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Public Health Laboratory preparedness;bioterrorism the New Challenge

Microscopy and Microanalysis 2020年第S2期7卷 180-181页

作者： Richard F. Meyer Centers for Disease Control and Prevention National Center for Infectious Diseases Bioterrorism Preparedness and Response Program Atlanta GA 30333 MS C-18

In the event of a bioterrorist attack, rapid screening, agent identification, and confirmatory diagnosis will be critical, so that prevention and treatment measures can be implemented quickly. However, because few biologic agents thought likely to be used as biological weapons represent major public health problems in the United States, we have limited capacity to diagnose them, either at the state and local or the federal level. to begin to address this new public health challenge the Laboratory response Network for bioterrorism (LRN) was *** LRN is a multi-level system designed to link state and local public health laboratories, clinical, military, veterinary, agricultural, water and food-testing laboratories. Operational in August of 1999, the LRN was established as a consequence of Presidential Decision Directive 39, increased congressional awareness of the huge biological weapons program in the former Soviet Union, the high level of risk to national security and subsequent emergency funding to the Centers for Disease Control and Prevention under the DHHS Operating Plan for Anti- bioterrorism Initiative.

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Civil Military Cooperation through the Laboratory response Network

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Prehospital and Disaster Medicine 2017年第S1期18卷 S14-S15页

作者： Stephen A. Morse Bioterrorism Preparedness and Response Program Centers for Disease Control and Prevention Atlanta Georgia USA

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Structure and infrastructure of infectious agent research literature: SARS

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SCIENTOMETRICS 2011年第1期86卷 195-209页

作者： Kostoff, Ronald N. Morse, Stephen A. Mitre Corp Mclean VA 22102 USA Ctr Dis Control Natl Ctr Infect Dis Bioterrorism Preparedness & Response Program Atlanta GA 30333 USA

Text mining was used to extract technical intelligence from the open source global SARS research literature. A SARS-focused query was applied to the Science Citation Index (SCI) (SCI 2008) database for the period 1998-early 2008. The SARS research literature infrastructure (prolific authors, key journals/institutions/countries, most cited authors/journals/documents) was obtained using bibliometrics, and the SARS research literature technical structure (hierarchical taxonomy) was obtained using computational linguistics/document clustering.

关键词： Severe acute respiratory syndrome (SARS) Coronavirus Infectious diseases Text mining Bibliometrics Citation analysis

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Severe eczema vaccinatum in a household contact of a smallpox vaccinee

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CLINICAL INFECTIOUS DISEASES 2008年第10期46卷 1555-1561页

作者： Vora, Surabhi Damon, Inger Fulginiti, Vincent Weber, Stephen G. Kahana, Madelyn Stein, Sarah L. Gerber, Susan I. Garcia-Houchins, Sylvia Lederman, Edith Hruby, Dennis Collins, Limone Scott, Dorothy Thompson, Kenneth Barson, John V. Regnery, Russell Hughes, Christine Daum, Robert S. Li, Yu Zhao, Hui Smith, Scott Braden, Zach Karem, Kevin Olson, Victoria Davidson, Whitni Trindade, Giliane Bolken, Tove Jordan, Robert Tien, Debbie Marcinak, John Univ Chicago Med Ctr Dept Pediat Infect Dis Sect Chicago IL 60637 USA Univ Chicago Med Ctr Sect Crit Care Dept Pediat Chicago IL 60637 USA Univ Chicago Med Ctr Infect Control Program Chicago IL 60637 USA Univ Chicago Med Ctr Dermatol Sect Chicago IL 60637 USA Univ Chicago Med Ctr Dept Pathol Chicago IL 60637 USA Chicago Dept Publ Hlth Chicago IL USA Ctr Dis Control & Prevent Poxvirus & Rabies Branch Atlanta GA USA Ctr Dis Control & Prevent Div Bioterrorism Preparedness & Response Atlanta GA USA Univ Arizona Tucson AZ USA Univ Colorado Denver CO 80202 USA SIGA Technol Corvallis OR USA US FDA Washington DC 20204 USA

