scholarly journals COVID-19 infections following outdoor mass gatherings in low incidence areas: retrospective cohort study

2020 ◽  
Author(s):  
Oren Miron ◽  
Kun-Hsing Yu ◽  
Rachel Wilf-Miron ◽  
Nadav Davidovitch
Keyword(s):  
United States ◽  
Retrospective Cohort ◽  
Outcome Measure ◽  
Moving Average ◽  
The United States ◽  
Mass Gathering ◽  
Main Outcome Measure ◽  
Mass Gatherings ◽  
Low Incidence ◽  
Incidence Increase

AbstractObjectiveIndoor mass gatherings in counties with high COVID-19 incidence have been linked to infections. We examined if outdoor mass gatherings in counties with low COVID-19 incidence are also followed by infections.MethodsWe retrospectively examined COVID-19 incidence in 20 counties that held mass gathering rallies (19 outdoor and 1 indoor) in the United States in August-September 2020. They were compared to the rest of the United States counties. We utilized a 7-day moving average and compared the change on the gathering date and 15 days later, based on the 95% confidence interval. For control counties we used the median of the gathering dates.SettingThe United StatesPopulation8.4 million in the counties holding mass gatherings, and 324 Million in the rest of the counties in the United States.Main Outcome MeasureChange in COVID-19 incidence rate per 100,000 capita during the two weeks following mass gatherings.ResultsIn the two weeks following the gatherings, the COVID-19 incidence increased significantly in 14 of 20 counties. The county with the highest incidence increase (3.8-fold) had the 2nd lowest incidence before the gathering. The county with the highest decrease (0.4-fold) had the 3rd highest incidence before the gathering. At the gathering date, the average incidence of counties with gatherings was lower than the rest of the United States, and after the gathering, it increased 1.5-fold, while the rest of the United States increased 1.02-fold.ConclusionThese results suggest that even outdoor gatherings in areas with low COVID-19 incidence are followed by increased infections, and that further precautions should be taken at such gatherings.What is already known on the topicMass gatherings have been linked to COVID-19 infections, but it is less clear how much it happens outdoors, and in areas with low incidence.What this study addsCOVID-19 infections increased significantly in 14 of 20 counties that held mass gathering rallies in the United States, 19 of which were outdoors. The county with the highest incidence increase (3.8-fold) was outdoors and had a low incidence before the gathering. The average incidence of all 20 counties with gatherings was lower at the gathering day compared with the rest of the United State, and it increased 1.5-fold following the gatherings. Our findings suggest a need for precautions in mass gatherings, even when outdoors and in areas with a low incidence of COVID-19.

scholarly journals Chorioretinal lesions in mothers of children with congenital toxoplasmosis in the National Collaborative Chicago-based, Congenital Toxoplasmosis Study

2010 ◽  
Vol 20 (1) ◽  
pp. 20 ◽  
Author(s):  
A. Gwendolyn Noble ◽  
Paul Latkany ◽  
Jaroslaw Kusmierczyk ◽  
Marilyn Mets ◽  
Peter Rabiah ◽  
...  
Keyword(s):  
United States ◽  
Primary Care ◽  
Primary Care Physicians ◽  
Outcome Measure ◽  
Congenital Toxoplasmosis ◽  
The United States ◽  
Outpatient Setting ◽  
Ocular Toxoplasmosis ◽  
Main Outcome Measure ◽  
Toxoplasmic Chorioretinitis

AIMS: To determine whether mothers of children with congenital toxoplasmosis have chorioretinal lesions consistent with toxoplasmosis. METHODS: Ophthalmologists in our study have examined 173 children with congenital toxoplasmosis in a hospital outpatient setting. These children were referred to us by their primary care physicians. One hundred and thirty mothers of these children had retina examinations of both eyes at least once. Main outcome measure was lesion(s) consistent with ocular toxoplasmosis. RESULTS: Of 130 mothers examined between 1991-2005, 10 (7.7%, 95% Confidence Interval 3.8%, 13.7%) had chorioretinal lesions which likely represent resolved toxoplasmic chorioretinitis. Most of these were small peripheral chorioretinal lesions. None reactivated between 1991-2005. CONCLUSIONS: Chorioretinal lesions consistent with quiescent ocular toxoplasmosis occur in mothers of children with congenital toxoplasmosis in the United States.

scholarly journals COVID-19 Mortality Following Mass Gatherings

2020 ◽  
Author(s):  
Oren Miron ◽  
Kun-Hsing Yu ◽  
Rachel Wilf-Miron ◽  
Nadav Davidovitch
Keyword(s):  
United States ◽  
Fold Increase ◽  
The United States ◽  
Mass Gathering ◽  
Mass Gatherings

AbstractWe examined Coronavirus Disease-2019 (COVID-19) mortality following 5 mass gatherings at outdoor rallies in the United States, during August 2020. We found that COVID-19 mortality started increasing 19-24 days after the mass gathering. In a 50-mile radius there was a 2.1-fold increase in COVID-19 mortality, and in a 51-100 miles radius there was a 1.4-fold increase. Our results suggest that precautions should be taken in mass gatherings and in at least a 50-mile radius, in order to limit COVID-19 mortality.

scholarly journals Burden of non-alcoholic steatohepatitis among children with type 2 diabetes mellitus

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Lauren Parlett ◽  
Qinli Ma ◽  
Qian Shi ◽  
Geoffrey Crawford ◽  
Laura Herrera Scott ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
United States ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cohort Study ◽  
Retrospective Cohort ◽  
The United States ◽  
Alcoholic Steatohepatitis ◽  
Diabetic Children

AbstractThis claims-based retrospective cohort study examined the prevalence and incremental impact of non-alcoholic steatohepatitis among children with type 2 diabetes mellitus in the United States. Although diagnoses of non-alcoholic steatohepatitis were not common among diabetic children, it was associated with significantly higher incremental healthcare cost and risk of hospitalization.

