59 results on '"Brett Whitaker"'
Search Results
2. Rapid Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 in Detention Facility, Louisiana, USA, May–June, 2020
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Megan Wallace, Allison E. James, Rachel Silver, Mitsuki Koh, Farrell A. Tobolowsky, Sean Simonson, Jeremy A. W. Gold, Rena Fukunaga, Henry Njuguna, Keith Bordelon, Jonathan Wortham, Melissa Coughlin, Jennifer L. Harcourt, Azaibi Tamin, Brett Whitaker, Natalie J. Thornburg, Ying Tao, Krista Queen, Anna Uehara, Clinton R. Paden, Jing Zhang, Suxiang Tong, Danielle Haydel, Ha Tran, Kaylee Kim, Kiva A. Fisher, Mariel Marlow, Jacqueline E. Tate, Reena H. Doshi, Theresa Sokol, and Kathryn G. Curran
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severe acute respiratory syndrome coronavirus 2 ,SARS-CoV-2 ,coronaviruses ,viruses ,coronavirus disease ,COVID-19 ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Abstract
To assess transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a detention facility experiencing a coronavirus disease outbreak and evaluate testing strategies, we conducted a prospective cohort investigation in a facility in Louisiana, USA. We conducted SARS-CoV-2 testing for detained persons in 6 quarantined dormitories at various time points. Of 143 persons, 53 were positive at the initial test, and an additional 58 persons were positive at later time points (cumulative incidence 78%). In 1 dormitory, all 45 detained persons initially were negative; 18 days later, 40 (89%) were positive. Among persons who were SARS-CoV-2 positive, 47% (52/111) were asymptomatic at the time of specimen collection; 14 had replication-competent virus isolated. Serial SARS-CoV-2 testing might help interrupt transmission through medical isolation and quarantine. Testing in correctional and detention facilities will be most effective when initiated early in an outbreak, inclusive of all exposed persons, and paired with infection prevention and control.
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- 2021
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3. SARS-CoV-2 Infections among Recent Organ Recipients, March–May 2020, United States
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Jefferson M. Jones, Ian Kracalik, Meenakshi M. Rana, Ann Nguyen, Brian C. Keller, Aaron Mishkin, Charles Hoopes, Thomas Kaleekal, Abhinav Humar, Juan Vilaro, Gene Im, Lou Smith, April Justice, Collette Leaumont, Stephen Lindstrom, Brett Whitaker, Ricardo M. La Hoz, Marian G. Michaels, David Klassen, Wendi Kuhnert, and Sridhar V. Basavaraju
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COVID-19 ,SARS-CoV-2 ,severe acute respiratory syndrome coronavirus 2 ,viruses ,respiratory infections ,zoonoses ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Abstract
We conducted public health investigations of 8 organ transplant recipients who tested positive for severe acute respiratory syndrome coronavirus 2 infection. Findings suggest the most likely source of transmission was community or healthcare exposure, not the organ donor. Transplant centers should educate transplant candidates and recipients about infection prevention recommendations.
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- 2021
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4. US CDC Real-Time Reverse Transcription PCR Panel for Detection of Severe Acute Respiratory Syndrome Coronavirus 2
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Xiaoyan Lu, Lijuan Wang, Senthilkumar K. Sakthivel, Brett Whitaker, Janna Murray, Shifaq Kamili, Brian Lynch, Lakshmi Malapati, Stephen A. Burke, Jennifer Harcourt, Azaibi Tamin, Natalie J. Thornburg, Julie M. Villanueva, and Stephen Lindstrom
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2019 novel coronavirus disease ,coronavirus disease ,COVID-19 ,severe acute respiratory syndrome coronavirus 2 ,SARS-CoV-2 ,viruses ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified as the etiologic agent associated with coronavirus disease, which emerged in late 2019. In response, we developed a diagnostic panel consisting of 3 real-time reverse transcription PCR assays targeting the nucleocapsid gene and evaluated use of these assays for detecting SARS-CoV-2 infection. All assays demonstrated a linear dynamic range of 8 orders of magnitude and an analytical limit of detection of 5 copies/reaction of quantified RNA transcripts and 1 x 10−1.5 50% tissue culture infectious dose/mL of cell-cultured SARS-CoV-2. All assays performed comparably with nasopharyngeal and oropharyngeal secretions, serum, and fecal specimens spiked with cultured virus. We obtained no false-positive amplifications with other human coronaviruses or common respiratory pathogens. Results from all 3 assays were highly correlated during clinical specimen testing. On February 4, 2020, the Food and Drug Administration issued an Emergency Use Authorization to enable emergency use of this panel.
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- 2020
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5. Severe Acute Respiratory Syndrome Coronavirus 2 from Patient with Coronavirus Disease, United States
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Jennifer Harcourt, Azaibi Tamin, Xiaoyan Lu, Shifaq Kamili, Senthil K. Sakthivel, Janna Murray, Krista Queen, Ying Tao, Clinton R. Paden, Jing Zhang, Yan Li, Anna Uehara, Haibin Wang, Cynthia Goldsmith, Hannah A. Bullock, Lijuan Wang, Brett Whitaker, Brian Lynch, Rashi Gautam, Craig Schindewolf, Kumari G. Lokugamage, Dionna Scharton, Jessica A. Plante, Divya Mirchandani, Steven G. Widen, Krishna Narayanan, Shinji Makino, Thomas G. Ksiazek, Kenneth S. Plante, Scott C. Weaver, Stephen Lindstrom, Suxiang Tong, Vineet D. Menachery, and Natalie J. Thornburg
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coronavirus ,viruses ,severe acute respiratory syndrome coronavirus 2 ,SARS-CoV-2 ,novel coronavirus disease 2019 ,COVID-19 ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Abstract
The etiologic agent of an outbreak of pneumonia in Wuhan, China, was identified as severe acute respiratory syndrome coronavirus 2 in January 2020. A patient in the United States was given a diagnosis of infection with this virus by the state of Washington and the US Centers for Disease Control and Prevention on January 20, 2020. We isolated virus from nasopharyngeal and oropharyngeal specimens from this patient and characterized the viral sequence, replication properties, and cell culture tropism. We found that the virus replicates to high titer in Vero-CCL81 cells and Vero E6 cells in the absence of trypsin. We also deposited the virus into 2 virus repositories, making it broadly available to the public health and research communities. We hope that open access to this reagent will expedite development of medical countermeasures.
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- 2020
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6. The epidemiology and estimated etiology of pathogens detected from the upper respiratory tract of adults with severe acute respiratory infections in multiple countries, 2014-2015.
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Jennifer Milucky, Tracy Pondo, Christopher J Gregory, Danielle Iuliano, Sandra S Chaves, John McCracken, Adel Mansour, Yuzhi Zhang, Mohammad Abdul Aleem, Bernard Wolff, Brett Whitaker, Toni Whistler, Clayton Onyango, Maria Renee Lopez, Na Liu, Mohammed Ziaur Rahman, Nong Shang, Jonas Winchell, Malinee Chittaganpitch, Barry Fields, Herberth Maldonado, Zhiping Xie, Stephen Lindstrom, Katherine Sturm-Ramirez, Joel Montgomery, Kai-Hui Wu, Chris A Van Beneden, and Adult TAC Working Group
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Medicine ,Science - Abstract
IntroductionEtiology studies of severe acute respiratory infections (SARI) in adults are limited. We studied potential etiologies of SARI among adults in six countries using multi-pathogen diagnostics.MethodsWe enrolled both adults with SARI (acute respiratory illness onset with fever and cough requiring hospitalization) and asymptomatic adults (adults hospitalized with non-infectious illnesses, non-household members accompanying SARI patients, adults enrolled from outpatient departments, and community members) in each country. Demographics, clinical data, and nasopharyngeal and oropharyngeal specimens were collected from both SARI patients and asymptomatic adults. Specimens were tested for presence of 29 pathogens utilizing the Taqman® Array Card platform. We applied a non-parametric Bayesian regression extension of a partially latent class model approach to estimate proportions of SARI caused by specific pathogens.ResultsWe enrolled 2,388 SARI patients and 1,135 asymptomatic adults from October 2013 through October 2015. We detected ≥1 pathogen in 76% of SARI patients and 67% of asymptomatic adults. Haemophilus influenzae and Streptococcus pneumoniae were most commonly detected (≥23% of SARI patients and asymptomatic adults). Through modeling, etiology was attributed to a pathogen in most SARI patients (range among countries: 57.3-93.2%); pathogens commonly attributed to SARI etiology included influenza A (14.4-54.4%), influenza B (1.9-19.1%), rhino/enterovirus (1.8-42.6%), and RSV (3.6-14.6%).ConclusionsUse of multi-pathogen diagnostics and modeling enabled attribution of etiology in most adult SARI patients, despite frequent detection of multiple pathogens in the upper respiratory tract. Seasonal flu vaccination and development of RSV vaccine would likely reduce the burden of SARI in these populations.
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- 2020
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7. Human parainfluenza virus surveillance in pediatric patients with lower respiratory tract infections: a special view of parainfluenza type 4
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Luciano M. Thomazelli, Danielle B.L. de Oliveira, Giuliana S. Durigon, Brett Whitaker, Shifaq Kamili, Eitan N. Berezin, and Edison L. Durigon
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Pediatrics ,RJ1-570 - Abstract
Objective: Characterize the role of human parainfluenza virus and its clinical features in Brazilian children under 2 years of age presenting with acute lower respiratory tract infections. Methods: Real‐time assays were used to identify strains of human parainfluenza virus and other common respiratory viruses in nasopharyngeal aspirates. One thousand and two children presenting with acute lower respiratory tract illnesses were enrolled from February 2008 to August 2010. Results: One hundred and four (10.4%) patients were human parainfluenza virus positive, of whom 60 (57.7%) were positive for human parainfluenza virus‐3, 30 (28.8%) for human parainfluenza virus‐4, 12 (11.5%) for human parainfluenza virus‐1, and two (1.9%) for human parainfluenza virus‐2. Seven (6.7%) patients had more than one strain of human parainfluenza virus detected. The most frequent symptoms were tachypnea and cough, similar to other viral respiratory infections. Clinical manifestations did not differ significantly between human parainfluenza virus‐1, ‐2, ‐3, and ‐4 infections. Human parainfluenza virus‐1, ‐3, and ‐4 were present in the population studied throughout the three years of surveillance, with human parainfluenza virus‐3 being the predominant type identified in the first two years. Conclusion: Human parainfluenza viruses contribute substantially to pediatric acute respiratory illness (ARI) in Brazil, with nearly 30% of this contribution attributable to human parainfluenza virus‐4. Resumo: Objetivo: Caracterizar o papel do VPH‐4 e suas características clínicas em crianças brasileiras com menos de dois anos de idade com infecções agudas do trato respiratório inferior. Métodos: Ensaios em tempo real foram utilizados para identificar tipos de VPH e outros vírus respiratórios comuns em aspirados nasofaríngeos. Mil e duas crianças com doença aguda do trato respiratório inferior foram inscritas para participar de fevereiro de 2008 a agosto de 2010. Resultados: 104 (10,4%) pacientes eram VPH positivos, dos quais 60 (57,7%) eram positivos para VPH‐3, 30 (28,8%) para VPH‐4, 12 (11,5%) para VPH‐1 e dois (1,9%) para VPH‐2. Sete (6,7%) apresentaram mais de um tipo de VPH detectado. Os sintomas mais frequentes foram tosse e taquipneia, semelhantes a outras infecções respiratórias virais. As manifestações clínicas não diferiram de forma significativa entre as infecções por VPH‐1, ‐2, ‐3 e ‐4. Os VPH‐1, ‐3 e ‐4 estavam presentes na população estudada ao longo dos três anos de vigilância, e o VPH‐3 foi o tipo predominante identificado nos primeiros dois anos. Conclusão: Os VPHs contribuem substancialmente para a DRA pediátrica no Brasil com quase 30% dessa contribuição atribuível ao VPH‐4. Keywords: Human parainfluenza virus, Respiratory virus, Pediatric patients, Acute respiratory illness, Human respirovirus 4, Palavras‐chave: Vírus da parainfluenza humana, Vírus respiratório, Pacientes pediátricos, Doença respiratória aguda, Respirovírus humano 4
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- 2018
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8. Strengthening laboratory capacity for detection of respiratory viral pathogens through the Global Health Security Agenda (GHSA) framework
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Brett Whitaker, Karen A. Alroy, Erica Guthrie, Sarah Schildecker, Susan Hiers, Jill Woodard, and S. Arunmozhi Balajee
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public health laboratory ,multiplex ,respiratory viruses ,global health security ,polymerase chain reaction ,Public aspects of medicine ,RA1-1270 ,Medicine (General) ,R5-920 - Abstract
Background: Endemic and emerging respiratory viruses are a threat to public health, and a robust public health laboratory system is essential to ensure global health security. Objective: This program sought to expand molecular laboratory testing capacity to detect a broad range of respiratory pathogens in clinical respiratory specimens collected during disease surveillance and outbreak investigations. Methods: As a part of the Global Health Security Agenda (GHSA), the United States Centers for Disease Control and Prevention utilised the equipment and training infrastructure already in place at the World Health Organization National Influenza Centers to expand testing capacity for respiratory viruses in laboratories in GHSA partner countries. This was done through the provision of quality assured reagents, including multiplex platforms and technical guidance for laboratory staff, as well as the assessment of laboratory testing accuracy. Conclusion: Early findings illustrated that GHSA laboratories have been able to expand testing capacity using specimens from routine surveillance, as well as from outbreak situations.
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- 2019
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9. Surveillance for Acute Respiratory Illnesses in Pediatric Chronic Care Facilities
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Lisa, Saiman, Mila M, Prill, Sibyl, Wilmont, Natalie, Neu, Luis, Alba, Alexandra, Hill-Ricciuti, Elaine, Larson, Brett, Whitaker, Xiaoyan, Lu, Shikha, Garg, Susan I, Gerber, and Lindsay, Kim
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Infectious Diseases ,Pediatrics, Perinatology and Child Health ,General Medicine - Abstract
Overall, 119 (33%) of 364 pediatric chronic care facility residents experienced 182 acute respiratory illnesses (ARIs) that met the surveillance definition which led to 31 (17%) emergency room visits, 34 (19%) acute care hospitalizations, and/or 25 (14%) ICU admissions. Continued PCR-positivity was observed in 35% of ARIs during follow-up testing.
