John Openshaw

All Publications

• Multisystem inflammatory syndrome in children (MIS-C) cases by vaccination status in California. Vaccine Le Marchand, C., Singson, J. R., Clark, A., Shah, D., Wong, M., Chavez, S., Naguit, M., Nelson, L., Rosen, H., Jain, S., Openshaw, J. J. 2024; 43 (Pt 1): 126499

  Abstract

  Multisystem inflammatory syndrome in children (MIS-C) is a rare condition occurring after SARS-CoV-2 infection in children under 21 years of age. Children (5-17 years) with MIS-C meeting the Centers for Disease Control (CDC) case definition were reported via California's passive disease surveillance system. Incidence of MIS-C was compared in unvaccinated and Pfizer-BioNTech vaccinated children aged 12-17 and 5-11 years. In the 12-17 year-old age group, there were 66 new cases among 872,936 unvaccinated children and 7 new cases among 2,117,575 vaccinated children. In the 5-11 year-old age group, there were 51 new cases among 2,113,725 unvaccinated children and 9 new cases among 1,221,293 vaccinated children. Compared with vaccinated children, the incident rate ratio of MIS-C was higher among unvaccinated children in both the 12-17-year-old group (22.9, 95 % confidence interval [CI]: 10.5-49.8, p < 0.0001) and the 5-11-year-old group (3.3, 95 % CI: 1.6-6.7, p = 0.0004). While MIS-C is rare, our results suggest that vaccination with the Pfizer-BioNTech vaccine is protective against MIS-C.

  View details for DOI 10.1016/j.vaccine.2024.126499

  View details for PubMedID 39515133

• Mixed methods approach to examining the implementation experience of a phone-based survey for a SARS-CoV-2 test-negative case-control study in California. PloS one Fukui, N., Li, S. S., DeGuzman, J., Myers, J. F., Openshaw, J., Sharma, A., Watt, J., Lewnard, J. A., Jain, S., Andrejko, K. L., Pry, J. M. 2024; 19 (5): e0301070

  Abstract

  To describe the implementation of a test-negative design case-control study in California during the Coronavirus Disease 2019 (COVID-19) pandemic.Test-negative case-control study.Between February 24, 2021 - February 24, 2022, a team of 34 interviewers called 38,470 Californians, enrolling 1,885 that tested positive for SARS-CoV-2 (cases) and 1,871 testing negative for SARS-CoV-2 (controls) for 20-minute telephone survey. We estimated adjusted odds ratios for answering the phone and consenting to participate using mixed effects logistic regression. We used a web-based anonymous survey to compile interviewer experiences.Cases had 1.29-fold (95% CI: 1.24-1.35) higher adjusted odds of answering the phone and 1.69-fold (1.56-1.83) higher adjusted odds of consenting to participate compared to controls. Calls placed from 4pm to 6pm had the highest adjusted odds of being answered. Some interviewers experienced mental wellness challenges interacting with participants with physical (e.g., food, shelter, etc.) and emotional (e.g., grief counseling) needs, and enduring verbal harassment from individuals called.Calls placed during afternoon hours may optimize response rate when enrolling controls to a case-control study during a public health emergency response. Proactive check-ins and continual collection of interviewer experience(s) and may help maintain mental wellbeing of investigation workforce. Remaining adaptive to the dynamic needs of the investigation team is critical to a successful study, especially in emergent public health crises, like that represented by the COVID-19 pandemic.

  View details for DOI 10.1371/journal.pone.0301070

  View details for PubMedID 38771784

  View details for PubMedCentralID PMC11108220

• Waning of 2-Dose BNT162b2 and mRNA-1273 Vaccine Effectiveness Against Symptomatic SARS-CoV-2 Infection Accounting for Depletion-of-Susceptibles Bias. American journal of epidemiology Andrejko, K. L., Pry, J. M., Myers, J. F., Mehrotra, M., Lamba, K., Lim, E., Fukui, N., DeGuzman, J. L., Openshaw, J., Watt, J., Jain, S., Lewnard, J. A., Covid-Case-Control Study Team, O. B. 2023; 192 (6): 895-907

  Abstract

  Concerns about the duration of protection conferred by coronavirus disease 2019 (COVID-19) vaccines have arisen in postlicensure evaluations. "Depletion of susceptibles," a bias driven by differential accrual of infection among vaccinated and unvaccinated individuals, may obscure vaccine effectiveness (VE) estimates, hindering interpretation. We enrolled California residents who received molecular SARS-CoV-2 tests in a matched, test-negative design, case-control study to estimate VE of mRNA-based COVID-19 vaccines between February 23 and December 5, 2021. We analyzed waning protection following 2 vaccine doses using conditional logistic regression models. Additionally, we used data from a population-based serological study to adjust for "depletion-of-susceptibles" bias and estimated VE for 3 doses, by time since second dose receipt. Pooled VE of BNT162b2 and mRNA-1273 against symptomatic SARS-CoV-2 infection was 91.3% (95% confidence interval (CI): 83.8, 95.4) at 14 days after second-dose receipt and declined to 50.8% (95% CI: 19.7, 69.8) at 7 months. Adjusting for depletion-of-susceptibles bias, we estimated VE of 53.2% (95% CI: 23.6, 71.2) at 7 months after primary mRNA vaccination series. A booster dose of BN162b2 or mRNA-1273 increased VE to 95.0% (95% CI: 82.8, 98.6). These findings confirm that observed waning of protection is not attributable to epidemiologic bias and support ongoing efforts to administer additional vaccine doses to mitigate burden of COVID-19.

  View details for DOI 10.1093/aje/kwad017

  View details for PubMedID 36702469

  View details for PubMedCentralID PMC10236522

• Real-world uptake of COVID-19 vaccination among individuals expressing vaccine hesitancy: A registry-linkage study. Vaccine Andrejko, K. L., Myers, J. F., Fukui, N., Nelson, L., Zhao, R., Openshaw, J., Watt, J. P., Jain, S., Lewnard, J. A., Pry, J. M. 2023; 41 (10): 1649-1656

