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Bryan Lau
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Stephan Ehrhardt
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sheriza N Baksh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Janna R Shapiro
- W. Harry Feinstone Department of Molecular Microbiology and Immunology; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jiangda Ou
- Department of Neurology, Brain Injury Outcomes, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Yu Bin Na
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Maria D Knoll
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Elysse Ornelas-Gatdula
- Chemistry-Biology Interface Program, Zanvyl Krieger School of Arts & Sciences, Johns Hopkins University, Baltimore MD, USA
| | - Netzahualcoyotl Arroyo-Curras
- Chemistry-Biology Interface Program, Zanvyl Krieger School of Arts & Sciences, Johns Hopkins University, Baltimore MD, USA
- Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Thomas J Gniadek
- Department of Pathology and Laboratory Medicine, Northshore University Health System, Evanston, IL
| | - Patrizio Caturegli
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jinke Wu
- Advanced Mammalian Biomanufacturing Innovation Center, Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Nelson Ndahiro
- Advanced Mammalian Biomanufacturing Innovation Center, Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Michael J Betenbaugh
- Advanced Mammalian Biomanufacturing Innovation Center, Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Alyssa Ziman
- Department of Pathology and Laboratory Medicine, Wing-Kwai and Alice Lee-Tsing Chung Transfusion Service, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Daniel F Hanley
- Department of Neurology, Brain Injury Outcomes, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Arturo Casadevall
- W. Harry Feinstone Department of Molecular Microbiology and Immunology; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Shmuel Shoham
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Evan M Bloch
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kelly A Gebo
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Aaron A R Tobian
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Oliver Laeyendecker
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Baltimore, MD, USA
| | - Andrew Pekosz
- W. Harry Feinstone Department of Molecular Microbiology and Immunology; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sabra L Klein
- W. Harry Feinstone Department of Molecular Microbiology and Immunology; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - David J Sullivan
- W. Harry Feinstone Department of Molecular Microbiology and Immunology; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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8
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Gebo KA, Heath SL, Fukuta Y, Zhu X, Baksh S, Abraham AG, Habtehyimer F, Shade D, Ruff J, Ram M, Laeyendecker O, Fernandez RE, Patel EU, Baker OR, Shoham S, Cachay ER, Currier JS, Gerber JM, Meisenberg B, Forthal DN, Hammitt LL, Huaman MA, Levine A, Mosnaim GS, Patel B, Paxton JH, Raval JS, Sutcliffe CG, Anjan S, Gniadek T, Kassaye S, Blair JE, Lane K, McBee NA, Gawad AL, Das P, Klein SL, Pekosz A, Bloch EM, Hanley D, Casadevall A, Tobian AAR, Sullivan DJ. Early antibody treatment, inflammation, and risk of post-COVID conditions. mBio 2023; 14:e0061823. [PMID: 37724870 PMCID: PMC10653913 DOI: 10.1128/mbio.00618-23] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 03/13/2023] [Accepted: 06/02/2023] [Indexed: 09/21/2023] Open
Abstract
IMPORTANCE Approximately 20% of individuals infected with SARS-CoV-2 experienced long-term health effects, as defined PCC. However, it is unknown if there are any early biomarkers associated with PCC or whether early intervention treatments may decrease the risk of PCC. In a secondary analysis of a randomized clinical trial, this study demonstrates that among outpatients with SARS-CoV-2, increased IL-6 at time of infection is associated with increased odds of PCC. In addition, among individuals treated early, within 5 days of symptom onset, with COVID-19 convalescent plasma, there was a trend for decreased odds of PCC after adjusting for other demographic and clinical characteristics. Future treatment studies should be considered to evaluate the effect of early treatment and anti-IL-6 therapies on PCC development.
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Affiliation(s)
- Kelly A. Gebo
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Sonya L. Heath
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Yuriko Fukuta
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA
| | - Xianming Zhu
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Sheriza Baksh
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Allison G. Abraham
- Department of Epidemiology, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Feben Habtehyimer
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - David Shade
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jessica Ruff
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Malathi Ram
- Departement of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Oliver Laeyendecker
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH, Baltimore, Maryland, USA
| | - Reinaldo E. Fernandez
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Eshan U. Patel
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Owen R. Baker
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Shmuel Shoham
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Edward R. Cachay
- Department of Medicine, Division of Infectious Diseases, University of California, San Diego, California, USA
| | - Judith S. Currier
- Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, California, USA
| | - Jonathan M. Gerber
- Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worchester, Massachusetts, USA
| | | | - Donald N. Forthal
- Department of Medicine, Division of Infectious Diseases, University of California, Irvine, California, USA
| | - Laura L. Hammitt
- Departement of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Moises A. Huaman
- Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati, Ohio, USA
| | - Adam Levine
- Department of Emergency Medicine, Rhode Island Hospital Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Giselle S. Mosnaim
- Department of Medicine, Division of Allergy and Immunology, Northshore University Health System, Evanston, Illinois, USA
| | - Bela Patel
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, Texas, USA
| | - James H. Paxton
- Department of Emergency Medicine, Wayne State University, Detroit, Michigan, USA
| | - Jay S. Raval
- Department of Pathology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Catherine G. Sutcliffe
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Departement of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Shweta Anjan
- Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, Florida, USA
| | - Thomas Gniadek
- Department of Pathology, Northshore University Health System, Evanston, Illinois, USA
| | - Seble Kassaye
- Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, DC, USA
| | - Janis E. Blair
- Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, Arizona, USA
| | - Karen Lane
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Nichol A. McBee
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Amy L. Gawad
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Piyali Das
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Sabra L. Klein
- Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Andrew Pekosz
- Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Evan M. Bloch
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Daniel Hanley
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Arturo Casadevall
- Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Aaron A. R. Tobian
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - David J. Sullivan
- Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - on behalf of the CSSC-004 Consortium
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Epidemiology, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
- Departement of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH, Baltimore, Maryland, USA
- Department of Medicine, Division of Infectious Diseases, University of California, San Diego, California, USA
- Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, California, USA
- Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worchester, Massachusetts, USA
- Luminis Health, Annapolis, Maryland, USA
- Department of Medicine, Division of Infectious Diseases, University of California, Irvine, California, USA
- Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati, Ohio, USA
- Department of Emergency Medicine, Rhode Island Hospital Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Department of Medicine, Division of Allergy and Immunology, Northshore University Health System, Evanston, Illinois, USA
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, Texas, USA
- Department of Emergency Medicine, Wayne State University, Detroit, Michigan, USA
- Department of Pathology, University of New Mexico, Albuquerque, New Mexico, USA
- Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, Florida, USA
- Department of Pathology, Northshore University Health System, Evanston, Illinois, USA
- Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, DC, USA
- Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, Arizona, USA
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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9
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Sutcliffe CG, Hamahuwa M, Miller E, Sinywimaanzi P, Hardick J, Morales J, Munachoonga P, Monze M, Manabe YC, Fenstermacher KZ, Rothman RE, Pekosz A, Thuma PE, Simulundu E. Respiratory viruses in rural Zambia during the second year of the COVID-19 pandemic. IJID Reg 2023; 8:90-94. [PMID: 37533553 PMCID: PMC10391682 DOI: 10.1016/j.ijregi.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 08/04/2023]
Abstract
Objectives Limited data on respiratory infections are available from sub-Saharan Africa during the COVID-19 pandemic. The objective of this study was to evaluate the burden of respiratory viruses in rural Zambia from 2019-2021. Methods Surveillance was initiated at Macha Hospital in Zambia in December 2018. Each week, patients with respiratory symptoms were enrolled from the outpatient clinic. Nasopharyngeal samples were collected and tested for respiratory pathogens. The prevalence of respiratory symptoms and viruses in 2021 was compared to results from 2019 and 2020. Results After seeing few cases of influenza virus and respiratory syncytial virus in 2020, a return to prepandemic levels was observed in 2021. Rhinovirus/enterovirus, parainfluenza virus 1-4, and adenovirus circulated from 2019 to 2021, while human metapneumovirus and human coronaviruses (HKU1, 229E, OC43, and NL63 subtypes) were observed sporadically. SARS-CoV-2 was observed consistently in 2021 after being first identified in December 2020. The proportion of participants with co-infections in 2021 (11.6%) was significantly higher than in 2019 (6.9%) or 2020 (7.7%). Conclusion Declines in influenza virus and respiratory syncytial virus were reversed once public health measures were lifted. Respiratory viruses contributed to a significant burden of respiratory infections in 2021. This study provides important information about respiratory viruses in this changing context and underrepresented region.
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Affiliation(s)
- Catherine G. Sutcliffe
- Johns Hopkins University Bloomberg School of Public Health, Department of Epidemiology, Baltimore, USA
- Johns Hopkins University Bloomberg School of Public Health, Department of International Health, Baltimore, USA
| | | | - Evan Miller
- Johns Hopkins University School of Medicine, Division of Infectious Diseases, Baltimore, USA
| | | | - Justin Hardick
- Johns Hopkins University School of Medicine, Division of Infectious Diseases, Baltimore, USA
| | - Juliet Morales
- Johns Hopkins University Bloomberg School of Public Health, Department of International Health, Baltimore, USA
| | | | - Mwaka Monze
- University Teaching Hospital, Virology Laboratory, Lusaka, Zambia
| | - Yukari C. Manabe
- Johns Hopkins University School of Medicine, Division of Infectious Diseases, Baltimore, USA
- Johns Hopkins University Bloomberg School of Public Health, Department of Microbiology and Immunology, Baltimore, USA
| | | | - Richard E. Rothman
- Johns Hopkins University School of Medicine, Department of Emergency Medicine, Baltimore, USA
| | - Andrew Pekosz
- Johns Hopkins University School of Medicine, Division of Infectious Diseases, Baltimore, USA
- Johns Hopkins University Bloomberg School of Public Health, Department of Microbiology and Immunology, Baltimore, USA
- Johns Hopkins University School of Medicine, Department of Emergency Medicine, Baltimore, USA
| | - Philip E. Thuma
- Macha Research Trust, Choma, Zambia
- Johns Hopkins University Bloomberg School of Public Health, Department of Microbiology and Immunology, Baltimore, USA
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10
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Zhu X, Gebo KA, Abraham AG, Habtehyimer F, Patel EU, Laeyendecker O, Gniadek TJ, Fernandez RE, Baker OR, Ram M, Cachay ER, Currier JS, Fukuta Y, Gerber JM, Heath SL, Meisenberg B, Huaman MA, Levine AC, Shenoy A, Anjan S, Blair JE, Cruser D, Forthal DN, Hammitt LL, Kassaye S, Mosnaim GS, Patel B, Paxton JH, Raval JS, Sutcliffe CG, Abinante M, Broderick P, Cluzet V, Cordisco ME, Greenblatt B, Petrini J, Rausch W, Shade D, Lane K, Gawad AL, Klein SL, Pekosz A, Shoham S, Casadevall A, Bloch EM, Hanley D, Sullivan DJ, Tobian AAR. Dynamics of inflammatory responses after SARS-CoV-2 infection by vaccination status in the USA: a prospective cohort study. Lancet Microbe 2023; 4:e692-e703. [PMID: 37659419 PMCID: PMC10475695 DOI: 10.1016/s2666-5247(23)00171-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 05/19/2023] [Accepted: 05/22/2023] [Indexed: 09/04/2023]
Abstract
BACKGROUND Cytokines and chemokines play a critical role in the response to infection and vaccination. We aimed to assess the longitudinal association of COVID-19 vaccination with cytokine and chemokine concentrations and trajectories among people with SARS-CoV-2 infection. METHODS In this longitudinal, prospective cohort study, blood samples were used from participants enrolled in a multi-centre randomised trial assessing the efficacy of convalescent plasma therapy for ambulatory COVID-19. The trial was conducted in 23 outpatient sites in the USA. In this study, participants (aged ≥18 years) were restricted to those with COVID-19 before vaccination or with breakthrough infections who had blood samples and symptom data collected at screening (pre-transfusion), day 14, and day 90 visits. Associations between COVID-19 vaccination status and concentrations of 21 cytokines and chemokines (measured using multiplexed sandwich immunoassays) were examined using multivariate linear mixed-effects regression models, adjusted for age, sex, BMI, hypertension, diabetes, trial group, and COVID-19 waves (pre-alpha or alpha and delta). FINDINGS Between June 29, 2020, and Sept 30, 2021, 882 participants recently infected with SARS-CoV-2 were enrolled, of whom 506 (57%) were female and 376 (43%) were male. 688 (78%) of 882 participants were unvaccinated, 55 (6%) were partly vaccinated, and 139 (16%) were fully vaccinated at baseline. After adjusting for confounders, geometric mean concentrations of interleukin (IL)-2RA, IL-7, IL-8, IL-15, IL-29 (interferon-λ), inducible protein-10, monocyte chemoattractant protein-1, and tumour necrosis factor-α were significantly lower among the fully vaccinated group than in the unvaccinated group at screening. On day 90, fully vaccinated participants had approximately 20% lower geometric mean concentrations of IL-7, IL-8, and vascular endothelial growth factor-A than unvaccinated participants. Cytokine and chemokine concentrations decreased over time in the fully and partly vaccinated groups and unvaccinated group. Log10 cytokine and chemokine concentrations decreased faster among participants in the unvaccinated group than in other groups, but their geometric mean concentrations were generally higher than fully vaccinated participants at 90 days. Days since full vaccination and type of vaccine received were not correlated with cytokine and chemokine concentrations. INTERPRETATION Initially and during recovery from symptomatic COVID-19, fully vaccinated participants had lower concentrations of inflammatory markers than unvaccinated participants suggesting vaccination is associated with short-term and long-term reduction in inflammation, which could in part explain the reduced disease severity and mortality in vaccinated individuals. FUNDING US Department of Defense, National Institutes of Health, Bloomberg Philanthropies, State of Maryland, Mental Wellness Foundation, Moriah Fund, Octapharma, HealthNetwork Foundation, and the Shear Family Foundation.