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- 2022
10. 377. Use of Mid-Turbinate Swab (MTS) versus Throat Swab (TS) for Detection of Respiratory Pathogens in Children, Kansas City, Missouri, November 2015 – May 2019
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Dithi Banerjee, Brian R Lee, Christopher J Harrison, Joana Y Lively, Brett Whitaker, Yingtao Zhou, and Rangaraj Selvarangan
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Infectious Diseases ,Oncology - Abstract
Background An optimal specimen collection method is important for pathogen detection in respiratory surveillance studies. Mid-turbinate swab (MTS) in combination with throat swab (TS) were used for collecting samples from children enrolled in Kansas City site of the New Vaccine Surveillance Network (NVSN), a prospective surveillance network for acute respiratory infections. A standalone MTS is used for standard of care (SOC) testing. We compared detections from NVSN MTS+TS vs. SOC MTS samples collected ±1 day of each other to evaluate the sensitivity of the single MTS collection in children. Methods Nucleic acid extracts from NVSN MTS+TS samples were tested by Luminex NxTag Respiratory Pathogen Panel (NxTag RPP). SOC MTS samples were tested by BioFire® Respiratory Panel 1.7. (FilmArray). All children, aged < 18 years enrolled in the inpatient and Emergency Department for NVSN (November 2015 to May 2019) with available historical MTS SOC testing results ±1 day of enrollment were included in the study. Concordance between results of NVSN MTS+TS and SOC MTS testing was measured. Results Paired NVSN and SOC samples were available from 315 subjects with median age of 16.8 months (IQR 5.0 months – 61.7 months); 59.3% (189/315) were from male subjects. An overall positivity of 93.6% was noted with 295 detections by one sample or the other. Of the 295 detections, 231 (78%) detections were in both samples; 35 (12%) detections by MTS+TS; and 29 (10%) detections by MTS only. High concordance ( >90%) and very good Kappa values (Table 1) between the 2 specimen collection methods was noted for most pathogens. 72% of discrepant samples were from children with median age 13.2 months (IQR 8.0 months – 38.6 months). Conclusion We observed high concordance between MTS and MTS+TS for all targets. Most discrepant samples were from young children in whom adequate sampling can be challenging, perhaps reducing sensitivity. Differences in time of collection and testing, and platform differences (NxTag RPP vs. FilmArray) may have impacted our data, e.g. due to variable assay sensitivities for specific targets. Regardless of these differences, our data show comparable performance between MTS alone and MTS+TS suggesting that MTS alone may be sufficient for respiratory pathogen surveillance in children. Disclosures Brian R. Lee, PhD, MPH, CDC: Grant/Research Support|Merck: Grant/Research Support Christopher J Harrison, MD, Astellas: Grant/Research Support|GSK: Grant/Research Support|Merck: Grant/Research Support|Pediatric news: Honoraria|Pfizer: Grant/Research Support Rangaraj Selvarangan, BVSc, PhD, D(ABMM), FIDSA, F(AAM), BioFire: Grant/Research Support|Luminex: Grant/Research Support.
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- 2022
11. CRISIS AS PEDAGOGY: Recommendations for Using the Pandemic in Leadership Education
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Brett Whitaker and Lori Kniffin
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- 2022
12. Epidemiologic Characteristics Associated With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Antigen-Based Test Results, Real-Time Reverse Transcription Polymerase Chain Reaction (rRT-PCR) Cycle Threshold Values, Subgenomic RNA, and Viral Culture Results From University Testing
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Jennifer M Folster, Natalie J. Thornburg, Magdalena Medrzycki, Devlin Cole, John Paul Bigouette, Geroncio C Fajardo, Bettina Bankamp, Ryan P. Westergaard, Kimberly Goffard, Collin Pitts, Hannah Browne, Jing Zhang, Miranda J Delahoy, Laura Ford, Jennifer L Harcourt, Michael D. Bowen, Christine Lee, Marie K. Kirby, Brandi Limbago, Ailam Lim, Brett Whitaker, Dena Bushman, Gaston Bonenfant, Kimberly Langolf, Blake Cherney, Tara Zochert, Hannah L Kirking, Bin Zhou, Dustin W Currie, Jacqueline E. Tate, Marie E Killerby, Glen R. Abedi, Motria Caudill, Nicole A. Aulik, Patrick Kelly, Douglas Gieryn, Allen C. Bateman, Azaibi Tamin, Ian W Pray, Krista Queen, Juliana Kahrs, and Patricia L. Shewmaker
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0301 basic medicine ,Microbiology (medical) ,Universities ,Epidemiology ,030106 microbiology ,RT-PCR ,Antigen test ,medicine.disease_cause ,Sensitivity and Specificity ,Asymptomatic ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Antigen ,law ,Major Article ,Sofia SARS Antigen FIA ,medicine ,Humans ,030212 general & internal medicine ,Antigens, Viral ,Polymerase chain reaction ,Coronavirus ,Reverse Transcriptase Polymerase Chain Reaction ,SARS-CoV-2 ,Viral culture ,business.industry ,COVID-19 ,Reverse Transcription ,Virology ,Reverse transcriptase ,Reverse transcription polymerase chain reaction ,AcademicSubjects/MED00290 ,Infectious Diseases ,Real-time polymerase chain reaction ,RNA ,medicine.symptom ,business - Abstract
Background Real-time reverse transcription polymerase chain reaction (rRT-PCR) and antigen tests are important diagnostics for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Sensitivity of antigen tests has been shown to be lower than that of rRT-PCR; however, data to evaluate epidemiologic characteristics that affect test performance are limited. Methods Paired mid-turbinate nasal swabs were collected from university students and staff and tested for SARS-CoV-2 using both Quidel Sofia SARS Antigen Fluorescent Immunoassay (FIA) and rRT-PCR assay. Specimens positive by either rRT-PCR or antigen FIA were placed in viral culture and tested for subgenomic RNA (sgRNA). Logistic regression models were used to evaluate characteristics associated with antigen results, rRT-PCR cycle threshold (Ct) values, sgRNA, and viral culture. Results Antigen FIA sensitivity was 78.9% and 43.8% among symptomatic and asymptomatic participants, respectively. Among rRT-PCR positive participants, negative antigen results were more likely among asymptomatic participants (odds ratio [OR] 4.6, 95% confidence interval [CI]: 1.3–15.4) and less likely among participants reporting nasal congestion (OR 0.1, 95% CI: .03–.8). rRT-PCR-positive specimens with higher Ct values (OR 0.5, 95% CI: .4–.8) were less likely, and specimens positive for sgRNA (OR 10.2, 95% CI: 1.6–65.0) more likely, to yield positive virus isolation. Antigen testing was >90% positive in specimens with Ct values Conclusions SARS-CoV-2 antigen test advantages include low cost, wide availability and rapid turnaround time, making them important screening tests. The performance of antigen tests may vary with patient characteristics, so performance characteristics should be accounted for when designing testing strategies and interpreting results.
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- 2021
13. Shedding of Culturable Virus, Seroconversion, and 6-Month Follow-up Antibody Responses in the First 14 Confirmed Cases of Coronavirus Disease 2019 in the United States
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Xiaoyan Lu, Hannah L Kirking, John T. Watson, Aron J. Hall, Melisa M Shah, Phillip P. Salvatore, Jeremy A W Gold, Brett Whitaker, Glen R. Abedi, Susan I. Gerber, Mohammad Ata Ur Rasheed, Jennifer L Harcourt, Marie E Killerby, Stephen Lindstrom, Melissa M. Coughlin, Stephanie A Kujawski, Alicia M. Fry, Jacqueline E. Tate, Claire M Midgley, Azaibi Tamin, and Natalie J. Thornburg
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biology ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Virology ,Virus ,Acute illness ,Infectious Diseases ,Antibody response ,biology.protein ,Immunology and Allergy ,Medicine ,Antibody ,Seroconversion ,business ,Month follow up - Abstract
We aimed to characterize presence of culturable virus in clinical specimens during acute illness, and antibody kinetics up to 6 months after symptom onset, among 14 early patients with coronavirus disease 2019 in the United States. We isolated viable severe acute respiratory syndrome coronavirus 2 from real-time reverse-transcription polymerase chain reaction–positive respiratory specimens collected during days 0–8 after onset, but not after. All 13 patients with 2 or more serum specimens developed anti-spike antibodies; 12 developed detectable neutralizing antibodies. We did not isolate virus after detection of neutralizing antibodies. Eight participants provided serum at 6 months after onset; all retained detectable anti-spike immunoglobulin G, and half had detectable neutralizing antibodies. Two participants reported not feeling fully recovered at 6 months.
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- 2021
14. Persistent SARS-CoV-2 RNA Shedding Without Evidence of Infectiousness: A Cohort Study of Individuals With COVID-19
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Kimberly Christensen, Elizabeth A. Dietrich, Anna R Yousaf, Almea Matanock, Sanjib Bhattacharyya, Daniel Owusu, Angela Dunn, Natalie J. Thornburg, Victoria T Chu, Brett Whitaker, Ian W Pray, Ashutosh Wadhwa, Mary Pomeroy, Tair Kiphibane, Nathaniel M. Lewis, Aron J. Hall, Sarah Willardson, Hannah L Kirking, Ryan P Westergaard, Trivikram Dasu, and Jacqueline E. Tate
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Adult ,Male ,viral shedding ,medicine.medical_specialty ,Time Factors ,Adolescent ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Virus Replication ,Persistence (computer science) ,Young Adult ,Nasopharynx ,Internal medicine ,Major Article ,Humans ,Immunology and Allergy ,Medicine ,Viral shedding ,Child ,Aged ,Aged, 80 and over ,Infectivity ,infectious period ,SARS-CoV-2 ,infectivity ,business.industry ,Viral culture ,Hazard ratio ,Age Factors ,viral culture ,COVID-19 ,RNA ,Middle Aged ,Virus Shedding ,AcademicSubjects/MED00290 ,Infectious Diseases ,COVID-19 Nucleic Acid Testing ,Child, Preschool ,RNA, Viral ,Female ,Contact Tracing ,business ,Cohort study - Abstract
Background To better understand severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) shedding and infectivity, we estimated SARS-CoV-2 RNA shedding duration, described participant characteristics associated with the first negative rRT-PCR test (resolution), and determined if replication-competent viruses was recoverable ≥10 days after symptom onset. Methods We collected serial nasopharyngeal specimens from 109 individuals with rRT-PCR–confirmed COVID-19 in Utah and Wisconsin. We calculated viral RNA shedding resolution probability using the Kaplan-Meier estimator and evaluated characteristics associated with shedding resolution using Cox proportional hazards regression. We attempted viral culture for 35 rRT-PCR–positive nasopharyngeal specimens collected ≥10 days after symptom onset. Results The likelihood of viral RNA shedding resolution at 10 days after symptom onset was approximately 3%. Time to shedding resolution was shorter among participants aged Conclusions Although most patients were positive for SARS-CoV-2 for ≥10 days after symptom onset, our findings suggest that individuals with mild to moderate COVID-19 are unlikely to be infectious ≥10 days after symptom onset.
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- 2021
15. SARS-CoV-2 Infections among Recent Organ Recipients, March–May 2020, United States
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Collette Fitzgerald Leaumont, Ricardo M. La Hoz, Brian C. Keller, Ian Kracalik, April Justice, Jefferson M. Jones, Gene Im, Charles W. Hoopes, Brett Whitaker, Ann Nguyen, Juan Vilaro, Aaron Mishkin, Lou C. Smith, Marian G. Michaels, Stephen Lindstrom, Sridhar V. Basavaraju, Abhinav Humar, Wendi L. Kuhnert, Thomas Kaleekal, David Klassen, and Meenakshi Rana
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Male ,Microbiology (medical) ,medicine.medical_specialty ,Epidemiology ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,030231 tropical medicine ,lcsh:Medicine ,Organ transplantation ,lcsh:Infectious and parasitic diseases ,03 medical and health sciences ,respiratory infections ,Postoperative Complications ,0302 clinical medicine ,Health care ,Humans ,Medicine ,Infection control ,viruses ,lcsh:RC109-216 ,030212 general & internal medicine ,Intensive care medicine ,Aged ,SARS-CoV-2 Infections among Recent Organ Recipients, March–May 2020, United States ,transplant recipients ,Transmission (medicine) ,business.industry ,SARS-CoV-2 ,Public health ,organ transplantation ,lcsh:R ,Dispatch ,COVID-19 ,Retrospective cohort study ,Middle Aged ,United States ,zoonoses ,retrospective studies ,Infectious Diseases ,surgical procedures, operative ,coronavirus disease ,Female ,business ,severe acute respiratory syndrome coronavirus 2 - Abstract
We conducted public health investigations of 8 organ transplant recipients who tested positive for severe acute respiratory syndrome coronavirus 2 infection. Findings suggest the most likely source of transmission was community or healthcare exposure, not the organ donor. Transplant centers should educate transplant candidates and recipients about infection prevention recommendations.
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- 2021
16. Rapid Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 in Detention Facility, Louisiana, USA, May–June, 2020
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Theresa Sokol, Farrell A Tobolowsky, Mariel Marlow, Ying Tao, Sean Simonson, Krista Queen, Jonathan M. Wortham, Ha Tran, Mitsuki Koh, Clinton R. Paden, Danielle Haydel, Jacqueline E. Tate, Brett Whitaker, Henry Njuguna, Kiva A Fisher, Rena Fukunaga, Reena H Doshi, Anna Uehara, Jeremy A W Gold, Azaibi Tamin, Jing Zhang, Kathryn G. Curran, Allison E James, Jennifer L Harcourt, Kaylee Kim, Suxiang Tong, Megan J. Wallace, Melissa M. Coughlin, Natalie J. Thornburg, Keith Bordelon, and Rachel Silver
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Male ,Epidemiology ,correctional facilities ,lcsh:Medicine ,medicine.disease_cause ,Disease Outbreaks ,law.invention ,COVID-19 Testing ,0302 clinical medicine ,law ,Infection control ,Cumulative incidence ,Prospective Studies ,030212 general & internal medicine ,Statistics & numerical data ,Coronavirus ,Incidence ,Incidence (epidemiology) ,transmission ,detention facilities ,serial testing ,Infectious Diseases ,coronavirus disease ,Specimen collection ,Female ,severe acute respiratory syndrome coronavirus 2 ,Adult ,Microbiology (medical) ,medicine.medical_specialty ,coronaviruses ,030231 tropical medicine ,lcsh:Infectious and parasitic diseases ,respiratory infections ,03 medical and health sciences ,Quarantine ,Disease Transmission, Infectious ,medicine ,Rapid Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 in Detention Facility, Louisiana, USA, May–June, 2020 ,Humans ,lcsh:RC109-216 ,viruses ,SARS-CoV-2 ,business.industry ,Research ,lcsh:R ,COVID-19 ,Outbreak ,Louisiana ,United States ,zoonoses ,Prisons ,Emergency medicine ,business - Abstract
To assess transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a detention facility experiencing a coronavirus disease outbreak and evaluate testing strategies, we conducted a prospective cohort investigation in a facility in Louisiana, USA. We conducted SARS-CoV-2 testing for detained persons in 6 quarantined dormitories at various time points. Of 143 persons, 53 were positive at the initial test, and an additional 58 persons were positive at later time points (cumulative incidence 78%). In 1 dormitory, all 45 detained persons initially were negative; 18 days later, 40 (89%) were positive. Among persons who were SARS-CoV-2 positive, 47% (52/111) were asymptomatic at the time of specimen collection; 14 had replication-competent virus isolated. Serial SARS-CoV-2 testing might help interrupt transmission through medical isolation and quarantine. Testing in correctional and detention facilities will be most effective when initiated early in an outbreak, inclusive of all exposed persons, and paired with infection prevention and control.
