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Article ; Online: Trends in Otitis Media Ambulatory Visits in American Indian and Alaska Native Children During the Pneumococcal Conjugate Vaccine Period and the COVID-19 Pandemic.

Bressler, Sara S / Bruden, Dana / Hammitt, Laura L / Chukwuma, Uzo / Fischer, Marc / Singleton, Rosalyn

The Pediatric infectious disease journal

2024 Volume 43, Issue 4, Page(s) 390–392

Abstract: Otitis media-associated outpatient visits among American Indians/Alaska Natives children <5 years old decreased by 52% (100 to 48 per 100 children per year) from 2003 to 2019. Otitis media visits decreased by another 50% from 2019 to 2020, but rebounded ... ...

Abstract	Otitis media-associated outpatient visits among American Indians/Alaska Natives children <5 years old decreased by 52% (100 to 48 per 100 children per year) from 2003 to 2019. Otitis media visits decreased by another 50% from 2019 to 2020, but rebounded between 2020 and 2021 back to a rate similar to 2019.
MeSH term(s)	Child ; Child, Preschool ; Humans ; Infant ; Alaska Natives ; American Indian or Alaska Native ; COVID-19/epidemiology ; COVID-19/prevention & control ; Indians, North American ; Otitis Media/epidemiology ; Otitis Media/prevention & control ; Pandemics ; Pneumococcal Vaccines ; Vaccines, Conjugate
Chemical Substances	Pneumococcal Vaccines ; Vaccines, Conjugate
Language	English
Publishing date	2024-01-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	392481-6
ISSN	1532-0987 ; 0891-3668
ISSN (online)	1532-0987
ISSN	0891-3668
DOI	10.1097/INF.0000000000004207
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Article ; Online: Invasive Pneumococcal Disease and Potential Impact of Pneumococcal Conjugate Vaccines Among Adults, Including Persons Experiencing Homelessness-Alaska, 2011-2020.

Steinberg, Jonathan / Bressler, Sara S / Orell, Laurie / Thompson, Gail C / Kretz, Anthony / Reasonover, Alisa L / Bruden, Dana / Bruce, Michael G / Fischer, Marc

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2023 Volume 78, Issue 1, Page(s) 172–178

Abstract: Background: Adults aged ≥65 years, adults with certain underlying medical conditions, and persons experiencing homelessness are at increased risk for invasive pneumococcal disease (IPD). Two new pneumococcal conjugate vaccines, 15-valent pneumococcal ... ...

Abstract	Background: Adults aged ≥65 years, adults with certain underlying medical conditions, and persons experiencing homelessness are at increased risk for invasive pneumococcal disease (IPD). Two new pneumococcal conjugate vaccines, 15-valent pneumococcal conjugate vaccine (PCV15) and 20-valent pneumococcal conjugate vaccine (PCV20), were recently approved for use in US adults. We describe the epidemiology of IPD among Alaska adults and estimate the proportion of IPD cases potentially preventable by new vaccines. Methods: We used statewide, laboratory-based surveillance data to calculate and compare IPD incidence rates and 95% confidence intervals (CIs) among Alaska adults aged ≥18 years during 2011-2020 and estimate the proportion of IPD cases that were caused by serotypes in PCV15 and PCV20. Results: During 2011-2020, 1164 IPD cases were reported among Alaska adults for an average annual incidence of 21.3 cases per 100 000 adults per year (95% CI, 20.1-22.5). Incidence increased significantly during the study period (P < .01). IPD incidence among Alaska Native adults was 4.7 times higher than among non-Alaska Native adults (95% CI, 4.2-5.2). Among adults experiencing homelessness in Anchorage, IPD incidence was 72 times higher than in the general adult population (95% CI, 59-89). Overall, 1032 (89%) Alaska adults with IPD had an indication for pneumococcal vaccine according to updated vaccination guidelines; 456 (39%) and 700 (60%) cases were caused by serotypes in PCV15 and PCV20, respectively. Conclusions: Use of PCV15 and PCV20 could substantially reduce IPD among adults in Alaska, including Alaska Native adults and adults experiencing homelessness.
MeSH term(s)	Adult ; Humans ; Infant ; Adolescent ; Streptococcus pneumoniae ; Vaccines, Conjugate ; Alaska/epidemiology ; Pneumococcal Infections/epidemiology ; Pneumococcal Infections/prevention & control ; Pneumococcal Vaccines ; Serogroup ; Incidence ; Ill-Housed Persons
Chemical Substances	Vaccines, Conjugate ; Pneumococcal Vaccines
Language	English
Publishing date	2023-09-30
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1093/cid/ciad597
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Article ; Online: Effectiveness of the COVID-19 vaccines on preventing symptomatic SARS-CoV-2 infections and hospitalizations in Southwestern Alaska, January-December 2021.

