this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr).Transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), is ongoing in many communities throughout the United States. Although case-based and syndromic surveillance are critical for monitoring the pandemic, these systems rely on persons obtaining testing or reporting a COVID-19-like illness. Using serologic tests to detect the presence of SARS-CoV-2 antibodies is an adjunctive strategy that estimates the prevalence of past infection in a population. During April 28-May 3, 2020, coinciding with the end of a statewide shelter-in-place order, CDC and the Georgia Department of Public Health conducted a serologic survey in DeKalb and Fulton counties in metropolitan Atlanta to estimate SARS-CoV-2 seroprevalence in the population. A two-stage cluster sampling design was used to randomly select 30 census blocks in each county, with a target of seven participating households per census block. Weighted estimates were calculated to account for the probability of selection and adjusted for age group, sex, and race/ethnicity. A total of 394 households and 696 persons participated and had a serology result; 19 (2.7%) of 696 persons had SARS-CoV-2 antibodies detected. The estimated weighted seroprevalence across these two metropolitan Atlanta counties was 2.5% (95% confidence interval [CI] = 1.4-4.5). Non-Hispanic black participants more commonly had SARS-CoV-2 antibodies than did participants of other racial/ethnic groups (p<0.01). Among persons with SARS-CoV-2 antibodies, 13 (weighted % = 49.9; 95% CI = 24.4-75.5) reported a COVID-19-compatible illness,* six (weighted % = 28.2; 95% CI = 11.9-53.3) sought medical care for a COVID-19-compatible illness, and five (weighted % = 15.7; 95% CI = 5.1-39.4) had been tested for SARS-CoV-2 infection, demonstrating that many of these infections would not have been identified through case-based
Some aspects of an obese body habitus may protect against fracture risk (higher bone mineral density [BMD] and greater tissue padding), while others may augment that risk (greater impact forces during a fall). To examine these competing pathways, we analyzed data from a multisite, multiethnic cohort of 1924 women, premenopausal or early perimenopausal at baseline. Obesity was defined as baseline body mass index (BMI) > 30 kg/m2. Composite indices of femoral neck strength relative to fall impact forces were constructed from DXA-derived bone size, BMD and body size. Incident fractures were ascertained annually during a median follow-up of 9 years. In multivariable linear regression adjusted for covariates, higher BMI was associated with higher BMD but with lower composite strength indices, suggesting that although BMD increases with greater skeletal loading, the increase is not sufficient to compensate for the increase in fall impact forces. During the follow-up, 201 women had fractures. In Cox proportional hazard analyses, obesity was associated with increased fracture hazard adjusted for BMD, consistent with greater fall impact forces in obese individuals. Adjusted for composite indices of femoral neck strength relative to fall impact forces, obesity was associated with decreased fracture hazard, consistent with a protective effect of soft tissue padding. Further adjustment for hip circumference, a surrogate marker of soft tissue padding, attenuated the obesity–fracture association. Our findings support that there are at least three major mechanisms by which obesity influences fracture risk: increased BMD in response to greater skeletal loading, increased impact forces, and greater absorption of impact forces by soft tissue padding. © 2014 American Society for Bone and Mineral Research.
In August 2006, a pyrethrin insecticide synergized with piperonyl butoxide (EverGreenH Crop Protection EC 60-6, McLaughlin Gormley King Company, Golden Valley, MN) was sprayed in ultralow volumes over the city of Davis, CA, by the Sacramento-Yolo Mosquito and Vector Control District to control mosquitoes transmitting West Nile virus. Concurrently, we evaluated the impact of the insecticide on nontarget arthropods by 1) comparing mortality of treatment and control groups of sentinel arthropods, and 2) measuring the diversity and abundance of dead arthropods found on treatment and control tarps placed on the ground. We found no effect of spraying on nontarget sentinel species including dragonflies (Sympetrum corruptum), spiders (Argiope aurantia), butterflies (Colias eurytheme), and honeybees (Apis mellifera). In contrast, significantly higher diversity and numbers of nontarget arthropods were found on ground tarps placed in sprayed versus unsprayed areas. All of the dead nontarget species were small-bodied arthropods as opposed to the large-bodied sentinels that were not affected. The mortality of sentinel mosquitoes placed at the same sites as the nontarget sentinels and ground tarps ranged from 0% to 100%. Dead mosquitoes were not found on the ground tarps. We conclude that aerial spraying with pyrethrins had no impact on the large-bodied arthropods placed in the spray zone, but did have a measurable impact on a wide range of small-bodied organisms.
We collected a total of 15,329 mosquitoes during weekly sampling in Davis, CA, from April through mid-October 2006 at 21 trap sites uniformly spaced 1.5 km apart over an area of approximately 26 km(2). Of these mosquitoes, 1,355 pools of Culex spp. were tested by multiplex reverse transcriptase-polymerase chain reaction, of which 16 pools (1.2%) were positive for West Nile virus (WNV). A degree-day model with a developmental threshold of 14.3 degrees C accurately predicted episodic WNV transmission after three extrinsic incubation periods after initial detection. Kriging interpolation delineated that Culex tarsalis were most abundant at traps near surrounding agriculture, whereas Cx. pipiens clustered within residential areas and greenbelt systems in the old portion of Davis. Spatial-temporal analyses were performed to test for clustering of locations of WNV-infected dead birds and traps with WNV-positive Cx. tarsalis and Cx. pipiens; human case incidence was mapped by census blocks. Significant multivariate spatial-temporal clustering was detected among WNV-infected dead birds and WNV-positive Cx. tarsalis, and a WNV-positive Cx. pipiens cluster overlapped areas with high incidences of confirmed human cases. Spatial analyses of WNV surveillance data may be an effective method to identify areas with an increased risk for human infection and to target control efforts to reduce the incidence of human disease.
Although horse cases frequently are reported during West Nile virus (WNV) outbreaks, few investigations have focused on the epidemiology of this transmission. From April to October 2003 to 2005, mosquito abundance and infection were monitored 3 days per week at an equine research facility at the University of California, Davis. Thirty-two nonvaccinated horses enrolled as controls in a vaccine study were bled monthly, and their serum was tested for evidence of WNV infection by plaque reduction neutralization test (PRNT). In 2004, one positive Culex pipiens pool was associated with a single horse that presented with confirmed WNV disease in late September. The annual incidence of clinical and subclinical WNV infection in the nonvaccinated horses was 16%, with an apparent to inapparent ratio of 1:4 among infected horses. In 2005, two Culex tarsalis and two Cx. pipiens WNV-positive pools were associated with an equine infection incidence of 62%, with an apparent to inapparent ratio of 1:17. The majority (79%) of 70 blood-engorged Cx. pipiens fed on birds and the remaining on equines (21%). Conversely, Cx. tarsalis fed primarily on equines (n = 23, 74%), followed by birds (n = 7, 23%) and 1 (3%) fed on a lagomorph. These data indicated that nonvaccinated horses were a sensitive indicator of WNV activity and that their risk of infection was associated with the presence of infection in Cx. pipiens and Cx. tarsalis, which served as both enzootic and bridge vectors amplifying WNV among birds and transmitting WNV to horses.
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