Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 10.655
Filtrar
1.
J Environ Manage ; 284: 112019, 2021 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-33540198

RESUMO

Fertilizers and manure applied to cropland to increase yields are often lost via surface erosion, soil leaching, and runoff, increasing nutrient loads in surface and sub-surface waters, degrading water quality, and worsening the 'dead zone' in the Gulf of Mexico. We leverage spatial and temporal variation in agricultural practices and precipitation events to examine how these factors affect stream total phosphorus (TP) concentrations and loads in the Sugar River (Wisconsin), recently listed as impaired. To perform our analysis, we first collected water quality data from 1995 to 2017 from 40 sites along the Sugar River and its tributaries. Starting in 2004, three dairy farms expanded to become concentrated animal feeding operations (CAFOs) in this watershed. We then estimated how time of year, stream position, discharge volume, and proximity to the newly expanded CAFOs affected TP concentrations and loads. Total P concentrations, which ranged from 0.02 to 1.4 mg/L and often exceeded the EPA surface water standard of 0.1 mg/L, increased with increases in stream discharge and proximity to dairy operations, peaking in early spring to mid-summer coincident with extreme precipitation events. Our empirical analysis also shows that TP concentrations downstream from the newly permitted CAFOs increased by 19% relative to upstream concentrations. When examining total daily phosphorus loads (concentration × discharge) from this 780 km2 watershed, we found that loads ranged from 5.88 to 4801 kg. Compared to upstream TP loads, those downstream from the CAFOs increased by 91% after the expansions - over four times that of concentration increases - implying that the rate of downstream phosphorus transfer has increased due to CAFO expansion. Our results argue for standards that focus on loads rather than concentrations and monitoring that includes peak events. As agriculture intensifies and extreme rainfall events become more frequent, it becomes increasingly important to limit soil and TP runoff from manure and fertilizer. Siting CAFOs carefully, limiting their size, and improving farming practices in proximity to CAFOs in spring and early summer could considerably reduce nutrient loads.


Assuntos
Monitoramento Ambiental , Fósforo , Agricultura , Animais , Golfo do México , Fósforo/análise , Movimentos da Água , Wisconsin
2.
J Insect Sci ; 21(1)2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33560361

RESUMO

Pest management of emerging pests can be challenging because very little fundamental knowledge is available to inform management strategies. One such pest, the red-headed flea beetle Systena frontalis (Fabricius) (Coleoptera: Chrysomelidae), is increasingly being identified as a pest of concern in cranberries Vaccinium macrocarpon Aiton (Ericales: Ericaceae). To improve our understanding of this pest and to develop more targeted management programs, we conducted field and laboratory studies to characterize the development, seasonal emergence patterns, and density-dependent plant injury. We found that significantly more flea beetle eggs hatched when exposed to sustained cold treatment between 0 and 5°C for 15 wk than at warmer temperatures, and for shorter and longer cold-period durations. The adults emerged sporadically over the summer, were patchily distributed, fed on both fruit and foliage, and preferentially fed on new plant growth. Using soil cores, we found eggs and larvae located relatively deep (>30 cm) in the soil. These patterns indicate that S. frontalis likely overwinters as eggs, and that targeting the larval stage may be the most effective management approach. Despite the cryptic nature of the larvae, continuing to improve our understanding of this life stage will be critical to optimizing control strategies.


Assuntos
Besouros/fisiologia , Herbivoria , Controle de Insetos , Traços de História de Vida , Vaccinium macrocarpon , Animais , Besouros/crescimento & desenvolvimento , Larva/crescimento & desenvolvimento , Óvulo/crescimento & desenvolvimento , Densidade Demográfica , Vaccinium macrocarpon/crescimento & desenvolvimento , Wisconsin
3.
Nat Commun ; 12(1): 166, 2021 01 08.
Artigo em Inglês | MEDLINE | ID: mdl-33420005

RESUMO

Habitat alteration can influence suitability, creating ecological traps where habitat preference and fitness are mismatched. Despite their importance, ecological traps are notoriously difficult to identify and their impact on host-pathogen dynamics remains largely unexplored. Here we assess individual bat survival and habitat preferences in the midwestern United States before, during, and after the invasion of the fungal pathogen that causes white-nose syndrome. Despite strong selection pressures, most hosts continued to select habitats where disease severity was highest and survival was lowest, causing continued population declines. However, some individuals used refugia where survival was higher. Over time, a higher proportion of the total population used refugia than before pathogen arrival. Our results demonstrate that host preferences for habitats with high disease-induced mortality can create ecological traps that threaten populations, even in the presence of accessible refugia.