Lefferts, Brian / Bruden, Dana / Plumb, Ian D / Hodges, Ellen / Bates, Elizabeth / January, Gerald / Bruce, Michael G

Vaccine

2023 Volume 41, Issue 23, Page(s) 3544–3549

Abstract: The population in rural southwest Alaska has been disproportionately affected by COVID-19. To assess the benefit of COVID-19 vaccines, we analyzed data from the regional health system. We estimated vaccine effectiveness (VE) during January 16-December 3, ...

Abstract	The population in rural southwest Alaska has been disproportionately affected by COVID-19. To assess the benefit of COVID-19 vaccines, we analyzed data from the regional health system. We estimated vaccine effectiveness (VE) during January 16-December 3, 2021, against symptomatic SARS-CoV-2 infection after a primary series or booster dose, and overall VE against hospitalization. VE of a primary series against symptomatic infection among adult residents was 91.3% (95% CI: 85.7, 95.2) during January 16-May 7, 2021, 50.3% (95% CI, 41.1%-58.8%) during July 17-September 24, and 37.0% (95% CI, 27.8-45.0) during September 25-December 3, 2021; VE of a booster dose during September 25-December 3, 2021, was 92.1% (95% CI: 87.2-95.2). During the overall study period, VE against hospitalization was 91.9% (95% CI: 85.4-95.5). COVID-19 vaccination offered strong protection against hospitalization and a booster dose restored protection against symptomatic infection.
MeSH term(s)	Adult ; Humans ; COVID-19 Vaccines ; COVID-19/epidemiology ; COVID-19/prevention & control ; Alaska/epidemiology ; SARS-CoV-2 ; Hospitalization
Chemical Substances	COVID-19 Vaccines
Language	English
Publishing date	2023-05-01
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	605674-x
ISSN	1873-2518 ; 0264-410X
ISSN (online)	1873-2518
ISSN	0264-410X
DOI	10.1016/j.vaccine.2023.04.070
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Zs.MO 458: Show issues

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Article ; Online: Immunogenicity of quadrivalent human papillomavirus vaccine among Alaska Native children aged 9-14 years at 5 years after vaccination.

Davis, Bionca M / Blake, Ian / Panicker, Gitika / Meites, Elissa / Thompson, Gail / Geis, Jesse / Bruden, Dana / Fischer, Marc / Singleton, Rosalyn / Unger, Elizabeth R / Markowitz, Lauri E / Bruce, Michael G

Vaccine

2024 Volume 42, Issue 14, Page(s) 3277–3281

Abstract: Background: Persistent human papillomavirus (HPV) infection can cause anogenital and oropharyngeal cancers. Many HPV infections and HPV-associated cancers are vaccine-preventable. Studies suggest long-term persistence of vaccine-induced antibodies. ... ...

