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Groom HC, Schmidt M, Calderwood LE, Mirza SA, Mattison C, Salas S, Donald J, Naleway AL. Attitudes toward a future norovirus vaccine among members of an integrated healthcare delivery system in Portland, Oregon, 2016-2017. Hum Vaccin Immunother 2024; 20:2317599. [PMID: 38416866 PMCID: PMC10903669 DOI: 10.1080/21645515.2024.2317599] [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] [Received: 12/01/2023] [Accepted: 02/08/2024] [Indexed: 03/01/2024] Open
Abstract
With recent advances in U.S. clinical trials for norovirus vaccines, it is an opportune time to examine what is known about the public receptivity to this novel vaccine. From October 2016-September 2017, we surveyed Kaiser Permanente Northwest members in Portland, Oregon, to ask their level of agreement on a 5-point scale with statements about the need for and willingness to get a potential norovirus vaccine for themselves or their child and analyzed their responses according to age, occupational status, prior vaccine uptake, and history of prior norovirus diagnoses. The survey response rate was 13.5% (n = 3,894); 807 (21%) responded as legal guardians, on behalf of a child <18 y of age and 3,087 (79%) were adults aged 18+ y. The majority of respondents were in agreement about getting the norovirus vaccine, if available (60% of legal guardians, 52% of adults aged 18-64 y, and 55% of adults aged 65+ y). Prior vaccination for influenza and rotavirus (among children) was the only correlate significantly associated with more positive attitudes toward receiving norovirus vaccine. Pre-pandemic attitudes in our all-ages study population reveal generally positive attitudes toward willingness to get a norovirus vaccine, particularly among those who previously received influenza or rotavirus vaccines.
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Affiliation(s)
- Holly C. Groom
- Science Programs Department, Kaiser Permanente Center for Health Research, Portland, OR, USA
| | - Mark Schmidt
- Science Programs Department, Kaiser Permanente Center for Health Research, Portland, OR, USA
| | - Laura E. Calderwood
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Cherokee Nation Operational Solutions, Tulsa, OK, USA
| | - Sara A. Mirza
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Claire Mattison
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Cherokee Nation Operational Solutions, Tulsa, OK, USA
| | - Suzanne Salas
- Science Programs Department, Kaiser Permanente Center for Health Research, Portland, OR, USA
| | - Judy Donald
- Science Programs Department, Kaiser Permanente Center for Health Research, Portland, OR, USA
| | - Allison L. Naleway
- Science Programs Department, Kaiser Permanente Center for Health Research, Portland, OR, USA
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Morrow AL, Payne DC, Conrey SC, McMorrow M, McNeal MM, Niu L, Burrell AR, Schlaudecker EP, Mattison C, Burke RM, DeFranco E, Teoh Z, Wrammert J, Atherton LJ, Thornburg NJ, Staat MA. Endemic coronavirus infections are associated with strong homotypic immunity in a US cohort of children from birth to 4 years. J Pediatric Infect Dis Soc 2024:piae016. [PMID: 38442245 DOI: 10.1093/jpids/piae016] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Indexed: 03/07/2024]
Abstract
BACKGROUND The endemic coronaviruses OC43, HKU1, NL63 and 229E cause cold-like symptoms and are related to SARS-CoV-2, but their natural histories are poorly understood. In a cohort of children followed from birth to 4 years, we documented all coronavirus infections, including SARS-CoV-2, to understand protection against subsequent infections with the same virus (homotypic immunity) or a different coronavirus (heterotypic immunity). METHODS Mother-child pairs were enrolled in metropolitan Cincinnati during the third trimester of pregnancy in 2017-18. Mothers reported their child's socio-demographics, risk factors, and weekly symptoms. Mid-turbinate nasal swabs were collected weekly. Blood was collected at 6 weeks, 6, 12, 18, 24 months and annually thereafter. Infections were detected by testing nasal swabs by an RT-PCR multi-pathogen panel and by serum IgG responses. Health care visits were documented from pediatric records. Analysis was limited to 116 children with high sample adherence. Re-consent for monitoring SARS-CoV-2 infections from June 2020 through November 2021 was obtained for 74 (64%) children. RESULTS We detected 345 endemic coronavirus infections (1.1 infections/child-year) and 21 SARS-CoV-2 infections (0.3 infections/child-year). Endemic coronavirus and SARS-CoV-2 infections were asymptomatic or mild. Significant protective homotypic immunity occurred after a single infection with OC43 (77%) and HKU1 (84%), and after two infections with NL63 (73%). No heterotypic protection against endemic coronaviruses or SARS-CoV-2 was identified. CONCLUSIONS Natural coronavirus infections were common and resulted in strong homotypic immunity but not heterotypic immunity against other coronaviruses, including SARS-CoV-2. Endemic coronavirus and SARS-CoV-2 infections in this US cohort were typically asymptomatic or mild.
