Tammy Sylvester - Academia.edu (original) (raw)

Papers by Tammy Sylvester

The Lancet Infectious Diseases, 2020

BACKGROUND To address the unmet medical need for an effective prophylactic vaccine against Ebola ... more BACKGROUND To address the unmet medical need for an effective prophylactic vaccine against Ebola virus we assessed the safety and immunogenicity of three different two-dose heterologous vaccination regimens with a replication-deficient adenovirus type 26 vector-based vaccine (Ad26.ZEBOV), expressing Zaire Ebola virus glycoprotein, and a non-replicating, recombinant, modified vaccinia Ankara (MVA) vector-based vaccine, encoding glycoproteins from Zaire Ebola virus, Sudan virus, and Marburg virus, and nucleoprotein from the Tai Forest virus. METHODS This randomised, observer-blind, placebo-controlled, phase 2 trial was done at seven hospitals in France and two research centres in the UK. Healthy adults (aged 18-65 years) with no history of Ebola vaccination were enrolled into four cohorts. Participants in cohorts I-III were randomly assigned (1:1:1) using computer-generated randomisation codes into three parallel groups (randomisation for cohorts II and III was stratified by country and age), in which participants were to receive an intramuscular injection of Ad26.ZEBOV on day 1, followed by intramuscular injection of MVA-BN-Filo at either 28 days (28-day interval group), 56 days (56-day interval group), or 84 days (84-day interval group) after the first vaccine. Within these three groups, participants in cohort II (14:1) and cohort III (10:3) were further randomly assigned to receive either Ad26.ZEBOV or placebo on day 1, followed by either MVA-BN-Filo or placebo on days 28, 56, or 84. Participants in cohort IV were randomly assigned (5:1) to receive one dose of either Ad26.ZEBOV or placebo on day 1 for vector shedding assessments. For cohorts II and III, study site personnel, sponsor personnel, and participants were masked to vaccine allocation until all participants in these cohorts had completed the post-MVA-BN-Filo vaccination visit at 6 months or had discontinued the trial, whereas cohort I was open-label. For cohort IV, study site personnel and participants were masked to vaccine allocation until all participants in this cohort had completed the post-vaccination visit at 28 days or had discontinued the trial. The primary outcome, analysed in all participants who had received at least one dose of vaccine or placebo (full analysis set), was the safety and tolerability of the three vaccination regimens, as assessed by participant-reported solicited local and systemic adverse events within 7 days of receiving both vaccines, unsolicited adverse events within 42 days of receiving the MVA-BN-Filo vaccine, and serious adverse events over 365 days of follow-up. The secondary outcome was humoral immunogenicity, as measured by the concentration of Ebola virus glycoprotein-binding antibodies at 21 days after receiving the MVA-BN-Filo vaccine. The secondary outcome was assessed in the per-protocol analysis set. This study is registered at ClinicalTrials.gov, NCT02416453, and EudraCT, 2015-000596-27. FINDINGS Between June 23, 2015, and April 27, 2016, 423 participants were enrolled: 408 in cohorts I-III were randomly assigned to the 28-day interval group (123 to receive Ad26.ZEBOV and MVA-BN-Filo, and 13 to receive placebo), the 56-day interval group (124 to receive Ad26.ZEBOV and MVA-BN-Filo, and 13 to receive placebo), and the 84-day interval group (117 to receive Ad26.ZEBOV and MVA-BN-Filo, and 18 to receive placebo), and 15 participants in cohort IV were assigned to receive Ad26.ZEBOV and MVA-BN-Filo (n=13) or to receive placebo (n=2). 421 (99·5%) participants received at least one dose of vaccine or placebo. The trial was temporarily suspended after two serious neurological adverse events were reported, one of which was considered as possibly related to vaccination, and per-protocol vaccination was disrupted for some participants. Vaccinations were generally well tolerated. Mild or moderate local adverse events (mostly pain) were reported after 206 (62%) of 332 Ad26.ZEBOV vaccinations, 136 (58%) of 236 MVA-BN-Filo vaccinations, and 11 (15%) of 72 placebo injections. Systemic adverse events were reported after 255 (77%) Ad26.ZEBOV vaccinations, 116 (49%) MVA-BN-Filo vaccinations, and 33 (46%) placebo injections, and included mostly mild or moderate fatigue, headache, or myalgia. Unsolicited adverse events occurred after 115 (35%) of 332 Ad26.ZEBOV vaccinations, 81 (34%) of 236 MVA-BN-Filo vaccinations, and 24 (33%) of 72 placebo injections. At 21 days after receiving the MVA-BN-Filo vaccine, geometric mean concentrations of Ebola virus glycoprotein-binding antibodies were 4627 ELISA units (EU)/mL (95% CI 3649-5867) in the 28-day interval group, 10 131 EU/mL (8554-11 999) in the 56-day interval group, and 11 312 mL (9072-14106) in the 84-day interval group, with antibody concentrations persisting at 1149-1205 EU/mL up to day 365. INTERPRETATION The two-dose heterologous regimen with Ad26.ZEBOV and MVA-BN-Filo was safe, well tolerated, and immunogenic, with humoral and cellular immune responses persisting for 1…

