Factors associated with measles resurgence in the United States in the post-elimination era

AbstractThere have been growing concerns of a potential re-establishment of measles transmission in the United States (US) in the years to come. This study aims to explore potential factors underlying the resurgence of measles in the US by objectively assessing the associations between annual incidence rates (AIR), case importation, vaccination status and disease outbreaks. Data on measles transmission between January 1st, 2001 and December 31st, 2019 were obtained from the national centres for disease control and prevention (CDC) surveillance databases and other published reports. Changes in incidence rates over time were assessed by binomial regression models. Of the 3874 cases of measles in the US over the study period, 3506 (90.5%, 95% CI: 89.5–91.4) occurred in US residents. The AIR per million population in US residents over this period was 0.60 (95% CI: 0.59–0.61), with an overall significant increase over time (p = 0.011). The median percentage of imported and vaccinated cases were 36% [17.9–46.6] and 15% [12.1–23.2] respectively. There was a significant decrease in the percentage of imported cases (p < 0.001) but not of vaccinated cases (p = 0.159) over time. There was a moderate and weak negative correlation between the AIR and the percentage of imported and vaccinated cases respectively (r = –0.59 and r = –0.27 respectively). On multiple linear regression there was a significant linear association between the AIR and the number of outbreaks (p = 0.003) but not with the percentage of imported cases (p = 0.436) and vaccinated cases (p = 0.692), R2 = 0.73. Strong negative and positive correlations were seen between the number of outbreaks and the percentage of imported cases (r = –0.61) and the of number states affected (r = 0.88) respectively. Despite the overall reduction in the percentage of imported cases of measles over the past two decades, pockets of internal transmission of the disease following importation via increasing number of outbreaks in unvaccinated subpopulations, reinforced by vaccine hesitancy, account for the sustained increase in measles incidence rates in the US. Controlling indigenous transmission through efficient vaccination coverage in at-risk subpopulations and among international US travellers, improved disease surveillance and rapid outbreak containment are essential in curbing the measles resurgence.

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130. increase in Multidrug Resistance (2011–2018) and the Emergence of Extensive Drug Resistance (2020) in shigella Sonnei in the United States

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.440 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S195-S195

Author(s):

Naeemah Z Logan ◽

Beth E Karp ◽

Kaitlin A Tagg ◽

Claire Burns-Lynch ◽

Jessica Chen ◽

...

Keyword(s):

United States ◽

Multidrug Resistance ◽

Disease Surveillance ◽

Sequence Data ◽

The United States ◽

Multidrug Resistant ◽

Shigella Sonnei ◽

Short Read ◽

Men 2 ◽

The Us

Abstract Background Multidrug-resistant (MDR) Shigella sonnei infections are a serious public health threat, and outbreaks are common among men who have sex with men (MSM). In February 2020, Australia’s Department of Health notified CDC of extensively drug-resistant (XDR) S. sonnei in 2 Australian residents linked to a cruise that departed from Florida. We describe an international outbreak of XDR S. sonnei and report on trends in MDR among S. sonnei in the United States. Methods Health departments (HDs) submit every 20th Shigella isolate to CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory for susceptibility testing. We defined MDR as decreased susceptibility to azithromycin (MIC ≥32 µg/mL) with resistance to ampicillin, ciprofloxacin, and cotrimoxazole, and XDR as MDR with additional resistance to ceftriaxone. We used PulseNet, the national subtyping network for enteric disease surveillance, to identify US isolates related to the Australian XDR isolates by short-read whole genome sequencing. We screened these isolates for resistance determinants (ResFinder v3.0) and plasmid replicons (PlasmidFinder) and obtained patient histories from HDs. We used long-read sequencing to generate closed plasmid sequences for 2 XDR isolates. Results NARMS tested 2,781 S. sonnei surveillance isolates during 2011–2018; 80 (2.9%) were MDR, including 1 (0.04%) that was XDR. MDR isolates were from men (87%), women (9%), and children (4%). MDR increased from 0% in 2011 to 15.3% in 2018 (Figure). In 2020, we identified XDR isolates from 3 US residents on the same cruise as the Australians. The US residents were 41–42 year-old men; 2 with available information were MSM. The US and Australian isolates were highly related (0–1 alleles). Short-read sequence data from all 3 US isolates mapped to the blaCTX-M-27 harboring IncFII plasmids from the 2 Australian isolates with >99% nucleotide identity. blaCTX-M-27 genes confer ceftriaxone resistance. Increase in Percentage of Shigella sonnei Isolates with Multidrug Resistance* in the United States, 2011–2018† Conclusion MDR S. sonnei is increasing and is most often identified among men. XDR S. sonnei infections are emerging and are resistant to all recommended antibiotics, making them difficult to treat without IV antibiotics. This outbreak illustrates the alarming capacity for XDR S. sonnei to disseminate globally among at-risk populations, such as MSM. Disclosures All Authors: No reported disclosures

