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Article ; Online: Deaths Associated with Pediatric Hepatitis of Unknown Etiology, United States, October 2021-June 2023.

Almendares, Olivia / Baker, Julia M / Sugerman, David E / Parashar, Umesh D / Reagan-Steiner, Sarah / Kirking, Hannah L / Gastañaduy, Paul A / Tate, Jacqueline E

Emerging infectious diseases

2024 Volume 30, Issue 4

Abstract: During October 2021-June 2023, a total of 392 cases of acute hepatitis of unknown etiology in children in the United States were reported to Centers for Disease Control and Prevention as part of national surveillance. We describe demographic and clinical ...

Abstract	During October 2021-June 2023, a total of 392 cases of acute hepatitis of unknown etiology in children in the United States were reported to Centers for Disease Control and Prevention as part of national surveillance. We describe demographic and clinical characteristics, including potential involvement of adenovirus in development of acute hepatitis, of 8 fatally ill children who met reporting criteria. The children had diverse courses of illness. Two children were immunocompromised when initially brought for care. Four children tested positive for adenovirus in multiple specimen types, including 2 for whom typing was completed. One adenovirus-positive child had no known underlying conditions, supporting a potential relationship between adenovirus and acute hepatitis in previously healthy children. Our findings emphasize the importance of continued investigation to determine the mechanism of liver injury and appropriate treatment. Testing for adenovirus in similar cases could elucidate the role of the virus.
MeSH term(s)	Child ; Humans ; United States/epidemiology ; Hepatitis ; Hepatitis A/epidemiology ; Viruses ; Acute Disease
Language	English
Publishing date	2024-04-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	1380686-5
ISSN	1080-6059 ; 1080-6040
ISSN (online)	1080-6059
ISSN	1080-6040
DOI	10.3201/eid3004.231140
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Article ; Online: Identification of Large Adenovirus Infection Outbreak at University by Multipathogen Testing, South Carolina, USA, 2022.

Tori, Marco E / Chontos-Komorowski, Judith / Stacy, Jason / Lamson, Daryl M / St George, Kirsten / Lail, Avril T / Stewart-Grant, Heather A / Bell, Linda J / Kirking, Hannah L / Hsu, Christopher H

Emerging infectious diseases

2024 Volume 30, Issue 2, Page(s) 358–362

Abstract: Using multipathogen PCR testing, we identified 195 students with adenovirus type 4 infections on a university campus in South Carolina, USA, during January-May 2022. We co-detected other respiratory viruses in 43 (22%) students. Continued surveillance of ...

Abstract	Using multipathogen PCR testing, we identified 195 students with adenovirus type 4 infections on a university campus in South Carolina, USA, during January-May 2022. We co-detected other respiratory viruses in 43 (22%) students. Continued surveillance of circulating viruses is needed to prevent virus infection outbreaks in congregate communities.
MeSH term(s)	Humans ; South Carolina/epidemiology ; Universities ; Adenoviridae Infections ; Disease Outbreaks ; Students
Language	English
Publishing date	2024-01-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	1380686-5
ISSN	1080-6059 ; 1080-6040
ISSN (online)	1080-6059
ISSN	1080-6040
DOI	10.3201/eid3002.230623
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Article ; Online: Reduced sensitivity of SARS-CoV-2 PCR testing with single-nostril nasal swabs.

Salvatore, Phillip P / Bhattacharyya, Sanjib / Christensen, Kim / Tate, Jacqueline E / Kirking, Hannah L

Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology

2021 Volume 140, Page(s) 104852

MeSH term(s)	COVID-19/diagnosis ; COVID-19 Nucleic Acid Testing/standards ; Humans ; Nose/virology ; Polymerase Chain Reaction/standards ; SARS-CoV-2/isolation & purification ; Sensitivity and Specificity ; Specimen Handling
Language	English
Publishing date	2021-05-09
Publishing country	Netherlands
Document type	Letter
ZDB-ID	1446080-4
ISSN	1873-5967 ; 1386-6532
ISSN (online)	1873-5967
ISSN	1386-6532
DOI	10.1016/j.jcv.2021.104852
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Article: Examination of Common Coronavirus Antibodies in SARS-CoV-2-Infected and Uninfected Participants in a Household Transmission Investigation.