  Abstract

  Uptake of COVID-19 vaccination remains suboptimal in the United States and other settings. Though early reports indicated that a strong majority of people were interested in receiving the COVID-19 vaccine, the association between vaccine intention and uptake is not yet fully understood. Ourobjective was todescribe predictors of vaccine uptake, and estimate the sensitivity, specificity, and predictive values of self-reported COVID-19 vaccine status compared to a comprehensive statewide COVID-19 vaccine registry.A cohort of California residents that received a molecular test for SARS-CoV-2 infection during 24 February-5 December 2021 were enrolled in a telephone-administered survey. Survey participants were matched with records in a statewide immunization registry. Cox proportional hazards model were used to compare time to vaccination among those unvaccinated at survey enrollment by self-reported COVID-19 vaccination intention.Among 864 participants who were unvaccinated at the time of interview, 272 (31%) had documentation of receipt of COVID-19 vaccination at a later date; including 194/423 (45.9%) who had initially reported being willing to receive vaccination, 41/185 (22.2%) who reported being unsure about vaccination, and 37/278 (13.3%) who reported unwillingness to receive vaccination.Adjusted hazard ratios (aHRs) for registry-confirmed COVID-19 vaccination were 0.49 (95% confidence interval: 0.32-0.76) and 0.21 (0.12-0.36) for participants expressing uncertainty and unwillingness to receive vaccination, respectively, as compared with participants who reported being willing to receive vaccination. Time to vaccination was shorter among participants from higher-income households (aHR = 3.30 [2.02-5.39]) and who reported co-morbidities or immunocompromising conditions (aHR = 1.54 [1.01-2.36]).Sensitivity of self-reported COVID-19 vaccination status was 82% (80-85%) overall, and 98% (97-99%) among those referencing vaccination records; specificity was 87% (86-89%).Willingness to receive COVID-19 vaccination was an imperfect predictor of real-world vaccine uptake. Improved messaging about COVID-19 vaccination regardless of previous SARS-CoV-2 infection status may help improve uptake.

  View details for DOI 10.1016/j.vaccine.2023.01.066

  View details for PubMedID 36746740

  View details for PubMedCentralID PMC9889259

• Receipt of COVID-19 and seasonal influenza vaccines in California (USA) during the 2021-2022 influenza season. Vaccine Andrejko, K. L., Myers, J. F., Openshaw, J., Fukui, N., Li, S., Watt, J. P., Murray, E. L., Hoover, C., Lewnard, J. A., Jain, S., Pry, J. M. 2023; 41 (6): 1190-1197

  Abstract

  Despite lower circulation of influenza virus throughout 2020-2022 during the COVID-19 pandemic, seasonal influenza vaccination has remained a primary tool to reduce influenza-associated illness and death. The relationship between the decision to receive a COVID-19 vaccine and/or an influenza vaccine is not well understood.We assessed predictors of receipt of 2021-2022 influenza vaccine in a secondary analysis of data from a case-control study enrolling individuals who received SARS-CoV-2 testing. We used mixed effects logistic regression to estimate factors associated with receipt of seasonal influenza vaccine. We also constructed multinomial adjusted marginal probability models of being vaccinated for COVID-19 only, seasonal influenza only, or both as compared with receipt of neither vaccination.Among 1261 eligible participants recruited between 22 October 2021-22 June 2022, 43% (545) were vaccinated with both seasonal influenza vaccine and >1 dose of a COVID-19 vaccine, 34% (426) received >1 dose of a COVID-19 vaccine only, 4% (49) received seasonal influenza vaccine only, and 19% (241) received neither vaccine. Receipt of >1 COVID-19 vaccine dose was associated with seasonal influenza vaccination (adjusted odds ratio [aOR]: 3.72; 95% confidence interval [CI]: 2.15-6.43); this association was stronger among participants receiving >1 COVID-19 booster dose (aOR = 16.50 [10.10-26.97]). Compared with participants testing negative for SARS- CoV-2 infection, participants testing positive had lower odds of receipt of 2021-2022 seasonal influenza vaccine (aOR = 0.64 [0.50-0.82]).Recipients of a COVID-19 vaccine were more likely to receive seasonal influenza vaccine during the 2021-2022 season. Factors associated with individuals' likelihood of receiving COVID-19 and seasonal influenza vaccines will be important to account for in future studies of vaccine effectiveness against both conditions. Participants who tested positive for SARS-CoV-2 in our sample were less likely to have received seasonal influenza vaccine, suggesting an opportunity to offer influenza vaccination before or after a COVID-19 diagnosis.

  View details for DOI 10.1016/j.vaccine.2022.12.052

  View details for PubMedID 36585281

  View details for PubMedCentralID PMC9780637

• Predictors of Severe Acute Respiratory Syndrome Coronavirus 2 Infection Following High-Risk Exposure. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America Andrejko, K. L., Pry, J., Myers, J. F., Openshaw, J., Watt, J., Birkett, N., DeGuzman, J. L., Barbaduomo, C. M., Dong, Z. N., Fang, A. T., Frost, P. M., Ho, T., Javadi, M. H., Li, S. S., Tran, V. H., Wan, C., Jain, S., Lewnard, J. A. 2022; 75 (1): e276-e288

  Abstract

  Non-pharmaceutical interventions (NPIs) are recommended for COVID-19 prevention. However, the effectiveness of NPIs in preventing SARS-CoV-2 transmission remains poorly quantified.We conducted a test-negative design case-control study enrolling cases (testing positive for SARS-CoV-2) and controls (testing negative) with molecular SARS-CoV-2 diagnostic test results reported to California Department of Public Health between 24 February-12 November, 2021. We used conditional logistic regression to estimate adjusted odds ratios (aORs) of case status among participants who reported contact with an individual known or suspected to have been infected with SARS-CoV-2 ("high-risk exposure") ≤14 days before testing.751 of 1448 cases (52%) and 255 of 1443 controls (18%) reported high-risk exposures ≤14 days before testing. Adjusted odds of case status were 3.02-fold (95% confidence interval: 1.75-5.22) higher when high-risk exposures occurred with household members (vs. other contacts), 2.10-fold (1.05-4.21) higher when exposures occurred indoors (vs. outdoors only), and 2.15-fold (1.27-3.67) higher when exposures lasted ≥3 hours (vs. shorter durations) among unvaccinated and partially-vaccinated individuals; excess risk associated with such exposures was mitigated among fully-vaccinated individuals. Cases were less likely than controls to report mask usage during high-risk exposures (aOR = 0.50 [0.29-0.85]). The adjusted odds of case status was lower for fully-vaccinated (aOR = 0.25 [0.15-0.43]) participants compared to unvaccinated participants. Benefits of mask usage were greatest among unvaccinated and partially-vaccinated participants, and in interactions involving non-household contacts or interactions occurring without physical contact.NPIs reduced the likelihood of SARS-CoV-2 infection following high-risk exposure. Vaccine effectiveness was substantial for partially and fully vaccinated persons.

