scholarly journals 667. An Emerging Tick-Borne Disease in Long Island, New York: Relapsing Fever Caused by Borrelia miyamotoi

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S241-S241
Author(s):  
Luis Marcos ◽  
Kalie Smith ◽  
Fredric Weinbaum ◽  
Eric Spitzer
Keyword(s):  
New York ◽  
Medical Center ◽  
Long Island ◽  
Suffolk County ◽  
University Hospital ◽  
Borrelia Miyamotoi ◽  
Relapsing Fever ◽  
Igg Antibody ◽  
Tick Borne Disease ◽  
East End

Abstract Background Suffolk County (Long Island, New York) reports annually the highest absolute number of tick-borne diseases in New York. A new Borrelia species, Borrelia miyamotoi which causes a relapsing fever, has been reported in New York recently. The aim of this study was to identify the number of cases of B. miyamotoi diagnosed in Suffolk county. Methods A retrospective chart review was performed in Stony Brook (SB) Medicine hospitals, SB University Hospital (the only tertiary medical center in Suffolk County) and Southampton Hospital (a major hospital in the east end of Suffolk County). Laboratory records were queried for a positive B. miyamotoi PCR test from blood or a positive IgG antibody with a B. miyamotoi-specific EIA that utilizes a recombinant GlpQ antigen (both tests performed in a commercial laboratory). Results Twenty-eight cases were positive for serology (IgG EIA; n = 19) or PCR (n = 9). None of the IgG-positive cases had a positive PCR result indicating that individuals were likely exposed to B. miyamotoi in the past. Of the nine PCR-positive cases (median age:67 years), eight were men, three were diagnosed in the outpatient clinic (33.3%) and six were diagnosed through the emergency department and required hospitalization (66.6%). Thrombocytopenia and transaminitis were common findings. Two-thirds of these nine cases were diagnosed in the period of 2016–2017 and one-third in the period, 2013–2015 (P = 0.17). Conclusion An increasing number of cases of B. miyamotoi were observed in Suffolk County during 2013–2017 and two-thirds required hospitalization. The real burden of this tick borne disease in Suffolk County and the rest of the state is unknown. Disclosures All authors: No reported disclosures.

scholarly journals 527. Corona Virus Disease-19 (COVID-19) in a Veterans Affairs Hospital at Suffolk County, Long Island, New York

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S330-S331
Author(s):  
George Psevdos ◽  
Aikaterini Papamanoli ◽  
Zeena Lobo
Keyword(s):  
New York ◽  
Virus Disease ◽  
Medical Center ◽  
Long Island ◽  
Demographic Data ◽  
Laboratory Data ◽  
Veterans Affairs ◽  
Suffolk County ◽  
Beta Lactam ◽  
Igg Antibody

Abstract Background The area of New York was hit hard by the COVID 19 pandemic with Suffolk county in Long Island numbering >40 thousand cases and 1900 deaths by the end of May 2020. The Veterans Affairs Medical Center (VAMC) at Northport NY serves over 30000 Veterans. We report our institution’s experience during the COVID 19 outbreak Methods Retrospective chart review of hospitalized Veterans (VETS) with COVID-19 from March 1st to May 31st 2020 at Northport VAMC Results A total of 141 VETS had laboratory confirmed SARS-CoV-2 infection, 67 got hospitalized, and 20/67 died. The median age of the hospitalized cohort was 73 years (33 to 94). Figure 1 shows the dates of tests, Tables 1 &2 summarize the demographic characteristics, medical history and laboratory findings. No co-infection with influenza or other respiratory viruses were identified. The deceased group was older 77.5 vs 71 years P 0.007, had lower oxygen saturation and higher respiratory rate on presentation, had longer length of stay P 0.091, more likely to be in ICU and intubated, had lower bicarbonate levels, higher SAPS P < 0.001, higher lactate dehydrogenase, blood urea nitrogen, potassium levels, and higher peak procalcitonin, CRP, ferritin, ESR levels. There was no difference between recovered and deceased in terms of comorbidities except atrial fibrillation. Also, no difference in use of ACE inhibitors, statins, famotidine, hydroxychloroquine (HCQ), azithromycin, doxycycline, steroids. Beta lactam antibiotics and tocilizumab were given more in the deceased group. HCQ was stopped in 1 patient due to QTc prolongation. No bacteremia identified in the recovered group contrary to two occasions in the deceased, E. faecalis and S. mitis. Six pneumonias in intubated deceased patients were identified (3 had received steroids and one tocilizumab) and 4 in recovered (2 intubated/steroids and 1 tocilizumab). 12 recovered patients had persistent positive nasopharyngeal PCR for SARS-CoV-2 for average 29 days (14 to 79 days), and 4 of them were checked and had detectable IgG antibody Dates of Tests for Hospitalized Veterans with COVID-19 Comparison of Demographic Data and Comorbidities in Recovered vs Diseased Hospitalized Veterans with COVID - 19 Comparison of Laboratory Data in Recovered vs Diseased Hospitalized Veterans with COVID - 19 Conclusion The inpatient mortality of hospitalized VETS with COVID-19 in our institution was 30%. Mortality was associated with older age. Ongoing monitoring of outcomes in hospitalized patients will be important to understand the evolving epidemiology of COVID-19 among US VETS. Disclosures All Authors: No reported disclosures