Abstract	Background: Persistent human papillomavirus (HPV) infection can cause anogenital and oropharyngeal cancers. Many HPV infections and HPV-associated cancers are vaccine-preventable. Studies suggest long-term persistence of vaccine-induced antibodies. However, data are limited among Alaska Native people. Methods: During 2011-2014, we enrolled Alaska Native children aged 9-14 years who received a 3-dose series of quadrivalent HPV vaccine (4vHPV). We collected sera at 1 month and 1, 2, 3, and 5 years post-vaccination to evaluate trends in type-specific immunoglobulin G antibody concentrations for the 4vHPV types (HPV 6/11/16/18). Results: All participants (N = 469) had detectable antibodies against all 4vHPV types at all timepoints post-vaccination. For all 4vHPV types, antibody levels peaked by 1 month post-vaccination and gradually declined in subsequent years. At 5 years post-vaccination, antibody levels were higher among children who received 4vHPV at a younger age. Conclusions: Alaska Native children maintained antibodies against all 4vHPV types at 5 years post-vaccination.
MeSH term(s)	Humans ; Child ; Adolescent ; Female ; Papillomavirus Infections/prevention & control ; Papillomavirus Infections/immunology ; Antibodies, Viral/blood ; Male ; Alaska Natives/statistics & numerical data ; Immunogenicity, Vaccine ; Alaska ; Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18/immunology ; Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18/administration & dosage ; Vaccination ; Immunoglobulin G/blood ; Papillomavirus Vaccines/immunology ; Papillomavirus Vaccines/administration & dosage
Chemical Substances	Antibodies, Viral ; Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18 ; Immunoglobulin G ; Papillomavirus Vaccines
Language	English
Publishing date	2024-04-15
Publishing country	Netherlands
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	605674-x
ISSN	1873-2518 ; 0264-410X
ISSN (online)	1873-2518
ISSN	0264-410X
DOI	10.1016/j.vaccine.2024.04.033
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Article ; Online: Risk factors for Ebola virus disease among household care providers, Sierra Leone, 2015.

Duffy, Nadezhda / Bruden, Dana / Thomas, Harold / Nichols, Erin / Knust, Barbara / Hennessy, Thomas / Reichler, Mary R

International journal of epidemiology

2022 Volume 51, Issue 5, Page(s) 1457–1468

Abstract: Background: Household contacts who provide care to an Ebola virus disease (EVD) case have a 3-fold higher risk of EVD compared with contacts who do not provide care.: Methods: We enrolled persons with confirmed EVD from December 2014 to April 2015 in ...

Abstract	Background: Household contacts who provide care to an Ebola virus disease (EVD) case have a 3-fold higher risk of EVD compared with contacts who do not provide care. Methods: We enrolled persons with confirmed EVD from December 2014 to April 2015 in Freetown, Sierra Leone, and their household contacts. Index cases and contacts were interviewed, and contacts were followed for 21 days to identify secondary cases. Epidemiological data were analysed to describe household care and to identify risk factors for developing EVD. Results: Of 838 contacts in 147 households, 156 (17%) self-reported providing care to the index case; 56 households had no care provider, 52 a single care provider and 39 multiple care providers. The median care provider age was 29 years, 68% were female and 32% were the index case's spouse. Care providers were more likely to report physical contact, contact with body fluids or sharing clothing, bed linens or utensils with an index case, compared with non-care providers (P <0.01). EVD risk among non-care providers was greater when the number of care providers in the household increased (odds ratio: 1.61; 95% confidence interval: 1.1, 2.4). In multivariable analysis, factors associated with care provider EVD risk included no piped water access and absence of index case fever, and protective factors included age <20 years and avoiding the index case. Conclusions: Limiting the number of care providers in a household could reduce the risk of EVD transmission to both care providers and non-care providers. Strategies to protect care providers from EVD exposure are needed.
MeSH term(s)	Adult ; Disease Outbreaks ; Family Characteristics ; Female ; Fever ; Hemorrhagic Fever, Ebola/epidemiology ; Humans ; Male ; Risk Factors ; Sierra Leone/epidemiology ; Young Adult
Language	English
Publishing date	2022-04-19
Publishing country	England
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	187909-1
ISSN	1464-3685 ; 0300-5771
ISSN (online)	1464-3685
ISSN	0300-5771
DOI	10.1093/ije/dyac081
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Article ; Online: Mortality among Alaska Native Adults with Confirmed Hepatitis C Virus Infection Compared with the General Population in Alaska, 1995-2016.