Assuntos
Doenças dos Animais , Quirópteros , Ecossistema , Sobrevida , Doenças dos Animais/microbiologia , Doenças dos Animais/mortalidade , Animais , Ascomicetos , Quirópteros/microbiologia , Conservação dos Recursos Naturais , Fungos/patogenicidade , Michigan , Nariz , Dinâmica Populacional , Temperatura , Wisconsin
4.
MMWR Morb Mortal Wkly Rep ; 70(4): 114-117, 2021 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-33507887

RESUMO

During September 3-November 16, 2020, daily confirmed cases of coronavirus disease 2019 (COVID-19) reported to the Wisconsin Department of Health Services (WDHS) increased at a rate of 24% per week, from a 7-day average of 674 (August 28-September 3) to 6,426 (November 10-16) (1). The growth rate during this interval was the highest to date in Wisconsin and among the highest in the United States during that time (1). To characterize potential sources of this increase, the investigation examined reported outbreaks in Wisconsin that occurred during March 4-November 16, 2020, with respect to their setting and number of associated COVID-19 cases.


Assuntos
/epidemiologia , Surtos de Doenças/estatística & dados numéricos , Vigilância em Saúde Pública , Instalações de Saúde/estatística & dados numéricos , Humanos , Incidência , Laboratórios , Assistência de Longa Duração , Prisões/estatística & dados numéricos , Universidades/estatística & dados numéricos , Wisconsin/epidemiologia
5.
MMWR Morb Mortal Wkly Rep ; 70(4): 136-140, 2021 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-33507890

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic has disrupted in-person learning in the United States, with approximately one half of all students receiving online-only instruction since March 2020.* Discontinuation of in-person schooling can result in many hardships (1) and disproportionately affects families of lower socioeconomic status (2). Current evidence suggests that transmission of SARS-CoV-2, the virus that causes COVID-19, in kindergarten through grade 12 (K-12) schools might not significantly contribute to COVID-19 spread nationwide (3). During August 31-November 29, 2020, COVID-19 cases, spread, and compliance with mask use were investigated among 4,876 students and 654 staff members who participated in in-person learning in 17 K-12 schools in rural Wisconsin. School-attributable COVID-19 case rates were compared with rates in the surrounding community. School administration and public health officials provided information on COVID-19 cases within schools. During the study period, widespread community transmission was observed, with 7%-40% of COVID-19 tests having positive results. Masking was required for all students and staff members at all schools, and rate of reported student mask-wearing was high (>92%). COVID-19 case rates among students and staff members were lower (191 cases among 5,530 persons, or 3,453 cases per 100,000) than were those in the county overall (5,466 per 100,000). Among the 191 cases identified in students and staff members, one in 20 cases among students was linked to in-school transmission; no infections among staff members were found to have been acquired at school. These findings suggest that, with proper mitigation strategies, K-12 schools might be capable of opening for in-person learning with minimal in-school transmission of SARS-CoV-2.


Assuntos
/epidemiologia , Instituições Acadêmicas/estatística & dados numéricos , Adolescente , Adulto , Criança , Pré-Escolar , Comportamento Cooperativo , Humanos , Máscaras/estatística & dados numéricos , Saúde Pública/legislação & jurisprudência , População Rural/estatística & dados numéricos , Professores Escolares/psicologia , Professores Escolares/estatística & dados numéricos , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Inquéritos e Questionários , Wisconsin/epidemiologia
6.
J Environ Manage ; 278(Pt 2): 111535, 2021 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-33142149

