scholarly journals 332 “Opt-Out” HIV Screening in the Emergency Department Discovers a High Prevalence of Undiagnosed HIV in the Upstate of South Carolina: Brief Report on the Conclusion of an 8-Year Emergency Department Collaboration With South Carolina Department of Health and Environmental Control

2018 ◽  
Vol 72 (4) ◽  
pp. S131 ◽  
Author(s):  
J.A. Zink ◽  
S. Fiske ◽  
C. Schammel ◽  
P. Moschella
1993 ◽  
Vol 110 (1) ◽  
pp. 31-39 ◽  
Author(s):  
S. P. Luby ◽  
J. L. Jones ◽  
J. M. Horan

SUMMARYBetween January and June 1990, Restaurant A in Greenville, South Carolina repeatedly failed local health department inspection and was repeatedly sanctioned. In September 1990, two persons, hospitalized with salmonellosis after attending a convention catered by Restaurant A, contacted the South Carolina Department of Health and Environmental Control. We inspected Restaurant A, interviewed food handlers, and surveyed by telephone persons from every sixth business attending the convention. Of 398 persons interviewed, 135 (34%) reported gastroenteritis. Nine had culture-confirmed salmonella infection. People who ate turkey were 4.6 times more likely to become ill than those who did not eat turkey (95% confidence interval 2.0, 10.6). We estimate that of 2430 attendees, 824 became ill. Sanitarians judged Restaurant A's kitchen too small to prepare over 500 meals safely. The cooked turkey was unrefrigerated for several hours, incompletely rewarmed, and rinsed with water to reduce its offensive odour prior to serving. Stronger sanctions may be needed against restaurants that repeatedly fail local health department inspection.


2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
M. Czarnogorski ◽  
J. Brown ◽  
V. Lee ◽  
J. Oben ◽  
I. Kuo ◽  
...  

Objective. To determine the prevalence of occult HIV infection in patients who decline routine HIV testing in an urban emergency department.Design, Setting, and Patients. Discarded blood samples were obtained from patients who had declined routine ED HIV testing. After insuring that the samples came from patients not known to be HIV positive, they were deidentified, and rapid HIV testing was preformed using 5 μL of whole blood.Main Outcome Measures. The prevalence of occult HIV infection in those who declined testing compared with prevalence in those who accepted testing.Results. 600 consecutive samples of patients who declined routine HIV screening were screened for HIV. Twelve (2%) were reactive. Over the same period of time, 4845 patients accepted routine HIV testing. Of these, 35 (0.7%) were reactive. The difference in the prevalence of HIV infection between those who declined and those who accepted testing was significant (). The relative risk of undetected HIV infection in the group that declined testing was 2.74 times higher (95% CI 1.44–5.18) compared with those accepted testing.Conclusion. The rate of occult HIV infection is nearly three-times higher in those who decline routine ED HIV testing compared with those who accept such testing. Interventions are urgently needed to decrease the opt-out rate in routine ED HIV testing settings.


2020 ◽  
Author(s):  
Christopher Steven McMahan ◽  
Stella Self ◽  
Lior Rennert ◽  
Corey Kalbaugh ◽  
David Kriebel ◽  
...  

ABSTRACTBACKGROUNDWastewater-based epidemiology (WBE) provides an opportunity for near real-time, cost-effective monitoring of community level transmission of SARS-CoV-2, the virus that causes COVID-19. Detection of SARS-CoV-2 RNA in wastewater can identify the presence of COVID-19 in the community, but methods are lacking for estimating the numbers of infected individuals based on wastewater RNA concentrations.METHODSComposite wastewater samples were collected from three sewersheds and tested for SARS-CoV-2 RNA. A Susceptible-Exposed-Infectious-Removed (SEIR) model based on mass rate of SARS-CoV-2 RNA in the wastewater was developed to predict the number of infected individuals. Predictions were compared to confirmed cases identified by the South Carolina Department of Health and Environmental Control for the same time period and geographic area.RESULTSModel predictions for the relationship between mass rate of virus release to the sewersheds and numbers of infected individuals were validated based on estimated prevalence from individual testing. A simplified equation to estimate the number of infected individuals fell within the 95% confidence limits of the model. The unreported rate for COVID-19 estimated by the model was approximately 12 times that of confirmed cases. This aligned well with an independent estimate for the state of South Carolina.CONCLUSIONSThe SEIR model provides a robust method to estimate the total number of infected individuals in a sewershed based on the mass rate of RNA copies released per day. This overcomes some of the limitations associated with individual testing campaigns and thereby provides an additional tool that can be used to better inform policy decisions.