Bressler, Sara S / Bruden, Dana / Nolen, Leisha D / Bruce, Michael G / Towshend-Bulson, Lisa / Spradling, Philip / McMahon, Brian J

Canadian journal of gastroenterology & hepatology

2022 Volume 2022, Page(s) 2573545

Abstract: Background: Hepatitis C virus (HCV) infection incidence rates in the United States have increased since 2010 as a byproduct of the opioid crisis despite the introduction of direct-acting antiviral agents in 2013. HCV infection is associated with higher ... ...

Abstract	Background: Hepatitis C virus (HCV) infection incidence rates in the United States have increased since 2010 as a byproduct of the opioid crisis despite the introduction of direct-acting antiviral agents in 2013. HCV infection is associated with higher rates of liver-related and nonhepatic causes of death. Methods: This study compared demographic characteristics and age-adjusted death rates from 1995 to 2016 among Alaska Native (AN) adults infected with HCV (AK-HepC) to rates among the AN and non-AN adult populations living in Alaska. Liver-related disease (LRD) and other disease-specific age-adjusted death rates were compared between the populations. Results: The all-cause death rate among the AK-HepC cohort was 2.2- and 3.4-fold higher than AN and non-AN adults, respectively, and remained stable over time in all populations. The LRD death rate among the AK-HepC cohort was 18- and 11-fold higher than the non-AN and AN, respectively. The liver cancer rate among the AK-HepC cohort was 26-fold higher compared to the Alaska statewide population. The AK-HepC cohort had elevated rates of death associated with nonhepatic diseases with circulatory disease having the highest rate in all populations. Among liver cancer deaths in the AK-HepC cohort, 32% had HCV listed as a contributing cause of death on the death certificate. Conclusions: Death rates in the AK-HepC cohort remained stable since 1995 and higher compared to the general population. People with HCV infection had an elevated risk for all-cause, liver-related, and nonhepatic causes of death. Hepatitis C infection may be underrepresented as a cause of mortality in the United States.
MeSH term(s)	Adult ; Alaska/epidemiology ; Alaska Natives ; Antiviral Agents/therapeutic use ; Hepacivirus ; Hepatitis C/complications ; Hepatitis C, Chronic ; Humans ; Liver Neoplasms/drug therapy ; United States
Chemical Substances	Antiviral Agents
Language	English
Publishing date	2022-02-08
Publishing country	Egypt
Document type	Journal Article
ZDB-ID	2762182-0
ISSN	2291-2797 ; 1916-7237 ; 0835-7900
ISSN (online)	2291-2797 ; 1916-7237
ISSN	0835-7900
DOI	10.1155/2022/2573545
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Zs.A 2360: Show issues

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Article ; Online: Rate and durability of the clearance of HBsAg in Alaska Native persons with long-term HBV infection: 1982-2019.

Bruden, Dana / McMahon, Brian J / Snowball, Mary / Towshend-Bulson, Lisa / Homan, Chriss / Johnston, Janet M / Simons, Brenna C / Bruce, Michael G / Cooley, Laura / Spradling, Philip R / Harris, Aaron M

Hepatology (Baltimore, Md.)

2023 Volume 79, Issue 6, Page(s) 1412–1420

Abstract: Background and aims: A functional cure and therapeutic end point of chronic HBV infection is defined as the clearance of HBsAg from serum. Little is known about the long-term durability of HBsAg loss in the Alaskan Native population.: Approach and ... ...