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Affiliation(s)
- Xianming Zhu
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Kelly A Gebo
- Department of Medicine, Division of Infectious Diseases, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Alison G Abraham
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Department of Epidemiology, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Feben Habtehyimer
- Department of Medicine, Division of Infectious Diseases, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Eshan U Patel
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| | - Oliver Laeyendecker
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Washington, DC, USA
| | - Thomas J Gniadek
- Department of Pathology and Laboratory Medicine, Northshore University Health System, Evanston, IL, USA
| | - Reinaldo E Fernandez
- Department of Medicine, Division of Infectious Diseases, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Owen R Baker
- Department of Medicine, Division of Infectious Diseases, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Malathi Ram
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| | - Edward R Cachay
- Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA, USA
| | - Judith S Currier
- Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, CA, USA
| | - Yuriko Fukuta
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX, USA
| | - Jonathan M Gerber
- Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Sonya L Heath
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Barry Meisenberg
- Department of Medicine and Research Institute of Luminis Health, Annapolis, MD, USA
| | - Moises A Huaman
- Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH, USA
| | - Adam C Levine
- Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Aarthi Shenoy
- Division of Hematology, Medstar DC Hospital, Washington, DC, USA
| | - Shweta Anjan
- Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Janis E Blair
- Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ, USA
| | - Daniel Cruser
- Department of Pathology, Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY, USA
| | - Donald N Forthal
- Department of Medicine, Division of Infectious Diseases, University of California, Irvine, CA, USA
| | - Laura L Hammitt
- Department of International Health, Johns Hopkins University, Baltimore, MD, USA
| | - Seble Kassaye
- Division of Infectious Diseases, Georgetown University Medical Center, Washington, DC, USA
| | - Giselle S Mosnaim
- Division of Allergy and Immunology, Department of Medicine, Northshore University Health System, Evanston, IL, USA
| | - Bela Patel
- Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX, USA
| | - James H Paxton
- Department of Emergency Medicine, Wayne State University, Detroit, MI, USA
| | - Jay S Raval
- Department of Pathology, University of New Mexico, Albuquerque, NM, USA
| | | | | | - Patrick Broderick
- Department of Emergency Medicine, Nuvance Health Danbury Hospital, Danbury, CT, USA
| | - Valerie Cluzet
- Department of Infectious Disease, Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY, USA
| | - Marie Elena Cordisco
- Department of Emergency Medicine, Nuvance Health Danbury Hospital, Danbury, CT, USA
| | - Benjamin Greenblatt
- Department of Emergency Medicine, Nuvance Health Norwalk Hospital, Norwark, CT, USA
| | - Joann Petrini
- Department of Emergency Medicine, Nuvance Health Danbury Hospital, Danbury, CT, USA
| | - William Rausch
- Department of Emergency Medicine, Nuvance Health Danbury Hospital, Danbury, CT, USA
| | - David Shade
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| | - Karen Lane
- Department of Neurology, Brain Injury Outcomes Division, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Amy L Gawad
- Department of Molecular Microbiology and Immunology, Johns Hopkins University, Baltimore, MD, USA
| | - Sabra L Klein
- Department of Molecular Microbiology and Immunology, Johns Hopkins University, Baltimore, MD, USA
| | - Andrew Pekosz
- Department of Molecular Microbiology and Immunology, Johns Hopkins University, Baltimore, MD, USA
| | - Shmuel Shoham
- Department of Medicine, Division of Infectious Diseases, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Arturo Casadevall
- Department of Molecular Microbiology and Immunology, Johns Hopkins University, Baltimore, MD, USA
| | - Evan M Bloch
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Daniel Hanley
- Department of Neurology, Brain Injury Outcomes Division, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - David J Sullivan
- Department of Molecular Microbiology and Immunology, Johns Hopkins University, Baltimore, MD, USA
| | - Aaron A R Tobian
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
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11
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Huaman MA, Raval JS, Paxton JH, Mosnaim GS, Patel B, Anjan S, Meisenberg BR, Levine AC, Marshall CE, Yarava A, Shenoy AG, Heath SL, Currier JS, Fukuta Y, Blair JE, Spivak ES, Petrini JR, Broderick PB, Rausch W, Cordisco M, Hammel J, Greenblatt B, Cluzet VC, Cruser D, Oei K, Abinante M, Hammitt LL, Sutcliffe CG, Forthal DN, Zand MS, Cachay ER, Kassaye SG, Ram M, Wang Y, Das P, Lane K, McBee NA, Gawad AL, Karlen N, Ford DE, Laeyendecker O, Pekosz A, Klein SL, Ehrhardt S, Lau B, Baksh SN, Shade DM, Casadevall A, Hanley DF, Ou J, Gniadek TJ, Ziman A, Shoham S, Gebo KA, Bloch EM, Tobian AAR, Sullivan DJ, Gerber JM. Transfusion reactions associated with COVID-19 convalescent plasma in outpatient clinical trials. Transfusion 2023; 63:1639-1648. [PMID: 37534607 PMCID: PMC10720768 DOI: 10.1111/trf.17485] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/20/2023] [Accepted: 06/20/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND COVID-19 convalescent plasma (CCP) is an important therapeutic option for outpatients at high risk of hospitalization from SARS-CoV-2 infection. We assessed the safety of outpatient CCP transfusions administered during clinical trials. STUDY DESIGN AND METHODS We analyzed data pertaining to transfusion-related reactions from two randomized controlled trials in the U.S. that evaluated the efficacy of CCP versus control plasma in various ambulatory settings. Multivariable logistic regression was used to assess whether CCP was associated with transfusion reactions, after adjusting for potential confounders. RESULTS The combined study reported 79/1351 (5.9%) adverse events during the transfusion visit, with the majority 62/1351 (4.6%) characterized by mild, allergic-type findings of urticaria, and/or pruritus consistent with minor allergic transfusion reactions; the other reported events were attributed to the patients' underlying disease, COVID-19, or vasovagal in nature. We found no difference in the likelihood of allergic transfusion reactions between those receiving CCP versus control plasma (adjusted odds ratio [AOR], 0.75; 95% CI, 0.43-1.31). Risk of urticaria and/or pruritus increased with a pre-existing diagnosis of asthma (AOR, 2.33; 95% CI, 1.16-4.67). We did not observe any CCP-attributed antibody disease enhancement in participants with COVID-19 or increased risk of infection. There were no life-threatening severe transfusion reactions and no patients required hospitalization related to transfusion-associated complications. DISCUSSION Outpatient plasma administration was safely performed for nearly 1400 participants. CCP is a safe therapeutic option for outpatients at risk of hospitalization from COVID-19.
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Affiliation(s)
- Moises A Huaman
- Department of Internal Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati, Ohio, USA
| | - Jay S Raval
- Department of Pathology, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
| | - James H Paxton
- Department of Emergency Medicine, Wayne State University, Detroit, Michigan, USA
| | - Giselle S Mosnaim
- Department of Medicine, Division of Allergy and Immunology, NorthShore University Health System, Evanston, Illinois, USA
| | - Bela Patel
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, Texas, USA
| | - Shweta Anjan
- Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA
| | | | - Adam C Levine
- Department of Emergency Medicine, Rhode Island Hospital & Brown University, Providence, Rhode Island, USA
| | - Christi E Marshall
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Anusha Yarava
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Aarthi G Shenoy
- Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center, DC, USA
| | - Sonya L Heath
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Judith S Currier
- Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, USA
| | - Yuriko Fukuta
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA
| | - Janis E Blair
- Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, Arizona, USA
| | - Emily S Spivak
- Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | | | | | | | | | - Jean Hammel
- Nuvance Health Norwalk Hospital, Norwalk, Connecticut, USA
| | | | - Valerie C Cluzet
- Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, New York, USA
| | - Daniel Cruser
- Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, New York, USA
| | - Kevin Oei
- Ascada Research, Fullerton, California, USA
| | | | - Laura L Hammitt
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Catherine G Sutcliffe
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Donald N Forthal
- Department of Medicine, Division of Infectious Diseases, University of California, Irvine, California, USA
| | - Martin S Zand
- Department of Medicine, University of Rochester Medical Center, Rochester, New York, USA
| | - Edward R Cachay
- Department of Medicine, Division of Infectious Diseases, University of California, San Diego, California, USA
| | - Seble G Kassaye
- Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center, DC, USA
| | - Malathi Ram
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Ying Wang
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Piyali Das
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Karen Lane
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Nichol A McBee
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Amy L Gawad
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Nicky Karlen
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Daniel E Ford
- Institute for Clinical and Translational Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Oliver Laeyendecker
- The Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA
| | - Andrew Pekosz
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Sabra L Klein
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Stephan Ehrhardt
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Bryan Lau
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Sheriza N Baksh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - David M Shade
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Arturo Casadevall
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Daniel F Hanley
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jiangda Ou
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Thomas J Gniadek
- Department of Pathology and Laboratory Medicine, NorthShore University Health System, Evanston, Illinois, USA
| | - Alyssa Ziman
- Department of Pathology and Laboratory Medicine, Wing-Kwai and Alice Lee-Tsing Chung Transfusion Service, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Shmuel Shoham
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Kelly A Gebo
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Evan M Bloch
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Aaron A R Tobian
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - David J Sullivan
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jonathan M Gerber
- Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
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12
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Sutcliffe CG, Moyo N, Hamahuwa M, Mutanga JN, van Dijk JH, Hamangaba F, Schue JL, Thuma PE, Moss WJ. The Evolving Pediatric HIV Epidemic in Rural Southern Zambia: The Beneficial Impact of Advances in Prevention and Treatment at a District Hospital From 2007 to 2019. Pediatr Infect Dis J 2023; 42:489-495. [PMID: 36795584 PMCID: PMC10360039 DOI: 10.1097/inf.0000000000003873] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
BACKGROUND Remarkable progress has been made in expanding access to services addressing the pediatric HIV epidemic, including programs to prevent mother-to-child transmission, early diagnosis and treatment for children living with HIV. Few long-term data are available from rural sub-Saharan Africa to assess implementation and impact of national guidelines. METHODS Results from 3 cross-sectional studies and 1 cohort study conducted at Macha Hospital in Southern Province, Zambia from 2007 to 2019 were summarized. For infant diagnosis, maternal antiretroviral treatment, infant test results and turnaround times for results were evaluated by year. For pediatric HIV care, the number and age of children initiating care and treatment, and treatment outcomes within 12 months were evaluated by year. RESULTS Receipt of maternal combination antiretroviral treatment increased from 51.6% in 2010-2012 to 93.4% in 2019, and the proportion of infants testing positive decreased from 12.4% to 4.0%. Turnaround times for results returning to clinic varied but were shorter when labs consistently used a text messaging system. The proportion of mothers receiving results was higher when a text message intervention was piloted. The number of children living with HIV enrolled into care and the proportion initiating treatment with severe immunosuppression and dying within 12 months decreased over time. CONCLUSIONS These studies demonstrate the long-term beneficial impact of implementing a strong HIV prevention and treatment program. While expansion and decentralization brought challenges, the program succeeded in decreasing the rate of mother-to-child transmission and ensuring that children living with HIV benefit from access to life-saving treatment.
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Affiliation(s)
- Catherine G. Sutcliffe
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, Maryland, USA
| | | | | | | | | | | | - Jessica L. Schue
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, Maryland, USA
| | - Philip E. Thuma
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, Maryland, USA
- Macha Research Trust, Choma, Zambia
| | - William J. Moss
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, Maryland, USA
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13
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le Roux SM, Odayar J, Sutcliffe CG, Salvatore PP, de Broucker G, Dowdy D, McCann NC, Frank SC, Ciaranello AL, Myer L, Vojnov L. Cost-effectiveness of point-of-care versus centralised, laboratory-based nucleic acid testing for diagnosis of HIV in infants: a systematic review of modelling studies. Lancet HIV 2023; 10:e320-e331. [PMID: 37149292 PMCID: PMC10175481 DOI: 10.1016/s2352-3018(23)00029-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 01/31/2023] [Accepted: 02/03/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND Point-of-care (POC) nucleic acid testing for diagnosis of HIV in infants facilitates earlier initiation of antiretroviral therapy (ART) than with centralised (standard-of-care, SOC) testing, but can be more expensive. We evaluated cost-effectiveness data from mathematical models comparing POC with SOC to provide global policy guidance. METHODS In this systematic review of modelling studies, we searched PubMed, MEDLINE, Embase, the National Health Service Economic Evaluation Database, Econlit, and conference abstracts, combining terms for "HIV" + "infant"/"early infant diagnosis" + "point-of-care" + "cost-effectiveness" + "mathematical models", without restrictions from database inception to July 15, 2022. We selected reports of mathematical cost-effectiveness models comparing POC with SOC for HIV diagnosis in infants younger than 18 months. Titles and abstracts were independently reviewed, with full-text review for qualifying articles. We extracted data on health and economic outcomes and incremental cost-effectiveness ratios (ICERs) for narrative synthesis. The primary outcomes of interest were ICERs (comparing POC with SOC) for ART initiation and survival of children living with HIV. FINDINGS Our search identified 75 records through database search. 13 duplicates were excluded, leaving 62 non-duplicate articles. 57 records were excluded and five were reviewed in full text. One article was excluded as it was not a modelling study, and four qualifying studies were included in the review. These four reports were from two mathematical models from two independent modelling groups. Two reports used the Johns Hopkins model to compare POC with SOC for repeat early infant diagnosis testing in the first 6 months in sub-Saharan Africa (first report, simulation of 25 000 children) and Zambia (second report, simulation of 7500 children). In the base scenario, POC versus SOC increased probability of ART initiation within 60 days of testing from 19% to 82% (ICER per additional ART initiation range US$430-1097; 9-month cost horizon) in the first report; and from 28% to 81% in the second ($23-1609, 5-year cost horizon). Two reports compared POC with SOC for testing at 6 weeks in Zimbabwe using the Cost-Effectiveness of Preventing AIDS Complications-Paediatric model (simulation of 30 million children; lifetime horizon). POC increased life expectancy and was considered cost-effective compared with SOC (ICER $711-850 per year of life saved in HIV-exposed children). Results were robust throughout sensitivity and scenario analyses. In most scenarios, platform cost-sharing (co-use with other programmes) resulted in POC being cost-saving compared with SOC. INTERPRETATION Four reports from two different models suggest that POC is a cost-effective and potentially cost-saving strategy for upscaling of early infant testing compared with SOC. FUNDING Bill & Melinda Gates Foundation, Unitaid, National Institute of Allergy and Infectious Diseases, National Institute of Child Health and Human Development, WHO, and Massachusetts General Hospital Research Scholars.
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Affiliation(s)
- Stanzi M le Roux
- Division of Epidemiology & Biostatistics, School of Public Health, University of Cape Town, Cape Town, South Africa.
| | - Jasantha Odayar
- Division of Epidemiology & Biostatistics, School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Catherine G Sutcliffe
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Phillip P Salvatore
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Gatien de Broucker
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - David Dowdy
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Nicole C McCann
- Medical Practice Evaluation Center, Department of Medicine, Massachusetts General Hospital Boston, MA, USA
| | - Simone C Frank
- Medical Practice Evaluation Center, Department of Medicine, Massachusetts General Hospital Boston, MA, USA
| | - Andrea L Ciaranello
- Medical Practice Evaluation Center, Department of Medicine, Massachusetts General Hospital Boston, MA, USA; Division of Infectious Diseases, Massachusetts General Hospital Boston, MA, USA
| | - Landon Myer
- Division of Epidemiology & Biostatistics, School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Lara Vojnov
- Global HIV, Hepatitis and STI Programme, World Health Organization, Geneva, Switzerland
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14
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Lutz CS, Hartman RM, Vigil DE, Britton A, Burrage AB, Campbell AP, Close RM, Desnoyers C, Dobson J, Garcia S, Halasa N, Honie E, Kobayashi M, McMorrow M, Mostafa HH, Parker D, Pohl K, Prill MM, Richards J, Roessler KC, Sutcliffe CG, Taylor K, Swango-Wilson A, Va P, Verani JR, Singleton RJ, Hammitt LL. Effectiveness of COVID-19 mRNA vaccines in preventing COVID-19-associated outpatient visits and hospitalizations among American Indian and Alaska Native persons, January–November 2021: a test-negative case-control analysis using surveillance data. Open Forum Infect Dis 2023; 10:ofad172. [PMID: 37089780 PMCID: PMC10114530 DOI: 10.1093/ofid/ofad172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 03/23/2023] [Indexed: 03/29/2023] Open
Abstract
Abstract
Background
Despite the disproportionate morbidity and mortality experienced by American Indian and Alaska Native (AI/AN) persons during the COVID-19 pandemic, few studies have reported vaccine effectiveness (VE) estimates among these communities.
Methods
We conducted a test-negative case-control analysis among AI/AN persons aged ≥12 years presenting for care from January 1, 2021 through November 30, 2021 to evaluate effectiveness of mRNA COVID-19 vaccines against COVID-19-associated outpatient visits and hospitalizations. Cases and controls were patients with ≥1 symptom consistent with COVID-19-like illness; cases were defined as those test-positive for SARS-CoV-2 and controls were defined as those test-negative for SARS-CoV-2. We used unconditional multivariable logistic regression to estimate VE, defined as 1 minus the adjusted odds ratio for vaccination among cases versus controls.
Results
The analysis included 207 cases and 267 test-negative controls. Forty-four percent of cases and 78% of controls received two doses of either BNT162b2 or mRNA-1273 vaccine. VE point estimates for two doses of mRNA vaccine were higher for hospitalized participants (94.6% [88.0–97.6]) than outpatient participants (86.5% [63.0–95.0]), but confidence intervals overlapped.
Conclusions
Among AI/AN persons, mRNA COVID-19 vaccines were highly effective in preventing COVID-associated outpatient visits and hospitalizations. Maintaining high vaccine coverage, including booster doses, will reduce the burden of disease in this population.
