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1.
Clin Infect Dis ; 73(11): e3670-e3676, 2021 12 06.
Article in English | MEDLINE | ID: mdl-32668450

ABSTRACT

BACKGROUND: Incidence of invasive disease due to Haemophilus influenzae serotype a (Hia) increased an average of 13% annually from 2002 through 2015. We describe clinical characteristics and adverse clinical outcomes of US invasive Hia cases detected through multistate surveillance during 2011-2015. METHODS: Medical record data were abstracted for cases reported in 8 jurisdictions conducting active population- and laboratory-based surveillance for invasive Hia disease across the United States. Isolates from sterile sites were serotyped using real-time polymerase chain reaction. Adverse clinical outcomes were defined as any possible complication of meningitis, bacteremic pneumonia, or bacteremia (including hearing loss and developmental delay, but excluding death) and were assessed at hospital discharge and one-year post-disease onset. RESULTS: During 2011-2015, 190 Hia cases were reported to the 8 participating sites; 169 (88.9%) had data abstracted. Many patients were aged <5 years (42.6%). Meningitis was the most common clinical presentation among those aged <1 year (71.4%); bacteremic pneumonia was the most common presentation among persons aged ≥50 years (78.7%). Overall, 95.9% of patients were hospitalized. Among those hospitalized, 47.5% were admitted to an intensive care unit and 6.2% died during hospitalization. At hospital discharge and one-year post-disease onset, adverse outcomes were identified in 17.7% and 17.8% of patients overall and in 43.9% and 48.5% of patients with meningitis (primarily children). CONCLUSIONS: Hia infection can cause severe disease that requires hospitalization and may also cause short- and long-term adverse clinical outcomes, especially among children. Novel vaccines could prevent morbidity and mortality.


Subject(s)
Bacteremia , Haemophilus Infections , Haemophilus Vaccines , Aged , Bacteremia/epidemiology , Child , Child, Preschool , Haemophilus Infections/epidemiology , Haemophilus Infections/prevention & control , Haemophilus influenzae , Humans , Incidence , Infant , Middle Aged , Serogroup , United States/epidemiology
2.
Clin Infect Dis ; 70(7): 1478-1481, 2020 03 17.
Article in English | MEDLINE | ID: mdl-31408094

ABSTRACT

Using population-based surveillance data, we quantified the secondary invasive group A Streptococcus disease risk among household contacts. The disease risk in the 30 days postexposure to an index-case patient was highest among individuals aged ≥65 years, versus the annual background incidence of all ages.


Subject(s)
Streptococcal Infections , Streptococcus pyogenes , Family Characteristics , Humans , Incidence , Population Surveillance , Streptococcal Infections/epidemiology , United States/epidemiology
3.
J Infect Dis ; 216(9): 1130-1140, 2017 11 27.
Article in English | MEDLINE | ID: mdl-28968661

ABSTRACT

Background: Limited data exist on the impact of the serogroup B meningococcal (MenB) vaccines MenB-FHbp and MenB-4C on meningococcal carriage and herd protection. We therefore assessed meningococcal carriage following a MenB vaccination campaign in response to a university serogroup B meningococcal disease outbreak in 2015. Methods: A convenience sample of students recommended for vaccination provided oropharyngeal swab specimens and completed questionnaires during 4 carriage surveys over 11 months. Isolates were tested by real-time polymerase chain reaction analysis, slide agglutination, and whole-genome sequencing. Vaccination history was verified via university records and the state immunization registry. Results: A total of 4225 oropharyngeal swab specimens from 3802 unique participants were analyzed. Total meningococcal and genotypically serogroup B carriage prevalence among sampled students were stable, at 11%-17% and 1.2%-2.4% during each round, respectively; no participants carried the outbreak strain. Neither 1-3 doses of MenB-FHbp nor 1-2 doses of MenB-4C was associated with decreased total or serogroup B carriage prevalence. Conclusions: While few participants completed the full MenB vaccination series, limiting analytic power, these data suggest that MenB-FHbp and MenB-4C do not have a large, rapid impact on meningococcal carriage and are unlikely to provide herd protection in the context of an outbreak response.