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Affiliation(s)
- Ardythe L Morrow
- Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Daniel C Payne
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Shannon C Conrey
- Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Meredith McMorrow
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Monica M McNeal
- Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Liang Niu
- Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Allison R Burrell
- Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Elizabeth P Schlaudecker
- Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Claire Mattison
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Rachel M Burke
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Emily DeFranco
- Department of Obstetrics & Gynecology, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Zheyi Teoh
- Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Jens Wrammert
- Division of Infectious Diseases, Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia, USA
- Emory Vaccine Center, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Lydia J Atherton
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Natalie J Thornburg
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mary A Staat
- Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
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Teoh Z, Conrey S, McNeal M, Burrell A, Burke RM, Mattison C, McMorrow M, Payne DC, Morrow AL, Staat MA. Burden of Respiratory Viruses in Children Less Than 2 Years Old in a Community-based Longitudinal US Birth Cohort. Clin Infect Dis 2023; 77:901-909. [PMID: 37157868 PMCID: PMC10838707 DOI: 10.1093/cid/ciad289] [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: 02/23/2023] [Revised: 04/24/2023] [Accepted: 05/04/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND Respiratory viral infections are a major cause of morbidity and hospitalization in young children. Nevertheless, the population burden of respiratory viral infections, especially asymptomatic cases, is not known due to the lack of prospective community-based cohort studies with intensive monitoring. METHODS To address this gap, we enacted the PREVAIL cohort, a Centers for Disease Control and Prevention-sponsored birth cohort in Cincinnati, Ohio, where children were followed from 0 to 2 years of age. Weekly text surveys were administered to record acute respiratory illnesses (ARIs), which were defined as the presence of cough or fever (≥38°C). Weekly midturbinate nasal swabs were collected and tested using the Luminex Respiratory Pathogen Panel, which detected 16 viral pathogens. Viral infection was defined as ≥1 positive tests from the same virus or viral subtype ≤30 days of a previous positive test. Maternal report and medical chart abstractions identified healthcare utilization. RESULTS From 4/2017 to 7/2020, 245 mother-infant pairs were recruited and followed. From the 13 781 nasal swabs tested, a total of 2211 viral infections were detected, of which 821 (37%) were symptomatic. Children experienced 9.4 respiratory viral infections/child-year; half were rhinovirus/enterovirus. Viral ARI incidence was 3.3 episodes/child-year. Emergency department visits or hospitalization occurred with only 15% of respiratory syncytial virus infections, 10% of influenza infections, and only 4% of all viral infections. Regardless of pathogen, most infections were asymptomatic or mild. CONCLUSIONS Respiratory viral infections are common in children 0-2 years. Most viral infections are asymptomatic or non-medically attended, underscoring the importance of community-based cohort studies.
