Katharine Sturm-Ramirez - Academia.edu (original) (raw)

Papers by Katharine Sturm-Ramirez

The global spread of H5N1 avian influenza A virus is a major human health threat due to its consi... more The global spread of H5N1 avian influenza A virus is a major human health threat due to its considerable pandemic potential. A pandemic could kill millions, especially in developing countries. Preparedness is crucial to prevent or delay a pandemic, and to reduce morbidity and mortality. Significant global investment has been directed toward helping developing countries build pandemic preparedness capacity; the U.S. Government (USG) is the leading international investor. The U.S. Department of Health and Human Services, Office of Global Health Affairs recently completed an analysis of perceived gaps in international pandemic preparedness. This report presents key findings and timely information which can be used by policymakers and other stakeholders for planning and program development. A multifaceted approach to data collection was employed, including a comprehensive literature review and roundtable discussions with subject matter experts from U.S. academic institutions, non-govern...

Archives of medical research, 1997

Parkinsonism & Related Disorders, 2007

International Congress Series, 2004

Waterfowl are the natural reservoir for all influenza A viruses, and these viruses are usually no... more Waterfowl are the natural reservoir for all influenza A viruses, and these viruses are usually nonpathogenic in wild aquatic birds. In late 2002, an outbreak of H5N1 influenza virus caused death among waterfowl in two Hong Kong nature parks. Genetic analysis showed that these viruses were novel H5N1 genotypes. In February 2003, a closely related H5N1 was isolated from human patients. This study aims to answer two questions: (1) Are the novel H5N1 antigenically different from the H5N1 viruses of 1997 and 2001? (2) Are they more pathogenic to ducks than previous genotypes? Antigenic analysis of the new isolates showed a different reactivity pattern from previous H5N1 isolates, suggesting antigenic drift has occurred. The new 2002 isolates caused acute disease in mallard ducks, including severe neurological symptoms and death. In contrast, previous H5N1 isolates and a 2003 human isolate did not cause any disease. Since 1961, this is the first time that influenza virus is reported to kill wild aquatic birds.

Avian Diseases, 2007

The H5N1 virus currently circulating is continuing to evolve, and it has already resulted in the ... more The H5N1 virus currently circulating is continuing to evolve, and it has already resulted in the extension of its host and geographical range. It is likely that H5N1 will become a global problem for the poultry industry. How many of the recent H5N1 changes observed have been induced by changing patterns in poultry raising? A change in attitude on the use of high-quality vaccines is a change that would drastically help in the control of the current epidemic in the poultry industry. This article provides an overview of the changing properties that have been observed during the current H5N1 outbreaks.

Journal of Clinical Microbiology, 2000

Entamoeba histolytica causes amebic colitis and liver abscess in developing countries such as Mex... more Entamoeba histolytica causes amebic colitis and liver abscess in developing countries such as Mexico and India. Entamoeba dispar is morphologically identical but is not associated with disease. Here we determined the ploidy of E. histolytica and developed PCR-based methods for distinguishing field isolates of E. histolytica or E. dispar . Fluorescence in situ hybridization showed that E. histolytica trophozoites are diploid for five “single-copy” probes tested. Intergenic sequences between superoxide dismutase and actin 3 genes of clinical isolates of E. histolytica from the New and Old Worlds were identical, as were those of E. dispar . These results suggest a bottleneck or demographic sweep in entamoebae which infect humans. In contrast, E. histolytica and E. dispar genes encoding repeat antigens on the surface of trophozoites (Ser-rich protein) or encysting parasites (chitinase) were highly polymorphic. chitinase alleles suggested that the early axenized strains of E. histolytica...

Clinical Infectious Diseases, 2021

Background Respiratory syncytial virus (RSV) is a leading cause of pediatric death, with >99% ... more Background Respiratory syncytial virus (RSV) is a leading cause of pediatric death, with >99% of mortality occurring in low- and lower middle-income countries. At least half of RSV-related deaths are estimated to occur in the community, but clinical characteristics of this group of children remain poorly characterized. Methods The RSV Global Online Mortality Database (RSV GOLD), a global registry of under-5 children who have died with RSV-related illness, describes clinical characteristics of children dying of RSV through global data sharing. RSV GOLD acts as a collaborative platform for global deaths, including community mortality studies described in this supplement. We aimed to compare the age distribution of infant deaths <6 months occurring in the community with in-hospital. Results We studied 829 RSV-related deaths <1 year of age from 38 developing countries, including 166 community deaths from 12 countries. There were 629 deaths that occurred <6 months, of which 1...