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Affiliation(s)
- Chelsea S Lutz
- Correspondence: Chelsea S. Lutz, MPH, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 415 N. Washington St, Baltimore, MD 21231 (); or Laura L. Hammitt, MD, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 415 N. Washington St, Baltimore, MD 21231 ()
| | - Rachel M Hartman
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Deionna E Vigil
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Amadea Britton
- CDC COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Amanda B Burrage
- Tuba City Service Unit, Navajo Area, Indian Health Service, Tuba City, Arizona, USA
| | - Angela P Campbell
- CDC COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ryan M Close
- Whiteriver Service Unit, Phoenix Area, Indian Health Service, Whiteriver, Arizona, USA
| | | | - Jennifer Dobson
- Alaska Native Tribal Health Consortium, Anchorage, Alaska, USA
| | - Starla Garcia
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Natasha Halasa
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Elvira Honie
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Miwako Kobayashi
- CDC COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Meredith McMorrow
- CDC COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Heba H Mostafa
- Division of Medical Microbiology, Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Dennie Parker
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kyle Pohl
- Alaska Native Tribal Health Consortium, Anchorage, Alaska, USA
| | - Mila M Prill
- CDC COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jennifer Richards
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kristen C Roessler
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Catherine G Sutcliffe
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kim Taylor
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | - Puthiery Va
- Chinle Service Unit, Navajo Area, Indian Health Service, Chinle, Arizona, USA
| | - Jennifer R Verani
- CDC COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Laura L Hammitt
- Correspondence: Chelsea S. Lutz, MPH, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 415 N. Washington St, Baltimore, MD 21231 (); or Laura L. Hammitt, MD, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 415 N. Washington St, Baltimore, MD 21231 ()
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15
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Gebo KA, Heath SL, Fukuta Y, Zhu X, Baksh S, Abraham AG, Habtehyimer F, Shade D, Ruff J, Ram M, Laeyendecker O, Fernandez RE, Patel EU, Baker OR, Shoham S, Cachay ER, Currier JS, Gerber JM, Meisenberg B, Forthal DN, Hammitt LL, Huaman MA, Levine A, Mosnaim GS, Patel B, Paxton JH, Raval JS, Sutcliffe CG, Anjan S, Gniadek T, Kassaye S, Blair JE, Lane K, McBee NA, Gawad AL, Das P, Klein SL, Pekosz A, Casadevall A, Bloch EM, Hanley D, Tobian AAR, Sullivan DJ. Early Treatment, Inflammation and Post-COVID Conditions. medRxiv 2023:2023.02.13.23285855. [PMID: 36824860 PMCID: PMC9949202 DOI: 10.1101/2023.02.13.23285855] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
Background Post-COVID conditions (PCC) are common and have significant morbidity. Risk factors for PCC include advancing age, female sex, obesity, and diabetes mellitus. Little is known about early treatment, inflammation, and PCC. Methods Among 883 individuals with confirmed SARS-CoV-2 infection participating in a randomized trial of CCP vs. control plasma with available biospecimens and symptom data, the association between early COVID treatment, cytokine levels and PCC was evaluated. Cytokine and chemokine levels were assessed at baseline, day 14 and day 90 using a multiplexed sandwich immuosassay (Mesoscale Discovery). Presence of any self-reported PCC symptoms was assessed at day 90. Associations between COVID treatment, cytokine levels and PCC were examined using multivariate logistic regression models. Results One-third of the 882 participants had day 90 PCC symptoms, with fatigue (14.5%) and loss of smell (14.5%) being most common. Cytokine levels decreased from baseline to day 90. In a multivariable analysis including diabetes, body mass index, race, and vaccine status, female sex (adjusted odds ratio[AOR]=2.70[1.93-3.81]), older age (AOR=1.32[1.17-1.50]), and elevated baseline levels of IL-6 (AOR=1.59[1.02-2.47]) were associated with development of PCC.There was a trend for decreased PCC in those with early CCP treatment (≤5 days after symptom onset) compared to late CCP treatment. Conclusion Increased IL-6 levels were associated with the development of PCC and there was a trend for decreased PCC with early CCP treatment in this predominately unvaccinated population. Future treatment studies should evaluate the effect of early treatment and anti-IL-6 therapies on PCC development.
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Affiliation(s)
- Kelly A Gebo
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Sonya L Heath
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL
| | - Yuriko Fukuta
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX
| | - Xianming Zhu
- Department of Pathology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Sheriza Baksh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Alison G Abraham
- Department of Epidemiology, University of Colorado, Anschutz Medical Campus, Aurora CO
| | - Feben Habtehyimer
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - David Shade
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Jessica Ruff
- Department of Pathology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Malathi Ram
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Oliver Laeyendecker
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH
| | - Reinaldo E Fernandez
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Eshan U Patel
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Owen R Baker
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Shmuel Shoham
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Edward R Cachay
- Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA
| | - Judith S Currier
- Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA
| | - Jonathan M Gerber
- Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA
| | | | - Donald N Forthal
- Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA
| | - Laura L Hammitt
- International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Moises A Huaman
- Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH
| | - Adam Levine
- Department of Emergency Medicine, Rhode Island Hospital Warren Alpert Medical School of Brown University, Providence, RI
| | - Giselle S Mosnaim
- Division of Allergy and Immunology, Department of Medicine, Northshore University Health System, Evanston, IL
| | - Bela Patel
- Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX
| | - James H Paxton
- Department of Emergency Medicine, Wayne State University, Detroit, MI
| | - Jay S Raval
- Department of Pathology, University of New Mexico, Albuquerque, NM
| | - Catherine G Sutcliffe
- International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Shweta Anjan
- Department of Medicine, Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL
| | - Thomas Gniadek
- Department of Pathology, Northshore University Health System, Evanston, IL
| | - Seble Kassaye
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Janis E Blair
- Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ
| | - Karen Lane
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Nichol A McBee
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Amy L Gawad
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Piyali Das
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Sabra L Klein
- Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C
| | - Andrew Pekosz
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Arturo Casadevall
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Evan M Bloch
- Department of Pathology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Daniel Hanley
- Department of Neurology, Brain Injury Outcomes Division, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Aaron A R Tobian
- Department of Pathology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - David J Sullivan
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
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16
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Sutcliffe CG, Sinywimaanzi P, Morales J, Sianyanda M, Muleka M, Fenstermacher KZJ, Monze M, Rothman RE, Pekosz A, Thuma PE, Simulundu E. Uptake of public health measures and vaccine acceptance during the COVID-19 pandemic in rural Zambia. Hum Vaccin Immunother 2022; 18:2153538. [PMID: 36482701 PMCID: PMC9762779 DOI: 10.1080/21645515.2022.2153538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Vaccines are effective tools to prevent COVID-19-related morbidity. However, coverage is low throughout sub-Saharan Africa. Uptake of public health measures, perceptions of COVID-19 illness and vaccines, and intention to vaccinate were evaluated in 2021-2022 in rural Zambia. Adherence to public health measures, perceptions of COVID-19 risk and severity, and vaccine acceptance increased significantly over time, particularly in December 2021, coinciding with the fourth pandemic wave and relaunch of the national vaccine campaign. Vaccine acceptance was associated with perceptions of vaccine safety and effectiveness, but not disease severity. These findings highlight the importance of strong pandemic response and public communication for increased uptake of mitigatory measures, including vaccine acceptance.
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Affiliation(s)
- Catherine G. Sutcliffe
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA,CONTACT Catherine G. Sutcliffe Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E6535, Baltimore, MD21205, USA
| | | | - Juliet Morales
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | | | - Mwaka Monze
- Virology Laboratory, University Teaching Hospital, Lusaka, Zambia
| | - Richard E. Rothman
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Andrew Pekosz
- Department of Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
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17
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Morales JA, Hamahuwa M, Moyo N, Mutanga JN, Schue JL, Maunga S, Thuma PE, Moss WJ, Sutcliffe CG. Factors associated with antiretroviral therapy use among pregnant women in rural and urban settings in Southern Province, Zambia: 2016-2019. Trop Med Int Health 2022; 27:902-912. [PMID: 36127148 PMCID: PMC10375440 DOI: 10.1111/tmi.13816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVES To assess antiretroviral therapy (ART) coverage among pregnant women living with HIV and compare the characteristics of women who received and did not receive ART during pregnancy in Zambia. METHODS A cross-sectional study was conducted at urban and rural health facilities in Southern Province, Zambia, from 2016 to 2019. Pregnant women living with HIV delivering at study sites were enrolled and administered a questionnaire, and the results of infant diagnostic testing for HIV at birth was documented. RESULTS About 1184 mother/infant pairs were enrolled. ART coverage was 93.7%. Most women who did not receive ART during pregnancy reported HIV diagnosis at delivery (18.0%) or during pregnancy (57.7%). The primary reported reason for not receiving ART was not wanting to take the drugs. Women who did not receive ART during pregnancy were significantly younger, less likely to have disclosed their HIV-infection status to others, and less likely to have received antenatal care than women who received ART. ART use correlated with higher levels of education in urban but not rural sites. Overall, 1.0% of infants were infected with HIV at birth, including 0.8% of infants born to women who received ART and 4.1% of infants born to women who did not. CONCLUSIONS Most women received ART according to guidelines, resulting in low perinatal transmission rates of HIV to infants. Efforts to increase ART coverage and prevent vertical transmission should focus on identifying incident HIV infections during pregnancy and strengthening counselling for newly diagnosed pregnant women.
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Affiliation(s)
- Juliet A Morales
- International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | | | | | - Jane N Mutanga
- Department of Paediatrics and Child Health, Livingstone Central Hospital, Livingstone, Zambia
| | - Jessica L Schue
- International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | | | - Philip E Thuma
- Macha Research Trust, Zambia.,Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - William J Moss
- Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
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18
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Katowa B, Kalonda A, Mubemba B, Matoba J, Shempela DM, Sikalima J, Kabungo B, Changula K, Chitanga S, Kasonde M, Kapona O, Kapata N, Musonda K, Monze M, Tembo J, Bates M, Zumla A, Sutcliffe CG, Kajihara M, Yamagishi J, Takada A, Sawa H, Chilengi R, Mukonka V, Muleya W, Simulundu E. Genomic Surveillance of SARS-CoV-2 in the Southern Province of Zambia: Detection and Characterization of Alpha, Beta, Delta, and Omicron Variants of Concern. Viruses 2022; 14:v14091865. [PMID: 36146671 PMCID: PMC9504048 DOI: 10.3390/v14091865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/15/2022] [Accepted: 08/19/2022] [Indexed: 11/16/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VOCs) have significantly impacted the global epidemiology of the pandemic. From December 2020 to April 2022, we conducted genomic surveillance of SARS-CoV-2 in the Southern Province of Zambia, a region that shares international borders with Botswana, Namibia, and Zimbabwe and is a major tourist destination. Genetic analysis of 40 SARS-CoV-2 whole genomes revealed the circulation of Alpha (B.1.1.7), Beta (B.1.351), Delta (AY.116), and multiple Omicron subvariants with the BA.1 subvariant being predominant. Whereas Beta, Delta, and Omicron variants were associated with the second, third, and fourth pandemic waves, respectively, the Alpha variant was not associated with any wave in the country. Phylogenetic analysis showed evidence of local transmission and possible multiple introductions of SARS-CoV-2 VOCs in Zambia from different European and African countries. Across the 40 genomes analysed, a total of 292 mutations were observed, including 182 missense mutations, 66 synonymous mutations, 23 deletions, 9 insertions, 1 stop codon, and 11 mutations in the non-coding region. This study stresses the need for the continued monitoring of SARS-CoV-2 circulation in Zambia, particularly in strategically positioned regions such as the Southern Province which could be at increased risk of introduction of novel VOCs.
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Affiliation(s)
- Ben Katowa
- Macha Research Trust, Choma 20100, Zambia
- Department of Biomedical Sciences, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia
| | - Annie Kalonda
- Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka 10101, Zambia
- Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia
- Africa Centre of Excellence for Infectious Diseases of Humans and Animals, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia
| | - Benjamin Mubemba
- Department of Wildlife Sciences, School of Natural Resources, Copperbelt University, Kitwe 50100, Zambia
- Department of Biomedical Sciences, School of Medicine, Copperbelt University, Ndola 50100, Zambia
| | | | | | - Jay Sikalima
- Churches Health Association of Zambia, Lusaka 10101, Zambia
| | - Boniface Kabungo
- Southern Provincial Health Office, Ministry of Health, Choma 20100, Zambia
| | - Katendi Changula
- Department of Paraclinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia
| | - Simbarashe Chitanga
- Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka 10101, Zambia
- Department of Preclinical Studies, School of Veterinary Medicine, University of Namibia, Windhoek Private Bag 13301, Namibia
- School of Life Sciences, College of Agriculture, Engineering and Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban 4000, South Africa
| | - Mpanga Kasonde
- Zambia National Public Health Institute, Ministry of Health, Lusaka 10101, Zambia
| | - Otridah Kapona
- Zambia National Public Health Institute, Ministry of Health, Lusaka 10101, Zambia
| | - Nathan Kapata
- Zambia National Public Health Institute, Ministry of Health, Lusaka 10101, Zambia
| | - Kunda Musonda
- Zambia National Public Health Institute, Ministry of Health, Lusaka 10101, Zambia
| | - Mwaka Monze
- Virology Laboratory, University Teaching Hospital, Lusaka 10101, Zambia
| | - John Tembo
- HerpeZ Infection Research and Training, University Teaching Hospital, Lusaka 10101, Zambia
| | - Matthew Bates
- HerpeZ Infection Research and Training, University Teaching Hospital, Lusaka 10101, Zambia
- School of Life and Environmental Sciences, University of Lincoln, Lincoln, Lincolnshire LN6 7TS, UK
| | - Alimuddin Zumla
- Division of Infection and Immunity, Centre for Clinical Microbiology, University College London, NIHR Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London NW3 2PF, UK
| | - Catherine G. Sutcliffe
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Masahiro Kajihara
- Division of Global Epidemiology, International Institute for Zoonosis Control, Hokkaido University, N20 W10, Kita-ku, Sapporo 001-0020, Japan
| | - Junya Yamagishi
- Division of Collaboration and Education, International Institute for Zoonosis Control, Hokkaido University, N20 W10, Kita-ku, Sapporo 001-0020, Japan
- International Collaboration Unit, International Institute for Zoonosis Control, Hokkaido University, N20 W10, Kita-ku, Sapporo 001-0020, Japan
| | - Ayato Takada
- Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia
- Africa Centre of Excellence for Infectious Diseases of Humans and Animals, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia
- Division of Global Epidemiology, International Institute for Zoonosis Control, Hokkaido University, N20 W10, Kita-ku, Sapporo 001-0020, Japan
- International Collaboration Unit, International Institute for Zoonosis Control, Hokkaido University, N20 W10, Kita-ku, Sapporo 001-0020, Japan
- One Health Research Center, Hokkaido University, N18 W9, Kita-ku, Sapporo 001-0020, Japan
| | - Hirofumi Sawa
- Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia
- Africa Centre of Excellence for Infectious Diseases of Humans and Animals, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia
- Division of Collaboration and Education, International Institute for Zoonosis Control, Hokkaido University, N20 W10, Kita-ku, Sapporo 001-0020, Japan
- One Health Research Center, Hokkaido University, N18 W9, Kita-ku, Sapporo 001-0020, Japan
- Division of Molecular Pathobiology, International Institute for Zoonosis Control, Hokkaido University, N20 W10, Kita-ku, Sapporo 001-0020, Japan
- Division of International Research Promotion, Hokkaido University International Institute for Zoonosis Control, N20 W10, Kita-ku, Sapporo 001-0020, Japan
- Global Virus Network, 725 W Lombard Street, Baltimore, MD 21201, USA
| | - Roma Chilengi
- Zambia National Public Health Institute, Ministry of Health, Lusaka 10101, Zambia
- Republic of Zambia State House, Lusaka 10101, Zambia
| | - Victor Mukonka
- Zambia National Public Health Institute, Ministry of Health, Lusaka 10101, Zambia
| | - Walter Muleya
- Department of Biomedical Sciences, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia
| | - Edgar Simulundu
- Macha Research Trust, Choma 20100, Zambia
- Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia
- Correspondence:
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19
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Loevinsohn G, Hamahuwa M, Hardick J, Sinywimaanzi P, Fenstermacher KZJ, Munachoonga P, Weynand A, Monze M, Manabe YC, Gaydos CA, Rothman RE, Pekosz A, Thuma PE, Simulundu E, Sutcliffe CG. Respiratory viruses in rural Zambia before and during the COVID-19 pandemic. Trop Med Int Health 2022; 27:647-654. [PMID: 35611546 PMCID: PMC9348166 DOI: 10.1111/tmi.13781] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES With the emergence of the COVID-19 pandemic, restrictions were implemented globally to control the virus. Data on respiratory pathogens in sub-Saharan Africa during the COVID-19 pandemic are scarce. This analysis was conducted to evaluate patterns of respiratory pathogens in rural Zambia before and during the first year of the pandemic. METHODS Surveillance was established in December 2018 at Macha Hospital in southern Zambia. Patients with respiratory symptoms in the outpatient and inpatient clinics were recruited. Nasopharyngeal samples were collected and tested for respiratory pathogens. The prevalence of respiratory symptoms and pathogens was evaluated and compared in the first (December 10, 2018-December 9, 2019) and second (December 10, 2019-November 30, 2020) years of surveillance. RESULTS Outpatient visits and admissions for respiratory illness significantly decreased from the first to second year, especially among children. SARS-CoV-2 was not detected from any participants in Year 2. Among outpatients and inpatients with respiratory symptoms, the prevalence of respiratory syncytial virus and influenza viruses decreased from the first to second year. In contrast, the prevalence of rhinovirus/enterovirus, metapneumovirus and parainfluenza virus increased. CONCLUSIONS The epidemiology of respiratory viruses in rural Zambia changed during the first year of the COVID-19 pandemic, suggesting that public health interventions may have had an impact on the introduction and circulation of respiratory pathogens in this area.