Stumpf, Megan M / Freeman, Brandi / Mills, Lisa / Lester, Sandra / Chu, Victoria T / Kirking, Hannah L / Thornburg, Natalie J / Killerby, Marie E

Open forum infectious diseases

2022 Volume 9, Issue 7, Page(s) ofac212

Abstract: We compared paired serum specimens from household contacts of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases with detectable SARS-CoV-2 seroconversion with contacts who remained seronegative. No protection from SARS-CoV-2 infection ... ...

Abstract	We compared paired serum specimens from household contacts of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases with detectable SARS-CoV-2 seroconversion with contacts who remained seronegative. No protection from SARS-CoV-2 infection was associated with human coronavirus antibodies; however, an increase in common betacoronavirus antibodies was associated with seroconversion to SARS-CoV-2 in mild to moderately ill cases.
Language	English
Publishing date	2022-07-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	2757767-3
ISSN	2328-8957
ISSN	2328-8957
DOI	10.1093/ofid/ofac212
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Article ; Online: Quantitative comparison of SARS-CoV-2 nucleic acid amplification test and antigen testing algorithms: a decision analysis simulation model.

Salvatore, Phillip P / Shah, Melisa M / Ford, Laura / Delaney, Augustina / Hsu, Christopher H / Tate, Jacqueline E / Kirking, Hannah L

BMC public health

2022 Volume 22, Issue 1, Page(s) 82

Abstract: Background: Antigen tests for SARS-CoV-2 offer advantages over nucleic acid amplification tests (NAATs, such as RT-PCR), including lower cost and rapid return of results, but show reduced sensitivity. Public health organizations recommend different ... ...

Abstract	Background: Antigen tests for SARS-CoV-2 offer advantages over nucleic acid amplification tests (NAATs, such as RT-PCR), including lower cost and rapid return of results, but show reduced sensitivity. Public health organizations recommend different strategies for utilizing NAATs and antigen tests. We sought to create a framework for the quantitative comparison of these recommended strategies based on their expected performance. Methods: We utilized a decision analysis approach to simulate the expected outcomes of six testing algorithms analogous to strategies recommended by public health organizations. Each algorithm was simulated 50,000 times in a population of 100,000 persons seeking testing. Primary outcomes were number of missed cases, number of false-positive diagnoses, and total test volumes. Outcome medians and 95% uncertainty ranges (URs) were reported. Results: Algorithms that use NAATs to confirm all negative antigen results minimized missed cases but required high NAAT capacity: 92,200 (95% UR: 91,200-93,200) tests (in addition to 100,000 antigen tests) at 10% prevalence. Selective use of NAATs to confirm antigen results when discordant with symptom status (e.g., symptomatic persons with negative antigen results) resulted in the most efficient use of NAATs, with 25 NAATs (95% UR: 13-57) needed to detect one additional case compared to exclusive use of antigen tests. Conclusions: No single SARS-CoV-2 testing algorithm is likely to be optimal across settings with different levels of prevalence and for all programmatic priorities. This analysis provides a framework for selecting setting-specific strategies to achieve acceptable balances and trade-offs between programmatic priorities and resource constraints.
MeSH term(s)	Algorithms ; COVID-19 ; COVID-19 Testing ; Decision Support Techniques ; Humans ; Nucleic Acid Amplification Techniques ; SARS-CoV-2 ; Sensitivity and Specificity
Language	English
Publishing date	2022-01-13
Publishing country	England
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	2041338-5
ISSN	1471-2458 ; 1471-2458
ISSN (online)	1471-2458
ISSN	1471-2458
DOI	10.1186/s12889-021-12489-8
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Article ; Online: Performance of Existing and Novel Symptom- and Antigen Testing-Based COVID-19 Case Definitions in a Community Setting.

Lee, Scott / Almendares, Olivia / Prince-Guerra, Jessica / Anderson, Mark / Heilig, Charles M / Tate, Jacqueline E / Kirking, Hannah L

American journal of epidemiology

2022 Volume 192, Issue 3, Page(s) 438–447

Abstract: Point-of-care antigen tests are an important tool for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection, yet are less clinically sensitive than real-time reverse-transcription polymerase chain reaction (RT-PCR), affecting their ... ...