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- 2021
17. Active surveillance for acute respiratory infections among pediatric long-term care facility staff
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Xiaoyan Lu, Alexandra Hill-Ricciuti, Elaine Larson, Brett Whitaker, Susan I. Gerber, Lisa Saiman, Luis Alba, Sibyl Wilmont, Lindsay Kim, Mila M. Prill, Shikha Garg, Natalie Neu, and Nimalie D. Stone
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Adult ,Male ,medicine.medical_specialty ,Infectious Disease Transmission, Patient-to-Professional ,Adolescent ,Epidemiology ,viruses ,Pilot Projects ,medicine.disease_cause ,Article ,Residential Facilities ,Infectious Disease Transmission, Professional-to-Patient ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Humans ,Medicine ,Prospective Studies ,030212 general & internal medicine ,Respiratory system ,Viral shedding ,Child ,Respiratory Tract Infections ,Subclinical infection ,Coronavirus ,Response rate (survey) ,Text Messaging ,0303 health sciences ,030306 microbiology ,business.industry ,Transmission (medicine) ,Health Policy ,Public Health, Environmental and Occupational Health ,Middle Aged ,Long-Term Care ,respiratory tract diseases ,Long-term care ,Infectious Diseases ,Child, Preschool ,Acute Disease ,Feasibility Studies ,Female ,New York City ,Rhinovirus ,business ,Sentinel Surveillance - Abstract
HIGHLIGHTS • Staff at pediatric long-term care facilities (pLTCF) were responsive to electronic messages asking about acute respiratory illness symptoms. • Staff in pLTCFs had respiratory viruses detected during acute respiratory infections and while asymptomatic. • Contagious presenteeism occurred as some participants with ARIs worked while symptomatic. • Staff with ARI may pose a risk of transmitting respiratory viral infections to frail and medically complex pLTCF residents., Background Transmission of respiratory viruses between staff and residents of pediatric long-term care facilities (pLTCFs) can occur. We assessed the feasibility of using text or email messages to perform surveillance for acute respiratory infections (ARIs) among staff. Methods From December 7, 2016 to May 7, 2017, 50 staff participants from two pLTCFs received weekly text or email requests to report the presence or absence of ARI symptoms. Those who fulfilled the ARI case definition (≥2 symptoms) had respiratory specimens collected to detect viruses by reverse transcriptase polymerase chain reaction assays. Pre- and post-surveillance respiratory specimens were collected to assess subclinical viral shedding. Results The response rate to weekly electronic messages was 93%. Twenty-one ARIs reported from 20 (40%) participants fulfilled the case definition. Respiratory viruses were detected in 29% (5/17) of specimens collected at symptom onset (influenza B, respiratory syncytial virus, coronavirus [CoV] 229E, rhinovirus [RV], and dual detection of CoV OC43 and bocavirus). Four participants had positive pre-surveillance (4 RV), and six had positive post-surveillance specimens (3 RV, 2 CoV NL63 and 1 adenovirus). Conclusions Electronic messaging to conduct ARI surveillance among pLTCF staff was feasible.
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- 2020
18. Severe Acute Respiratory Syndrome Coronavirus 2 Prevalence, Seroprevalence, and Exposure among Evacuees from Wuhan, China, 2020
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Amber K. Haynes, Nancy W. Knight, Jesica R. Jacobs, Rebekah J Stewart, Denise Borntrager, Melissa A. Rolfes, Marie E Killerby, George S. Odongo, Brian Lynch, Martin S. Cetron, Barbara E. Mahon, Janna R. Murray, Glen R. Abedi, Geoffrey B. Hutchinson, Aron J. Hall, Mark W Tenforde, Casey Barton Behravesh, Kenta Ishii, Errin C. Rider, Xiaoyan Lu, Clive Brown, Barney S. Graham, Stephen Lindstrom, Lisa D. Rotz, Kathleen Moser, Benjamin D Hallowell, Brett Whitaker, Lijuan Wang, Nicki Pesik, Kim Saruwatari, Loretta Foster, Emily McDonald, Sandra Lester, Lakshmi Malapati, Mohammad Ata Ur Rasheed, Gina Douville, Leora R. Feldstein, Shahrokh Roohi, Brandi Freeman, Jonathan Steinberg, Kizzmekia S. Corbett, Mary Pomeroy, Senthilkumar K. Sakthivel, Natalie J. Thornburg, Neenaben Bhakta, Christina M. Carlson, Shifaq Kamili, Olubukola M. Abiona, Christopher R. Braden, and Panagiotis Maniatis
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Male ,Epidemiology ,Cross-sectional study ,lcsh:Medicine ,COVID-19 Testing ,0302 clinical medicine ,Seroepidemiologic Studies ,Pandemic ,Prevalence ,030212 general & internal medicine ,Young adult ,Respiratory system ,Child ,Travel ,quarantine ,Middle Aged ,Infectious Diseases ,medicine.anatomical_structure ,coronavirus disease ,Child, Preschool ,Cohort ,Synopsis ,Female ,medicine.symptom ,Coronavirus Infections ,severe acute respiratory syndrome coronavirus 2 ,Adult ,Wuhan ,Microbiology (medical) ,China ,Adolescent ,Pneumonia, Viral ,030231 tropical medicine ,evacuees ,Asymptomatic ,2019 novel coronavirus disease ,lcsh:Infectious and parasitic diseases ,Betacoronavirus ,Young Adult ,respiratory infections ,03 medical and health sciences ,Environmental health ,medicine ,Humans ,Seroprevalence ,viruses ,lcsh:RC109-216 ,Pandemics ,Aged ,Clinical Laboratory Techniques ,business.industry ,SARS-CoV-2 ,lcsh:R ,Infant, Newborn ,Infant ,COVID-19 ,United States ,zoonoses ,Cross-Sectional Studies ,Severe Acute Respiratory Syndrome Coronavirus 2 Prevalence, Seroprevalence, and Exposure among Evacuees from Wuhan, China, 2020 ,business ,Respiratory tract - Abstract
To determine prevalence of, seroprevalence of, and potential exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among a cohort of evacuees returning to the United States from Wuhan, China, in January 2020, we conducted a cross-sectional study of quarantined evacuees from 1 repatriation flight. Overall, 193 of 195 evacuees completed exposure surveys and submitted upper respiratory or serum specimens or both at arrival in the United States. Nearly all evacuees had taken preventive measures to limit potential exposure while in Wuhan, and none had detectable SARS-CoV-2 in upper respiratory tract specimens, suggesting the absence of asymptomatic respiratory shedding among this group at the time of testing. Evidence of antibodies to SARS-CoV-2 was detected in 1 evacuee, who reported experiencing no symptoms or high-risk exposures in the previous 2 months. These findings demonstrated that this group of evacuees posed a low risk of introducing SARS-CoV-2 to the United States.
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- 2020
19. US CDC Real-Time Reverse Transcription PCR Panel for Detection of Severe Acute Respiratory Syndrome Coronavirus 2
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Stephen Lindstrom, Lakshmi Malapati, Julie Villanueva, Shifaq Kamili, Janna Murray, Jennifer L Harcourt, Stephen A. Burke, Xiaoyan Lu, Brett Whitaker, Senthilkumar K. Sakthivel, Azaibi Tamin, Natalie J. Thornburg, Brian Lynch, and Lijuan Wang
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Emergency Use Authorization ,Epidemiology ,viruses ,lcsh:Medicine ,medicine.disease_cause ,real-time reverse transcription PCR ,Feces ,0302 clinical medicine ,Limit of Detection ,Nasopharynx ,030212 general & internal medicine ,Coronavirus ,biology ,Infectious dose ,US CDC Real-Time Reverse Transcription PCR Panel for Detection of Severe Acute Respiratory Syndrome Coronavirus 2 ,Nucleocapsid Proteins ,Fluoresceins ,Reverse transcription polymerase chain reaction ,Infectious Diseases ,Real-time polymerase chain reaction ,coronavirus disease ,Synopsis ,RNA, Viral ,medicine.symptom ,Coronavirus Infections ,severe acute respiratory syndrome coronavirus 2 ,Microbiology (medical) ,030231 tropical medicine ,Pneumonia, Viral ,real-time RT-PCR ,Real-Time Polymerase Chain Reaction ,Virus ,2019 novel coronavirus disease ,lcsh:Infectious and parasitic diseases ,03 medical and health sciences ,Betacoronavirus ,respiratory infections ,medicine ,Coronavirus Nucleocapsid Proteins ,Humans ,lcsh:RC109-216 ,Pandemics ,DNA Primers ,Fluorescent Dyes ,business.industry ,SARS-CoV-2 ,lcsh:R ,Sputum ,Reproducibility of Results ,COVID-19 ,biology.organism_classification ,Phosphoproteins ,Virology ,United States ,zoonoses ,Centers for Disease Control and Prevention, U.S ,business ,Biomarkers - Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified as the etiologic agent associated with coronavirus disease, which emerged in late 2019. In response, we developed a diagnostic panel consisting of 3 real-time reverse transcription PCR assays targeting the nucleocapsid gene and evaluated use of these assays for detecting SARS-CoV-2 infection. All assays demonstrated a linear dynamic range of 8 orders of magnitude and an analytical limit of detection of 5 copies/reaction of quantified RNA transcripts and 1 x 10-1.5 50% tissue culture infectious dose/mL of cell-cultured SARS-CoV-2. All assays performed comparably with nasopharyngeal and oropharyngeal secretions, serum, and fecal specimens spiked with cultured virus. We obtained no false-positive amplifications with other human coronaviruses or common respiratory pathogens. Results from all 3 assays were highly correlated during clinical specimen testing. On February 4, 2020, the Food and Drug Administration issued an Emergency Use Authorization to enable emergency use of this panel.
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- 2020
20. Severe Acute Respiratory Syndrome Coronavirus 2 from Patient with Coronavirus Disease, United States
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Shifaq Kamili, Kenneth S. Plante, Yan Li, Rashi Gautam, Craig Schindewolf, Lijuan Wang, Krishna Narayanan, Hannah A. Bullock, Janna Murray, Brett Whitaker, Brian Lynch, Natalie J. Thornburg, Azaibi Tamin, Cynthia S. Goldsmith, Scott C. Weaver, Shinji Makino, Clinton R. Paden, Stephen Lindstrom, Dionna Scharton, Ying Tao, Kumari G. Lokugamage, Anna Uehara, Jing Zhang, Krista Queen, Senthil Kumar K. Sakthivel, Steven G. Widen, Vineet D. Menachery, Haibin Wang, Xiaoyan Lu, Suxiang Tong, Thomas G. Ksiazek, Divya Mirchandani, Jennifer L Harcourt, and Jessica A. Plante
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Epidemiology ,Expedited ,viruses ,coronavirus ,Severe Acute Respiratory Syndrome Coronavirus 2 from Patient with 2019 Novel Coronavirus Disease, United States ,Oropharynx ,lcsh:Medicine ,medicine.disease_cause ,Virus Replication ,0302 clinical medicine ,Nasopharynx ,Pandemic ,Chlorocebus aethiops ,Medicine ,characterization ,030212 general & internal medicine ,Coronavirus ,biology ,Infectious Diseases ,PCR ,Coronavirus Infections ,isolation ,severe acute respiratory syndrome coronavirus 2 ,Microbiology (medical) ,Washington ,030231 tropical medicine ,Pneumonia, Viral ,Genome, Viral ,Virus ,2019 novel coronavirus disease ,Cell Line ,lcsh:Infectious and parasitic diseases ,03 medical and health sciences ,respiratory infections ,Betacoronavirus ,Animals ,Humans ,lcsh:RC109-216 ,Pandemics ,Vero Cells ,business.industry ,SARS-CoV-2 ,Research ,lcsh:R ,Outbreak ,COVID-19 ,biology.organism_classification ,medicine.disease ,Virology ,United States ,zoonoses ,Pneumonia ,Viral Tropism ,novel coronavirus disease 2019 ,Tissue tropism ,Vero cell ,business - Abstract
The etiologic agent of an outbreak of pneumonia in Wuhan, China, was identified as severe acute respiratory syndrome coronavirus 2 in January 2020. A patient in the United States was given a diagnosis of infection with this virus by the state of Washington and the US Centers for Disease Control and Prevention on January 20, 2020. We isolated virus from nasopharyngeal and oropharyngeal specimens from this patient and characterized the viral sequence, replication properties, and cell culture tropism. We found that the virus replicates to high titer in Vero-CCL81 cells and Vero E6 cells in the absence of trypsin. We also deposited the virus into 2 virus repositories, making it broadly available to the public health and research communities. We hope that open access to this reagent will expedite development of medical countermeasures.
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- 2020
21. Strengthening timely detection and reporting of unusual respiratory events from health facilities in Yaoundé, Cameroon
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Bienvenu Etogo, Brett Whitaker, Elise Seukap, Luc Christian Gwom, Gwladys Chavely Monamele, Chanceline Bilounga Ndongo, Alain Georges M Etoundi, Arunmozhi Balajee, Henri Manga, Omer G. Pasi, Richard Njouom, Karen A. Alroy, Carolle Yanique Tayimetha, Sebastien Kenmoe, Dorine Tseuko, and Alexey Clara
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Epidemiology ,030231 tropical medicine ,Early detection ,International Health Regulations ,03 medical and health sciences ,0302 clinical medicine ,Influenza A Virus, H1N1 Subtype ,Health facility ,early warning and response ,Medicine ,Humans ,Public Health Surveillance ,030212 general & internal medicine ,Cameroon ,Respiratory Tract Infections ,global health security ,Warning system ,Bacteria ,business.industry ,event‐based surveillance ,Public health ,Public Health, Environmental and Occupational Health ,Outbreak ,Original Articles ,medicine.disease ,Triage ,Haemophilus influenzae ,3. Good health ,health facility ,Klebsiella pneumoniae ,Streptococcus pneumoniae ,Infectious Diseases ,Viruses ,surveillance ,Christian ministry ,Original Article ,Medical emergency ,Health Facilities ,Public Health ,business - Abstract
Background The International Health Regulations state that early detection and immediate reporting of unusual health events is important for early warning and response systems. Objective To describe a pilot surveillance program established in health facilities in Yaounde, Cameroon in 2017 which aimed to enable detection and reporting of public health events. Methods Cameroon's Ministry of Health, in partnership with the US Centers for Disease Control and Prevention, Cameroon Pasteur Center, and National Public Health Laboratory, implemented event-based surveillance (EBS) in nine Yaounde health facilities. Four signals were defined that could indicate possible public health events, and a reporting, triage, and verification system was established among partner organizations. A pre-defined laboratory algorithm was defined, and a series of workshops trained health facilities, laboratory, and public health staff for surveillance implementation. Results From May 2017 to January 2018, 30 signals were detected, corresponding to 15 unusual respiratory events. All health facilities reported a signal at least once, and more than three-quarters of health facilities reported ≥2 times. Among specimens tested, the pathogens detected included Klebsiella pneumoniae, Moraxella catarrhalis, Streptococcus pneumoniae, Haemophilus influenza, Staphylococcus aureus, Pneumocystis jiroveci, influenza A (H1N1) virus, rhinovirus, and adenovirus. Conclusions The events detected in this pilot were caused by routine respiratory bacteria and viruses, and no novel influenza viruses or other emerging respiratory threats were identified. The surveillance system, however, strengthened relationships and communication linkages between health facilities and public health authorities. Astute clinicians can play a critical role in early detection and EBS is one approach that may enable reporting of emerging outbreaks and public health events.