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Affiliation(s)
- Zheyi Teoh
- Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Shannon Conrey
- Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Division of Epidemiology, Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Monica McNeal
- Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Allison Burrell
- Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Division of Epidemiology, Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Rachel M Burke
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Claire Mattison
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Cherokee Nation Assurance, Arlington, Virginia, USA
| | - Meredith McMorrow
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Daniel C Payne
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ardythe L Morrow
- Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Division of Epidemiology, Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Mary Allen Staat
- Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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Gailani AE, Teoh Z, Conrey SC, Burke RM, Cline AR, Killerby ME, Lu X, Mattison C, McNeal M, Morrow AL, Payne DC, Staat MA. 92. Incidence of Adenovirus Respiratory Infection and Coinfection in a Longitudinal Birth Cohort. Open Forum Infect Dis 2022. [PMCID: PMC9752874 DOI: 10.1093/ofid/ofac492.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background Adenoviruses (AdVs) are a common cause of acute respiratory illness (ARI) in children and are often detected with other viruses (coinfection). However, the community incidence of AdV infections is poorly understood due to a lack of prospective studies outside the hospital setting. Here, we aim to characterize respiratory AdV infections and coinfections in a prospective birth cohort of children. Methods The PREVAIL cohort is a CDC-funded, 2-year birth cohort, conducted from 2017–2020 in Cincinnati, OH. ARI was defined as the presence of cough or fever identified with weekly maternal text surveys and medical chart review. Mid-turbinate nasal swabs were collected weekly. Swabs were tested using Luminex Respiratory Pathogen Panel. AdV infection was defined as a swab positive for AdV and included subsequent positives < 30 days apart. Coinfection was defined as detection of any other virus(es) during an AdV infection. Children who submitted at least 70% of weekly samples were included in our analysis. Results 101 children met inclusion criteria, representing 165 child-years. 137 distinct AdV infections were identified (incidence 0.84 infections per child year), with 98 (97%) children having ≥1 AdV infection. Only 40% (n=55) of AdV infections were symptomatic. Of those with symptomatic infections, 51% (n=28) sought medical care, with 42% (n=23) presenting to a primary care provider and 9% (n=5) resulting in an ED visit or hospital admission. Coinfections were detected in 67% (n=92) of AdV infections, with 45% (n=62) coinfected with 1 virus, 19% (n=26) with 2 viruses, and 3% (n=4) with ≥3 viruses. 77% of coinfections (n=71) were rhino/enterovirus. The number of coinfections or the specific coinfection virus was not associated with an increase in symptom prevalence or symptom severity (all p > 0.05). Viral Coinfection Frequency with Adenovirus Infection in the PREVAIL Cohort. Adenovirus Infection and Coinfection in the PREVAIL Cohort. Conclusion In this cohort of healthy children, AdVs were a common cause of respiratory infection. Most infections were asymptomatic or resulted in mild symptoms. Two-thirds of AdV infections involved viral coinfections, but coinfection was not associated with more frequent or severe symptoms. Our findings suggest studies that only include symptomatic or hospitalized patients may overestimate AdVs disease severity. Disclosures All Authors: No reported disclosures.
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Affiliation(s)
- Adam E Gailani
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Zheyi Teoh
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | | | | | - Allison R Cline
- University of Cincinnati College of Medicine, Cincinnati, Ohio
| | | | - Xiaoyan Lu
- Centers for Disease Control and Prevention, Atalnta, Georgia
| | | | - Monica McNeal
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | | | - Daniel C Payne
- US Centers for Disease Control and Prevention, Atlanta, Georgia
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Teoh Z, Conrey SC, Cline AR, Mattison C, Payne DC, McNeal M, Burke RM, McMorrow ML, Morrow AL, Staat MA. 95. Prolonged respiratory viral infection associated with presence of coinfections in an urban birth cohort. Open Forum Infect Dis 2022. [PMCID: PMC9751789 DOI: 10.1093/ofid/ofac492.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background Prolonged infection by respiratory viruses has been reported, especially in hospitalized or immunocompromised children. However, little is known of factors contributing to prolonged respiratory viral infection, particularly in asymptomatic and less severe infections. We examined characteristics associated with prolonged viral infection in a community-based birth cohort. Methods The PREVAIL cohort is a CDC-sponsored two-year birth cohort in Cincinnati, Ohio conducted during 4/2017 to 8/2020. Mid-turbinate nasal swabs were collected weekly from children and tested using the Luminex Respiratory Pathogen Panel. The primary outcome was prolonged viral infection, which was defined as a viral nucleic acid detection lasting 4 or more weeks. Proportions of prolonged viral infections were compared using Fisher’s exact test with Holms corrections. Adjusted odds ratios (aOR) and 95% confidence intervals were calculated using a mixed effects logistic regression model while controlling for within-subject clustering, viral species, child age, child sex, symptom status, and coinfection. This analysis was limited to subjects who provided at least 70% of weekly samples. Results Among 101 children, providing 7871 child-weeks of follow-up, we identified 780 viral infections. The median duration of infection across all respiratory viruses was 1 week, except for bocavirus and coronavirus NL63, each with 2 weeks; 40% of bocavirus and >10% of adenovirus, coronavirus NL63, RSV A, human metapneumovirus, and parainfluenza 1 infections were associated with prolonged infection (>4 weeks). No prolonged infections were detected for influenza A or B, coronavirus 229E or HKU1, or parainfluenza 2 or 4 infections. Viral coinfection (aOR=3.1, 95% CI 1.9, 5.0) and female sex (aOR 1.8, 95%CI 1.1, 2.9) were significantly associated with prolonged infection, while symptom status and child age were not. Conclusion In the PREVAIL cohort, detection of respiratory viruses lasting 4 weeks or longer was common for certain respiratory pathogens and was especially prolonged for bocavirus. Biological factors such as the presence of additional viral infections or child sex may affect the likelihood of prolonged infection. Disclosures All Authors: No reported disclosures.