  View details for DOI 10.1093/cid/ciab1040

  View details for PubMedID 34932817

  View details for PubMedCentralID PMC8903328

• Reported cases of multisystem inflammatory syndrome in children aged 12-20 years in the USA who received a COVID-19 vaccine, December, 2020, through August, 2021: a surveillance investigation. The Lancet. Child & adolescent health Yousaf, A. R., Cortese, M. M., Taylor, A. W., Broder, K. R., Oster, M. E., Wong, J. M., Guh, A. Y., McCormick, D. W., Kamidani, S., Schlaudecker, E. P., Edwards, K. M., Creech, C. B., Staat, M. A., Belay, E. D., Marquez, P., Su, J. R., Salzman, M. B., Thompson, D., Campbell, A. P. 2022; 6 (5): 303-312

  Abstract

  Multisystem inflammatory syndrome in children (MIS-C) is a hyperinflammatory condition associated with antecedent SARS-CoV-2 infection. In the USA, reporting of MIS-C after vaccination is required under COVID-19 vaccine emergency use authorisations. We aimed to investigate reports of individuals aged 12-20 years with MIS-C after COVID-19 vaccination reported to passive surveillance systems or through clinician outreach to the US Centers for Disease Control and Prevention (CDC).In this surveillance activity, we investigated potential cases of MIS-C after COVID-19 vaccination reported to CDC's MIS-C national surveillance system, the Vaccine Adverse Event Reporting System (co-administered by CDC and the US Food and Drug Administration), and CDC's Clinical Immunization Safety Assessment Project. A multidisciplinary team adjudicated cases by use of the CDC MIS-C definition. Any positive SARS-CoV-2 serology test satisfied case criteria; although anti-nucleocapsid antibodies indicate previous SARS-CoV-2 infection, anti-spike protein antibodies indicate either past or recent infection or COVID-19 vaccination. We describe the demographic and clinical features of cases, stratified by laboratory evidence of SARS-CoV-2 infection. To calculate the reporting rate of MIS-C, we divided the count of all individuals meeting the MIS-C case definition, and of those without evidence of SARS-CoV-2 infection, by the number of individuals aged 12-20 years in the USA who received one or more COVID-19 vaccine doses up to Aug 31, 2021, obtained from CDC national vaccine surveillance data.Using surveillance results from Dec 14, 2020, to Aug 31, 2021, we identified 21 individuals with MIS-C after COVID-19 vaccination. Of these 21 individuals, median age was 16 years (range 12-20); 13 (62%) were male and eight (38%) were female. All 21 were hospitalised: 12 (57%) were admitted to an intensive care unit and all were discharged home. 15 (71%) of 21 individuals had laboratory evidence of past or recent SARS-CoV-2 infection, and six (29%) did not. As of Aug 31, 2021, 21 335 331 individuals aged 12-20 years had received one or more doses of a COVID-19 vaccine, making the overall reporting rate for MIS-C after vaccination 1·0 case per million individuals receiving one or more doses in this age group. The reporting rate in only those without evidence of SARS-CoV-2 infection was 0·3 cases per million vaccinated individuals.Here, we describe a small number of individuals with MIS-C who had received one or more doses of a COVID-19 vaccine before illness onset; the contribution of vaccination to these illnesses is unknown. Our findings suggest that MIS-C after COVID-19 vaccination is rare. Continued reporting of potential cases and surveillance for MIS-C illnesses after COVID-19 vaccination is warranted.US Centers for Disease Control and Prevention.

  View details for DOI 10.1016/S2352-4642(22)00028-1

  View details for PubMedID 35216660

  View details for PubMedCentralID PMC8864018

• Prevention of Coronavirus Disease 2019 (COVID-19) by mRNA-Based Vaccines Within the General Population of California. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America Andrejko, K. L., Pry, J., Myers, J. F., Jewell, N. P., Openshaw, J., Watt, J., Jain, S., Lewnard, J. A. 2022; 74 (8): 1382-1389

  Abstract

  Estimates of coronavirus disease 2019 (COVID-19) vaccine effectiveness under real-world conditions, and understanding of barriers to uptake, are necessary to inform vaccine rollout.We enrolled cases (testing positive) and controls (testing negative) from among the population whose SARS-CoV-2 molecular diagnostic test results from 24 February to 29 April 2021 were reported to the California Department of Public Health. Participants were matched on age, sex, and geographic region. We assessed participants' self-reported history of mRNA-based COVID-19 vaccine receipt (BNT162b2 and mRNA-1273). Participants were considered fully vaccinated 2 weeks after second dose receipt. Among unvaccinated participants, we assessed willingness to receive vaccination. We measured vaccine effectiveness (VE) via the matched odds ratio of prior vaccination, comparing cases with controls.We enrolled 1023 eligible participants aged ≥18 years. Among 525 cases, 71 (13.5%) received BNT162b2 or mRNA-1273; 20 (3.8%) were fully vaccinated with either product. Among 498 controls, 185 (37.1%) received BNT162b2 or mRNA-1273; 86 (16.3%) were fully vaccinated with either product. Two weeks after second dose receipt, VE was 87.0% (95% confidence interval: 68.6-94.6%) and 86.2% (68.4-93.9%) for BNT162b2 and mRNA-1273, respectively. Fully vaccinated participants receiving either product experienced 91.3% (79.3-96.3%) and 68.3% (27.9-85.7%) VE against symptomatic and asymptomatic infection, respectively. Among unvaccinated participants, 42.4% (159/375) residing in rural regions and 23.8% (67/281) residing in urban regions reported hesitancy to receive COVID-19 vaccination.Authorized mRNA-based vaccines are effective at reducing documented SARS-CoV-2 infections within the general population of California. Vaccine hesitancy presents a barrier to reaching coverage levels needed for herd immunity.

  View details for DOI 10.1093/cid/ciab640

  View details for PubMedID 34282839

  View details for PubMedCentralID PMC8406879

• Effectiveness of Face Mask or Respirator Use in Indoor Public Settings for Prevention of SARS-CoV-2 Infection - California, February-December 2021. MMWR. Morbidity and mortality weekly report Andrejko, K. L., Pry, J. M., Myers, J. F., Fukui, N., DeGuzman, J. L., Openshaw, J., Watt, J. P., Lewnard, J. A., Jain, S. 2022; 71 (6): 212-216

  Abstract

  The use of face masks or respirators (N95/KN95) is recommended to reduce transmission of SARS-CoV-2, the virus that causes COVID-19 (1). Well-fitting face masks and respirators effectively filter virus-sized particles in laboratory conditions (2,3), though few studies have assessed their real-world effectiveness in preventing acquisition of SARS-CoV-2 infection (4). A test-negative design case-control study enrolled randomly selected California residents who had received a test result for SARS-CoV-2 during February 18-December 1, 2021. Face mask or respirator use was assessed among 652 case-participants (residents who had received positive test results for SARS-CoV-2) and 1,176 matched control-participants (residents who had received negative test results for SARS-CoV-2) who self-reported being in indoor public settings during the 2 weeks preceding testing and who reported no known contact with anyone with confirmed or suspected SARS-CoV-2 infection during this time. Always using a face mask or respirator in indoor public settings was associated with lower adjusted odds of a positive test result compared with never wearing a face mask or respirator in these settings (adjusted odds ratio [aOR] = 0.44; 95% CI = 0.24-0.82). Among 534 participants who specified the type of face covering they typically used, wearing N95/KN95 respirators (aOR = 0.17; 95% CI = 0.05-0.64) or surgical masks (aOR = 0.34; 95% CI = 0.13-0.90) was associated with significantly lower adjusted odds of a positive test result compared with not wearing any face mask or respirator. These findings reinforce that in addition to being up to date with recommended COVID-19 vaccinations, consistently wearing a face mask or respirator in indoor public settings reduces the risk of acquiring SARS-CoV-2 infection. Using a respirator offers the highest level of personal protection against acquiring infection, although it is most important to wear a mask or respirator that is comfortable and can be used consistently.

