Publications by authors named "Lucia Pawloski"

Article Synopsis
  • In 2020, the CSTE revised the pertussis case definition, recognizing PCR-positive cases as confirmed, regardless of cough duration, to improve case reporting.
  • The evaluation showed that 9.5% of reported cases in Enhanced Pertussis Surveillance were newly classified under the updated definition, leading to an estimated additional 582 cases nationally.
  • The change in definition allowed for better tracking of pertussis cases, even during a significant decline in reported cases due to COVID-19, enhancing opportunities for public health measures.
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Pertussis, caused by , can cause debilitating respiratory symptoms, so whole-cell pertussis vaccines (wPVs) were introduced in the 1940s. However, reactogenicity of wPV necessitated the development of acellular pertussis vaccines (aPVs) that were introduced in the 1990s. Since then, until the COVID-19 pandemic began, reported pertussis incidence was increasing, suggesting that aPVs do not induce long-lasting immunity and may not effectively prevent transmission.

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Article Synopsis
  • Respiratory diphtheria is a severe infection primarily spread through respiratory droplets, and a significant outbreak occurred among Myanmar nationals in Bangladesh from 2017 to 2019.
  • Whole-genome sequencing (WGS) was used to analyze isolates from 53 diphtheria cases, revealing that they were toxigenic biovar mitis strains with resistance to penicillin and grouped into four phylogenetic clusters across refugee camps.
  • The study highlighted high levels of antibiotic resistance in co-circulating non-diphtheritic species, underscoring WGS's effectiveness in tracking microbial relationships and resistance factors during diphtheria outbreaks.
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Background: Post-exposure prophylaxis (PEP) for pertussis is recommended for household contacts of pertussis cases in the United States within 21 days of exposure, but data on PEP effectiveness for prevention of secondary cases in the setting of widespread pertussis vaccination are limited. We implemented a multi-state evaluation of azithromycin PEP use and effectiveness among household contacts.

Methods: Culture- or PCR-confirmed pertussis cases were identified through surveillance.

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The diagnosis of dengue disease, caused by the dengue virus (DENV) (a flavivirus), often requires serologic testing during acute and early convalescent phases of the disease. Some symptoms of DENV infection, such as nonspecific fever, are similar to those caused by infection with SARS-CoV-2, the virus that causes COVID-19. In studies with few COVID-19 cases, positive DENV immunoglobulin M (IgM) results were reported with various serologic tests, indicating possible cross-reactivity in these tests for DENV and SARS-CoV-2 infections (1,2).

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Article Synopsis
  • The study investigates the presence of SARS-CoV-2 on surfaces in households with confirmed COVID-19 cases, highlighting the potential for transmission through fomites.
  • It involved sampling 15 surfaces in 10 households, finding SARS-CoV-2 RNA in 15% of the samples, predominantly on nightstands, pillows, and light switches.
  • Although viable virus was detected from one sample, the findings suggest that while surface contamination can occur, the risk of transmission through surfaces is relatively low, particularly early in the infection.
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Many countries have reported antigenic divergence among circulating strains, mainly in those countries which introduced the acellular pertussis (aP) vaccine. This phenomenon can be seen, for example, with the recent rise of pertactin (Prn)-deficient strains, one of the antigens included in aP vaccine formulas. The whole cell pertussis (wP) vaccine has been used in Brazil since 1977 for the primary pertussis, diphtheria and tetanus immunization series.

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Background: Maternal Tetanus, diphtheria, and acellular pertussis (Tdap) vaccination provides antibody transfer to newborn infants and may affect their antibody response to the primary vaccination series. This study aimed to assess the effect of Tdap vaccination during pregnancy on infant antibody response to the whole cell pertussis (DTwP) primary series.

Methods: Plasma from 318 pregnant women (243 Tdap-vaccinated and 75 unvaccinated) and their infants (cord blood) was collected at delivery; infant blood was again collected at 2 and 7 months, before and after their primary DTwP series.

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Article Synopsis
  • The study explored how SARS-CoV-2 spreads within households in the U.S. and calculated the household secondary infection rate (SIR) to help develop strategies for reducing transmission.
  • Researchers recruited patients with confirmed SARS-CoV-2 infections and their household members in Utah and Wisconsin, gathering demographic data and conducting tests over several visits.
  • Results showed a 29% overall secondary infection rate, with higher rates among children and spouses, indicating that individuals with weakened immune systems or diabetes are at greater risk, suggesting the need for strict self-isolation measures.
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Background: Detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has principally been performed through the use of real-time reverse-transcription polymerase chain reaction testing. Results of such tests can be reported as cycle threshold (Ct) values, which may provide semi-quantitative or indirect measurements of viral load. Previous reports have examined temporal trends in Ct values over the course of a SARS-CoV-2 infection.