RESUMO

To better inform land management decisions, we explored relationships between land use data and stream nitrate-nitrite (NO3NO2) concentration data in the Yahara River Watershed (YRW) in south-central Wisconsin, USA. Three metrics were used to evaluate the extent of different land uses in the watershed: (1) the area percentage of each land use in both the watershed and in a range of riparian zone widths, (2) the area factor, which refers to the ratio of the area of woodland, recreational, open and vacant subdivided land, or wetlands in the riparian zone (6.1-213.4 m widths) to agricultural areas in the rest of watershed, which indicates the buffering capacity of the riparian zone, and (3) the inverse-distance-weighted (IDW) area percentage with proximity to sub-watershed outlet and to stream, which characterizes spatial arrangement in the watershed by assigning a higher weight to patches closer to the outlet or stream and a lower weight to those farther away. We found significant, positive correlations between the extent of agricultural areas and stream NO3NO2 concentrations. NO3NO2 concentrations were highly correlated to area factor metrics for all riparian zone widths such that as area factor decreased, NO3NO2 concentrations increased. There was also a marked increase in NO3NO2 concentrations at a threshold of approximately 60% agricultural area with IDW proximity to stream. Wetland area percentage in the entire watershed and IDW wetland area percentage with proximity to stream were negatively correlated to stream NO3NO2 concentrations. Compared to the simple area percentage metric, area factor and IDW wetland area percentage with proximity to stream were better indicators of stream NO3NO2 concentrations. Results from this study indicate that, in addition to land use area percentage, spatial distributions of land uses should be considered when managing watersheds. This study also demonstrates the value of citizen-based sampling data and reveals opportunities to improve the utility of such data.


Assuntos
Nitratos , Rios , Agricultura , Nitratos/análise , Nitritos , Wisconsin
7.
MMWR Morb Mortal Wkly Rep ; 69(5152): 1633-1637, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33382676

RESUMO

To prevent further transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), CDC currently recommends that persons who have been in close contact with someone with SARS-CoV-2 infection should quarantine (stay away from other persons) for 14 days after the last known contact.* However, quarantine might be difficult to maintain for a prolonged period. A shorter quarantine might improve compliance, and CDC recommends two options to reduce the duration of quarantine for close contacts without symptoms, based on local circumstances and availability of testing: 1) quarantine can end on day 10 without a test or 2) quarantine can end on day 7 after receiving a negative test result.† However, shorter quarantine might permit ongoing disease transmission from persons who develop symptoms or become infectious near the end of the recommended 14-day period. Interim data from an ongoing study of household transmission of SARS-CoV-2 were analyzed to understand the proportion of household contacts that had detectable virus after a shortened quarantine period. Persons who were household contacts of index patients completed a daily symptom diary and self-collected respiratory specimens for 14 days. Specimens were tested for SARS-CoV-2 using reverse transcription-polymerase chain reaction (RT-PCR). Among 185 household contacts enrolled, 109 (59%) had detectable SARS-CoV-2 at any time; 76% (83/109) of test results were positive within 7 days, and 86% (94 of 109) were positive within 10 days after the index patient's illness onset date. Among household contacts who received negative SARS-CoV-2 test results and were asymptomatic through day 7, there was an 81% chance (95% confidence interval [CI] = 67%-90%) of remaining asymptomatic and receiving negative RT-PCR test results through day 14; this increased to 93% (95% CI = 78%-98%) for household members who were asymptomatic with negative RT-PCR test results through day 10. Although SARS-CoV-2 quarantine periods shorter than 14 days might be easier to adhere to, there is a potential for onward transmission from household contacts released before day 14.


Assuntos
/diagnóstico , Busca de Comunicante , Características da Família , Quarentena/estatística & dados numéricos , Humanos , Tennessee/epidemiologia , Fatores de Tempo , Wisconsin/epidemiologia
8.
MMWR Morb Mortal Wkly Rep ; 69(5152): 1642-1647, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33382679