Online Journal of Public Health Informatics, 2018

ObjectiveDemonstrate the utility of a One Health collaboration during a leptospirosis outbreak to... more ObjectiveDemonstrate the utility of a One Health collaboration during a leptospirosis outbreak to expand outreach in human, environmental and animal health arenas.IntroductionThe One Health paradigm emphasizes cooperation and interdisciplinary collaboration to promote health and well-being among people, animals and the environment. Though the concept of One Health has been around since the 1800’s, the phrase “One Health” was more recently coined, and projects are being developed globally under its sponsorship. Maricopa County Department of Public Health (MCDPH) has been working at a local level to enhance its One Health surveillance efforts and partnerships. This One Health partnership, comprised of representatives from the Arizona Department of Agriculture (ADA), Arizona Department of Health Services (ADHS), Arizona Game and Fish Department (AzGFD), Arizona Veterinary Medicine Association (AzVMA), Centers for Disease Control & Prevention (CDC), MCDPH, Midwestern University (MWU) Ve...

mBio, 2019

Enteroviruses frequently result in respiratory and gastrointestinal illness; however, multiple su... more Enteroviruses frequently result in respiratory and gastrointestinal illness; however, multiple subtypes, including poliovirus, can cause severe neurologic disease. Recent biennial increases (i.e., 2014, 2016, and 2018) in cases of non-polio acute flaccid paralysis have led to speculations that other enteroviruses, specifically enterovirus D68 (EV-D68), are emerging to fill the niche that was left from poliovirus eradication. A cluster of 11 suspect cases of pediatric acute flaccid myelitis (AFM) was identified in 2016 in Phoenix, AZ. Multiple genomic analyses identified the presence of EV-D68 in the majority of clinical AFM cases. Beyond limited detection of herpesvirus, no other likely etiologies were found in the cluster. These findings strengthen the likelihood that EV-D68 is a cause of AFM and show that the rapid molecular assays developed for this study are useful for investigations of AFM and EV-D68.