  View details for DOI 10.15585/mmwr.mm7106e1

  View details for PubMedID 35143470

  View details for PubMedCentralID PMC8830622

• Deaths in Children and Adolescents Associated With COVID-19 and MIS-C in the United States. Pediatrics McCormick, D. W., Richardson, L. C., Young, P. R., Viens, L. J., Gould, C. V., Kimball, A., Pindyck, T., Rosenblum, H. G., Siegel, D. A., Vu, Q. M., Komatsu, K., Venkat, H., Openshaw, J. J., Kawasaki, B., Siniscalchi, A. J., Gumke, M., Leapley, A., Tobin-D'Angelo, M., Kauerauf, J., Reid, H., White, K., Ahmed, F. S., Richardson, G., Hand, J., Kirkey, K., Larson, L., Byers, P., Garcia, A., Ojo, M., Zamcheck, A., Lash, M. K., Lee, E. H., Reilly, K. H., Wilson, E., de Fijter, S., Naqvi, O. H., Harduar-Morano, L., Burch, A. K., Lewis, A., Kolsin, J., Pont, S. J., Barbeau, B., Bixler, D., Reagan-Steiner, S., Koumans, E. H. 2021; 148 (5)

  Abstract

  To describe the demographics, clinical characteristics, and hospital course among persons <21 years of age with a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-associated death.We conducted a retrospective case series of suspected SARS-CoV-2-associated deaths in the United States in persons <21 years of age during February 12 to July 31, 2020. All states and territories were invited to participate. We abstracted demographic and clinical data, including laboratory and treatment details, from medical records.We included 112 SARS-CoV-2-associated deaths from 25 participating jurisdictions. The median age was 17 years (IQR 8.5-19 years). Most decedents were male (71, 63%), 31 (28%) were Black (non-Hispanic) persons, and 52 (46%) were Hispanic persons. Ninety-six decedents (86%) had at least 1 underlying condition; obesity (42%), asthma (29%), and developmental disorders (22%) were most commonly documented. Among 69 hospitalized decedents, common complications included mechanical ventilation (75%) and acute respiratory failure (82%). The sixteen (14%) decedents who met multisystem inflammatory syndrome in children (MIS-C) criteria were similar in age, sex, and race and/or ethnicity to decedents without MIS-C; 11 of 16 (69%) had at least 1 underlying condition.SARS-CoV-2-associated deaths among persons <21 years of age occurred predominantly among Black (non-Hispanic) and Hispanic persons, male patients, and older adolescents. The most commonly reported underlying conditions were obesity, asthma, and developmental disorders. Decedents with coronavirus disease 2019 were more likely than those with MIS-C to have underlying medical conditions.

  View details for DOI 10.1542/peds.2021-052273

  View details for PubMedID 34385349

  View details for PubMedCentralID PMC9837742

• A planetary health model for reducing exposure to faecal contamination in urban informal settlements: Baseline findings from Makassar, Indonesia. Environment international French, M. A., Fiona Barker, S., Taruc, R. R., Ansariadi, A., Duffy, G. A., Saifuddaolah, M., Zulkifli Agussalim, A., Awaluddin, F., Zainal, Z., Wardani, J., Faber, P. A., Fleming, G., Ramsay, E. E., Henry, R., Lin, A., O'Toole, J., Openshaw, J., Sweeney, R., Sinharoy, S. S., Kolotelo, P., Jovanovic, D., Schang, C., Higginson, E. E., Prescott, M. F., Burge, K., Davis, B., Ramirez-Lovering, D., Reidpath, D., Greening, C., Allotey, P., Simpson, J. A., Forbes, A., Chown, S. L., McCarthy, D., Johnston, D., Wong, T., Brown, R., Clasen, T., Luby, S., Leder, K., RISE consortium 2021; 155: 106679

  Abstract

  BACKGROUND: The intense interactions between people, animals and environmental systems in urban informal settlements compromise human and environmental health. Inadequate water and sanitation services, compounded by exposure to flooding and climate change risks, expose inhabitants to environmental contamination causing poor health and wellbeing and degrading ecosystems. However, the exact nature and full scope of risks and exposure pathways between human health and the environment in informal settlements are uncertain. Existing models are limited to microbiological linkages related to faecal-oral exposures at the individual level, and do not account for a broader range of human-environmental variables and interactions that affect population health and wellbeing.METHODS: We undertook a 12-month health and environmental assessment in 12 flood-prone informal settlements in Makassar, Indonesia. We obtained caregiver-reported health data, anthropometric measurements, stool and blood samples from children<5years, and health and wellbeing data for children 5-14years and adult respondents. We collected environmental data including temperature, mosquito and rat species abundance, and water and sediment samples. Demographic, built environment and household asset data were also collected. We combined our data with existing literature to generate a novel planetary health model of health and environment in informal settlements.RESULTS: Across the 12 settlements, 593 households and 2764 participants were enrolled. Two-thirds (64·1%) of all houses (26·3-82·7% per settlement) had formal land tenure documentation. Cough, fever and diarrhoea in the week prior to the survey were reported among an average of 34.3%, 26.9% and 9.7% of children aged<5years, respectively; although proportions varied over time, prevalence among these youngest children was consistently higher than among children 5-14years or adult respondents. Among children<5years, 44·3% experienced stunting, 41·1% underweight, 12.4% wasting, and 26.5% were anaemic. There was self- or carer-reported poor mental health among 16.6% of children aged 5-14years and 13.9% of adult respondents. Rates of potential risky exposures from swimming in waterways, eating uncooked produce, and eating soil or dirt were high, as were exposures to flooding and livestock. Just over one third of households (35.3%) had access to municipal water, and contamination of well water with E. coli and nitrogen species was common. Most (79·5%) houses had an in-house toilet, but no houses were connected to a piped sewer network or safe, properly constructed septic tank. Median monthly settlement outdoor temperatures ranged from 26·2°C to 29.3°C, and were on average, 1·1°C warmer inside houses than outside. Mosquito density varied over time, with Culex quinquefasciatus accounting for 94·7% of species. Framed by a planetary health lens, our model includes four thematic domains: (1) the physical/built environment; (2) the ecological environment; (3) human health; and (4) socio-economic wellbeing, and is structured at individual, household, settlement, and city/beyond spatial scales.CONCLUSIONS: Our planetary health model includes key risk factors and faecal-oral exposure pathways but extends beyond conventional microbiological faecal-oral enteropathogen exposure pathways to comprehensively account for a wider range of variables affecting health in urban informal settlements. It includes broader ecological interconnections and planetary health-related variables at the household, settlement and city levels. It proposes a composite framework of markers to assess water and sanitation challenges and flood risks in urban informal settlements for optimal design and monitoring of interventions.