RESUMO

Antigen-based tests for SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), are inexpensive and can return results within 15 minutes (1). Antigen tests have received Food and Drug Administration (FDA) Emergency Use Authorization (EUA) for use in asymptomatic and symptomatic persons within the first 5-12 days after symptom onset (2). These tests have been used at U.S. colleges and universities and other congregate settings (e.g., nursing homes and correctional and detention facilities), where serial testing of asymptomatic persons might facilitate early case identification (3-5). However, test performance data from symptomatic and asymptomatic persons are limited. This investigation evaluated performance of the Sofia SARS Antigen Fluorescent Immunoassay (FIA) (Quidel Corporation) compared with real-time reverse transcription-polymerase chain reaction (RT-PCR) for SARS-CoV-2 detection among asymptomatic and symptomatic persons at two universities in Wisconsin. During September 28-October 9, a total of 1,098 paired nasal swabs were tested using the Sofia SARS Antigen FIA and real-time RT-PCR. Virus culture was attempted on all antigen-positive or real-time RT-PCR-positive specimens. Among 871 (79%) paired swabs from asymptomatic participants, the antigen test sensitivity was 41.2%, specificity was 98.4%, and in this population the estimated positive predictive value (PPV) was 33.3%, and negative predictive value (NPV) was 98.8%. Antigen test performance was improved among 227 (21%) paired swabs from participants who reported one or more symptoms at specimen collection (sensitivity = 80.0%; specificity = 98.9%; PPV = 94.1%; NPV = 95.9%). Virus was isolated from 34 (46.6%) of 73 antigen-positive or real-time RT-PCR-positive nasal swab specimens, including two of 18 that were antigen-negative and real-time RT-PCR-positive (false-negatives). The advantages of antigen tests such as low cost and rapid turnaround might allow for rapid identification of infectious persons. However, these advantages need to be balanced against lower sensitivity and lower PPV, especially among asymptomatic persons. Confirmatory testing with an FDA-authorized nucleic acid amplification test (NAAT), such as RT-PCR, should be considered after negative antigen test results in symptomatic persons, and after positive antigen test results in asymptomatic persons (1).


Assuntos
Antígenos Virais/análise , /diagnóstico , Serviços de Saúde para Estudantes , Adolescente , Adulto , Doenças Assintomáticas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Universidades , Wisconsin/epidemiologia , Adulto Jovem
9.
Am J Bot ; 107(12): 1677-1692, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33315246

RESUMO

PREMISE: We tested 25 classic and novel hypotheses regarding trait-origin, trait-trait, and trait-environment relationships to account for flora-wide variation in life history, habit, and especially reproductive traits using a plastid DNA phylogeny of most native (96.6%, or 1494/1547 species) and introduced (87.5%, or 690/789 species) angiosperms in Wisconsin, USA. METHODS: We assembled data on life history, habit, flowering, dispersal, mating system, and occurrence across open/closed/mixed habitats across species in the state phylogeny. We used phylogenetically structured analyses to assess the strength and statistical significance of associations predicted by our models. RESULTS: Introduced species are more likely to be annual herbs, occupy open habitats, have large, visually conspicuous, hermaphroditic flowers, and bear passively dispersed seeds. Among native species, hermaphroditism is associated with larger, more conspicuous flowers; monoecy is associated with small, inconspicuous flowers and passive seed dispersal; and dioecy is associated with small, inconspicuous flowers and fleshy fruits. Larger flowers with more conspicuous colors are more common in open habitats, and in understory species flowering under open (spring) canopies; fleshy fruits are more common in closed habitats. Wind pollination may help favor dioecy in open habitats. CONCLUSIONS: These findings support predictions regarding how breeding systems depend on flower size, flower color, and fruit type, and how those traits depend on habitat. This study is the first to combine flora-wide phylogenies with complete trait databases and phylogenetically structured analyses to provide powerful tests of evolutionary hypotheses about reproductive traits and their variation with geographic source, each other, and environmental conditions.


