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2.
Vaccine ; 38(34): 5430-5435, 2020 07 22.
Artículo en Inglés | MEDLINE | ID: mdl-32620371

RESUMEN

BACKGROUND: Health-seeking behaviors change during pandemics and may increase with regard to illnesses with symptoms similar to the pandemic. The global reaction to COVID-19 may drive interest in vaccines for other diseases. OBJECTIVES: Our study investigated the correlation between global online interest in COVID-19 and interest in CDC-recommended routine vaccines. DESIGN, SETTINGS, MEASUREMENTS: This infodemiology study used Google Trends data to quantify worldwide interest in COVID-19 and CDC-recommended vaccines using the unit search volume index (SVI), which estimates volume of online search activity relative to highest volume of searches within a specified period. SVIs from December 30, 2019 to March 30, 2020 were collected for "coronavirus (Virus)" and compared with SVIs of search terms related to CDC-recommended adult vaccines. To account for seasonal variation, we compared SVIs from December 30, 2019 to March 30, 2020 with SVIs from the same months in 2015 to 2019. We performed country-level analyses in ten COVID-19 hotspots and ten countries with low disease burden. RESULTS: There were significant positive correlations between SVIs for "coronavirus (Virus)" and search terms for pneumococcal (R = 0.89, p < 0.0001) and influenza vaccines (R = 0.93, p < 0.0001) in 2020, which were greater than SVIs for the same terms in 2015-2019 (p = 0.005, p < 0.0001, respectively). Eight in ten COVID-19 hotspots demonstrated significant positive correlations between SVIs for coronavirus and search terms for pneumococcal and influenza vaccines. LIMITATIONS: SVIs estimate relative changes in online interest and do not represent the interest of people with no Internet access. CONCLUSION: A peak in worldwide interest in pneumococcal and influenza vaccines coincided with the COVID-19 pandemic in February and March 2020. Trends are likely not seasonal in origin and may be driven by COVID-19 hotspots. Global events may change public perception about the importance of vaccines. Our findings may herald higher demand for pneumonia and influenza vaccines in the upcoming season.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Vacunas contra la Influenza , Almacenamiento y Recuperación de la Información/estadística & datos numéricos , Internet , Pandemias/prevención & control , Vacunas Neumococicas , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Vacunas Virales , Centers for Disease Control and Prevention, U.S. , Educación en Salud/estadística & datos numéricos , Humanos , Motor de Búsqueda/estadística & datos numéricos , Estados Unidos
4.
J Prim Care Community Health ; 11: 2150132720938046, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32659152

RESUMEN

This document establishes safety guidelines for physicians, nurses, and allied health care and facility staff who may be exposed to patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a health care facility. SARS-CoV-2 infection is highly contagious and places health care workers at risk for infection resulting in coronavirus disease (COVID-19). Physicians, nurses, and allied health care and facility staff in all frontline environments must be provided and utilize necessary personal protective equipment (PPE). It is important that health care staff adopt a universal set of guidelines in which to conduct themselves in order to minimize infection with the SARS-CoV-2 contagion. The establishment of these guidelines is necessary in this viral pandemic since such directives can create a standard of safety that is universally accepted. These guidelines establish a framework to provide consistency among health care facilities and staff from the time the staff member arrives at the health care facility until they return home. These guidelines provide a practical description of the minimum necessary protection for physicians, nurses, and allied health care and facility staff against SARS-CoV-2 infection.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Personal de Salud , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , Seguridad , Centers for Disease Control and Prevention, U.S. , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/transmisión , Humanos , Equipo de Protección Personal , Neumonía Viral/epidemiología , Neumonía Viral/transmisión , Estados Unidos/epidemiología
5.
MMWR Morb Mortal Wkly Rep ; 69(28): 938-940, 2020 Jul 17.
Artículo en Inglés | MEDLINE | ID: mdl-32673302

RESUMEN

Mosquitoborne disease outbreaks occur every year in the United States from one or more of the arboviral diseases dengue, West Nile, LaCrosse, Eastern equine encephalitis, and Zika (1). Public opinion communicated through traditional and social media and the Internet, competing public health and resource priorities, and local conditions can impede the ability of vector control organizations to prevent and respond to outbreaks of mosquitoborne disease. The Environmental Protection Agency (EPA) and CDC performed a coordinated review of the concerns and challenges associated with continuation of mosquito surveillance and control during public health emergencies and disasters. This report highlights the first joint recommendation from EPA and CDC. Mosquito surveillance and control should be maintained by state and local mosquito control organizations to the extent that local conditions and resources will allow during public health emergencies and natural disasters. Integrated pest management (IPM) is the best approach for mosquito control (2). IPM uses a combination of methods, including both physical and chemical means of control (3). For chemical means of control, CDC and EPA recommend the use of larvicides and adulticides following the EPA label. It is imperative that public health recommendations be followed to ensure the safety of the pesticide applicator and the public.


Asunto(s)
Brotes de Enfermedades , Monitoreo del Ambiente , Control de Mosquitos/organización & administración , Desastres Naturales , Centers for Disease Control and Prevention, U.S. , Humanos , Estados Unidos/epidemiología , United States Environmental Protection Agency
6.
Health Secur ; 18(3): 250-256, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32525747

RESUMEN

After implementing restrictions to curb the spread of coronavirus, governments in the United States and around the world are trying to identify the path to social and economic recovery. The White House and the Centers for Disease Control and Prevention have published guidelines to assist US states, counties, and territories in planning these efforts. As the impact of the coronavirus pandemic has not been uniform, these central guidelines need to be translated into practice in ways that recognize variation among jurisdictions. We present a core methodology to assist governments in this task, presenting a case for appropriate actions at each stage of recovery based on scientific data and analysis. Specifically, 3 types of data are needed: data on the spread of disease should be analyzed alongside data on the overall health of the population and data on infrastructure-for example, the capacity of health systems. Local circumstances will produce different needs and present different setbacks, and governments may need to reinstate as well as relax restrictions. Transparent, defensible analysis can assist in making these decisions and communicating them to the public. In the absence of a widely administered vaccine, analysis remains one of our most important tools in addressing the coronavirus pandemic.


Asunto(s)
Control de Enfermedades Transmisibles/normas , Infecciones por Coronavirus/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , Guías de Práctica Clínica como Asunto , Cuarentena/normas , Centers for Disease Control and Prevention, U.S. , Infecciones por Coronavirus/epidemiología , Femenino , Humanos , Masculino , Pandemias/estadística & datos numéricos , Neumonía Viral/epidemiología , Salud Pública , Estados Unidos
7.
N Engl J Med ; 383(4): 334-346, 2020 07 23.
Artículo en Inglés | MEDLINE | ID: mdl-32598831

RESUMEN

BACKGROUND: Understanding the epidemiology and clinical course of multisystem inflammatory syndrome in children (MIS-C) and its temporal association with coronavirus disease 2019 (Covid-19) is important, given the clinical and public health implications of the syndrome. METHODS: We conducted targeted surveillance for MIS-C from March 15 to May 20, 2020, in pediatric health centers across the United States. The case definition included six criteria: serious illness leading to hospitalization, an age of less than 21 years, fever that lasted for at least 24 hours, laboratory evidence of inflammation, multisystem organ involvement, and evidence of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) based on reverse-transcriptase polymerase chain reaction (RT-PCR), antibody testing, or exposure to persons with Covid-19 in the past month. Clinicians abstracted the data onto standardized forms. RESULTS: We report on 186 patients with MIS-C in 26 states. The median age was 8.3 years, 115 patients (62%) were male, 135 (73%) had previously been healthy, 131 (70%) were positive for SARS-CoV-2 by RT-PCR or antibody testing, and 164 (88%) were hospitalized after April 16, 2020. Organ-system involvement included the gastrointestinal system in 171 patients (92%), cardiovascular in 149 (80%), hematologic in 142 (76%), mucocutaneous in 137 (74%), and respiratory in 131 (70%). The median duration of hospitalization was 7 days (interquartile range, 4 to 10); 148 patients (80%) received intensive care, 37 (20%) received mechanical ventilation, 90 (48%) received vasoactive support, and 4 (2%) died. Coronary-artery aneurysms (z scores ≥2.5) were documented in 15 patients (8%), and Kawasaki's disease-like features were documented in 74 (40%). Most patients (171 [92%]) had elevations in at least four biomarkers indicating inflammation. The use of immunomodulating therapies was common: intravenous immune globulin was used in 144 (77%), glucocorticoids in 91 (49%), and interleukin-6 or 1RA inhibitors in 38 (20%). CONCLUSIONS: Multisystem inflammatory syndrome in children associated with SARS-CoV-2 led to serious and life-threatening illness in previously healthy children and adolescents. (Funded by the Centers for Disease Control and Prevention.).


Asunto(s)
Infecciones por Coronavirus/complicaciones , Neumonía Viral/complicaciones , Síndrome de Respuesta Inflamatoria Sistémica/epidemiología , Síndrome de Respuesta Inflamatoria Sistémica/virología , Adolescente , Betacoronavirus , Centers for Disease Control and Prevention, U.S. , Niño , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/terapia , Cuidados Críticos , Femenino , Glucocorticoides/uso terapéutico , Humanos , Inmunoglobulinas Intravenosas/uso terapéutico , Inmunomodulación , Inflamación , Tiempo de Internación , Masculino , Síndrome Mucocutáneo Linfonodular/epidemiología , Síndrome Mucocutáneo Linfonodular/terapia , Síndrome Mucocutáneo Linfonodular/virología , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/terapia , Estudios Prospectivos , Respiración Artificial , Estudios Retrospectivos , Síndrome de Respuesta Inflamatoria Sistémica/terapia , Estados Unidos
8.
Nursing ; 50(7): 48-52, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32558791

RESUMEN

This article explores the nature of stigma and discusses how stigma negatively affects both adults and children with epilepsy.


Asunto(s)
Epilepsia/psicología , Educación en Salud/organización & administración , Estigma Social , Adulto , Centers for Disease Control and Prevention, U.S. , Niño , Epilepsia/epidemiología , Fundaciones , Humanos , Prevalencia , Estados Unidos/epidemiología
10.
Medicine (Baltimore) ; 99(24): e20774, 2020 Jun 12.
Artículo en Inglés | MEDLINE | ID: mdl-32541529

RESUMEN

BACKGROUND: The US Centers for Disease Control and Prevention (CDC) regularly issues "travel health notices" that address disease outbreaks of novel coronavirus disease (COVID)-19 in destinations worldwide. The notices are classified into 3 levels based on the risk posed by the outbreak and what precautions should be in place to prevent spreading. What objectively observed criteria of these COVID-19 situations are required for classification and visualization? This study aimed to visualize the epidemic outbreak and the provisional case fatality rate (CFR) using the Rasch model and Bayes's theorem and developed an algorithm that classifies countries/regions into categories that are then shown on Google Maps. METHODS: We downloaded daily COVID-19 outbreak numbers for countries/regions from the GitHub website, which contains information on confirmed cases in more than 30 Chinese locations and other countries/regions. The Rasch model was used to estimate the epidemic outbreak for each country/region using data from recent days. All responses were transformed by using the logarithm function. The Bayes's base CFRs were computed for each region. The geographic risk of transmission of the COVID-19 epidemic was thus determined using both magnitudes (i.e., Rasch scores and CFRs) for each country. RESULTS: The top 7 countries were Iran, South Korea, Italy, Germany, Spain, China (Hubei), and France, with values of {4.53, 3.47, 3.18, 1.65, 1.34 1.13, 1.06} and {13.69%, 0.91%, 47.71%, 0.23%, 24.44%, 3.56%, and 16.22%} for the outbreak magnitudes and CFRs, respectively. The results were consistent with the US CDC travel advisories of warning level 3 in China, Iran, and most European countries and of level 2 in South Korea on March 16, 2020. CONCLUSION: We created an online algorithm that used the CFRs to display the geographic risks to understand COVID-19 transmission. The app was developed to display which countries had higher travel risks and aid with the understanding of the outbreak situation.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/transmisión , Brotes de Enfermedades , Neumonía Viral/epidemiología , Neumonía Viral/transmisión , Algoritmos , Teorema de Bayes , Centers for Disease Control and Prevention, U.S. , China/epidemiología , Infecciones por Coronavirus/mortalidad , Presentación de Datos , Visualización de Datos , Europa (Continente)/epidemiología , Salud Global , Humanos , Irán/epidemiología , Modelos Estadísticos , Pandemias , Neumonía Viral/mortalidad , República de Corea/epidemiología , Medición de Riesgo , Viaje , Estados Unidos/epidemiología
12.
RNA ; 26(7): 771-783, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-32358057