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Affiliation(s)
- Zheyi Teoh
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | | | - Allison R Cline
- University of Cincinnati College of Medicine, Cincinnati, Ohio
| | | | - Daniel C Payne
- US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Monica McNeal
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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Conrey S, Burrell A, Mattison C, Payne D, Staat MA, Nommsen-Rivers L, Morrow A. Pre-pregnancy Obesity Associated With Lower Odds of Meeting Breastfeeding Recommendations When Controlling for Prenatal Intentions. Curr Dev Nutr 2022. [PMCID: PMC9194244 DOI: 10.1093/cdn/nzac061.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objectives
The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding (EBF) to 6 months of age, with continued breastfeeding (any BF) for at least 1 year. Maternal obesity has been associated with reduced duration of any and exclusive BF. However, few studies have incorporated degree of obesity or controlled for prenatal BF intentions when comparing BF outcomes. We calculated odds of meeting AAP BF recommendations by pre-pregnancy BMI category while controlling for prenatal BF intentions and demographics in PREVAIL, a CDC-funded birth cohort in Cincinnati, OH.
Methods
Prenatally, enrolled subjects completed a 3rd trimester questionnaire including demographics, pre-pregnancy weight and height, and EBF intention to 6 months. BMI (kg/m2) was categorized as healthy (18.5–24.9), overweight (25–29.9), obesity 1 (30–34.9), or obesity 2+ (≥35). Postnatally, mothers self-reported BF initiation, exclusivity, and duration via quarterly study questionnaires. Logistic regression compared EBF to 6 months and ABF to 1 year across BMI categories among those who initiated BF. All models were adjusted for maternal race, education, income and intention to EBF to 6 months.
Results
Of N = 245 enrolled subjects, the pre-pregnancy maternal obesity prevalence was 41% (n = 100), with 23% (n = 57) meeting Obesity 2 + criteria. There were no significant differences between BMI categories in intention to EBF to 6 months or BF initiation, with high (84–87%) initiation rates. Healthy BMI mothers reported the highest (40%) and mothers with obesity 2 + the lowest (4%), rates of EBF to 6 months (aOR 0.13 (CI 0.02–0.57)). Although only 26% of mothers provided any BF at the 1 year mark, healthy BMI mothers (49%) were more likely to achieve this recommendation than mothers with overweight (13%, aOR 0.11 (CI: 0.04, 0.34)), obesity 1 (16%, aOR 0.11 (CI 0.03, 0.33) and obesity 2+ (10%, aOR 0.15 (CI 0.04, 0.46)).
Conclusions
Despite high BF initiation rates, increasing BMI category was associated with decreasing odds of meeting AAP BF recommendations after adjustment for demographics and prenatal EBF intention in the PREVAIL Cohort. Whether these findings can be explained by physiologic barriers associated with higher BMI merits further attention.
Funding Sources
Centers for Disease Control and Prevention.