Assuntos
Magnoliopsida , Flores , Magnoliopsida/genética , Melhoramento Vegetal , Polinização , História Reprodutiva , Wisconsin
10.
MMWR Morb Mortal Wkly Rep ; 69(44): 1631-1634, 2020 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-33151916

RESUMO

Improved understanding of transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), within households could aid control measures. However, few studies have systematically characterized the transmission of SARS-CoV-2 in U.S. households (1). Previously reported transmission rates vary widely, and data on transmission rates from children are limited. To assess household transmission, a case-ascertained study was conducted in Nashville, Tennessee, and Marshfield, Wisconsin, commencing in April 2020. In this study, index patients were defined as the first household members with COVID-19-compatible symptoms who received a positive SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR) test result, and who lived with at least one other household member. After enrollment, index patients and household members were trained remotely by study staff members to complete symptom diaries and obtain self-collected specimens, nasal swabs only or nasal swabs and saliva samples, daily for 14 days. For this analysis, specimens from the first 7 days were tested for SARS-CoV-2 using CDC RT-PCR protocols.† A total of 191 enrolled household contacts of 101 index patients reported having no symptoms on the day of the associated index patient's illness onset, and among these 191 contacts, 102 had SARS-CoV-2 detected in either nasal or saliva specimens during follow-up, for a secondary infection rate of 53% (95% confidence interval [CI] = 46%-60%). Among fourteen households in which the index patient was aged <18 years, the secondary infection rate from index patients aged <12 years was 53% (95% CI = 31%-74%) and from index patients aged 12-17 years was 38% (95% CI = 23%-56%). Approximately 75% of secondary infections were identified within 5 days of the index patient's illness onset, and substantial transmission occurred whether the index patient was an adult or a child. Because household transmission of SARS-CoV-2 is common and can occur rapidly after the index patient's illness onset, persons should self-isolate immediately at the onset of COVID-like symptoms, at the time of testing as a result of a high risk exposure, or at the time of a positive test result, whichever comes first. Concurrent to isolation, all members of the household should wear a mask when in shared spaces in the household.§.


Assuntos
Infecções por Coronavirus/transmissão , Características da Família , Pneumonia Viral/transmissão , Adolescente , Adulto , Idoso , Betacoronavirus/isolamento & purificação , Criança , Pré-Escolar , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Estudos Prospectivos , Tennessee/epidemiologia , Wisconsin/epidemiologia , Adulto Jovem
11.
Health Aff (Millwood) ; 39(11): 1926-1934, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33136498

RESUMO

This study aimed to understand racial/ethnic differences in coronavirus disease 2019 (COVID-19) screening, symptom presentation, hospitalization, and mortality, using data from 31,549 adults tested for COVID-19 between March 1 and July 10, 2020, in Milwaukee and Southeast Wisconsin. Racial/ethnic differences existed in adults who screened positive for COVID-19 (4.5 percent of non-Hispanic Whites, 14.9 percent of non-Hispanic Blacks, and 14.8 percent of Hispanics). After adjustment for demographics and comorbidities, Blacks and Hispanics were more than three times more likely to screen positive and two times more likely to be hospitalized relative to Whites, and Hispanics were two times more likely to die than Whites. Given the long-standing history of structural racism, residential segregation, and social risk in the US and their role as contributors to poor health, we propose and discuss the part these issues play as explanatory factors for our findings.


Assuntos
Grupos de Populações Continentais , Infecções por Coronavirus , Grupos Étnicos/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Pandemias , Pneumonia Viral , Afro-Americanos/estatística & dados numéricos , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/terapia , Estudos Transversais , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Hispano-Americanos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/diagnóstico , Pneumonia Viral/mortalidade , Pneumonia Viral/terapia , Wisconsin
12.
Nat Commun ; 11(1): 5558, 2020 11 03.
Artigo em Inglês | MEDLINE | ID: mdl-33144575

RESUMO

Evidence-based public health approaches that minimize the introduction and spread of new SARS-CoV-2 transmission clusters are urgently needed in the United States and other countries struggling with expanding epidemics. Here we analyze 247 full-genome SARS-CoV-2 sequences from two nearby communities in Wisconsin, USA, and find surprisingly distinct patterns of viral spread. Dane County had the 12th known introduction of SARS-CoV-2 in the United States, but this did not lead to descendant community spread. Instead, the Dane County outbreak was seeded by multiple later introductions, followed by limited community spread. In contrast, relatively few introductions in Milwaukee County led to extensive community spread. We present evidence for reduced viral spread in both counties following the statewide "Safer at Home" order, which went into effect 25 March 2020. Our results suggest patterns of SARS-CoV-2 transmission may vary substantially even in nearby communities. Understanding these local patterns will enable better targeting of public health interventions.


