Dengue surveillance in Veterans Affairs healthcare facilities, 2007-2010.
BACKGROUND: Although dengue is endemic in Puerto Rico (PR), 2007 and 2010 were recognized as epidemic years. In the continental United States (US), outside of the Texas-Mexico border, there had not been a dengue outbreak since 1946 until dengue re-emerged in Key West, Florida (FL), in 2009-2010. The...
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ftdoajarticles:oai:doaj.org/article:07eb747abfac461aba9bcf1e2b23fab8 2023-05-15T15:14:15+02:00 Dengue surveillance in Veterans Affairs healthcare facilities, 2007-2010. Patricia L Schirmer Cynthia A Lucero-Obusan Stephen R Benoit Luis M Santiago Danielle Stanek Achintya Dey Mirsonia Martinez Gina Oda Mark Holodniy 2013-01-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0002040 https://doaj.org/article/07eb747abfac461aba9bcf1e2b23fab8 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC3597482?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0002040 https://doaj.org/article/07eb747abfac461aba9bcf1e2b23fab8 PLoS Neglected Tropical Diseases, Vol 7, Iss 3, p e2040 (2013) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2013 ftdoajarticles https://doi.org/10.1371/journal.pntd.0002040 2022-12-31T00:59:51Z BACKGROUND: Although dengue is endemic in Puerto Rico (PR), 2007 and 2010 were recognized as epidemic years. In the continental United States (US), outside of the Texas-Mexico border, there had not been a dengue outbreak since 1946 until dengue re-emerged in Key West, Florida (FL), in 2009-2010. The objective of this study was to use electronic and manual surveillance systems to identify dengue cases in Veterans Affairs (VA) healthcare facilities and then to clinically compare dengue cases in Veterans presenting for care in PR and in FL. METHODOLOGY: Outpatient encounters from 1/2007-12/2010 and inpatient admissions (only available from 10/2009-12/2010) with dengue diagnostic codes at all VA facilities were identified using VA's Electronic Surveillance System for Early Notification of Community-based Epidemics (ESSENCE). Additional case sources included VA data from Centers for Disease Control and Prevention BioSense and VA infection preventionists. Case reviews were performed. Categorical data was compared using Mantel-Haenszel or Fisher Exact tests and continuous variables using t-tests. Dengue case residence was mapped. FINDINGS: Two hundred eighty-eight and 21 PR and FL dengue cases respectively were identified. Of 21 FL cases, 12 were exposed in Key West and 9 were imported. During epidemic years, FL cases had significantly increased dengue testing and intensive care admissions, but lower hospitalization rates and headache or eye pain symptoms compared to PR cases. There were no significant differences in clinical symptoms, laboratory abnormalities or outcomes between epidemic and non-epidemic year cases in FL and PR. Confirmed/probable cases were significantly more likely to be hospitalized and have thrombocytopenia or leukopenia compared to suspected cases. CONCLUSIONS: Dengue re-introduction in the continental US warrants increased dengue surveillance and education in VA. Throughout VA, under-testing of suspected cases highlights the need to emphasize use of diagnostic testing to better understand the ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLoS Neglected Tropical Diseases 7 3 e2040 |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
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English |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Patricia L Schirmer Cynthia A Lucero-Obusan Stephen R Benoit Luis M Santiago Danielle Stanek Achintya Dey Mirsonia Martinez Gina Oda Mark Holodniy Dengue surveillance in Veterans Affairs healthcare facilities, 2007-2010. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
BACKGROUND: Although dengue is endemic in Puerto Rico (PR), 2007 and 2010 were recognized as epidemic years. In the continental United States (US), outside of the Texas-Mexico border, there had not been a dengue outbreak since 1946 until dengue re-emerged in Key West, Florida (FL), in 2009-2010. The objective of this study was to use electronic and manual surveillance systems to identify dengue cases in Veterans Affairs (VA) healthcare facilities and then to clinically compare dengue cases in Veterans presenting for care in PR and in FL. METHODOLOGY: Outpatient encounters from 1/2007-12/2010 and inpatient admissions (only available from 10/2009-12/2010) with dengue diagnostic codes at all VA facilities were identified using VA's Electronic Surveillance System for Early Notification of Community-based Epidemics (ESSENCE). Additional case sources included VA data from Centers for Disease Control and Prevention BioSense and VA infection preventionists. Case reviews were performed. Categorical data was compared using Mantel-Haenszel or Fisher Exact tests and continuous variables using t-tests. Dengue case residence was mapped. FINDINGS: Two hundred eighty-eight and 21 PR and FL dengue cases respectively were identified. Of 21 FL cases, 12 were exposed in Key West and 9 were imported. During epidemic years, FL cases had significantly increased dengue testing and intensive care admissions, but lower hospitalization rates and headache or eye pain symptoms compared to PR cases. There were no significant differences in clinical symptoms, laboratory abnormalities or outcomes between epidemic and non-epidemic year cases in FL and PR. Confirmed/probable cases were significantly more likely to be hospitalized and have thrombocytopenia or leukopenia compared to suspected cases. CONCLUSIONS: Dengue re-introduction in the continental US warrants increased dengue surveillance and education in VA. Throughout VA, under-testing of suspected cases highlights the need to emphasize use of diagnostic testing to better understand the ... |
format |
Article in Journal/Newspaper |
author |
Patricia L Schirmer Cynthia A Lucero-Obusan Stephen R Benoit Luis M Santiago Danielle Stanek Achintya Dey Mirsonia Martinez Gina Oda Mark Holodniy |
author_facet |
Patricia L Schirmer Cynthia A Lucero-Obusan Stephen R Benoit Luis M Santiago Danielle Stanek Achintya Dey Mirsonia Martinez Gina Oda Mark Holodniy |
author_sort |
Patricia L Schirmer |
title |
Dengue surveillance in Veterans Affairs healthcare facilities, 2007-2010. |
title_short |
Dengue surveillance in Veterans Affairs healthcare facilities, 2007-2010. |
title_full |
Dengue surveillance in Veterans Affairs healthcare facilities, 2007-2010. |
title_fullStr |
Dengue surveillance in Veterans Affairs healthcare facilities, 2007-2010. |
title_full_unstemmed |
Dengue surveillance in Veterans Affairs healthcare facilities, 2007-2010. |
title_sort |
dengue surveillance in veterans affairs healthcare facilities, 2007-2010. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2013 |
url |
https://doi.org/10.1371/journal.pntd.0002040 https://doaj.org/article/07eb747abfac461aba9bcf1e2b23fab8 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 7, Iss 3, p e2040 (2013) |
op_relation |
http://europepmc.org/articles/PMC3597482?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0002040 https://doaj.org/article/07eb747abfac461aba9bcf1e2b23fab8 |
op_doi |
https://doi.org/10.1371/journal.pntd.0002040 |
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PLoS Neglected Tropical Diseases |
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7 |
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3 |
container_start_page |
e2040 |
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1766344725942501376 |