Publications by authors named "Adria Lee"

Observed peaks of acute flaccid myelitis (AFM) cases have occurred biennially since 2014 in the United States. We aimed to determine if AFM etiology differed between peak and nonpeak years, considering that clinical features of AFM differ by virus etiology. We compared clinical and laboratory characteristics of AFM cases that occurred during peak (2016 and 2018, n = 366) and nonpeak (2015 and 2017, n = 50) years.

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  • * The majority of cases (93%) were linked to the 22 outbreaks, with 89% occurring in unvaccinated individuals, highlighting the risk of outbreaks from international travelers to unvaccinated populations.
  • * Major outbreaks in Orthodox Jewish communities in New York accounted for 75% of cases, necessitating strong public health responses and ongoing collaboration to maintain high vaccination rates and prevent further transmission.
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  • Acute flaccid myelitis (AFM) is a neurological condition causing limb weakness, and significant cases were reported starting in 2014, prompting the CDC to begin standardized surveillance in the U.S. to understand its impact and causes.
  • During a study from 2015 to 2017, 305 pediatric patients showed symptoms of AFM, with the majority being confirmed cases; the demographic data indicated most were male, with an average age of 6 years, often following a respiratory or febrile illness.
  • Laboratory testing revealed viral connections, particularly with enteroviruses, highlighting the need for further research to fully understand AFM's causes and associated risks.*
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Background: Acute flaccid myelitis (AFM), a serious paralytic illness, was first recognized as a distinct condition in 2014, when cases were reported concurrent with a large U.S. outbreak of severe respiratory illness caused by enterovirus D-68 (EV-D68).

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  • As of April 2019, the U.S. saw 704 measles cases, the highest in a year since 1994, with 71% of those cases in unvaccinated individuals.
  • Measles is highly contagious and can lead to serious complications, with 9% of patients requiring hospitalization and 13 outbreaks accounting for 94% of cases, mostly in underimmunized communities.
  • There is a risk of renewed measles transmission due to increasing global cases and unvaccinated travelers, emphasizing the importance of vaccination and prompt reporting of suspected cases.
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Background: Although measles was declared eliminated from the United States in 2000, measles cases and outbreaks continue to occur, resulting from importations of the disease from countries where it remains endemic.

Methods: We describe the epidemiology of international importations of measles virus into the United States during the postelimination era.

Results: From 2001 to 2016, 553 imported measles cases were reported to the Centers for Disease Control and Prevention.

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In August 2018, CDC noted an increased number of reports of patients having symptoms clinically compatible with acute flaccid myelitis (AFM), a rare condition characterized by rapid onset of flaccid weakness in one or more limbs and spinal cord gray matter lesions, compared with August 2017. Since 2014, CDC has conducted surveillance for AFM using a standardized case definition (1,2). An Epi-X* notice was issued on August 23, 2018, to increase clinician awareness and provide guidance for case reporting.

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Introduction: The appropriate use of clinically accurate diagnostic tests is essential for the detection of pertussis, a poorly controlled vaccine-preventable disease. The purpose of this study was to estimate the sensitivity and specificity of different diagnostic criteria including culture, multi-target polymerase chain reaction (PCR), anti-pertussis toxin IgG (IgG-PT) serology, and the use of a clinical case definition. An additional objective was to describe the optimal timing of specimen collection for the various tests.

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  • The study investigates the link between HIV infection and meningococcal disease, assessing data from 2000 to 2008 across nine U.S. sites.
  • Out of reported cases, 33 individuals with HIV had meningococcal disease, making up 2.0% of all cases, predominantly affecting adult males aged 25-64.
  • Results showed a significantly higher incidence of meningococcal disease in HIV-infected individuals compared to those without HIV, highlighting the increased risk associated with AIDS.
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While PCR is the most common method used for detecting Bordetella pertussis in the United States, most laboratories use insertion sequence 481 (IS481), which is not specific for B. pertussis; therefore, the relative contribution of other Bordetella species is not understood. The objectives of this study were to evaluate the proportion of other Bordetella species misidentified as B.

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Background: A recent increase in Bordetella pertussis without the pertactin protein, an acellular vaccine immunogen, has been reported in the United States. Determining whether pertactin-deficient (PRN(-)) B. pertussis is evading vaccine-induced immunity or altering the severity of illness is needed.

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