Infectious Disease

Fungal infections (FI) are a leading cause of morbidity and mortality among patients undergoing allo-SCT. The newer anti-fungal agents, the echinocandins and extended spectrum azoles, have offered alternatives to Amphotericin B and fluconazole. Data from large patient samples evaluating the magnitude of benefit with the newer anti-fungal agents are lacking.

Objective

We analyzed the Nationwide Inpt Sample (NIS) database from Healthcare Cost and Utilization project to evaluate the trends in the incidence of FI and to evaluate the potential impact of newer anti-fungal agents on in-hospital mortality (IHM) among allo-SCT recipients.

Immigrants and refugees are required to undergo tuberculosis (TB) screening before entering the United States (US)(1). Nearly 700 overseas panel physicians designated by the US Department of State, perform these screenings (2). Over 450,000 new immigrants and nearly 80,000 refugees arrive in the US each year with their medical documentation (3). Those with culture positive or smear positive TB are treated prior to arrival in the US; those with radiographic or symptomatic TB but negative smears and culture may enter the US with Class B TB(4). After arrival, CDC's Electronic Disease Notification system (EDN) notifies the health departments of the results of overseas examinations.

Objective

To conduct preliminary assessment of the US destination locations among newly arriving immigrants and refugees with tuberculosis classifications

People usually celebrate holidays by inviting family and friends to have food at home, or by gathering and eating at restaurants or in other public venues. This increased exposure to food with a common source can create conditions for outbreaks of gastrointestinal illnesses. Holidays can also be targeted by bioterrorists who seek to maximize physical damage, psychological impact, and publicity around dates of patriotic or religious significance. They might aim at contaminating food and water supplies, especially with CDC-defined category B agents that can cause diseases such as salmonellosis, shigellosis, cholera, crytosporidiosis, as well as infections with Escherichia coli O157:H7 and the Epsilon toxin of Clostridium perfringens. Hence, there is a need to quantify whether gastrointestinal illnesses increase around holidays. This can also help determine a baseline of the incidence to which future holiday periods should be compared to. This research does not focus on specific reportable diseases. That will be the purpose of forthcoming research. Instead, ED visits with gastrointestinal symptoms are used to leverage the capability of syndromic surveillance for early detection.

Objective

To quantify Emergency Department (ED) visits with gastrointestinal symptoms during Federal holidays in Miami-Dade.

Public health officials and epidemiologists have been attempting to eradicate syphilis for decades, but national incidence rates are again on the rise. It has been suggested that the syphilis epidemic in the US is a "rare example of unforced, endogenous oscillations in disease incidence, with an 8-11-yr period that is predicted by the natural dynamics of syphilis infection, to which there is partially protective immunity." While the time series of aggregate case counts seems to support this claim, between 1990 and 2010 there seems to have been a significant change in the spatial distribution of the syphilis epidemic. It is unclear if this change can also be attributed to "endogenous" factors or whether it is due to exogenous factors such as behavioral changes (e.g., the widespread use of the internet for anonymous sexual encounters). For example, it is pointed out that levels of syphilis in 1989 were abnormally high in counties in North Carolina (NC) immediately adjacent to highways. The hypothesis was that this may be due truck drivers and prostitution, and/or the emerging cocaine market. Our results indicate that syphilis distribution in NC has changed since 1989, diffusing away from highway counties.

Objective

To study the spatial distribution of syphilis at the county level for specific states and nationally, and to determine how this might have changed over time in order to improve disease surveillance.

Seasonality has a major effect on the spatial and temporal (i.e. spatiotemporal) dynamics of natural systems and their populations (1). Although the seasonality of influenza in temperate countries is widely recognized, inter-regional spread of influenza in the United States has not been well characterized.

Objective

To study the seasonality of influenza in the United States between 1972 and 2007 through the evaluation of the timing, velocity, and spatial spread of annual epidemic cycles.

Unpublished statewide 2009 H1N1 epidemiological data suggests that rates of lab-confirmed H1N1-related hospitalization were three to four times higher in Black and Hispanic populations compared to White, non-Hispanic populations (Alfred DeMaria, MDPH, personal communication, 2010). There is an absence of socioeconomic data in most public health surveillance systems, and population-based statewide descriptions of H1N1-related hospitalizations according to race/ethnic group and SES have not been described.

Objective

1) Investigate 2009 H1N1-related ICU admissions in Massachusetts by race/ethnic group;

2) Investigate the association between ICU stay and race/ethnic group adjusted for socioeconomic status (SES).

Noroviruses are the single most common cause of epidemic, non-bacterial gastroenteritis worldwide. NoVs cause an estimated 68-80% of gastroenteritis outbreaks in industrialized countries and possibly more in developing countries.

Objective

The purpose of this study was to identify global epidemiologic trends in human norovirus (NoV) outbreaks by transmission route and setting, and describe relationships between these characteristics, attack rates and the occurrence of genogroup I (GI) or genogroup II (GII) strains in outbreaks.

While norovirus is the leading cause of gastroenteritis in the United States, leading to an estimated 21 million illnesses per year [1], timely surveillance data are limited. Google Insights for Search (GIfS) is a new application that allows users to track specific Google search queries during specified time periods and geographic regions [2].

Objective

We compared norovirus syndromic search query trends with existing surveillance data in the United States in order to assess whether GIfS data can be used to monitor norovirus disease.

In March-April, 2011, Salt Lake Valley Health Department (SLVHD) investigated an outbreak of measles (N=9) resulting from a single imported case from Europe. Syndromic surveillance was used to identify measles-like illness (MLI) and enhance early case detection, which is crucial for proper public health intervention [1].

Objective

To detect measles cases during an outbreak using syndromic surveillance.

After the 2009 H1N1 influenza pandemic, CDC initiated community-based surveillance of self-reported influenza-like illness (ILI)[1], defined as the presence of fever with cough or sore throat. Although ILI is frequently attributed to other pathogens, including rhinovirus, routine surveillance of ILI at the population level does aid in the detection of nascent influenza outbreaks. In the United States, approximately 90% of influenza-related deaths occur among adults aged 65 years and older[2]. We explored the association of influenza vaccination with ILI, among this vulnerable age group.

Objective

To explore the association of influenza vaccination with Influenza-like illness ( ILI) among adults aged 65 years and older