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- 2020
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22. Yin and Yang: Opposing Viewpoints on Western-Based Leadership Studies Programs in Mainland China
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Jeff Bourgeois and Brett Whitaker
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- 2022
23. Descriptive evaluation of antibody responses to severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection in plasma and gingival crevicular fluid in a nursing home cohort-Arkansas, June-August 2020
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Jan Vinjé, Paige Gable, Azaibi Tamin, Sarah E Gilbert, Natalie J. Thornburg, Jennifer Y Huang, L. Clifford McDonald, Kathryn A Seely, Nakia S Clemmons, Kelley Garner, Naveen Patil, Kenny Nguyen, Tafarra Haney, Amanda K Lyons, Nicole E Brown, Veronica Costantini, Caitlin Biedron, Elizabeth Beshearse, Amy J. Schuh, Christopher J. Gregory, Jennifer L Harcourt, Lisa Mills, Preeta K. Kutty, Brett Whitaker, Atul Kothari, Alison Laufer Halpin, Diya Surie, Megan M Stumpf, Trent Gulley, Allison C Brown, Melissa M. Coughlin, Sandra Lester, Sarah Sabour, Susan Bollinger, and Mohammad Ata Ur Rasheed
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Microbiology (medical) ,Epidemiology ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Antibodies, Viral ,Immune system ,Medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Arkansas ,biology ,Viral culture ,business.industry ,SARS-CoV-2 ,COVID-19 ,Gingival Crevicular Fluid ,Pneumonia ,Antibodies, Neutralizing ,Immunoglobulin A ,Nursing Homes ,Infectious Diseases ,Antibody response ,Immunoglobulin M ,Immunoglobulin G ,Cohort ,Immunology ,Antibody Formation ,biology.protein ,Antibody ,Nursing homes ,business - Abstract
Objective:To characterize and compare severe acute respiratory coronavirus virus 2 (SARS-CoV-2)–specific immune responses in plasma and gingival crevicular fluid (GCF) from nursing home residents during and after natural infection.Design:Prospective cohort.Setting:Nursing home.Participants:SARS-CoV-2–infected nursing home residents.Methods:A convenience sample of 14 SARS-CoV-2–infected nursing home residents, enrolled 4–13 days after real-time reverse transcription polymerase chain reaction diagnosis, were followed for 42 days. After diagnosis, plasma SARS-CoV-2–specific pan-Immunoglobulin (Ig), IgG, IgA, IgM, and neutralizing antibodies were measured at 5 time points, and GCF SARS-CoV-2–specific IgG and IgA were measured at 4 time points.Results:All participants demonstrated immune responses to SARS-CoV-2 infection. Among 12 phlebotomized participants, plasma was positive for pan-Ig and IgG in all 12 participants. Neutralizing antibodies were positive in 11 participants; IgM was positive in 10 participants, and IgA was positive in 9 participants. Among 14 participants with GCF specimens, GCF was positive for IgG in 13 participants and for IgA in 12 participants. Immunoglobulin responses in plasma and GCF had similar kinetics; median times to peak antibody response were similar across specimen types (4 weeks for IgG; 3 weeks for IgA). Participants with pan-Ig, IgG, and IgA detected in plasma and GCF IgG remained positive throughout this evaluation, 46–55 days after diagnosis. All participants were viral-culture negative by the first detection of antibodies.Conclusions:Nursing home residents had detectable SARS-CoV-2 antibodies in plasma and GCF after infection. Kinetics of antibodies detected in GCF mirrored those from plasma. Noninvasive GCF may be useful for detecting and monitoring immunologic responses in populations unable or unwilling to be phlebotomized.
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- 2021
24. Respiratory viral surveillance of healthcare personnel and patients at an adult long-term care facility
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Nimalie D. Stone, Suxiang Tong, Shikha Garg, Mila M. Prill, Senthilkumar K. Sakthivel, Hilary M. Babcock, H. Keipp Talbot, Brett Whitaker, Caroline A O'Neil, Yange Zhang, Lindsay Kim, Susan I. Gerber, and Jing Zhang
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Adult ,Male ,0301 basic medicine ,Microbiology (medical) ,medicine.medical_specialty ,Epidemiology ,Health Personnel ,030106 microbiology ,03 medical and health sciences ,0302 clinical medicine ,Absenteeism ,Influenza, Human ,Health care ,Humans ,Medicine ,030212 general & internal medicine ,Respiratory system ,Respiratory Tract Infections ,Aged ,Respiratory illness ,business.industry ,Middle Aged ,Long-Term Care ,respiratory tract diseases ,Care facility ,Long-term care ,Infectious Diseases ,Influenza Vaccines ,Virus Diseases ,Epidemiological Monitoring ,Emergency medicine ,Female ,Seasons ,business - Abstract
We conducted active surveillance of acute respiratory viral infections (ARIs) among residents and healthcare personnel (HCP) at a long-term care facility during the 2015–2016 respiratory illness season. ARIs were observed among both HCP and patients, highlighting the importance of including HCP in surveillance programs.
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- 2019
25. Comparison of FTD® respiratory pathogens 33 and a singleplex CDC assay for the detection of respiratory viruses: A study from Cameroon
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Karen A. Alroy, Clarisse Tcharnenwa, Sebastien Kenmoe, S. Arunmozhi Balajee, Mohamadou Njankouo Ripa, Richard Njouom, Brett Whitaker, Gwladys Chavely Monamele, and Cyprien Nde Kengne
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Adult ,Male ,Microbiology (medical) ,Adolescent ,ARI, Acute respiratory infections ,Real-Time Polymerase Chain Reaction ,Article ,Molecular diagnostic ,Nasopharynx ,mental disorders ,Humans ,Medicine ,Multiplex ,Cameroon ,Respiratory system ,Child ,Respiratory Tract Infections ,rRT-PCR, real-time reverse transcription polymerase chain reaction ,CDC, Centers for Disease Control and Prevention ,Aged ,Aged, 80 and over ,PPA, positive percentage agreement ,Respiratory viruses ,Clinical Laboratory Techniques ,Diagnostic Tests, Routine ,Reverse Transcriptase Polymerase Chain Reaction ,business.industry ,Infant, Newborn ,Infant ,General Medicine ,Middle Aged ,Virology ,Disease control ,Respiratory pathogens ,Reverse transcription polymerase chain reaction ,Infectious Diseases ,Molecular Diagnostic Techniques ,CPC, Centre Pasteur Cameroon ,Virus Diseases ,Child, Preschool ,Female ,NPA, negative percentage agreement ,business - Abstract
Introduction: This study compares the detection of 14 common respiratory viruses by two different real-time reverse transcription polymerase chain reaction (rRT-PCR) methods: in house singleplex tests developed by the Centers for Disease Control and Prevention and the commercially available Fast Track Diagnostic (FTD®) Respiratory Pathogens 33 multiplex test. Methods: A total of 217 nasopharyngeal swabs were analyzed using CDC singleplex rRT-PCR and FTD® Respiratory Pathogens 33 multiplex assays, for the detection of 14 respiratory viruses. Results: The results showed that 179/217 (82.5%) samples were positive with the singleplex method and 183/217 (84.3%) with the FTD® Respiratory Pathogens 33 multiplex test. Excellent or satisfactory agreement was obtained for all viruses (k > 0.6) except Parainfluenzavirus 4 (k = 0.24) and influenza B (k = 0.51). Conclusion: Although the multiplex FTD kits were more expensive than the singleplex assay, the FTD kits yielded rapid results in a shorter timeframe, increasing efficiency of diagnosis.
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- 2019
26. Use of TaqMan Array card for the detection of respiratory viral pathogens in children under 5 years old hospitalised with acute medical illness in Ballabgarh, Haryana, India
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A. Danielle Iuliano, Brett Whitaker, Siddhartha Saha, Bharti Gaur, Shobha Broor, Sanjay K Rai, Jonas M. Winchell, Renu B. Lal, Seema Jain, and Anand Krishnan
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0301 basic medicine ,viruses ,lcsh:QR1-502 ,specificity ,medicine.disease_cause ,lcsh:Microbiology ,law.invention ,0302 clinical medicine ,Immunology and Microbiology (miscellaneous) ,law ,Lab-On-A-Chip Devices ,Immunology and Allergy ,030212 general & internal medicine ,Monoplex ,Respiratory Tract Infections ,Micro-fluidic card ,Polymerase chain reaction ,biology ,virus diseases ,Microfluidic Analytical Techniques ,Infectious Diseases ,Molecular Diagnostic Techniques ,Child, Preschool ,Viruses ,Rhinovirus ,Microbiology (medical) ,030106 microbiology ,Immunology ,India ,Real-Time Polymerase Chain Reaction ,Microbiology ,Sensitivity and Specificity ,Virus ,viral pathogen diagnosis ,03 medical and health sciences ,Human metapneumovirus ,stomatognathic system ,medicine ,TaqMan ,Humans ,General Immunology and Microbiology ,business.industry ,Infant, Newborn ,Outbreak ,Infant ,biology.organism_classification ,sensitivity ,Virology ,Reverse transcriptase ,business - Abstract
Historical specimens collected from hospitalized children were tested for the following 13 viruses: influenza A and B; respiratory syncytial virus (RSV); parainfluenza viruses 1–3; human metapneumovirus; rhinovirus; coronaviruses 229E, OC43, NL63 and HKU1 and Adenovirus using monoplex real-time reverse transcriptase polymerase chain reaction (rRT-PCR). They were retested using TaqMan Array Card (TAC), a micro-fluidic system, capable of simultaneous multi-pathogen testing, to evaluate its sensitivity and specificity against monoplex rRT-PCR. TAC showed high sensitivity (71%–100%) and specificity (98%–100%) for these viruses in comparison to monoplex rRT-PCR. Multi-specimen detection with high sensitivity and specificity makes TAC a potentially useful tool for both surveillance and outbreak investigations.
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- 2019
27. Incidence, risk factors, and viral etiology of community-acquired acute lower respiratory tract infection among older adults in rural north India
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Rajesh Kumar, Debjani Ram Purakayastha, Giridara Gopal, Shivram Dhakad, Aashish Choudhary, Anand Krishnan, Lalit Dar, Avinash Choudekar, Reshmi Chhokar, Siddhartha Saha, Ritvik Amarchand, Stephen Lindstrom, Brett Whitaker, Ramesh Kumar, Kathryn E. Lafond, Venkatesh Vinayak Narayan, Abhishek Wahi, and Aparajit Ballav Dey
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medicine.medical_specialty ,Chronic bronchitis ,030231 tropical medicine ,India ,Respiratory Syncytial Virus Infections ,Rate ratio ,03 medical and health sciences ,0302 clinical medicine ,Human metapneumovirus ,Risk Factors ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Risk factor ,Respiratory Tract Infections ,Aged ,biology ,business.industry ,Health Policy ,Incidence (epidemiology) ,Incidence ,Public Health, Environmental and Occupational Health ,Infant ,Odds ratio ,Articles ,biology.organism_classification ,respiratory tract diseases ,Respiratory Syncytial Virus, Human ,Cohort ,Etiology ,business - Abstract
Background There are limited data on incidence, risk factors and etiology of acute lower respiratory tract infection (LRTI) among older adults in low- and middle-income countries. Methods We established a cohort of community dwelling older adults ≥60 years and conducted weekly follow-up for acute respiratory infections (ARI) during 2015-2017. Nurses assessed ARI cases for LRTI, collecting combined nasal/throat swabs from all LRTI cases and an equal number of age- and sex-matched asymptomatic neighbourhood controls. Swabs were tested for influenza viruses, respiratory syncytial virus (RSV), human metapneumovirus (hMPV), and parainfluenza viruses (PIV) using polymerase chain reaction. LRTI and virus-specific LRTI incidence was calculated per 1000 person-years. We estimated adjusted incidence rate ratios (IRR) for risk factors using Poisson regression and calculated etiologic fractions (EF) using adjusted odds ratios for detection of viral pathogens in LRTI cases vs controls. Results We followed 1403 older adults for 2441 person-years. LRTI and LRTI-associated hospitalization incidences were 248.3 (95% confidence interval (CI) = 229.3-268.8) and 12.7 (95% CI = 8.9-18.1) per 1000 person-years. Persons with pre-existing chronic bronchitis as compared to those without (incidence rate ratio (IRR) = 4.7, 95% CI = 3.9-5.6); aged 65-74 years (IRR = 1.6, 95% CI = 1.3-2.0) and ≥75 years (IRR = 1.8, 95% CI = 1.4-2.4) as compared to 60-64 years; and persons in poorest wealth quintile (IRR = 1.4, 95% CI = 1.1-1.8); as compared to those in wealthiest quintile were at higher risk for LRTI. Virus was detected in 10.1% of LRTI cases, most commonly influenza (3.8%) and RSV (3.0%). EF for RSV and influenza virus was 83.9% and 83.6%, respectively. Conclusion In this rural cohort of older adults, the incidence of LRTI was substantial. Chronic bronchitis was an important risk factor; influenza virus and RSV were major viral pathogens.
