Publications by authors named "Nicki Pesik"

On August 29, 2021, the United States government oversaw the emergent establishment of Operation Allies Welcome (OAW), led by the U.S. Department of Homeland Security (DHS) and implemented by the U.

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Background: The Diamond Princess cruise ship was the site of a large outbreak of coronavirus disease 2019 (COVID-19). Of 437 Americans and their travel companions on the ship, 114 (26%) tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Methods: We interviewed 229 American passengers and crew after disembarkation following a ship-based quarantine to identify risk factors for infection and characterize transmission onboard the ship.

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  • - A study was conducted on 195 evacuees returning from Wuhan, China, in January 2020, to assess their exposure to SARS-CoV-2 following their quarantine.
  • - Nearly all evacuees had taken preventive measures and none had detectable SARS-CoV-2 in their respiratory samples, indicating no asymptomatic shedding among them.
  • - Only one evacuee tested positive for antibodies despite no symptoms or reported high-risk exposures, suggesting that this group posed a low risk of bringing the virus to the U.S.
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  • - An estimated 30 million passengers travel on 272 cruise ships globally each year, creating close quarters that can facilitate the spread of respiratory illnesses like COVID-19.
  • - The COVID-19 virus, which was first identified in December 2019, has led to significant outbreaks on cruise ships, especially affecting vulnerable older populations aged 65 and older.
  • - Between February and March 2020, over 800 confirmed COVID-19 cases and 10 deaths were linked to multiple cruise ship voyages, prompting public health officials to recommend a halt to all cruise travel during the pandemic.
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To achieve compliance with the revised World Health Organization International Health Regulations (IHR 2005), countries must be able to rapidly prevent, detect, and respond to public health threats. Most nations, however, remain unprepared to manage and control complex health emergencies, whether due to natural disasters, emerging infectious disease outbreaks, or the inadvertent or intentional release of highly pathogenic organisms. The US Centers for Disease Control and Prevention (CDC) works with countries and partners to build and strengthen global health security preparedness so they can quickly respond to public health crises.

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Using data from travelers to 4 countries in the Middle East, we estimated 3,250 (95% CI 1,300-6,600) severe cases of Middle East respiratory syndrome occurred in this region during September 2012-January 2016. This number is 2.3-fold higher than the number of laboratory-confirmed cases recorded in these countries.

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Objective: CDC routinely conducts contact investigations involving travelers on commercial conveyances, such as aircrafts, cargo vessels, and cruise ships.

Methods: The agency used established systems of communication and partnerships with other federal agencies to quickly provide accurate traveler contact information to states and jurisdictions to alert contacts of potential exposure to two travelers with Middle East Respiratory Syndrome Coronavirus (MERS-CoV) who had entered the United States on commercial flights in April and May 2014.

Results: Applying the same process used to trace and notify travelers during routine investigations, such as those for tuberculosis or measles, CDC was able to notify most travelers of their potential exposure to MERS-CoV during the first few days of each investigation.

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During the 2014-2016 Ebola virus disease (Ebola) epidemic in West Africa, CDC implemented travel and border health measures to prevent international spread of the disease, educate and protect travelers and communities, and minimize disruption of international travel and trade. CDC staff provided in-country technical assistance for exit screening in countries in West Africa with Ebola outbreaks, implemented an enhanced entry risk assessment and management program for travelers at U.S.

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In 2012, an outbreak of infection with Middle East respiratory syndrome coronavirus (MERS-CoV), was detected in the Arabian Peninsula. Modeling can produce estimates of the expected annual number of symptomatic cases of MERS-CoV infection exported and the likelihood of exportation from source countries in the Middle East to countries outside the region.

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  • The CDC Quarantine Stations provide essential drugs that are either not available or have limited supply in the U.S. for urgent health treatments.
  • A study found that distributing these drugs from quarantine stations saves an average of 6.66 hours per shipment compared to sending them from CDC headquarters in Atlanta.
  • The findings support keeping a decentralized distribution model, emphasizing the benefits of the CDC's regional presence for efficient drug delivery.
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Zika virus is a flavivirus transmitted primarily by Aedes species mosquitoes. Increasing evidence links Zika virus infection during pregnancy to adverse pregnancy and birth outcomes, including pregnancy loss, intrauterine growth restriction, eye defects, congenital brain abnormalities, and other fetal abnormalities. The virus has also been determined to be sexually transmitted.

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Zika virus is a mosquito-borne flavivirus primarily transmitted by Aedes aegypti mosquitoes (1,2). Infection with Zika virus is asymptomatic in an estimated 80% of cases (2,3), and when Zika virus does cause illness, symptoms are generally mild and self-limited. Recent evidence suggests a possible association between maternal Zika virus infection and adverse fetal outcomes, such as congenital microcephaly (4,5), as well as a possible association with Guillain-Barré syndrome.

