A5067515532- Respiratory viral infections research
- Influenza Virus Research Studies
- Data-Driven Disease Surveillance
- Viral gastroenteritis research and epidemiology
- Mosquito-borne diseases and control
- Vaccine Coverage and Hesitancy
- Viral Infections and Vectors
- COVID-19 Clinical Research Studies
- COVID-19 epidemiological studies
- Clostridium difficile and Clostridium perfringens research
- Viral Infections and Outbreaks Research
- Tuberculosis Research and Epidemiology
- SARS-CoV-2 and COVID-19 Research
- Hepatitis Viruses Studies and Epidemiology
- Reproductive tract infections research
- COVID-19 and healthcare impacts
- Syphilis Diagnosis and Treatment
- Antibiotic Use and Resistance
- Medical Device Sterilization and Disinfection
- Hepatitis B Virus Studies
- Public Health Policies and Education
- Hepatitis C virus research
- Smoking Behavior and Cessation
- HIV, Drug Use, Sexual Risk
- Mycobacterium research and diagnosis
United States Department of Veterans Affairs
2013-2025
Veterans Health Administration
2013-2025
Palo Alto Veterans Institute for Research
2015-2023
American Public Health Association
2023
Office of the Assistant Secretary for Health
2013-2022
VA Palo Alto Health Care System
2020-2022
Society of Hematologic Oncology
2020
Engineering Associates (United States)
2017
Stanford University
2015
COVID-19 mRNA vaccines (Pfizer-BioNTech and Moderna) have been shown to be highly protective against COVID-19-associated hospitalizations (1-3). Data are limited on the level of protection hospitalization among disproportionately affected populations in United States, particularly during periods which B.1.617.2 (Delta) variant SARS-CoV-2, virus that causes COVID-19, predominates (2). U.S. veterans older, more racially diverse, higher prevalences underlying medical conditions than persons...
Coronavirus disease 2019 (COVID-19) is primarily a respiratory illness, although increasing evidence indicates that infection with SARS-CoV-2, the virus causes COVID-19, can affect multiple organ systems (1).Data examine all in-hospital complications of COVID-19 and compare these those associated other viral pathogens, such as influenza, are lacking.To assess electronic health records (EHRs) from 3,948 hospitalized patients (March 1-May 31, 2020) 5,453 influenza (October 1, 2018-February...
The mRNA COVID-19 vaccines (Moderna and Pfizer-BioNTech) provide strong protection against severe COVID-19, including hospitalization, for at least several months after receipt of the second dose (1,2).However, studies examining immune responses differences in COVID-19-associated hospitalization real-world settings, by vaccine product, are limited.To understand how effectiveness (VE) might change with time, CDC collaborators assessed comparative Moderna Pfizer-BioNTech preventing two periods...
Cardiac injury is a known potential complication of influenza infection. Because U.S. veterans cared for at the Department Veterans Affairs are older and have more cardiovascular disease (CVD) risk factors than general population, cardiac complications We investigated biomarkers characteristics associated events among who received biomarker testing ≤30 days after laboratory-confirmed virus Laboratory-confirmed cases Affairs' facilities October 2010–December 2012 were identified using...
Background COVID-19 has disproportionately affected older adults and certain racial ethnic groups in the United States. Data quantifying disease burden, as well describing clinical outcomes during hospitalization among these groups, are needed. Objective We aimed to describe interim rates severe by age group race ethnicity US veterans using a multisite surveillance network. Methods implemented platform 5 Veterans Affairs Medical Centers located Atlanta, Bronx, Houston, Palo Alto, Los...
Background Zika virus (ZIKV) is an important flavivirus infection. Although ZIKV infection rarely fatal, risk for severe disease in adults not well described. Our objective was to describe the spectrum of illness U.S. Veterans with Methodology Case series study including patients laboratory-confirmed or presumed positive all Health Administration (VHA) medical centers. Adjusted odds ratios clinical variables associated hospitalization and neurologic complications performed. Principal...
Abstract Background Influenza and Respiratory Syncytial Virus (RSV) cause seasonal epidemics with substantial morbidity mortality. Veterans Health Administration’s (VHA) large elderly population is at higher risk for complications, including hospitalization death. Herein we summarize VHA’s annual surveillance data influenza RSV activity vaccinations. Methods Influenza-like-illness (ILI) as well RSV-coded outpatient visits hospitalizations, laboratory testing, antivirals were obtained from...
Abstract Background Increasing evidence exists that West Nile Virus (WNV) transmission, distribution, and incidence is impacted by climate change. WNV the most common mosquito-borne disease in U.S., but there little data Veterans. Herein, we describe epidemiology of VHA during 2010-2023. Methods WNV-coded hospitalizations, visits, laboratory results were obtained from sources (1/1/2010-12/31/2023). We included individuals aged 18 years above with ICD-9/10-CM encounters and/or a positive IgM...
Abstract Background Acute gastroenteritis (AGE) burden, etiology, and severity in adults is not well characterized. We implemented a multisite AGE surveillance platform 4 Veterans Affairs Medical Centers (Atlanta, Georgia; Bronx, New York; Houston, Texas; Los Angeles, California), collectively serving >320 000 patients annually. Methods From 1 July 2016 to 30 June 2018, we actively identified inpatient case non-AGE controls through prospective screening of admitted passively...
