Ensuring the Safety of Yellow Fever Vaccination in Travelers—The Experience at a Large U.S. Academic Medical Center in Colorado

Bandali, Mehdi; Schultz, Jonathan; Than, Kimlien; McGregor, Donna; Archuleta, Solana; Chadalawada, Sindhu; Mundo, William; Chastain, Daniel B; Franco‐Paredes, Carlos; Reno, Elaine; Henao‐Martínez, Andrés F.

doi:10.3390/tropicalmed5030125

Cited by 4 publications

(3 citation statements)

References 17 publications

(17 reference statements)

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“…The regions have an autochthonous transmission of all four distinct dengue virus serotypes since 1990, with serotype two currently being the most predominant 15 . Yellow fever is endemic in the region 16 , and the Zika virus was introduced into Iquitos in late 2016 17 .…”

Section: Methodsmentioning

confidence: 99%

Seroprevalence of anti-SARS-CoV-2 antibodies in Iquitos, Loreto, Peru

Álvarez-Antonio

Sánchez

Calampa

et al. 2021

Preprint

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SummaryBackgroundDetection of SARS-CoV-2 antibodies among people at risk is critical for understanding both the prior transmission of COVID-19 and vulnerability of the population to the continuing transmission and, when done serially, the intensity of ongoing transmission over an interval in a community. In this study, we estimated the seroprevalence of COVID-19 in a representative population-based cohort of Iquitos, one of the regions with the highest mortality rates from COVID-19 in Peru, where a devastating number of cases occurred in March 2020.MethodsWe conducted a population-based study of transmission tested each participant using the COVID-19 IgG/IgM Rapid Test from Orient Gene Biotech and used survey analysis methods to estimate seroprevalence accounting for the sampling design effect and test performance characteristics. Here we report results from the baseline (13 to 18 July 2020) and the first month of follow-up (13 to 18 August 2020) study.FindingsWe enrolled a total of 716 participants and estimated seroprevalence of 70.0% (95% CI: 67.0%–73.4%), a test-re-test positivity of 65% (95% CI: 61.0%–68.3%), and an incidence of new exposures of 1.8% (95% CI: 0.9%–3.2%) data that suggest that transmission is ongoing but is occurring at low levels. We observed significant differences in the seroprevalence between age groups, with participants 18 to 29 years of age having lower seroprevalence than children <12 years of age (Prevalence ratio =0.85 [PR]; 95% CI: 0.73 – 0.98), suggesting that children were not refractory to infection in this setting.InterpretationIquitos demonstrates one of the highest rates of seroprevalence of COVID-19 worldwide. Current data shows a limited case burden in Iquitos for the past seven months and suggests that these levels are sufficient to provide significant but incomplete herd immunity.FundingDirección Regional de Salud de Loreto, DIRESA, Loreto, Peru

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Section: Methodsmentioning

confidence: 99%

Seroprevalence of anti-SARS-CoV-2 antibodies in Iquitos, Loreto, Peru

Álvarez-Antonio

Sánchez

Calampa

et al. 2021

Preprint

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“…The regions have had an autochthonous transmission of all four distinct dengue virus serotypes since 1990, with serotype 2 currently the most predominant. 16 Yellow fever is endemic in the region, 17 and Zika virus was introduced into Iquitos in late 2016. 18 This study was done by the Directorate of Epidemiology, Executive Directorate of Prevention and Control of Diseases, and Regional Directorate of Health of Loreto, following the public health emergency in April and May, 2020, when more than 1000 Iquitos residents, including more than 50 health workers, died during the first wave of the pandemic.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Seroprevalence of anti-SARS-CoV-2 antibodies in Iquitos, Peru in July and August, 2020: a population-based study

Álvarez-Antonio¹,

Sánchez²,

Calampa³

et al. 2021

The Lancet Global Health

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Background Detection of anti-SARS-CoV-2 antibodies among people at risk of infection is crucial for understanding both the past transmission of COVID-19 and vulnerability of the population to continuing transmission and, when done serially, the intensity of ongoing transmission over an interval in a community. We aimed to estimate the seroprevalence of COVID-19 in a representative population-based cohort in Iquitos, one of the regions with the highest mortality rates from COVID-19 in Peru, where a devastating number of cases occurred in March, 2020. MethodsWe did a population-based study of SARS-CoV-2 transmission in Iquitos at two timepoints: July 13-18, 2020 (baseline), and Aug 13-18, 2020 (1-month follow-up). We obtained a geographically stratified representative sample of the city population using the 2017 census data, which was updated on Jan 20, 2020. We included people who were inhabitants of Iquitos since COVID-19 was identified in Peru (March 6, 2020) or earlier. We excluded people living in institutions, people receiving any pharmacological treatment for COVID-19, people with any contraindication for phlebotomy, and health workers or individuals living with an active health worker. We tested each participant for IgG and IgM anti-SARS-CoV-2 antibodies using the COVID-19 IgG/IgM Rapid Test (Zhejiang Orient Gene Biotech, China). We used survey analysis methods to estimate seroprevalence accounting for the sampling design effect and test performance characteristics.Findings We identified 726 eligible individuals and enrolled a total of 716 participants (99%), distributed across 40 strata (four districts, two sexes, and five age groups). We excluded ten individuals who: did not have consent from a parent or legal representative (n=3), had moved to Iquitos after March 6, 2020 (n=3), were in transit (n=2), or had respiratory symptoms (n=1). After adjusting for the study sampling effects and sensitivity and specificity of the test, we estimated a seroprevalence of 70% (95% CI 67-73) at baseline and 66% (95% CI 62-70) at 1 month of follow-up, with a test-retest positivity of 65% (95% CI 61-68), and an incidence of new exposures of 2% (95% CI 1-3). We observed significant differences in the seroprevalence between age groups, with participants aged 18-29 years having lower seroprevalence than those aged younger than 12 years (prevalence ratio 0•85 [95% CI 0•73-0•98]; p=0•029).Interpretation After the first epidemic peak, Iquitos had one of the highest rates of seroprevalence of anti-SARS-CoV-2 antibodies worldwide. Nevertheless, the city experienced a second wave starting in January, 2021, probably due to the emergence of the SARS-CoV-2 P1 variant, which has shown higher transmissibility and reinfection rates.

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