Subject(s)
Antigens, Bacterial/immunology , Disease Outbreaks/prevention & control , Immunization Programs , Meningococcal Infections/prevention & control , Meningococcal Vaccines/administration & dosage , Meningococcal Vaccines/immunology , Vaccination , Female , Humans , Male , Oregon , Universities
4.
MMWR Morb Mortal Wkly Rep ; 66(37): 999-1000, 2017 Sep 22.
Article in English | MEDLINE | ID: mdl-28934181

ABSTRACT

Since 2011, the New York City (NYC) Department of Health and Mental Hygiene (DOHMH) has typically been notified of three or fewer cases of hepatitis A virus (HAV) infection each year among men who have sex with men (MSM) who reported no travel to countries where HAV is endemic. This year, DOHMH noted an increase in HAV infections among MSM with onsets in January-March 2017, and notified other public health jurisdictions via Epi-X, CDC's communication exchange network. As a result, 51 patients with HAV infection involving MSM were linked to the increase in NYC.


Subject(s)
Hepatitis A/epidemiology , Homosexuality, Male , Adult , Humans , Incidence , Male , New York City/epidemiology
5.
Clin Infect Dis ; 61(4): 584-92, 2015 Aug 15.
Article in English | MEDLINE | ID: mdl-25904365

ABSTRACT

BACKGROUND: An estimated 20 000 new hepatitis B virus (HBV) infections occur each year in the United States. We describe the results of enhanced surveillance for acute hepatitis B at 7 federally funded sites over a 6-year period. METHODS: Health departments in Colorado, Connecticut, Minnesota, Oregon, Tennessee, 34 counties in New York state, and New York City were supported to conduct enhanced, population-based surveillance for acute HBV from 2006 through 2011. Demographic and risk factor data were collected on symptomatic cases using a standardized form. Serum samples from a subset of cases were also obtained for molecular analysis. RESULTS: In the 6-year period, 2220 acute hepatitis B cases were reported from the 7 sites. For all sites combined, the incidence rate of HBV infection declined by 19%, but in Tennessee incidence increased by 90%, mainly among persons of white race/ethnicity and those aged 40-49 years. Of all reported cases, 66.1% were male, 57.1% were white, 58.4% were aged 30-49 years, and 60.1% were born in the United States. The most common risk factor identified was any drug use, notably in Tennessee; healthcare exposure was also frequently reported. The most common genotype for all reported cases was HBV genotype A (82%). CONCLUSIONS: Despite an overall decline in HBV infection, attributable to successful vaccination programs, a rise in incident HBV infection related to drug use is an increasing concern in some localities.


Subject(s)
Hepatitis B/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Child , Demography , Epidemiological Monitoring , Ethnicity , Female , Genotype , Hepatitis B virus/classification , Hepatitis B virus/genetics , Hepatitis B virus/isolation & purification , Humans , Incidence , Male , Middle Aged , Risk Factors , Surveys and Questionnaires , United States/epidemiology , Young Adult
6.
MMWR Morb Mortal Wkly Rep ; 64(14): 399, 2015 Apr 17.
Article in English | MEDLINE | ID: mdl-25879900

ABSTRACT

On January 8, 2014, the Ohio Department of Health notified the Oregon Public Health Division (OPHD) of campylobacteriosis in two Ohio residents recently returned from Oregon. The travelers reported consuming chicken liver pâté* at an Oregon restaurant. On January 10, OPHD received additional reports of campylobacteriosis in two persons who had consumed chicken liver pâté at another Oregon restaurant. Campylobacter jejuni was isolated in cultures of fecal specimens from three patients. OPHD investigated to determine the sources of the illnesses and to institute preventive measures.


