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Featured researches published by Patricia A. Yu.


Clinical Infectious Diseases | 2008

Nonfoodborne Vibrio Infections: An Important Cause of Morbidity and Mortality in the United States, 1997–2006

Amy M. Dechet; Patricia A. Yu; Nana Koram; John A. Painter

BACKGROUND Infections due to Vibrio species cause an estimated 8000 illnesses annually, often through consumption of undercooked seafood. Like foodborne Vibrio infections, nonfoodborne Vibrio infections (NFVI) also result in serious illness, but awareness of these infections is limited. METHODS We analyzed illnesses occuring during the period 1997-2006 that were reported to the Centers for Disease Control and Preventions Cholera and Other Vibrio Illness Surveillance system. The diagnosis of NFVI required isolation of Vibrio species from a patient with contact with seawater. RESULTS Of 4754 Vibrio infections reported, 1210 (25%) were NFVIs. Vibrio vulnificus infections were the most common (accounting for 35% of NFVIs), with 72% of V. vulnificus infections reported from residents of Gulf Coast states. Infections due to V. vulnificus resulted in fever (72% of cases), cellulitis (85%), amputation (10%), and death (17%). V. vulnificus caused 62 NFVI-associated deaths (78%). Recreational activities accounted for 70% of exposures for patients with NFVIs associated with all species. Patients with liver disease were significantly more likely to die as a result of infection (odds ratio, 7.8; 95% confidence interval, 2.8-21.9). Regardless of pre-existing conditions, patients were more likely to die when hospitalization occurred >2 days after symptom onset (odds ratio, 2.9; 95% confidence interval, 1.8-4.8). CONCLUSION NFVIs, especially those due to V. vulnificus, demonstrate high morbidity and mortality. Persons with liver disease should be advised of the risks associated with seawater exposure if a wound is already present or is likely to occur. Clinicians should consider Vibrio species as an etiologic agent in infections occurring in persons with recent seawater exposure, even if the individual was only exposed during recreational marine activities. Immediate antibiotic treatment with aggressive monitoring is advised in suspected cases.


Clinical Infectious Diseases | 2009

Multistate Outbreak of Salmonella Typhimurium and Saintpaul Infections Associated with Unpasteurized Orange Juice—United States, 2005

Seema Jain; Sally A. Bidol; Jana Austin; Erica Berl; Franny Elson; Mysheika LeMaile Williams; Marshall Deasy; Mària Moll; Vickie Rea; Jazmin Vojdani; Patricia A. Yu; Robert M. Hoekstra; Christopher R. Braden; Michael Lynch

BACKGROUND Infection due to Salmonella species causes an estimated 1.4 million illnesses and 400 deaths annually in the United States. Orange juice is a known vehicle of salmonellosis, for which regulatory controls have recently been implemented. We investigated a nationwide outbreak of Salmonella infection to determine the magnitude of the outbreak and to identify risk factors for infection. METHODS We identified cases through national laboratory-based surveillance. In a case-control study, we defined a case as infection with Salmonella serotype Typhimurium that demonstrated the outbreak pulsed-field gel electrophoresis pattern in a person with illness onset from 1 May through 31 July 2005; control subjects were identified through random digit dialing. RESULTS We identified 152 cases in 23 states. Detailed information was available for 95 cases. The median age of patients was 23 years; 46 (48%) of the 95 patients were female. For 38 patients and 53 age-group matched control subjects in 5 states, illness was associated with consuming orange juice (90% vs. 43%; odds ratio, 22.2; 95% confidence interval, 3.5-927.5). In a conditional logistic regression model, illness was associated with consuming unpasteurized orange juice from company X (53% vs. 0%; odds ratio, 38.0; 95% confidence interval, 6.5-infinity). The US Food and Drug Administration found that company X was noncompliant with the juice Hazard Analysis and Critical Control Point regulation and isolated Salmonella serotype Saintpaul from company Xs orange juice. CONCLUSIONS Unpasteurized orange juice from company X was the vehicle of a widespread outbreak of salmonellosis. Although the route of contamination is unknown, noncompliance with the juice Hazard Analysis and Critical Control Point regulation likely contributed to this outbreak. Pasteurization or other reliable treatment of orange juice could prevent similar outbreaks.