Background. We report the first confirmed case of eczema vaccinatum in the United States related to smallpox vaccination since routine vaccination was discontinued in 1972. A 28-month-old child with refractory atopic dermatitis developed eczema vaccinatum after exposure to his father, a member of the US military who had recently received smallpox vaccine. The father had a history of inactive eczema but reportedly reacted normally to the vaccine. The child's mother also developed contact vaccinia infection. Methods. Treatment of the child included vaccinia immune globulin administered intravenously, used for the first time in a pediatric patient;cidofovir, never previously used for human vaccinia infection;and ST-246, an investigational agent being studied for the treatment of orthopoxvirus infection. Serological response to vaccinia virus and viral DNA levels, correlated with clinical events, were utilized to monitor the course of disease and to guide therapy. Burn patient-type management was required, including skin grafts. Results. The child was discharged from the hospital after 48 days and has recovered with no apparent systemic sequelae or significant scarring. Conclusion. This case illustrates the need for careful screening prior to administration of smallpox vaccine and awareness by clinicians of the ongoing vaccination program and the potential risk for severe adverse events related to vaccinia virus.

关键词： Antibodies Viral Benzamides Child Preschool Cytosine DNA Viral Dermatitis Atopic

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A case of naturally acquired inhalation anthrax: Clinical care and analyses of anti-protective antigen immunoglobulin G and lethal factor

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CLINICAL INFECTIOUS DISEASES 2007年第7期44卷 968-971页

作者： Walsh, James J. Pesik, Nicki Quinn, Conrad P. Urdaneta, Veronica Dykewicz, Clare A. Boyer, Anne E. Guarner, Jeannette Wilkins, Patricia Norville, Kim J. Barr, John R. Zaki, Sherif R. Patel, Jean B. Reagan, Sarah P. Pirkle, James L. Treadwell, Tracee A. Messonnier, Nancy Rosenstein Rotz, Lisa D. Meyer, Richard F. Stephens, David S. Ctr Dis Control & Prevent Bioterrorism Preparedness & Response Program Coordinating Ctr Infect Dis Natl Ctr Environm Hlth Atlanta GA 30333 USA Emory Univ Sch Med Atlanta GA 30322 USA Ctr Dis Control & Prevent Div Bacterial & Mycot Dis Coordinating Ctr Infect Dis Natl Ctr Environm Hlth Atlanta GA 30333 USA Ctr Dis Control & Prevent Div Viral & Rickettsial Dis Coordinating Ctr Infect Dis Natl Ctr Environm Hlth Atlanta GA 30333 USA Ctr Dis Control & Prevent Div Healthcare Qual Promot Coordinating Ctr Infect Dis Natl Ctr Environm Hlth Atlanta GA 30333 USA Ctr Dis Control & Prevent Div Sci Lab Coordinating Ctr Environm Hlth & Injury Prevent Natl Ctr Environm Hlth Atlanta GA 30333 USA Penn Dept Hlth Div Infect Dis Epidemiol Harrisburg PA 17108 USA

This report describes the first case of naturally acquired inhalation anthrax in the United States since 1976. The patient's clinical course included adjunctive treatment with human anthrax immunoglobulin. Clinical correlation of serologic assays for the lethal factor component of lethal toxin and anti-protective antigen immunoglobulin G are also presented.

关键词： Anthrax Anthrax Vaccines Antigens Bacterial Immunoglobulin G

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Experiences with community core clinical microbiology laboratories: Practices and models that work and those that don't

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Clinical Microbiology Newsletter 2006年第14期28卷 105-110页

作者： Gray, Larry D. Miller, J. Michael Connelly, Robin TriHealth Laboratories Department of Pathology and Laboratory Medicine University of Cincinnati College of Medicine Cincinnati OH United States Laboratory Response Branch Bioterrorism Preparedness and Response Program Centers for Disease Control and Prevention Atlanta GA United States LabCorp Tucker GA United States

For the last several years, most clinical microbiologists have heard, talked, and thought about;have been threatened with;or have actually experienced the consolidation of clinical microbiology (CM) services. We present (i) concepts, experiences, and practices that we and others have found to be successful during the operation of consolidated CM laboratories, (ii) practices that were disappointingly unsuccessful, (iii) seven decisions that can increase the chances of maintaining high-quality CM services after consolidation, and (iv) studies performed to evaluate and compare the results of practical clinical microbiology testing performed at core laboratories and those performed at associated rapid response (i.e., stat, on-site, in-house, or primary) laboratories. If culture protocols are optimized for efficiency and clinical relevance, and if appropriately experienced personnel staff the core laboratory, the laboratory can provide CM services that meet or exceed those currently provided by the in-house laboratory of the local facility or hospital. © 2006 Elsevier Inc. All rights reserved.