  View details for DOI 10.1016/j.envint.2021.106679

  View details for PubMedID 34126296

• Monitoring of diverse enteric pathogens across environmental and host reservoirs with TaqMan array cards and standard qPCR: a methodological comparison study LANCET PLANETARY HEALTH Lappan, R., Henry, R., Chown, S. L., Luby, S. P., Higginson, E. E., Bata, L., Jirapanjawat, T., Schang, C., Openshaw, J. J., O'Toole, J., Lin, A., Tela, A., Turagabeci, A., Wong, T. F., French, M. A., Brown, R. R., Leder, K., Greening, C., McCarthy, D. 2021; 5 (5): E297-E308

  View details for Web of Science ID 000648653900013

• Study design, rationale and methods of the Revitalising Informal Settlements and their Environments (RISE) study: a cluster randomised controlled trial to evaluate environmental and human health impacts of a water-sensitive intervention in informal settlements in Indonesia and Fiji. BMJ open Leder, K., Openshaw, J. J., Allotey, P., Ansariadi, A., Barker, S. F., Burge, K., Clasen, T. F., Chown, S. L., Duffy, G. A., Faber, P. A., Fleming, G., Forbes, A. B., French, M., Greening, C., Henry, R., Higginson, E., Johnston, D. W., Lappan, R., Lin, A., Luby, S. P., McCarthy, D., O'Toole, J. E., Ramirez-Lovering, D., Reidpath, D. D., Simpson, J. A., Sinharoy, S. S., Sweeney, R., Taruc, R. R., Tela, A., Turagabeci, A. R., Wardani, J., Wong, T., Brown, R., RISE Consortium, Awaluddin, F., Batagol, B., Bata, L., Bulachi, D., Cahan, B., Davis, B., El-Sioufi, M., Jovanovic, D., Prescott, M. F., Ramsay, E., Rogersh, B., Saifuddaolah, M., Schang, C., Tseng, C., Vamosi, R., Vilsoni, S., Vakarewa, I., Zulkifli, A. 2021; 11 (1): e042850

  Abstract

  INTRODUCTION: Increasing urban populations have led to the growth of informal settlements, with contaminated environments linked to poor human health through a range of interlinked pathways. Here, we describe the design and methods for the Revitalising Informal Settlements and their Environments (RISE) study, a transdisciplinary randomised trial evaluating impacts of an intervention to upgrade urban informal settlements in two Asia-Pacific countries.METHODS AND ANALYSIS: RISE is a cluster randomised controlled trial among 12 settlements in Makassar, Indonesia, and 12 in Suva, Fiji. Six settlements in each country have been randomised to receive the intervention at the outset; the remainder will serve as controls and be offered intervention delivery after trial completion. The intervention involves a water-sensitive approach, delivering site-specific, modular, decentralised infrastructure primarily aimed at improving health by decreasing exposure to environmental faecal contamination. Consenting households within each informal settlement site have been enrolled, with longitudinal assessment to involve health and well-being surveys, and human and environmental sampling. Primary outcomes will be evaluated in children under 5 years of age and include prevalence and diversity of gastrointestinal pathogens, abundance and diversity of antimicrobial resistance (AMR) genes in gastrointestinal microorganisms and markers of gastrointestinal inflammation. Diverse secondary outcomes include changes in microbial contamination; abundance and diversity of pathogens and AMR genes in environmental samples; impacts on ecological biodiversity and microclimates; mosquito vector abundance; anthropometric assessments, nutrition markers and systemic inflammation in children; caregiver-reported and self-reported health symptoms and healthcare utilisation; and measures of individual and community psychological, emotional and economic well-being. The study aims to provide proof-of-concept evidence to inform policies on upgrading of informal settlements to improve environments and human health and well-being.ETHICS: Study protocols have been approved by ethics boards at Monash University, Fiji National University and Hasanuddin University.TRIAL REGISTRATION NUMBER: ACTRN12618000633280; Pre-results.

  View details for DOI 10.1136/bmjopen-2020-042850

  View details for PubMedID 33419917

• Monitoring of diverse enteric pathogens across environmental and host reservoirs with TaqMan array cards and standard qPCR: a methodological comparison study. The Lancet. Planetary health Lappan, R. n., Henry, R. n., Chown, S. L., Luby, S. P., Higginson, E. E., Bata, L. n., Jirapanjawat, T. n., Schang, C. n., Openshaw, J. J., O'Toole, J. n., Lin, A. n., Tela, A. n., Turagabeci, A. n., Wong, T. H., French, M. A., Brown, R. R., Leder, K. n., Greening, C. n., McCarthy, D. n. 2021; 5 (5): e297–e308

  Abstract

  Multiple bacteria, viruses, protists, and helminths cause enteric infections that greatly impact human health and wellbeing. These enteropathogens are transmited via several pathways through human, animal, and environmental reservoirs. Individual qPCR assays have been extensively used to detect enteropathogens within these types of samples, whereas the TaqMan array card (TAC), which allows simultaneous detection of multiple enteropathogens, has only previously been validated in human clinical samples.In this methodological comparison study, we compared the performance of a custom 48-singleplex TAC relative to standard qPCR. We established the sensitivity and specificity of each method for the detection of eight enteric targets, by using spiked samples with varying levels of PCR inhibition. We then tested the prevalence and abundance of pathogens in wastewater from Melbourne (Australia), and human, animal, and environmental samples from informal settlements in Suva, Fiji using both TAC and qPCR.Both methods exhibited similarly h specificity (TAC 100%, qPCR 94%), sensitivity (TAC 92%, qPCR 100%), and quantitation accuracy (TAC 91%, qPCR 99%) in non-inhibited sample matrices with spiked gene fragments. PCR inhibitors substantially affected detection via TAC, though this issue was alleviated by ten-fold sample dilution. Among samples from informal settlements, the two techniques performed similarly for detection (89% agreement) and quantitation (R2 0·82) for the eight enteropathogen targets. The TAC additionally included 38 other enteric targets, enabling detection of diverse faecal pathogens and extensive environmental contamination that would be prohibitively labour intensive to assay by standard qPCR.The two techniques produced similar results across diverse sample types, with qPCR prioritising greater sensitivity and quantitation accuracy, and TAC trading small reductions in these for a cost-effective larger enteropathogen panel enabling a greater number of enteric pathogens to be analysed concurrently, which is beneficial given the abundance and variety of enteric pathogens in environments such as urban informal settlements. The ability to monitor multiple enteric pathogens across diverse reservoirs could allow better resolution of pathogen exposure pathways, and the design and monitoring of interventions to reduce pathogen load.Wellcome Trust Our Planet, Our Health programme.