Assuntos
Betacoronavirus/genética , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Genoma Viral/genética , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Infecções por Coronavirus/prevenção & controle , Geografia , Humanos , Programas de Rastreamento/métodos , Epidemiologia Molecular/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Dispositivos de Proteção Respiratória , Estados Unidos/epidemiologia , Wisconsin/epidemiologia
13.
Environ Monit Assess ; 192(11): 724, 2020 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-33095309

RESUMO

Nitrate contamination of drinking water, common in agricultural areas, increases the risk of certain cancers and impacts fetal development during pregnancy. Building on previously published methodology, this study evaluates nitrate-attributable disease cases and adverse birth outcomes as well as their economic costs for Wisconsin, USA. Nitrate is the most common contaminant in groundwater in Wisconsin. Two-thirds of the state's residents use groundwater as the primary source of drinking water. Here, we analyze nitrate exposure from drinking water in Wisconsin based on nitrate test results for community water systems for the period of 2010-2017 and a novel methodology for estimating nitrate exposure for the 28% of state's residents who use private wells. We estimate that annually, 111-298 combined cases of colorectal, ovarian, thyroid, bladder, and kidney cancer in Wisconsin may be due to nitrate contamination of drinking water. Each year, up to 137-149 cases of very low birth weight, 72-79 cases of very preterm birth, and two cases of neural tube defects could be due to nitrate exposure from drinking water. The direct medical cost estimates for all nitrate-attributable adverse health outcomes range between $23 and $80 million annually. Simulating targeted reductions in the counties with the highest current drinking water nitrate concentrations resulted in similar reductions in adverse health outcomes as statewide reduction efforts, up to nitrate reductions of 20%. Time trend analysis suggests that groundwater nitrate concentrations are overall increasing. Thus, nitrate contamination of water supplies in Wisconsin is a public health problem that needs to be addressed.


Assuntos
Água Potável , Nascimento Prematuro , Monitoramento Ambiental , Feminino , Humanos , Nitratos/análise , Gravidez , Wisconsin
16.
WMJ ; 119(3): 177-181, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33091285

RESUMO

INTRODUCTION: Early reports have raised concerns regarding the clinical sensitivity of nasopharyngeal SARS-CoV-2 reverse transcriptase-polymerase chain reaction (RT-PCR) testing for patients with COVID-19 symptoms, which has led to requests for repeat testing at our institution. However, to our knowledge, there are no reports to date of the utilization or results of repeat testing to help guide this practice. METHODS: The authors searched the institutional laboratory information system for consecutive patients who were tested for SARS-CoV-2 by RT-PCR of a nasopharyngeal specimen over a 1-month period. Characteristics and results of patients who received a single or multiple tests were documented and analyzed. RESULTS: Six thousand three (6003) tests were performed on 5757 patients; 272 (4.7%) patients were positive based on their initial test results. Two hundred thirty-six (4%) patients were tested more than once, with 226 (96%) tested twice. The largest proportion of these patients (n=160, 71%) were those who had an initial negative test followed by a repeat test for persistent symptoms. This group included all 7 patients who had discordant positive results on their second test; the result concordance rate within this group was 96%. CONCLUSION: In a population of patients with a low positive rate for SARS-CoV-2 by nasopharyngeal RT-PCR testing, repeat nasopharyngeal testing of negative patients who have persistent symptoms still yields a negative result in 96% of the cases.


Assuntos
Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Pandemias , Prevalência , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Sensibilidade e Especificidade , Wisconsin/epidemiologia
17.
WMJ ; 119(3): 198-201, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33091289

RESUMO

BACKGROUND: Several studies describing Coronavirus disease 2019 (COVID-19) have been reported; however, to our knowledge, no case series has been published from the Midwest. OBJECTIVE: To describe demographic characteristics and outcomes of patients admitted with COVID-19 to a Wisconsin academic medical center. METHODS: We performed a retrospective analysis of data obtained for COVID-19 patients admitted from March 14, 2020, through April 19, 2020. RESULTS: One hundred sixty-eight patients were admitted. Outcomes measured include time in the intensive care unit (53%), mechanical ventilation (18%), and death (19%). ICU patients had higher rates of diabetes, obesity, and higher inflammatory markers. The majority of patients admitted were African American (68%). CONCLUSION: This case series highlights demographic similarities and differences, as well as outcomes, among COVID-19 patients in a Wisconsin Academic Medical Center compared to those reported in other geographic regions.