Journal of Clinical Microbiology | 2010

First Report Worldwide of an Infant Botulism Case Due to Clostridium botulinum Type E

Carolina Lúquez; Janet K. Dykes; Patricia A. Yu; Brian H. Raphael; Susan E. Maslanka

ABSTRACT Clostridium botulinum type E has been associated with botulism in adults but never in infants. Infant botulism type E cases have been associated with neurotoxigenic strains of C. butyricum. We report the first infant botulism case due to C. botulinum type E worldwide.


Clinical Infectious Diseases | 2012

Peramivir Use for Treatment of Hospitalized Patients with Influenza A(H1N1)pdm09 under Emergency Use Authorization, October 2009 – June 2010

Yon Yu; Shikha Garg; Patricia A. Yu; Hye-Joo Kim; Anita Patel; Toby L. Merlin; Stephen C. Redd; Timothy M. Uyeki

BACKGROUND In response to the influenza A(H1N1)pdm09 (pH1N1) pandemic, peramivir, an investigational intravenous neuraminidase inhibitor, was made available for treatment of hospitalized patients with pH1N1 in the United States under an Emergency Use Authorization (EUA). The Centers for Disease Control and Prevention (CDC) implemented a program to manage peramivir distribution to requesting clinicians under EUA. We describe results of the CDCs peramivir program and 3 related surveys. METHODS We analyzed data on peramivir requests made by clinicians to the CDC through an electronic request system. Three surveys were administered to enhance clinician compliance with adverse event reporting, to conduct product accountability, and to collect data on peramivir-treated patients. Descriptive analyses were performed, and 2-source capture-recapture analysis based on the 3 surveys was used to estimate the number of patients who received peramivir through the EUA. RESULTS From 23 October 2009 to 23 June 2010, CDC received 1371 clinician requests for peramivir and delivered 2129 five-day adult treatment course equivalents of peramivir to 563 hospitals. Based on survey responses, at least 1274 patients (median age, 43 years; range, 0-92 years; 49% male) received ≥1 doses of peramivir (median duration, 6 days). Capture-recapture analysis yielded estimates for the potential total number of peramivir recipients ranging from 1185 (95% confidence interval [CI], 1076-1293) to 1490 (95% CI, 1321-1659). CONCLUSIONS Approximately 1274 hospitalized patients received peramivir through EUA program during the pH1N1 pandemic. Further analyses are needed to assess the clinical effectiveness of peramivir treatment of hospitalized patients with pH1N1.


Clinical Infectious Diseases | 2018

Safety and Improved Clinical Outcomes in Patients Treated With New Equine-Derived Heptavalent Botulinum Antitoxin

Patricia A. Yu; Neal H Lin; Barbara E. Mahon; Jeremy Sobel; Yon Yu; Rajal K. Mody; Weidong Gu; Jennifer Clements; Hye-Joo Kim; Agam K Rao

Background Botulism is a rare, life-threatening paralytic illness. Equine-derived heptavalent botulinum antitoxin (HBAT), the only currently available treatment for noninfant botulism in the United States, was licensed in 2013. No reports have systematically examined safety and clinical benefit of HBAT among botulism patients. Methods From March 2010 through March 2013, we collected data prospectively and through medical record reviews of patients with confirmed or suspected botulism who were treated with HBAT under an expanded-access Investigational New Drug program. Results Among 249 HBAT-treated patients, 1 (<1%) child experienced an HBAT-related serious adverse event (hemodynamic instability characterized by bradycardia, tachycardia, and asystole); 22 (9%) patients experienced 38 nonserious adverse events reported by physicians to be HBAT related. Twelve (5%) deaths occurred; all were determined to be likely unrelated to HBAT. Among 104 (42%) patients with confirmed botulism, those treated early (≤2 days) spent fewer days in the hospital (median, 15 vs 25 days; P < .01) and intensive care (10 vs 17 days; P = .04) than those treated later. Improvements in any botulism sign/symptom were detected a median of 2.4 days and in muscle strength a median of 4.8 days after HBAT. Conclusions HBAT was safe and provided clinical benefit in treated patients. HBAT administration within 2 days of symptom onset was associated with shorter hospital and intensive care stays. These results highlight the importance of maintaining clinical suspicion for botulism among patients presenting with paralytic illness to facilitate early HBAT treatment before laboratory confirmation might be available. Clinical consultation and, if indicated, HBAT release, are available to clinicians 24/7 through their state health department in conjunction with CDC.


