Publications by authors named "Ruth Lynfield"

Article Synopsis
  • - The study investigates the impact of social vulnerability on clinical outcomes for hospitalized influenza patients, analyzing data from over 57,000 cases between the 2014-2015 and 2018-2019 influenza seasons across 13 states.
  • - It aims to understand how social vulnerability correlates with severe outcomes like ICU admission, use of advanced respiratory support, and 30-day mortality, while also examining patterns of vaccine and antiviral use based on social vulnerability levels.
  • - Findings reveal that patients from areas with high social vulnerability experience worse outcomes, such as higher rates of needing invasive ventilation support compared to those from less vulnerable areas.
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Importance: Respiratory syncytial virus (RSV) infection can cause severe illness in adults. However, there is considerable uncertainty in the burden of RSV-associated hospitalizations among adults prior to RSV vaccine introduction.

Objective: To describe the demographic characteristics of adults hospitalized with laboratory-confirmed RSV and to estimate annual rates and numbers of RSV-associated hospitalizations, intensive care unit (ICU) admissions, and in-hospital deaths.

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Background: While the estimated number of U.S. influenza-associated deaths is reported annually, detailed data on the epidemiology of influenza-associated deaths, including the burden of in-hospital versus post-hospital discharge deaths are limited.

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Problem/condition: Seasonal influenza accounts for 9.3 million-41 million illnesses, 100,000-710,000 hospitalizations, and 4,900-51,000 deaths annually in the United States. Since 2003, the Influenza Hospitalization Surveillance Network (FluSurv-NET) has been conducting population-based surveillance for laboratory-confirmed influenza-associated hospitalizations in the United States, including weekly rate estimations and descriptions of clinical characteristics and outcomes for hospitalized patients.

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Article Synopsis
  • Minnesota expanded its viral genomic surveillance to include human respiratory syncytial virus (RSV).
  • Whole-genome sequencing was performed on 575 specimens collected from healthcare facilities between July 2023 and February 2024.
  • Two subgroups of RSV, A and B, showed distinct genomic differences, and researchers identified 23 clusters of genetically identical genomes.
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The COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) was established in March 2020 to monitor trends in hospitalizations associated with SARS-CoV-2 infection. COVID-NET is a geographically diverse population-based surveillance system for laboratory-confirmed COVID-19-associated hospitalizations with a combined catchment area covering approximately 10% of the US population. Data collected in COVID-NET includes monthly counts of hospitalizations for persons with confirmed SARS-CoV-2 infection who reside within the defined catchment area.

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Article Synopsis
  • - The study focuses on the molecular characteristics of non-tuberculous mycobacteria (NTM) that can cause infections outside of the lungs, detailing a collection of 45 extrapulmonary isolates over a span of six months from various sites.
  • - Key findings revealed that the most frequently isolated species were Mycobacterium avium, Mycobacterium chelonae, and Mycobacterium fortuitum, with significant variations in sequence types and the presence of antimicrobial resistance genes in some isolates.
  • - The research emphasizes the need for ongoing surveillance to monitor the prevalence and resistance patterns of NTM, helping to identify emerging strains and improve understanding of their virulence factors.
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Article Synopsis
  • * From October 2022 to April 2024, there were 1,470 COVID-19-related hospitalizations among infants, with rates higher than any age group except those 75 and older.
  • * The percentage of hospitalized infants whose mothers were vaccinated dropped significantly, and severe outcomes were common, with many requiring intensive care and some serious cases resulting in death, highlighting the need for pregnant individuals to get vaccinated.
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  • * From May 12 to July 13, 2024, 38 states participated in testing, with 11 sites showing high levels of influenza A virus and 24 sites detecting the H5 subtype.
  • * Investigations revealed that many high-level detections corresponded with human influenza activity and identified possible animal sources, providing valuable data for future respiratory illness monitoring.
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Article Synopsis
  • Pneumonia is frequent among adults hospitalized with confirmed influenza, but the impact of how quickly antiviral treatment is given on severe outcomes is not well understood.
  • The study analyzed data from over 26,000 adults hospitalized between 2012-2019 to see how the timing of antiviral treatment (given on the day of admission vs. later) affected 30-day mortality rates.
  • Results showed that those who received treatment later (days 2-5) had a significantly higher risk of death compared to those treated on the same day of admission, emphasizing the need for prompt treatment.
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The COVID-19 pandemic has highlighted the need to upgrade systems for infectious disease surveillance and forecasting and modeling of the spread of infection, both of which inform evidence-based public health guidance and policies. Here, we discuss requirements for an effective surveillance system to support decision making during a pandemic, drawing on the lessons of COVID-19 in the U.S.