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The comparison of vaccine hesitancy of COVID-19 vaccination in China and the United States

10.1101/2021.04.29.21256317 ◽

2021 ◽

Author(s):

Taoran Liu ◽

Zonglin He ◽

Jian Huang ◽

Ni Yan ◽

Qian Chen ◽

...

Keyword(s):

United States ◽

Propensity Score ◽

Propensity Score Matching ◽

Discrete Choice ◽

Choice Experiments ◽

The United States ◽

Discrete Choice Experiments ◽

Vaccine Hesitancy ◽

The Us ◽

The Cost

AbstractObjectivesTo investigate the differences in vaccine hesitancy and preference of the currently available COVID-19 vaccines between two countries, viz. China and the United States (US).MethodA cross-national survey was conducted in both China and the US, and discrete choice experiments as well as Likert scales were utilized to assess vaccine preference and the underlying factors contributing to the vaccination acceptance. A propensity score matching (PSM) was performed to enable a direct comparison between the two countries.ResultsA total of 9,077 (5,375 and 3,702, respectively, from China and the US) respondents have completed the survey. After propensity score matching, over 82.0% respondents from China positively accept the COVID-19 vaccination, while 72.2% respondents form the US positively accept it. Specifically, only 31.9% of Chinese respondents were recommended by a doctor to have COVID-19 vaccination, while more than half of the US respondents were recommended by a doctor (50.2%), local health board (59.4%), or friends and families (64.8%). The discrete choice experiments revealed that respondents from the US attached the greatest importance to the efficacy of COVID-19 vaccines (44.41%), followed by the cost of vaccination (29.57%), whereas those from China held a different viewpoint that the cost of vaccination covers the largest proportion in their trade-off (30.66%), and efficacy ranked as the second most important attribute (26.34%). Also, respondents from China tend to concerned much more about the adverse effect of vaccination (19.68% vs 6.12%) and have lower perceived severity of being infected with COVID-19.ConclusionWhile the overall acceptance and hesitancy of COVID-19 vaccination in both countries are high, underpinned distinctions between countries are observed. Owing to the differences in COVID-19 incidence rates, cultural backgrounds, and the availability of specific COVID-19 vaccines in two countries, the vaccine rollout strategies should be nation-dependent.

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Abstract WMP60: Temporal Trends in Incidence, Prevalence and Epidemiological Characteristics of Cerebral Venous Thrombosis in the United States

Stroke ◽

10.1161/str.51.suppl_1.wmp60 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Fadar Otite ◽

Smit Patel ◽

Richa Sharma ◽

Pushti Khandwala ◽

Devashish Desai ◽

...

Keyword(s):

United States ◽

Risk Factors ◽

Cerebral Venous Thrombosis ◽

The United States ◽

P Value ◽

Joinpoint Regression ◽

The Us ◽

Epidemiological Characteristics ◽

Over Time ◽

Age And Sex

Background: The primary aim of this study is to describe current trends in racial-, age- and sex-specific incidence, clinical characteristics and burden of cerebral venous thrombosis (CVT) in the United States (US). Methods: Validated International Classification of Disease codes were used to identify all adult new cases of CVT (n=5,567) in the State Inpatients Database of New York and Florida (2006-2016) and all cases of CVT in the entire US from the National Inpatient Sample 2005-2016 (weighted n=57,315). Incident CVT counts were combined with annual US Census data to compute age and sex-specific incidence of CVT. Joinpoint regression was used to evaluate trends in incidence over time. Results: From 2005-2016, 0.47%-0.80% of all strokes in the US were CVTs but this proportion increased by 70.4% over time. Of all CVTs over this period, 66.7% were in females but this proportion declined over time (p<0.001). Pregnancy/puerperium (27.4%) and cancer (11.8%) were the most common risk factors in women, while cancer (19.5%) and central nervous trauma (11.3) were the most common in men. Whereas the prevalence of pregnancy/puerperium declined significantly over time in women, that of cancer, inflammatory conditions and trauma increased over time in both sexes. Annual age and sex-standardized incidence of CVT in cases/million population ranged from 13.9-20.2, but incidence varied significantly by sex (women: 20.3-26.9; men 6.8-16.8) and by age/sex (women 18-44yo: 24.0-32.6%; men: 18-44yo: 5.3-12.8). Age and sex-standardized incidence also differed by race (Blacks:18.6-27.2; whites: 14.3-18.5; Asians: 5.1-13.8). On joinpoint regression, incidence increased across 2006-2016 but most of this increase was driven by increase in all age groups of men (combined annualized percentage change (APC) 9.2%, p-value <0.001), women 45-64 yo (APC 7.8%, p-value <0.001) and women ≥65 yo (APC 7.4%, p-value <0.001). Incidence in women 18-44 yo remained unchanged over time . Conclusion: The epidemiological characteristics of CVT patients in the US is changing. Incidence increased significantly over the last decade. Further studies are needed to determine whether this increase represents a true increase from changing risk factors or artefactual increase from improved detection.

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The Democratic Deficit of United States Federalism? Red State, Blue State, Purple?

Federal Law Review ◽

10.1177/0067205x1804600410 ◽

2018 ◽

Vol 46 (4) ◽

pp. 645-667

Author(s):

Vicki C Jackson

Keyword(s):

United States ◽

State Legislatures ◽

The United States ◽

State Legislature ◽

Democratic Deficit ◽

The Us ◽

The 1960S ◽

Us Senate ◽

The One ◽

Over Time

Aspects of an entrenched constitution that were essential parts of founding compromises, and justified as necessary when a constitution was first adopted, may become less justifiable over time. Is this the case with respect to the structure of the United States Senate? The US Senate is hardwired in the Constitution to consist of an equal number of Senators from each state—the smallest of which currently has about 585,000 residents, and the largest of which has about 39.29 million. As this essay explains, over time, as population inequalities among states have grown larger, so too has the disproportionate voting power of smaller-population states in the national Senate. As a result of the ‘one-person, one-vote’ decisions of the 1960s that applied to both houses of state legislatures, each state legislature now is arguably more representative of its state population than the US Congress is of the US population. The ‘democratic deficit’ of the Senate, compared to state legislative bodies, also affects presidential (as compared to gubernatorial) elections. When founding compromises deeply entrenched in a constitution develop harder-to-justify consequences, should constitutional interpretation change responsively? Possible implications of the ‘democratic’ difference between the national and the state legislatures for US federalism doctrine are explored, especially with respect to the ‘pre-emption’ doctrine. Finally, the essay briefly considers the possibilities of federalism for addressing longer term issues of representation, polarisation and sustaining a single nation.

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Has survival improved for nasopharyngeal carcinoma in the United States?

Otolaryngology ◽

10.1016/j.otohns.2004.09.018 ◽

2005 ◽

Vol 132 (2) ◽

pp. 303-308 ◽

Cited By ~ 29

Author(s):

Jivianne T. Lee ◽

Clifford Y. Ko

Keyword(s):