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Affiliation(s)
- Gideon Loevinsohn
- Department of EpidemiologyJohns Hopkins University Bloomberg School of Public HealthBaltimoreMarylandUSA
- Department of Emergency MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | | | - Justin Hardick
- Division of Infectious DiseasesJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | | | | | | | - Austin Weynand
- Department of EpidemiologyJohns Hopkins University Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Mwaka Monze
- Virology LaboratoryUniversity Teaching HospitalLusakaZambia
| | - Yukari C. Manabe
- Division of Infectious DiseasesJohns Hopkins University School of MedicineBaltimoreMarylandUSA
- Department of Microbiology and ImmunologyJohns Hopkins University Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Charlotte A. Gaydos
- Department of EpidemiologyJohns Hopkins University Bloomberg School of Public HealthBaltimoreMarylandUSA
- Department of Emergency MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
- Division of Infectious DiseasesJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Richard E. Rothman
- Department of Emergency MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Andrew Pekosz
- Department of Emergency MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
- Division of Infectious DiseasesJohns Hopkins University School of MedicineBaltimoreMarylandUSA
- Department of Microbiology and ImmunologyJohns Hopkins University Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Philip E. Thuma
- Macha Research TrustMachaZambia
- Department of Microbiology and ImmunologyJohns Hopkins University Bloomberg School of Public HealthBaltimoreMarylandUSA
| | | | - Catherine G. Sutcliffe
- Department of EpidemiologyJohns Hopkins University Bloomberg School of Public HealthBaltimoreMarylandUSA
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20
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Cella E, Sutcliffe CG, Tso C, Paul E, Ritchie N, Colelay J, Denny E, Grant LR, Weatherholtz RC, Hammitt LL, Azarian T. Carriage prevalence and genomic epidemiology of Staphylococcus aureus among Native American children and adults in the Southwestern USA. Microb Genom 2022; 8. [PMID: 35551692 PMCID: PMC9465076 DOI: 10.1099/mgen.0.000806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Native American individuals in the Southwestern USA experience a higher burden of invasive Staphylococcus aureus disease than the general population. However, little is known about S. aureus carriage in these communities. A cross-sectional study was conducted to determine the carriage prevalence, risk factors and genomic epidemiology of S. aureus among Native American children (<5 years, n=121) and adults (≥18 years, n=167) in the Southwestern USA. Short- and long-read sequencing data were generated using Illumina and Oxford Nanopore Technology platforms to produce high-quality hybrid assemblies, and antibiotic-resistance, virulence and pangenome analyses were performed. S. aureus carriage prevalence was 20.7 % among children, 30.2 % among adults 18–64 years and 16.7 % among adults ≥65 years. Risk factors among adults included recent surgery, prior S. aureus infection among household members, and recent use of gyms or locker rooms by household members. No risk factors were identified among children. The bacterial population structure was dominated by clonal complex 1 (CC1) (21.1 %), CC5 (22.2 %) and CC8 (22.2 %). Isolates from children and adults were intermixed throughout the phylogeny. While the S. aureus population was diverse, the carriage prevalence was comparable to that in the general USA population. Genomic and risk-factor data suggest household, community and healthcare transmission are important components of the local epidemiology.
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Affiliation(s)
- Eleonora Cella
- University of Central Florida, 4110 Libra Drive, Orlando, FL 32816, USA
| | - Catherine G Sutcliffe
- Johns Hopkins Bloomberg School of Public Health, 415 North Washington Street, Baltimore, MD 21231, USA
| | - Carol Tso
- Johns Hopkins Bloomberg School of Public Health, 415 North Washington Street, Baltimore, MD 21231, USA
| | - Ella Paul
- Johns Hopkins Bloomberg School of Public Health, 415 North Washington Street, Baltimore, MD 21231, USA
| | - Nina Ritchie
- Johns Hopkins Bloomberg School of Public Health, 415 North Washington Street, Baltimore, MD 21231, USA
| | - Janene Colelay
- Johns Hopkins Bloomberg School of Public Health, 415 North Washington Street, Baltimore, MD 21231, USA
| | - Estar Denny
- Johns Hopkins Bloomberg School of Public Health, 415 North Washington Street, Baltimore, MD 21231, USA
| | - Lindsay R Grant
- Johns Hopkins Bloomberg School of Public Health, 415 North Washington Street, Baltimore, MD 21231, USA.,Present address: Global Pneumococcal Vaccines, Scientific Affairs and Epidemiology, Pfizer Inc, USA
| | - Robert C Weatherholtz
- Johns Hopkins Bloomberg School of Public Health, 415 North Washington Street, Baltimore, MD 21231, USA
| | - Laura L Hammitt
- Johns Hopkins Bloomberg School of Public Health, 415 North Washington Street, Baltimore, MD 21231, USA
| | - Taj Azarian
- University of Central Florida, 4110 Libra Drive, Orlando, FL 32816, USA
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Sullivan DJ, Gebo KA, Shoham S, Bloch EM, Lau B, Shenoy AG, Mosnaim GS, Gniadek TJ, Fukuta Y, Patel B, Heath SL, Levine AC, Meisenberg BR, Spivak ES, Anjan S, Huaman MA, Blair JE, Currier JS, Paxton JH, Gerber JM, Petrini JR, Broderick PB, Rausch W, Cordisco ME, Hammel J, Greenblatt B, Cluzet VC, Cruser D, Oei K, Abinante M, Hammitt LL, Sutcliffe CG, Forthal DN, Zand MS, Cachay ER, Raval JS, Kassaye SG, Foster EC, Roth M, Marshall CE, Yarava A, Lane K, McBee NA, Gawad AL, Karlen N, Singh A, Ford DE, Jabs DA, Appel LJ, Shade DM, Ehrhardt S, Baksh SN, Laeyendecker O, Pekosz A, Klein SL, Casadevall A, Tobian AAR, Hanley DF. Early Outpatient Treatment for Covid-19 with Convalescent Plasma. N Engl J Med 2022; 386:1700-1711. [PMID: 35353960 PMCID: PMC9006786 DOI: 10.1056/nejmoa2119657] [Citation(s) in RCA: 159] [Impact Index Per Article: 79.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Polyclonal convalescent plasma may be obtained from donors who have recovered from coronavirus disease 2019 (Covid-19). The efficacy of this plasma in preventing serious complications in outpatients with recent-onset Covid-19 is uncertain. METHODS In this multicenter, double-blind, randomized, controlled trial, we evaluated the efficacy and safety of Covid-19 convalescent plasma, as compared with control plasma, in symptomatic adults (≥18 years of age) who had tested positive for severe acute respiratory syndrome coronavirus 2, regardless of their risk factors for disease progression or vaccination status. Participants were enrolled within 8 days after symptom onset and received a transfusion within 1 day after randomization. The primary outcome was Covid-19-related hospitalization within 28 days after transfusion. RESULTS Participants were enrolled from June 3, 2020, through October 1, 2021. A total of 1225 participants underwent randomization, and 1181 received a transfusion. In the prespecified modified intention-to-treat analysis that included only participants who received a transfusion, the primary outcome occurred in 17 of 592 participants (2.9%) who received convalescent plasma and 37 of 589 participants (6.3%) who received control plasma (absolute risk reduction, 3.4 percentage points; 95% confidence interval, 1.0 to 5.8; P = 0.005), which corresponded to a relative risk reduction of 54%. Evidence of efficacy in vaccinated participants cannot be inferred from these data because 53 of the 54 participants with Covid-19 who were hospitalized were unvaccinated and 1 participant was partially vaccinated. A total of 16 grade 3 or 4 adverse events (7 in the convalescent-plasma group and 9 in the control-plasma group) occurred in participants who were not hospitalized. CONCLUSIONS In participants with Covid-19, most of whom were unvaccinated, the administration of convalescent plasma within 9 days after the onset of symptoms reduced the risk of disease progression leading to hospitalization. (Funded by the Department of Defense and others; CSSC-004 ClinicalTrials.gov number, NCT04373460.).
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Affiliation(s)
- David J Sullivan
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Kelly A Gebo
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Shmuel Shoham
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Evan M Bloch
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Bryan Lau
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Aarthi G Shenoy
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Giselle S Mosnaim
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Thomas J Gniadek
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Yuriko Fukuta
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Bela Patel
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Sonya L Heath
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Adam C Levine
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Barry R Meisenberg
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Emily S Spivak
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Shweta Anjan
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Moises A Huaman
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Janis E Blair
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Judith S Currier
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - James H Paxton
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Jonathan M Gerber
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Joann R Petrini
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Patrick B Broderick
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - William Rausch
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Marie-Elena Cordisco
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Jean Hammel
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Benjamin Greenblatt
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Valerie C Cluzet
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Daniel Cruser
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Kevin Oei
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Matthew Abinante
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Laura L Hammitt
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Catherine G Sutcliffe
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Donald N Forthal
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Martin S Zand
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Edward R Cachay
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Jay S Raval
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Seble G Kassaye
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - E Colin Foster
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Michael Roth
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Christi E Marshall
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Anusha Yarava
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Karen Lane
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Nichol A McBee
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Amy L Gawad
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Nicky Karlen
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Atika Singh
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Daniel E Ford
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Douglas A Jabs
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Lawrence J Appel
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - David M Shade
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Stephan Ehrhardt
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Sheriza N Baksh
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Oliver Laeyendecker
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Andrew Pekosz
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Sabra L Klein
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Arturo Casadevall
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Aaron A R Tobian
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
| | - Daniel F Hanley
- From the Department of Medicine, Division of Infectious Diseases (K.A.G., S.S.), the Department of Pathology (E.M.B., C.E.M., A.A.R.T.), the Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N.A.M., A.L.G., N.K., D.F.H.), the Department of Ophthalmology (D.A.J.), the Welch Center for Prevention, Epidemiology and Clinical Research (L.J.A.), and the Institute for Clinical and Translational Research (D.E.F.), Johns Hopkins School of Medicine, and the Departments of Molecular Microbiology and Immunology (D.J.S., A.S., A.P., S.L.K., A.C.), International Health (L.L.H., C.G.S.), and Epidemiology (B.L., D.M.S., S.E., S.N.B.), Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda (O.L.), and Luminis Health, Annapolis (B.R.M.) - all in Maryland; the Department of Medicine, Division of Hematology and Oncology, MedStar Washington Hospital Center (A.G.S.), and the Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center (S.G.K.) - both in Washington, DC; the Division of Allergy and Immunology, Department of Medicine (G.S.M.), and the Department of Pathology (T.J.G.), NorthShore University Health System, Evanston, IL; the Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine (Y.F.), the Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center (B.P.), Houston, and The Next Practices Group, Austin (E.C.F.) - all in Texas; the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (S.L.H.); the Department of Emergency Medicine, Rhode Island Hospital, Brown University, Providence, RI (A.C.L.); the Department of Medicine, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City (E.S.S.); the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami (S.A.); the Department of Medicine, Division of Infectious Diseases, University of Cincinnati, Cincinnati (M.A.H.); the Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.E.B.); the Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles (J.S.C.), Ascada Research (K.O., M.A.), the Department of Medicine, Division of Infectious Diseases, University of California, Irvine (D.N.F.), and the Department of Medicine, Division of Infectious Diseases, University of California, San Diego (E.R.C.) - all in California; the Department of Emergency Medicine, Wayne State University, Detroit (J.H.P.); the Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester (J.M.G.); Nuvance Health (J.R.P., W.R., M.-E.C.), and Nuvance Health Danbury Hospital (P.B.B.), Danbury, and Nuvance Health Norwalk Hospital, Norwalk (J.H., B.G.) - all in Connecticut; Nuvance Health Vassar Brothers Medical Center, Poughkeepsie (V.C.C., D.C.), the Department of Medicine, University of Rochester Medical Center, Rochester (M.S.Z.), and the Bliss Group, New York (M.R.) - all in New York; and the Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM (J.S.R.)
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22
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Close RM, Sutcliffe CG, Galdun P, Reid A, Askew MR, Davidson AM, Kellywood K, Parker D, Patel J, Romancito E, Brown LB, McAuley JB, Hammitt LL. Point-of-care molecular diagnostics for the detection of group A Streptococcus in non-invasive skin and soft tissue infections: a validation study. Diagn Microbiol Infect Dis 2022; 103:115729. [DOI: 10.1016/j.diagmicrobio.2022.115729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 05/15/2022] [Accepted: 05/20/2022] [Indexed: 01/21/2023]
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Mubemba B, Mburu MM, Changula K, Muleya W, Moonga LC, Chambaro HM, Kajihara M, Qiu Y, Orba Y, Hayashida K, Sutcliffe CG, Norris DE, Thuma PE, Ndubani P, Chitanga S, Sawa H, Takada A, Simulundu E. Current knowledge of vector-borne zoonotic pathogens in Zambia: A clarion call to scaling-up "One Health" research in the wake of emerging and re-emerging infectious diseases. PLoS Negl Trop Dis 2022; 16:e0010193. [PMID: 35120135 PMCID: PMC8849493 DOI: 10.1371/journal.pntd.0010193] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 02/16/2022] [Accepted: 01/24/2022] [Indexed: 12/19/2022] Open
Abstract
Background Although vector-borne zoonotic diseases are a major public health threat globally, they are usually neglected, especially among resource-constrained countries, including those in sub-Saharan Africa. This scoping review examined the current knowledge and identified research gaps of vector-borne zoonotic pathogens in Zambia. Methods and findings Major scientific databases (Web of Science, PubMed, Scopus, Google Scholar, CABI, Scientific Information Database (SID)) were searched for articles describing vector-borne (mosquitoes, ticks, fleas and tsetse flies) zoonotic pathogens in Zambia. Several mosquito-borne arboviruses have been reported including Yellow fever, Ntaya, Mayaro, Dengue, Zika, West Nile, Chikungunya, Sindbis, and Rift Valley fever viruses. Flea-borne zoonotic pathogens reported include Yersinia pestis and Rickettsia felis. Trypanosoma sp. was the only tsetse fly-borne pathogen identified. Further, tick-borne zoonotic pathogens reported included Crimean-Congo Haemorrhagic fever virus, Rickettsia sp., Anaplasma sp., Ehrlichia sp., Borrelia sp., and Coxiella burnetii. Conclusions This study revealed the presence of many vector-borne zoonotic pathogens circulating in vectors and animals in Zambia. Though reports of human clinical cases were limited, several serological studies provided considerable evidence of zoonotic transmission of vector-borne pathogens in humans. However, the disease burden in humans attributable to vector-borne zoonotic infections could not be ascertained from the available reports and this precludes the formulation of national policies that could help in the control and mitigation of the impact of these diseases in Zambia. Therefore, there is an urgent need to scale-up “One Health” research in emerging and re-emerging infectious diseases to enable the country to prepare for future epidemics, including pandemics. Despite vector-borne zoonoses being a major public health threat globally, they are often overlooked, particularly among resource-constrained countries in sub-Saharan Africa, including Zambia. Therefore, we reviewed the current knowledge and identified research gaps of vector-borne zoonotic pathogens in Zambia. We focussed on mosquito-, tick-, flea- and tsetse fly-borne zoonotic pathogens reported in the country. Although we found evidence of circulation of several vector-borne zoonotic pathogens among vectors, animals and humans, clinical cases in humans were rarely reported. This suggests sparse capacity for diagnosis of vector-borne pathogens in healthcare facilities in the country and possibly limited awareness and knowledge of the local epidemiology of these infectious agents. Establishment of facility-based surveillance of vector-borne zoonoses in health facilities could provide valuable insights on morbidity, disease severity, and mortalities associated with infections as well as immune responses. In addition, there is also need for increased genomic surveillance of vector-borne pathogens in vectors and animals and humans for a better understanding of the molecular epidemiology of these diseases in Zambia. Furthermore, vector ecology studies aimed at understanding the drivers of vector abundance, pathogen host range (i.e., including the range of vectors and reservoirs), parasite-host interactions and factors influencing frequency of human-vector contacts should be prioritized. The study revealed the need for Zambia to scale-up One Health research in emerging and re-emerging infectious diseases to enable the country to be better prepared for future epidemics, including pandemics.
