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1. Risk Factors for Kala-Azar in Bangladesh

Author

Caryn Bern, Allen W. Hightower, Rajib Chowdhury, Mustakim Ali, Josef Amann, Yukiko Wagatsuma, Rashidul Haque, Katie Kurkjian, Louise E. Vaz, Moarrita Begum, Tangin Akter, Catherine B. Cetre-Sossah, Indu B. Ahluwalia, Ellen Dotson, W. Evan Secor, Robert F. Breiman, and James H. Maguire

Subjects
disease outbreaks, Epidemiology, leishmaniasis, risk factors, Visceral, prevention & control, Medicine, Infectious and parasitic diseases, RC109-216
Abstract

Since 1990, South Asia has experienced a resurgence of kala-azar (visceral leishmaniasis). To determine risk factors for kala-azar, we performed cross-sectional surveys over a 3-year period in a Bangladeshi community. By history, active case detection, and serologic screening, 155 of 2,356 residents had kala-azar with onset from 2000 to 2003. Risk was highest for persons 3–45 years of age, and no significant difference by sex was seen. In age-adjusted multivariable models, 3 factors were identified: proximity to a previous kala-azar patient (odds ratio [OR] 25.4, 95% confidence interval [CI] 15–44 within household; OR 3.2 95% CI 1.7–6.1 within 50 m), bed net use in summer (OR 0.7, 95% CI 0.53–0.93), and cattle per 1,000 m2 (OR 0.8, 95% CI 0.70–0.94]). No difference was seen by income, education, or occupation; land ownership or other assets; housing materials and condition; or keeping goats or chickens inside bedrooms. Our data confirm strong clustering and suggest that insecticide-treated nets could be effective in preventing kala-azar.

Published
2005
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2. Cholera in United States Associated with Epidemic in Hispaniola

Author

Anna E. Newton, Katherine E. Heiman, Ann Schmitz, Tom Török, Andria Apostolou, Heather Hanson, Prabhu Gounder, Susan Bohm, Katie Kurkjian, Michele B. Parsons, Deborah Talkington, Steven Stroika, Lawrence C. Madoff, Franny Elson, David Sweat, Venessa Cantu, Okey Akwari, Barbara E. Mahon, and Eric D. Mintz

Subjects
cholera, Vibrio cholerae, bacteria, Haiti, Dominican Republic, Hispaniola, Medicine, Infectious and parasitic diseases, RC109-216
Abstract

Cholera is rare in the United States (annual average 6 cases). Since epidemic cholera began in Hispaniola in 2010, a total of 23 cholera cases caused by toxigenic Vibrio cholerae O1 have been confirmed in the United States. Twenty-two case-patients reported travel to Hispaniola and 1 reported consumption of seafood from Haiti.

Published
2011
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3. Incidence of medically attended influenza during pandemic and post-pandemic seasons through the Influenza Incidence Surveillance Project, 2009–13

Author

Ann Thomas, Steve Di Lonardo, Lyn Finelli, Ashley Fowlkes, Katie Kurkjian, Carol Davis, Andrea Steffens, Oluwakemi Oni, Jon Temte, Ruth Lynfield, Heather Rubino, Michelle Feist, Matthew Biggerstaff, Christine Selzer, Karen Martin, Rachelle Boulton, Lisa McHugh, Nicole Bryan, and Jose Lojo

Subjects
Adult, Pulmonary and Respiratory Medicine, Male, Pediatrics, medicine.medical_specialty, Adolescent, Population, medicine.disease_cause, Antiviral Agents, Article, Young Adult, Age Distribution, Influenza A Virus, H1N1 Subtype, Ambulatory care, Pandemic, Influenza, Human, Influenza A virus, medicine, Sore throat, Ambulatory Care, Outpatient clinic, Humans, Child, education, Intensive care medicine, Pandemics, Aged, education.field_of_study, business.industry, Incidence, Influenza A Virus, H3N2 Subtype, Incidence (epidemiology), Vaccination, Infant, virus diseases, Middle Aged, United States, Hospitalization, Influenza B virus, Influenza Vaccines, Child, Preschool, Population Surveillance, Female, Seasons, medicine.symptom, business
Abstract

Summary Background Since the introduction of pandemic influenza A (H1N1) to the USA in 2009, the Influenza Incidence Surveillance Project has monitored the burden of influenza in the outpatient setting through population-based surveillance. Methods From Oct 1, 2009, to July 31, 2013, outpatient clinics representing 13 health jurisdictions in the USA reported counts of influenza-like illness (fever including cough or sore throat) and all patient visits by age. During four years, staff at 104 unique clinics (range 35–64 per year) with a combined median population of 368 559 (IQR 352 595–428 286) attended 35 663 patients with influenza-like illness and collected 13 925 respiratory specimens. Clinical data and a respiratory specimen for influenza testing by RT-PCR were collected from the first ten patients presenting with influenza-like illness each week. We calculated the incidence of visits for influenza-like illness using the size of the patient population, and the incidence attributable to influenza was extrapolated from the proportion of patients with positive tests each week. Findings The site-median peak percentage of specimens positive for influenza ranged from 58·3% to 77·8%. Children aged 2 to 17 years had the highest incidence of influenza-associated visits (range 4·2–28·0 per 1000 people by year), and adults older than 65 years had the lowest (range 0·5–3·5 per 1000 population). Influenza A H3N2, pandemic H1N1, and influenza B equally co-circulated in the first post-pandemic season, whereas H3N2 predominated for the next two seasons. Of patients for whom data was available, influenza vaccination was reported in 3289 (28·7%) of 11 459 patients with influenza-like illness, and antivirals were prescribed to 1644 (13·8%) of 11 953 patients. Interpretation Influenza incidence varied with age groups and by season after the pandemic of 2009 influenza A H1N1. High levels of influenza virus circulation, especially in young children, emphasise the need for additional efforts to increase the uptake of influenza vaccines and antivirals. Funding US Centers for Disease Control and Prevention.

Published
2015

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