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- 2021
28. Infectious Period of Severe Acute Respiratory Syndrome Coronavirus 2 in 17 Nursing Home Residents—Arkansas, June–August 2020
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Mohammad Ata Ur Rasheed, Natalie J. Thornburg, Susan Bollinger, Davina Campbell, Christopher J. Gregory, Jennifer Y Huang, David Lonsway, Gillian McAllister, Ashley Paulick, Amelia Bhatnagar, Michelle Adamczyk, Diya Surie, L. Clifford McDonald, Kathryn A Seely, Kelley Garner, Sarah Sabour, Nakia S Clemmons, Alison Laufer Halpin, Elizabeth Beshearse, Rohan Chakravorty, Karen Anderson, Jennifer L Harcourt, Preeta K. Kutty, Hollis Houston, Erin Breaker, Tafarra Haney, Brett Whitaker, Sarah E Gilbert, Natashia Reese, Atul Kothari, Lori Spicer, Allison C Brown, Allison E James, K. Allison Perry-Dow, Megan M Stumpf, Paige Gable, Azaibi Tamin, Robin Brown, Lisa A. Mills, Trent Gulley, Melissa M. Coughlin, Amanda K Lyons, Naveen Patil, Pamela Higdem, Jordan Murdoch, and Caitlin Biedron
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0301 basic medicine ,Saliva ,medicine.medical_specialty ,RT-PCR ,nursing homes ,medicine.disease_cause ,Serology ,03 medical and health sciences ,0302 clinical medicine ,Interquartile range ,Internal medicine ,Major Article ,Medicine ,030212 general & internal medicine ,Seroconversion ,Coronavirus ,Infectivity ,SARS-CoV-2 ,infectivity ,business.industry ,COVID-19 ,Anterior nares ,AcademicSubjects/MED00290 ,030104 developmental biology ,medicine.anatomical_structure ,Infectious Diseases ,Oncology ,Cohort ,business - Abstract
Background To estimate the infectious period of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in older adults with underlying conditions, we assessed duration of coronavirus disease 2019 (COVID-19) symptoms, reverse-transcription polymerase chain reaction (RT-PCR) positivity, and culture positivity among nursing home residents. Methods We enrolled residents within 15 days of their first positive SARS-CoV-2 test (diagnosis) at an Arkansas facility from July 7 to 15, 2020 and instead them for 42 days. Every 3 days for 21 days and then weekly, we assessed COVID-19 symptoms, collected specimens (oropharyngeal, anterior nares, and saliva), and reviewed medical charts. Blood for serology was collected on days 0, 6, 12, 21, and 42. Infectivity was defined by positive culture. Duration of culture positivity was compared with duration of COVID-19 symptoms and RT-PCR positivity. Data were summarized using measures of central tendency, frequencies, and proportions. Results We enrolled 17 of 39 (44%) eligible residents. Median participant age was 82 years (range, 58–97 years). All had ≥3 underlying conditions. Median duration of RT-PCR positivity was 22 days (interquartile range [IQR], 8–31 days) from diagnosis; median duration of symptoms was 42 days (IQR, 28–49 days). Of 9 (53%) participants with any culture-positive specimens, 1 (11%) severely immunocompromised participant remained culture-positive 19 days from diagnosis; 8 of 9 (89%) were culture-positive ≤8 days from diagnosis. Seroconversion occurred in 12 of 12 (100%) surviving participants with ≥1 blood specimen; all participants were culture-negative before seroconversion. Conclusions Duration of infectivity was considerably shorter than duration of symptoms and RT-PCR positivity. Severe immunocompromise may prolong SARS-CoV-2 infectivity. Seroconversion indicated noninfectivity in this cohort.
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- 2021
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29. Performance of an Antigen-Based Test for Asymptomatic and Symptomatic SARS-CoV-2 Testing at Two University Campuses - Wisconsin, September-October 2020
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Ian W, Pray, Laura, Ford, Devlin, Cole, Christine, Lee, John Paul, Bigouette, Glen R, Abedi, Dena, Bushman, Miranda J, Delahoy, Dustin, Currie, Blake, Cherney, Marie, Kirby, Geroncio, Fajardo, Motria, Caudill, Kimberly, Langolf, Juliana, Kahrs, Patrick, Kelly, Collin, Pitts, Ailam, Lim, Nicole, Aulik, Azaibi, Tamin, Jennifer L, Harcourt, Krista, Queen, Jing, Zhang, Brett, Whitaker, Hannah, Browne, Magdalena, Medrzycki, Patricia, Shewmaker, Jennifer, Folster, Bettina, Bankamp, Michael D, Bowen, Natalie J, Thornburg, Kimberly, Goffard, Brandi, Limbago, Allen, Bateman, Jacqueline E, Tate, Douglas, Gieryn, Hannah L, Kirking, Ryan, Westergaard, Marie, Killerby, and Phili, Wong
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Adult ,Male ,Emergency Use Authorization ,medicine.medical_specialty ,Health (social science) ,Adolescent ,Universities ,Epidemiology ,Student Health Services ,Health, Toxicology and Mutagenesis ,Population ,01 natural sciences ,Asymptomatic ,Sensitivity and Specificity ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,COVID-19 Testing ,Wisconsin ,Health Information Management ,Antigen ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,0101 mathematics ,education ,Antigens, Viral ,Asymptomatic Diseases ,education.field_of_study ,Viral culture ,business.industry ,SARS-CoV-2 ,010102 general mathematics ,COVID-19 ,General Medicine ,Middle Aged ,Specimen collection ,Nasal Swab ,Female ,medicine.symptom ,business - Abstract
Antigen-based tests for SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), are inexpensive and can return results within 15 minutes (1). Antigen tests have received Food and Drug Administration (FDA) Emergency Use Authorization (EUA) for use in asymptomatic and symptomatic persons within the first 5-12 days after symptom onset (2). These tests have been used at U.S. colleges and universities and other congregate settings (e.g., nursing homes and correctional and detention facilities), where serial testing of asymptomatic persons might facilitate early case identification (3-5). However, test performance data from symptomatic and asymptomatic persons are limited. This investigation evaluated performance of the Sofia SARS Antigen Fluorescent Immunoassay (FIA) (Quidel Corporation) compared with real-time reverse transcription-polymerase chain reaction (RT-PCR) for SARS-CoV-2 detection among asymptomatic and symptomatic persons at two universities in Wisconsin. During September 28-October 9, a total of 1,098 paired nasal swabs were tested using the Sofia SARS Antigen FIA and real-time RT-PCR. Virus culture was attempted on all antigen-positive or real-time RT-PCR-positive specimens. Among 871 (79%) paired swabs from asymptomatic participants, the antigen test sensitivity was 41.2%, specificity was 98.4%, and in this population the estimated positive predictive value (PPV) was 33.3%, and negative predictive value (NPV) was 98.8%. Antigen test performance was improved among 227 (21%) paired swabs from participants who reported one or more symptoms at specimen collection (sensitivity = 80.0%; specificity = 98.9%; PPV = 94.1%; NPV = 95.9%). Virus was isolated from 34 (46.6%) of 73 antigen-positive or real-time RT-PCR-positive nasal swab specimens, including two of 18 that were antigen-negative and real-time RT-PCR-positive (false-negatives). The advantages of antigen tests such as low cost and rapid turnaround might allow for rapid identification of infectious persons. However, these advantages need to be balanced against lower sensitivity and lower PPV, especially among asymptomatic persons. Confirmatory testing with an FDA-authorized nucleic acid amplification test (NAAT), such as RT-PCR, should be considered after negative antigen test results in symptomatic persons, and after positive antigen test results in asymptomatic persons (1).
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- 2020
30. Respiratory Syncytial Virus–Associated Hospitalizations Among Young Children: 2015–2016
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Peter G. Szilagyi, Gayle E Langley, Julie A. Boom, Brett Whitaker, Mary Allen Staat, Parvin H. Azimi, Monica N Singer, Leila C. Sahni, Geoffrey A. Weinberg, Angela P Campbell, Pedro A. Piedra, John V. Williams, Natasha B. Halasa, Daniella Figueroa-Downing, Christopher J. Harrison, Rangaraj Selvarangan, Darius McDaniel, Mila M. Prill, Brian Rha, Aaron T. Curns, Monica M. McNeal, Joana Y Lively, Eileen J. Klein, Daniel C. Payne, Jennifer E. Schuster, Laura S Stewart, Gina Weddle, Barbara A. Pahud, Vasanthi Avadhanula, Susan I. Gerber, Flor M. Munoz, and Janet A. Englund
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Male ,Palivizumab ,Pediatrics ,medicine.medical_specialty ,Time Factors ,Respiratory Syncytial Virus Infections ,medicine ,Humans ,Prospective Studies ,Respiratory system ,Prospective cohort study ,Nose ,Respiratory tract infections ,business.industry ,Infant ,Gestational age ,medicine.disease ,Hospitalization ,medicine.anatomical_structure ,Premature birth ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Population study ,Female ,business ,medicine.drug - Abstract
BACKGROUND: Respiratory syncytial virus (RSV) is a major cause of hospitalized acute respiratory illness (ARI) among young children. With RSV vaccines and immunoprophylaxis agents in clinical development, we sought to update estimates of US pediatric RSV hospitalization burden. METHODS: Children RESULTS: Among 2969 hospitalized children included in analyses, 1043 (35%) tested RSV-positive; 903 (87%) children who were RSV-positive were CONCLUSIONS: During the 2015–2016 season, RSV infection was associated with one-third of ARI hospitalizations in our study population of young children. Hospitalization rates were highest in infants
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- 2020
31. Isolation and characterization of SARS-CoV-2 from the first US COVID-19 patient
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Jennifer Harcourt, Azaibi Tamin, Xiaoyan Lu, Shifaq Kamili, Senthil Kumar. Sakthivel, Janna Murray, Krista Queen, Ying Tao, Clinton R. Paden, Jing Zhang, Yan Li, Anna Uehara, Haibin Wang, Cynthia Goldsmith, Hannah A. Bullock, Lijuan Wang, Brett Whitaker, Brian Lynch, Rashi Gautam, Craig Schindewolf, Kumari G. Lokugamage, Dionna Scharton, Jessica A. Plante, Divya Mirchandani, Steven G. Widen, Krishna Narayanan, Shinji Makino, Thomas G. Ksiazek, Kenneth S. Plante, Scott C. Weaver, Stephen Lindstrom, Suxiang Tong, Vineet D. Menachery, and Natalie J. Thornburg
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0303 health sciences ,Isolation (health care) ,030306 microbiology ,business.industry ,viruses ,Outbreak ,medicine.disease_cause ,medicine.disease ,Virology ,Virus ,Article ,3. Good health ,03 medical and health sciences ,Pneumonia ,Cell culture ,medicine ,Vero cell ,business ,Tropism ,030304 developmental biology ,Coronavirus - Abstract
The etiologic agent of the outbreak of pneumonia in Wuhan China was identified as severe acute respiratory syndrome associated coronavirus 2 (SARS-CoV-2) in January, 2020. The first US patient was diagnosed by the State of Washington and the US Centers for Disease Control and Prevention on January 20, 2020. We isolated virus from nasopharyngeal and oropharyngeal specimens, and characterized the viral sequence, replication properties, and cell culture tropism. We found that the virus replicates to high titer in Vero-CCL81 cells and Vero E6 cells in the absence of trypsin. We also deposited the virus into two virus repositories, making it broadly available to the public health and research communities. We hope that open access to this important reagent will expedite development of medical countermeasures.Article SummaryScientists have isolated virus from the first US COVID-19 patient. The isolation and reagents described here will serve as the US reference strain used in research, drug discovery and vaccine testing.
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- 2020
32. First 12 patients with coronavirus disease 2019 (COVID-19) in the United States
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Rebecca Sunenshine, Diane Buell, Martin Fenstersheib, Christopher Shepherd, Margie Morgan, Cheri Grigg, Rebecca Fisher, Marc Fischer, Isaac Benowitz, Rebecca C. Woodruff, Isaac Ghinai, Brandon Bonin, John T. Watson, Kelly Lo, Shifaq Kamili, Olivia Almendares, Glenn E. Mathisen, Catherine M. Brown, Lynn Mello, Ruth N. Moro, Matthew Westercamp, Hannah L Kirking, Brian Rha, Sara Cody, Alison M. Binder, Moon Kim, Dawn Terashita, Sarah Scott, Joana Y Lively, Lauren Epstein, Holly M. Biggs, Shanon Smith, Timothy M. Uyeki, Jan King, Manisha Patel, Marielle J Fricchione, Aron J. Hall, Alicia P. Budd, Krista Queen, Vaughn Barry, Lindsay Kim, Kevin Chatham-Stephens, Kathleen Harriman, Francisco N Alvarez, Melissa A Rolfes, Mark A. Pallansch, Karen K. Wong, Anna R Yousaf, Jennifer P Collins, Graham Gerrard, Chelsea Foo, Ying Tao, Jennifer O'Shea, Miwako Kobayashi, Elizabeth Traub, Jeffrey D. Gunzenhauser, Megan J. Wallace, Heather Reese, Stephanie A Kujawski, Elsa Villarino, Azaibi Tamin, Olivia L McGovern, Keith Erickson, Xiaoyan Lu, Michelle Livingston, Lawrence C. Madoff, Hollianne Bruce, Glen R. Abedi, N Seema Ahmed, Oren Friedman, Matthew Zahn, Nora Chea, Susan Robinson, Matthew Donahue, Bryan Stierman, Thomas Haupt, Sarah Wilkerson, Rachel Bystritsky, Melissa M. Garcia, Sarah L. Rudman, Kayla N. Anderson, Jonathan Bryant-Genevier, Suxiang Tong, Victoria T Chu, Jennifer R. Verani, Jennifer C. Hunter, Mariel Marlow, Satish K. Pillai, Massimo Pacilli, Janell Routh, Amy Xie, Kiran Joshi, Anna Uehara, Howard Chiou, Vishal Dasari, Nancy McClung, Regina Sy-Santos, Jonathan M. Wortham, Michael Ben-Aderet, Patrick Dawson, Meredith Haddix, Gary I. Gutkin, Claire M Midgley, Sung-Sil Moon, Ahmet Tural, Jeremy A. Falk, Shannon A. Novosad, William V. Stoecker, Lindsey M. Duca, Janna Murray, Isabel Pedraza, Rachel Rubin, Michael A. Jhung, Michelle Holshue, Anna Kocharian, Amber K. Haynes, Romeo R. Galang, Gregory Marks, Traci DeSalvo, Jennifer L Harcourt, Karri Bartlett, Lijuan Wang, Jennifer E Layden, Alicia M. Fry, Mathew D. Esona, Erin E. Conners, Philip Robinson, George A. Diaz, Susa I. Gerber, George S Han, Suzanne Evans, Prabhu Gounder, Audrey Meier, Brian Lynch, Senthilkumar K. Sakthivel, Tiffany Wu, Jordan Cates, Talia Pindyck, Yan Li, Kenneth Komatsu, Stephanie R. Black, Mitali Mehta, Varun Shetty, Claire Jarashow, Brett Whitaker, Max W. Jacobs, E. Matt Charles, Scott Lindquist, Clinton R. Paden, Amanda Kita-Yarbro, Max Cohen, Sharon Balter, Talar Kamali, Heather J. Rhodes, Ethan A. Smith, Ruth Link-Gelles, Jing Zhang, Sajan Patel, Rachel Klos, Marie E Killerby, Grace M Vahey, Natalie J. Thornburg, Suzanne Donovan, Cora Hoover, Tristan D. McPherson, Aaron T. Curns, Nichole Quick, Sara E. Oliver, Demian Christiansen, Ram Koppaka, Jonathan Grein, Rekha Murthy, Leora R. Feldstein, Karlyn D. Beer, Jennifer Lo, Stephen Lindstrom, Lakshmi Malapati, and Ian W. Pray
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medicine.medical_specialty ,Viral culture ,business.industry ,Urine ,Disease ,medicine.disease_cause ,medicine.disease ,Virus ,Pneumonia ,Internal medicine ,Epidemiology ,medicine ,Respiratory system ,business ,Coronavirus - Abstract
IntroductionMore than 93,000 cases of coronavirus disease (COVID-19) have been reported worldwide. We describe the epidemiology, clinical course, and virologic characteristics of the first 12 U.S. patients with COVID-19.MethodsWe collected demographic, exposure, and clinical information from 12 patients confirmed by CDC during January 20–February 5, 2020 to have COVID-19. Respiratory, stool, serum, and urine specimens were submitted for SARS-CoV-2 rRT-PCR testing, virus culture, and whole genome sequencing.ResultsAmong the 12 patients, median age was 53 years (range: 21–68); 8 were male, 10 had traveled to China, and two were contacts of patients in this series. Commonly reported signs and symptoms at illness onset were fever (n=7) and cough (n=8). Seven patients were hospitalized with radiographic evidence of pneumonia and demonstrated clinical or laboratory signs of worsening during the second week of illness. Three were treated with the investigational antiviral remdesivir. All patients had SARS-CoV-2 RNA detected in respiratory specimens, typically for 2–3 weeks after illness onset, with lowest rRT-PCR Ct values often detected in the first week. SARS-CoV-2 RNA was detected after reported symptom resolution in seven patients. SARS-CoV-2 was cultured from respiratory specimens, and SARS-CoV-2 RNA was detected in stool from 7/10 patients.ConclusionsIn 12 patients with mild to moderately severe illness, SARS-CoV-2 RNA and viable virus were detected early, and prolonged RNA detection suggests the window for diagnosis is long. Hospitalized patients showed signs of worsening in the second week after illness onset.