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Scientific reports, Jan 20, 2018

Avian influenza viruses, including highly pathogenic strains, pose severe economic, animal and pu... more Avian influenza viruses, including highly pathogenic strains, pose severe economic, animal and public health concerns. We implemented live bird market surveillance in Bangladesh to identify the subtypes of avian influenza A viruses in domestic waterfowl and market environments. We collected waterfowl samples monthly from 4 rural sites from 2007 to 2012 and environmental samples from 4 rural and 16 urban sites from 2009 to 2012. Samples were tested through real-time RT-PCR, virus culture, and sequencing to detect and characterize avian influenza A viruses. Among 4,308 waterfowl tested, 191 (4.4%) were positive for avian influenza A virus, including 74 (1.9%) avian influenza A/H5 subtype. The majority (99%, n = 73) of the influenza A/H5-positive samples were from healthy appearing waterfowl. Multiple subtypes, including H1N1, H1N3, H3N2, H3N6, H3N8, H4N1, H4N2, H4N6, H5N1 (clades 2.2.2, 2.3.2.1a, 2.3.4.2), H5N2, H6N1, H7N9, H9N2, H11N2 and H11N3, H11N6 were detected in waterfowl and e...

Influenza and other respiratory viruses, Jan 2, 2017

Seasonal influenza-associated mortality estimates help identify the burden of disease and assess ... more Seasonal influenza-associated mortality estimates help identify the burden of disease and assess the value of public health interventions such as annual influenza immunization. Vital registration is limited in Bangladesh making it difficult to estimate seasonal influenza mortality. Our study aimed to estimate seasonal influenza-associated mortality rates for 2010-2012 in Bangladesh. We conducted surveillance among hospitalized patients with severe acute respiratory illness (SARI) for persons aged ≥5 years and severe pneumonia for children <5 years in 11 sites across Bangladesh. We defined the catchment areas of these sites and conducted a community survey in 22 randomly selected unions (administrative units) within the catchment areas to identify respiratory deaths. We multiplied the proportion of influenza-positive patients at our surveillance sites by the age-specific number of respiratory deaths identified to estimate seasonal influenza-associated mortality. Among 4221 surveil...

The American journal of tropical medicine and hygiene, Jan 6, 2017

Although acute diarrheal deaths have declined globally among children < 5 years, it may still ... more Although acute diarrheal deaths have declined globally among children < 5 years, it may still contribute to childhood mortality as an underlying or contributing cause. The aim of this project was to estimate the incidence of acute diarrhea-associated deaths, regardless of primary cause, among children < 5 years in Bangladesh during 2010-12. We conducted a survey in 20 unions (administrative units) within the catchment areas of 10 tertiary hospitals in Bangladesh. Through social networks, our field team identified households where children < 5 years were reported to have died during 2010-12. Trained data collectors interviewed caregivers of the deceased children and recorded illness symptoms, health care seeking, and other information using an abbreviated international verbal autopsy questionnaire. We classified the deceased based upon the presence of diarrhea before death. We identified 880 deaths, of which 36 (4%) died after the development of acute diarrhea, 17 (2%) had d...

The Journal of infectious diseases, Jan 15, 2017

In March 2011, a multidisciplinary team investigated 2 human cases of highly pathogenic avian inf... more In March 2011, a multidisciplinary team investigated 2 human cases of highly pathogenic avian influenza A(H5N1) virus infection, detected through population-based active surveillance for influenza in Bangladesh, to assess transmission and contain further spread. We collected clinical and exposure history of the case patients and monitored persons coming within 1 m of a case patient during their infectious period. Nasopharyngeal wash specimens from case patients and contacts were tested with real-time reverse-transcription polymerase chain reaction, and virus culture and isolates were characterized. Serum samples were tested with microneutralization and hemagglutination inhibition assays. We tested poultry, wild bird, and environmental samples from case patient households and surrounding areas for influenza viruses. Two previously healthy case patients, aged 13 and 31 months, had influenzalike illness and fully recovered. They had contact with poultry 7 and 10 days before illness ons...