Subject(s)
Campylobacter Infections/epidemiology , Campylobacter jejuni/isolation & purification , Disease Outbreaks , Food Microbiology , Foodborne Diseases/epidemiology , Meat/microbiology , Animals , Campylobacter Infections/microbiology , Chickens , Cooking , Feces/microbiology , Foodborne Diseases/microbiology , Humans , Liver , Ohio/epidemiology , Oregon/epidemiology , Restaurants
7.
Hepatology ; 57(3): 917-24, 2013 Mar.
Article in English | MEDLINE | ID: mdl-22383058

ABSTRACT

UNLABELLED: Reports of hepatitis B virus (HBV) and hepatitis C virus (HCV) transmission associated with unsafe medical practices have been increasing in the United States. However, the contribution of healthcare exposures to the burden of new infections is poorly understood outside of recognized outbreaks. We conducted a case-control study at three health departments that perform enhanced viral hepatitis surveillance in New York and Oregon. Reported cases of symptomatic acute hepatitis B and hepatitis C occurring in persons≥55 years of age from 2006 to 2008 were enrolled. Controls were identified using telephone directories and matched to individual cases by age group (55-59, 60-69, and ≥70 years) and residential postal code. Data collection covered exposures within 6 months before symptom onset (cases) or date of interview (controls). Forty-eight (37 hepatitis B and 11 hepatitis C) case and 159 control patients were enrolled. Case patients were more likely than controls to report one or more behavioral risk exposures, including sexual or household contact with an HBV or HCV patient, >1 sex partner, illicit drug use, or incarceration (21% of cases versus 4% of controls exposed; matched odds ratio [mOR]=7.1; 95% confidence interval [CI]: 2.1, 24.1). Case patients were more likely than controls to report hemodialysis (8% of cases; mOR=13.0; 95% CI: 1.5, 115), injections in a healthcare setting (58%; mOR=2.7; 95% CI: 1.3, 5.3), and surgery (33%; mOR=2.3; 95% CI: 1.1, 4.7). In a multivariate model, behavioral risks (adjusted OR [aOR]=5.4; 95% CI: 1.5, 19.0; 17% attributable risk), injections (aOR=2.7; 95% CI: 1.3, 5.8; 37% attributable risk), and hemodialysis (aOR=11.5; 95% CI: 1.2, 107; 8% attributable risk) were associated with case status. CONCLUSION: Healthcare exposures may represent an important source of new HBV and HCV infections among older adults.


Subject(s)
Ambulatory Care/statistics & numerical data , Hepatitis B/epidemiology , Hepatitis B/transmission , Hepatitis C/epidemiology , Hepatitis C/transmission , Acute Disease , Age Distribution , Aged , Case-Control Studies , Equipment Contamination/statistics & numerical data , Female , Hospitalization/statistics & numerical data , Humans , Injections/adverse effects , Injections/statistics & numerical data , Male , Middle Aged , New York/epidemiology , Population Surveillance , Risk Factors , Sex Distribution , Vaccination/adverse effects , Vaccination/statistics & numerical data
9.
Zoonoses Public Health ; 69(3): 167-174, 2022 05.
Article in English | MEDLINE | ID: mdl-35048538