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The first ever case of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) was reported in September 2012. This report describes the approaches taken by CDC, in collaboration with the World Health Organization (WHO) and other partners, to respond to this novel virus, and outlines the agency responses prior to the first case appearing in the United States in May 2014. During this time, CDC's response integrated multiple disciplines and was divided into three distinct phases: before, during, and after the initial activation of its Emergency Operations Center.

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  • The CDC Quarantine Stations provide essential drug products for emergency treatment that are not widely available in the U.S.
  • After analyzing shipment records, it was found that using these stations saves an average of 6.66 hours per shipment compared to distributing from a central site in Atlanta.
  • The results support maintaining a decentralized distribution model to enhance the efficiency of lifesaving drug delivery.
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Before the current Ebola epidemic in West Africa, there were few documented cases of symptomatic Ebola patients traveling by commercial airline, and no evidence of transmission to passengers or crew members during airline travel. In July 2014 two persons with confirmed Ebola virus infection who were infected early in the Nigeria outbreak traveled by commercial airline while symptomatic, involving a total of four flights (two international flights and two Nigeria domestic flights). It is not clear what symptoms either of these two passengers experienced during flight; however, one collapsed in the airport shortly after landing, and the other was documented to have fever, vomiting, and diarrhea on the day the flight arrived.

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In response to the largest recognized Ebola virus disease epidemic now occurring in West Africa, the governments of affected countries, CDC, the World Health Organization (WHO), and other international organizations have collaborated to implement strategies to control spread of the virus. One strategy recommended by WHO calls for countries with Ebola transmission to screen all persons exiting the country for "unexplained febrile illness consistent with potential Ebola infection." Exit screening at points of departure is intended to reduce the likelihood of international spread of the virus.

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Background: The WHO declared the 2014 west African Ebola epidemic a public health emergency of international concern in view of its potential for further international spread. Decision makers worldwide are in need of empirical data to inform and implement emergency response measures. Our aim was to assess the potential for Ebola virus to spread across international borders via commercial air travel and assess the relative efficiency of exit versus entry screening of travellers at commercial airports.

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  • In December 2013, the first locally-acquired chikungunya virus infections were reported in the Caribbean, with over 55,000 cases noted by May 16, signaling an ongoing outbreak.
  • Researchers developed models to predict potential new locations for CHIKV spread by analyzing travel patterns, local infection rates, and climate factors, identifying several cities that could receive infected travelers.
  • The models indicate a high probability of local transmission in various Caribbean regions, and potential, albeit uncertain, spread to areas in the continental U.S. and beyond, highlighting the usefulness of such modeling for assessing outbreak risks with limited data.
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  • Since mid-March 2014, there's been a rise in reported cases of MERS-CoV, especially in Saudi Arabia and the UAE, leading to increased travel-related cases globally.
  • The first MERS case in the United States was confirmed in Indiana on May 2, 2014, followed by a second case in Florida on May 11, both involving travelers from Saudi Arabia.
  • The report aims to raise awareness among health professionals about MERS-CoV, emphasizing the importance of considering this infection in travelers from the Arabian Peninsula and updating guidelines for evaluation and care.
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CDC is investigating reports of potential occupational exposure to human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and Mycobacterium tuberculosis among workers performing preparation and dissection procedures on human nontransplant anatomical materials at a nontransplant anatomical donation center in Arizona. CDC is working with Arizona public health officials to inform persons exposed to these potentially infected materials. Nontransplant anatomical centers around the United States process thousands of donated cadavers annually.

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The Centers for Disease Control and Prevention convened panels of anthrax experts to review and update guidelines for anthrax postexposure prophylaxis and treatment. The panels included civilian and military anthrax experts and clinicians with experience treating anthrax patients. Specialties represented included internal medicine, pediatrics, obstetrics, infectious disease, emergency medicine, critical care, pulmonology, hematology, and nephrology.

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Inhalation anthrax occurred in a man who vacationed in 4 US states where anthrax is enzootic. Despite an extensive multi-agency investigation, the specific source was not detected, and no additional related human or animal cases were found. Although rare, inhalation anthrax can occur naturally in the United States.

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Bacillus anthracis was identified in a 61-year-old man hospitalized in Minnesota, USA. Cooperation between the hospital and the state health agency enhanced prompt identification of the pathogen. Treatment comprising antimicrobial drugs, anthrax immune globulin, and pleural drainage led to full recovery; however, the role of passive immunization in anthrax treatment requires further evaluation.

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