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- 2020
33. Expanding severe acute respiratory infection ( <scp>SARI</scp> ) surveillance beyond influenza: The process and data from 1 year of implementation in Vietnam
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Karen A. Alroy, Trang Thuy Do, Phu Dac Tran, Tan Quang Dang, Long Ngoc Vu, Nga Thi Hang Le, Anh Duc Dang, Nghia Duy Ngu, Tu Huy Ngo, Phuong Vu Mai Hoang, Lan Trong Phan, Thuong Vu Nguyen, Long Thanh Nguyen, Thinh Viet Nguyen, Mai Quang Vien, Huy Xuan Le, Anh The Dao, Trieu Bao Nguyen, Duoc Tho Pham, Van Thi Tuyet Nguyen, Thanh Ngoc Pham, Binh Hai Phan, Brett Whitaker, Thuy Thi Thu Do, Phuong Anh Dao, S. Arunmozhi Balajee, and Anthony W. Mounts
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Male ,0301 basic medicine ,Routine testing ,Epidemiology ,respiratory syncytial virus ,medicine.disease_cause ,influenza virus ,0302 clinical medicine ,Severe acute respiratory infection ,Global health ,030212 general & internal medicine ,Child ,Respiratory Tract Infections ,Aged, 80 and over ,Reverse Transcriptase Polymerase Chain Reaction ,adenovirus ,Middle Aged ,Orthomyxoviridae ,Respiratory pathogens ,rhinovirus ,Infectious Diseases ,Vietnam ,Virus Diseases ,Child, Preschool ,Epidemiological Monitoring ,Viruses ,Respiratory virus ,Female ,Original Article ,Christian ministry ,Rhinovirus ,severe acute respiratory infection ,Adult ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Adolescent ,030106 microbiology ,Real-Time Polymerase Chain Reaction ,Young Adult ,03 medical and health sciences ,medicine ,Humans ,Aged ,global health security ,business.industry ,Infant, Newborn ,Public Health, Environmental and Occupational Health ,Infant ,Original Articles ,Emergency medicine ,business - Abstract
Background In 2016, as a component of the Global Health Security Agenda, the Vietnam Ministry of Health expanded its existing influenza sentinel surveillance for severe acute respiratory infections (SARI) to include testing for 7 additional viral respiratory pathogens. This article describes the steps taken to implement expanded SARI surveillance in Vietnam and reports data from 1 year of expanded surveillance. Methods The process of expanding the suite of pathogens for routine testing by real‐time reverse transcriptase–polymerase chain reaction (rRT‐PCR) included laboratory trainings, procurement/distribution of reagents, and strengthening and aligning SARI surveillance epidemiology practices at sentinel sites and regional institutes (RI). Results Surveillance data showed that of 4003 specimens tested by the RI laboratories, 20.2% (n = 810) were positive for influenza virus. Of the 3193 influenza‐negative specimens, 41.8% (n = 1337) were positive for at least 1 non‐influenza respiratory virus, of which 16.2% (n = 518), 13.4% (n = 428), and 9.6% (n = 308) tested positive for respiratory syncytial virus, rhinovirus, and adenovirus, respectively. Conclusions The Government of Vietnam has demonstrated that expanding respiratory viral surveillance by strengthening and building upon an influenza platform is feasible, efficient, and practical.
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- 2018
34. Non-mumps Viral Parotitis During the 2014–2015 Influenza Season in the United States
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Anna Strain, Mary Anne Jackson, Lori Webber, Jaime Christensen, Lenee Blanton, Thomas Haupt, Lyn Finelli, Kay Radford, Natalie A Kramer, Anna Kocharian, Brett Whitaker, Rebecca J. McNall, John R. Barnes, Jennifer B. Rosen, Jennifer Palm, Melissa A Rolfes, John J Dreisig, Beth M. Isaac, Alexander J. Millman, Pamela Talley, Rebecca Garten, Sara Robinson, Stefanie Cole, Tonya Danz, Karen Martin, George Turabelidze, Jeffrey P. Davis, Daniel Leifer, Peter Shult, Meghan Pearce Weinberg, Erik Reisdorf, Senthilkumar K. Sakthivel, Lisa McHugh, Ruth Lynfield, David E. Wentworth, Michael A. Jhung, and Lina I Elbadawi
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Adult ,Male ,0301 basic medicine ,Microbiology (medical) ,Simplexvirus ,food.ingredient ,Adolescent ,viruses ,030106 microbiology ,medicine.disease_cause ,Article ,Virus ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,food ,Surveys and Questionnaires ,Influenza, Human ,Sore throat ,medicine ,Humans ,030212 general & internal medicine ,Child ,Mumps ,Articles and Commentaries ,Aged ,Aged, 80 and over ,business.industry ,Infant, Newborn ,Infant ,Outbreak ,Pharyngitis ,Cytomegalovirus ,Middle Aged ,medicine.disease ,Virology ,United States ,Human Parainfluenza Virus ,Infectious Diseases ,Child, Preschool ,Viruses ,Female ,Seasons ,medicine.symptom ,business ,Parotitis - Abstract
Background During the 2014-2015 US influenza season, 320 cases of non-mumps parotitis (NMP) among residents of 21 states were reported to the Centers for Disease Control and Prevention (CDC). We conducted an epidemiologic and laboratory investigation to determine viral etiologies and clinical features of NMP during this unusually large occurrence. Methods NMP was defined as acute parotitis or other salivary gland swelling of >2 days duration in a person with a mumps- negative laboratory result. Using a standardized questionnaire, we collected demographic and clinical information. Buccal samples were tested at the CDC for selected viruses, including mumps, influenza, human parainfluenza viruses (HPIVs) 1-4, adenoviruses, cytomegalovirus, Epstein-Barr virus (EBV), herpes simplex viruses (HSVs) 1 and 2, and human herpes viruses (HHVs) 6A and 6B. Results Among the 320 patients, 65% were male, median age was 14.5 years (range, 0-90), and 67% reported unilateral parotitis. Commonly reported symptoms included sore throat (55%) and fever (48%). Viruses were detected in 210 (71%) of 294 NMP patients with adequate samples for testing, ≥2 viruses were detected in 37 samples, and 248 total virus detections were made among all samples. These included 156 influenza A(H3N2), 42 HHV6B, 32 EBV, 8 HPIV2, 2 HPIV3, 3 adenovirus, 4 HSV-1, and 1 HSV-2. Influenza A(H3N2), HHV6B, and EBV were the most frequently codetected viruses. Conclusions Our findings suggest that, in addition to mumps, clinicians should consider respiratory viral (influenza) and herpes viral etiologies for parotitis, particularly among patients without epidemiologic links to mumps cases or outbreaks.
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- 2018
35. Acute respiratory infections among returning Hajj pilgrims—Jordan, 2014
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Sultan Alqasrawi, Dean D. Erdman, Rebecca M. Dahl, Ibrahim Iblan, Suxiang Tong, Alison M. Binder, Brett Whitaker, Susan I. Gerber, Stephen Lindstrom, Daniel C. Payne, Sami Sheikh Ali, Mohannad Al Nsour, Aktham Haddadin, Jawad Mofleh, Tarek Alsanouri, Brian Rha, LaShondra Berman, Jing Zhang, and Mohammad Mousa Al-Abdallat
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0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,Adolescent ,Middle East respiratory syndrome coronavirus ,viruses ,Respiratory tract infections ,medicine.disease_cause ,Article ,03 medical and health sciences ,MERS-CoV ,Young Adult ,0302 clinical medicine ,Virology ,Surveys and Questionnaires ,Epidemiology ,Health care ,Hajj ,medicine ,Humans ,030212 general & internal medicine ,Respiratory system ,Intensive care medicine ,Aged ,Aged, 80 and over ,Jordan ,business.industry ,Public health ,Middle Aged ,030104 developmental biology ,Infectious Diseases ,Crowding ,Virus Diseases ,Emergency medicine ,Viruses ,Etiology ,Enterovirus ,Female ,business - Abstract
Highlights • Surveillance for respiratory illness in Hajj pilgrims took place in Jordan in 2014. • 58% of the 125 subjects returning from Hajj tested positive for at least one virus. • Rhino/enterovirus was the most commonly detected viral pathogen (47% of subjects). • No cases of Middle East Respiratory Syndrome coronavirus were detected., Background The emergence of Middle East Respiratory Syndrome coronavirus (MERS-CoV) has prompted enhanced surveillance for respiratory infections among pilgrims returning from the Hajj, one of the largest annual mass gatherings in the world. Objectives To describe the epidemiology and etiologies of respiratory illnesses among pilgrims returning to Jordan after the 2014 Hajj. Study design Surveillance for respiratory illness among pilgrims returning to Jordan after the 2014 Hajj was conducted at sentinel health care facilities using epidemiologic surveys and molecular diagnostic testing of upper respiratory specimens for multiple respiratory pathogens, including MERS-CoV. Results Among the 125 subjects, 58% tested positive for at least one virus; 47% tested positive for rhino/enterovirus. No cases of MERS-CoV were detected. Conclusions The majority of pilgrims returning to Jordan from the 2014 Hajj with respiratory illness were determined to have a viral etiology, but none were due to MERS-CoV. A greater understanding of the epidemiology of acute respiratory infections among returning travelers to other countries after Hajj should help optimize surveillance systems and inform public health response practices.
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- 2017
36. Improved Detection of Respiratory Pathogens by Use of High-Quality Sputum with TaqMan Array Card Technology
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Brett Whitaker, Wesley H. Self, Christopher Trabue, Anna M. Bramley, Richard G. Wunderink, Cynthia G. Whitney, Sandra R. Arnold, Bernard J. Wolff, Jonas M. Winchell, Jonathan A. McCullers, Kathryn M. Edwards, Seema Jain, and Kathleen A. Thurman
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Adult ,Male ,0301 basic medicine ,Microbiology (medical) ,medicine.medical_specialty ,Pathogen detection ,Adolescent ,Epidemiology ,030106 microbiology ,Real-Time Polymerase Chain Reaction ,Gastroenterology ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Community-acquired pneumonia ,Internal medicine ,medicine ,TaqMan ,Humans ,030212 general & internal medicine ,Child ,Pathogen ,Aged ,Aged, 80 and over ,business.industry ,Infant, Newborn ,Sputum ,Infant ,Pneumonia ,Middle Aged ,medicine.disease ,Respiratory pathogens ,Community-Acquired Infections ,Molecular Diagnostic Techniques ,Child, Preschool ,Immunology ,Etiology ,Pharynx ,Female ,medicine.symptom ,business - Abstract
New diagnostic platforms often use nasopharyngeal or oropharyngeal (NP/OP) swabs for pathogen detection for patients hospitalized with community-acquired pneumonia (CAP). We applied multipathogen testing to high-quality sputum specimens to determine if more pathogens can be identified relative to NP/OP swabs. Children (P < 0.0001) and adults (88% versus 61%; P < 0.0001); for each pathogen targeted, crossing threshold ( C T ) values were earlier in sputum. Both bacterial (361 versus 294) and viral detections (245 versus 140) were more common in sputum versus NP/OP specimens, respectively, in both children and adults. When available, high-quality sputum may be useful for testing in hospitalized CAP patients.