ABSTRACT

In December 2018, PulseNet, the national laboratory network for enteric disease surveillance, identified an increase in Salmonella Typhimurium isolates with an uncommon pulsed-field gel electrophoresis pattern which was previously isolated from hedgehogs. CDC, state, and local health partners interviewed patients with a questionnaire that focused on hedgehog exposures, conducted traceback of patients' hedgehog purchases, and collected hedgehog faecal pellets and environmental samples. Isolates in this outbreak were analysed using core-genome multi-locus sequence typing (cgMLST) and compared to sequence data from historic clinical isolates from a 2011-2013 outbreak of Salmonella Typhimurium illnesses linked to pet hedgehogs. Fifty-four illnesses in 23 states were identified between October 2018 and September 2019. Patients ranged from <1 to 95 years, and 65% were female. Eight patients were hospitalized. Eighty-one per cent (29/36) of patients interviewed reported contact with a hedgehog before becoming ill; of these, 21 (72%) reported owning a hedgehog. Analysis of 53 clinical, 11 hedgehog, and two hedgehog bedding isolates from this outbreak, seven hedgehog isolates obtained prior to this outbreak, and two clinical isolates from the 2011-2013 outbreak fell into three distinct groupings (37 isolates in Clade 1 [0-10 alleles], 28 isolates in Clade 2 [0-7 alleles], and eight isolates in Clade 3 [0-12 alleles]) and were collectively related within 0-31 alleles by cgMLST. Purchase information available from 20 patients showed hedgehogs were purchased from multiple breeders across nine states, a pet store, and through an online social media website; a single source of hedgehogs was not identified. This outbreak highlights the ability of genetic sequencing analysis to link historic and ongoing Salmonella illness outbreaks and demonstrates the strain of Salmonella linked to hedgehogs might continue to be a health risk to hedgehog owners unless measures are taken to prevent transmission.


Subject(s)
Hedgehogs , Salmonella Infections, Animal , Animals , Disease Outbreaks , Female , Humans , Multilocus Sequence Typing/veterinary , Salmonella Infections, Animal/epidemiology , Salmonella typhimurium/genetics , United States/epidemiology
10.
Public Health Rep ; 126(3): 344-8, 2011.
Article in English | MEDLINE | ID: mdl-21553662

ABSTRACT

OBJECTIVES: Both HIV and hepatitis C virus (HCV) can be transmitted through percutaneous exposure to blood in similar high-risk populations. HCV and HIV/AIDS surveillance databases were matched in Colorado, Connecticut, and Oregon to measure the frequency of co-infection and to characterize coinfected people. METHODS: We defined a case of HCV infection as a person with a reactive antibody for hepatitis C, medical diagnosis, positive viral-load test result, or positive genotype reported to any of three state health departments from the start of each state's hepatitis C registry through June 30, 2008. We defined a case of HIV/AIDS as a person diagnosed and living with HIV/AIDS at the start of each state's respective hepatitis C registry through June 30, 2008. HIV/AIDS and hepatitis C datasets were matched using Link King, public domain record linkage and consolidation software, and all potential matches were manually reviewed before acceptance as a match. RESULTS: The proportion of reported hepatitis C cases co-infected with HIV/ AIDS was 1.8% in Oregon, 1.9% in Colorado, and 4.9% in Connecticut. Conversely, the proportion of HIV/AIDS cases co-infected with hepatitis C was consistently higher in the three states: 4.4% in Oregon, 9.7% in Colorado, and 23.6% in Connecticut. CONCLUSIONS: Electronic matching of registries is a potentially useful and efficient way to transfer information from one registry to another. In addition, it can provide a measure of the public health burden of HIV/AIDS and hepatitis C co-infection and provide insight into prevention and medical care needs for respective states.


Subject(s)
HIV Infections/epidemiology , Hepatitis C/epidemiology , Information Storage and Retrieval/methods , Registries , Adolescent , Adult , Aged , Colorado/epidemiology , Connecticut/epidemiology , Female , HIV Infections/complications , HIV Infections/transmission , Hepatitis C/complications , Hepatitis C/transmission , Humans , Male , Middle Aged , Oregon/epidemiology , Population Surveillance , Risk Factors
11.
Emerg Infect Dis ; 15(9): 1499-502, 2009 Sep.
Article in English | MEDLINE | ID: mdl-19788825

ABSTRACT

Surveillance for hepatitis C virus infection in 6 US sites identified 20,285 newly reported cases in 12 months (report rate 69 cases/100,000 population, range 25-108/100,000). Staff reviewed 4 laboratory reports per new case. Local surveillance data can document the effects of disease, support linkage to care, and help prevent secondary transmission.