Assuntos
Centros Médicos Acadêmicos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Admissão do Paciente/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Idoso , Betacoronavirus , Infecções por Coronavirus/mortalidade , Demografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/mortalidade , Estudos Retrospectivos , Fatores de Risco , Wisconsin/epidemiologia
18.
WMJ ; 119(3): 202-204, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33091290

RESUMO

BACKGROUND: The COVID-19 pandemic has forced many practices to completely change the interface between health care providers and patients. Patients presenting with facial trauma present a special risk for COVID-19 transmission, as contact with respiratory and ocular secretions is common, and so special precautions must be taken in managing them. METHODS: We created guidelines and a triage/management algorithm for patients presenting with facial trauma to decrease the risk of COVID-19 transmission. CONCLUSIONS: In this paper, we present a set of guidelines and a triage algorithm we have successfully implemented to mitigate the spread of COVID-19 while managing facial trauma. We believe that these guidelines can help other providers restructure their practices during this pandemic.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Serviço Hospitalar de Emergência/normas , Traumatismos Faciais/terapia , Controle de Infecções/normas , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Triagem/normas , Algoritmos , Betacoronavirus , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Humanos , Telemedicina , Universidades , Wisconsin/epidemiologia
20.
MMWR Morb Mortal Wkly Rep ; 69(43): 1600-1604, 2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33119558

RESUMO

During July 2-August 11, 2020, an outbreak of coronavirus disease 2019 (COVID-19) occurred at a boys' overnight summer school retreat in Wisconsin. The retreat included 152 high school-aged boys, counselors, and staff members from 21 states and territories and two foreign countries. All attendees were required to provide documentation of either a positive serologic test result* within the past 3 months or a negative reverse transcription-polymerase chain reaction (RT-PCR) tests result for SARS-CoV-2 (the virus that causes COVID-19) ≤7 days before travel, to self-quarantine within their households for 7 days before travel, and to wear masks during travel. On July 15, the Wisconsin Department of Health Services (WDHS) began an investigation after being notified that two students at the retreat had received positive SARS-CoV-2 RT-PCR test results. WDHS offered RT-PCR testing to attendees on July 28 and serologic testing on August 5 and 6. Seventy-eight (51%) attendees received positive RT-PCR results (confirmed cases), and 38 (25%) met clinical criteria for COVID-19 without a positive RT-PCR result (probable cases). By the end of the retreat, 118 (78%) persons had received a positive serologic test result. Among 24 attendees with a documented positive serologic test result before the retreat, all received negative RT-PCR results. After RT-PCR testing on July 28, WDHS recommended that remaining susceptible persons (asymptomatic and with negative RT-PCR test results) quarantine from other students and staff members at the retreat. Recommended end dates for isolation or quarantine were based on established guidance (1,2) and determined in coordination with CDC. All attendees were cleared for interstate and commercial air travel to return home on August 11. This outbreak investigation documented rapid spread of SARS-CoV-2, likely from a single student, among adolescents and young adults in a congregate setting. Mitigation plans that include prearrival quarantine and testing, cohorting, symptom monitoring, early identification and isolation of cases, mask use, enhanced hygiene and disinfection practices, and maximal outdoor programming are necessary to prevent COVID-19 outbreaks in these settings (3,4).


Assuntos
Acampamento , Infecções por Coronavirus/epidemiologia , Surtos de Doenças , Pneumonia Viral/epidemiologia , Instituições Acadêmicas , Adolescente , Adulto , Técnicas de Laboratório Clínico/estatística & dados numéricos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/transmissão , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/transmissão , Fatores de Tempo , Wisconsin/epidemiologia , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA