A5088543321- Mosquito-borne diseases and control
- Viral Infections and Vectors
- Global Maternal and Child Health
- Malaria Research and Control
- Autoimmune and Inflammatory Disorders Research
- COVID-19 epidemiological studies
- Viral Infections and Outbreaks Research
- Burkholderia infections and melioidosis
- Leptospirosis research and findings
- Poverty, Education, and Child Welfare
- HIV/AIDS Research and Interventions
- SARS-CoV-2 detection and testing
- SARS-CoV-2 and COVID-19 Research
- COVID-19 Impact on Reproduction
- Marine animal studies overview
- Adolescent and Pediatric Healthcare
- Biosensors and Analytical Detection
- Parasite Biology and Host Interactions
- Insect symbiosis and bacterial influences
- Long-Term Effects of COVID-19
- Underwater Acoustics Research
- Parvovirus B19 Infection Studies
- Turtle Biology and Conservation
- Hematological disorders and diagnostics
- Data-Driven Disease Surveillance
Puerto Rico Department of Health
2014-2024
Centers for Disease Control and Prevention
2015-2024
National Center for Emerging and Zoonotic Infectious Diseases
2017-2024
Vector & Vector-Borne Diseases Research Institute
2024
AID Atlanta
2024
Centers for Disease Control and Prevention
2014-2022
Muhimbili University of Health and Allied Sciences
2022
Pacific Research Institute
2021
Vitalant
2021
University of Vermont Medical Center
2021
To estimate the frequency and duration of detectable Zika virus (ZIKV) RNA in human body fluids, we prospectively assessed a cohort newly infected participants Puerto Rico.We evaluated samples obtained from 150 (including 55 men) whom ZIKV was detected on reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay urine or blood an enhanced arboviral clinical surveillance site. We collected serum, urine, saliva, semen, vaginal secretions weekly for first month then at 2, 4, 6 months. All...
Pregnant women living in or traveling to areas with local mosquito-borne Zika virus transmission are at risk for infection, which can lead severe fetal and infant brain abnormalities microcephaly (1). In February 2016, CDC recommended 1) routine testing infection of asymptomatic pregnant ongoing the first prenatal care visit, 2) retesting during second trimester who initially test negative, 3) signs symptoms consistent disease (e.g., fever, rash, arthralgia, conjunctivitis) any time...
Zika virus infection during pregnancy causes serious birth defects and might be associated with neurodevelopmental abnormalities in children. Early identification of intervention for problems can improve cognitive, social, behavioral functioning.Pregnancies laboratory evidence confirmed or possible infants resulting from these pregnancies are included the U.S. Pregnancy Infant Registry (USZPIR) followed through active surveillance methods. This report includes data on children aged ≥1 year...
† Symptoms of Zika virus disease include acute onset fever, maculopapular rash, arthralgia, or conjunctivitis.§ Persons with ongoing possible exposure those who reside in frequently travel (e.g., daily weekly) to an area risk for transmission.¶ For the purposes this guidance, recent virus/flavivirus infection is defined as a during current pregnancy periconceptional period (i.e., 8 weeks before conception 6 last menstrual period).
Zika virus is a flavivirus transmitted primarily by Aedes aegypti and albopictus mosquitoes, infection can be asymptomatic or result in an acute febrile illness with rash (1). during pregnancy cause of microcephaly other severe birth defects (2). Infection has also been associated Guillain-Barré syndrome (GBS) (3) thrombocytopenia (4,5). In December 2015, the Puerto Rico Department Health (PRDH) reported first locally acquired case infection. This report provides update to epidemiology...
Abstract We report two patients that developed severe thrombocytopenia after Zika virus (ZIKV) infection. The first patient had 1000 platelets/μL and died multiple hemorrhages. second 2000 platelets/μL, melena ecchymoses, recovered receiving intravenous immunoglobulin. ZIKV may be associated with immune-mediated thrombocytopenia.
Identifying etiologies of acute febrile illnesses (AFI) is challenging due to non-specific presentation and limited availability diagnostics. Prospective AFI studies provide a methodology describe the syndrome by age etiology, findings that can be used develop case definitions multiplexed diagnostics optimize management. We conducted 3-year prospective study in Puerto Rico. Patients with fever ≤7 days were offered enrollment, clinical data specimens collected at enrollment upon discharge or...
Problem/Condition: Dengue is the most prevalent mosquitoborne viral illness worldwide and endemic in Puerto Rico.Dengue's clinical spectrum can range from mild, undifferentiated febrile to hemorrhagic manifestations, shock, multiorgan failure, death severe cases.The disease presentation nonspecific; therefore, various other illnesses (e.g., arboviral respiratory pathogens) cause similar symptoms.Enhanced surveillance necessary determine prevalence, characterize epidemiology of disease,...
Zika virus is a flavivirus transmitted primarily by Aedes species mosquitoes. Increasing evidence links infection during pregnancy to adverse and birth outcomes, including loss, intrauterine growth restriction, eye defects, congenital brain abnormalities, other fetal abnormalities. The has also been determined be sexually transmitted. Because of the potential risks associated with pregnancy, CDC recommended that health care providers discuss prevention unintended women couples who reside in...
Zika virus is a flavivirus transmitted primarily by Aedes species mosquitoes, and symptoms of infection can include rash, fever, arthralgia, conjunctivitis (1).* during pregnancy cause microcephaly other severe brain defects (2). Infection has also been associated with Guillain-Barré syndrome (3). In December 2015, Puerto Rico became the first U.S. jurisdiction to report local transmission virus, index patient reporting symptom onset on November 23, 2015 (4). This provides an update...