  View details for DOI 10.1016/S2542-5196(21)00051-6

  View details for PubMedID 33964239

• Inadequate Minority Representation within SARS-CoV-2 Vaccine Trials. The American journal of tropical medicine and hygiene Craft, J. F., Travassos, M. A., Foppiano Palacios, C., Openshaw, J. J. 2020

  Abstract

  Minority communities have borne the brunt of COVID-19 disease in the United States. Nonwhites have contracted most of the SARS-CoV-2 infections; COVID-19 mortality rates for Black Americans are more than twice those for whites. Given this, studying the most effective ways to prevent and treat SARS-CoV-2 in these populations should be a research priority, particularly with respect to vaccine trials. Federal guidelines from the National Institutes of Health and Food and Drug Administration emphasize the need for inclusion of minority groups in these trials, but none of the publicly available SARS-CoV-2 vaccine trial protocols require representative sampling of minorities. This piece emphasizes the importance of adequate inclusion of minority communities in SARS-CoV-2 vaccine trials, and the implications of this inclusion for SARS-CoV-2 vaccine distribution.

  View details for DOI 10.4269/ajtmh.20-1294

  View details for PubMedID 33200726

• Population-scale longitudinal mapping of COVID-19 symptoms, behaviour and testing. Nature human behaviour Allen, W. E., Altae-Tran, H., Briggs, J., Jin, X., McGee, G., Shi, A., Raghavan, R., Kamariza, M., Nova, N., Pereta, A., Danford, C., Kamel, A., Gothe, P., Milam, E., Aurambault, J., Primke, T., Li, W., Inkenbrandt, J., Huynh, T., Chen, E., Lee, C., Croatto, M., Bentley, H., Lu, W., Murray, R., Travassos, M., Coull, B. A., Openshaw, J., Greene, C. S., Shalem, O., King, G., Probasco, R., Cheng, D. R., Silbermann, B., Zhang, F., Lin, X. 2020

  Abstract

  Despite the widespread implementation of public health measures, coronavirus disease 2019 (COVID-19) continues to spread in the United States. To facilitate an agile response to the pandemic, we developed How We Feel, a web and mobile application that collects longitudinal self-reported survey responses on health, behaviour and demographics. Here, we report results from over 500,000 users in the United States from 2 April 2020 to 12 May 2020. We show that self-reported surveys can be used to build predictive models to identify likely COVID-19-positive individuals. We find evidence among our users for asymptomatic or presymptomatic presentation; show a variety of exposure, occupational and demographic risk factors for COVID-19 beyond symptoms; reveal factors for which users have been SARS-CoV-2 PCR tested; and highlight the temporal dynamics of symptoms and self-isolation behaviour. These results highlight the utility of collecting a diverse set of symptomatic, demographic, exposure and behavioural self-reported data to fight the COVID-19 pandemic.

  View details for DOI 10.1038/s41562-020-00944-2

  View details for PubMedID 32848231

• COVID-19, Quarantines, Sheltering-in-Place, and Human Rights: The Developing Crisis. The American journal of tropical medicine and hygiene Openshaw, J. J., Travassos, M. A. 2020

  Abstract

  As COVID-19 has spread across the globe, quarantines and sheltering-in-place orders have become important public health tools but, as currently implemented, have eroded human rights, particularly for the marginalized, including essential workers, detainees, women, and children. Quarantines and sheltering-in-place orders must include explicit guarantees of human rights protections. We outline protections for the quarantined that communities and governments should strive to guarantee.

  View details for DOI 10.4269/ajtmh.20-0528

  View details for PubMedID 32504462

• Influenza in U.S. Detention Centers - The Desperate Need for Immunization. The New England journal of medicine Foppiano Palacios, C., Openshaw, J. J., Travassos, M. A. 2020

  View details for DOI 10.1056/NEJMp1916894

  View details for PubMedID 31995681

• COVID-19 outbreaks in U.S. immigrant detention centers: the urgent need to adopt CDC guidelines for prevention and evaluation. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America Openshaw, J. J., Travassos, M. A. 2020

  Abstract

  There have been several significant outbreaks of COVID-19 in federal immigrant detention centers, which lack clear and consistent guidelines across Department of Homeland Security (DHS) agencies to limit the spread of COVID-19. The Centers for Disease Control and Prevention (CDC) has issued detailed guidelines for the control, prevention, and evaluation of COVID-19 in detention facilities. While the DHS's Immigration and Customs Enforcement agency has stated that it complies with CDC recommendations, its policies significantly differ from these CDC guidelines, placing detainees at risk for contracting COVID-19. This submission urges the adoption of CDC guidelines across DHS-associated facilities. Such a policy change has the potential to protect and save the lives of the most vulnerable populations under the auspices of the federal government.

  View details for DOI 10.1093/cid/ciaa692

  View details for PubMedID 32474574

• Hospital-based zoonotic disease surveillance in Bangladesh: design, field data and difficulties. Philosophical transactions of the Royal Society of London. Series B, Biological sciences Das, P., Sazzad, H. M., Aleem, M. A., Rahman, M. Z., Rahman, M., Anthony, S. J., Lipkin, W. I., Gurley, E. S., Luby, S. P., Openshaw, J. J. 2019; 374 (1782): 20190019

  Abstract

  Early detection of zoonotic diseases allows for the implementation of early response measures, reducing loss of human life and economic disruption. We implemented a surveillance system in hospitals in Bangladesh to screen acutely ill hospitalized patients with severe respiratory infection and meningoencephalitis for zoonotic exposures. Patients were screened for the risk of zoonotic exposures with five questions covering vocational exposures, sick domestic animal and wild animal contact, and date palm sap consumption in the three weeks preceding illness onset. Patients giving at least one positive response were considered a potential zoonotic exposure. From September 2013 to March 2017, a total of 11 429 hospitalized patients across 14 participating hospitals were screened for exposures. Overall, 2% of patients reported a potential zoonotic exposure in the three-week period prior to becoming ill. Sixteen per cent of hospitalized patients with reported exposures died. After routine surveillance diagnostic testing, 88% of patients admitted to the hospital after a potential zoonotic exposure did not have a laboratory diagnosed aetiology for their illness. Hospital-based surveillance systems such as the Bangladeshi example presented here could play an important future role in the early detection of zoonotic spillover diseases. This article is part of the theme issue 'Dynamic and integrative approaches to understanding pathogen spillover'.