Objective: We investigated COVID-19 infection and death among healthcare personnel (HCP) in the United States Veterans Health Administration. Methods: HCP with positive Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) reverse transcription polymerase chain reaction tests between March 1 August 31, 2020 were included. Risk ratios calculated for sex, age, race/ethnicity, Veteran status, occupation category, facility of employment by inpatient test percent positivity death. Results:...
This study examines respiratory syncytial virus (RSV) genomic surveillance results from 2 large US networks after the introduction of RSV vaccines.
Background During December 2013, the first locally transmitted chikungunya virus (CHIKV) infections in Americas were reported Caribbean. Although CHIKV infection is rarely fatal, risk for severe disease increases with age and medical comorbidities. Herein we describe characteristics of Veterans Health Administration (VHA) patients and, among those diagnosed Puerto Rico, investigated factors hospitalization. Methodology We queried VHA's national electronic records to identify testing during...
Reporting of Coronavirus disease 2019 (COVID-19) co-infections with other respiratory pathogens has varied. We evaluated 825,280 molecular and/or viral culture assays within the Veterans Health Administration from September 29, to May 31, 2020. Severe acute syndrome coronavirus 2 (SARS-CoV-2) was detected in 10,222 174,746 (5.8%) individuals. 30,063 (17.2%) individuals tested for SARS-CoV-2 had additional pathogen testing; co-infection identified 56 3757 (1.5%) positive SARS-CoV-2. Among...
Abstract Purpose To determine factors that put US veterans with active tuberculosis at risk for extrapulmonary (EPTB) compared pulmonary tuberculosis. Methods We included laboratory-confirmed from 1990–2022 in our retrospective cohort study. Multivariable logistic regression was used to estimate the association of demographic and clinical EPTB. Results Of 7493 aged 20–100 years (median, 58 years) tuberculosis, 1397 (19%) had The most common EPTB infection among pleural (31.4%), while...
We describe an outbreak of simultaneous Clostridium difficile and norovirus infections in a long-term-care facility. Thirty patients experienced acute gastroenteritis, four had co-infection with identical C. 027 genotype II.4 New Orleans strains. Co-occurring infection requires improved understanding risk factors, clinical impact, testing strategies.
Telephone triage (TT) is a method whereby medical professionals speak by telephone to patients assess their symptoms or health concerns and offer advice. These services are often administered through an electronic TT system, which guides during the encounter use of structured protocols algorithms help determine severity patients’ issue refer them appropriate care. also emerging data source for public surveillance infectious noninfectious diseases, including influenza. We calculated Spearman...
Abstract Background Norovirus is an important cause of epidemic acute gastroenteritis (AGE), yet the burden endemic disease in adults has not been well documented. We estimated prevalence and incidence outpatient community-acquired inpatient norovirus AGE at 4 Veterans Affairs Medical Centers (VAMC) (Atlanta, Georgia; Bronx, New York; Houston, Texas; Los Angeles, California) examined trends over surveillance years. Methods From November 2011 to September 2015, stool specimens collected...
An estimated 179 million acute gastroenteritis (AGE) illnesses occur annually in the United States. The role of noroviruses hospital-related AGE has not been well-documented U. S. We population incidence community- acquired outpatient and inpatient norovirus encounters, as well hospital-acquired among inpatients at four Veterans Affairs (VA) Medical Centers (VAMCs). Fifty (4%) 1,160 stool specimens collected ≤7 days from symptom onset tested positive for norovirus. During a one year period,...
Abstract Background Early threat detection and situational awareness are vital to achieving a comprehensive accurate view of health-related events for federal, state, local health agencies. Key this public syndromic surveillance systems that can analyze large data sets discover patterns, trends, correlations significance. In 2020, Department Veterans Affairs (VA) evaluated its system identified areas improvement. Methods Using the Centers Disease Control Prevention (CDC) Guidelines...
Exposure to carbon monoxide (CO), the odorless, colorless gas resulting from incomplete combustion of hydrocarbons, is preventable. Despite significant risk morbidity and mortality associated with CO poisoning, there currently exists no active national surveillance system in United States (U.S.). Our study aims use electronic health record data describe epidemiology poisoning Veterans Health Administration healthcare population.We identified unique inpatient outpatient encounters coded...
We describe influenza activity in the US Veterans Affairs (VA) population for 2010-2011 through 2015-2016 seasons and compare with national CDC FluView data. VA confirmed cases ranged from 1005 to 11 506 per season; triage calls 6090 10 346; outpatient visits 3849 13 406; antiviral prescriptions 3650 32 826; hospitalizations 546 4673; deaths hospitalized patients 17 139. Peak was generally same as observed nationally by CDC. For analyzed, correlation between %ILI (r = .863), .953), positive...
International Classification of Diseases diagnostic codes are used to estimate acute gastroenteritis (AGE) disease burden. We validated AGE-related in pediatric and adult populations using 2 multiregional active surveillance platforms. The sensitivity AGE was similar (54% 58%) both increased with addition vomiting-specific codes.
BackgroundThe U.S. Department of Veterans Affairs (VA) and Defense (DoD) had more than 18 million healthcare beneficiaries in 2011. Both Departments conduct individual surveillance for disease events health threats. MethodsWe performed joint separate analyses VA DoD outpatient visit data from October 2006 through September 2010 to demonstrate geographic demographic coverage, timeliness influenza epidemic awareness, impact on spatial cluster detection achieved a biosurveillance platform....