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Background: Pertussis remains an important global public health concern, despite the presence of extensive immunization programs. Incidence and severity of pertussis are typically higher in neonates and young infants. As a strategy to protect these young infants, maternal vaccination with Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) has been recommended in Brazil.

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We characterized 170 complete genome assemblies from clinical Bordetella pertussis isolates representing geographic and temporal diversity in the United States. These data capture genotypic shifts, including increased pertactin deficiency, occurring amid the current pertussis disease resurgence and provide a foundation for needed research to direct future public health control strategies.

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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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Despite high vaccine coverage, pertussis cases in the United States have increased over the last decade. Growing evidence suggests that disease resurgence results, in part, from genetic divergence of circulating strain populations away from vaccine references. The United States employs acellular vaccines exclusively, and current isolates are predominantly deficient in at least one immunogen, pertactin (Prn).

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The Latin American Pertussis Project (LAPP), established in 2009, is a collaboration between the Centers for Disease Control and Prevention, Pan American Health Organization, Sabin Vaccine Institute, and the ministries of health of 6 countries in Latin America. The project goal is to expand understanding of pertussis epidemiology in Latin America to inform strategies for control and prevention. Here we describe LAPP structure and activities.

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Bordetella pertussis infection has been increasing in the US, with reported cases reaching over 50,000 in 2012, a number last observed in the 1950s. Concurrently, B. pertussis lacking the pertactin protein, one of the immunogens included in the acellular vaccine formulations, has rapidly emerged since 2010, and has become the predominant circulating phenotype.

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Article Synopsis
  • In the U.S., infants have the highest rates of pertussis incidence and related deaths, highlighting the need for better understanding of risk factors for effective prevention.
  • The study involved infants ≤4 months with confirmed pertussis and matched controls, focusing on their household contacts and breastfeeding methods to determine potential protective factors.
  • Results indicated that prolonged cough in household contacts, especially mothers, increased pertussis odds in infants, while breastfeeding with limited formula use appeared to reduce the odds of infection significantly.
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Article Synopsis
  • Pertussis serodiagnosis is becoming more common in the US, even without FDA-approved tests, leading researchers to assess the effectiveness of various serology assays for diagnosing pertussis.
  • In the study, 43 different antigen-antibody combinations were tested, using serum samples from confirmed pertussis cases, a reference standard, and healthy donors to evaluate their precision and clinical accuracy.
  • Results showed that while there was some variability in the assays, notably in their positive and negative agreement rates, tests calibrated to reference standards demonstrated high accuracy, suggesting these seroassays could enhance pertussis diagnosis criteria.
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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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Although pertussis disease is vaccine preventable, Washington State experienced a substantial rise in pertussis incidence beginning in 2011. By June 2012, the reported cases reached 2,520 (37.5 cases per 100,000 residents), a 1,300% increase compared with the same period in 2011.

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Pertussis remains an important public health problem in many countries despite extensive immunization. Cultures and real-time PCR (RT-PCR) assays are the recommended pertussis diagnostic tests, but they lack sensitivity at the later stage of the disease. This study introduces the IgG anti-pertussis toxin enzyme-linked immunosorbent assay (PT ELISA) in our routine diagnosis to improve disease burden estimation.

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Background: During 9 May 2010-7 May 2011, an outbreak of pertussis-like illness (incidence, 80 cases per 100 000 persons) occurred in Franklin County, Ohio. The majority of cases were identified by IS481-directed polymerase chain reaction (PCR), which does not differentiate among Bordetella species. We sought to determine outbreak etiology and epidemiologic characteristics.

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An anti-pertussis toxin (PT) IgG enzyme-linked immunosorbent assay (ELISA) was analytically validated for the diagnosis of pertussis at a cutoff of 94 ELISA units (EU)/ml. Little was known about the performance of this ELISA in the diagnosis of adults recently vaccinated with tetanus-diphtheria-acellular pertussis (Tdap) vaccine, which contains PT. The goal of this study was to determine when the assay can be used following Tdap vaccination.

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Background And Objectives: We investigated a pertussis outbreak characterized by atypical cases, confirmed by polymerase chain reaction (PCR) alone at a single laboratory, which persisted despite high vaccine coverage and routine control measures. We aimed to determine whether Bordetella pertussis was the causative agent and advise on control interventions.

Methods: We conducted case ascertainment, confirmatory testing for pertussis and other pathogens, and an assessment for possible sources of specimen contamination, including a survey of clinic practices, sampling clinics for B pertussis DNA, and review of laboratory quality indicators.

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