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Affiliation(s)
- Benjamin Mubemba
- Department of Wildlife Sciences, School of Natural Resources, Copperbelt University, Kitwe, Zambia
- Department of Biomedical Sciences, School of Medicine, Copperbelt University, Ndola, Zambia
| | | | - Katendi Changula
- Department of Paraclinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - Walter Muleya
- Department of Biomedical Sciences, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - Lavel C. Moonga
- Division of Collaboration and Education, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan
| | - Herman M. Chambaro
- Division of Molecular Pathobiology, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan
| | - Masahiro Kajihara
- Division of Global Epidemiology, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan
| | - Yongjin Qiu
- Division of International Research Promotion, Hokkaido University International Institute for Zoonosis Control, Sapporo, Japan
| | - Yasuko Orba
- Division of Molecular Pathobiology, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan
- International Collaboration Unit, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan
| | - Kyoko Hayashida
- Division of Collaboration and Education, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan
- International Collaboration Unit, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan
| | - Catherine G. Sutcliffe
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Douglas E. Norris
- The W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | | | | | - Simbarashe Chitanga
- Department of Paraclinical Studies, School of Veterinary Medicine, University of Namibia, Windhoek, Namibia
- Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, Zambia
- School of Life Sciences, College of Agriculture, Engineering and Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Hirofumi Sawa
- Division of Molecular Pathobiology, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan
- Division of International Research Promotion, Hokkaido University International Institute for Zoonosis Control, Sapporo, Japan
- International Collaboration Unit, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan
- Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
- Africa Centre of Excellence for Infectious Diseases of Humans and Animals, University of Zambia, Lusaka, Zambia
- Global Virus Network, Baltimore, Maryland, United States of America
- One Health Research Center, Hokkaido University, Sapporo, Japan
| | - Ayato Takada
- Division of Global Epidemiology, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan
- Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
- Africa Centre of Excellence for Infectious Diseases of Humans and Animals, University of Zambia, Lusaka, Zambia
- * E-mail: (AT); (ES)
| | - Edgar Simulundu
- Macha Research Trust, Choma, Zambia
- Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
- * E-mail: (AT); (ES)
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Sullivan DJ, Gebo KA, Shoham S, Bloch EM, Lau B, Shenoy AG, Mosnaim GS, Gniadek TJ, Fukuta Y, Patel B, Heath SL, Levine AC, Meisenberg BR, Spivak ES, Anjan S, Huaman MA, Blair JE, Currier JS, Paxton JH, Gerber JM, Petrini JR, Broderick PB, Rausch W, Cordisco ME, Hammel J, Greenblatt B, Cluzet VC, Cruser D, Oei K, Abinante M, Hammitt LL, Sutcliffe CG, Forthal DN, Zand MS, Cachay ER, Raval JS, Kassaye SG, Foster EC, Roth M, Marshall CE, Yarava A, Lane K, McBee NA, Gawad AL, Karlen N, Singh A, Ford DE, Jabs DA, Appel LJ, Shade DM, Ehrhardt S, Baksh SN, Laeyendecker O, Pekosz A, Klein SL, Casadevall A, Tobian AAR, Hanley DF. Randomized Controlled Trial of Early Outpatient COVID-19 Treatment with High-Titer Convalescent Plasma. medRxiv 2021:2021.12.10.21267485. [PMID: 34981068 PMCID: PMC8722611 DOI: 10.1101/2021.12.10.21267485] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The efficacy of polyclonal high titer convalescent plasma to prevent serious complications of COVID-19 in outpatients with recent onset of illness is uncertain. METHODS This multicenter, double-blind randomized controlled trial compared the efficacy and safety of SARS-CoV-2 high titer convalescent plasma to placebo control plasma in symptomatic adults ≥18 years positive for SARS-CoV-2 regardless of risk factors for disease progression or vaccine status. Participants with symptom onset within 8 days were enrolled, then transfused within the subsequent day. The measured primary outcome was COVID-19-related hospitalization within 28 days of plasma transfusion. The enrollment period was June 3, 2020 to October 1, 2021. RESULTS A total of 1225 participants were randomized and 1181 transfused. In the pre-specified modified intention-to-treat analysis that excluded those not transfused, the primary endpoint occurred in 37 of 589 (6.3%) who received placebo control plasma and in 17 of 592 (2.9%) participants who received convalescent plasma (relative risk, 0.46; one-sided 95% upper bound confidence interval 0.733; P=0.004) corresponding to a 54% risk reduction. Examination with a model adjusting for covariates related to the outcome did not change the conclusions. CONCLUSION Early administration of high titer SARS-CoV-2 convalescent plasma reduced outpatient hospitalizations by more than 50%. High titer convalescent plasma is an effective early outpatient COVID-19 treatment with the advantages of low cost, wide availability, and rapid resilience to variant emergence from viral genetic drift in the face of a changing pandemic. Trial Registration ClinicalTrials.gov number, NCT04373460.
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Affiliation(s)
- David J Sullivan
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Kelly A Gebo
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Shmuel Shoham
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Evan M Bloch
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Bryan Lau
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Aarthi G Shenoy
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Giselle S Mosnaim
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Thomas J Gniadek
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Yuriko Fukuta
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Bela Patel
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Sonya L Heath
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Adam C Levine
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Barry R Meisenberg
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Emily S Spivak
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Shweta Anjan
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Moises A Huaman
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Janis E Blair
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Judith S Currier
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - James H Paxton
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Jonathan M Gerber
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Joann R Petrini
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Patrick B Broderick
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - William Rausch
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Marie Elena Cordisco
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Jean Hammel
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Benjamin Greenblatt
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Valerie C Cluzet
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Daniel Cruser
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Kevin Oei
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Matthew Abinante
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Laura L Hammitt
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Catherine G Sutcliffe
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Donald N Forthal
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Martin S Zand
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Edward R Cachay
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Jay S Raval
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Seble G Kassaye
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - E Colin Foster
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Michael Roth
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Christi E Marshall
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Anusha Yarava
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Karen Lane
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Nichol A McBee
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Amy L Gawad
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Nicky Karlen
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Atika Singh
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Daniel E Ford
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Douglas A Jabs
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Lawrence J Appel
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - David M Shade
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Stephan Ehrhardt
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Sheriza N Baksh
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Oliver Laeyendecker
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Andrew Pekosz
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Sabra L Klein
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Arturo Casadevall
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Aaron A R Tobian
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
| | - Daniel F Hanley
- Department of Medicine, Division of Infectious Diseases (S.S., K.G.) Department of Pathology (E.B., C.M. A.T.), Department of Neurology, Brain Injury Outcomes Division (A.Y., K.L., N. M., A.G., N.K. D.H.), Department of Ophthalmology (DJ), Welch Center (L.A.), Institute for Clinical and Translational Research (D.F.), Johns Hopkins University School of Medicine; the Departments of Molecular Microbiology and Immunology (A.C., D.S., S.K., A.P.), International Health (L.H., C.S.), and Epidemiology (B.L., D.S., S.E.) Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH (O.L.); Department of Medicine, Division of Hematology and Oncology, Medstar Washington Hospital Center, Washington, DC (A.S.); Division of Allergy and Immunology, Department of Medicine (G.M.), Department of Pathology (T.G.), Northshore University Health System, Evanston, IL; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Y.F.); Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX (B.P.); Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL (S.H.); Department of Emergency Medicine, Rhode Island Hospital/Brown University, Providence, RI (A.L.); Luminis Health, Annapolis, MD (B. M.); Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT (E.S); Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL (S.A.); Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH (M.H.); Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ (J.B.); Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA (J.C.); Department of Emergency Medicine, Wayne State University, Detroit, MI (J.P.); Department of Medicine, Division of Hematology and Oncology, University of Massachusetts, Worchester, MA (J.G.); Nuvance Health, Danbury, CT (J.P., W.R., M.E.C); Nuvance Health Danbury Hospital, Danbury, CT (P.B.); Nuvance Health Norwalk Hospital, Norwalk, CT (J.H., B.G.); Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY (V.C., D.C.); Ascada Research, Fullerton, CA (K.O, M.A.); Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, CA (D.F.); Department of Medicine, University of Rochester, Rochester, NY (M.Z.); Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA (E.C.); Department of Pathology, University of New Mexico, Albuquerque, NM (J.R.); Department of Medicine, Division of Infectious Diseases, Medstar Georgetown University Hospital, Washington, D.C. (S.K.), The Bliss Group, New York City, NY, (M.R.) The Next Practice, Austin, TX (C.F.)
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25
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McCormick S, Ward KM, Sutcliffe CG, Irvin R, Chander G, Brooner RK, Mehta SH, Thomas DL, Sulkowski M, Falade-Nwulia O. Impact of Co-occurring Drug Use, Hazardous Alcohol Use, and Mental Health Disorders on Drug Use Patterns in People With HIV and Hepatitis C Virus Infection. Open Forum Infect Dis 2021; 8:ofab520. [PMID: 35559126 PMCID: PMC9088503 DOI: 10.1093/ofid/ofab520] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 10/18/2021] [Indexed: 11/13/2022] Open
Abstract
Drug use, hazardous alcohol use, and mental health disorders are prevalent among people with HIV and hepatitis C virus (HCV) infection. Co-occurrence of alcohol use and depression negatively impacts substance use patterns. Nevertheless, HCV treatment provides a promising opportunity to identify and address co-occurring drug use, hazardous alcohol use, and mental health disorders.
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Affiliation(s)
- Sean McCormick
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Kathleen M Ward
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Catherine G Sutcliffe
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Risha Irvin
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Robert K Brooner
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Shruti H Mehta
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - David L Thomas
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Mark Sulkowski
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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26
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Loevinsohn G, Hamahuwa M, Sinywimaanzi P, Fenstermacher KZJ, Shaw-Saliba K, Pekosz A, Monze M, Rothman RE, Simulundu E, Thuma PE, Sutcliffe CG. Facility-based surveillance for influenza and respiratory syncytial virus in rural Zambia. BMC Infect Dis 2021; 21:986. [PMID: 34548020 PMCID: PMC8453466 DOI: 10.1186/s12879-021-06677-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 09/10/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND While southern Africa experiences among the highest mortality rates from respiratory infections, the burden of influenza and respiratory syncytial virus (RSV) in rural areas is poorly understood. METHODS We implemented facility-based surveillance in Macha, Zambia. Outpatients and inpatients presenting with influenza-like illness (ILI) underwent testing for influenza A, influenza B, and RSV and were prospectively followed for 3 to 5 weeks to assess clinical course. Log-binomial models assessed correlates of infection and clinical severity. RESULTS Between December 2018 and December 2019, 17% of all outpatients presented with ILI and 16% of inpatients were admitted with an acute respiratory complaint. Influenza viruses and RSV were detected in 17% and 11% of outpatient participants with ILI, and 23% and 16% of inpatient participants with ILI, respectively. Influenza (July-September) and RSV (January-April) prevalence peaks were temporally distinct. RSV (relative risk [RR]: 1.78; 95% confidence interval [CI] 1.51-2.11), but not influenza, infection was associated with severe disease among patients with ILI. Underweight patients with ILI were more likely to be infected with influenza A (prevalence ratio [PR]: 1.72; 95% CI 1.04-2.87) and to have severe influenza A infections (RR: 2.49; 95% CI 1.57-3.93). CONCLUSIONS Populations in rural Zambia bear a sizeable burden of viral respiratory infections and severe disease. The epidemiology of infections in this rural area differs from that reported from urban areas in Zambia.
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Affiliation(s)
- Gideon Loevinsohn
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Room E6535, Baltimore, MD, 21205, USA
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | | | | | - Kathryn Shaw-Saliba
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Andrew Pekosz
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mwaka Monze
- Virology Laboratory, University Teaching Hospital, Lusaka, Zambia
| | - Richard E Rothman
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Philip E Thuma
- Macha Research Trust, Macha, Choma, Zambia
- Department of Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Catherine G Sutcliffe
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Room E6535, Baltimore, MD, 21205, USA.
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27
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Ward KM, Falade-Nwulia O, Moon J, Sutcliffe CG, Brinkley S, Haselhuhn T, Katz S, Herne K, Arteaga L, Mehta SH, Latkin C, Brooner RK, Sulkowski MS. Non-adherence to LDV/SOF did not predict SVR in a randomized controlled trial of HIV/HCV coinfected persons who use drugs. J Infect Dis 2021; 225:903-911. [PMID: 34543417 DOI: 10.1093/infdis/jiab477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 09/17/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Eliminating Hepatitis C Virus (HCV) will require effective treatment delivery to persons with substance use disorders (SUDs). We evaluated the relationship between ledipasvir/sofosbuvir treatment persistence (receiving 84 tablets), adherence, and sustained virologic response (SVR) in persons with HIV/HCV coinfection. METHODS Of the 144 participants with HIV/HCV and SUDs, 110 initiated a 12-week treatment course under one of three conditions (usual care, peer mentors, and cash incentives). We used self-report, pharmacy pill counts, and expected date of refill to examine adherence. Persistent participants were categorized as high adherence (taking ≥90% of doses) or low adherence (taking <90% of doses). RESULTS Most participants persisted on treatment after initiation (n=105), with 95% (n=100) achieving SVR. One-third (34%) of participants had moderate/heavy alcohol use by the biomarker phosphatidylethanol (PEth ≥50 ng/mL), and 44% had urine toxicology positive for cocaine or heroin at enrollment. The proportion of persons with high adherence was 72% (n=76) and low adherence, 28%. Although low adherence was associated with moderate/heavy alcohol use by PEth (RR 2.77, 95% CI 1.50-5.12), SVR did not vary according to adherence (p=0.702), and most participants (97%) with low adherence achieved SVR. CONCLUSION Treatment persistence led to high SVR rates among persons with HIV/HCV, despite imperfect adherence and SUDs.
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Affiliation(s)
- Kathleen M Ward
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore MD, USA
| | | | - Juhi Moon
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore MD, USA
| | - Catherine G Sutcliffe
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore MD, USA
| | - Sherilyn Brinkley
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore MD, USA
| | - Taryn Haselhuhn
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore MD, USA
| | - Stephanie Katz
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore MD, USA
| | - Kayla Herne
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore MD, USA
| | - Lilian Arteaga
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore MD, USA
| | - Shruti H Mehta
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore MD, USA
| | - Carl Latkin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore MD, USA
| | - Robert K Brooner
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore MD, USA
| | - Mark S Sulkowski
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore MD, USA
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28
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Loevinsohn G, Hardick J, Mehoke T, Sinywimaanzi P, Hamahuwa M, Fenstermacher KZJ, Shaw-Saliba K, Thielen P, Evans J, Bowden K, Zudock K, Sauer LM, Monze M, Gaydos CA, Rothman RE, Pekosz A, Thuma PE, Sutcliffe CG. Nosocomial Respiratory Infections in a Rural Zambian Hospital. Am J Trop Med Hyg 2021; 105:818-821. [PMID: 34280144 DOI: 10.4269/ajtmh.20-1470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 04/25/2021] [Indexed: 11/07/2022] Open
Abstract
The burden of nosocomial respiratory infections in rural southern Africa is poorly understood. We established a surveillance program at a rural Zambian hospital to detect influenza-like illness (ILI) and respiratory infections among hospitalized patients and a cohort of healthcare workers (HCWs). Nasopharyngeal specimens from symptomatic patients and HCWs underwent broadly multiplexed molecular testing to detect viruses and atypical bacteria. During 1 year of surveillance, 15 patients (1.7% of admissions) developed ILI more than 48 hours after admission. Among 44 HCWs, 19 (43%) experienced at least one ILI episode, with a total of 31 ILI episodes detected. Respiratory viruses were detected in 45% of patient and 55% of HCW specimens. The cumulative incidence of influenza infection among HCWs over 1 year was 9%. Overall, respiratory viruses were commonly found among patients and HCWs in a rural Zambian hospital with limited infection control infrastructure.
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Affiliation(s)
- Gideon Loevinsohn
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.,Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Justin Hardick
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Thomas Mehoke
- Applied Physics Laboratory, Johns Hopkins University, Laurel, Maryland
| | | | | | | | - Kathryn Shaw-Saliba
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Peter Thielen
- Applied Physics Laboratory, Johns Hopkins University, Laurel, Maryland
| | - Jared Evans
- Applied Physics Laboratory, Johns Hopkins University, Laurel, Maryland
| | - Kenneth Bowden
- Applied Physics Laboratory, Johns Hopkins University, Laurel, Maryland
| | - Kristina Zudock
- Applied Physics Laboratory, Johns Hopkins University, Laurel, Maryland
| | - Lauren M Sauer
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Mwaka Monze
- Virology Laboratory, University Teaching Hospital, Lusaka, Zambia
| | - Charlotte A Gaydos
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Richard E Rothman
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Andrew Pekosz
- Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Philip E Thuma
- Macha Research Trust, Choma, Zambia.,Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Catherine G Sutcliffe
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
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29
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Schue JL, van Dijk JH, Hamangaba F, Hamahuwa M, Moyo N, Thuma PE, Moss WJ, Sutcliffe CG. Treatment outcomes among children younger than five years living with HIV in rural Zambia, 2008-2018: a cohort study. BMC Pediatr 2021; 21:315. [PMID: 34261465 PMCID: PMC8278691 DOI: 10.1186/s12887-021-02793-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 06/30/2021] [Indexed: 12/01/2022] Open
Abstract
Background HIV testing and treatment guidelines for children in sub-Saharan Africa have evolved over time, such that children are now treated at younger ages. The objective of this study was to describe the treatment experience for immunologic, virologic, and growth outcomes among HIV-infected Zambian children younger than 5 years of age from 2008 to 2018. Methods Participants enrolled in a clinical cohort study in Macha, Zambia and initiating antiretroviral treatment before 5 years of age between 2008 and 2015 were included in the analysis and followed up to the end of 2018. Outcomes, including growth, CD4+ T-cell percentage, viral suppression, and mortality, were evaluated among all children using longitudinal and survival analyses. Comparisons by age at treatment initiation (< 1, 1 to < 2, and 2 to < 5 years) were also evaluated. Results Three hundred eighty-one children initiating treatment before 5 years of age between 2008 and 2015 were included in the analysis. Growth metrics and CD4+ T-cell percentage improved over time after treatment initiation. However, 20% of children remained underweight and 40% of children remained stunted after the first 36 months of treatment. 85% of children had a viral load < 400 copies/mL after 12 months of treatment. However, children < 1 year at treatment initiation were more likely to have a detectable viral load in the first 12 months of treatment and less likely to achieve viral suppression compared to older children. Mortality was highest in the first 12 months of treatment, among underweight children, and among children initiating treatment in 2008–2010 compared to 2011–2015. Conclusions Most children initiating antiretroviral treatment from 2008 to 2015 in rural Zambia responded well to treatment. However, many children remained underweight and stunted, and experienced high mortality rates during the first few months of treatment. This supports continued efforts to improve early infant diagnosis, nutritional support, and pediatric drug formulations. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-02793-y.