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A healthcare provider unknowingly treated a patient with mpox and subsequently developed ocular mpox without rash. She breastfed during illness; her infant was not infected. This report addresses 3 challenges in mpox management and control: diagnosis in the absence of rash, exposures in healthcare settings, and management of lactating patients.

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2019–2020 at 6 US sites. Among 159 CRE cases in children (median age 5 years), CRE was isolated from urine for 131 (82.4%) and blood from 20 (12.

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Article Synopsis
  • The study investigated the characteristics of healthcare personnel (HCP) who tested positive for SARS-CoV-2 from April 2020 to December 2021 to inform protective measures for this workforce.
  • Over 7,500 case-HCP were analyzed, revealing that a significant proportion of certified nursing assistants, medical assistants, and home healthcare workers identified as non-Hispanic Black or Hispanic, with many residing in areas of high social vulnerability.
  • Findings suggest that tailored infection prevention strategies should be developed according to HCP roles and social vulnerability to effectively reduce the risk of SARS-CoV-2 infection.
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Background: Understanding the epidemiology of carbapenem-resistant A. baumannii complex (CRAB) and the patients impacted is an important step toward informing better infection prevention and control practices and improving public health response.

Methods: Active, population-based surveillance was conducted for CRAB in 9 U.

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  • - The study focuses on how respiratory syncytial virus (RSV) affects cardiac health in adults aged 50 and older, highlighting that there's less awareness of these complications compared to those associated with influenza and SARS-CoV-2.
  • - Using data from hospitalized RSV patients over several years, the research aimed to assess the prevalence and severity of acute cardiac events, finding that about 22.4% of patients experienced such events during their hospitalization.
  • - Among the 6,248 patients analyzed, around 15.8% had acute heart failure, while 7.5% dealt with acute ischemic conditions, suggesting significant cardiac risks associated with RSV infection in this age group.
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Persons with HIV (PWH) are at increased risk for bacterial infections, and previous publications document an increased risk for invasive meningococcal disease (IMD) in particular. This analysis provides evidence that PWH face a 6-fold increase in risk for IMD based on Active Bacterial Core surveillance data collected during 2009-2019.

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Severe outcomes were common among adults hospitalized for COVID-19 or influenza, while the percentage of COVID-19 hospitalizations involving critical care decreased from October 2021 to September 2022. During the Omicron BA.5 period, intensive care unit admission frequency was similar for COVID-19 and influenza, although patients with COVID-19 had a higher frequency of in-hospital death.

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Objectives: Surveillance systems for unexplained deaths that might have an infectious etiology are rare. We examined the Minnesota Department of Health Unexplained Deaths and Critical Illnesses of Possible Infectious Etiology and Medical Examiner Infectious Deaths (UNEX/MED-X) surveillance system,-a system that expanded postmortem surveillance for infectious diseases during the COVID-19 pandemic by leveraging standard (medical examiner [ME]) and expanded (mortuary) surveillance to identify COVID-19-related deaths.

Methods: MEs, coroners, or morticians collected postmortem swabs from decedents with an infectious prodrome or with SARS-CoV-2 exposure before death but with no known recent infectious disease testing.

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Background: We described changes in 2016─2020 carbapenem-resistant Enterobacterales (CRE) incidence rates in 7 US sites that conduct population-based CRE surveillance.

Methods: An incident CRE case was defined as the first isolation of , spp., or spp.

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Background: Older age and chronic conditions are associated with severe influenza outcomes; however, data are only comprehensively available for adults ≥65 years old. Using data from the Influenza Hospitalization Surveillance Network (FluSurv-NET), we identified characteristics associated with severe outcomes in adults 18-49 years old hospitalized with influenza.

Methods: We included FluSurv-NET data from nonpregnant adults 18-49 years old hospitalized with laboratory-confirmed influenza during the 2011-2012 through 2018-2019 seasons.

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Background: Influenza is a substantial cause of annual morbidity and mortality; however, correctly identifying those patients at increased risk for severe disease is often challenging. Several severity indices have been developed; however, these scores have not been validated for use in patients with influenza. We evaluated the discrimination of three clinical disease severity scores in predicting severe influenza-associated outcomes.

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