Publications by authors named "Curns A"

Article Synopsis
  • Rotavirus was a major cause of gastroenteritis in US children until the introduction of vaccines in 2006, which led to significant reductions in severe cases.
  • A study from 2009 to 2022 analyzed vaccine effectiveness (VE) using data from children with acute gastroenteritis, revealing a 78% effectiveness rate against severe rotavirus-related medical visits.
  • The effectiveness varied by severity of disease, showing 94% effectiveness against very severe cases, with younger children benefiting the most from vaccination.
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Background: The coronavirus disease 2019 pandemic disrupted respiratory syncytial virus (RSV) seasonality resulting in early, atypical RSV seasons in 2021 and 2022, with an intense 2022 peak overwhelming many pediatric healthcare facilities.

Methods: We conducted prospective surveillance for acute respiratory illness during 2016-2022 at 7 pediatric hospitals. We interviewed parents, reviewed medical records, and tested respiratory specimens for RSV and other respiratory viruses.

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Background: Most U.S. acute gastroenteritis (AGE) episodes in children are attributed to norovirus, whereas very little information is available on adenovirus 40/41 (AdV40/41), astrovirus or sapovirus.

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Background: Respiratory syncytial virus (RSV) is the leading cause of hospitalization in US infants. Accurate estimates of severe RSV disease inform policy decisions for RSV prevention.

Methods: We conducted prospective surveillance for children <5 years old with acute respiratory illness from 2016 to 2020 at 7 pediatric hospitals.

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Article Synopsis
  • The 2016-17 mumps outbreak in Arkansas led to the evaluation of a third dose of the MMR vaccine (MMR3) among school children, as it was the largest outbreak since 2006.
  • A study using a generalized linear mixed effects model assessed the vaccine effectiveness (VE) of MMR3 compared to two doses of MMR, gathering data from school registries and immunization records.
  • Results showed that MMR3 had a 52.7% incremental VE overall, with a higher effectiveness of 64.0% in schools experiencing high mumps transmission, indicating that the third dose offers additional protection during outbreaks.
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To describe the impact of the US varicella vaccination program on severe varicella outcomes, we analyzed varicella hospitalizations using the National Inpatient Sample 1993-2019 and varicella deaths using the National Center for Health Statistics data 1990-2019. Over 25 years of vaccination program (1995-2019), varicella hospitalizations, and deaths declined 94% and 97%, respectively, among persons aged <50 years. Most of the decline (∼90%) occurred during the 1-dose period (through 2006/2007) by attaining and maintaining high vaccination coverage; additional declines occurred during the 2-dose period, especially in the age groups covered by the 2-dose recommendation.

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The New Vaccine Surveillance Network (NVSN) is a prospective, active, population-based surveillance platform that enrolls children with acute respiratory illnesses (ARIs) at seven pediatric medical centers. ARIs are caused by respiratory viruses including influenza virus, respiratory syncytial virus (RSV), human metapneumovirus (HMPV), human parainfluenza viruses (HPIVs), and most recently SARS-CoV-2 (the virus that causes COVID-19), which result in morbidity among infants and young children (1-6). NVSN estimates the incidence of pathogen-specific pediatric ARIs and collects clinical data (e.

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For the 15 years before rotavirus vaccine introduction in 2006, annual rotavirus activity in the United States showed a distinct spatiotemporal pattern, peaking first in the Southwest and last in the Northeast. We modeled spatiotemporal trends in rotavirus laboratory detections from 2009 to 2021. Laboratories reporting to the National Respiratory and Enteric Virus Surveillance System were eligible for inclusion in a given surveillance year (July to June) if ≥1 polymerase chain reaction or enzyme immunoassay rotavirus test per week was reported during ≥26 weeks and totaling ≥100 annual tests.

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As of March 2021, three COVID-19 vaccines had been authorized by the U.S. Food and Drug Administration (FDA) for use in the United States.

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Importance: Multisystem inflammatory syndrome in children (MIS-C) is associated with recent or current SARS-CoV-2 infection. Information on MIS-C incidence is limited.

Objective: To estimate population-based MIS-C incidence per 1 000 000 person-months and to estimate MIS-C incidence per 1 000 000 SARS-CoV-2 infections in persons younger than 21 years.

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Background: Following the introduction of rotavirus immunization in 2006 in the United States, there were substantial declines in the domestic rotavirus disease burden. In this study, we assess the value for money achieved by the program in the decade following vaccine introduction.

Methods: We applied an age-specific, static, multicohort compartmental model to examine the impact and cost-effectiveness of the US rotavirus immunization program in children <5 years of age using healthcare utilization data from 2001 to 2015 inclusive.