  View details for DOI 10.1098/rstb.2019.0019

  View details for PubMedID 31401956

• Impact of Silver Ion Laundry Treatment on Athletic Gear and Environmental Pathogens and Athlete Health Balachandran, P., Openshaw, J. J. LIPPINCOTT WILLIAMS & WILKINS. 2019: 286

  View details for Web of Science ID 000481662801108

• Impact of Silver Ion Laundry Treatment on Athletic Gear and Environmental Pathogens and Athlete Health Balachandran, P., Openshaw, J. J. LIPPINCOTT WILLIAMS & WILKINS. 2019: 604

  View details for Web of Science ID 000481662802306

• Structural Equation Modeling (SEM) of Cysticercosis in School-Aged Children in Tibetan Rural Farming Areas of Western China: Implications for Intervention Planning. International journal of environmental research and public health Zhou, H., Wang, Q., Zhou, J., Li, T., Medina, A., Felt, S. A., Rozelle, S., Openshaw, J. J. 2019; 16 (5)

  Abstract

  Neurocysticercosis (NCC) significantly contributes to morbidity in developing countries. We recently published a study of prevalence and risk factors in school-aged children in three mountainous areas in Sichuan province of western China. Using structural equation modeling (SEM) on data from that study to guide intervention planning, here we examine risk factors grouped into three broad interventional categories: sociodemographics, human behavior, and sources of pork and pig husbandry. Because neuroimaging is not easily available, using SEM allows for the use of multiple observed variables (serological tests and symptoms) to represent probable NCC cases. Data collected from 2608 students was included in this analysis. Within this group, seroprevalence of cysticercosis IgG antibodies was 5.4%. SEM results showed that sociodemographic factors (beta = 0.33, p < 0.05), sources of pork and pig husbandry (beta = 0.26, p < 0.001), and behavioral factors (beta = 0.33, p < 0.05) were all directly related to probable NCC in school-aged children. Sociodemographic factors affected probable NCC indirectly via sources of pork and pig husbandry factors (beta = 0.07, p < 0.001) and behavioral variables (beta = 0.07, p < 0.001). Both sociodemographic factors (beta = 0.07, p < 0.05) and sources of pork and pig husbandry factors (beta = 0.10, p < 0.01) affected probable NCC indirectly via behavioral variables. Because behavioral variables not only had a large direct effect but also served as a critical bridge to strengthen the effect of sociodemographics and sources of pork and pig husbandry on probable NCC, our findings suggest that interventions targeting behavioral factors may be the most effective in reducing disease.

  View details for PubMedID 30836642

• Structural Equation Modeling (SEM) of Cysticercosis in School-Aged Children in Tibetan Rural Farming Areas of Western China: Implications for Intervention Planning INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH Zhou, H., Wang, Q., Zhou, J., Li, T., Medina, A., Felt, S. A., Rozelle, S., Openshaw, J. J. 2019; 16 (5)

  View details for DOI 10.3390/ijerph16050780

  View details for Web of Science ID 000462664200105

• High prevalence of taeniasis and Taenia solium cysticercosis in children in western Sichuan, China. Acta tropica Li, T. n., Chen, X. n., Wang, H. n., Openshaw, J. J., Zhong, B. n., Felt, S. A., Ito, A. n., Luby, S. P. 2019: 105133

  Abstract

  Data in China on human Taenia infections, including Taenia solium cysticercosis, is largely lacking. We aimed to determine the prevalence of taeniasis with all three human Taenia species as well as T. solium cysticercosis in primary school-aged children in minority areas of western Sichuan, China. During April 2016 to December 2017, we did a cross-sectional study in five western Sichuan Province primary schools in Liangshan (3 schools), Ganzi (1 school) and Aba (1 school) prefectures. Diagnosis of taeniasis was made by stool microscopy for presence of Taenia eggs, as well as recovery of taeniid tapeworms or proglottids by medicinal treatment followed by species identification using multiplex PCR. Diagnosis of T. solium cysticercosis was made serologically using an ELISA with low-molecular-weight antigens purified from T. solium cyst fluid to detect specific IgG antibodies. A total of 1,672 children were screened for taeniasis and 1,639 were evaluated for cysticercosis antibodies. Overall prevalence of taeniasis was 7.5% but was as high as 15.6% at one school site (e.g., Shuiluo). Of the three known human Taenia species, adult T. solium tapeworms were detected in 42 children from four of the five schools (all three schools in Liangshan and one in Aba), giving a prevalence of T. solium taeniasis of 2.5% (95% confidence interval 0-6.7%). Cysticercosis antibody seropositivity by school varied from 2.3% to 15.6% (overall 7.5%). T. solium taeniasis carriers were more likely to have cysticercosis antibodies than chlidren without T. solium taeniasis (43.6% vs 6.6%). Schools with higher prevalences of T. solium taeniasis were more likely to have children with human cysticercosis IgG antibodies. This study discloses a high prevalence of taeniasis and T. solium cysticercosis in primary school-aged children in minority areas of western Sichuan, suggesting an urgent necessity for school-based disease control.

  View details for DOI 10.1016/j.actatropica.2019.105133

  View details for PubMedID 31415736

• Prevalence and risk factors for Taenia solium cysticercosis in school-aged children: A school based study in western Sichuan, People's Republic of China PLOS NEGLECTED TROPICAL DISEASES Openshaw, J. J., Medina, A., Felt, S. A., Li, T., Huan, Z., Rozelle, S., Luby, S. P. 2018; 12 (5)

  View details for DOI 10.1371/journal.pntd.0006465

  View details for Web of Science ID 000434021900026

• Prevalence and risk factors for Taenia solium cysticercosis in school-aged children: A school based study in western Sichuan, People's Republic of China. PLoS neglected tropical diseases Openshaw, J. J., Medina, A. n., Felt, S. A., Li, T. n., Huan, Z. n., Rozelle, S. n., Luby, S. P. 2018; 12 (5): e0006465

  Abstract

  Taenia solium cysticercosis affects millions of impoverished people worldwide and can cause neurocysticercosis, an infection of the central nervous system which is potentially fatal. Children may represent an especially vulnerable population to neurocysticercosis, due to the risk of cognitive impairment during formative school years. While previous epidemiologic studies have suggested high prevalence in rural China, the prevalence in children as well as risk factors and impact of disease in low-resource areas remain poorly characterized.Utilizing school based sampling, we conducted a cross-sectional study, administering a questionnaire and collecting blood for T. solium cysticercosis antibodies in 2867 fifth and sixth grade students across 27 schools in west Sichuan. We used mixed-effects logistic regression models controlling for school-level clustering to study associations between risk factors and to characterize factors influencing the administration of deworming medication. Overall prevalence of cysticercosis antibodies was 6%, but prevalence was significantly higher in three schools which all had prevalences of 15% or higher. Students from households owning pigs (adjusted odds ratio [OR] 1.81, 95% CI 1.08-3.03), from households reporting feeding their pigs human feces (adjusted OR 1.49, 95% CI 1.03-2.16), and self-reporting worms in their feces (adjusted OR 1.85, 95% CI 1.18-2.91) were more likely to have cysticercosis IgG antibodies. Students attending high prevalence schools were more likely to come from households allowing pigs to freely forage for food (OR 2.26, 95% CI 1.72-2.98) and lacking a toilet (OR 1.84, 95% CI 1.38-2.46). Children who were boarding at school were less likely to have received treatment for gastrointestinal worms (adjusted OR 0.58, 95% CI 0.42-0.80).Our study indicates high prevalences of cysticercosis antibodies in young school aged children in rural China. While further studies to assess potential for school-based transmission are needed, school-based disease control may be an important intervention to ensure the health of vulnerable pediatric populations in T. solium endemic areas.