Abstract	Background and aims: A functional cure and therapeutic end point of chronic HBV infection is defined as the clearance of HBsAg from serum. Little is known about the long-term durability of HBsAg loss in the Alaskan Native population. Approach and results: We performed a retrospective cohort study of Alaska Native patients with chronic HBV-monoinfection from January 1982 through December 2019. The original group in this cohort was identified during a 1982 to 1987 population-based screening for 3 HBV serologic markers in 53,000 Alaska Native persons. With close to 32,000 years of follow-up, we assessed the frequency and duration of HBsAg seroclearance (HBsAg-negative for > 6 mo). We examined factors associated with HBsAg clearance and followed persons for a median of 13.1 years afterward to assess the durability of HBsAg clearance. Among 1079 persons with an average length of follow-up of 33 years, 260 (24%) cleared HBsAg at a constant rate of 0.82% per person/per year. Of the 260 persons who cleared, 249 (96%) remained HBsAg-negative, while 11 persons had ≥ 2 transient HBsAg-positive results in subsequent follow-up. Conclusions: Of the patients with chronic HBV monoinfection, 0.82% of people per year achieved a functional cure. HBsAg seroclearance was durable for treated and nontreated patients and lasted, on average, over 13 years without seroreversion.
MeSH term(s)	Humans ; Hepatitis B Surface Antigens/blood ; Female ; Male ; Retrospective Studies ; Hepatitis B, Chronic/blood ; Hepatitis B, Chronic/immunology ; Hepatitis B, Chronic/epidemiology ; Adult ; Alaska Natives/statistics & numerical data ; Middle Aged ; Young Adult ; Alaska/epidemiology ; Hepatitis B virus/immunology ; Adolescent ; Follow-Up Studies ; Time Factors ; Aged
Language	English
Publishing date	2023-11-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	604603-4
ISSN	1527-3350 ; 0270-9139
ISSN (online)	1527-3350
ISSN	0270-9139
DOI	10.1097/HEP.0000000000000658
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Zs.A 1660: Show issues

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Article ; Online: Use of Rapid Antigen Testing for SARS-CoV-2 in Remote Communities - Yukon-Kuskokwim Delta Region, Alaska, September 15, 2020-March 1, 2021.

Hodges, Ellen / Lefferts, Brian / Bates, Elizabeth / Desnoyers, Christine / Bruden, Dana / Bruce, Michael / McLaughlin, Joseph

MMWR. Morbidity and mortality weekly report

2021 Volume 70, Issue 33, Page(s) 1120–1123

Abstract: Controlling the spread of SARS-CoV-2, the virus that causes COVID-19, in Alaska is challenging. Alaska includes many remote and isolated villages with small populations (ranging from 15 to >1,000 persons) that are accessible only by air from larger ... ...

Abstract	Controlling the spread of SARS-CoV-2, the virus that causes COVID-19, in Alaska is challenging. Alaska includes many remote and isolated villages with small populations (ranging from 15 to >1,000 persons) that are accessible only by air from larger communities. Until rapid point-of-care testing became widely available, a primary challenge in the diagnosis of COVID-19 in rural Alaska was slow turnaround times for SARS-CoV-2 test results, attributable to the need to transport specimens to testing facilities. To provide more timely test results and isolation of cases, the Yukon Kuskokwim Health Corporation (YKHC) introduced Abbott BinaxNOW COVID-19 Ag rapid antigen test (BinaxNOW) on November 9, 2020, in the rural Yukon-Kuskokwim Delta region in southwestern Alaska. To evaluate the impact of implementing antigen testing, YKHC reviewed the results of 54,981 antigen and molecular tests for SARS-CoV-2 performed in the Yukon-Kuskokwim Delta during September 15, 2020-March 1, 2021. Introduction of rapid, point-of-care testing was followed by a more than threefold reduction in daily SARS-CoV-2 case rates during approximately 1 month before the introduction of COVID-19 vaccination. The median turnaround time for SARS-CoV-2 test results decreased by >30%, from 6.4 days during September 15-November 8, 2020, to 4.4 days during November 9, 2020-March 1, 2021 (p<0.001). Daily incidence decreased 65% after the introduction of BinaxNOW, from 342 cases per 100,000 population during the week of November 9 to 119 during the week of December 13 (p<0.001). These findings indicate that point-of-care rapid antigen testing can be a valuable tool in reducing turnaround times in rural communities where local access to laboratory-based nucleic acid amplification testing (NAAT) is not readily available and could thereby reduce transmission by facilitating rapid isolation of infected persons, contact tracing, and implementation of local mitigation strategies.
MeSH term(s)	Alaska/epidemiology ; Antigens, Viral ; COVID-19/diagnosis ; COVID-19/epidemiology ; COVID-19 Serological Testing/methods ; COVID-19 Serological Testing/statistics & numerical data ; Humans ; Rural Population ; SARS-CoV-2/immunology ; SARS-CoV-2/isolation & purification ; Time Factors
Chemical Substances	Antigens, Viral
Language	English
Publishing date	2021-08-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	412775-4
ISSN	1545-861X ; 0149-2195
ISSN (online)	1545-861X
ISSN	0149-2195
DOI	10.15585/mmwr.mm7033a3
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Zs.B 1827: Show issues