United States ◽

Nasopharyngeal Carcinoma ◽

Survival Rates ◽

The United States ◽

Incidence Rates ◽

World Health ◽

Type Iii ◽

Favorable Histology ◽

Health Organization ◽

Over Time

OBJECTIVE: To analyze the epidemiologic patterns and survival rates for patients with nasopharyngeal carcinoma over the last three decades. METHODS: The National Cancer Institute (NCI) Surveillance, Epidemiology, and End Results (SEER) program tumor registries were used to identify patients with nasopharyngeal carcinoma in the United States from 1973 to 1999. Incidence and survival rates for each decade were then determined according to age, gender, race, histological type, and stage using the SEER statistical program. RESULTS: From 1973 to 1999, 4680 cases of patients with nasopharyngeal carcinoma in the United States were sampled by the NCI/SEER database. Overall incidence rates for each decade essentially remained unchanged over time (0.7/100,000). Asians exhibited the highest incidence rates (3.0–4.2), followed by blacks (0.7–1.1) and then whites (0.4–0.7). In contrast, survival rates have gradually improved over time for all stages and histological types (35.7% 5-year survival in the 1970s vs. 44.1% in the 1980, and 51% in the 1990s). With respect to race, Asians demonstrated the best 5-year survival rate (62.9%) followed by whites (42.6%) and then blacks (36.2%). However, this may be due to histology, because Asians were also found to have a greater proportion of World Health Organization (WHO) type III cases (27.6%) in comparison to the other 2 groups (22.4% for blacks and 15% for whites). CONCLUSIONS: Although the incidence rates of nasopharyngeal carcinoma have remained essentially unchanged in the United States in the last 3 decades, survival rates for each stage and histological subtype have exhibited considerable improvement over time. The higher survival rates in Asians may be partially attributed to the more favorable histology (type III) often seen in this group. EBM rating: B-3.

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The Adverse Consequences of the Politics of Agency Design for Presidential Management in the United States: The Relative Durability of Insulated Agencies

British Journal of Political Science ◽

10.1017/s0007123404000109 ◽

2004 ◽

Vol 34 (3) ◽

pp. 377-404 ◽

Cited By ~ 40

Author(s):

DAVID E. LEWIS

Keyword(s):

United States ◽

Public Policies ◽

The United States ◽

Executive Branch ◽

Us Congress ◽

The Us ◽

Presidential Management ◽

Agency Design ◽

Over Time ◽

Expected Duration

The US Congress has often sought to limit presidential influence over certain public policies by designing agencies that are insulated from presidential control. Whether or not insulated agencies persist over time has important consequences for presidential management. If those agencies that persist over time are also those that are the most immune from presidential direction, this has potentially fatal consequences for the president's ability to manage the executive branch. Modern presidents will preside over a less and less manageable bureaucracy over time. This article explains why agencies insulated from presidential control are more durable than other agencies and shows that they have a significantly higher expected duration than other agencies. The conclusion is that modern American presidents preside over a bureaucracy that is increasingly insulated from their control.

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Incidence of testicular cancer in the United States from 1992 to 2009.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.6_suppl.339 ◽

2013 ◽

Vol 31 (6_suppl) ◽

pp. 339-339 ◽

Cited By ~ 2

Author(s):

Manas Nigam ◽

Brisa Aschebrook-Kilfoy ◽

Sergey Shikanov ◽

Scott E. Eggener

Keyword(s):

United States ◽

Testicular Cancer ◽

White Men ◽

The United States ◽

Incidence Rates ◽

The Us ◽

Hispanic Men ◽

Tumor Characteristic ◽

Race Ethnicity ◽

Hispanic White

339 Background: The incidence of testicular cancer (TC) increased in the US through 2003. However, little is known about these trends after 2003. We sought to determine trends in TC incidence based on race, ethnicity and tumor characteristics. Methods: TC incidence and tumor characteristic data from 1992-2009 were extracted from the Surveillance, Epidemiology, and End Results-13 (SEER) registry. Trends were determined using JoinPoint. Results: TC incidence in the US increased from 1992 (5.7/100,000) to 2009 (6.8/100,000) with annual percentage change (APC) of 1.1% (p < 0.001). TC rates were highest in non-Hispanic white men (1992: 7.5/100,000; 2009: 8.6/1000) followed by Hispanic men (1992: 4.0/100,000; 2009: 6.3/100,000) and lowest among non-Hispanic black men (1992: 0.7/100,000; 2009: 1.7/100,000). Significantly increasing incidence rates were observed in non-Hispanic white men (1.2%, p < 0.001) but most prominently among Hispanics, especially from 2002-2009 (5.6%, p < 0.01). A significant increase was observed for localized TC (1.21%, p < 0.001) and metastatic TC (1.43%, p < 0.01). Increased incidence occurred in localized tumors for non-Hispanic white men (1.56%, p <0.001), while Hispanic men experienced an increase in localized (2.6%, p < 0.001), regionalized (16.5% from 2002-09, p < 0.01), and distant (2.6%, p < 0.01) disease. Conclusions: Through 2009, testicular cancer incidence continues to increase in the United States, most notably among Hispanic men. [Table: see text]

