Dataset Information

Enhanced Surveillance for Histoplasmosis-9 States, 2018-2019.

ABSTRACT: Background:Histoplasmosis is often described as the most common endemic mycosis in the United States, but much remains unknown about its epidemiology among the general population. Methods:We conducted enhanced surveillance in 9 states during 2018-2019 by identifying cases through routine surveillance and interviewing 301 patients about their clinical features and exposures. Results:Before being tested for histoplasmosis, 60% saw a health care provider ?3 times, and 53% received antibacterial medication. The median time from seeking health care to diagnosis (range) was 23 (0-269) days. Forty-nine percent were hospitalized, and 69% said that histoplasmosis interfered with their daily activities (median [range], 56 [2-3960] days). Possible exposures included handling plants (48%) and bird or bat droppings (24%); 22% reported no specific exposures. Only 15% had heard of histoplasmosis before their illness. Conclusions:Histoplasmosis can be severe and prolonged. Additional educational efforts to increase public and provider awareness and reduce delays in diagnosis are needed.

SUBMITTER: Benedict K

PROVIDER: S-EPMC7491707 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Enhanced Surveillance for Histoplasmosis-9 States, 2018-2019.

Benedict Kaitlin K McCracken Stephanie S Signs Kimberly K Ireland Malia M Amburgey Victoria V Serrano Jose Antonio JA Christophe Natalie N Gibbons-Burgener Suzanne S Hallyburton Sara S Warren Kimberly A KA Keyser Metobo Alison A Odom Racheal R Groenewold Matthew R MR Jackson Brendan R BR

Open forum infectious diseases 20200817 9

<h4>Background</h4>Histoplasmosis is often described as the most common endemic mycosis in the United States, but much remains unknown about its epidemiology among the general population.<h4>Methods</h4>We conducted enhanced surveillance in 9 states during 2018-2019 by identifying cases through routine surveillance and interviewing 301 patients about their clinical features and exposures.<h4>Results</h4>Before being tested for histoplasmosis, 60% saw a health care provider ≥3 times, and 53% rece ...[more]

PMID: 32964064

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Project description:Rotavirus A (RVA) vaccines succeeded in lowering the burden of acute gastroenteritis (AGE) worldwide, especially preventing severe disease and mortality. In 2019, Brazil completed 13 years of RVA vaccine implementation (Rotarix™) within the National Immunization Program (NIP), and as reported elsewhere, the use of Rotarix™ in the country has reduced childhood mortality and morbidity due to AGE. Even though both marketed vaccines are widely distributed, the surveillance of RVA causing AGE and the monitoring of circulating genotypes are important tools to keep tracking the epidemiological scenario and vaccines impact. Thus, our study investigated RVA epidemiological features, viral load and G and P genotypes circulation in children and adults presenting AGE symptoms in eleven states from three out of five regions in Brazil. By using TaqMan®-based one-step RT-qPCR, we investigated a total of 1536 stool samples collected from symptomatic inpatients, emergency department visits and outpatients from January 2018 to December 2019. G and P genotypes of RVA-positive samples were genetically characterized by multiplex RT-PCR or by nearly complete fragment sequencing. We detected RVA in 12% of samples, 10.5% in 2018 and 13.7% in 2019. A marked winter/spring seasonality was observed, especially in Southern Brazil. The most affected age group was children aged >24-60 months, with a positivity rate of 18.8% (p < 0.05). Evaluating shedding, we found a statistically lower RVA viral load in stool samples collected from children aged up to six months compared to the other age groups (p < 0.05). The genotype G3P[8] was the most prevalent during the two years (83.7% in 2018 and 65.5% in 2019), and nucleotide sequencing of some strains demonstrated that they belonged to the emergent equine-like G3P[8] genotype. The dominance of an emergent genotype causing AGE reinforces the need for continuous epidemiological surveillance to assess the impact of mass RVA immunization as well as to monitor the emergence of novel genotypes.

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Enhanced Surveillance for Histoplasmosis-9 States, 2018-2019.

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Enhanced Surveillance for Histoplasmosis-9 States, 2018-2019.

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