Publications by authors named "Sandy P Althomsons"
A nationwide tuberculosis outbreak linked to a viable bone allograft product contaminated with Mycobacterium tuberculosis was identified in June 2021. Our subsequent investigation identified 73 healthcare personnel with new latent tuberculosis infection following exposure to the contaminated product, product recipients, surgical instruments, or medical waste.
View Article and Find Full Text PDFObjective: This study describes characteristics of large tuberculosis (TB) outbreaks in the United States detected using novel molecular surveillance methods during 2014-2016 and followed for 2 years through 2018.
Methods: We developed 4 genotype-based detection algorithms to identify large TB outbreaks of ≥10 cases related by recent transmission during a 3-year period. We used whole-genome sequencing and epidemiologic data to assess evidence of recent transmission among cases.
Background: Mycobacterium tuberculosis transmission through solid organ transplantation has been well described, but transmission through transplanted tissues is rare. We investigated a tuberculosis outbreak in the USA linked to a bone graft product containing live cells derived from a single deceased donor.
Methods: In this outbreak report, we describe the management and severity of the outbreak and identify opportunities to improve tissue transplant safety in the USA.
Article Synopsis
- Early identification of tuberculosis (TB) clusters is essential for preventing future outbreaks and intervention opportunities.
- Researchers analyzed U.S. TB surveillance data from 2009-2018, using machine learning to predict which clusters of TB cases were likely to grow beyond expected levels.
- The study found that cluster characteristics, such as the timing of case accumulation, were more crucial predictors of growth than individual patient demographics, highlighting a comprehensive approach for public health strategies.
Article Synopsis
- - Residents of long-term care facilities (LTCFs) and healthcare personnel (HCP) face a high risk of COVID-19 deaths, with nearly 182,000 fatalities in the U.S. linked to these groups as of March 2021.
- - LTCF residents and HCP were prioritized for COVID-19 vaccinations, with programs like the federal Pharmacy Partnership for Long-Term Care Program aimed at providing on-site vaccinations.
- - From March to April 2021, data showed that only 56.8% of HCP in a sample of 300 LTCFs were vaccinated, with lower rates among aides and a correlation between lower vaccination rates and increased social vulnerability in certain communities, highlighting the need for greater vaccination
Article Synopsis
- Universal genotyping of tuberculosis cases in the U.S. helps identify early clusters that could lead to outbreaks, allowing public health officials to allocate resources effectively.
- Analyzing data from 2009-2018, the study found 1,516 tuberculosis clusters, with 231 growing to six or more cases, particularly among vulnerable populations like substance users, the homeless, and incarcerated individuals.
- The study suggests that clusters with three cases or more within a year should receive immediate attention, focusing on outreach to high-risk groups to prevent further spread.
Introduction: Pediatric tuberculosis (TB) cases are sentinel events for transmission in communities because children, by definition, must have been infected relatively recently. However, these events are not consistently identified by genotype-dependent surveillance alerting methods because many pediatric TB cases are not culture-positive, a prerequisite for genotyping.
Methods: We developed 3 potential indicators of ongoing TB transmission based on identifying counties in the United States with relatively high pediatric (aged <15 years) TB incidence: (1) a case proportion indicator: an above-average proportion of pediatric TB cases among all TB cases; (2) a case rate indicator: an above-average pediatric TB case rate; and (3) a statistical model indicator: a statistical model based on a significant increase in pediatric TB cases from the previous 8-quarter moving average.
We previously reported use of genotype surveillance data to predict outbreaks among incident tuberculosis clusters. We propose a method to detect possible outbreaks among endemic tuberculosis clusters. We detected 15 possible outbreaks, of which 10 had epidemiologic data or whole-genome sequencing results.
View Article and Find Full Text PDFBackground: Early identification of outbreaks remains a key component in continuing to reduce the burden of infectious disease in the United States. Previous studies have applied statistical methods to detect unexpected cases of disease in space or time. The objectives of our study were to assess the ability and timeliness of three spatio-temporal methods to detect known outbreaks of tuberculosis.
View Article and Find Full Text PDFArticle Synopsis
- Researchers analyzed tuberculosis clusters in the U.S. to predict which small groups of patients (3 individuals) might turn into larger outbreaks (at least 6 cases).
- They found that certain factors, such as homelessness, substance abuse, or incarceration, significantly increased the likelihood of a cluster becoming an outbreak, especially if the third case appeared quickly.
- Of the high-risk clusters identified, over half (53%) ended up spreading into outbreaks, indicating that routine data could help target areas for more intense public health investigations.
Rationale: Delays in the diagnosis of tuberculosis (TB) can result in progression to advanced disease. Patients with pulmonary TB and advanced disease are more likely to transmit disease and fail treatment.
Objectives: To examine clinical, epidemiological, and geographic factors associated with advanced pulmonary TB to further understanding of delayed diagnosis and transmission.