Abstract	Point-of-care antigen tests are an important tool for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection, yet are less clinically sensitive than real-time reverse-transcription polymerase chain reaction (RT-PCR), affecting their efficacy as screening procedures. Our goal in this analysis was to see whether we could improve this sensitivity by considering antigen test results in combination with other relevant information, namely exposure status and reported symptoms. In November 2020, we collected 3,419 paired upper respiratory specimens tested by RT-PCR and the Abbott BinaxNOW (Abbott Laboratories, Abbott Park, Illinois) antigen test at 2 community testing sites in Pima County, Arizona. We used symptom, exposure, and antigen-testing data to evaluate the sensitivity and specificity of various symptom definitions in predicting RT-PCR positivity. Our analysis yielded 6 novel multisymptom case definitions with and without antigen test results, the best of which overall achieved a Youden's J index of 0.66, as compared with 0.53 for antigen testing alone. Using a random forest as a guide, we show that this definition, along with our others, does not lose the ability to generalize well to new data despite achieving optimal performance in our sample. Our methodology is broadly applicable, and our code is publicly available to aid public health practitioners in developing or fine-tuning their own case definitions.
MeSH term(s)	Humans ; COVID-19 ; SARS-CoV-2 ; Arizona ; Public Health ; Sensitivity and Specificity ; Antigens, Viral
Chemical Substances	Antigens, Viral
Language	English
Publishing date	2022-11-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	2937-3
ISSN	1476-6256 ; 0002-9262
ISSN (online)	1476-6256
ISSN	0002-9262
DOI	10.1093/aje/kwac196
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Article: Tuberculosis Infection in Children.

Stewart, Rebekah J / Wortham, Jonathan / Parvez, Farah / Bamrah Morris, Sapna / Kirking, Hannah L / Hatzenbuehler Cameron, Lindsay / Cruz, Andrea T

The journal for nurse practitioners : JNP

2022 Volume 16, Issue 9, Page(s) 673–678

Abstract: Globally, tuberculosis (TB) is the leading cause of infectious disease mortality; however, clinicians in the United States are increasingly unfamiliar with TB and the recommended tests and treatment for latent TB infection. Compared with adults, children ...

Abstract	Globally, tuberculosis (TB) is the leading cause of infectious disease mortality; however, clinicians in the United States are increasingly unfamiliar with TB and the recommended tests and treatment for latent TB infection. Compared with adults, children who develop TB more often develop severe disease, and children < 2 years are particularly susceptible to developing TB disease after initial infection. Nurse practitioners who work in primary care are on the front lines of identifying children at high risk and obtaining testing and treatment. This article reviews the clinical course for identifying children at risk for TB and provides updated guidelines for testing and treatment.
Language	English
Publishing date	2022-07-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	2202063-9
ISSN	1878-058X ; 1555-4155
ISSN (online)	1878-058X
ISSN	1555-4155
DOI	10.1016/j.nurpra.2020.06.027
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Article ; Online: SARS-CoV-2 Viral Shedding and Rapid Antigen Test Performance - Respiratory Virus Transmission Network, November 2022-May 2023.

Smith-Jeffcoat, Sarah E / Mellis, Alexandra M / Grijalva, Carlos G / Talbot, H Keipp / Schmitz, Jonathan / Lutrick, Karen / Ellingson, Katherine D / Stockwell, Melissa S / McLaren, Son H / Nguyen, Huong Q / Rao, Suchitra / Asturias, Edwin J / Davis-Gardner, Meredith E / Suthar, Mehul S / Kirking, Hannah L

MMWR. Morbidity and mortality weekly report

2024 Volume 73, Issue 16, Page(s) 365–371

Abstract: As population immunity to SARS-CoV-2 evolves and new variants emerge, the role and accuracy of antigen tests remain active questions. To describe recent test performance, the detection of SARS-CoV-2 by antigen testing was compared with that by reverse ... ...