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Affiliation(s)
- Jessica L Schue
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, USA
| | - Janneke H van Dijk
- Erasmus University, Burgemeester Oudlaan 50, 3062, PA, Rotterdam, Netherlands
| | | | | | | | - Philip E Thuma
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, USA.,Macha Research Trust, Choma, Zambia
| | - William J Moss
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, USA
| | - Catherine G Sutcliffe
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, USA.
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30
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Sutcliffe CG, Moyo N, Schue JL, Mutanga JN, Hamahuwa M, Munachoonga P, Maunga S, Thuma PE, Moss WJ. The NSEBA Demonstration Project: implementation of a point-of-care platform for early infant diagnosis of HIV in rural Zambia. Trop Med Int Health 2021; 26:1036-1046. [PMID: 33999480 PMCID: PMC8416694 DOI: 10.1111/tmi.13627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To describe the experience and resource requirements of implementing point-of-care testing for early infant diagnosis of HIV in rural Zambia. METHODS A demonstration project was conducted using a hub-and-spoke model in 2018-2019 at five clinics in rural Zambia. Two testing hubs were established, and all HIV-exposed infants were tested with the GeneXpert system. Data on costs, turnaround times and test results were collected. RESULTS Seven hundred and eighty six tests were conducted. At the hubs, results were available a median of 2.4 (IQR: 2.1, 2.8) hours after sample collection and most mothers (84%) received same-day results. At the spoke facilities, results were available a median of 9 days (IQR: 7, 12) after sample collection and provided to the mother a median of 16 days (IQR: 10, 28) after sample collection. Eleven children tested positive, and 9 (82%) started treatment a median of 13 days (IQR: 7, 21) after sample collection and on the day mothers received results. In contrast, results from matching samples sent for routine testing were available a median of 38 days (IQR: 27, 61) after sample collection and provided to the mother a median of 91 days (IQR: 47, 135) after sample collection. CONCLUSIONS Implementing point-of-care testing in a network of rural health centres in Zambia required significant initial and ongoing investment in infrastructure, training and supervision. However, point-of-care testing can rapidly diagnose HIV-infected infants, so they can benefit from early treatment.
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Affiliation(s)
| | | | - Jessica L Schue
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | | | | | - Philip E Thuma
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Macha Research Trust, Choma, Zambia
| | - William J Moss
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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31
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De Broucker G, Salvatore PP, Mutembo S, Moyo N, Mutanga JN, Thuma PE, Moss WJ, Sutcliffe CG. The cost-effectiveness of scaling-up rapid point-of-care testing for early infant diagnosis of HIV in southern Zambia. PLoS One 2021; 16:e0248217. [PMID: 33690733 PMCID: PMC7943017 DOI: 10.1371/journal.pone.0248217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 02/22/2021] [Indexed: 01/06/2023] Open
Abstract
Introduction Early infant diagnosis (EID) and treatment can prevent much of the HIV-related morbidity and mortality experienced by children but is challenging to implement in sub-Saharan Africa. Point-of-care (PoC) testing would decentralize testing and increase access to rapid diagnosis. The objective of this study was to determine the cost-effectiveness of PoC testing in Southern Province, Zambia. Methods A decision tree model was developed to compare health outcomes and costs between the standard of care (SoC) and PoC testing using GeneXpert and m-PIMA platforms. The primary health outcome was antiretroviral treatment (ART) initiation within 60 days of sample collection. Additional outcomes included ART initiation by 12 months of age and death prior to ART initiation. Costs included both capital and recurrent costs. Health outcomes and costs were combined to create incremental cost effectiveness ratios (ICERs). Results The proportion of children initiating ART within 60 days increased from 27.8% with SoC to 79.8–82.8% with PoC testing depending on the algorithm and platform. The proportion of children initiating ART by 12 months of age increased from 50.9% with SoC to 84.0–86.5% with PoC testing. The proportion of HIV-infected children dying prior to ART initiation decreased from 18.1% with SoC to 3.8–4.6% with PoC testing. Total program costs were similar for the SoC and GeneXpert but higher for m-PIMA. ICERs for PoC testing were favorable, ranging from $23–1,609 for ART initiation within 60 days, $37–2,491 for ART initiation by 12 months of age, and $90–6,188 for deaths prior to ART initiation. Factors impacting the costs of PoC testing, including the lifespan of the testing instruments and integrated utilization of PoC platforms, had the biggest impact on the ICERs. Integrating utilization across programs decreased costs for the EID program, such that PoC testing was cost-saving in some situations. Conclusion PoC testing has the potential to improve linkage to care and ART initiation for HIV-infected infants and should be considered for implementation within EID programs to achieve equity in access to HIV services and reduce HIV-related pediatric morbidity and mortality.
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Affiliation(s)
- Gatien De Broucker
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Phillip P. Salvatore
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | | | | | | | | | - William J. Moss
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Catherine G. Sutcliffe
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
- * E-mail:
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Salvatore PP, de Broucker G, Vojnov L, Moss WJ, Dowdy DW, Sutcliffe CG. Modeling the cost-effectiveness of point-of-care platforms for infant diagnosis of HIV in sub-Saharan African countries. AIDS 2021; 35:287-297. [PMID: 33394672 PMCID: PMC7789262 DOI: 10.1097/qad.0000000000002739] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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] [Indexed: 11/26/2022]
Abstract
BACKGROUND Early infant diagnosis of HIV (EID) improves child survival through earlier initiation of antiretroviral therapy (ART). In many settings, ART initiation is hindered by delays in testing performed in centralized labs. Point-of-care (PoC) platforms offer opportunities to improve the timeliness of ART initiation. METHODS We used a mathematical model to estimate the costs and performance of on-site PoC testing using three platforms (m-PIMA, GeneXpert IV, and GeneXpert Edge) compared with the standard of care (SoC). Primary outcomes included ART initiation within 60 days of sample collection, HIV-related mortality before ART initiation, and incremental cost-effectiveness ratios (ICERs). RESULTS PoC testing significantly increased ART initiation within 60 days (from 19% with SoC to 82-84% with PoC) and decreased HIV-related mortality (from 23% with SoC to 5% with PoC). ART initiation and mortality were similar across PoC platforms. When only used for EID and with high coverage of prevention of mother-to-child transmission (PMTCT) programs, ICERs for PoC testing compared with the SoC ranged from $430 to $1097 per additional infant on ART within 60 days and from $1527 to $3888 per death averted. PoC-based testing was more cost-effective in settings with lower PMTCT coverage, greater delays in the SoC, and when PoC instruments could be integrated with other disease programs. CONCLUSION Our findings illustrate that PoC platforms can dramatically improve the timeliness of EID and linkage to HIV care. The cost-effectiveness of PoC platforms depends on the cost of PoC testing, existing access to diagnostic testing, and the ability to integrate PoC testing with non-EID programs.
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Affiliation(s)
| | - Gatien de Broucker
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Lara Vojnov
- Department of HIV and Global Hepatitis Programme, World Health Organization, Geneva, Switzerland
| | - William J Moss
- Department of Epidemiology
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - David W Dowdy
- Department of Epidemiology
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Catherine G Sutcliffe
- Department of Epidemiology
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Loevinsohn G, Hardick J, Sinywimaanzi P, Fenstermacher KZJ, Shaw-Saliba K, Monze M, Gaydos CA, Rothman RE, Pekosz A, Thuma PE, Sutcliffe CG. Respiratory pathogen diversity and co-infections in rural Zambia. Int J Infect Dis 2020; 102:291-298. [PMID: 33127501 PMCID: PMC7817328 DOI: 10.1016/j.ijid.2020.10.054] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 10/20/2020] [Accepted: 10/22/2020] [Indexed: 11/26/2022] Open
Abstract
Objectives: The role of respiratory co-infections in modulating disease severity remains understudied in southern Africa, particularly in rural areas. This study was performed to characterize the spectrum of respiratory pathogens in rural southern Zambia and the prognostic impact of co-infections. Methods: Respiratory specimens collected from inpatient and outpatient participants in a viral surveillance program in 2018–2019 were tested for selected viruses and a typical bacteria using the Xpert Xpress Flu/RSV assay and FilmArray Respiratory Panel EZ. Participants were followed for 3–5 weeks to assess their clinical course. Multivariable regression was used to examine the role of co-infections in influencing disease severity. Results: A respiratory pathogen was detected in 63.2% of samples from 671 participants who presented with influenza-like illness. Common pathogens identified included influenza virus (18.2% of samples), respiratory syncytial virus (RSV) (11.8%), rhinovirus (26.4%), and coronavirus (6.0%). Overall, 6.4% of participants were co-infected with multiple respiratory pathogens. Compared to mono-infections, co-infections were found not to be associated with severe clinical illness either overall (relative risk (RR) 0.72, 95% confidence interval (CI) 0.39–1.32) or specifically with influenza virus (RR 0.80, 95% CI 0.14–4.46) or RSV infections (RR 0.44, 95% CI 0.17–1.11). Conclusions: Respiratory infections in rural southern Zambia were associated with a wide range of viruses. Respiratory co-infections in this population were not associated with clinical severity.
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Affiliation(s)
- Gideon Loevinsohn
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA; Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Justin Hardick
- Division of Infectious Diseases, Department of Medicine Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | | | - Kathryn Shaw-Saliba
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Mwaka Monze
- Virology Laboratory, University Teaching Hospital, Lusaka, Zambia
| | - Charlotte A Gaydos
- Division of Infectious Diseases, Department of Medicine Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Richard E Rothman
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Andrew Pekosz
- Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Philip E Thuma
- Macha Research Trust, Macha, Zambia; Virology Laboratory, University Teaching Hospital, Lusaka, Zambia
| | - Catherine G Sutcliffe
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.
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Irvin R, Chander G, Ward KM, Manogue S, Falade-Nwulia O, Moon J, Sutcliffe CG, Brinkley S, Haselhuhn T, Katz S, Herne K, Arteaga L, Thomas DL, Mehta SH, Sulkowski MS. Unreported alcohol use was common but did not impact hepatitis C cure in HIV-infected persons who use drugs. J Viral Hepat 2020; 27:476-483. [PMID: 31854069 PMCID: PMC7890377 DOI: 10.1111/jvh.13251] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 11/19/2019] [Accepted: 11/25/2019] [Indexed: 12/20/2022]
Abstract
We investigated the prevalence and impact of heavy alcohol use on the hepatitis C virus (HCV) care continuum amongst HIV/HCV co-infected persons who use drugs. In the CHAMPS study, 144 HIV/HCV co-infected persons were randomized to contingent cash incentives, peer mentors and usual care to evaluate the impact on HCV care. Alcohol use was ascertained using the 10-item AUDIT (hazardous: male ≥8, female ≥4) and phosphatidylethanol (PEth) (heavy: ≥50 ng/mL), an alcohol biomarker. Log binomial regression was used to evaluate the association between heavy alcohol use and failure to initiate treatment and to achieve sustained virologic response (SVR). Of the 135 participants with PEth data, median age was 55 years, 59% were male, 92% were Black, 91% reported a history of drug use, and 97% were on antiretroviral therapy. Hazardous drinking was reported on AUDIT by 28% of participants, and 35% had heavy alcohol use by PEth. Of the 47 individuals with a PEth ≥50 ng/mL, 23 (49%) reported no or minimal alcohol use by AUDIT. HCV treatment was initiated in 103 of 135 participants, and SVR was achieved in 92%. PEth ≥50 ng/mL (Relative Risk [RR] 0.72, 95% CI 0.35-1.48) was not significantly associated with failure to initiate HCV treatment or failure to achieve SVR (RR 0.85, 95% CI 0.46-1.57).In conclusion, alcohol use was common and frequently not detected by self-report. However, heavy alcohol use, even when measured objectively, was not associated with failure to initiate HCV treatment or to achieve cure.
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Affiliation(s)
- Risha Irvin
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Geetanjali Chander
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Kathleen M. Ward
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Sean Manogue
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Oluwaseun Falade-Nwulia
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Juhi Moon
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Catherine G. Sutcliffe
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Sherilyn Brinkley
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Taryn Haselhuhn
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Stephanie Katz
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Kayla Herne
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Lilian Arteaga
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - David L. Thomas
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Shruti H. Mehta
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Mark S. Sulkowski
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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Sutcliffe CG, Grant LR, Reid A, Douglass G, Brown LB, Kellywood K, Weatherholtz RC, Hubler R, Quintana A, Close R, McAuley JB, Santosham M, O'Brien KL, Hammitt LL. High Burden of Staphylococcus aureus Among Native American Individuals on the White Mountain Apache Tribal Lands. Open Forum Infect Dis 2020; 7:ofaa061. [PMID: 32190709 PMCID: PMC7066796 DOI: 10.1093/ofid/ofaa061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 02/21/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This study was done to determine the burden of invasive Staphylococcus aureus on the White Mountain Apache Tribal lands. METHODS Active population and laboratory-based surveillance for invasive S aureus infections was conducted from May 2016 to April 2018. A case was defined as a Native American individual living on or around the White Mountain Apache Tribal lands with S aureus isolated from a normally sterile body site. RESULTS Fifty-three cases were identified. Most cases were adults (90.6%) and had ≥1 underlying medical condition (86.8%), the most common of which were diabetes (49.1%) and obesity (41.5%). A total of 26.4% cases were categorized as community acquired. Most infections were methicillin-resistant (75.5%). A total of 7.5% of cases required amputation, and 7.7% of cases died within 30 days of initial culture. The incidence of invasive S aureus was 156.3 per 100 000 persons. The age-adjusted incidence of invasive methicillin-resistant S aureus was 138.2 per 100 000 persons. CONCLUSIONS This community has a disproportionately high burden of invasive methicillin-resistant S aureus compared with the general US population. Interventions are urgently needed to reduce the morbidity and mortality associated with these infections.
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Affiliation(s)
- Catherine G Sutcliffe
- Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Lindsay R Grant
- Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Angelina Reid
- Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Grace Douglass
- Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Laura B Brown
- Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kamellia Kellywood
- Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Robert C Weatherholtz
- Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Robin Hubler
- Pfizer Vaccine Medical Development, Scientific and Clinical Affairs, Collegeville, Pennsylvania, USA
| | - Alvaro Quintana
- Pfizer Vaccine Medical Development, Scientific and Clinical Affairs, Collegeville, Pennsylvania, USA
| | - Ryan Close
- Whiteriver Service Unit, Indian Health Service, Whiteriver, Arizona, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - James B McAuley
- Whiteriver Service Unit, Indian Health Service, Whiteriver, Arizona, USA.,Rush Medical College, Rush University, Chicago, Illinois, USA
| | - Mathuram Santosham
- Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Katherine L O'Brien
- Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Laura L Hammitt
- Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Sutcliffe CG, Mutanga JN, Moyo N, Schue JL, Hamahuwa M, Thuma PE, Moss WJ. Acceptability and feasibility of testing for HIV infection at birth and linkage to care in rural and urban Zambia: a cross-sectional study. BMC Infect Dis 2020; 20:227. [PMID: 32183751 PMCID: PMC7079396 DOI: 10.1186/s12879-020-4947-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 03/04/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Early infant diagnosis is important for timely identification of HIV-infected infants and linkage to care. Testing at birth has been implemented to facilitate earlier diagnosis of HIV infection but may present new challenges. This study was conducted to understand the acceptability and feasibility of birth testing in urban and rural settings in southern Zambia. METHODS This cross-sectional study was conducted at 11 hospitals and clinics in Livingstone, Choma, and Macha in Southern Province, Zambia from 2016 to 2018. Infants born to pregnant women living with HIV at the sites were eligible for enrollment. After enrollment, a questionnaire was administered to the mother and a dried blood spot card was collected from infants for testing at a central laboratory. When results were available, mothers were notified to return to the clinic. Acceptability of birth testing was evaluated based on the proportion of women who agreed to participate and the reasons for non-participation among women who declined. Feasibility of testing at birth was evaluated using turnaround times for returning results, the proportion of women receiving results, and linkage to care for infants testing positive. RESULTS One thousand four hundred three women were approached for the study. A small proportion declined due to refusal of birth testing (0 to 8.2% across sites). One thousand two hundred ninety women agreed to have their infants tested. The proportion of mothers receiving results ranged from 51.6 to 92.1%, and was significantly lower at the hospital than clinics in Livingstone (51.6% vs. 69.8%; p < 0.0001) and Macha (69.5% vs. 85.7%; p < 0.0001) but not Choma (85.7% vs. 92.1%; p = 0.34). For mothers who received test results, the median turnaround time from sample collection was 67 days in Livingstone and 53 days in Macha and Choma. Overall, 23 (1.8%) infants tested positive for HIV but only 8 (34.8%) were linked to care a median of 68 days (range: 29, 784) after sample collection. CONCLUSIONS While testing at birth was acceptable, this study highlights the operational challenges under a centralized laboratory testing system. Point-of-care platforms are needed for rapid testing and return of results so HIV-infected children can be identified, linked to care, and treated as early as possible.