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Wikswo ME, Roberts V, Marsh Z, Manikonda K, Gleason B, Kambhampati A, Mattison C, Calderwood L, Balachandran N, Cardemil C, Hall AJ. Enteric illness outbreaks reported through the National Outbreak Reporting System, United States, 2009-19. Clin Infect Dis 2021; 74:1906-1913. [PMID: 34498027 DOI: 10.1093/cid/ciab771] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The National Outbreak Reporting System (NORS) captures data on foodborne, waterborne, and enteric illness outbreaks in the United States. The aim of this study is to describe enteric illness outbreaks reported during 11 years of surveillance. METHODS We extracted finalized reports from NORS for outbreaks occurring during 2009-2019. Outbreaks were included if they were caused by an enteric etiology or if any patients reported diarrhea, vomiting, bloody stools, or unspecified acute gastroenteritis. RESULTS A total of 38,395 outbreaks met inclusion criteria, increasing from 1,932 in 2009 to 3,889 in 2019. Outbreaks were most commonly transmitted through person-to-person contact (n=23,812, 62%) and contaminated food (n=9,234, 24%). Norovirus was the most commonly reported etiology, reported in 22,820 (59%) outbreaks, followed by Salmonella (n=2,449, 6%) and Shigella (n=1,171, 3%). Norovirus outbreaks were significantly larger, with a median of 22 illnesses per outbreak, than outbreaks caused by the other most common outbreak etiologies (p<0.0001, all comparisons). Hospitalization rates were higher in outbreaks caused by Salmonella and E. coli outbreaks (20.9% and 22.8%, respectively) than those caused by norovirus (2%). The case fatality rate was highest in E. coli outbreaks (0.5%) and lowest in Shigella and Campylobacter outbreaks (0.02%). CONCLUSIONS Norovirus caused the most outbreaks and outbreak-associated illness, hospitalizations, and deaths. However, persons in E. coli and Salmonella outbreaks were more likely to be hospitalized or die. Outbreak surveillance through NORS provides the relative contributions of each mode of transmission and etiology for reported enteric illness outbreaks, which can guide targeted interventions.
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Affiliation(s)
- Mary E Wikswo
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Virginia Roberts
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Zachary Marsh
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Karunya Manikonda
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Brigette Gleason
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Anita Kambhampati
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States.,Cherokee Nation Assurance, Arlington, VA, United States
| | - Claire Mattison
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States.,Oak Ridge Institute for Science and Education, Oak Ridge, TN, United States
| | - Laura Calderwood
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States.,Oak Ridge Institute for Science and Education, Oak Ridge, TN, United States
| | - Neha Balachandran
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States.,Oak Ridge Institute for Science and Education, Oak Ridge, TN, United States
| | - Cristina Cardemil
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Aron J Hall
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
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Burke RM, Mattison C, Pindyck T, Dahl RM, Rudd J, Bi D, Curns AT, Parashar U, Hall AJ. Burden of Norovirus in the United States, as Estimated Based on Administrative Data: Updates for Medically Attended Illness and Mortality, 2001-2015. Clin Infect Dis 2021; 73:e1-e8. [PMID: 32291450 PMCID: PMC8112883 DOI: 10.1093/cid/ciaa438] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [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: 02/19/2020] [Accepted: 04/13/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Up-to-date estimates of the burden of norovirus, a leading cause of acute gastroenteritis (AGE) in the United States, are needed to assess the potential value of norovirus vaccines in development. We aimed to estimate the rates, annual counts, and healthcare charges of norovirus-associated ambulatory clinic encounters, emergency department (ED) visits, hospitalizations, and deaths in the United States. METHODS We analyzed administrative data on AGE outcomes from 1 July 2001 through 30 June 2015. Data were sourced from IBM MarketScan Commercial and Medicare Supplemental Databases (ambulatory clinic and ED visits), the Healthcare Utilization Project National Inpatient Sample (hospitalizations), and the National Center for Health Statistics multiple-cause-of-mortality data (deaths). Outcome data (ambulatory clinic and ED visits, hospitalizations, or deaths) were summarized by month, age group, and setting. Healthcare charges were estimated based on insurance claims. Monthly counts of cause-unspecified gastroenteritis-associated outcomes were modeled as functions of cause-specified outcomes, and model residuals were analyzed to estimate norovirus-associated outcomes. Healthcare charges were estimated by applying average charges per cause-unspecified gastroenteritis encounter to the estimated number of norovirus encounters. RESULTS We estimate 900 deaths (95% confidence interval [CI], 650-1100), 109 000 hospitalizations (95% CI, 80 000-145 000), 465 000 ED visits (95% CI, 348 000-610 000), and 2.3 million ambulatory clinic encounters (95% CI, 1.7-2.9 million) annually due to norovirus, with an associated $430-$740 million in healthcare charges. CONCLUSIONS Norovirus causes a substantial health burden in the United States each year, and an effective vaccine could have important public health impact.