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A simulation model for assessing aberration detection methods used in public health surveillance for systems with limited baselines

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STATISTICS IN MEDICINE 2005年第4期24卷 543-550页

作者： Hutwagner, LC Thompson, WW Seeman, GM Treadwell, T Ctr Dis Control & Prevent Natl Ctr Infect Dis Bioterrorism Preparedness & Response Program Atlanta GA 30333 USA Natl Immunizat Program Immunizat Safety Branch Div Epidemiol & Surveillance Atlanta GA 30333 USA

Public health officials continue to develop and implement new types of ongoing surveillance systems in an attempt to detect aberrations in surveillance data as early as possible. In public health surveillance, aberrations are traditionally defined as an observed value being, greater than an expected historical value for that same time period. To account for seasonality, traditional aberration detection methods use three or more years of baseline data across the same time period to calculate the expected historical value. Due to the recent implementation of short-term bioterrorism surveillance systems, many of the new surveillance systems have limited historical data from which to calculate an expected baseline value. Three limited baseline aberration detection methods, C1-MILD, C2-MEDIUM, and C3-ULTRA, were developed based on a one-sided positive CUSUM (cumulative sum) calculation, a commonly used quality control method used in the manufacturing industry. To evaluate the strengths and weakness of these methods, data were simulated to represent syndromic data collected through the recently developed hospital-based enhanced syndromic surveillance systems. The three methods were applied to the simulated data and estimates of sensitivity, specificity, and false-positive rates for the three methods were obtained. For the six syndromes, sensitivity for the C1-MILD. C2-MEDIUM. and C3-ULTRA models averaged 48.2, 51.3, and 53.7 per cent, respectively. Similarly, the specificities averaged 97.7, 97.8, and 96.1 per cent, respectively. The average false-positive rates for the three models were 31.8, 29.2, and 41.5 per cent, respectively. The results highlight the value and importance of developing and testing new aberration detection methods for public health surveillance data with limited baseline information. Copyright (C) 2005 John Wiley Sons, Ltd.

关键词： aberration surveillance syndromic

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Evaluation of human-to-human transmission of monkeypox from infected patients to health care workers

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CLINICAL INFECTIOUS DISEASES 2005年第5期40卷 689-694页

作者： Fleischauer, AT Kile, JC Davidson, M Fischer, M Karem, KL Teclaw, R Messersmith, H Pontones, P Beard, BA Braden, ZH Cono, J Sejvar, JJ Khan, AS Damon, I Kuehnert, MJ Ctr Dis Control & Prevent Natl Ctr Infect Dis Bioterrorism Preparedness & Response Program Atlanta GA 30333 USA Lutheran Hosp Indiana Ft Wayne IN USA Indiana State Dept Hlth Indianapolis IN 46202 USA

Background. In 2003, human monkeypox was first identified in the United States. The outbreak was associated with exposure to infected prairie dogs, but the potential for person-to-person transmission was a concern. This study examines health care worker (HCW) exposure to 3 patients with confirmed monkeypox. Methods. Exposed HCWs, defined as HCWs who entered a 2-m radius surrounding case patients with confirmed monkeypox, were identified by infection-control practitioners. A self-administered questionnaire and analysis of paired serum specimens determined exposure status, immune response, and postexposure signs and symptoms of monkeypox. Results. Of 81 exposed HCWs, 57 (70%) participated in the study. Among 57 participants, 40 (70%) had greater than or equal to1 unprotected exposure;none reported signs or symptoms consistent with monkeypox illness. One exposed HCW (2%), who had been vaccinated for smallpox within the past year, had serological evidence of recent orthopoxvirus infection;acute- and convalescent-phase serum specimens tested positive for anti-orthopoxvirus IgM. No exposed HCWs had signs and symptoms consistent with monkeypox. Conclusion. More than three-quarters of exposed HCWs reported at least 1 unprotected encounter with a patient who had monkeypox. One asymptomatic HCW showed laboratory evidence of recent orthopoxvirus infection, which was possibly attributable to either recent infection or smallpox vaccination. Transmission of monkeypox likely is a rare event in the health care setting.