RESUMEN

The current COVID-19 pandemic presents a serious public health crisis, and a better understanding of the scope and spread of the virus would be aided by more widespread testing. Nucleic-acid-based tests currently offer the most sensitive and early detection of COVID-19. However, the "gold standard" test pioneered by the U.S. Centers for Disease Control and Prevention takes several hours to complete and requires extensive human labor, materials such as RNA extraction kits that could become in short supply, and relatively scarce qPCR machines. It is clear that a huge effort needs to be made to scale up current COVID-19 testing by orders of magnitude. There is thus a pressing need to evaluate alternative protocols, reagents, and approaches to allow nucleic-acid testing to continue in the face of these potential shortages. There has been a tremendous explosion in the number of papers written within the first weeks of the pandemic evaluating potential advances, comparable reagents, and alternatives to the "gold-standard" CDC RT-PCR test. Here we present a collection of these recent advances in COVID-19 nucleic acid testing, including both peer-reviewed and preprint articles. Due to the rapid developments during this crisis, we have included as many publications as possible, but many of the cited sources have not yet been peer-reviewed, so we urge researchers to further validate results in their own laboratories. We hope that this review can urgently consolidate and disseminate information to aid researchers in designing and implementing optimized COVID-19 testing protocols to increase the availability, accuracy, and speed of widespread COVID-19 testing.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Técnicas de Laboratorio Clínico , Técnicas de Amplificación de Ácido Nucleico/métodos , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , Betacoronavirus/genética , Sistemas CRISPR-Cas , Centers for Disease Control and Prevention, U.S. , Repeticiones Palindrómicas Cortas Agrupadas y Regularmente Espaciadas , Infecciones por Coronavirus/diagnóstico , Humanos , Nasofaringe/virología , Técnicas de Amplificación de Ácido Nucleico/instrumentación , Sistemas de Atención de Punto , ARN Viral/genética , ARN Viral/aislamiento & purificación , Reacción en Cadena en Tiempo Real de la Polimerasa/instrumentación , Factores de Tiempo , Estados Unidos , Flujo de Trabajo
13.
Emerg Infect Dis ; 26(8)2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32396505

RESUMEN

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified as the etiologic agent associated with coronavirus disease, which emerged in late 2019. In response, we developed a diagnostic panel consisting of 3 real-time reverse transcription PCR assays targeting the nucleocapsid gene and evaluated use of these assays for detecting SARS-CoV-2 infection. All assays demonstrated a linear dynamic range of 8 orders of magnitude and an analytical limit of detection of 5 copies/reaction of quantified RNA transcripts and 1 x 10-1.5 50% tissue culture infectious dose/mL of cell-cultured SARS-CoV-2. All assays performed comparably with nasopharyngeal and oropharyngeal secretions, serum, and fecal specimens spiked with cultured virus. We obtained no false-positive amplifications with other human coronaviruses or common respiratory pathogens. Results from all 3 assays were highly correlated during clinical specimen testing. On February 4, 2020, the Food and Drug Administration issued an Emergency Use Authorization to enable emergency use of this panel.