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- 2017
37. Big Questions for Leadership Education
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Brett Whitaker and Jill Arensdorf
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0502 economics and business ,05 social sciences ,050109 social psychology ,0501 psychology and cognitive sciences ,Sociology ,050203 business & management ,Education - Published
- 2018
38. Epidemiology of viral acute lower respiratory infections in a community-based cohort of rural north Indian children
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Anand Krishnan, Siddhartha Saha, Vishnubhatla Sreenivas, Rakesh Kumar, Marc-Alain Widdowson, Bharti Gaur Pandey, Kathryn E. Lafond, Avinash Choudekar, Shobha Broor, Seema Jain, Brett Whitaker, Venkatesh Vinayak Narayan, Sushil K. Kabra, Debjani R Purkayastha, Giridara Gopal, Ritvik Amarchand, and Stephen Lindstrom
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Male ,Rural Population ,medicine.medical_specialty ,030231 tropical medicine ,India ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Human metapneumovirus ,Internal medicine ,Throat ,Epidemiology ,Sore throat ,Humans ,Medicine ,030212 general & internal medicine ,Child ,Respiratory Tract Infections ,2. Zero hunger ,biology ,business.industry ,Incidence ,Health Policy ,Incidence (epidemiology) ,Public Health, Environmental and Occupational Health ,Infant ,Articles ,Odds ratio ,biology.organism_classification ,3. Good health ,medicine.anatomical_structure ,Child, Preschool ,Acute Disease ,Cohort ,Female ,medicine.symptom ,business ,Cohort study - Abstract
Background In India, community-based acute lower respiratory infections (ALRI) burden studies are limited, hampering development of prevention and control strategies. Methods We surveyed children
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- 2019
39. Population-based Surveillance for Medically Attended Human Parainfluenza Viruses From the Influenza Incidence Surveillance Project, 2010–2014
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Andrea Steffens, Ashley Fowlkes, Lyn Finelli, and Brett Whitaker
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0301 basic medicine ,Pediatrics ,Original Studies ,0302 clinical medicine ,Epidemiology ,Outpatient clinic ,030212 general & internal medicine ,Child ,education.field_of_study ,Paramyxoviridae Infections ,Incidence (epidemiology) ,Incidence ,Age Factors ,3. Good health ,Human Parainfluenza Virus ,Infectious Diseases ,Croup ,Child, Preschool ,Population Surveillance ,ComputingMethodologies_DOCUMENTANDTEXTPROCESSING ,surveillance ,Paramyxovirinae ,epidemiology ,Seasons ,Microbiology (medical) ,medicine.medical_specialty ,Adolescent ,parainfluenza virus ,030106 microbiology ,Population ,Respirovirus Infections ,03 medical and health sciences ,Age Distribution ,Ambulatory care ,children ,Influenza, Human ,medicine ,Humans ,Pediatrics, Perinatology, and Child Health ,education ,business.industry ,Infant ,medicine.disease ,United States ,population-based ,Parainfluenza Virus 1, Human ,Parainfluenza Virus 3, Human ,Bronchiolitis ,Pediatrics, Perinatology and Child Health ,DNA, Viral ,business - Abstract
Supplemental Digital Content is available in the text., Background: Parainfluenza viruses (PIV) have been shown to contribute substantially to pediatric hospitalizations in the United States. However, to date, there has been no systematic surveillance to estimate the burden among pediatric outpatients. Methods: From August 2010 through July 2014, outpatient health care providers with enumerated patient populations in 13 states and jurisdictions participating in the Influenza Incidence Surveillance Project conducted surveillance of patients with influenza-like illness (ILI). Respiratory specimens were collected from the first 10 ILI patients each week with demographic and clinical data. Specimens were tested for multiple respiratory viruses, including PIV1–4, using reverse transcriptase–polymerase chain reaction assays. Cumulative incidence was calculated using provider patient population size as the denominator. Results: PIVs 1–3 were detected in 8.0% of 7716 ILI-related outpatient specimens: 30% were PIV1, 26% PIV2 and 44% PIV3. PIV circulation varied noticeably by year and type, with PIV3 predominating in 2010–2011 (incidence 110 per 100,000 children), PIV1 in 2011–2012 (89 per 100,000), dual predominance of PIV2 and PIV3 (88 and 131 per 100,000) in 2012–2013 and PIV3 (100 per 100,000) in 2013–2014. The highest incidence of PIV detections was among patients aged
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- 2016
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40. Transmission of Middle East Respiratory Syndrome Coronavirus Infections in Healthcare Settings, Abu Dhabi
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Lia M. Haynes, Suxiang Tong, Zyad Al Bandar, Susan I. Gerber, Asma Al Ameri, Laila Abdel Wareth, Ahmed Khudair, Wafa Al Dhaheri, Farida Al Hosani, David T. Kuhar, Bashir Aden, Stefan Weber, Negar N. Alami, Duc B. Nguyen, Jennifer C. Hunter, Wesal Abu Amer, Jurgen Sasse, Huong Pham, Mariam Al Mulla, Kheir Abu Elkheir, Andrew Turner, Hala Imambaccus, Feda El Saleh, Sudhir Bunga, Brett Whitaker, Alexander J. Kallen, Nawal Al Kaabi, Aron J. Hall, Farrukh Amin Sheikh, and Kimberly Pringle
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0301 basic medicine ,Male ,Epidemiology ,Health authority ,viruses ,lcsh:Medicine ,medicine.disease_cause ,MERS-CoV ,0302 clinical medicine ,Health care ,Infection control ,030212 general & internal medicine ,Aged, 80 and over ,Cross Infection ,Transmission (medicine) ,Incidence (epidemiology) ,Incidence ,transmission ,virus diseases ,Middle Aged ,Hospitals ,Infectious Diseases ,Abu dhabi ,healthcare-associated infections ,Female ,Microbiology (medical) ,Adult ,Camelus ,Middle East respiratory syndrome coronavirus ,Health Personnel ,United Arab Emirates ,Transmission of Middle East Respiratory Syndrome Coronavirus Infections in Healthcare Settings, Abu Dhabi ,lcsh:Infectious and parasitic diseases ,03 medical and health sciences ,coronavirus infections ,Environmental health ,medicine ,nosocomial infections ,Animals ,Humans ,lcsh:RC109-216 ,Aged ,business.industry ,Research ,lcsh:R ,zoonoses ,030104 developmental biology ,Immunology ,Healthcare settings ,Communicable Disease Control ,business ,Middle East Respiratory Syndrome coronavirus - Abstract
Early detection and adherence to infection prevention recommendations are necessary to avoid transmission., Middle East respiratory syndrome coronavirus (MERS-CoV) infections sharply increased in the Arabian Peninsula during spring 2014. In Abu Dhabi, United Arab Emirates, these infections occurred primarily among healthcare workers and patients. To identify and describe epidemiologic and clinical characteristics of persons with healthcare-associated infection, we reviewed laboratory-confirmed MERS-CoV cases reported to the Health Authority of Abu Dhabi during January 1, 2013–May 9, 2014. Of 65 case-patients identified with MERS-CoV infection, 27 (42%) had healthcare-associated cases. Epidemiologic and genetic sequencing findings suggest that 3 healthcare clusters of MERS-CoV infection occurred, including 1 that resulted in 20 infected persons in 1 hospital. MERS-CoV in healthcare settings spread predominantly before MERS-CoV infection was diagnosed, underscoring the importance of increasing awareness and infection control measures at first points of entry to healthcare facilities.
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- 2016
41. Response to Emergence of Middle East Respiratory Syndrome Coronavirus, Abu Dhabi, United Arab Emirates, 2013–2014
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Stefan Weber, Negar N. Alami, Jennifer C. Hunter, Duc B. Nguyen, Huong Pham, Ying Tao, Lindsay Kim, Jurgen Sasse, Aron J. Hall, Mariam Al Mulla, Farida Al Hosani, Aaron T. Curns, Brett Whitaker, Bashir Aden, Lia M. Haynes, Sudhir Bunga, Feda El Saleh, Kheir Abou Elkheir, Krishna Pradeep, Suxiang Tong, Kimberly Pringle, Ahmed Khudhair, Andrew Turner, Zyad Al Bandar, Susan I. Gerber, and Wafa Al Dhaheri
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0301 basic medicine ,Male ,Epidemiology ,viruses ,lcsh:Medicine ,medicine.disease_cause ,Communicable Diseases, Emerging ,MERS-CoV ,0302 clinical medicine ,Public health surveillance ,Infection control ,risk factors ,030212 general & internal medicine ,clusters ,Young adult ,Traditional medicine ,Medical record ,Respiratory disease ,Middle Aged ,respiratory disease ,humanities ,Infectious Diseases ,Abu dhabi ,Synopsis ,Middle East Respiratory Syndrome Coronavirus ,Female ,medicine.symptom ,Coronavirus Infections ,Microbiology (medical) ,Adult ,medicine.medical_specialty ,Middle East respiratory syndrome coronavirus ,030106 microbiology ,education ,United Arab Emirates ,Asymptomatic ,lcsh:Infectious and parasitic diseases ,03 medical and health sciences ,Young Adult ,Internal medicine ,medicine ,Humans ,lcsh:RC109-216 ,asymptomatic infection ,Retrospective Studies ,business.industry ,lcsh:R ,medicine.disease ,public health surveillance ,business ,Response to Emergence of Middle East Respiratory Syndrome Coronavirus, Abu Dhabi, United Arab Emirates, 2013–2014 - Abstract
We found that this virus may be detected in mildly ill and asymptomatic case-patients., In January 2013, several months after Middle East respiratory syndrome coronavirus (MERS-CoV) was first identified in Saudi Arabia, Abu Dhabi, United Arab Emirates, began surveillance for MERS-CoV. We analyzed medical chart and laboratory data collected by the Health Authority–Abu Dhabi during January 2013–May 2014. Using real-time reverse transcription PCR, we tested respiratory tract samples for MERS-CoV and identified 65 case-patients. Of these patients, 23 (35%) were asymptomatic at the time of testing, and 4 (6%) showed positive test results for >3 weeks (1 had severe symptoms and 3 had mild symptoms). We also identified 6 clusters of MERS-CoV cases. This report highlights the potential for virus shedding by mildly ill and asymptomatic case-patients. These findings will be useful for MERS-CoV management and infection prevention strategies.
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- 2016
42. Vigilância dos vírus parainfluenza humanos em pacientes pediátricos com infecções do trato respiratório inferior: uma visão especial do parainfluenza tipo 4
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Eitan Naaman Berezin, Giuliana Stravinskas Durigon, Luciano M. Thomazelli, Brett Whitaker, Danielle Bruna Leal Oliveira, Edison Luiz Durigon, and Shifaq Kamili
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0301 basic medicine ,Doença respiratória aguda ,viruses ,Pediatric patients ,Respiratory virus ,Human parainfluenza virus ,0302 clinical medicine ,Nasopharynx ,030212 general & internal medicine ,Respirovírus humano 4 ,Respiratory system ,Vírus respiratório ,Respiratory Tract Infections ,Human respirovirus 4 ,education.field_of_study ,Respiratory tract infections ,Reverse Transcriptase Polymerase Chain Reaction ,lcsh:RJ1-570 ,virus diseases ,respiratory system ,Parainfluenza Virus 4, Human ,Human Parainfluenza Virus ,medicine.anatomical_structure ,Child, Preschool ,Population Surveillance ,Acute Disease ,Seasons ,medicine.symptom ,030106 microbiology ,Population ,Pacientes pediátricos ,Real-Time Polymerase Chain Reaction ,Tachypnea ,03 medical and health sciences ,stomatognathic system ,medicine ,Humans ,Vírus da parainfluenza humana ,education ,Respiratory illness ,Acute respiratory illness ,business.industry ,Infant, Newborn ,Infant ,lcsh:Pediatrics ,Virology ,respiratory tract diseases ,Pediatrics, Perinatology and Child Health ,business ,Respiratory tract - Abstract
Objective: Characterize the role of human parainfluenza virus and its clinical features in Brazilian children under 2 years of age presenting with acute lower respiratory tract infections. Methods: Real-time assays were used to identify strains of human parainfluenza virus and other common respiratory viruses in nasopharyngeal aspirates. One thousand and two children presenting with acute lower respiratory tract illnesses were enrolled from February 2008 to August 2010. Results: One hundred and four (10.4%) patients were human parainfluenza virus positive, of whom 60 (57.7%) were positive for human parainfluenza virus-3, 30 (28.8%) for human parainfluenza virus-4, 12 (11.5%) for human parainfluenza virus-1, and two (1.9%) for human parainfluenza virus-2. Seven (6.7%) patients had more than one strain of human parainfluenza virus detected. The most frequent symptoms were tachypnea and cough, similar to other viral respiratory infections. Clinical manifestations did not differ significantly between human parainfluenza virus-1, -2, -3, and -4 infections. Human parainfluenza virus-1, -3, and -4 were present in the population studied throughout the three years of surveillance, with human parainfluenza virus-3 being the predominant type identified in the first two years. Conclusion: Human parainfluenza viruses contribute substantially to pediatric acute respiratory illness (ARI) in Brazil, with nearly 30% of this contribution attributable to human parainfluenza virus-4. Resumo: Objetivo: Caracterizar o papel do VPH-4 e suas características clínicas em crianças brasileiras com menos de dois anos de idade com infecções agudas do trato respiratório inferior. Métodos: Ensaios em tempo real foram utilizados para identificar tipos de VPH e outros vírus respiratórios comuns em aspirados nasofaríngeos. Mil e duas crianças com doença aguda do trato respiratório inferior foram inscritas para participar de fevereiro de 2008 a agosto de 2010. Resultados: 104 (10,4%) pacientes eram VPH positivos, dos quais 60 (57,7%) eram positivos para VPH-3, 30 (28,8%) para VPH-4, 12 (11,5%) para VPH-1 e dois (1,9%) para VPH-2. Sete (6,7%) pacientes apresentaram mais de um tipo de VPH detectado. Os sintomas mais frequentes foram tosse e taquipneia, semelhantes a outras infecções respiratórias virais. As manifestações clínicas não diferiram de forma significativa entre as infecções por VPH-1, -2, -3 e -4. Os VPH-1, -3 e -4 estavam presentes na população estudada ao longo dos três anos de vigilância, e o VPH-3 foi o tipo predominante identificado nos primeiros dois anos. Conclusão: Os VPHs contribuem substancialmente para a DRA pediátrica no Brasil com quase 30% dessa contribuição atribuível ao VPH-4. Keywords: Human parainfluenza virus, Respiratory virus, Pediatric patients, Acute respiratory illness, Human respirovirus 4, Palavras-chave: Vírus da parainfluenza humana, Vírus respiratório, Pacientes pediátricos, Doença respiratória aguda, Respirovírus humano 4
- Published
- 2018
43. 1241. Surveillance for Viral Respiratory Infections in Pediatric Chronic Care Facilities
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Natalie Neu, Lindsay Kim, Xiaoyan Lu, Elaine Larson, Mila M. Prill, Brett Whitaker, Sibyl Wilmont, Shikha Garg, Nimalie D. Stone, Susan I. Gerber, and Lisa Saiman
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Chronic care ,medicine.medical_specialty ,biology ,Respiratory tract infections ,business.industry ,Human bocavirus ,Clinical Neurology ,medicine.disease_cause ,biology.organism_classification ,respiratory tract diseases ,Vaccination ,Abstracts ,Infectious Diseases ,B. Poster Abstracts ,Oncology ,Specimen collection ,Parechovirus ,medicine ,Rhinovirus ,Viral shedding ,Intensive care medicine ,business - Abstract
Background Residents of pediatric chronic care facilities (PCCFs) are vulnerable to acute respiratory infections (ARIs) due to their underlying medical conditions and infection control challenges in congregate living. Methods We conducted active, prospective surveillance for ARIs (defined as ≥2 new signs/symptoms of respiratory illness) among all residents in three PCCFs near New York City from December 7, 2016 to May 7, 2017. The parents/guardians of some residents also provided consent for research specimen collection at the start of the study. In that subset, nasopharyngeal swabs were obtained ≤4 days of ARI symptom onset and weekly for 4 weeks of follow-up to assess viral shedding. Influenza, respiratory syncytial virus (RSV), rhinovirus (RV), coronavirus (229E, NL63, OC43, HKU1), parainfluenzavirus (PIV 1–4), metapneumovirus (MPV), adenovirus (AdV), bocavirus (BoV), enterovirus, parechovirus, and M. pneumoniae were tested by the Fast Track Diagnostics Respiratory Pathogens 21 real-time RT-PCR panel. Results Subset with research specimen collection: Among 79 residents (aged 0–20 years, median = 8), 60 ARIs were reported in 37 (47%) residents. Swabs were obtained at illness onset for 53/60 ARI episodes; among these, there were 25 single-virus detections and five co-detections. An additional 33 single- and five co-detections occurred in 175 follow-up swabs (table). Molecular typing of 32 RV+ specimens identified 13 RV types. All residents: During the 2016–2017 influenza season, 308/322 (96%) age-eligible residents received influenza vaccine and 168/364 (46%) received prophylactic antivirals for influenza exposures. Although influenza was not detected in research swabs, it was detected in 3/200 tests conducted for clinical purposes. Conclusion ARIs were common among residents of three PCCFs, and a variety of respiratory viruses were detected. The rarity of influenza may reflect strong infection control practices in these facilities, including vaccination and prophylactic use of antivirals. Disclosures All authors: No reported disclosures.
