Publications by authors named "Laura A S Quilter"
We analyzed syphilis case notifications in reproductive age women during 2013-2022. Late/unknown duration syphilis grew faster after 2020 (45.8% versus 17.
View Article and Find Full Text PDFRisk of Clade II Mpox Associated with Intimate and Nonintimate Close Contact Among Men Who Have Sex with Men and Transgender Adults - United States, August 2022-July 2023.
MMWR Morb Mortal Wkly Rep
October 2024
Article Synopsis
- A global outbreak of clade II mpox has been primarily affecting gay, bisexual, and other men who have sex with men (MSM) since May 2022, with limited understanding of transmission routes.
- A study analyzed 457 case-patients and 1,030 control patients (aged 18-49) to estimate the odds of mpox transmission based on different types of close contact; results showed that those engaging in condomless receptive anal sex had a 5.4 times higher odds of contracting mpox.
- Despite the effectiveness of the mpox vaccine, vaccination rates are low, highlighting the need for a comprehensive prevention strategy that includes vaccination promotion and safer sex practices.
Article Synopsis
- STIs are on the rise in the U.S., with over 2.5 million cases of gonorrhea, chlamydia, and syphilis reported in 2022, posing serious health risks for untreated women, including infertility and pregnancy complications.
- Staying updated on STI guidelines is challenging due to frequent changes; new recommendations emphasize syphilis screening for high-risk populations, including three screenings during pregnancy regardless of risk.
- The article discusses updates on extragenital screening for gonorrhea and chlamydia, treatment guidelines for several STIs, and addresses challenges in diagnosing genital herpes and mpox in women, especially during pregnancy.
Article Synopsis
- In May 2023, an increase in mpox cases was observed in Chicago, primarily among fully vaccinated individuals, prompting an investigation into the outbreak's characteristics and causes.
- Researchers assessed demographic and health data from patients, analyzed viral genomes, and evaluated the humoral antibody responses to understand vaccine effectiveness and potential compromises.
- Of the 49 identified cases, 57% were fully vaccinated, with findings suggesting that increased exposure through higher median numbers of sexual partners was a key factor in the outbreak, despite overall vaccine effectiveness.
Article Synopsis
- - A case of tinea genitalis was reported in an immunocompetent woman in Pennsylvania, caused by Trichophyton indotineae, likely from sexual contact.
- - The infection showed resistance to terbinafine, the standard antifungal treatment, but responded positively to itraconazole.
- - It's important for healthcare providers to recognize T. indotineae as a possible cause of antifungal-resistant genital infections.
Gonorrhea rates continue to rise in the United States and Neisseria gonorrhoeae's propensity to develop resistance to all therapies used for treatment has complicated the management of gonorrhea. Ceftriaxone is the only remaining highly effective recommended regimen for gonococcal treatment and few new anti-gonococcal antimicrobials are being developed. The 2021 CDC STI Treatment Guidelines increased the dose of ceftriaxone to 500 mg (1 g if ≥ 150 kg) for uncomplicated infections.
View Article and Find Full Text PDFBackground: During the 2022 mpox outbreak, most cases were associated with sexual contact, and many people with mpox sought care from sexual health clinics and programs. The National Network of STD Clinical Prevention Training Centers, in partnership with the Centers for Disease Control and Prevention, conducted a survey of US sexual health clinics and programs to assess knowledge, practices, and experiences around mpox to inform a future public health response.
Methods: Between August 31 and September 13, 2022, the National Network of STD Clinical Prevention Training Centers facilitated a web-based survey.
Article Synopsis
- Orthopoxviruses, including the monkeypox virus (MPXV), have shown unpredictable patterns of illness and spread, first noted in the late 1950s among primates and later causing human cases in Africa since the 1970s.
- In May 2022, a new MPXV outbreak emerged notably among gay, bisexual, and other men who have sex with men, marking a shift in transmission dynamics.
- The article discusses prior knowledge of mpox, insights gained during the 2022 outbreak, and the ongoing research needed to enhance global health measures against this virus.
Article Synopsis
- * The CDC conducted simulations to determine how the levels of immunity among MSM (from vaccination or past infections) can influence the risk and potential size of future mpox outbreaks.
- * Jurisdictions with higher immunity (50%-100%) face minimal risk of recurrence, while those with lower immunity (below 25%) are more likely to experience larger outbreaks, highlighting the importance of ongoing access to mpox vaccinations.
Monkeypox (mpox) is a serious viral zoonosis endemic in west and central Africa. An unprecedented global outbreak was first detected in May 2022. CDC activated its emergency outbreak response on May 23, 2022, and the outbreak was declared a Public Health Emergency of International Concern on July 23, 2022, by the World Health Organization (WHO),* and a U.