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Changes in the Incidence of Endstage Renal Disease Due to Lupus Nephritis in the United States, 1996–2004

The Journal of Rheumatology ◽

10.3899/jrheum.080625 ◽

2009 ◽

Vol 36 (1) ◽

pp. 63-67 ◽

Cited By ~ 85

Author(s):

MICHAEL M. WARD

Keyword(s):

United States ◽

Lupus Nephritis ◽

Renal Disease ◽

The United States ◽

Population Based ◽

Incidence Rates ◽

Endstage Renal Disease ◽

The Us ◽

Population Based Registry ◽

Us Census

ObjectiveTo determine if the incidence of endstage renal disease (ESRD) due to lupus nephritis has decreased from 1996 to 2004.MethodsPatients age 15 years or older with incident ESRD due to lupus nephritis in 1996–2004 and living in one of the 50 United States or the District of Columbia were identified using the US Renal Data System, a national population-based registry of all patients receiving renal replacement therapy for ESRD. Incidence rates were computed for each calendar year, using population estimates of the US census as denominators.ResultsOver the 9-year study period, 9199 new cases of ESRD due to lupus nephritis were observed. Incidence rates, adjusted to the age, sex, and race composition of the US population in 2000, were 4.4 per million in 1996 and 4.9 per million in 2004. Compared to the pooled incidence rate in 1996–1998, the relative risk of ESRD due to lupus nephritis in 1999–2000 was 0.99 (95% CI 0.93–1.06), in 2001–2002 was 0.99 (95% CI 0.92–1.06), and in 2003–2004 was 0.96 (95% CI 0.89–1.02). Findings were similar in analyses stratified by sex, age group, race, and socioeconomic status.ConclusionThere was no decrease in the incidence of ESRD due to lupus nephritis between 1996 and 2004. This may reflect the limits of effectiveness of current treatments, or limitations in access, use, or adherence to treatment.

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The Changing Shape of the World Automobile Industry: A Multilayer Network Analysis of International Trade in Components and Parts

10.36687/inetwp173 ◽

2022 ◽

Author(s):

Margherita Russo ◽

◽

Fabrizio Alboni ◽

Jorge Carreto Sanginés ◽

Manlio De Domenico ◽

...

Keyword(s):