Author(s):  
Scott V. Harder ◽  
Joseph A. Gellici ◽  
Andrew Wachob

Groundwater levels are examined to document and evaluate short- and long-term trends observed in each of the major aquifers in the State. Data are compiled from groundwater-monitoring networks maintained by the South Carolina Department of Natural Resources (DNR), the South Carolina Department of Health and Environmental Control (DHEC), and the United States Geological Survey (USGS). The data are used in the support of groundwater management and allocation, assessment of droughts, groundwater-flow modeling, and resource assessment. Hydrographs from approximately 170 wells are reviewed with periods of record ranging from 1 to 56 years.


Author(s):  
Kimberly W. Jones ◽  
Ronald Bullman

The Town of Bluffton, South Carolina was a one square mile coastal village until it experienced exponential growth in the early 2000s, and today is approximately 54 square miles. Until this recent growth, few sources of possible impairments to water quality were recognized within the watershed, and even fewer within close proximity to the river itself. In 2007, the Town was told by the S.C. Department of Health and Environmental Control (SCDHEC) that fecal coliform levels in the May River headwaters were increasing and in 2009 the river received a shellfish harvesting classification down-grade. In response to this down-grade, the Town of Bluffton, with Beaufort County and stakeholders, committed to take action to restore shellfish harvesting in the river and to prevent further degradation to the river. Following the U.S. EPA (EPA) guidelines for developing watershed plans, Town staff worked for nearly a year with consultants, Beaufort County, topic experts and local residents to develop the May River Watershed Action Plan which was adopted by Town Council in November 2011.


2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S513-S513
Author(s):  
Elizabeth A Aguilera ◽  
Gilhen Rodriguez ◽  
Gabriela P Del Bianco ◽  
Gloria Heresi ◽  
James Murphy ◽  
...  

Abstract Background The Emergency Department (ED) at Memorial Hermann Hospital (MHH) - Texas Medical Center (TMC), Houston, Texas has a long established screening program targeted at detection of HIV infections. The impact of the COVID-19 pandemic on this screening program is unknown. Methods The Routine HIV screening program includes opt-out testing of all adults 18 years and older with Glasgow score > 9. HIV 4th generation Ag/Ab screening, with reflex to Gennius confirmatory tests are used. Pre-pandemic (March 2019 to February 2020) to Pandemic period (March 2020 to February 2021) intervals were compared. Results 72,929 patients visited MHH_ED during the pre-pandemic period and 57,128 in the pandemic period, a 22% decline. The number of patients tested for HIV pre-pandemic was 9433 and 6718 pandemic, a 29% decline. When the pandemic year was parsed into first and last 6 months interval and compared to similar intervals in the year pre pandemic, 39% followed by 16% declines in HIV testing were found. In total, 354 patients were HIV positives, 209, (59%) in the pre-pandemic and 145 (41%) in the pandemic period.The reduction in new HIV infections found was directly proportional to the decline in patients visiting the MHH-ED where the percent of patients HIV positive was constant across intervals (2.21% vs 2.26%). Demographic and outcome characteristics were constant across the compared intervals. Conclusion The COVID -19 pandemic reduced detection of new HIV infections by screening in direct proportion to the reduction in MHH-ED patient visits. The impact of COVID-19 pandemic decreased with duration of the pandemic. Disclosures All Authors: No reported disclosures


2012 ◽  
Vol 102 (5) ◽  
pp. 877-883 ◽  
Author(s):  
Jeffrey Sankoff ◽  
Emily Hopkins ◽  
Comilla Sasson ◽  
Alia Al-Tayyib ◽  
Brooke Bender ◽  
...  

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