关键词： Human Infection as complication of medical care transmission symptoms < 1>

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Safety profile of smallpox vaccine: Insights from the laboratory worker smallpox vaccination program

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CLINICAL INFECTIOUS DISEASES 2005年第8期40卷 1133-1140页

作者： Baggs, J Chen, RT Damon, IK Rotz, L Allen, C Fullerton, KE Casey, C Nordenberg, D Mootrey, G Ctr Dis Control & Prevent Natl Immunizat Program Epidemiol & Surveillance Div Immunizat Safety Branch Atlanta GA 30333 USA Ctr Dis Control & Prevent Natl Ctr Infect Dis Bioterrorism Preparedness & Response Program Atlanta GA 30333 USA Ctr Dis Control & Prevent Natl Ctr Infect Dis Sci Resources Program CDC Drug Serv Atlanta GA 30333 USA

Background. The frequency of mild-to-moderate adverse events following smallpox vaccination was not well documented or reported during the pre-eradication era. This report describes the frequency of such symptoms among 936 adult smallpox vaccinees with and without a history of prior smallpox vaccination. Methods. Diary cards were distributed to 1006 laboratory workers and members of the Centers for Disease Control and Prevention (CDC) smallpox response team who received smallpox vaccination under an investigational new drug protocol during 2001-2002. Vaccinees were requested to complete the diary card daily and return it to the CDC 28 days after vaccination. The proportion of vaccinees reporting symptoms was determined and compared among subgroups. Results. Ninety-three percent of the diary cards were returned. The most common symptom reported was "itching at vaccination site." Primary vaccines reported statistically higher proportions of the following 11 symptoms: joint pain (25% vs. 11%;P = .0011), muscle pain (46% vs. 19%;P < .0001), fatigue (43% vs. 29%;P = .0161), swelling at vaccination site (58% vs. 33%;), itching on the body (31% vs. 17%;P = .0048), abdominal pain (11% vs. 2%;P = .0012), swollen or tender lymph nodes (71% vs. 33%;P < .0001), pain at injection site (48% vs. 30%;), headache ( 40% vs. 25%;), backache (17% vs. 7%;P = .0090), and fever ( temperature, >= 100 degrees F [37.7 degrees C];20% vs. 9%;P = .0047). Conclusions. This analysis suggests that previously unvaccinated persons aged ! 30 years experienced more symptoms than did previously vaccinated persons. The findings of increased proportions with joint pain, abdominal pain, backache, and difficulty breathing were unexpected. As with recently described cardiac adverse events, these symptoms are suggestive of systemic involvement and warrant further study.

关键词： Smallpox Vaccination symptoms < 1> Vaccines

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Foodborne botulism in the Republic of Georgia: Implications for preparedness planning

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CLINICAL INFECTIOUS DISEASES 2004年第3期39卷 363-365页

作者： Hennessy, TW Rotz, LD Ctr Dis Control & Prevent Arctic Invest Program Natl Ctr Infect Dis Dept Hlth & Human Serv Anchorage AK 99508 USA Ctr Dis Control & Prevent Bioterrorism Preparedness & Response Program Natl Ctr Infect Dis Dept Hlth & Human Serv Atlanta GA USA

This article presents information on the foodborne botulism cases in the Republic of Georgia. The analysis of relevant data may provide Georgia with a cost-saving alternative to the management of botulism cases and may offer guidance for those who are preparing plans for mass numbers of casualties due to botulinum intoxication. It is informed that individual medical records of greater than 700 patients with botulism during 1980-2002 was studied to determine the initial clinical presentation and the eventual outcome of the disease.

关键词： bioterrorism Botulism Disease Outbreaks Georgia (Republic) Humans Triage United States

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