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Affiliation(s)
| | | | | | - Jessica L. Schue
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD USA
| | | | - Philip E. Thuma
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD USA
- Macha Research Trust, Choma, Zambia
| | - William J. Moss
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD USA
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Sutcliffe CG, Grant LR, Cloessner E, Klugman KP, Vidal JE, Reid R, Colelay J, Weatherholtz RC, Chochua S, Jacobs MR, Santosham M, O’Brien KL, Hammitt LL. Association of Laboratory Methods, Colonization Density, and Age With Detection of Streptococcus pneumoniae in the Nasopharynx. Am J Epidemiol 2019; 188:2110-2119. [PMID: 31509184 DOI: 10.1093/aje/kwz191] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 08/19/2019] [Accepted: 08/23/2018] [Indexed: 12/30/2022] Open
Abstract
Culture-based methods for detecting Streptococcus pneumoniae in the nasopharynx lack sensitivity. In this study, we aimed to compare the performance of culture and molecular methods in detecting pneumococcus in the nasopharynx of healthy individuals and to evaluate the associations of age and colonization density with detection. Between 2010 and 2012, nasopharyngeal specimens were collected from healthy individuals living on Navajo Nation and White Mountain Apache Tribal lands in the United States. Pneumococci were detected by means of broth-enrichment culture and autolysin-encoding gene (lytA) quantitative polymerase chain reaction (qPCR). Among 982 persons evaluated (median age, 18.7 years; 47% male), 35% were culture-positive and an additional 27% were qPCR-positive. Agreement between culture and qPCR was 70.9% but was higher among children (age <18 years) (75.9%-84.4%) than among adults (age ≥18 years) (61.0%-74.6%). The mean density of colonization was lower for culture-negative samples (3.14 log10 copies/mL) than for culture-positive samples (5.02 log10 copies/mL), overall and for all age groups. The percent culture-positive increased with increasing density, exceeding 80% at densities of ≥10,000 copies/mL. Mean colonization density decreased with age. Use of qPCR improved detection of pneumococcus in the nasopharynx of healthy individuals. This finding was most notable among adults, probably because of improved detection of low-density colonization.
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Affiliation(s)
- Catherine G Sutcliffe
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
- Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Lindsay R Grant
- Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Emily Cloessner
- Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Keith P Klugman
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Jorge E Vidal
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Raymond Reid
- Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Janene Colelay
- Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Robert C Weatherholtz
- Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Sopio Chochua
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Michael R Jacobs
- Department of Pathology, School of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Mathuram Santosham
- Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Katherine L O’Brien
- Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Laura L Hammitt
- Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
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Falade-Nwulia O, Sutcliffe CG, Mehta SH, Moon J, Chander G, Keruly J, Katzianer J, Thomas DL, Moore RD, Sulkowski MS. Hepatitis C Elimination in People With HIV Is Contingent on Closing Gaps in the HIV Continuum. Open Forum Infect Dis 2019; 6:ofz426. [PMID: 31667200 PMCID: PMC6814283 DOI: 10.1093/ofid/ofz426] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 09/25/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Bolstered by the high efficacy of hepatitis C virus (HCV) treatment, the World Health Organization has called for HCV elimination by 2030. People with HIV (PWH) have been identified as a population in which elimination should be prioritized. METHODS We examined progress in HCV elimination through the HCV care continuum among patients infected with HIV/HCV receiving HIV care at Johns Hopkins Hospital in Baltimore, Maryland, United States. Patients with HIV care visits in at least 2 consecutive years were followed through December 15, 2018, for referral to HCV care, treatment initiation, and cure. RESULTS Among 593 HIV/HCV-coinfected individuals, 547 (92%) were referred for HCV care, 517 (87%) were evaluated for HCV treatment, 457 (77%) were prescribed HCV treatment, 426 (72%) initiated treatment, and 370 (62%) achieved HCV cure. In multivariable analysis, advanced liver disease (hazard ratio [HR], 1.48; 95% confidence interval [CI], 1.17-1.88) remained significantly positively associated with HCV treatment initiation. Conversely, being insured by state Medicaid (HR, 0.75; 95% CI, 0.61-0.92), having an HIV RNA >400 copies/mL (HR, 0.29; 95% CI, 0.18-0.49), and having missed 1%-24% (HR, 0.72; 95% CI, 0.54-0.97), 25%-49% (HR, 0.66; 95% CI, 0.49-0.89), and ≥50% of HIV care visits (HR, 0.39; 95% CI, 0.25-0.60) were significantly negatively associated with HCV treatment initiation. CONCLUSIONS HCV infection can be eliminated in PWH. However, HCV elimination requires unrestricted access to HCV treatment and improved methods of retaining people in medical care.
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Affiliation(s)
- Oluwaseun Falade-Nwulia
- Division of Infectious Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Catherine G Sutcliffe
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Shruti H Mehta
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Juhi Moon
- Division of Infectious Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Geetanjali Chander
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jeanne Keruly
- Division of Infectious Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jennifer Katzianer
- Johns Hopkins Pharmaquip, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
| | - David L Thomas
- Division of Infectious Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Richard D Moore
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Mark S Sulkowski
- Division of Infectious Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Sutcliffe CG, Shet A, Varghese R, Veeraraghavan B, Manoharan A, Wahl B, Chandy S, Sternal J, Khan R, Singh RK, Santosham M, Arora NK. Nasopharyngeal carriage of Streptococcus pneumoniae serotypes among children in India prior to the introduction of pneumococcal conjugate vaccines: a cross-sectional study. BMC Infect Dis 2019; 19:605. [PMID: 31291902 PMCID: PMC6621985 DOI: 10.1186/s12879-019-4254-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 07/03/2019] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Streptococcus pneumoniae is a major cause of pneumonia, meningitis, and other serious infections among children in India. India introduced the 13-valent pneumococcal conjugate vaccine (PCV) in several states in 2017, and is expected to expand to nationwide coverage in the near future. To establish a baseline for measuring the impact of PCV in India, we assessed overall and serotype-specific nasopharyngeal carriage in two pediatric populations. METHODS A cross-sectional study was conducted in Palwal District, Haryana, from December 2016 to July 2017, prior to vaccine introduction. Children 2-59 months of age with clinical pneumonia seeking healthcare and those in the community with no clear illness were targeted for enrollment. A nasopharyngeal swab was collected and tested for pneumococcus using conventional culture and sequential multiplex PCR. Isolates were tested for antimicrobial resistance using an E test. Children were considered colonized if pneumococcus was isolated by culture or PCR. The prevalence of pneumococcal and serotype-specific colonization was compared between groups of children using log-binomial regression. RESULTS Among 601 children enrolled, 91 had clinical pneumonia and 510 were community children. The proportion colonized with S. pneumoniae was 74.7 and 54.5% among children with clinical pneumonia and community children, respectively (adjusted prevalence ratio: 1.38; 95% confidence interval: 1.19, 1.60). The prevalence of PCV13 vaccine-type colonization was similar between children with clinical pneumonia (31.9%) and community children (28.0%; p = 0.46). The most common colonizing serotypes were 6A, 6B, 14, 19A, 19F, and 23F, all of which are included in the PCV13 vaccine product. Antimicrobial resistance to at least one drug was similar between isolates from children with clinical pneumonia (66.1%) and community children (61.5%; p = 0.49); while resistance to at least two drugs was more common among isolates from children with clinical pneumonia (25.8% vs. 16.4%; p = 0.08). Resistance for all drugs was consistently higher for PCV13 vaccine-type serotypes compared to non-vaccine serotypes in both groups. CONCLUSION This study provides baseline information on the prevalence of serotype-specific pneumococcal colonization among children prior to the introduction of PCV in India. Our results suggest a role for pneumococcal vaccines in reducing pneumococcal colonization and antimicrobial resistant isolates circulating in India.
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Affiliation(s)
- Catherine G Sutcliffe
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
| | - Anita Shet
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Rosemol Varghese
- Christian Medical College, Ida Scudder Road, Vellore, Tamil Nadu, 632004, India
| | | | - Anand Manoharan
- The CHILDS Trust Medical Research Foundation, 12-A Nageswara Road, Nungambakkam, Chennai, 600034, India
| | - Brian Wahl
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Sara Chandy
- The CHILDS Trust Medical Research Foundation, 12-A Nageswara Road, Nungambakkam, Chennai, 600034, India
| | - Jack Sternal
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Raziuddin Khan
- The INCLEN Trust International, F-1/5, 2nd Floor, Okhla Industrial Area Phase - 1, New Delhi, 110020, India
| | - Rakesh Kumar Singh
- The INCLEN Trust International, F-1/5, 2nd Floor, Okhla Industrial Area Phase - 1, New Delhi, 110020, India
| | - Mathuram Santosham
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Narendra K Arora
- The INCLEN Trust International, F-1/5, 2nd Floor, Okhla Industrial Area Phase - 1, New Delhi, 110020, India.
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Ward KM, Falade-Nwulia O, Moon J, Sutcliffe CG, Brinkley S, Haselhuhn T, Katz S, Herne K, Arteaga L, Mehta SH, Latkin C, Brooner RK, Sulkowski MS. A Randomized Controlled Trial of Cash Incentives or Peer Support to Increase HCV Treatment for Persons With HIV Who Use Drugs: The CHAMPS Study. Open Forum Infect Dis 2019; 6:ofz166. [PMID: 31049365 PMCID: PMC6488268 DOI: 10.1093/ofid/ofz166] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 04/05/2019] [Indexed: 12/16/2022] Open
Abstract
Background Despite access to direct-acting antivirals, barriers to a hepatitis C virus (HCV) cure persist, especially among persons living with human immunodeficiency virus (HIV) (PLWH) who use drugs. Interventions such as peer mentors or cash incentives may improve the care continuum. Methods The CHAMPS (Chronic HepAtitis C Management to ImProve OutcomeS) study randomized 144 PLWH, recruited from an outpatient clinic, with substance use disorders into three treatment groups: usual care (UC) (n = 36), UC plus cash incentives (n = 54), and UC plus peer mentors (n = 54) to evaluate HCV treatment uptake and cure. All participants received 12-weeks of ledipasvir/sofosbuvir (LDV/SOF). Trained peer mentors had well-controlled HIV and HCV. Cash incentives were contingent on visit attendance (maximum $220). The primary endpoint was HCV treatment initiation; secondary endpoints included sustained virologic response (SVR) and HCV reinfection. Results The majority of participants were male (61%), Black (93%), and unemployed (85%). Depression and active drug and alcohol use were common. Overall, 110 of 144 (76%) participants initiated LDV/SOF. Although treatment initiation rates were higher in PLWH randomized to peers (83%, 45 of 54) or cash (76%, 41 of 54) compared to UC (67%, 24 of 36), these differences were not statistically significant (P = .11). Most PLWH who initiated treatment achieved SVR (100 of 110, 91%). LDV/SOF was well tolerated; peers and cash had no effect on drug and alcohol use during therapy. One individual from the cash cohort experienced HCV reinfection. Conclusion After removal of system barriers, one-third of PLWH in UC did not initiate HCV treatment. Among those who initiated, SVR rates were high. Research involving PLWH who use drugs should focus on overcoming barriers to treatment initiation. Clinical trial information The registration data for the trial are in the ClinicalTrials.gov database, number NCT02402218.
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Affiliation(s)
- Kathleen M Ward
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | | | - Juhi Moon
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Catherine G Sutcliffe
- Department of Epidemiology, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Sherilyn Brinkley
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Taryn Haselhuhn
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Stephanie Katz
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Kayla Herne
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Lilian Arteaga
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Shruti H Mehta
- Department of Epidemiology, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Carl Latkin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Robert K Brooner
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Mark S Sulkowski
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
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Sutcliffe CG, Grant LR, Reid A, Douglass GK, Weatherholtz RC, Hubler R, Quintana A, Reid R, Yazzie D, Santosham M, O’Brien KL, Hammitt LL. The burden of Staphylococcus aureus among Native Americans on the Navajo Nation. PLoS One 2019; 14:e0213207. [PMID: 30835749 PMCID: PMC6400378 DOI: 10.1371/journal.pone.0213207] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 02/16/2019] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Native Americans in the southwestern United States have a higher risk for many infectious diseases and may be at higher risk for Staphylococcus aureus due to the high prevalence of risk factors for S. aureus. Recent data on invasive S. aureus infections among Native Americans are limited. METHODS Active population- and laboratory-based surveillance was conducted in 2016-2017 on the Navajo Nation to document the rate of invasive S. aureus. A case of invasive S.aureus infection was defined as a Native American individual with S. aureus isolated from a normally sterile body site whose reported community of residence was on or around the Navajo Nation. RESULTS One hundred and fifty-nine cases of invasive S. aureus from 152 individuals were identified. The median age of cases was 56.3 years and 35% were female. Thirty-five percent of cases had community-acquired infections. Ninety-three percent of cases had underlying medical conditions, including diabetes (60%) and obesity (42%), 28% of cases had a documented prior S. aureus infection, and 33% were infected with methicillin-resistant S. aureus. The annual incidence of invasive S. aureus and of invasive methicillin-resistant S. aureus was 64.9/100,000 persons and 21.2/100,000 persons, respectively. CONCLUSIONS This community has a high burden of invasive S. aureus infections. Further research is needed to identify prevention strategies and opportunities for intervention.
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Affiliation(s)
- Catherine G. Sutcliffe
- Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Lindsay R. Grant
- Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Angelina Reid
- Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Grace K. Douglass
- Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Robert C. Weatherholtz
- Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Robin Hubler
- Pfizer Vaccine Medical Development, Scientific and Clinical Affairs, Pfizer Inc, Collegeville, Pennsylvania, United States of America
| | - Alvaro Quintana
- Pfizer Vaccine Medical Development, Scientific and Clinical Affairs, Pfizer Inc, Collegeville, Pennsylvania, United States of America
| | - Raymond Reid
- Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Del Yazzie
- Navajo Epidemiology Center, Window Rock, Arizona, United States of America
| | - Mathuram Santosham
- Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Katherine L. O’Brien
- Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Laura L. Hammitt
- Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
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Sutcliffe CG, Palamountain KM, Maunga S, Searle KM, Thuma PE, Moss WJ, Fisher MJ. The feasibility of fingerstick blood collection for point-of-care HIV-1 viral load monitoring in rural Zambia. ACTA ACUST UNITED AC 2018; 1. [PMID: 30734030 DOI: 10.15641/ghi.v1i2.585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Viral load monitoring for HIV treatment is recommended but not feasible in many settings. A point-of-care test using capillary blood would increase access but may require up to 200 μL of blood to achieve a lower limit of detection of 1000 copies/mL. This cross-sectional study evaluated the feasibility of collecting 200 μL of capillary blood and blood collection preferences among adults in rural Zambia. Adults seeking HIV counseling and testing at Macha Hospital were recruited in 2015. Capillary blood was collected in four 50 μL tubes. Blood collection was categorized as complete (200 μL collected), partial (all tubes filled but <200 μL obtained due to collection techniques), or incomplete (1-4 tubes attempted; <200 μL obtained due to insufficient blood flow). One fingerstick was required for 90% of the 201 participants. A median blood volume of 196 μL was collected. Complete, partial and incomplete collection was achieved in 34%, 59% and 6% of participants. The majority of participants (95%) preferred fingerstick over venous blood collection. A point-of-care viral load test requiring up to 200 μL of blood is feasible in a rural setting but would require training and supervision to ensure that sufficient blood was collected.