Asunto(s)
Betacoronavirus/genética , Infecciones por Coronavirus/diagnóstico , Proteínas de la Nucleocápside/genética , Neumonía Viral/diagnóstico , ARN Viral/genética , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , Biomarcadores/análisis , Centers for Disease Control and Prevention, U.S. , Infecciones por Coronavirus/virología , Cartilla de ADN/síntesis química , Cartilla de ADN/genética , Heces/virología , Fluoresceínas/química , Colorantes Fluorescentes/química , Humanos , Límite de Detección , Nasofaringe/virología , Pandemias , Neumonía Viral/virología , Reacción en Cadena en Tiempo Real de la Polimerasa/normas , Reproducibilidad de los Resultados , Esputo/virología , Estados Unidos
16.
Ann Epidemiol ; 45: 12-23, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32439148

RESUMEN

PURPOSE: After years of stable or declining HIV prevalence and declining incidence among people who inject drugs (PWID) in the United States, some rapidly emerging outbreaks have recently occurred in new areas (e.g., Scott County, Indiana). However, to our knowledge, trends over time in HIV prevalence among PWID in US metropolitan statistical areas (MSAs) across all major regions of the country have not been systematically estimated beyond 2002, and the extent to which HIV prevalence may be increasing in other areas is largely unknown. This article estimates HIV prevalence among PWID in 89 of the most populated US MSAs, both overall and by geographic region, using more recent surveillance and HIV testing data. METHODS: We computed MSA-specific annual estimates of HIV prevalence (both diagnosed and undiagnosed infections) among PWID for these 89 MSAs, for 1992-2013, using several data series from the Centers for Disease Control and Prevention's (CDC) National HIV Surveillance System and National HIV Prevention Monitoring and Evaluation data; Holmberg's (1997) estimates of 1992 PWID population size and of HIV prevalence and incidence among PWID; and research estimates from published literature using 1992-2013 data. A mixed effects model, with time nested within MSAs, was used to regress the literature review estimates on all of the other data series. Multiple imputation was used to address missing data. Resulting estimates were validated using previous 1992-2002 estimates of HIV prevalence and data on antiretroviral (ARV) prescription volumes and examined for patterns based on geographic region, numbers of people tested for HIV, and baseline HIV prevalence. RESULTS: Mean (across all MSAs) trends over time suggested decreases through 2002 (from approximately 11.4% in 1992 to 9.2% in 2002), followed by a period of stability, and steep increases after 2010 (to 10.6% in 2013). Validation analyses found a moderate positive correlation between our estimates and ARV prescription volumes (r = 0.45), and a very strong positive correlation (r = 0.94) between our estimates and previous estimates by Tempalski et al. (2009) for 1992-2002 (which used different methods). Analysis by region and baseline prevalence suggested that mean increases in later years were largely driven by MSAs in the Western United States and by MSAs in the Midwest that had low baseline prevalence. Our estimates suggest that prevalence decreased across all years in the Eastern United States. These trends were particularly clear when MSAs with very low numbers of people tested for HIV were removed from analyses to reduce unexplained variability in mean trajectories. CONCLUSIONS: Our estimates suggest a fairly large degree of variation in 1992-2013 trajectories of PWID HIV prevalence among 89 US MSAs, particularly by geographic region. They suggest that public health responses in many MSAs (particularly those with larger HIV prevalence among PWID in the early 1990s) were sufficient to decrease or maintain HIV prevalence over time. However, future research should investigate potential factors driving the estimated increase in prevalence after 2002 MSAs in the West and Midwest. These findings have potentially important implications for program and/or policy decisions, but estimates for MSAs with low HIV testing denominators should be interpreted with caution and verified locally before planning action.