Subject(s)
Hepatitis C/epidemiology , Population Surveillance/methods , Adolescent , Adult , Age Distribution , Centers for Disease Control and Prevention, U.S. , Child , Child, Preschool , Female , Hepatitis C/virology , Humans , Infant , Infant, Newborn , Male , Middle Aged , Program Evaluation , United States/epidemiology , Young Adult
12.
Article in English | MEDLINE | ID: mdl-19273915

ABSTRACT

PURPOSE: To compare the pain induced by tissue infiltration of lidocaine 2% with epinephrine 1:100,000 versus articaine 4% with epinephrine 1:100,000 for eyelid surgery. METHODS: Thirty patients undergoing bilateral eyelid surgery were enrolled in a prospective, randomized, double-masked study. Each subject received injections of lidocaine 2% with epinephrine 1:100,000 (Xylocaine) on one side and articaine 4% with epinephrine 1:100,000 (Septocaine) on the other for surgical anesthesia. The patients rated the pain of infiltration using a 100-mm visual analogue scale immediately after receiving each injection. The pain scores were compared using the paired t test. RESULTS: Twenty-two of the 30 patients (73.3%) rated the articaine injection as less painful than the lidocaine injection. The mean pain score for lidocaine was 42.60 +/- 24.74 and the pain score for articaine was 31.85 +/- 20.28 (p = 0.011). CONCLUSIONS: In this study, infiltration of articaine was less painful than lidocaine for eyelid surgery, making articaine an attractive alternative for local anesthesia.


Subject(s)
Anesthesia, Local/methods , Anesthetics, Local/adverse effects , Carticaine/adverse effects , Epinephrine/adverse effects , Eyelid Diseases/surgery , Lidocaine/adverse effects , Pain/chemically induced , Adolescent , Adult , Aged , Aged, 80 and over , Anesthetics, Local/administration & dosage , Double-Blind Method , Drug Combinations , Female , Humans , Injections , Male , Middle Aged , Pain Measurement , Prospective Studies , Young Adult
13.
Open Forum Infect Dis ; 6(5): ofz190, 2019 May.
Article in English | MEDLINE | ID: mdl-31123695

ABSTRACT

We characterized 22 meningococcal disease cases due to nongroupable Neisseria meningitidis, a rare cause of invasive disease. Disease presentation and severity were similar to those for serogroupable meningococcal disease. However, 7 (32%) patients had complement deficiency or abnormal complement testing results, highlighting the importance of complement testing for nongroupable cases.

14.
PLoS One ; 14(5): e0217632, 2019.
Article in English | MEDLINE | ID: mdl-31145765

ABSTRACT

Detection of clusters of Legionnaires' disease, a leading waterborne cause of pneumonia, is challenging. Clusters vary in size and scope, are associated with a diverse range of aerosol-producing devices, including exposures such as whirlpool spas and hotel water systems typically associated with travel, and can occur without an easily identified exposure source. Recently, jurisdictions have begun to use SaTScan spatio-temporal analysis software prospectively as part of routine cluster surveillance. We used data collected by the Active Bacterial Core surveillance platform to assess the ability of SaTScan to detect Legionnaires' disease clusters. We found that SaTScan analysis using traditional surveillance data and geocoded residential addresses was unable to detect many common Legionnaires' disease cluster types, such as those associated with travel or a prolonged time between cases. Additionally, signals from an analysis designed to simulate a real-time search for clusters did not align with clusters identified by traditional surveillance methods or a retrospective SaTScan analysis. A geospatial analysis platform better tailored to the unique characteristics of Legionnaires' disease epidemiology would improve cluster detection and decrease time to public health action.


