Twenty-nine laboratory-confirmed West Nile virus (WNV) encephalitis patients were bled serially so that WNV-reactive immunoglobulin (Ig) M activity could be determined. Of those patients bled, 7 (60%) of 12 had anti-WNV IgM at approximately 500 days after onset. Clinicians should be cautious when interpreting serologic results from early season WNV IgM-positive patients.
Center convened a meeting of senior government officials, hospital leaders, clinicians, and public health officials on Hospital Preparedness for Pandemic Influenza in Baltimore, Maryland. A list of meeting participants is provided in Appendix 1. Individual comments were not for attribution so as to foster a frank and open discussion.The purpose of the meeting was to examine ways the U.S. healthcare community, and especially hospitals, can prepare to care for the large number of patients that would be expected during an influenza pandemic. At the meeting, the group was asked to discuss the serious challenges hospitals and communities will confront, to try to reach accord on what high-level solutions should be pursued, and to examine actions and next steps that the group or others might take to bring about such changes.To structure the meeting conversation, the staff of the Center for Biosecurity presented its initial assessment of the issues. The assessment was informed by analyzing pre-meeting discussions with the group and other government and clinical leaders and by reviewing information from a broad range of government and industry reports and peer-reviewed literature. This meeting report synopsizes the presentations given at the meeting and the group's discussions.Initially, a vision of success in hospital preparedness was proposed: U.S. hospitals, individually and jointly, will be able to provide medical care for flu victims while maintaining other essential medical services in the community during and after a pandemic.
This article describes and analyzes key aspects of the medical response to Hurricane Katrina in New Orleans. It is based on interviews with individuals involved in the response and on analysis of published reports and news articles. Findings include: (1) federal, state, and local disaster plans did not include provisions for keeping hospitals functioning during a large-scale emergency; (2) the National Disaster Medical System (NDMS) was ill-prepared for providing medical care to patients who needed it; (3) there was no coordinated system for recruiting, deploying, and managing volunteers; and (4) many Gulf Coast residents were separated from their medical records. The article makes recommendations for improvement.
Background
New York City (NYC) was the U.S. epicenter of the Spring 2020 COVID-19 pandemic. We present seroprevalence of SARS-CoV-2 infection and correlates of seropositivity immediately after the first wave.
Methods
From a serosurvey of adult NYC residents (May 13-July 21, 2020), we calculated the prevalence of SARS-CoV-2 antibodies stratified by participant demographics, symptom history, health status, and employment industry. We used multivariable regression models to assess associations between participant characteristics and seropositivity.
Results
Seroprevalence among 45,367 participants was 23.6% (95% CI, 23.2%-24.0%). High seroprevalence (>30%) was observed among Black and Hispanic individuals, people from high poverty neighborhoods, and people in health care or essential worker industry sectors. COVID-19 symptom history was associated with seropositivity (adjusted relative risk=2.76; 95% CI, 2.65-2.88). Other risk factors included sex, age, race/ethnicity, residential area, employment sector, working outside the home, contact with a COVID-19 case, obesity, and increasing numbers of household members.
Conclusions
Based on a large serosurvey in a single U.S. jurisdiction, we estimate that just under one-quarter of NYC adults were infected in the first few months of the COVID-19 epidemic. Given disparities in infection risk, effective interventions for at-risk groups are needed during ongoing transmission.
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