Continued Evidence of the Impact of Rotavirus Vaccine in Children Less Than 3 Years of Age From the United States New Vaccine Surveillance Network: A Multisite Active Surveillance Program, 2006–2016

Author(s):  
Mary Allen Staat ◽  
Daniel C Payne ◽  
Natasha Halasa ◽  
Geoffrey A Weinberg ◽  
Stephanie Donauer ◽  
...  

Abstract Background Since 2006, the New Vaccine Surveillance Network has conducted active, population-based surveillance for acute gastroenteritis (AGE) hospitalizations and emergency department (ED) visits in 3 United States counties. Trends in the epidemiology and disease burden of rotavirus hospitalizations and ED visits were examined from 2006 to 2016. Methods Children < 3 years of age hospitalized or visiting the ED with AGE were enrolled from January 2006 through June 2016. Bulk stool specimens were collected and tested for rotavirus. Rotavirus-associated hospitalization and ED visit rates were calculated annually with 2006–2007 defined as the prevaccine period and 2008–2016 as the postvaccine period. Rotavirus genotype trends were compared over time. Results Over 11 seasons, 6954 children with AGE were enrolled and submitted a stool specimen (2187 hospitalized and 4767 in the ED). Comparing pre- and postvaccine periods, the proportion of children with rotavirus dramatically declined for hospitalization (49% vs 10%) and ED visits (49% vs 8%). In the postvaccine era, a biennial pattern of rotavirus rates was observed, with a trend toward an older median age. G1P[8] (63%) was the predominant genotype in the prevaccine period with a significantly lower proportion (7%) in the postvaccine period (P < .001). G2P[4] remained stable (8% to 14%) in both periods, whereas G3P[8] and G12P[8] increased in proportion from pre- to postvaccine periods (1% to 25% and 17% to 40%), respectively. Conclusions The epidemiology and disease burden of rotavirus has been altered by rotavirus vaccination with a biennial disease pattern, sustained low rates of rotavirus in children < 3 years of age, and a shift in the residual genotypes from G1P[8] to other genotypes.

2020 ◽  
Author(s):  
Brett R. Bayles ◽  
Michaela F George ◽  
Haylea Hannah ◽  
Patti Culross ◽  
Rochelle R. Ereman ◽  
...  

Background: The first shelter-in-place (SIP) order in the United States was issued across six counties in the San Francisco Bay Area to reduce the impact of COVID-19 on critical care resources. We sought to assess the impact of this large-scale intervention on emergency departments (ED) in Marin County, California. Methods: We conducted a retrospective descriptive and trend analysis of all ED visits in Marin County, California from January 1, 2018 to May 4, 2020 to quantify the temporal dynamics of ED utilization before and after the March 17, 2020 SIP order. Results: The average number of ED visits per day decreased by 52.3% following the SIP order compared to corresponding time periods in 2018 and 2019. Both respiratory and non-respiratory visits declined, but this negative trend was most pronounced for non-respiratory admissions. Conclusions: The first SIP order to be issued in the United States in response to COVID-19 was associated with a significant reduction in ED utilization in Marin County.


2021 ◽  
Vol 111 (3) ◽  
pp. 485-493
Author(s):  
Ashley Schappell D'Inverno ◽  
Nimi Idaikkadar ◽  
Debra Houry

Objectives. To report trends in sexual violence (SV) emergency department (ED) visits in the United States. Methods. We analyzed monthly changes in SV rates (per 100 000 ED visits) from January 2017 to December 2019 using Centers for Disease Control and Prevention’s National Syndromic Surveillance Program data. We stratified the data by sex and age groups. Results. There were 196 948 SV-related ED visits from January 2017 to December 2019. Females had higher rates of SV-related ED visits than males. Across the entire time period, females aged 50 to 59 years showed the highest increase (57.33%) in SV-related ED visits, when stratified by sex and age group. In all strata examined, SV-related ED visits displayed positive trends from January 2017 to December 2019; 10 out of the 24 observed positive trends were statistically significant increases. We also observed seasonal trends with spikes in SV-related ED visits during warmer months and declines during colder months, particularly in ages 0 to 9 years and 10 to 19 years. Conclusions. We identified several significant increases in SV-related ED visits from January 2017 to December 2019. Syndromic surveillance offers near-real-time surveillance of ED visits and can aid in the prevention of SV.