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Affiliation(s)
- Rachel M. Burke
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Claire Mattison
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | - Talia Pindyck
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Rebecca M. Dahl
- Maximus Federal, contracting agency to the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jessica Rudd
- Maximus Federal, contracting agency to the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Daoling Bi
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Aaron T Curns
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Umesh Parashar
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Aron J. Hall
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Kaufman JA, Mattison C, Fretts AM, Umans JG, Cole SA, Voruganti VS, Goessler W, Best LG, Zhang Y, Tellez-Plaza M, Navas-Acien A, Gribble MO. Arsenic, blood pressure, and hypertension in the Strong Heart Family Study. Environ Res 2021; 195:110864. [PMID: 33581093 PMCID: PMC8021390 DOI: 10.1016/j.envres.2021.110864] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 02/02/2021] [Accepted: 02/05/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Arsenic has been associated with hypertension, though it is unclear whether associations persist at the exposure concentrations (e.g. <100 μg/L) in drinking water occurring in parts of the Western United States. METHODS We assessed associations between arsenic biomarkers and systolic blood pressure (SBP), diastolic blood pressure (DBP), and hypertension in the Strong Heart Family Study, a family-based cohort of American Indians from the Northern plains, Southern plains, and Southwest. We included 1910 participants from three study centers with complete baseline visit data (2001-2003) in the cross-sectional analysis of all three outcomes, and 1453 participants in the prospective analysis of incident hypertension (follow-up 2006-2009). We used generalized estimating equations with exchangeable correlation structure conditional on family membership to estimate the association of arsenic exposure biomarker levels with SBP or DBP (linear regressions) or hypertension prevalence and incidence (Poisson regressions), adjusting for urine creatinine, urine arsenobetaine, and measured confounders. RESULTS We observed cross-sectional associations for a two-fold increase in inorganic and methylated urine arsenic species of 0.64 (95% CI: 0.07, 1.35) mm Hg for SBP, 0.49 (95% CI: 0.03, 1.02) mm Hg for DBP, and a prevalence ratio of 1.10 (95% CI: 1.01, 1.21) for hypertension in fully adjusted models. During follow-up, 14% of subjects developed hypertension. We observed non-monotonic relationships between quartiles of arsenic and incident hypertension. Effect estimates were null for incident hypertension with continuous exposure metrics. Stratification by study site revealed elevated associations in Arizona, the site with the highest arsenic levels, while results for Oklahoma and North and South Dakota were largely null. Blood pressure changes with increasing arsenic concentrations were larger for those with diabetes at baseline. CONCLUSIONS Our results suggest a modest cross-sectional association of arsenic exposure biomarkers with blood pressure, and possible non-linear effects on incident hypertension.
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Affiliation(s)
- John A Kaufman
- Department of Epidemiology, Emory University, Atlanta, GA, USA.
| | - Claire Mattison
- Department of Environmental Health, Emory University, Atlanta, GA, USA
| | - Amanda M Fretts
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA
| | - Jason G Umans
- Department of Medicine, Georgetown University Medical Center, Washington, DC, USA
| | - Shelley A Cole
- Texas Biomedical Research Institute, San Antonio, TX, USA
| | - V Saroja Voruganti
- Department of Nutrition, University of North Carolina, Chapel Hill, NC, USA
| | | | - Lyle G Best
- Missouri Breaks Industries Research, Inc., Eagle Butte, SD, United States
| | - Ying Zhang
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Maria Tellez-Plaza
- Department of Chronic Diseases Epidemiology, National Center for Epidemiology, Carlos III Health Institute, Madrid, Spain
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University, New York, NY, USA
| | - Matthew O Gribble
- Department of Epidemiology, Emory University, Atlanta, GA, USA; Department of Environmental Health, Emory University, Atlanta, GA, USA
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Schmidt MA, Salas SB, Yamshchikov V, Groom H, Rosales G, Donald J, Marsh Z, Burke R, Mattison C, Naleway A, Hall AJ. 694. The CAGE Study: Prevalence of Acute Gastroenteritis and Enteric Virus Infection in the Community. Open Forum Infect Dis 2018. [PMCID: PMC6253814 DOI: 10.1093/ofid/ofy210.701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
There are currently limited data about the occurrence and characteristics of sporadic acute gastroenteritis (AGE). In this study, we sought to (1) estimate the average point prevalence of AGE over a 1-year period; (2) describe health-seeking behaviors among those with AGE; and (3) calculate the proportion of stool samples testing positive for enteric viral pathogens.
