Surveillance of Flea-Borne Typhus in California, 2011-2019.

Flea-borne typhus (FBT), also referred to as murine typhus, is an acute febrile disease in humans caused by the bacteria Rickettsia typhi. Currently, cases of FBT are reported for public health surveillance purposes (i.e., to detect incidence and outbreaks) in a few U.S. states. In California, healthcare providers and testing laboratories are mandated to report to their respective local public health jurisdictions whenever R. typhi or antibodies reactive to R. typhi are detected in a patient, who then report cases to state health department. In this study, we characterize the epidemiology of flea-borne typhus cases in California from 2011 to 2019. A total of 881 cases were reported during this period, with most cases reported among residents of Los Angeles and Orange Counties (97%). Demographics, animal exposures, and clinical courses for case patients were summarized. Additionally, spatiotemporal cluster analyses pointed to five areas in southern California with persistent FBT transmission.

Examining associations between prescription stimulant misuse frequency and misuse characteristics by race/ethnicity.

INTRODUCTION: The misuse use of prescription stimulants (MPS) among college students is a pressing public health concern. Past research suggests there is variation in MPS frequency by race/ethnicity. According to the Theory of Triadic Influence, a health behavior can increase in frequency based on experiences and characteristics of the behavior. Thus, our aim was to examine the association between experiences and characteristics of MPS with MPS frequency, by race/ethnicity. METHODS: A probability sample of students attending two California universities completed a paper-based, psychometrically validated, instrument. Students who reported engaging in MPS in their lifetime were also asked questions about frequency, cost per pill, administration routes, sources, and experience with the drug. We used regression analyses to address our research questions, and conducted analyses by racial/ethnic group (i.e. for students identifying as Asian, Latinx, and White). RESULTS: MPS frequency did not vary by race/ethnicity. The influence of characteristics of misuse on frequency varied by race/ethnicity. Additionally, frequency of experiencing the desired outcome was significantly associated with increased MPS frequency across all three racial/ethnic groups. CONCLUSIONS: Characteristics of misuse are important to consider when screening for misuse and potential dependence. Particular attention should be given to these characteristics by race/ethnicity. Implications for future research are discussed.

Post-Acute Sequelae of SARS-CoV-2 Infection Among Adults Aged ≥18 Years - Long Beach, California, April 1-December 10, 2020.

Post-acute sequelae of COVID-19, also known as "long COVID," is used to describe the long-term symptoms that might be experienced weeks to months after primary infection with SARS-CoV-2, the virus that causes COVID-19. Among persons with a previous COVID-19 diagnosis, estimates of the prevalence of sequelae range from 5% among nonhospitalized persons to 80% among hospitalized persons (1,2). Studies have analyzed the aftereffects of COVID-19, but few have assessed the demographic characteristics associated with long COVID (3,4). Health disparities resulting from pervasive structural and socioeconomic barriers in the U.S. health care system might contribute to differences in these effects and might continue to exacerbate existing inequities (5). To identify trends in post-acute sequelae, the Long Beach Department of Health and Human Services (LBDHHS) interviewed a random sample of 366 persons aged ≥18 years who received a positive SARS-CoV-2 test result during April 1-December 10, 2020. One third of the persons interviewed reported having at least one symptom 2 months after their positive test result, with higher odds of sequelae among persons aged 40-54 years, females, and those with preexisting conditions. Black or African American (Black) participants had higher odds of reporting dyspnea and myalgia/arthralgia compared with other racial/ethnic groups. Persons who were aged ≥40 years, female, Black, or who reported known preexisting conditions also reported higher numbers of distinct sequelae. As the number of recovered COVID-19 patients increases, monitoring the prevalence of post-acute sequelae among larger cohorts in diverse populations will be necessary to understand and manage this condition. Identification of groups disproportionately affected by post-acute COVID-19 sequelae can help develop efforts to prioritize preventions and treatment strategies, including vaccination of groups at higher risk for these long-term sequelae, and access to testing and care for post-acute sequelae.

Prescription stimulant diversion on a college campus: Intrapersonal, interpersonal and environmental correlates.

INTRODUCTION: Prescription stimulant diversion is a behavior that increases the availability and accessibility of prescription stimulants for purposes such as misuse. As such, we aimed to develop a theory-guided understanding of diversion correlates. METHODS: Data are from a probability sample of 499 undergraduate college students attending one California university. Participants completed a 100-item survey related to prescription stimulant misuse and diversion. We first calculated prevalence of diversion and associations with demographic variables. Next, to examine intrapersonal, interpersonal and environmental correlates of diversion, we estimated three separate nested logistic regression models. RESULTS: Prescription stimulant diversion was reported by approximately 10% of the sample. In the nested logistic analyses, diversion was found to be associated with intrapersonal, interpersonal and environmental variables. CONCLUSIONS: These findings highlight the importance of examining a comprehensive set of correlates to identify subgroups of students at risk for engaging in sharing and/or selling of prescription stimulants.

Prescription stimulant misuse avoidance self-efficacy: Correlates and moderation by race/ethnicity.

This study examined whether personality characteristics, attention deficit hyperactivity disorder (ADHD) symptomology, psychological distress, and religiosity were associated with prescription stimulant avoidance self-efficacy and whether these relationships were moderated by race/ethnicity among a probability sample of 1,053 college students. We used regression analyses to examine associations between avoidance self-efficacy and the independent variables of interest, and moderation analyses to identify whether these associations were moderated by race/ethnicity. Inattention, hyperactivity, sensation seeking, and psychological distress were inversely associated with prescription stimulant avoidance self-efficacy, whereas religiosity had a direct association. Moreover, greater inattention was a risk factor for lower self-efficacy among students identifying as White but not for students identifying as Asian. Increased religiosity was a risk factor for students identifying as Latinx, whereas it was a protective factor for students identifying as White. Prevention implications are discussed.

Pharmacological cognitive enhancement: Examining the ethical principles guiding college students' abstention.

OBJECTIVES: To understand the ethical principles guiding college students' abstention from pharmacological cognitive enhancement (PCE), and to determine the correlates associated with endorsing different principles. DESIGN: One-stage cluster sampling was used to implement a paper-based survey among undergraduate students attending one university in the U.S. Thematic analysis was used to explore the ethical principles guiding PCE abstention. Multivariate logistic regression analyses were used to examine sociodemographic correlates associated with endorsed ethical principles. PARTICIPANTS: Of the 499 eligible students who completed the survey (student response proportion: 94.7%), 259 students had a negative attitude towards PCE, did not engage in PCE, and provided reasons for abstention. RESULTS: The thematic analysis resulted in the identification of eight themes, with respondents often endorsing more than one theme per response. The three themes most endorsed were non-malfeasance (i.e., avoiding PCE to prevent harm), disapproval of drugs (i.e., a moral opposition to substance use) and dosage beneficence (i.e., adhering to dosage guidance to promote health). The sociodemographic correlates associated with endorsing each theme varied across themes. CONCLUSIONS: Students abstain from PCE for a multitude of reasons, many of which are guided by ethical principles. These findings may be incorporated into future prevention programming messages.