2000 ◽  
Vol 63 (6) ◽  
pp. 807-809 ◽  
Author(s):  
DAVID J. WALLACE ◽  
THOMAS VAN GILDER ◽  
SUE SHALLOW ◽  
TERRY FIORENTINO ◽  
SUZANNE D. SEGLER ◽  
...  

In 1997, the Foodborne Diseases Active Surveillance Program (FoodNet) conducted active surveillance for culture-confirmed cases of Campylobacter, Escherichia coli O157, Listeria, Salmonella, Shigella, Vibrio, Yersinia, Cyclospora, and Cryptosporidium in five Emerging Infections Program sites. FoodNet is a collaborative effort of the Centers for Disease Control and Prevention's National Center for Infectious Diseases, the United States Department of Agriculture's Food Safety and Inspection Service, the Food and Drug Administration's Center for Food Safety and Applied Nutrition, and state health departments in California, Connecticut, Georgia, Minnesota, and Oregon. The population under active surveillance for food-borne infections was approximately 16.1 million persons or roughly 6% of the United States Population. Through weekly or monthly contact with all clinical laboratories in these sites, 8,576 total isolations were recorded: 2,205 cases of salmonellosis, 1,273 cases of shigellosis, 468 cases of cryptosporidiosis, 340 of E. coli O157:H7 infections, 139 of yersiniosis, 77 of listeriosis, 51 of Vibrio infections, and 49 of cyclosporiasis. Results from 1997 demonstrate that while there are regional and seasonal differences in reported incidence rates of certain bacterial and parasitic diseases, and that some pathogens showed a change in incidence from 1996, the overall incidence of illness caused by pathogens under surveillance was stable. More data over more years are needed to assess if observed variations in incidence reflect yearly fluctuations or true changes in the burden of foodborne illness.


PLoS ONE ◽  
2015 ◽  
Vol 10 (3) ◽  
pp. e0118369 ◽  
Author(s):  
Carrie Reed ◽  
Sandra S. Chaves ◽  
Pam Daily Kirley ◽  
Ruth Emerson ◽  
Deborah Aragon ◽  
...  

2011 ◽  
Vol 185 (4S) ◽  
Author(s):  
Max Kates ◽  
Gina Badalato ◽  
Olga Yeshchina ◽  
Neda Sadeghi ◽  
James McKiernan

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18111-e18111
Author(s):  
Oladimeji Akinboro ◽  
Odunayo Olorunfemi ◽  
Daniel Pomerantz ◽  
Stephen Jesmajian ◽  
Gbolahan Ogunbayo ◽  
...  

e18111 Background: Metastatic cancer accounts for 90% of cancer deaths. However, the impact of metastatic cancer on hospitalization patterns and in-hospital mortality is unknown. We sought to examine trends in hospitalizations and mortality among adults with metastatic cancers in the United States. Methods: We obtained data from the National Inpatient Sample for hospitalized adults, aged ≥18 years, with metastatic cancer listed as a discharge diagnosis from 2004 to 2013. We estimated and trended the following: i) proportion of hospitalized adults with metastatic cancers; ii) leading causes of hospitalization for adults with metastatic cancer; and iii) in-hospital mortality among adults with metastatic cancer. Independent associations of in-hospital mortality with age, gender, race/ethnicity, payment source, and hospital type were examined with multivariable logistic regression. Survey weights were applied in estimating the population-based rates, odds ratios, and confidence intervals (CI). Results: 3.0% (95% CI 2.9-3.1%) and 3.2% (95% CI 3.0-3.3%) of hospitalized adults had metastatic cancers in 2004 and 2013, respectively ( P for trend 0.07). The leading causes of hospitalization from 2004 to 2013 were: maintenance chemotherapy/radiotherapy – 3.5% (95% CI 3.2-3.8%); pneumonia – 3.2% (95% CI 3.1-3.3%); complications of surgery, medical care, devices, and implants – 2.8% (95% CI 2.8-2.9%); fluid/electrolyte abnormalities – 2.4% (95% CI 2.4-2.5%); and heart failure/pulmonary circulation diseases – 2.2% (95% CI 2.1-2.2%). In-hospital mortality for patients with metastatic cancer declined from 10.3% (95% CI 9.9-10.7%) in 2004 to 8.1% (95% CI 7.8-8.3%) in 2013 ( P for trend < 0.01). Higher odds of in-hospital mortality were consistently seen each year with increasing age, non-Hispanic blacks, self-payment, and admissions at hospitals other than urban teaching hospitals. Conclusions: The relative hospitalization rates for adults with metastatic cancer remain stable. Significant declines in in-hospital mortality for these patients are noted but disparities are seen for certain groups. The economic burden and policy implications of these findings for end-of-life care warrant further investigation.