Zika virus (ZIKV) infection during pregnancy is a cause of congenital microcephaly and severe fetal brain defects, it has been associated with other adverse birth outcomes.To estimate the number pregnant women infected ZIKV in Puerto Rico cases.We conducted modeling study from April to July 2016. Using parameters derived published reports, outcomes were modeled probabilistically using Monte Carlo simulation. We used uncertainty distributions reflect limited information available for...
Hemophagocytic lymphohistiocytosis (HLH) is a rare, potentially fatal disorder characterized by fever, pancytopenia, hepatosplenomegaly, and increased serum ferritin. HLH being increasingly reported as complication of dengue, common tropical acute febrile illness.After cluster pediatric dengue-associated patients was identified during the 2012-2013 dengue epidemic in Puerto Rico, active surveillance case-control investigation conducted at four referral hospitals to determine incidence...
Aedes species mosquitoes transmit chikungunya virus, as well dengue and Zika viruses, bite most often during the day.* Infectious mosquito bites frequently occur in around homes (1,2). Caribbean countries first reported local transmission of virus December 2013, soon after, spread throughout Americas (3). Puerto Rico its laboratory-positive case May 2014 (4), subsequently identified approximately 29,000 suspected cases island by end 2015.(†) Because conventional vector control approaches...
Abstract We modeled the potential cost-effectiveness of increasing access to contraception in Puerto Rico during a Zika virus outbreak. The intervention is projected cost an additional $33.5 million family planning services and likely be cost-saving for healthcare system overall. It could reduce virus–related costs by $65.2 ($2.8 from less testing monitoring $62.3 avoided virus–associated microcephaly [ZAM]). estimates are influenced methods used, frequency ZAM, lifetime incremental ZAM....
Death in patients with chikungunya is rare and has been associated encephalitis, hemorrhage, septic shock. We describe clinical, histologic, immunohistochemical findings individuals who died following virus (CHIKV) infection.
The representativeness and timeliness of sentinel surveillance for endemic emerging arboviral respiratory diseases in low-resource settings are understudied. We compared laboratory-confirmed epidemic dengue, non-epidemic Zika, chikungunya, COVID-19 (pre-Omicron Omicron periods) cases reported Puerto Rico's Sentinel Enhanced Dengue Surveillance System (SEDSS) with island-wide trends by the Department Health's passive disease system (PADSS). plotted over time to assess used lagged...
Investigation of melioidosis cases in eastern Puerto Rico revealed high rates Burkholderia pseudomallei seropositivity, and the bacterium was isolated from soil, suggesting regional endemicity. Increased awareness is needed to enable early case identification antimicrobial therapy.
BACKGROUND In the absence of active blood donation screening, dengue viruses (DENV) have been implicated in only a limited number transfusion transmissions worldwide. This study attempted to identify if from donors testing negative by an NS1‐antigen (Ag) enzyme‐linked immunosorbent assay (ELISA) but confirmed positive for DENV RNA caused DENV‐related disease recipients during epidemic years 2010 2012 Puerto Rico. STUDY DESIGN AND METHODS Donation aliquots investigational NS1‐Ag ELISA were...
Zika virus is a cause of microcephaly and brain abnormalities (1), it the first known mosquito-borne infection to congenital anomalies in humans. The establishment comprehensive surveillance system monitor pregnant women with will provide data further elucidate full range potential outcomes for fetuses infants mothers asymptomatic symptomatic during pregnancy. In February 2016, disease infections became nationally notifiable conditions United States (2). Cases laboratory evidence who have...
Background Leptospirosis is a potentially fatal bacterial zoonosis that endemic throughout the tropics and may be misdiagnosed as dengue. Delayed hospital admission of leptospirosis patients associated with increased mortality. Methodology/Principal Findings During concurrent dengue/leptospirosis epidemic in Puerto Rico 2010, suspected dengue tested dengue-negative were for leptospirosis. Fatal non-fatal hospitalized matched 1:1–3 by age. Records from all medical visits evaluated factors...
Background Burkholderia pseudomallei is a soil-dwelling bacterium and the causative agent of melioidosis. The global burden distribution melioidosis poorly understood, including in Caribbean. B. was previously isolated from humans soil eastern Puerto Rico but abundance as whole has not been thoroughly investigated. Methodology/Principal findings We collected 600 environmental samples (500 100 water) 60 sites around Rico. identified by isolating it via culturing and/or using PCR to detect its...
Hospitalization of patients during outbreaks chikungunya virus has been reported to be uncommon (0.5-8.7%), but more frequent among infants and the elderly. CHIKV was first detected in Puerto Rico May 2014. We enrolled with acute febrile illness (AFI) presenting two hospital emergency departments tested them for infection describe frequency detection CHIKV-infected patients, identify risk factors hospitalization, severe manifestations.Serum specimens were collected from AFI by rRT-PCR....
Public health responses to outbreaks of dengue, chikungunya, and Zika virus have been stymied by the inability control primary vector, Aedes aegypti mosquitos. Consequently, need for novel approaches vector is urgent. Placement three autocidal gravid ovitraps (AGO traps) in ~85% homes a community was previously shown sustainably reduce density female Ae. >80%. Following introduction chikungunya (CHIKV) Puerto Rico, we conducted seroprevalence survey estimate prevalence CHIKV infection...
Dengue and influenza are pathogens of global concern cause febrile illness similar to COVID-19. We analyzed data from an enhanced surveillance system operating three emergency departments urgent care clinic in Puerto Rico identify clinical features predictive or dengue compared with Participants fever respiratory symptoms aged ≥18 years enrolled May 2012-January 2021 dengue, influenza, SARS-CoV-2 confirmed by reverse transcriptase polymerase chain reaction were included. calculated adjusted...