American Journal of Public Health | 2018

Planning Considerations for State, Local, Tribal, and Territorial Partners to Receive Medical Countermeasures From CDC’s Strategic National Stockpile During a Public Health Emergency

Tina R. Bhavsar; Deborah L. Esbitt; Patricia A. Yu; Yon Yu; Susan Gorman

The Centers for Disease Control and Preventions Strategic National Stockpile is a national repository of potentially life-saving medical countermeasures including pharmaceuticals and medical supplies for use in a public health emergency severe enough to cause local, regional, and state supplies to run out. Several planning considerations can assist state, local, tribal, and territorial jurisdictions in preparing to receive, distribute, dispense, and administer medical countermeasures from the Strategic National Stockpile. These considerations include, but are not limited to, issues surrounding regulatory requirements, controlled substances, cold chain management, and ancillary supply needs. Multiple aspects to consider for each of these functions are discussed here to assist partners in their planning efforts.


Morbidity and Mortality Weekly Report | 2008

Surveillance for Waterborne Disease and Outbreaks Associated with Recreational Water Use and Other Aquatic Facility-Associated Health Events --- United States, 2005--2006

Jonathan S. Yoder; Michele C. Hlavsa; Gunther F. Craun; Hill; Roberts; Patricia A. Yu; Hicks La; Alexander Nt; Calderon Rl; Sharon L. Roy; Michael J. Beach


Morbidity and Mortality Weekly Report | 2006

Surveillance for waterborne disease and outbreaks associated with recreational water - United States, 2003-2004.

Eric J. Dziuban; Jennifer L. Liang; Gunther F. Craun; Vincent R. Hill; Patricia A. Yu; John A. Painter; Matthew R. Moore; Rebecca L. Calderon; Sharon L. Roy; Michael J. Beach


Clinical Infectious Diseases | 2008

Severe Diarrhea Caused by Cholera Toxin–Producing Vibrio cholerae Serogroup O75 Infections Acquired in the Southeastern United States

Melissa Tobin-D'Angelo; Allison R. Smith; Sandra N. Bulens; Stepy Thomas; Mary Hodel; Hidemasa Izumiya; Eiji Arakawa; Masatomo Morita; Haruo Watanabe; Constance Marin; Michele B. Parsons; Kathy D. Greene; Kara Cooper; Danielle Haydel; Cheryl A. Bopp; Patricia A. Yu; Eric D. Mintz


Archive | 2008

Surveillance for waterborne disease and outbreaks associated with recreational water use and other aquatic facility-associated health events-- United States, 2005-2006; and, Surveillance for waterborne disease and outbreaks associated with drinking water and water not intended for drinking-- United States, 2005-2006

Nicole T. Alexander; Michael J. Beach; Lauri A. Hicks; Vincent R. Hill; Michele C. Hlavsa; Sharon L. Roy; Jonathan S. Yoder; Patricia A. Yu

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Michael J. Beach

Centers for Disease Control and Prevention

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Sharon L. Roy

Centers for Disease Control and Prevention

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Yon Yu

Centers for Disease Control and Prevention

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Anna Nowak-Węgrzyn

Icahn School of Medicine at Mount Sinai

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Brian H. Raphael

Centers for Disease Control and Prevention

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Carolina Lúquez

Centers for Disease Control and Prevention

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Edith Schussler

Icahn School of Medicine at Mount Sinai

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Gunther F. Craun

United States Environmental Protection Agency

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Hye-Joo Kim

Centers for Disease Control and Prevention

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Janet K. Dykes

Centers for Disease Control and Prevention

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