Epidemic Ribotype 027 Lineages: Comparisons of Texas Versus Worldwide Strains.

Background: The epidemic e ribotype 027 strain resulted from the dissemination of 2 separate fluoroquinolone-resistant lineages: FQR1 and FQR2. Both lineages were reported to originate in North America; however, confirmatory large-scale investigations of ribotype 027 epidemiology using whole genome sequencing has not been undertaken in the United States.

Methods: Whole genome sequencing and single-nucleotide polymorphism (SNP) analysis was performed on 76 clinical ribotype 027 isolates obtained from hospitalized patients in Texas with infection and compared with 32 previously sequenced worldwide strains.

Systemic Delays in the Initiation of Antiretroviral Therapy for Clinically Eligible HIV-Infected Patients in Houston, Texas: The Providers' Report Card.

Background: The current US HIV treatment guidelines support initiation of antiretroviral therapy (ART) for persons with HIV for personal health benefits and prevention of HIV transmission. However, high levels of adherence to ART are critical to maximize individual and public health benefits. We examined the nonclinical barriers to ART initiation for clinically eligible individuals and the provider- and patient-related factors associated with these barriers among HIV-infected patients in Houston/Harris County, Texas.

Modeling and Forecasting Influenza-like Illness (ILI) in Houston, Texas Using Three Surveillance Data Capture Mechanisms.

Objective The objective was to forecast and validate prediction estimates of influenza activity in Houston, TX using four years of historical influenza-like illness (ILI) from three surveillance data capture mechanisms. Background Using novel surveillance methods and historical data to estimate future trends of influenza-like illness can lead to early detection of influenza activity increases and decreases. Anticipating surges gives public health professionals more time to prepare and increase prevention efforts.

West Nile Virus Outbreak in Houston and Harris County, Texas, USA, 2014.

Since 2002, West Nile virus (WNV) has been detected every year in Houston and the surrounding Harris County, Texas. In 2014, the largest WNV outbreak to date occurred, comprising 139 cases and causing 2 deaths. Additionally, 1,286 WNV-positive mosquito pools were confirmed, the most reported in a single mosquito season.

Frequency and Determinants of Preventive Care Counseling by HIV Medical Care Providers during Encounters with Newly Diagnosed and Established HIV-Infected Patients.

This study evaluates the frequency and determinants of preventive care counseling by HIV medical care providers (HMCPs) during encounters with newly diagnosed and established HIV-infected patients. Data used were from a probability sample of HMCPs in Houston/Harris County, Texas, surveyed in 2009. Overall, HMCPs offered more preventive care counseling to newly diagnosed than the established patients (adjusted odds ratio [AOR] = 7.

Managing the Personal Side of Health Care among Patients with HIV/AIDS.

The study describes the HIV care providers' sociodemographic and medical practice characteristics and the health care services offered to patients during medical care encounters in Houston/Harris County, Texas. We used data from the pilot cycle of the Centers for Disease Control and Prevention Medical Monitoring Project Provider Survey conducted in June to September 2009. The average age and HIV care experience of the providers were 46.

Assessment of Antimicrobial Stewardship Activities in a Large Metropolitan Area.

Purpose: To describe antimicrobial stewardship programs (ASPs) of acute and long-term acute care (LTAC) hospitals in Houston, Texas.

Methods: Two-part survey to clinical pharmacists and pharmacy directors. All acute care and LTAC facilities from the Harris County Medical Society database were invited to participate.

Survival analysis, long-term outcomes, and percentage of recovery up to 8 years post-infection among the Houston West Nile virus cohort.

In 2012, we witnessed a resurgence of West Nile virus (WNV) in the United States, with the largest outbreak of human cases reported since 2003. WNV is now endemic and will continue to produce epidemics over time, therefore defining the long-term consequences of WNV infection is critical. Over a period of eight years, we prospectively followed a cohort of 157 WNV-infected subjects in the Houston metropolitan area to observe recovery over time and define the long-term clinical outcomes.

System and Patient Barriers to Care among People Living with HIV/AIDS in Houston/Harris County, Texas: HIV Medical Care Providers' Perspectives.

In the United States, a considerable number of people diagnosed with HIV are not receiving HIV medical care due to some barriers. Using data from the Medical Monitoring Project survey of HIV medical care providers in Houston/Harris County, Texas, we assessed the HIV medical care providers' perspectives of the system and patient barriers to HIV care experienced by people living with HIV/AIDS (PLWHA). The study findings indicate that of the 14 HIV care barriers identified, only 1 system barrier and 7 patient barriers were considered of significant (P ≤ .

Likely female-to-female sexual transmission of HIV--Texas, 2012.

In August 2012, the Houston Department of Health contacted CDC regarding the rare transmission of human immunodeficiency virus (HIV) likely by sexual contact between two women. The case was investigated, and laboratory testing confirmed that the woman with newly diagnosed HIV infection had a virus virtually identical to that of her female partner, who was diagnosed previously with HIV and who had stopped receiving antiretroviral treatment in 2010. This report describes this case of HIV infection, likely acquired by female-to-female sexual transmission during the 6-month monogamous relationship of the HIV-discordant couple (one negative, one positive).

Characteristics and risk of syphilis diagnosis among HIV-infected male cohort: a population-based study in Houston, Texas.