Subject(s)
Legionella pneumophila/isolation & purification , Legionnaires' Disease/epidemiology , Pneumonia/enzymology , Population Surveillance , Cluster Analysis , Disease Outbreaks , Humans , Legionella pneumophila/pathogenicity , Legionnaires' Disease/microbiology , Pneumonia/microbiology , Pneumonia/prevention & control , Prospective Studies , Retrospective Studies , Software , Water Microbiology
15.
J Adolesc Health ; 63(2): 151-156, 2018 08.
Article in English | MEDLINE | ID: mdl-30149923

ABSTRACT

PURPOSE: Between January and May 2015, seven people at a large, public university developed invasive serogroup B meningococcal disease. One case was fatal. Attack rates were highest among freshmen and members of sororities, and fraternities (Greek organizations). Mass vaccination clinics using newly licensed serogroup B vaccine were held in March, May, and October 2015. No cases occurred after the second mass vaccination clinic. METHODS: We surveyed vaccine recipients at each clinic from March to October 2015 to determine preferred methods for notification about vaccination clinics, assess motivations for attending, and evaluate the clinic attendee population. RESULTS: Vaccination rates were low; 15% of undergraduates received one vaccine dose. An additional 11% received two doses of the three-dose MenB-FHbp series, and 4% completed a serogroup B meningococcal vaccine series at a mass vaccination clinic. University freshmen were 2.3 times as likely (confidence interval: 2.2-2.9) and Greek members 1.3 times as likely (confidence interval: 1.2-1.4) to attend a mass vaccination clinic as nonfreshmen or non-Greek members, respectively. Attendees reported e-mail as their preferred communication method (90%). Concerns about developing meningococcal disease (66%) and parental request (56%) were the most commonly cited motivations for attending a vaccination clinic. CONCLUSIONS: The serogroup B meningococcal outbreak at this large, public university disproportionately affected freshmen and students affiliated with Greek organizations. Despite low overall vaccination rates, the vaccination campaign did reach the populations at risk. In future outbreaks at large universities, we recommend focusing vaccination efforts on specific at-risk populations to maximize vaccination of those most at risk for this deadly disease.


Subject(s)
Disease Outbreaks/prevention & control , Mass Vaccination , Meningococcal Infections/prevention & control , Meningococcal Vaccines/administration & dosage , Neisseria meningitidis, Serogroup B/isolation & purification , Adolescent , Female , Humans , Male , Meningococcal Vaccines/immunology , Oregon , Universities
16.
J Immigr Minor Health ; 17(1): 7-12, 2015 Feb.
Article in English | MEDLINE | ID: mdl-24705737

ABSTRACT

National surveys indicate prevalence of chronic hepatitis B among foreign-born persons in the USA is 5.6 times higher than US-born. Centers for Disease Control and Prevention funded chronic hepatitis B surveillance in Emerging Infections Program sites. A case was any chronic hepatitis B case reported to participating sites from 2001 to 2010. Sites collected standardized demographic data on all cases. We tested differences between foreign- and US-born cases by age, sex, and pregnancy using Chi square tests. We examined trends by birth country during 2005-2010. Of 36,008 cases, 21,355 (59.3%) reported birth in a country outside the USA, 2,323 (6.5%) were US-born. Compared with US-born, foreign-born persons were 9.2 times more frequent among chronic hepatitis B cases. Foreign-born were more frequently female, younger, ever pregnant, and born in China. Percentages of cases among foreign-born persons were constant during 2005-2010. Our findings support information from US surveillance for Hepatitis B screening and vaccination efforts.


Subject(s)
Emigrants and Immigrants , Hepatitis B, Chronic/epidemiology , Population Surveillance , Adolescent , Adult , Female , Humans , Male , Middle Aged , Prevalence , United States/epidemiology
17.
Infect Control Hosp Epidemiol ; 35(4): 356-61, 2014 Apr.
Article in English | MEDLINE | ID: mdl-24602939

