The BP Deepwater Horizon oil spill (DHOS) created widespread concern about threats to health among residents of the Louisiana Gulf Coast. This study uses data from the Resilient Children, Youth, and Communities study-a longitudinal cohort survey of households with children in DHOS-affected areas of South Louisiana-to consider the effect of DHOS exposure on health trajectories of children, an especially vulnerable population subgroup. Results from latent linear growth curve models show that family DHOS exposure via physical contact and job/income loss both negatively influenced initial child health. However, the effects of physical exposure dissipated over time while the effects of job/income loss persisted. This pattern holds for both general child health and the number of recent physical health problems children had experienced. These findings help to bridge the literature on disaster impacts and resilience/vulnerability, with the literature on socioeconomic status as a fundamental cause of health outcomes over the life course. Keywords BP Deepwater Horizon . Child health . Disaster . Oil spill The Deepwater Horizon oil spill (DHOS) ranks as the largest accidental marine oil spill in history by volume 1 and length of shoreline oiled (Nixon et al. 2016). The disaster was set in motion on April 20, 2010, when the BP-leased Deepwater Horizon oil rig
Public health staff had few plans or protocols to guide them and often found themselves improvising and problem-solving with new organizations in the context of an overburdened health care system (Disaster Med Public Health Preparedness. 2016;10:436-442).
Introduction
Nearly all existing respiratory syncytial virus (RSV) incidence estimates are based on real-time polymerase chain reaction (RT–PCR) testing of nasal or nasopharyngeal (NP) swabs. Adding testing of additional specimen types to NP swab RT–PCR increases RSV detection. However, prior studies only made pairwise comparisons and the synergistic effect of adding multiple specimen types has not been quantified. We compared RSV diagnosis by NP swab RT–PCR alone versus NP swab plus saliva, sputum, and serology.
Methods
This was a prospective cohort study over two study periods (27 December 2021 to 1 April 2022 and 22 August 2022 to 11 November 2022) of patients aged ≥ 40 years hospitalized for acute respiratory illness (ARI) in Louisville, KY. NP swab, saliva, and sputum specimens were collected at enrollment and PCR tested (Luminex ARIES platform). Serology specimens were obtained at acute and convalescent timepoints (enrollment and 30–60-day visit). RSV detection rate was calculated for NP swab alone and for NP swab plus all other specimen type/test.
Results
Among 1766 patients enrolled, 100% had NP swab, 99% saliva, 34% sputum, and 21% paired serology specimens. RSV was diagnosed in 56 (3.2%) patients by NP swab alone, and in 109 (6.2%) patients by NP swab plus additional specimens, corresponding to a 1.95 times higher rate [95% confidence interval (CI) 1.62, 2.34]. Limiting the comparison to the 150 subjects with all four specimen types available (i.e., NP swab, saliva, sputum, and serology), there was a 2.60-fold increase (95% CI 1.31, 5.17) compared to NP swab alone (3.3% versus 8.7%). Sensitivities by specimen type were: NP swab 51%, saliva 70%, sputum 72%, and serology 79%.
Conclusions
Diagnosis of RSV in adults was several-fold greater when additional specimen types were added to NP swab, even with a relatively low percentage of subjects with sputum and serology results available. Hospitalized RSV ARI burden estimates in adults based solely on NP swab RT–PCR should be adjusted for underestimation.
Supplementary Information
The online version contains supplementary material available at 10.1007/s40121-023-00805-1.
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