Abstract	As population immunity to SARS-CoV-2 evolves and new variants emerge, the role and accuracy of antigen tests remain active questions. To describe recent test performance, the detection of SARS-CoV-2 by antigen testing was compared with that by reverse transcription-polymerase chain reaction (RT-PCR) and viral culture testing during November 2022-May 2023. Participants who were enrolled in a household transmission study completed daily symptom diaries and collected two nasal swabs (tested for SARS-CoV-2 via RT-PCR, culture, and antigen tests) each day for 10 days after enrollment. Among participants with SARS-CoV-2 infection, the percentages of positive antigen, RT-PCR, and culture results were calculated each day from the onset of symptoms or, in asymptomatic persons, from the date of the first positive test result. Antigen test sensitivity was calculated using RT-PCR and viral culture as references. The peak percentage of positive antigen (59.0%) and RT-PCR (83.0%) results occurred 3 days after onset, and the peak percentage of positive culture results (52%) occurred 2 days after onset. The sensitivity of antigen tests was 47% (95% CI = 44%-50%) and 80% (95% CI = 76%-85%) using RT-PCR and culture, respectively, as references. Clinicians should be aware of the lower sensitivity of antigen testing compared with RT-PCR, which might lead to false-negative results. This finding has implications for timely initiation of SARS-CoV-2 antiviral treatment, when early diagnosis is essential; clinicians should consider RT-PCR for persons for whom antiviral treatment is recommended. Persons in the community who are at high risk for severe COVID-19 illness and eligible for antiviral treatment should seek testing from health care providers with the goal of obtaining a more sensitive diagnostic test than antigen tests (i.e., an RT-PCR test).
MeSH term(s)	Humans ; COVID-19/diagnosis ; COVID-19/transmission ; SARS-CoV-2/isolation & purification ; SARS-CoV-2/immunology ; SARS-CoV-2/genetics ; COVID-19 Serological Testing ; Adult ; Virus Shedding ; Antigens, Viral/analysis ; Male ; Sensitivity and Specificity ; Female ; Middle Aged ; COVID-19 Nucleic Acid Testing ; Young Adult ; Adolescent ; United States/epidemiology ; Aged ; COVID-19 Testing
Chemical Substances	Antigens, Viral
Language	English
Publishing date	2024-04-25
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.mm7316a2
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Article ; Online: Evaluation of Correctional Facility COVID-19 Outbreaks With Layered Mitigation Strategies Including Vaccination: Colorado, 2020-2021.

Martinez, Heather E / Marshall, Kristen E / Showell, Velton W / Tate, Jacqueline E / Kirking, Hannah L / Broudy, Melissa / Matzinger, Shannon R / Burakoff, Alexis / Deng, Li / Payne, Daniel C / Fleming-Dutra, Katherine / Jervis, Rachel H

Journal of correctional health care : the official journal of the National Commission on Correctional Health Care

2023 Volume 29, Issue 3, Page(s) 198–205

Abstract: In 2020-2021, a Colorado corrections facility experienced four COVID-19 outbreaks. Case counts, attack rates (ARs) in people who are detained or incarcerated (PDI), and mitigation measures used in each outbreak were compared to evaluate effects of ... ...

Abstract	In 2020-2021, a Colorado corrections facility experienced four COVID-19 outbreaks. Case counts, attack rates (ARs) in people who are detained or incarcerated (PDI), and mitigation measures used in each outbreak were compared to evaluate effects of combined strategies. Serial PCR testing, isolation/quarantine, and masking were implemented in outbreak 1. Daily staff antigen testing began in outbreak 2. Facility-wide COVID-19 vaccination started in outbreak 3 and coverage increased by the end of outbreak 4 (PDI: <1% to 59%, staff: 27% to 40%). Despite detection of variants of concern, outbreaks 3 and 4 had 97% lower PDI ARs (both 1%) than outbreak 2 (29%). Daily staff testing and increasing vaccination coverage, with other outbreak mitigation strategies, are important to reduce COVID-19 transmission in congregate settings.
MeSH term(s)	Humans ; COVID-19/epidemiology ; COVID-19/prevention & control ; Colorado/epidemiology ; COVID-19 Vaccines ; Disease Outbreaks/prevention & control ; Correctional Facilities ; Vaccination
Chemical Substances	COVID-19 Vaccines
Language	English
Publishing date	2023-03-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	2233559-6
ISSN	1940-5200 ; 1078-3458
ISSN (online)	1940-5200
ISSN	1078-3458
DOI	10.1089/jchc.21.12.0146
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Article ; Online: Notes from the Field: Multipathogen Respiratory Virus Testing Among Primary and Secondary School Students and Staff Members in a Large Metropolitan School District - Missouri, November 2, 2022-April 19, 2023.

Goldman, Jennifer L / Lee, Brian R / Porter, Janelle / Deliu, Anila / Tilsworth, Shannon / Almendares, Olivia M / Sleweon, Sadia / Kirking, Hannah L / Selvarangan, Rangaraj / Schuster, Jennifer E

MMWR. Morbidity and mortality weekly report

2023 Volume 72, Issue 28, Page(s) 772–774

MeSH term(s)	Humans ; Missouri/epidemiology ; Students ; Schools
Language	English
Publishing date	2023-07-14
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.mm7228a4
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