Developing National Genotype-Independent Indicators for Recent Mycobacterium Tuberculosis Transmission Using Pediatric Cases—United States, 2011-2017

2021 ◽  
pp. 003335492098521
Author(s):  
Alexia V. Harrist ◽  
Clinton J. McDaniel ◽  
Jonathan M. Wortham ◽  
Sandy P. Althomsons
Keyword(s):  
United States ◽  
Mycobacterium Tuberculosis ◽  
Statistical Model ◽  
Moving Average ◽  
The United States ◽  
Tuberculosis Transmission ◽  
Average Proportion ◽  
Pediatric Tb ◽  
Case Rate ◽  
Pediatric Tuberculosis

Introduction Pediatric tuberculosis (TB) cases are sentinel events for Mycobacterium tuberculosis transmission in communities because children, by definition, must have been infected relatively recently. However, these events are not consistently identified by genotype-dependent surveillance alerting methods because many pediatric TB cases are not culture-positive, a prerequisite for genotyping. Methods We developed 3 potential indicators of ongoing TB transmission based on identifying counties in the United States with relatively high pediatric (aged <15 years) TB incidence: (1) a case proportion indicator: an above-average proportion of pediatric TB cases among all TB cases; (2) a case rate indicator: an above-average pediatric TB case rate; and (3) a statistical model indicator: a statistical model based on a significant increase in pediatric TB cases from the previous 8-quarter moving average. Results Of the 249 US counties reporting ≥2 pediatric TB cases during 2009-2017, 240 and 249 counties were identified by the case proportion and case rate indicators, respectively. The statistical model indicator identified 40 counties with a significant increase in the number of pediatric TB cases. We compared results from the 3 indicators with an independently generated list of 91 likely transmission events involving ≥2 pediatric cases (ie, known TB outbreaks or case clusters with reported epidemiologic links). All counties with likely transmission events involving multiple pediatric cases were identified by ≥1 indicator; 23 were identified by all 3 indicators. Practice Implications This retrospective analysis demonstrates the feasibility of using routine TB surveillance data to identify counties where ongoing TB transmission might be occurring, even in the absence of available genotyping data.

scholarly journals 1428. Lyme Disease Treatment in the United States: Prescribing Patterns from a Nationwide Commercial Insurance Database, 2016-2018

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S720-S720
Author(s):  
Amy M Beeson ◽  
Grace E Marx ◽  
Amy M Schwartz ◽  
Alison F Hinckley
Keyword(s):  
United States ◽  
Lyme Disease ◽  
Standard Treatment ◽  
Age Distribution ◽  
Public Health Problem ◽  
The United States ◽  
Adverse Outcomes ◽  
Prescribing Patterns ◽  
Antibiotic Prescribing ◽  
Low Incidence

Abstract Background Lyme disease (LD) is the most common vector-borne disease in the United States and is a significant public health problem. The use of non-standard antibiotic treatment regimens for LD has been associated with adverse effects; however, the overall landscape of treatment has not been described previously. We aimed to describe real-world antibiotic prescribing patterns for LD. Methods We performed a retrospective analysis of the MarketScan commercial claims database of outpatient encounters from 2016-2018 in the United States. We identified all individuals with a visit that included an LD diagnosis code and a prescription within 30 days of the visit for one or more of 12 antibiotics that may be prescribed for LD. We then categorized each individual as having received either standard or non-standard treatment during the two-year period. Standard treatment was defined as treatment with a first, second or third-line antibiotic for LD, for no longer than 30 days, and for no more than two episodes during the study period. Descriptive and multivariable analyses were performed to compare characteristics of people who received standard vs non-standard treatment for LD. Results A total of 84,769 prescriptions met criteria for inclusion, written for 45,926 unique patients. The mean duration of prescriptions was 21.4 days (SD 10.8). Most individuals (84.5%) treated for LD received standard treatment during the study period. Female gender (OR 1.5, p&lt; 0.0001) and age 19-45 (p=0.0003) were significantly associated with being prescribed non-standard LD treatment. Treatment in low-incidence states (OR 2.2 compared to high-incidence states, p&lt; 0.0001) and during non-summer months (OR 2.2, p&lt; 0.0001) was more likely to be non-standard. Age distribution of patients receiving treatment for Lyme disease, by gender and age at first prescription Seasonality of standard versus non-standard treatment of Lyme disease Conclusion In this population of employed, young, and insured patients, young and middle-aged women were at the highest risk of receiving non-standard LD treatment. Treatments prescribed in states with low incidence of LD or during non-summer months were also more likely to be non-standard, a trend which likely reflects misdiagnosis or overtreatment of LD. Future studies are needed to further define prescriber and patient factors associated with non-standard LD treatment and related adverse outcomes. Disclosures All Authors: No reported disclosures

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