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- 2018
44. Evaluation of Patients under Investigation for MERS-CoV Infection, United States, January 2013–October 2014
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Christina Chommanard, Brett Whitaker, Luis Lowe, Eileen Schneider, Jessica M. Rudd, and Susan I. Gerber
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Microbiology (medical) ,Genes, Viral ,Epidemiology ,Middle East respiratory syndrome coronavirus ,coronavirus ,lcsh:Medicine ,patients under investigation ,Real-Time Polymerase Chain Reaction ,medicine.disease_cause ,lcsh:Infectious and parasitic diseases ,MERS-CoV ,MERS ,Humans ,Medicine ,Molecular diagnostic techniques ,Infection control ,viruses ,lcsh:RC109-216 ,Coronavirus ,PUI ,Evaluation of Patients under Investigation for MERS-CoV Infection, United States, January 2013–October 2014 ,Case detection ,Reverse Transcriptase Polymerase Chain Reaction ,business.industry ,Middle East respiratory syndrome ,lcsh:R ,Dispatch ,medicine.disease ,Virology ,United States ,Infectious Diseases ,Molecular Diagnostic Techniques ,surveillance ,Middle East Respiratory Syndrome Coronavirus ,Coronavirus Infections ,business - Abstract
Middle East respiratory syndrome (MERS) cases continue to be reported from the Middle East. Evaluation and testing of patients under investigation (PUIs) for MERS are recommended. In 2013-2014, two imported cases were detected among 490 US PUIs. Continued awareness is needed for early case detection and implementation of infection control measures.
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- 2015
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45. 751. Acute Respiratory Illness Hospitalizations Among Young Children: Multi-Center Viral Surveillance Network, United States, 2015–2016
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Gayle E Langley, Mary Allen Staat, Janet A. Englund, Christopher J. Harrison, Brett Whitaker, Geoffrey A. Weinberg, Julie A. Boom, Monica N Singer, Aaron T. Curns, Rangaraj Selvarangan, Daniel C. Payne, Leila C. Sahni, Natasha B. Halasa, Daniella Figueroa-Downing, Joana Yu, Susan I. Gerber, John V Williams, Parvin H. Azimi, Mila M. Prill, Brian Rha, Eileen J. Klein, Monica M. McNeal, Angela P Campbell, and Darius McDaniel
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medicine.medical_specialty ,Respiratory illness ,Respiratory tract infections ,business.industry ,medicine.medical_treatment ,medicine.disease_cause ,medicine.disease ,Comorbidity ,Abstracts ,Infectious Diseases ,Oncology ,B. Poster Abstracts ,Intensive care ,Epidemiology ,Emergency medicine ,medicine ,Enterovirus ,Rhinovirus ,business ,Watchful waiting - Abstract
Background Viral infections are a significant cause of severe acute respiratory illnesses (ARI) in young children. Understanding the current epidemiology of these viruses is important for informing treatment and prevention measures. We describe the New Vaccine Surveillance Network (NVSN) and report preliminary results from 2015 to 2016. Methods Prospective active surveillance for hospitalized ARI was conducted from November 1, 2015 to June 30, 2016 among children Results Among 2,974 hospitalized children with ARI whose specimens were tested for viruses, 2,228 (75%) were 1 virus detected in 234 (8%). RSV was detected in 1,039 (35%) children with ARI, HMPV in 245 (8%), influenza in 104 (4%), and PIV-1, PIV-2, and PIV-3 in 49 (2%), 2 ( Conclusion During the 2015–2016 season, viral detections were common in young children hospitalized for ARI at seven US sites. NVSN combines clinical data with current molecular laboratory techniques to describe respiratory virus epidemiology in cases of hospitalized pediatric ARI in order to inform current and future prevention, treatment, and healthcare utilization measures. Disclosures N. Halasa, Sanofi Pasteur: Investigator, Research support. GSK: Consultant, Consulting fee. Moderna: Consultant, Consulting fee. J. Englund, Gilead: Consultant and Investigator, Consulting fee and Research support. Novavax: Investigator, Research support. GlaxoSmithKline: Investigator, Research support. Alios: Investigator, Research support. MedImmune: Investigator, Research support. J. V. Williams, Quidel: Board Member, Consulting fee. GlaxoSmithKline: Consultant, Consulting fee.
- Published
- 2018
46. Real-Time Reverse Transcription-PCR Assay Panel for Middle East Respiratory Syndrome Coronavirus
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Emad Mohareb, Laura Rose, Shifaq Kamili, Brett Whitaker, Emad Elassal, Tarek Alsanouri, Dean D. Erdman, Luis Lowe, Xiaoyan Lu, Aktham Haddadin, and Senthil Kumar K. Sakthivel
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Adult ,Microbiology (medical) ,Middle East respiratory syndrome coronavirus ,viruses ,medicine.disease_cause ,Real-Time Polymerase Chain Reaction ,Virus ,Virology ,medicine ,Humans ,Gene ,Respiratory Tract Infections ,Coronavirus ,Respiratory tract infections ,business.industry ,Reverse Transcriptase Polymerase Chain Reaction ,United States Food and Drug Administration ,Infant, Newborn ,virus diseases ,Infant ,medicine.disease ,United States ,respiratory tract diseases ,Reverse transcription polymerase chain reaction ,Real-time polymerase chain reaction ,Molecular Diagnostic Techniques ,Middle East respiratory syndrome ,Reagent Kits, Diagnostic ,business ,Coronavirus Infections - Abstract
A new human coronavirus (CoV), subsequently named Middle East respiratory syndrome (MERS)-CoV, was first reported in Saudi Arabia in September 2012. In response, we developed two real-time reverse transcription-PCR (rRT-PCR) assays targeting the MERS-CoV nucleocapsid (N) gene and evaluated these assays as a panel with a previously published assay targeting the region upstream of the MERS-CoV envelope gene (upE) for the detection and confirmation of MERS-CoV infection. All assays detected ≤10 copies/reaction of quantified RNA transcripts, with a linear dynamic range of 8 log units and 1.3 × 10 −3 50% tissue culture infective doses (TCID 50 )/ml of cultured MERS-CoV per reaction. All assays performed comparably with respiratory, serum, and stool specimens spiked with cultured virus. No false-positive amplifications were obtained with other human coronaviruses or common respiratory viral pathogens or with 336 diverse clinical specimens from non-MERS-CoV cases; specimens from two confirmed MERS-CoV cases were positive with all assay signatures. In June 2012, the U.S. Food and Drug Administration authorized emergency use of the rRT-PCR assay panel as an in vitro diagnostic test for MERS-CoV. A kit consisting of the three assay signatures and a positive control was assembled and distributed to public health laboratories in the United States and internationally to support MERS-CoV surveillance and public health responses.
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- 2013
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47. Viruses Detected Among Sporadic Cases of Parotitis, United States, 2009-2011
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Kay Radford, William J. Bellini, Dean D. Erdman, Carole J. Hickman, Rebecca J. McNall, Gregory S. Wallace, Brett Whitaker, D. Scott Schmid, Paul A. Rota, Albert E. Barskey, Shur-Wern Wang Chern, M. Steven Oberste, and Phalasy Juieng
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Adult ,Male ,Herpesvirus 4, Human ,Adolescent ,Herpesvirus 6, Human ,viruses ,Mumps virus ,Antibodies, Viral ,medicine.disease_cause ,Virus ,Serology ,Humans ,Immunology and Allergy ,Medicine ,Child ,Aged ,biology ,business.industry ,Human bocavirus ,Human parechovirus ,Infant ,Middle Aged ,biology.organism_classification ,medicine.disease ,Virology ,United States ,Human Parainfluenza Virus ,Infectious Diseases ,Specimen collection ,Child, Preschool ,DNA, Viral ,Viruses ,Immunology ,RNA, Viral ,Female ,Seasons ,business ,Parotitis - Abstract
Background. Sporadic cases of parotitis are generally assumed to be mumps, which often requires a resourceintensive public health response. This project surveyed the frequency of viruses detected among such cases. Methods. During 2009–2011, 8 jurisdictions throughout the United States investigated sporadic cases of parotitis. Epidemiologic information, serum, and buccal and oropharyngeal swabs were collected. Polymerase chain reaction methods were used to detect a panel of viruses. Anti–mumps virus immunoglobulin M (IgM) antibodies were detected using a variety of methods. Results. Of 101 specimens, 38 were positive for a single virus: Epstein-Barr virus (23), human herpesvirus (HHV)-6B (10), human parainfluenza virus (HPIV)-2 (3), HPIV-3 (1), and human bocavirus (1). Mumps virus, enteroviruses (including human parechovirus), HHV-6A, HPIV-1, and adenoviruses were not detected. Early specimen collection did not improve viral detection rate. Mumps IgM was detected in 17% of available specimens. Patients in whom a virus was detected were younger, but no difference was seen by sex or vaccination profile. No seasonal patterns were identified. Conclusions. Considering the timing of specimen collection, serology results, patient vaccination status, and time of year may be helpful in assessing the likelihood that a sporadic case of parotitis without laboratory confirmation is mumps.
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- 2013
48. Field evaluation of TaqMan Array Card (TAC) for the simultaneous detection of multiple respiratory viruses in children with acute respiratory infection
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Marika K. Iwane, Geoffrey A. Weinberg, Dean D. Erdman, Kenneth C. Schnabel, Mila M. Prill, Lynne M. Shelley, Brett Whitaker, Caroline B. Hall, and Peter G. Szilagyi
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Male ,viruses ,Real-Time Polymerase Chain Reaction ,medicine.disease_cause ,Sensitivity and Specificity ,Article ,Virus ,03 medical and health sciences ,0302 clinical medicine ,Human metapneumovirus ,Virology ,medicine ,TaqMan ,Humans ,030212 general & internal medicine ,Respiratory system ,Child ,Respiratory Tract Infections ,Viral diagnostics ,Respiratory viruses ,0303 health sciences ,biology ,Reverse Transcriptase Polymerase Chain Reaction ,030306 microbiology ,Infant ,Respiratory infection ,biology.organism_classification ,Reverse transcriptase ,3. Good health ,Human Parainfluenza Virus ,Infectious Diseases ,Molecular Diagnostic Techniques ,Acute respiratory infection ,Virus Diseases ,Child, Preschool ,Viruses ,Immunology ,Female ,Rhinovirus - Abstract
Background Multipathogen reverse transcription real-time PCR (RT-qPCR) platforms have proven useful in surveillance for acute respiratory illness (ARI) and study of respiratory outbreaks of unknown etiology. The TaqMan® Array Card (TAC, Life Technologies™), can simultaneously test 7 clinical specimens for up to 21 individual pathogens (depending on arrangement of controls and use of duplicate wells) by arrayed singleplex RT-qPCR on a single assay card, using minimal amounts of clinical specimens. A previous study described the development of TAC for the detection of respiratory viral and bacterial pathogens; the assay was evaluated against well-characterized analytical materials and a limited collection of human clinical specimens. Objectives We wished to compare TAC assay performance against standard individual RT-qPCR assays for respiratory viral detection, focusing on 10 viruses (adenovirus, human metapneumovirus, human parainfluenza viruses 1–4, influenza viruses A and B, respiratory syncytial virus, and rhinovirus) from a larger collection of human specimens. Study design We used specimens from 942 children with ARI enrolled systematically in a population-based, ARI surveillance study (New Vaccine Surveillance Network, NVSN). Results Compared with standard individual RT-qPCR assays, the sensitivity of TAC for the targeted viruses ranged from 54% to 95% (54%, 56%, and 75% for adenovirus, human parainfluenza viruses-1 and -2, respectively, and 82%–95% for the other viruses). Assay specificity was 99%, and coefficients of variation for virus controls ranged from 1.5% to 4.5%. Conclusion The TAC assay should prove useful for multipathogen studies and rapid outbreak response.
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- 2013
49. Clinical Outcomes and Respiratory Virus Detections in Children With Neurologic/Neuromuscular Disorders Hospitalized for Acute Respiratory Infection, 2013–2015
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Sarah Bistodeau, Brett Whitaker, Dave Boxrud, Anna Strain, Hannah Friedlander, Andrea Steffens, Ashley Fowlkes, Sandra S. Chaves, Ruth Lynfield, and Kathryn Como-Sabetti
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Pediatrics ,medicine.medical_specialty ,Infectious Diseases ,Oncology ,Respiratory tract infections ,business.industry ,Treatment outcome ,medicine ,Respiratory infection ,Respiratory virus ,business - Published
- 2016
50. Genetic diversity and genomic distribution of homologs encoding NBS-LRR disease resistance proteins in sunflower
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Brett Whitaker, Christopher A Taylor, Alex M. Plocik, Osman Radwan, Adam Heesacker, Richard W Michelmore, Rick Kesseli, Sonali Gandhi, Alexander Kozik, and Steven J. Knapp
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DNA, Plant ,Molecular Sequence Data ,Genome ,DNA sequencing ,Helianthus annuus ,Genetics ,Amino Acid Sequence ,Helianthus ,Molecular Biology ,Conserved Sequence ,Phylogeny ,Plant Diseases ,Plant Proteins ,Expressed Sequence Tags ,Comparative genomics ,Expressed sequence tag ,Base Sequence ,biology ,fungi ,Fungi ,Chromosome Mapping ,Genetic Variation ,food and beverages ,General Medicine ,biology.organism_classification ,Sunflower ,Oomycetes ,GenBank ,embryonic structures ,Databases, Nucleic Acid ,Genome, Plant - Abstract
Three-fourths of the recognition-dependent disease resistance genes (R-genes) identified in plants encode nucleotide binding site (NBS) leucine-rich repeat (LRR) proteins. NBS-LRR homologs have only been isolated on a limited scale from sunflower (Helianthus annuus L.), and most of the previously identified homologs are members of two large NBS-LRR clusters harboring downy mildew R-genes. We mined the sunflower EST database and used comparative genomics approaches to develop a deeper understanding of the diversity and distribution of NBS-LRR homologs in the sunflower genome. Collectively, 630 NBS-LRR homologs were identified, 88 by mining a database of 284,241 sunflower ESTs and 542 by sequencing 1,248 genomic DNA amplicons isolated from common and wild sunflower species. DNA markers were developed from 196 unique NBS-LRR sequences and facilitated genetic mapping of 167 NBS-LRR loci. The latter were distributed throughout the sunflower genome in 44 clusters or singletons. Wild species ESTs were a particularly rich source of novel NBS-LRR homologs, many of which were tightly linked to previously mapped downy mildew, rust, and broomrape R-genes. The DNA sequence and mapping resources described here should facilitate the discovery and isolation of recognition-dependent R-genes guarding sunflower from a broad spectrum of economically important diseases. Sunflower nucleotide and amino acid sequences have been deposited in DDBJ/EMBL/GenBank under accession numbers EF 560168-EF 559378 and ABQ 58077-ABQ 57529.
- Published
- 2008
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