United States ◽

Network Analysis ◽

Trade Agreement ◽

The United States ◽

Trade Network ◽

Trade Relations ◽

Automotive Components ◽

The Us ◽

The World ◽

Over Time

In 2018, after 25 years of the North America Trade Agreement (NAFTA), the United States requested new rules which, among other requirements, increased the regional con-tent in the production of automotive components and parts traded between the three part-ner countries, United States, Canada and Mexico. Signed by all three countries, the new trade agreement, USMCA, is to go into force in 2022. Nonetheless, after the 2020 Presi-dential election, the new treaty's future is under discussion, and its impact on the automo-tive industry is not entirely defined. Another significant shift in this industry – the acceler-ated rise of electric vehicles – also occurred in 2020: while the COVID-19 pandemic largely halted most plants in the automotive value chain all over the world, at the reopen-ing, the tide is now running against internal combustion engine vehicles, at least in the an-nouncements and in some large investments planned in Europe, Asia and the US. The definition of the pre-pandemic situation is a very helpful starting point for the analysis of the possible repercussions of the technological and geo-political transition, which has been accelerated by the epidemic, on geographical clusters and sectorial special-isations of the main regions and countries. This paper analyses the trade networks emerg-ing in the past 25 years in a new analytical framework. In the economic literature on inter-national trade, the study of the automotive global value chains has been addressed by us-ing network analysis, focusing on the centrality of geographical regions and countries while largely overlooking the contribution of countries' bilateral trading in components and parts as structuring forces of the subnetwork of countries and their specific position in the overall trade network. The paper focuses on such subnetworks as meso-level structures emerging in trade network over the last 25 years. Using the Infomap multilayer clustering algorithm, we are able to identify clusters of countries and their specific trades in the automotive internation-al trade network and to highlight the relative importance of each cluster, the interconnec-tions between them, and the contribution of countries and of components and parts in the clusters. We draw the data from the UN Comtrade database of directed export and import flows of 30 automotive components and parts among 42 countries (accounting for 98% of world trade flows of those items). The paper highlights the changes that occurred over 25 years in the geography of the trade relations, with particular with regard to denser and more hierarchical network gener-ated by Germany’s trade relations within EU countries and by the US preferential trade agreements with Canada and Mexico, and the upsurge of China. With a similar overall va-riety of traded components and parts within the main clusters (dominated respectively by Germany, US and Japan-China), the Infomap multilayer analysis singles out which com-ponents and parts determined the relative positions of countries in the various clusters and the changes over time in the relative positions of countries and their specialisations in mul-tilateral trades. Connections between clusters increase over time, while the relative im-portance of the main clusters and of some individual countries change significantly. The focus on US and Mexico and on Germany and Central Eastern European countries (Czech Republic, Hungary, Poland, Slovakia) will drive the comparative analysis.

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Effects of climate changes and road exposure on the rapidly rising legionellosis incidence rates in the United States

PLoS ONE ◽

10.1371/journal.pone.0250364 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0250364

Author(s):

Xiang Y. Han

Keyword(s):

United States ◽

Inverse Correlation ◽

The United States ◽

Incidence Rates ◽

Ultraviolet B ◽

Uvb Radiation ◽

Climate Anomalies ◽

Temperature And Precipitation ◽

The Us ◽

Rising Incidence

Legionellosis is an infection acquired through inhalation of aerosols that are contaminated with environmental bacteria Legionella spp. The bacteria require warm temperature for proliferation in bodies of water and moist soil. The legionellosis incidence in the United States has been rising rapidly in the past two decades without a clear explanation. In the meantime, the US has recorded consecutive years of above-norm temperature since 1997 and precipitation surplus since 2008. The present study analyzed the legionellosis incidence in the US during the 20-year period of 1999 to 2018 and correlated with concurrent temperature, precipitation, solar ultraviolet B (UVB) radiation, and vehicle mileage data. The age-adjusted legionellosis incidence rates rose exponentially from 0.40/100,000 in 1999 (with 1108 cases) to 2.69/100,000 in 2018 (with 9933 cases) at a calculated annual increase of 110%. In regression analyses, the rise correlated with an increase in vehicle miles driven and with temperature and precipitation levels that have been above the 1901–2000 mean since 1997 and 2008, respectively, suggesting more road exposure to traffic-generated aerosols and promotive effects of anomalous climate. Remarkably, the regressions with cumulative anomalies of temperature and precipitation were robust (R2 ≥ 0.9145, P ≤ 4.7E-11), implying possible changes to microbial ecology in the terrestrial and aquatic environments. An interactive synergy between annual precipitation and vehicle miles was also found in multiple regressions. Meanwhile, the bactericidal UVB radiation has been decreasing, which also contributed to the rising incidence in an inverse correlation. The 2018 legionellosis incidence peak corresponded to cumulative effects of the climate anomalies, vast vehicle miles (3,240 billion miles, 15904 km per capita), record high precipitation (880.1 mm), near record low UVB radiation (7488 kJ/m2), and continued above-norm temperature (11.96°C). These effects were examined and demonstrated in California, Florida, New Jersey, Ohio, and Wisconsin, states that represent diverse incidence rates and climates. The incidence and above-norm temperature both rose most in cold Wisconsin. These results suggest that warming temperature and precipitation surplus have likely elevated the density of Legionella bacteria in the environment, and together with road exposure explain the rapidly rising incidence of legionellosis in the United States. These trends are expected to continue, warranting further research and efforts to prevent infection.

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