  View details for PubMedID 29738570

  View details for PubMedCentralID PMC5959190

• EVIDENCE CONSISTENT WITH SCHOOL BASED TRANSMISSION OF <it>TAENIA SOLIUM</it> CYSTICERCOSIS IN PRIMARY SCHOOLS, SOUTHWEST CHINA Openshaw, J., Chedid, C., Medina, A., Felt, S., Li, T., Huan, Z., Rozelle, S., Luby, S. AMER SOC TROP MED & HYGIENE. 2018: 7

  View details for Web of Science ID 000461386602022

• High prevalence of Taenia solium taeniasis and cysticercosis in Tibetan schoolchildren in western Sichuan, China: a cross-sectional study Li, T., Openshaw, J. J., Chen, X., Medina, A. C., Felt, S. A., Zhou, H., Rozelle, S. D., Luby, S. P. ELSEVIER SCIENCE INC. 2017: S89

  View details for Web of Science ID 000440459400090

• TAENIA SOLIUM AND NEUROCYSTICERCOSIS BURDEN AND DECREASED ACADEMIC PERFORMANCE ASSOCIATED WITH BRAIN INFECTION IN SCHOOL AGED CHILDREN, SOUTHWEST CHINA Openshaw, J. J., Medina, A., Felt, S. A., Li, T., Huan, Z., Rozelle, S., Luby, S. P. AMER SOC TROP MED & HYGIENE. 2017: 139–40

  View details for Web of Science ID 000412851501447

• Reduction in bacterial contamination of hospital textiles by a novel silver-based laundry treatment AMERICAN JOURNAL OF INFECTION CONTROL Openshaw, J. J., Morris, W. M., Lowry, G. V., Nazmi, A. 2016; 44 (12): 1705-1708

  Abstract

  Treating hospital patient textiles with ionic silver after each washing results in a significant decrease in microbial contamination. Although further study is needed to better understand the role textiles play in hospital-acquired infections and to quantify the influence of silver textile treatment on health care-associated infection risk and patient outcomes, ionic silver treatment of textiles may prove useful in hospital-acquired infection reduction strategies.

  View details for DOI 10.1016/j.ajic.2016.06.021

  View details for Web of Science ID 000392626300057

  View details for PubMedID 27561434

• Bat Hunting and Bat-Human Interactions in Bangladeshi Villages: Implications for Zoonotic Disease Transmission and Bat Conservation. Transboundary and emerging diseases Openshaw, J. J., Hegde, S., Sazzad, H. M., KHAN, S. U., Hossain, M. J., Epstein, J. H., Daszak, P., Gurley, E. S., Luby, S. P. 2016: -?

  Abstract

  Bats are an important reservoir for emerging zoonotic pathogens. Close human-bat interactions, including the sharing of living spaces and hunting and butchering of bats for food and medicines, may lead to spillover of zoonotic disease into human populations. We used bat exposure and environmental data gathered from 207 Bangladeshi villages to characterize bat exposures and hunting in Bangladesh. Eleven percent of households reported having a bat roost near their homes, 65% reported seeing bats flying over their households at dusk, and 31% reported seeing bats inside their compounds or courtyard areas. Twenty percent of households reported that members had at least daily exposure to bats. Bat hunting occurred in 49% of the villages surveyed and was more likely to occur in households that reported nearby bat roosts (adjusted prevalence ratio [aPR] 2.3, 95% CI 1.1-4.9) and villages located in north-west (aPR 7.5, 95% CI 2.5-23.0) and south-west (aPR 6.8, 95% CI 2.1-21.6) regions. Our results suggest high exposure to bats and widespread hunting throughout Bangladesh. This has implications for both zoonotic disease spillover and bat conservation.

  View details for DOI 10.1111/tbed.12505

  View details for PubMedID 27125493

  View details for PubMedCentralID PMC5086320

• Increased Morbidity and Mortality in Domestic Animals Eating Dropped and Bitten Fruit in Bangladeshi Villages: Implications for Zoonotic Disease Transmission. EcoHealth Openshaw, J. J., Hegde, S., Sazzad, H. M., Khan, S. U., Hossain, M. J., Epstein, J. H., Daszak, P., Gurley, E. S., Luby, S. P. 2016; 13 (1): 39-48

  Abstract

  We used data on feeding practices and domestic animal health gathered from 207 Bangladeshi villages to identify any association between grazing dropped fruit found on the ground or owners directly feeding bat- or bird-bitten fruit and animal health. We compared mortality and morbidity in domestic animals using a mixed effects model controlling for village clustering, herd size, and proxy measures of household wealth. Thirty percent of household heads reported that their animals grazed on dropped fruit and 20% reported that they actively fed bitten fruit to their domestic herds. Household heads allowing their cattle to graze on dropped fruit were more likely to report an illness within their herd (adjusted prevalence ratio 1.17, 95% CI 1.02-1.31). Household heads directly feeding goats bitten fruit were more likely to report illness (adjusted prevalence ratio 1.35, 95% CI 1.16-1.57) and deaths (adjusted prevalence ratio 1.64, 95% CI 1.13-2.4). Reporting of illnesses and deaths among goats rose as the frequency of feeding bitten fruit increased. One possible explanation for this finding is the transmission of bat pathogens to domestic animals via bitten fruit consumption.

  View details for DOI 10.1007/s10393-015-1080-x

  View details for PubMedID 26668032

• Bat hunting and bat-human interactions in Bangladeshi villages: implications for zoonotic disease transmission and bat conservation Transboundary & Emerging Disease Openshaw, J. J., et al 2016
• Increased morbidity and mortality in domestic animals fed ground and bitten fruit in Bangladeshi villages: implications for bat borne zoonotic disease transmission EcoHealth Openshaw, J. J., et al 2015
• Rocky mountain spotted fever in the United States, 2000-2007: interpreting contemporary increases in incidence. American journal of tropical medicine and hygiene Openshaw, J. J., et al 2010; 83 (1): 174–182
• Eczema vaccinatum resulting from the transmission of vaccinia virus from a smallpox vaccinee: an investigation of potential fomites in the home environment Vaccine Lederman, E., Miramontes, R., Openshaw, J., et al 2009; 27 (3): 375-7
• Human Ehrlichiosis: Clinical and Ecological Challenges Southern Medical Journal Openshaw, J. J., Swerdlow, D. 2007; 100 (8): 769-770
• Purple Glove Syndrome Following Intravenous Phenytoin Administration Vascular Medicine Chokshi, R., Openshaw, J., Mehta, N., Mohler, E. 2007; 12: 29-31
• Rickettsia parkeri rickettsiosis and its clinical distinction from Rocky Mountain spotted fever Clin Infect Dis. Paddock, C., Finley, R., Wright, C., Robinson, H., Schrodt, B., Lane, C., Ekenna, O., Blass, M., Tamminga, C., Ohi, C., McLellan, S., Goddard, J., Holman, R., Openshaw, J., Sumner, J., Zaki, S., Eremeeva, M. 2006; 47 (9): 1188-96