Methods
Starting in October 2016, we recruited 52 weekly, age-stratified, random samples of Kaiser Permanente Northwest members to complete an online survey and, for a subset of participants, to submit a stool specimen. The survey included questions about the occurrence of vomiting and/or diarrhea within the previous 30 days and, for those reporting AGE symptoms, related health-seeking behaviors. Collected stool samples were tested for norovirus, astrovirus, sapovirus, and rotavirus by RT-qPCR.
Results
We received a total of 3,483 surveys from eligible participants, 417 (12%) of whom reported having had AGE symptoms (Figure 1). Of these, 70 (17%) sought related medical care across a spectrum of clinical encounter types (Figure 2). We also received a total of 531 stool samples, 74 from symptomatic and 457 from asymptomatic individuals. Among them, we detected norovirus in 12% and 3% of samples (P = 0.0005), respectively; astrovirus and sapovirus in 1% of samples in each group; and rotavirus in 8% and 7% of samples, respectively.
Conclusion
Our findings of AGE within the community are consistent with previous estimates using models of medically attended AGE occurrence and reported rates of health-seeking behavior. The prevalence of enteric viral infection among people in the community without AGE was generally low. These data can be used to generate age-stratified incidence estimates of community AGE and specifically that associated with enteric viral pathogens. Such disease burden data are needed to guide the development, targeting, and anticipated impacts of interventions, such as vaccines.
Disclosures
M. A. Schmidt, Takeda Vaccines, Inc.: Investigator, Research grant. S. B. Salas, Takeda Vaccines, Inc.: Investigator, Research grant. H. Groom, Takeda Vaccines, Inc.: Investigator, Research grant. G. Rosales, Takeda Vaccines, Inc.: Investigator, Research grant. J. Donald, Takeda Vaccines, Inc.: Investigator, Research grant. A. Naleway, Takeda Vaccines, Inc.: Investigator, Research grant.
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Affiliation(s)
- Mark A Schmidt
- Kaiser Permanente Center for Health Research, Portland, Oregon
| | - S Bianca Salas
- Kaiser Permanente Center for Health Research, Portland, Oregon
| | | | - Holly Groom
- Kaiser Permanente Center for Health Research, Portland, Oregon
| | | | - Judy Donald
- Kaiser Permanente Center for Health Research, Portland, Oregon
| | - Zach Marsh
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Rachel Burke
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Claire Mattison
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Allison Naleway
- Kaiser Permanente Center for Health Research, Portland, Oregon
| | - Aron J Hall
- Centers for Disease Control and Prevention, Atlanta, Georgia
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Jacoby T, Flanagan H, Faykin A, Seto AG, Mattison C, Ota I. Two protein-tyrosine phosphatases inactivate the osmotic stress response pathway in yeast by targeting the mitogen-activated protein kinase, Hog1. J Biol Chem 1997; 272:17749-55. [PMID: 9211927 DOI: 10.1074/jbc.272.28.17749] [Citation(s) in RCA: 134] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Protein phosphatases inactivate mitogen-activated protein kinase (MAPK) signaling pathways by dephosphorylating components of the MAPK cascade. Two genes encoding protein-tyrosine phosphatases, PTP2, and a new phosphatase, PTP3, have been isolated in a genetic selection for negative regulators of an osmotic stress response pathway called HOG, for high osmolarity glycerol, in budding yeast. PTP2 and PTP3 were isolated as multicopy suppressors of a severe growth defect due to hyperactivation of the HOG pathway. Phosphatase activity is required for suppression since mutation of the catalytic Cys residue in Ptp2 and Ptp3, destroys suppressor function and biochemical activity. The substrate of these phosphatases is likely to be the MAPK, Hog1. Catalytically inactive Ptp2 and Ptp3 coprecipitate with Hog1 from yeast extracts. In addition, strains lacking PTP2 and PTP3 do not dephosphorylate Hog1-phosphotyrosine as well as wild type. The latter suggests that PTP2 and PTP3 play a role in adaptation. Consistent with this role, osmotic stress induces expression of PTP2 and PTP3 transcripts in a Hog1-dependent manner. Thus Ptp2 and Ptp3 likely act in a negative feedback loop to inactivate Hog1.
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Affiliation(s)
- T Jacoby
- Department of Chemistry and Biochemistry, University of Colorado, Boulder, Colorado 80309-0215, USA
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