scholarly journals The Burden of Neurocysticercosis at a Single New York Hospital

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Amy Spallone ◽  
Luboslav Woroch ◽  
Keith Sweeney ◽  
Roberta Seidman ◽  
Luis A. Marcos
Keyword(s):  
United States ◽  
New York ◽  
Medical Center ◽  
Long Island ◽  
Taenia Solium ◽  
The United States ◽  
University Hospital ◽  
Predominantly Hispanic ◽  
Icd 10 ◽  
Risk Patients

Neurocysticercosis (NCC), a disease caused by the larval pork tapeworm Taenia solium, has emerged as an important infection in the United States. In this study, we describe the spectrum of NCC infection in eastern Long Island, where there is a growing population of immigrants from endemic countries. A retrospective study was designed to identify patients diagnosed with NCC using ICD-9 and ICD-10 codes in the electronic medical records at Stony Brook University Hospital between 2005 and 2016. We identified 52 patients (56% male, median age: 35 years) diagnosed with NCC in the only tertiary medical center in Suffolk County. Twenty-five cases were reported in the last three years of the study. Forty-eight (94%) patients self-identified as Hispanic or Latino in the electronic medical record. Twenty-two (44%) and 28 (56%) patients had parenchymal and extraparenchymal lesions, respectively. Nineteen (41.3%) patients presented with seizures to the emergency department. Six patients (11.7%) had hydrocephalus, and five of them required frequent hospitalizations and neurosurgical interventions, including permanent ventriculoperitoneal shunts or temporary external ventricular drains. No deaths were reported. The minimum accumulated estimated cost of NCC hospitalizations during the study period for all patients was approximately 1.4 million United States dollars (USD). In conclusion, NCC predominantly affects young, Hispanic immigrants in Eastern Long Island, particularly in zip codes correlating to predominantly Hispanic communities. The number of cases diagnosed increased at an alarming rate during the study period. Our study suggests a growing need for screening high-risk patients and connecting patients to care in hopes of providing early intervention and treatment to avoid potentially detrimental neurological sequelae.

NEWS AND ANNOUNCEMENTS

PEDIATRICS ◽  
1971 ◽  
Vol 48 (6) ◽  
pp. 1004-1005
Keyword(s):  
New York ◽  
General Practice ◽  
American Academy ◽  
Medical Center ◽  
Long Island ◽  
Nassau County ◽  
Lecture Series ◽  
Complete Program ◽  
Recreation Activities

Nassau County (N.Y.) Pediatric Postgraduate Lecture Series 1971-1972: Weekly lectures are sponsored by the Nassau County Medical Center for practicing pediatricians on Long Island each Thursday at 11:30 A.M. in the Recreation Activities Building on the Medical Center Grounds. American Academy of General Practice credit has been applied for; there is no registration fee. Further information and a complete program are available from P. J. Collipp, M.D., Department of Pediatrics, Nassau County Medical Center, 2201 Hempstead Turnpike, East Meadow, L.I., New York 11554.

scholarly journals Epidemiology of Neurocysticercosis at Stony Brook University Hospital, Long Island, New York

2016 ◽  
Vol 3 (suppl_1) ◽  
Author(s):  
Amy Spallone ◽  
Robert Chow ◽  
Luis A. Marcos
Keyword(s):  
New York ◽  
Long Island ◽  
University Hospital

scholarly journals 665. Key Clinical and Laboratory Features in Early Diagnosis of Ehrlichiosis in an Endemic Area of Long Island, New York