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Article ; Online: HBV Genotype: A Significant Risk Factor in Determining Which Patients With Chronic HBV Infection Should Undergo Surveillance for HCC: The Hepatitis B Alaska Study.

McMahon, Brian J / Nolen, Leisha D / Snowball, Mary / Homan, Chriss / Negus, Susan / Roik, Elena / Spradling, Philip R / Bruden, Dana

Hepatology (Baltimore, Md.)

2021 Volume 74, Issue 6, Page(s) 2965–2973

Abstract: Background and aims: Information is limited regarding HBV genotype and the outcome of chronic HBV (CHB) infection. We examined the effect of HBV genotype on HCC occurrence in Alaska Native (AN) persons with CHB, where five HBV genotypes are found: A2, ... ...

Abstract	Background and aims: Information is limited regarding HBV genotype and the outcome of chronic HBV (CHB) infection. We examined the effect of HBV genotype on HCC occurrence in Alaska Native (AN) persons with CHB, where five HBV genotypes are found: A2, B6, C2, D, and F1. Approach and results: We calculated HCC incidence per 1,000 person-years of follow-up to determine which groups by age, sex, and genotype met current American Association for the Study of Liver Diseases (AASLD) HCC surveillance criteria. We used Poisson regression to compare HCC risk by genotype, age, sex, and Alaska region. Incidence of HCC was calculated using the sex-specific AASLD cutoff recommended for the Asian population of 50 years for women and 40 years for men. HCC screening was conducted semiannually using alpha-fetoprotein levels and abdominal ultrasound. Among 1,185 AN persons, median follow-up was 35.1 years; 667 (63%) were male. The HBV genotype distribution was 49% D, 18% F, 13% A, 6% C, 3% B, 0.1% H, and 12% undetermined. Sixty-three cases of HCC occurred. HCC incidence for genotype F was 5.73 per 1,000 person-years of follow-up, followed by 4.77 for C, 1.28 for A, 0.47 for D, and 0.00 for B. The HCC risk was higher for genotypes F (relative rate [RR], 12.7; 95% CI, 6.1-26.4), C (RR, 10.6; 95% CI, 4.3-26.0), and A (RR, 2.9; 95% CI, 1.0-8.0) compared to genotypes B and D. Among men < 40 years of age and women < 50 years of age, genotype F had the highest incidence (4.79/1,000 person-years). Conclusions: HBV genotype was strongly associated with HCC. HBV genotype should be considered in risk factor stratification.
MeSH term(s)	Adolescent ; Adult ; Age Factors ; Alaska/epidemiology ; Carcinoma, Hepatocellular/epidemiology ; Carcinoma, Hepatocellular/pathology ; Carcinoma, Hepatocellular/virology ; Child ; Female ; Follow-Up Studies ; Genotyping Techniques/statistics & numerical data ; Hepatitis B virus/genetics ; Hepatitis B virus/isolation & purification ; Hepatitis B virus/pathogenicity ; Hepatitis B, Chronic/diagnosis ; Hepatitis B, Chronic/epidemiology ; Hepatitis B, Chronic/pathology ; Hepatitis B, Chronic/virology ; Humans ; Incidence ; Liver Neoplasms/epidemiology ; Liver Neoplasms/pathology ; Liver Neoplasms/virology ; Male ; Middle Aged ; Retrospective Studies ; Risk Assessment/methods ; Risk Assessment/statistics & numerical data ; Risk Factors ; Seroepidemiologic Studies ; Sex Factors ; Young Adult
Language	English
Publishing date	2021-09-20
Publishing country	United States
Document type	Journal Article ; Observational Study ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	604603-4
ISSN	1527-3350 ; 0270-9139
ISSN (online)	1527-3350
ISSN	0270-9139
DOI	10.1002/hep.32065
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Article ; Online: Antigen Test Positivity After COVID-19 Isolation - Yukon-Kuskokwim Delta Region, Alaska, January-February 2022.