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Affiliation(s)
- Catherine G Sutcliffe
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | | | | | - Kelly M Searle
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Philip E Thuma
- Macha Research Trust, Choma, Zambia.,Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - William J Moss
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.,Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Mark J Fisher
- Center for Innovation in Global Health Technologies, Northwestern University, Evanston, IL, USA
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Sutcliffe CG, Thuma PE, van Dijk JH, Sinywimaanzi K, Mweetwa S, Hamahuwa M, Moss WJ. Use of mobile phones and text messaging to decrease the turnaround time for early infant HIV diagnosis and notification in rural Zambia: an observational study. BMC Pediatr 2017; 17:66. [PMID: 28270134 PMCID: PMC5341427 DOI: 10.1186/s12887-017-0822-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 02/24/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Early infant diagnosis of HIV infection is challenging in rural sub-Saharan Africa as blood samples are sent to central laboratories for HIV DNA testing, leading to delays in diagnosis and treatment initiation. Simple technologies to rapidly deliver results to clinics and notify mothers of test results would decrease many of these delays. The feasibility of using mobile phones to contact mothers was evaluated. In addition, the first two years of implementation of a national short message service (SMS) reporting system to deliver test results from the laboratory to the clinic were evaluated. METHODS The study was conducted in Macha, Zambia from 2013 to 2015 among mothers of HIV-exposed infants. Mothers were interviewed about mobile phone use and willingness to be contacted directly or through their rural health center. Mothers were contacted according to their preferred method of communication when test results were available. Mothers of positive infants were asked to return to the clinic as soon as possible. Dates of sample collection, delivery of test results to the clinic and notification of mothers were documented in addition to test results. RESULTS Four hundred nineteen mothers and infants were enrolled. Only 30% of mothers had ever used a mobile phone. 96% of mobile phone owners were reached by study staff and 98% of mothers without mobile phones were contacted through their rural health center. Turnaround times for mothers of positive infants were approximately 2 weeks shorter than for mothers of negative infants. Delivery of test results by the national SMS system improved from 2013 to 2014, with increases in the availability of texted results (38 vs. 91%) and arrival of the texted result prior to the hardcopy report (27 vs. 83%). Texted results arriving at the clinic before the hardcopy were received a median of 19 days earlier. Four discrepancies between texted and hardcopy results were identified out of 340 tests. CONCLUSIONS Mobile phone and text messaging technology has the potential to improve early infant diagnosis but challenges to widespread implementation need to be addressed, including low mobile phone ownership, use and coverage in rural areas.
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Affiliation(s)
- Catherine G Sutcliffe
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD, USA.
| | | | - Janneke H van Dijk
- Macha Research Trust, Macha Hospital, Choma, Zambia.,Department of Immunology and Infectious Diseases, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | | | | | | | - William J Moss
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD, USA
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Sutcliffe CG, Searle K, Matakala HK, Greenman MP, Rainwater-Lovett K, Thuma PE, Moss WJ. Measles and Rubella Seroprevalence Among HIV-infected and Uninfected Zambian Youth. Pediatr Infect Dis J 2017; 36:301-306. [PMID: 27879554 PMCID: PMC5303148 DOI: 10.1097/inf.0000000000001422] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Measles and congenital rubella syndrome remain significant causes of morbidity and mortality despite available vaccines. HIV-infected youth may be at increased risk of measles because of greater waning immunity after vaccination. At a population level, they constitute a potentially large pool of susceptibles to measles and rubella. More data among HIV-infected youth in sub-Saharan Africa are needed to guide vaccination policy and control strategies. METHODS This cross-sectional study was nested within 2 ongoing studies of malaria and HIV in Zambia. Dried blood spot cards from youth (5-15 years) in these studies from 2009 to 2013 were tested for IgG antibodies to measles and rubella viruses. HIV-uninfected youth, HIV-infected treatment-naive youth and HIV-infected youth receiving antiretroviral therapy (ART) were compared. RESULTS A total of 617 HIV-uninfected, 144 HIV-infected treatment-naive and 128 HIV-infected youth receiving ART were included in this study. The proportion seropositive for measles virus was significantly higher among HIV-uninfected youth (92.5%) compared with HIV-infected treatment-naive youth (74.1%) and HIV-infected youth receiving ART (71.9%). No differences by age were observed. The proportion seropositive for rubella virus was significantly higher among HIV-uninfected youth (54.7%) compared with HIV-infected treatment-naive youth (41.7%) and HIV-infected youth receiving ART (49.6%), with increases observed by age for all groups. CONCLUSIONS Measles seroprevalence was lower among HIV-infected than uninfected youth, consistent with waning immunity after measles vaccination. HIV-infected youth would benefit from revaccination. Half of all youth in rural Zambia were susceptible to rubella and may need targeting for catch-up rubella campaigns when measles-rubella vaccine is introduced.
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Affiliation(s)
- Catherine G Sutcliffe
- From the *Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland; †Macha Research Trust, Macha Hospital, Choma, Zambia; and ‡Department of Pediatrics-Infectious Diseases, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland
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Wansom T, Falade-Nwulia O, Sutcliffe CG, Mehta SH, Moore RD, Thomas DL, Sulkowski MS. Barriers to Hepatitis C Virus (HCV) Treatment Initiation in Patients With Human Immunodeficiency Virus/HCV Coinfection: Lessons From the Interferon Era. Open Forum Infect Dis 2017; 4:ofx024. [PMID: 28480293 DOI: 10.1093/ofid/ofx024] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 02/06/2017] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Hepatitis C is a major cause of mortality among human immunodeficiency virus (HIV)-infected patients, yet hepatitis C virus (HCV) treatment uptake has historically been low. Although the removal of interferon removes a major barrier to HCV treatment uptake, oral therapies alone may not fully eliminate barriers in this population. METHODS Within the Johns Hopkins Hospital HIV cohort, a nested case-control study was conducted to identify cases, defined as patients initiating HCV treatment between January 1996 and 2013, and controls, which were selected using incidence density sampling (3:1 ratio). Controls were matched to cases on date of enrollment. Conditional logistic regression was used to evaluate factors associated with HCV treatment initiation. RESULTS Among 208 treated cases and 624 untreated controls, the presence of advanced fibrosis (odds ratio [OR], 2.23; 95% confidence interval [CI], 1.26-3.95), recent active drug use (OR, 0.36; 95% CI, 0.19-0.69), and non-black race (OR, 2.01; 95% CI, 1.26-3.20) were independently associated with initiation of HCV therapy. An increasing proportion of missed visits was also independently associated with lower odds of HCV treatment (25%-49% missed visits [OR, 0.49; 95% CI, 0.27-0.91] and ≥50% missed visits [OR, 0.24; 95% CI, 0.12-0.48]). CONCLUSIONS Interferon-free treatments may not be sufficient to fully overcome barriers to HCV care in HIV-infected patients. Interventions to increase engagement in care for HIV and substance use are needed to expand HCV treatment uptake.
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Affiliation(s)
- Tanyaporn Wansom
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Oluwaseun Falade-Nwulia
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Catherine G Sutcliffe
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Shruti H Mehta
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Richard D Moore
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - David L Thomas
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Mark S Sulkowski
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Sutcliffe CG, Thea DM, Seidenberg P, Chipeta J, Mwananyanda L, Somwe SW, Duncan J, Mwale M, Mulindwa J, Mwenechenya M, Izadnegahdar R, Moss WJ. Erratum to: A clinical guidance tool to improve the care of children hospitalized with severe pneumonia in Lusaka, Zambia. BMC Pediatr 2016; 16:159. [PMID: 27687798 PMCID: PMC5041277 DOI: 10.1186/s12887-016-0698-3] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Catherine G Sutcliffe
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD, USA.
| | - Donald M Thea
- Center for Global Health and Development, Boston University School of Public Health, Boston University, Boston, MA, USA
| | - Philip Seidenberg
- Department of Emergency Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - James Chipeta
- Department of Paediatrics, University of Zambia, School of Medicine, Lusaka, Zambia
| | | | - Somwe Wa Somwe
- Department of Paediatrics, University of Zambia, School of Medicine, Lusaka, Zambia
| | - Julie Duncan
- University of Missouri School of Medicine, Columbia Missouri, MO, USA
| | - Magdalene Mwale
- Zambia Center for Applied Health Research and Development, Lusaka, Zambia
| | - Justin Mulindwa
- Department of Paediatrics, University of Zambia, School of Medicine, Lusaka, Zambia
| | - Musaku Mwenechenya
- Department of Paediatrics, University of Zambia, School of Medicine, Lusaka, Zambia
| | | | - William J Moss
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD, USA
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Sutcliffe CG, Thea DM, Seidenberg P, Chipeta J, Mwananyanda L, Somwe SW, Duncan J, Mwale M, Mulindwa J, Mwenechenya M, Izadnegahdar R, Moss WJ. A clinical guidance tool to improve the care of children hospitalized with severe pneumonia in Lusaka, Zambia. BMC Pediatr 2016; 16:136. [PMID: 27542355 PMCID: PMC4992255 DOI: 10.1186/s12887-016-0665-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 08/05/2016] [Indexed: 11/29/2022] Open
Abstract
Background Pneumonia is the leading infectious cause of death among children, with approximately half of deaths attributable to pneumonia occurring in limited health resource settings of sub-Saharan Africa. Clinical guidance tools and checklists have been used to improve health outcomes and standardize care. This study was conducted to evaluate the impact of a clinical guidance tool designed to improve outcomes for children hospitalized with severe pneumonia in Zambia. Methods This study was conducted at University Teaching Hospital in Lusaka, Zambia from October 10, 2011 to March 21, 2014 among children 1 month to 5 years of age with severe pneumonia. In March 2013, a clinical guidance tool was implemented to standardize and improve care. In-hospital mortality pre-and post-implementation was compared. Results Four hundred forty-three children were enrolled in the pre-intervention period and 250 in the post-intervention period. Overall, 18.2 % of children died during hospitalization, with 44 % of deaths occurring within the first 24 h after admission. Mortality was associated with HIV infection status, pneumonia severity, and weight-for-height z-score. Despite improving and standardizing the care received, the clinical guidance tool did not significantly reduce mortality (relative risk: 0.89; 95 % CI: 0.65, 1.23). The tool appeared to be more effective among HIV-exposed but uninfected children and children younger than 6 months of age. Conclusions Simple tools are needed to ensure that children hospitalized with pneumonia receive the best possible care in accordance with recommended guidelines. The clinical guidance tool was well-accepted and easy to use and succeeded in standardizing and improving care. Further research is needed to determine if similar interventions can improve treatment outcomes and should be implemented on a larger scale. Electronic supplementary material The online version of this article (doi:10.1186/s12887-016-0665-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Catherine G Sutcliffe
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD, USA.
| | - Donald M Thea
- Center for Global Health and Development, Boston University School of Public Health, Boston University, Boston, MA, USA
| | - Philip Seidenberg
- Department of Emergency Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - James Chipeta
- Department of Paediatrics, University of Zambia, School of Medicine, Lusaka, Zambia
| | | | - Somwe Wa Somwe
- Department of Paediatrics, University of Zambia, School of Medicine, Lusaka, Zambia
| | - Julie Duncan
- University of Missouri School of Medicine, Columbia Missouri, MO, USA
| | - Magdalene Mwale
- Zambia Center for Applied Health Research and Development, Lusaka, Zambia
| | - Justin Mulindwa
- Department of Paediatrics, University of Zambia, School of Medicine, Lusaka, Zambia
| | - Musaku Mwenechenya
- Department of Paediatrics, University of Zambia, School of Medicine, Lusaka, Zambia
| | | | - William J Moss
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD, USA
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Arya BK, Bhattacharya SD, Sutcliffe CG, Saha MK, Bhattacharyya S, Niyogi SK, Moss WJ, Panda S, Das RS, Mallick M, Mandal S. Immunogenicity and safety of two doses of catch-up immunization with Haemophilus influenzae type b conjugate vaccine in Indian children living with HIV. Vaccine 2016; 34:2267-74. [PMID: 26988256 DOI: 10.1016/j.vaccine.2016.03.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 02/01/2016] [Accepted: 03/04/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Children living with HIV are at increased risk of disease from Haemophilus influenzae type b (Hib). Data are limited on the immunogenicity of a two-dose, catch-up schedule for Hib conjugate vaccine (HibCV) among HIV-infected children accessing antiretroviral therapy (ART) late. OBJECTIVES The objectives of the study were to: (1) evaluate baseline immunity to Hib and the immunogenicity and safety of two doses of HibCV among HIV-infected Indian children; and (2) document the threshold antibody level required to prevent Hib colonization among HIV-infected children following immunization. METHODS We conducted a prospective cohort study among HIV-infected children 2-15 years of age and HIV-uninfected children 2-5 years of age. HIV-infected children received two doses of HibCV and uninfected children received one. Serum anti-Hib PRP IgG antibodies were measured at baseline and two months after immunization in the HIV-infected children. Nasopharyngeal (NP) swabs were collected at baseline and follow-up. RESULTS 125 HIV-infected and 44 uninfected children participated. 40% of HIV-infected children were receiving ART and 26% had a viral load >100,000 copies/mL. The geometric mean concentration of serum anti-Hib PRP antibody increased from 0.25 μg/mL at baseline to 2.65 μg/mL after two doses of HibCV, representing a 10.6-fold increase (p<0.0001). 76% percent of HIV-infected children mounted an immune response. Moderate or severe immune suppression, trimethoprim/sulfamethoxazole prophylaxis, and lower baseline antibody levels were associated with lower post-vaccine serum anti-Hib PRP IgG antibodies. A serum anti-Hib PRP IgG antibody level ≥ 3.3 μg/mL was protective against Hib NP colonization. There were no differences in adverse events between HIV-infected and uninfected children. CONCLUSION Including a catch-up immunization schedule for older HIV infected children in countries introducing Hib vaccines is important. Older HIV-infected children with delayed access to ART and without suppressed viral loads mounted an adequate immune response following two doses of HibCV.
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Affiliation(s)
- Bikas K Arya
- School of Medical Science and Technology, Indian Institute of Technology (IIT) - Kharagpur, India
| | | | - Catherine G Sutcliffe
- International Vaccine Access Center and Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Malay K Saha
- National HIV Reference Laboratory/Division of Virology, National Institute of Cholera and Enteric Diseases (NICED)/Indian Council of Medical Research (ICMR)-Kolkata, India
| | | | - Swapan Kumar Niyogi
- Division of Bacteriology, National Institute of Cholera and Enteric Diseases (NICED)/Indian Council of Medical Research (ICMR)-Kolkata, India
| | - William J Moss
- International Vaccine Access Center and Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Samiran Panda
- Division of Epidemiology, National Institute of Cholera and Enteric Diseases (NICED)/Indian Council of Medical Research (ICMR)-Kolkata, India
| | - Ranjan Saurav Das
- School of Medical Science and Technology, Indian Institute of Technology (IIT) - Kharagpur, India
| | - Mausom Mallick
- National HIV Reference Laboratory/Division of Virology, National Institute of Cholera and Enteric Diseases (NICED)/Indian Council of Medical Research (ICMR)-Kolkata, India
| | - Sutapa Mandal
- Division of Bacteriology, National Institute of Cholera and Enteric Diseases (NICED)/Indian Council of Medical Research (ICMR)-Kolkata, India
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Sutcliffe CG, Moss WJ. The downside of success: confirmation of HIV infection in early treated children. Lancet Infect Dis 2015; 15:751-2. [PMID: 26043883 DOI: 10.1016/s1473-3099(15)00086-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Accepted: 04/20/2015] [Indexed: 11/17/2022]
Affiliation(s)
| | - William J Moss
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
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Sutcliffe CG, Schultz K, Brannock JM, Giardiello FM, Platz EA. Do people know whether they are overweight? Concordance of self-reported, interviewer-observed, and measured body size. Cancer Causes Control 2014; 26:91-8. [PMID: 25376830 DOI: 10.1007/s10552-014-0487-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 10/28/2014] [Indexed: 02/06/2023]
Abstract
PURPOSE To evaluate associations among self-reported, interviewer-observed, and measured body size in a healthcare setting. METHODS A total of 543 adult men and women undergoing colonoscopy were enrolled into a cross-sectional study conducted from 2002 to 2008 at the Johns Hopkins Hospital Outpatient Center. Self-reported and interviewer-observed Stunkard body size figure numbers and measured body mass index (BMI) were collected and evaluated. The body size figures and BMI were categorized as normal weight, overweight, and obese. RESULTS Correlation between self-reported and interviewer-observed body size figure numbers (r = 0.62) was lower than the correlation between self-reported (r = 0.72) or interviewer-observed (r = 0.84) body size figure number and BMI. Participants underestimated body size by about one figure compared with the interviewers (mean 0.92 ± 1.25). Agreement on normal weight, overweight, and obese between the interviewer-observed body size figures and BMI categories (kappa = 0.40) was higher than for the self-reported body size figures and BMI categories (kappa = 0.23). Among participants who judged themselves in the normal weight category by the figures, 38 and 13 % were overweight and obese, respectively, as measured by BMI. Among participants who judged themselves overweight by the body size figures, 57 % were obese as measured by BMI. CONCLUSIONS Although self-reported body size and measured body size were well correlated, participants underestimated their body size in comparison with interviewers. Many individuals misperceive themselves as normal weight when they are overweight or obese by BMI, which may hinder prevention and control efforts.
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Affiliation(s)
- Catherine G Sutcliffe
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Room E6132, 615 N. Wolfe St., Baltimore, MD, 21205, USA
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