Influenza and other respiratory viruses, Sep 8, 2017

We determined influenza A(H1N1)pdm09 antibody levels before and after the first wave of the pande... more We determined influenza A(H1N1)pdm09 antibody levels before and after the first wave of the pandemic in an urban community in Dhaka, Bangladesh. We identified a cohort of households by stratified random sampling. We collected baseline serum specimens during July-August 2009, just prior to the initial wave of the 2009 pandemic in this community and a second specimen during November 2009, after the pandemic peak. Paired sera were tested for antibodies against A(H1N1)pdm09 virus using microneutralization assay and hemagglutinin inhibition (HI) assay. A fourfold increase in antibody titer by either assay with a titer of ≥40 in the convalescent sera was considered a seroconversion. At baseline, an HI titer of ≥40 was considered seropositive. We collected information on clinical illness from weekly home visits. We tested 779 paired sera from the participants. At baseline, before the pandemic wave, 1% overall and 3% of persons >60 years old were seropositive. After the first wave of the...

Journal of global health, 2017

Respiratory syncytial virus (RSV) is the leading cause of acute respiratory illness in young chil... more Respiratory syncytial virus (RSV) is the leading cause of acute respiratory illness in young children and results in significant economic burden. There is no vaccine to prevent RSV illness but a number of vaccines are in development. We conducted this study to estimate the costs of severe RSV illness requiring hospitalization among children <5 years and associated financial impact on households in Bangladesh. Data of this study could be useful for RSV vaccine development and also the value of various preventive strategies, including use of an RSV vaccine in children if one becomes available. From May through October 2010, children aged <5 years with laboratory-confirmed RSV were identified from a sentinel influenza program database at four tertiary hospitals. Research assistants visited case-patients' homes after hospital discharge and administered a structured questionnaire to record direct medical costs (physician consultation fee, costs for hospital bed, medicines and d...

Patient Preference and Adherence, 2017

Background: Pharmacies in Bangladesh serve as an important source of health service. A survey in ... more Background: Pharmacies in Bangladesh serve as an important source of health service. A survey in Dhaka reported that 48% of respondents with symptoms of acute respiratory illness (ARI) identified local pharmacies as their first point of care. This study explores the factors driving urban customers to seek health care from pharmacies for ARI, their treatment adherence, and outcome. Methods: A cross-sectional study was conducted among 100 selected pharmacies within Dhaka from June to December 2012. Study participants were patients or patients' relatives aged .18 years seeking care for ARI from pharmacies without prescription. Structured interviews were conducted with customers after they sought health service from drug sellers and again over phone 5 days postinterview to discuss treatment adherence and outcome. Results: We interviewed 302 customers patronizing 76 pharmacies; 186 (62%) sought care for themselves and 116 (38%) sought care for a sick relative. Most customers (215; 71%) were males. The majority (90%) of customers sought care from the study pharmacy as their first point of care, while 18 (6%) had previously sought care from another pharmacy and 11 (4%) from a physician for their illness episodes. The most frequently reported reasons for seeking care from pharmacies were ease of access to pharmacies (86%), lower cost (46%), availability of medicine (33%), knowing the drug seller (20%), and convenient hours of operation (19%). The most commonly recommended drugs were acetaminophen dispensed in 76% (228) of visits, antihistamine in 69% (208), and antibiotics in 42% (126). On follow-up, most (86%) of the customers had recovered and 12% had sought further treatment. Conclusion: People with ARI preferred to seek care at pharmacies rather than clinics because these pharmacies were more accessible and provided prompt treatment and medicine with no service charge. We recommend raising awareness among drug sellers on proper dispensing practices and enforcement of laws and regulations for drug sales.

Influenza and other respiratory viruses, May 16, 2017

Detections of influenza A subtype specific antibody responses are often complicated by the presen... more Detections of influenza A subtype specific antibody responses are often complicated by the presence of cross-reactive antibodies. We developed two novel multiplex platforms for antibody detection. The multiplexed magnetic fluorescence microsphere immunoassay (MAGPIX) is a high throughput laboratory-based assay. Chembio Dual Path Platform (DPP) is a portable and rapid test that could be used in the field. Twelve recombinant globular head domain hemagglutinin (GH HA1) antigens from A(H1N1)pdm09 (pH1N1), A(H2N2), A(H3N2), A(H5N1), A(H7N9), A(H9N2), A(H13N9), B/Victoria lineage, B/Yamagata lineage viruses, and protein A control were used. Human sera from U.S. residents either vaccinated (with H5N1 or pH1N1) or infected with pH1N1 influenza viruses, and sera from live bird market workers in Bangladesh (BDPW) were evaluated. GH HA1 antigens and serum adsorption using full ectodomain recombinant hemagglutinins from A(H1N1) and A(H3N2) were introduced into the platforms to reduce cross-reac...