Lefferts, Brian / Blake, Ian / Bruden, Dana / Hagen, Melissa B / Hodges, Ellen / Kirking, Hannah L / Bates, Elizabeth / Hoeldt, Amanda / Lamont, Brenda / Saydah, Sharon / MacNeil, Adam / Bruce, Michael G / Plumb, Ian D

MMWR. Morbidity and mortality weekly report

2022 Volume 71, Issue 8, Page(s) 293–298

Abstract: Isolation is recommended during acute infection with SARS-CoV-2, the virus that causes COVID-19, but the duration of infectiousness varies among individual persons. Rapid antigen test results have been correlated with detection of viable virus (1-3) and ... ...

Abstract	Isolation is recommended during acute infection with SARS-CoV-2, the virus that causes COVID-19, but the duration of infectiousness varies among individual persons. Rapid antigen test results have been correlated with detection of viable virus (1-3) and might inform isolation guidance, but data are limited for the recently emerged SARS-CoV-2 B.1.1.529 (Omicron) variant. On January 5, 2022, the Yukon-Kuskokwim Health Corporation (YKHC) recommended that persons with SARS-CoV-2 infection isolate for 10 days after symptom onset (or, for asymptomatic persons, 10 days after a positive nucleic acid amplification or antigen test result). However, isolation could end after 5-9 days if symptoms were resolving or absent, fever was absent for ≥24 hours without fever-reducing medications, and an Abbott BinaxNOW COVID-19 Ag (BinaxNOW) rapid antigen test result was negative. Antigen test results and associated individual characteristics were analyzed among 3,502 infections reported to YKHC during January 1-February 9, 2022. After 5-9 days, 396 of 729 persons evaluated (54.3%) had a positive antigen test result, with a declining percentage positive over time. In a multivariable model, a positive antigen test result was more likely after 5 days compared with 9 days (adjusted odds ratio [aOR] = 6.39) or after symptomatic infection (aOR = 9.63), and less likely after previous infection (aOR = 0.30), receipt of a primary COVID-19 vaccination series (aOR = 0.60), or after both previous infection and receipt of a primary COVID-19 vaccination series (aOR = 0.17). Antigen tests might be a useful tool to guide recommendations for isolation after SARS-CoV-2 infection. During the 10 days after infection, persons might be infectious to others and are recommended to wear a well-fitting mask when around others, even if ending isolation after 5 days.
MeSH term(s)	Adolescent ; Adult ; Alaska/epidemiology ; Alaska Natives ; COVID-19/diagnosis ; COVID-19/prevention & control ; COVID-19/transmission ; COVID-19 Serological Testing ; Child ; Child, Preschool ; Female ; Health Planning Guidelines ; Humans ; Infant ; Male ; Middle Aged ; Quarantine ; SARS-CoV-2 ; Young Adult
Language	English
Publishing date	2022-02-25
Publishing country	United States
Document type	Technical Report
ZDB-ID	412775-4
ISSN	1545-861X ; 0149-2195
ISSN (online)	1545-861X
ISSN	0149-2195
DOI	10.15585/mmwr.mm7108a3
Database	MEDical Literature Analysis and Retrieval System OnLINE

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