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Objectives: Nonpharmaceutical interventions against coronavirus disease 2019 likely have a role in decreasing viral acute respiratory illnesses (ARIs). We aimed to assess the frequency of respiratory syncytial virus (RSV) and influenza ARIs before and during the coronavirus disease 2019 pandemic.

Methods: This study was a prospective, multicenter, population-based ARI surveillance, including children seen in the emergency departments and inpatient settings in 7 US cities for ARI.

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Article Synopsis
  • - The report examines the demographic, clinical, and epidemiologic features of 544 individuals in the U.S. who were suspected of having COVID-19 during its early stages from January 17 to February 29, 2020, highlighting how the pandemic quickly evolved.
  • - The CDC consulted with public health officials to conduct testing, and out of the 544 persons under investigation (PUI), 36 tested positive for SARS-CoV-2, with notable differences in travel history before and after February 12, 2020.
  • - The findings emphasize the importance of preparedness for future pandemics, specifically the need for rapid testing and broad surveillance strategies to track community transmission, including cases that may not show symptoms. *
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Background: A third measles-mumps-rubella vaccine (MMR) dose (MMR3) is recommended in the United States for persons at increased risk for mumps during outbreaks. MMR3 is also likely given to persons who might have received 2 doses of MMR but lack documentation. Since MMR3 safety data are limited, we describe adverse events in persons receiving MMR3 in a nonoutbreak setting.

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Article Synopsis
  • Previous reports on COVID-19 cases in children were primarily based on health jurisdiction records.
  • A study was conducted from January to March 2020, testing 3,187 children for SARS-CoV-2 as part of ongoing surveillance.
  • Only 4 children (0.1%) tested positive for the virus from March 20-31, even though community transmission was increasing.
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Background: Respiratory syncytial virus (RSV) is a major cause of hospitalized acute respiratory illness (ARI) among young children. With RSV vaccines and immunoprophylaxis agents in clinical development, we sought to update estimates of US pediatric RSV hospitalization burden.

Methods: Children <5 years old hospitalized for ARI were enrolled through active, prospective, population-based surveillance from November 1, 2015, to June 30, 2016, at 7 US pediatric hospital sites.

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Article Synopsis
  • The study estimates the annual burden of norovirus in the U.S., highlighting its significant role in causing acute gastroenteritis (AGE), with substantial healthcare implications.
  • An analysis of healthcare data from 2001 to 2015 revealed approximately 900 deaths, 109,000 hospitalizations, 465,000 emergency department visits, and 2.3 million clinic encounters related to norovirus each year.
  • The estimated healthcare costs associated with norovirus range from $430 million to $740 million annually, indicating that developing an effective vaccine could greatly benefit public health.
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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.

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Importance: Rotavirus vaccines have been recommended for universal US infant immunization for more than 10 years, and understanding their effectiveness is key to the continued success of the US rotavirus vaccine immunization program.

Objective: To assess the association of RotaTeq (RV5) and Rotarix (RV1) with inpatient and emergency department (ED) visits for rotavirus infection.

Design, Setting, And Participants: This case-control vaccine effectiveness study was performed at inpatient and ED clinical settings in 7 US pediatric medical institutions from November 1, 2009, through June 30, 2016.

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Before the introduction of rotavirus vaccine in the United States in 2006, rotavirus infection was the leading cause of severe gastroenteritis among U.S. children (1).

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In the fall of 2014, an outbreak of enterovirus D68 (EV-D68)-associated acute respiratory illness (ARI) occurred in the United States (1,2); before 2014, EV-D68 was rarely reported to CDC (2,3). In the United States, reported EV-D68 detections typically peak during late summer and early fall (3). EV-D68 epidemiology is not fully understood because testing in clinical settings seldom has been available and detections are not notifiable to CDC.

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Diarrheal disease morbidity decreased after the 2006 US introduction of rotavirus vaccine. We calculated diarrheal death rates for children who were <5 years of age during 2005-2016. Death rates declined from 2.

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Background: The effectiveness of rotavirus vaccines in low and very low birth weight infants (LBW and VLBW) weighing <2500 and <1500 g at birth, respectively, a high-risk population for severe rotavirus gastroenteritis, has not been well examined.

Methods: We analyzed inpatient commercial claims data for US children <5 years of age from July 2001 to June 2015. Claims for acute gastroenteritis (AGE) and rotavirus-coded hospitalizations and LBW, VLBW and normal birth weight (NBW) infants were identified.

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We compared acute gastroenteritis (AGE)-related hospitalization rates among children <5 years of age during the pre-rotavirus vaccine (2000-2006) and post-rotavirus vaccine (2008-2013) periods to estimate national reductions in AGE-related hospitalizations and associated costs. We estimate that between 2008 and 2013, AGE-related hospitalizations declined by 382000, and $1.228 billion in medical costs were averted.

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