5 results on '"Brunette, Gary"'
Search Results
2. Chikungunya and Dengue Virus Infections Among United States Community Service Volunteers Returning from the Dominican Republic, 2014.
- Author
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Millman AJ, Esposito DH, Biggs HM, Decenteceo M, Klevos A, Hunsperger E, Munoz-Jordan J, Kosoy OI, McPherson H, Sullivan C, Voorhees D, Baron D, Watkins J, Gaul L, Sotir MJ, Brunette G, Fischer M, Sharp TM, and Jentes ES
- Subjects
- Dominican Republic epidemiology, Humans, Travel, United States epidemiology, Chikungunya Fever epidemiology, Dengue epidemiology, Volunteers
- Abstract
Chikungunya spread throughout the Dominican Republic (DR) after the first identified laboratory-confirmed cases were reported in April 2014. In June 2014, a U.S.-based service organization operating in the DR reported chikungunya-like illnesses among several staff. We assessed the incidence of chikungunya virus (CHIKV) and dengue virus (DENV) infection and illnesses and evaluated adherence to mosquito avoidance measures among volunteers/staff deployed in the DR who returned to the United States during July-August 2014. Investigation participants completed a questionnaire that collected information on demographics, medical history, self-reported illnesses, and mosquito exposures and avoidance behaviors and provided serum for CHIKV and DENV diagnostic testing by reverse transcription polymerase chain reaction and IgM enzyme-linked immunosorbent assay. Of 102 participants, 42 (41%) had evidence of recent CHIKV infection and two (2%) had evidence of recent DENV infection. Of the 41 participants with evidence of recent CHIKV infection only, 39 (95%) reported fever, 37 (90%) reported rash, and 37 (90%) reported joint pain during their assignment. All attended the organization's health trainings, and 89 (87%) sought a pretravel health consultation. Most (∼95%) used insect repellent; however, only 30% applied it multiple times daily and < 5% stayed in housing with window/door screens. In sum, CHIKV infections were common among these volunteers during the 2014 chikungunya epidemic in the DR. Despite high levels of preparation, reported adherence to mosquito avoidance measures were inconsistent. Clinicians should discuss chikungunya with travelers visiting areas with ongoing CHIKV outbreaks and should consider chikungunya when diagnosing febrile illnesses in travelers returning from affected areas., (© The American Society of Tropical Medicine and Hygiene.)
- Published
- 2016
- Full Text
- View/download PDF
3. Use of Japanese encephalitis vaccine in US travel medicine practices in Global TravEpiNet.
- Author
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Deshpande BR, Rao SR, Jentes ES, Hills SL, Fischer M, Gershman MD, Brunette GW, Ryan ET, LaRocque RC, and The Global TravEpiNet Consortium
- Subjects
- Adolescent, Adult, Aged, Demography, Encephalitis, Japanese epidemiology, Female, Guideline Adherence, Health Knowledge, Attitudes, Practice, Humans, Male, Middle Aged, Practice Guidelines as Topic, Risk Assessment, Travel Medicine, United States epidemiology, Vaccination, Young Adult, Encephalitis Virus, Japanese immunology, Encephalitis, Japanese prevention & control, Endemic Diseases prevention & control, Japanese Encephalitis Vaccines administration & dosage, Travel
- Abstract
Few data regarding the use of Japanese encephalitis (JE) vaccine in clinical practice are available. We identified 711 travelers at higher risk and 7,578 travelers at lower risk for JE who were seen at US Global TravEpiNet sites from September of 2009 to August of 2012. Higher-risk travelers were younger than lower-risk travelers (median age = 29 years versus 40 years, P < 0.001). Over 70% of higher-risk travelers neither received JE vaccine during the clinic visit nor had been previously vaccinated. In the majority of these instances, clinicians determined that the JE vaccine was not indicated for the higher-risk traveler, which contradicts current recommendations of the Advisory Committee on Immunization Practices. Better understanding is needed of the clinical decision-making regarding JE vaccine in US travel medicine practices., (© The American Society of Tropical Medicine and Hygiene.)
- Published
- 2014
- Full Text
- View/download PDF
4. Possible rabies exposures in Peace Corps volunteers, 2011.
- Author
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Harvey K, Jentes ES, Charles M, Johnson KJ, Petersen B, Lamias MJ, Blanton JD, Sotir MJ, and Brunette GW
- Subjects
- Health Surveys, Humans, Post-Exposure Prophylaxis, Rabies Vaccines therapeutic use, Surveys and Questionnaires, United States, Vaccination, Peace Corps, Rabies prevention & control, Volunteers statistics & numerical data
- Abstract
We surveyed Peace Corps Medical Officers (PCMOs) to determine the frequency of and responses to possible rabies exposures of U.S. Peace Corps volunteers (PCVs). Surveys were sent to 56 PCMOs serving in countries with moderate or high rabies vaccine recommendations from the U.S. Centers for Disease Control and Prevention (CDC), of which 38 (68%) responded. Thirty-seven PCMOs reported that, of 4,982 PCVs, 140 (3%) experienced possible rabies exposures. Of these, 125 (89%) had previously received rabies vaccination, 129 (92%) presented with adequately cleansed wounds, and 106 (76%) were deemed to require and were given post-exposure prophylaxis (PEP). Of 35 respondents, 30 (86%) reported that rabies vaccine was always accessible to PCVs in their country within 24 hours. Overall, the Peace Corps is successful at preventing and treating possible rabies exposures. However, this study identified a few gaps in policy implementation. The Peace Corps should continue and strengthen efforts to provide education, preexposure vaccination, and PEP to PCVs.
- Published
- 2014
- Full Text
- View/download PDF
5. Pre-travel health care of immigrants returning home to visit friends and relatives.
- Author
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LaRocque RC, Deshpande BR, Rao SR, Brunette GW, Sotir MJ, Jentes ES, Ryan ET, and The Global TravEpiNet Consortium
- Subjects
- Adolescent, Adult, Aged, Child, Child, Preschool, Cohort Studies, Emigrants and Immigrants, Female, Health Knowledge, Attitudes, Practice, Humans, Logistic Models, Male, Middle Aged, Multivariate Analysis, Vaccination statistics & numerical data, Young Adult, Communicable Disease Control methods, Delivery of Health Care, Health Planning Guidelines, Public Health, Travel statistics & numerical data
- Abstract
Immigrants returning home to visit friends and relatives (VFR travelers) are at higher risk of travel-associated illness than other international travelers. We evaluated 3,707 VFR and 17,507 non-VFR travelers seen for pre-travel consultation in Global TravEpiNet during 2009-2011; all were traveling to resource-poor destinations. VFR travelers more commonly visited urban destinations than non-VFR travelers (42% versus 30%, P < 0.0001); 54% of VFR travelers were female, and 18% of VFR travelers were under 6 years old. VFR travelers sought health advice closer to their departure than non-VFR travelers (median days before departure was 17 versus 26, P < 0.0001). In multivariable analysis, being a VFR traveler was an independent predictor of declining a recommended vaccine. Missed opportunities for vaccination could be addressed by improving the timing of pre-travel health care and increasing the acceptance of vaccines. Making pre-travel health care available in primary care settings may be one step to this goal.
- Published
- 2013
- Full Text
- View/download PDF
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