Background: This population-based study assessed the characteristics, timing, and risk of syphilis diagnoses among HIV-infected males in Houston, Texas.

Methods: A retrospective cohort of males newly diagnosed as having HIV between January 2000 and December 2002 was constructed using HIV surveillance data. These individuals were cross-referenced to sexually transmitted disease surveillance data to ascertain early syphilis diagnoses for the subsequent 10 years.

Identification of dengue fever cases in Houston, Texas, with evidence of autochthonous transmission between 2003 and 2005.

Houston, Texas, maintains an environment conducive to dengue virus (DENV) emergence; however, surveillance is passive and diagnostic testing is not readily available. To determine if DENV is present in the area, we tested 3768 clinical specimens (2138 cerebrospinal fluid [CSF] and 1630 serum) collected from patients with suspected mosquito-borne viral disease between 2003 and 2005. We identified 47 immunoglobulin M (IgM)-positive dengue cases, including two cases that were positive for viral RNA in serum for dengue serotype 2.

Determinants of fruits and vegetables consumption among persons with doctor-diagnosed chronic diseases.

Objective: The objective of this study was to examine the factors associated with fruits and vegetables consumption pattern among persons with doctor-diagnosed chronic diseases.

Method: The authors examined cross-sectional, random-digit-dialed health survey data collected in 2008 in Houston, Texas, a city with a diverse ethnic population. The survey sample, which was designed to represent all households with telephones, was drawn using standard list-assisted random-digit-dialing methodology from telephone exchanges that serve the study area.

Disparities in fruits and vegetables consumption in houston, Texas: implications for health promotion.

Background: The consumption of the recommended amount of fruits and vegetables is believed to help prevent nutrient deficiency disorders and lower the risk of several chronic diseases. Information on the disparity of fruit and vegetable consumption may be useful in designing targeted health promotion programs for increasing fruit and vegetable consumption. The objective of this pilot study was to examine disparities in fruit and vegetable consumption among Houston residents based on sociodemographic characteristics.

Pulsed-field gel electrophoresis for Salmonella infection surveillance, Texas, USA, 2007.

To identify sources of transmission for area clusters, in 2007 the Houston Department of Health and Human Services conducted an 8-month study of enhanced surveillance of Salmonella infection. Protocol included patient interviews and linking the results of interviews to clusters of pulsed-field gel electrophoresis patterns detected by the local PulseNet laboratory.

Late HIV diagnosis in Houston/Harris County, Texas, 2000-2007.

This cross-sectional study aimed to evaluate the prevalence and predictive factors associated with late HIV diagnoses in Houston, Texas using surveillance data. Study subjects were Houston/Harris County residents, 13 years or older, diagnosed with HIV and reported to the Houston Department of Health and Human Services. Late HIV diagnosis was defined as an AIDS diagnosis within three months of an HIV diagnosis.

Self-reported health, functional status and chronic disease in community dwelling older adults: untangling the role of demographics.

Self-reported health, a widely used measure of general health status in population studies, can be affected by certain demographic variables such as gender, race/ethnicity and education. This cross-sectional assessment of the current health status of older adult residents was conducted in an inner-city Houston neighborhood in May, 2007. A survey instrument, with questions on chronic disease prevalence, health limitations/functional status, self-reported subjective health status in addition to demographic data on households was administered to a systematic random sample of residents.

Services oriented architectures and rapid deployment of ad-hoc health surveillance systems: lessons from Katrina relief efforts.

During the Hurricane Katrina relief efforts, a new city was born overnight within the City of Houston to provide accommodation and health services for thousands of evacuees deprived of food, rest, medical attention, and sanitation. The hurricane victims had been exposed to flood water, toxic materials, physical injury, and mental stress. This scenario was an invitation for a variety of public health hazards, primarily infectious disease outbreaks.

Social and mental health needs assessment of Katrina evacuees.

Hurricane Katrina made landfall along the Gulf Coast as a Category 3 storm on August 29, 2005. Many residents were evacuated to neighboring cities owing to massive destruction. Working with the City of Houston Health Department, researchers conducted a medical and psychological needs assessment of 124 Hurricane Katrina evacuees in Houston shelters from September 4-12, 2005.

The utility of geographic information systems (GIS) in rapid epidemiological assessments following weather-related disasters: methodological issues based on the Tropical Storm Allison Experience.

Flooding is the most common natural disaster worldwide, and is the leading cause of weather-related deaths in the United States. Tropical storm Allison hit landfall near Galveston, Texas on June 5, 2001, causing the most severe flood-related damage ever recorded in the Houston metropolitan area. This devastating storm dumped 37 in of rain in 24h on parts of the city, killing 22 people and causing more than $5 billion in damage.

Rapid assessment of household needs in the Houston area after Tropical Storm Allison.

Background: Tropical Storm Allison, which hit landfall near Galveston, Texas, on June 5, 2001, caused the most severe flood-related damage ever recorded in the Houston metropolitan area. The main goal of the public health response to tropical storm Allison was to evaluate the immediate health needs of the community.

Methods: To estimate damage and household needs, we conducted a rapid needs assessment in the areas most affected by flooding with use of a modified cluster sampling method facilitated by Geographical Information Systems methodology.