2017 ◽  
Vol 29 (5) ◽  
pp. 453-460 ◽  
Author(s):  
Abdel AM Shaheen ◽  
Ranjani Somayaji ◽  
Robert Myers ◽  
Christopher H Mody

Cryptococcal disease, caused by Cryptococcus neoformans and Cryptococcus gattii, is associated with significant morbidity and mortality but limited data exist on its incidence and impact. A study utilizing the Nationwide Inpatient Sample from 2000 to 2007 to examine the epidemiology and impact of cryptococcal disease in the United States was undertaken. The International Classification of Diseases 9th Version code was used to identify hospital discharges with diagnosis of Cryptococcus (117.5). Our primary outcome was the incidence rate of cryptococcal admissions. The impact of AIDS, age, and sex on hospitalization rates, mortality, and costs was assessed. The results showed that a total of 10,077 hospitalizations for cryptococcosis occurred corresponding to a weighted estimate of 49,010 cases. The median age was 43 years (interquartile range 34–54), and 26% were female. Approximately 64% of cases occurred in persons with AIDS. Although rates declined overall, age-adjusted rates were significantly higher in males with AIDS than in uninfected persons (p < 0.001). The mortality rate decreased but was greater in HIV-uninfected versus infected cohorts (12% versus 10%, p < 0.001). Conversely, hospital costs were greater in persons with AIDS ($40,671 versus $40,096, p=0.02). Although cryptococcal disease rates are decreasing over time, the associated mortality and costs remain concerning.


BMJ ◽  
2018 ◽  
pp. k4372 ◽  
Author(s):  
Yash S Khandwala ◽  
Valerie L Baker ◽  
Gary M Shaw ◽  
David K Stevenson ◽  
Ying Lu ◽  
...  

AbstractObjectiveTo evaluate the impact of advanced paternal age on maternal and perinatal outcomes in the United States.DesignRetrospective, population based cohort study.SettingUS.Population40 529 905 documented live births between 2007 and 2016.Main outcome measuresPrimary perinatal outcomes were gestational age, birth weight, Apgar score at five minutes, admission to a neonatal intensive care unit, need for postpartum antibiotics, and seizures. Primary maternal outcomes were gestational diabetes and pre-eclampsia. Secondary outcome was the number of preventable perinatal events.ResultsHigher paternal age was associated with an increased risk of premature birth, low birth weight, and low Apgar score. After adjustment for maternal age, infants born to fathers aged 45 years or older had 14% higher odds of premature birth (odds ratio 1.14, 95% confidence interval 1.13 to 1.15), independent of gestational age, and 18% higher odds of seizures (1.18, 0.97 to 1.44) compared with infants of fathers aged 25 to 34 years. The odds of gestational diabetes was 34% higher (1.34, 1.29 to 1.38) in mothers with the oldest partners. 13.2% (95% confidence interval 12.5% to 13.9%) of premature births and 18.2% (17.5% to 18.9%) of gestational diabetes in births associated with older fathers were estimated to be attributable to advanced paternal age.ConclusionsAdvanced paternal age is associated with negative effects on both mothers and offspring. Given the relatively low prevalence of advanced paternal age in the US, population level impacts are currently modest. Nevertheless, as advanced paternal age has doubled in the US over the past generation, further investigation is warranted of the impact on birth outcomes and public health.


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