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Buss B.F.,CDC | Jereb J.,National Center for Viral Hepatitis | Murphy C.N.,University of Nebraska Medical Center | Iwen P.C.,University of Nebraska Medical Center | Robbe-Austerman S.,U.S. Department of Agriculture
Morbidity and Mortality Weekly Report | Year: 2016

What is already known about this topic? Mycobacterium bovis, a zoonotic pathogen of cattle, causes tuberculosis in persons who consume unpasteurized contaminated dairy products. Airborne person-to-person transmission has been suspected but is difficult to confirm. What is added by this report? A large contact investigation around two patients with M. bovis pulmonary tuberculosis and the findings from molecular epidemiology strengthen the evidence for person-to-person transmission of M. bovis infection. What are the implications for public health practice? The persistence of M. bovis in cattle internationally and the failure to pasteurize dairy products in many locations means that further infections in humans should be anticipated. Persons with M. bovis infections should be asked about foodborne exposures. Contact investigations for M. bovis disease should be conducted using the same methods as for M. tuberculosis disease. © 2016, Department of Health and Human Services. All rights reserved.


Tao G.,National Center for Viral Hepatitis | Hoover K.W.,National Center for Viral Hepatitis | Nye M.B.,Laboratory Corporation of America Holdings | Body B.A.,Laboratory Corporation of America Holdings
Sexually Transmitted Diseases | Year: 2014

Background: In the United States, chlamydia screening has been recommended for all pregnant women by the Centers for Disease Control and Prevention (CDC) but only for pregnant women who are at increased risk by the US Preventive Services Task Force (USPSTF). Very limited evidence, such as age-specific chlamydia positivity in pregnant women, has been used to develop these recommendations. Methods: We analyzed data from a large commercial laboratory corporation in the United States in 2013. At the first prenatal visit made by women aged 15 to 44 years for whom a chlamydia test was performed between June 2008 and July 2010, we estimated positivity of chlamydia by age, insurance coverage, geographic region, and test type. Results: Of 601,001 pregnant women aged 15 to 44 years who had routine prenatal care, 62.9% had private insurance and 32.9% had Medicaid coverage, 60.3% resided in the South region, and 43.2% were aged 15 to 24 years, 26.8% were aged 25 to 29 years, and 19.1% were aged 30 to 34 years. Chlamydia positivity was 3.6% overall, and significantly decreased as age increased (15-19 years: 9.6 %; 20-24 years: 5.2%; 25-29 years: 1.8%; 30-34 years: 0.9%; and 35-44 years: 0.6%; P < 0.05). Conclusions: Our findings of higher positivity among younger pregnant women suggest that the yield is likely to be greater from screening younger pregnant women than from screening older pregnant women to identify chlamydia infection. The benefits of harmonizing CDC and USPSTF recommendations for pregnant women could be explored by reviewing age-specific positivity data and estimating the frequency of prenatal adverse health outcomes caused by chlamydia to develop consensus regarding the age limit for pregnant women who should be screened. © 2014 American Sexually Transmitted Diseases Association All rights reserved.


Vishwanathan S.A.,National Center for Viral Hepatitis | Morris M.R.,National Center for Viral Hepatitis | Wolitski R.J.,National Center for Viral Hepatitis | Luo W.,National Center for Viral Hepatitis | And 11 more authors.
PLoS ONE | Year: 2015

Background Personal lubricant use is common during anal intercourse. Some water-based products with high osmolality and low pH can damage genital and rectal tissues, and the polymer polyquaternium 15 (PQ15) can enhance HIV replication in vitro. This has raised concerns that lubricants with such properties may increase STD/HIV infection risk, although in vivo evidence is scarce. We use a macaque model to evaluate rectal cytotoxicity and SHIV infection risk after use of a highly osmolar (>8,000 mOsm/kg) water-based lubricant with pH of 4.4, and containing PQ15. Methods Cytotoxicity was documented by measuring inflammatory cytokines and epithelial tissue sloughing during six weeks of repeated, non-traumatic lubricant or control buffer applications to rectum and anus. We measured susceptibility to SHIVSF162P3 infection by comparing virus doses needed for rectal infection in twenty-one macaques treated with lubricant or control buffer 30 minutes prior to virus exposure. Results Lubricant increased pro-inflammatory cytokines and tissue sloughing while control buffer (phosphate buffered saline; PBS) did not. However, the estimated AID50 (50% animal infectious dose) was not different in lubricant- And control buffer-treated macaques (p = 0.4467; logistic regression models). Conclusions Although the test lubricant caused acute cytotoxicity in rectal tissues, it did not increase susceptibility to infection in this macaque model. Thus neither the lubricant-induced type/extent of inflammation nor the presence of PQ15 affected infection risk. This study constitutes a first step in the in vivo evaluation of lubricants with regards to HIV transmission.

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