RESUMO
There is concern that in-person schooling during the coronavirus disease 2019 (COVID-19) pandemic will facilitate disease transmission. Through asymptomatic surveillance and contact tracing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), we found low rates of asymptomatic SARS-CoV-2 infection and little in-school transmission of COVID-19 when physical distancing and masking strategies were enforced despite a high community prevalence of COVID-19.
Assuntos
Infecções Assintomáticas/epidemiologia , COVID-19/transmissão , Instituições Acadêmicas/organização & administração , Adolescente , COVID-19/diagnóstico , COVID-19/epidemiologia , Teste para COVID-19 , Criança , Pré-Escolar , Busca de Comunicante/métodos , Feminino , Humanos , Masculino , Pandemias , Prevalência , Estudos Prospectivos , SARS-CoV-2 , Instituições Acadêmicas/estatística & dados numéricos , Tennessee/epidemiologiaRESUMO
We used the FilmArray meningitis/encephalitis panel for evaluation of sepsis in febrile neonates. We detected human herpesvirus 6, a virus we did not routinely test for previously, in the cerebrospinal fluid of 7 neonates. In all 7 cases, detection of the virus did not warrant antiviral treatment.
Assuntos
DNA Viral/análise , Encefalite/complicações , Herpesvirus Humano 6/genética , Meningite/diagnóstico , Infecções por Roseolovirus/diagnóstico , Sepse/virologia , Centros de Atenção Terciária , Encefalite/diagnóstico , Encefalite/virologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Meningite/complicações , Reação em Cadeia da Polimerase Multiplex , Infecções por Roseolovirus/complicações , Infecções por Roseolovirus/virologia , Sepse/diagnóstico , Sepse/etiologiaRESUMO
BACKGROUND: Extensively drug-resistant (XDR) tuberculosis (TB) is a global public health emergency. We investigated the characteristics and extent of XDR TB in California to inform public health interventions. METHODS: XDR TB was defined as TB with resistance to at least isoniazid, rifampin, a fluoroquinolone, and 1 of 3 injectable second-line drugs (amikacin, kanamycin, or capreomycin). Pre-XDR TB was defined as TB with resistance to isoniazid and rifampin and either a fluoroquinolone or second-line injectable agent but not both. We analyzed TB case reports submitted to the state TB registry for the period 1993-2006. Local health departments and the state TB laboratory were queried to ensure complete drug susceptibility reporting. RESULTS: Among 424 multidrug-resistant (MDR) TB cases with complete drug susceptibility reporting, 18 (4.2%) were extensively drug resistant, and 77 (18%) were pre-extensively drug resistant. The proportion of pre-XDR TB cases increased over time, from 7% in 1993 to 32% in 2005 (P = .02)). Among XDR TB cases, 83% of cases involved foreign-born patients, and 43% were diagnosed in patients within 6 months after arrival in the United States. Mexico was the most common country of origin. Five cases (29%) of XDR TB were acquired during therapy in California. All patients with XDR TB had pulmonary disease, and most had prolonged infectious periods; the median time for conversion of sputum culture results was 195 days. Among 17 patients with known outcomes, 7 (41.2%) completed therapy, 5 (29.4%) moved, and 5 (29.4%) died. One patient continues to receive treatment. CONCLUSIONS: XDR TB and pre-XDR TB cases comprise a substantial fraction of MDR TB cases in California, indicating the need for interventions that improve surveillance, directly observed therapy, and rapid drug susceptibility testing and reporting.