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- Chancroid, a sexually transmitted infection, has been reportable in the U.S. since 1944, but since 2011, fewer than 20 cases have been reported annually, raising questions about the effectiveness of national surveillance.
- A recent study assessed the quality and usefulness of the National Notifiable Diseases Surveillance System for chancroid, finding low data quality and sensitivity due to limited diagnostic testing and clinician awareness.
- The findings suggest that the current surveillance system is inadequate for monitoring trends in chancroid cases, prompting a reevaluation of its status as a notifiable condition and the need for alternative monitoring strategies.
In a Policy Forum piece, Dr. Nicola Low and colleagues define the research agenda for Mpox virus and transmission through sexual contact.
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- Early in the pandemic, cruise travel led to increased spread of COVID-19, particularly from Nile River cruises in Egypt, with 149 confirmed cases reported across various US states after travelers returned.
- Among those affected, there was a notable impact with 4.7% mortality and 28.1% hospitalization rates, and most transmission events traced back to Wisconsin.
- Phylogenetic analysis indicated that travelers were likely infected in Egypt, emphasizing the heightened risk of SARS-CoV-2 exposure associated with river cruises.
Background: Syphilis can cause neurologic, ocular, or otic manifestations, possibly resulting in permanent disability or death. In 2018, the Centers for Disease Control and Prevention began collecting syphilis clinical manifestation data via the National Notifiable Diseases Surveillance System. We present the first reported US syphilis neurologic, ocular, and otic manifestation prevalence estimates.
View Article and Find Full Text PDFBackground: We investigated differences in gonococcal antimicrobial susceptibility by anatomic site among cisgender men who have sex with men (MSM) using specimens collected through the Centers for Disease Control and Prevention's enhanced Gonococcal Isolate Surveillance Project and Strengthening the US Response to Resistant Gonorrhea.
Methods: During the period January 1, 2018-December 31, 2019, 12 enhanced Gonococcal Isolate Surveillance Project and 8 Strengthening the US Response to Resistant Gonorrhea sites collected urogenital, pharyngeal, and rectal isolates from cisgender MSM in sexually transmitted disease clinics. Gonococcal isolates were sent to regional laboratories for antimicrobial susceptibility testing by agar dilution.
Background: Cruise travel contributed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission when there were relatively few cases in the United States. By 14 March 2020, the Centers for Disease Control and Prevention (CDC) issued a No Sail Order suspending US cruise operations; the last US passenger ship docked on 16 April.
Methods: We analyzed SARS-CoV-2 outbreaks on cruises in US waters or carrying US citizens and used regression models to compare voyage characteristics.
Most estimates of the combined burden and cost of sexually transmitted infections (STIs) in the United States have focused on 8 common STIs with established national surveillance strategies (chlamydia, gonorrhea, syphilis, trichomoniasis, genital herpes, human papillomavirus, and sexually transmitted human immunodeficiency virus and hepatitis B). However, over 30 STIs are primarily sexually transmitted or sexually transmissible. In this article, we review what is known about the burden of "other STIs" in the United States, including those where sexual transmission is not the primary transmission route of infection.
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- Neurosyphilis can occur at any stage of syphilis infection, making its prevalence difficult to measure, especially regarding neurologic and ocular symptoms among patients with early syphilis (ES).
- A study surveyed 9,123 ES patients from 2016 to 2017, finding that only 1.7% reported neurologic or ocular symptoms, with just one-third undergoing lumbar puncture for further evaluation.
- The study highlights the low prevalence of symptoms but emphasizes the need to address barriers preventing some patients from receiving appropriate clinical evaluations for potential neurosyphilis or ocular syphilis.
Article Synopsis
- The study focused on identifying factors associated with anorectal infections of NG and CT in asymptomatic men who have sex with men (MSM) in Kenya, aiming to improve targeted treatment in low-lab capacity settings.
- Among 698 participants, the prevalence of infections was 5.2%, with a notable 58.3% being asymptomatic; key risk factors included younger age, HIV positivity, and unprotected anal sex.
- A model-derived risk score for asymptomatic men showed good sensitivity (81%) and specificity (66%), suggesting it could effectively identify cases for presumptive treatment if validated in other contexts.
Background: Neisseria gonorrhoeae (gonorrhea) remains an important cause of reproductive and obstetric complications. There has been limited population-based research to evaluate the association between maternal gonorrhea and adverse birth outcomes.
Methods: A population-based retrospective cohort study was conducted of women with singleton pregnancies in Washington State from 2003 to 2014 using linked birth certificate and birth hospitalization discharge data.
This report describes clinical manifestations of histoplasmosis in 6-month-old dizygotic twins, one of whom developed disseminated histoplasmosis of infancy while his sibling remained well, but developed serologic evidence of histoplasmosis. The report also documents histoplasma antigen concentrations in serum and urine before, during and after completing antifungal therapy.
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