ABSTRACT

OBJECTIVE: To establish a statewide network to detect, control, and prevent the spread of carbapenem-resistant Enterobacteriaceae (CRE) in a region with a low incidence of CRE infection. DESIGN: Implementation of the Drug Resistant Organism Prevention and Coordinated Regional Epidemiology (DROP-CRE) Network. SETTING AND PARTICIPANTS: Oregon infection prevention and microbiology laboratory personnel, including 48 microbiology laboratories, 62 acute care facilities, and 140 long-term care facilities. METHODS: The DROP-CRE working group, comprising representatives from academic institutions and public health, convened an interdisciplinary advisory committee to assist with planning and implementation of CRE epidemiology and control efforts. The working group established a statewide CRE definition and surveillance plan; increased the state laboratory capacity to perform the modified Hodge test and polymerase chain reaction for carbapenemases in real time; and administered surveys that assessed the needs and capabilities of Oregon infection prevention and laboratory personnel. Results of these inquiries informed CRE education and the response plan. RESULTS: Of 60 CRE reported from November 2010 through April 2013, only 3 were identified as carbapenemase producers; the cases were not linked, and no secondary transmission was found. Microbiology laboratories, acute care facilities, and long-term care facilities reported lacking carbapenemase testing capability, reliable interfacility communication, and CRE awareness, respectively. Survey findings informed the creation of the Oregon CRE Toolkit, a state-specific CRE guide booklet. CONCLUSIONS: A regional epidemiology surveillance and response network has been implemented in Oregon in advance of widespread CRE transmission. Prospective surveillance will determine whether this collaborative approach will be successful at forestalling the emergence of this important healthcare-associated pathogen.


Subject(s)
Carbapenems/pharmacology , Drug Resistance, Microbial , Enterobacteriaceae Infections/prevention & control , Enterobacteriaceae/drug effects , Bacterial Proteins/genetics , Bacterial Proteins/isolation & purification , Carbapenems/therapeutic use , Clinical Laboratory Techniques , Cross Infection/prevention & control , Enterobacteriaceae/enzymology , Enterobacteriaceae Infections/epidemiology , Humans , Incidence , Oregon/epidemiology , Population Surveillance , Real-Time Polymerase Chain Reaction , beta-Lactamases/genetics , beta-Lactamases/isolation & purification
18.
J Diabetes Sci Technol ; 6(4): 858-66, 2012 Jul 01.
Article in English | MEDLINE | ID: mdl-22920812

ABSTRACT

INTRODUCTION: The risk of acute hepatitis B among adults with diabetes mellitus is unknown. We investigated the association between diagnosed diabetes and acute hepatitis B. METHODS: Confirmed acute hepatitis B cases were reported in 2009-2010 to eight Emerging Infections Program (EIP) sites; diagnosed diabetes status was determined. Behavioral Risk Factor Surveillance System respondents residing in EIP sites comprised the comparison group. Odds ratios (ORs) comparing acute hepatitis B among adults with diagnosed diabetes versus without diagnosed diabetes were determined by multivariate logistic regression, adjusting for age, sex, and race/ethnicity, and stratified by the presence or absence of risk behaviors for hepatitis B virus (HBV) infection. RESULTS: During 2009-2010, EIP sites reported 865 eligible acute hepatitis B cases among persons aged ≥23 years; 95 (11.0%) had diagnosed diabetes. Comparison group diabetes prevalence was 9.1%. Among adults without hepatitis B risk behaviors and with reported diabetes status, the OR for acute hepatitis B comparing adults with and without diabetes was 1.9 (95% confidence interval [CI] = 1.4, 2.6); ORs for adults ages 23-59 and ≥60 years were 2.1 (95% CI = 1.6, 2.8) and 1.5 (95% = CI 0.9, 2.5), respectively. CONCLUSIONS: Diabetes was independently associated with an increased risk for acute hepatitis B among adults without HBV risk behaviors.


Subject(s)
Diabetes Mellitus/epidemiology , Hepatitis B/epidemiology , Hepatitis B/etiology , Acute Disease , Adult , Aged , Aged, 80 and over , Diabetes Complications/epidemiology , Diabetes Complications/ethnology , Diabetes Mellitus/diagnosis , Diabetes Mellitus/ethnology , Female , Hepatitis B/ethnology , Humans , Male , Middle Aged , Population Surveillance , Prevalence , Risk Factors , Young Adult
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