Asunto(s)
Infecciones por VIH/epidemiología , Abuso de Sustancias por Vía Intravenosa/epidemiología , Población Urbana/estadística & datos numéricos , Adulto , Centers for Disease Control and Prevention, U.S. , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Vigilancia de la Población , Prevalencia , Estados Unidos/epidemiología
19.
JMIR Public Health Surveill ; 6(2): e18808, 2020 04 30.
Artículo en Inglés | MEDLINE | ID: mdl-32325425

RESUMEN

The coronavirus disease 2019 (COVID-19) outbreak has required institutions to rapidly adapt to changing public health circumstances. The Centers for Disease Control and Prevention has encouraged health care facilities to explore novel health care delivery modes. However, many institutions may not be prepared to begin offering digital health and telehealth services. Chatbots are one digital health tool that can help evolve triage and screening processes in a scalable manner. Here, we present a decision-making and implementation framework for deploying COVID-19 screening chatbots at pediatric health care facilities.


Asunto(s)
Técnicas de Laboratorio Clínico/métodos , Infecciones por Coronavirus/diagnóstico , Coronavirus/aislamiento & purificación , Prestación de Atención de Salud/métodos , Brotes de Enfermedades/prevención & control , Neumonía Viral/diagnóstico , Guías de Práctica Clínica como Asunto , Telemedicina/métodos , Betacoronavirus , Centers for Disease Control and Prevention, U.S. , Niño , Infecciones por Coronavirus/epidemiología , Instituciones de Salud , Humanos , Tamizaje Masivo , Pandemias/prevención & control , Neumonía Viral/epidemiología , Salud Pública , Práctica de Salud Pública , Triaje , Estados Unidos/epidemiología
20.
Turk J Med Sci ; 50(SI-1): 495-508, 2020 04 21.
Artículo en Inglés | MEDLINE | ID: mdl-32299201

RESUMEN

Nobody can be fully prepared to a pandemic. Of course there are signs of it, the scientists can predict, alarming speeches can be made. But there are always alarmist people around, maybe that is why sometimes even the most serious warnings may be not considered by the authorities on time. The first patients may be lost without a proper diagnosis. When everybody realizes that there may be a big problem in the horizon, sometimes it is too late. That is why it is very important to monitor contagious diseases and follow the warnings and releases of national and international disease control centers and other related organizations. China celebrated Lunar New Year with more than 40 thousand families on the 18 of January 2020. Nobody seem to be expecting this emerging new viral pneumonia outbreak appeared in Wuhan, in the last days of 2019, will break the chains and turn out to be a pandemic! But maybe this time it was not too late. There were four important pandemics within the last century: Spanish Flu, Hong Kong Flu, Asian Flu and Swine Flu. Each left different story behind. Millions of people had infected, hundreds, thousands of people died. This time, the Modern World had different tools to limit the SARS CoV2 outbreak. The national and international institutions of our globe were all communicating and taking precautions in a very fast manner than ever. However, this time, unexpectedly, the SARS-CoV-2 contagion was also faster. Besides the international organizations like WHO, UNESCO and UNICEF, the roles of local authorities, health ministries, disease control centers, health protection agencies, research centers and universities are all very important in different operational levels to control and survive from the pandemic. This paper will review the immediate response of different national and international institutions and authorities to COVID-19 pandemic.


Asunto(s)
Personal Administrativo , Infecciones por Coronavirus/prevención & control , Cooperación Internacional , Pandemias/prevención & control , Neumonía Viral/prevención & control , Betacoronavirus , Centers for Disease Control and Prevention, U.S. , Infecciones por Coronavirus/epidemiología , Educación a Distancia/métodos , Humanos , Neumonía Viral/epidemiología , Turquia , UNESCO , Estados Unidos , Universidades , Organización Mundial de la Salud
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