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S240-S241
Author(s):  
Olga Kaplun ◽  
Kalie Smith ◽  
Teresa Khoo ◽  
Eric Spitzer ◽  
Fredric Weinbaum ◽  
...  
Keyword(s):  
New York ◽  
Clinical Presentation ◽  
Average Length ◽  
Kidney Injury ◽  
Length Of Hospital Stay ◽  
Retrospective Chart Review ◽  
Suffolk County ◽  
University Hospital ◽  
Laboratory Findings ◽  
Significant Difference

Abstract Background Human monocytic ehrlichiosis (HME) is a tick-borne disease caused by Ehrlichia chafeensis in the northeast United States. Suffolk County, New York has the highest amount of HME cases in NY (176 from 2010 to 2014). Our aim is to identify risk factors for HME and compare clinical presentation and laboratory findings of young vs. older adults. Methods A retrospective chart review from January 1, 2014 to December 31, 2017 was performed on all patients ≥18 years who presented to the ER at Stony Brook University Hospital (SBUH) or Stony Brook Southampton Hospital (SBSH) with (i) ICD-9 code 082.4 or ICD-10 code A77.40 and (ii) a positive E. Chafeensis PCR. Data were collected on demographics, clinical presentation, and laboratory results. Results Twenty-seven cases of HME were found and separated into Group 1 (G1, n = 10) or Group 2 (G2, n = 17) based on age (Table 1). G1 had a significantly higher chance of being Hispanic than G2. Twenty-four of the 27 patients (89%) were hospitalized with an average length of stay of 3.4 days (range 1–14 days).The only significant difference in clinical presentation was that G1 was more likely to have myalgia (P = 0.02). 40% or more of patients in both groups presented with an acute kidney injury and the average length of hospital stay in days was 4.0 ± 2.9 and 3.2 ± 3.1 for G1 and G2, respectively. The number of cases overall have increased 6.0% per year between 2014 and 2017. Thrombocytopenia presented in all cases. Conclusion. HME is prevalent in Suffolk County. Clinical presentation and laboratory findings were largely similar between the two groups, except the younger population more often presented with myalgia. A risk factor in this study was to be young and Hispanic, likely due to occupational exposure. Disclosures All authors: No reported disclosures.

scholarly journals Detection of Anaplasma phagocytophilum, Babesia microti, Borrelia burgdorferi, Borrelia miyamotoi, and Powassan Virus in Ticks by a Multiplex Real-Time Reverse Transcription-PCR Assay

mSphere ◽  
2017 ◽  
Vol 2 (2) ◽  
Author(s):  
Rafal Tokarz ◽  
Teresa Tagliafierro ◽  
D. Moses Cucura ◽  
Ilia Rochlin ◽  
Stephen Sameroff ◽  
...  
Keyword(s):  
High Frequency ◽  
Suffolk County ◽  
Babesia Microti ◽  
Borrelia Miyamotoi ◽  
Pcr Assay ◽  
Content Type ◽  
Powassan Virus ◽  
Pathogen Prevalence ◽  
Tick Borne Disease

ABSTRACT The understanding of pathogen prevalence is an important factor in the determination of human risks for tick-borne diseases and can help guide diagnosis and treatment. The implementation of our assay addresses a critical need in surveillance of tick-borne diseases, through generation of a comprehensive assessment of pathogen prevalence in I. scapularis. Our finding of a high frequency of ticks infected with Babesia microti in Suffolk County, NY, implicates this agent as a probable frequent cause of non-Lyme tick-borne disease in this area. Ixodes scapularis ticks are implicated in transmission of Anaplasma phagocytophilum, Borrelia burgdorferi, Borrelia miyamotoi, Babesia microti, and Powassan virus. We describe the establishment and implementation of the first multiplex real-time PCR assay with the capability to simultaneously detect and differentiate all five pathogens in a single reaction. The application of this assay for analysis of ticks at sites in New York and Connecticut revealed a high prevalence of B. microti in ticks from Suffolk County, NY. These findings are consistent with reports of a higher incidence of babesiosis from clinicians managing the care of patients with tick-borne diseases in this region. IMPORTANCE The understanding of pathogen prevalence is an important factor in the determination of human risks for tick-borne diseases and can help guide diagnosis and treatment. The implementation of our assay addresses a critical need in surveillance of tick-borne diseases, through generation of a comprehensive assessment of pathogen prevalence in I. scapularis. Our finding of a high frequency of ticks infected with Babesia microti in Suffolk County, NY, implicates this agent as a probable frequent cause of non-Lyme tick-borne disease in this area.

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