MMWR. Morbidity and Mortality Weekly Report, 2017

MMWR. Morbidity and Mortality Weekly Report, 2015

Motor vehicle accidents are the leading cause of death among youths and young adults aged 16-25 y... more Motor vehicle accidents are the leading cause of death among youths and young adults aged 16-25 years in the United States (1). The prevalence of drinking and driving among high school students aged 16-19 years has declined by 54%, from 22.3% in 1991 to 10.3% in 2011 (2). However, the prevalence of weekend nighttime driving under the influence of marijuana (based on biochemical assays) among drivers aged ≥16 years has increased by 48%, from 8.6% in 2007 to 12.6% in 2013-2014 (3). Use of marijuana alone and in combination with alcohol has been shown to impair driving abilities (4-9). This report provides the most recent self-reported national estimates of driving under the influence of alcohol, marijuana, and alcohol and marijuana combined among persons aged 16-25 years, using data from the Substance Abuse and Mental Health Services Administration (SAMHSA) National Survey on Drug Use and Health (NSDUH) from 2002-2014. Prevalence data on driving under the influence of both substances were examined for two age groups (16-20 years and 21-25 years) and by sex and race/ethnicity. During 2002-2014, the prevalence of driving under the influence of alcohol alone significantly declined by 59% among persons aged 16-20 years (from 16.2% in 2002 to 6.6% in 2014; p<0.001) and 38% among persons 21-25 years (from 29.1% in 2002 to 18.1% in 2014; p<0.001). In addition, the prevalence of driving under the influence of alcohol and marijuana combined significantly declined by 39%, from 2.3% in 2002 to 1.4% in 2014 (p<0.001) among persons aged 16-20 years and from 3.1% in 2002 to 1.9% in 2014 (p<0.001) among persons aged 21-25 years. The prevalence of driving under the influence of marijuana alone declined 18%, from 3.8% in 2002 to 3.1% in 2014 (p = 0.05) only among persons aged 16-20 years. Effective public safety interventions,* such as minimum legal drinking age laws, prohibition of driving with any alcohol level >0 for persons aged <21 years, targeted mass media campaigns, roadside testing (e.g., sobriety checkpoints), and graduated driver licensing programs (10) have contributed to the decline in driving under the influence of alcohol in this population. These or similar interventions might be useful to prevent driving under the influence of other substances, such as marijuana alone or combined with other substances. NSDUH collects annual information about the use of illicit drugs, † alcohol, and tobacco among the noninstitutionalized U.S. civilian population aged ≥12 years via household face-to-face interviews, using a computer-assisted personal interviewing system. § Unweighted sample sizes for 2002-2014

© 2009 Wagner et al; licensee BioMed Central Ltd. This is an Open Access article distributed unde... more © 2009 Wagner et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License

Morbidity and Mortality Weekly Report, 2015

Skin infections are a common problem among athletes at all levels of competition; among wrestlers... more Skin infections are a common problem among athletes at all levels of competition; among wrestlers, 8.5% of all adverse events are caused by skin infections. Wrestlers are at risk because of the constant skin-to-skin contact required during practice and competition. The most common infections transmitted among high school wrestlers include fungal infections (e.g., ringworm), the viral infection herpes gladiatorum caused by herpes simplex virus-1 (HSV-1), and bacterial infections (e.g., impetigo) caused by Staphylococcus or Streptococcus species, including methicillin-resistant Staphylococcal aureus (MRSA). On February 7, 2014, the Maricopa County Department of Public Health was notified of multiple wrestlers who reported skin lesions 2 weeks after participating in a wrestling tournament at school A. The tournament was held on January 24-25 and included 168 wrestlers representing 24 schools. The county health department initiated an investigation to identify cases of skin lesion, dete...

Journal of the American Veterinary Medical Association, 2021

OBJECTIVE-To describe clinical, diagnostic, and epidemiological features of an outbreak of leptos... more OBJECTIVE-To describe clinical, diagnostic, and epidemiological features of an outbreak of leptospirosis in dogs in

Vector-Borne and Zoonotic Diseases, 2020

West Nile virus (WNV) and St. Louis encephalitis virus (SLEV) are closely related mosquitoborne f... more West Nile virus (WNV) and St. Louis encephalitis virus (SLEV) are closely related mosquitoborne flaviviruses that can cause neuroinvasive disease. No concurrent WNV and SLEV disease outbreaks have previously been identified. When concurrent outbreaks occurred in 2015 in Maricopa County, Arizona, we collected data to describe the epidemiology, and to compare

Pedagogy in Health Promotion, 2018

Rabies postexposure prophylaxis (PEP) is administered for rabies prevention after a human exposur... more Rabies postexposure prophylaxis (PEP) is administered for rabies prevention after a human exposure to a potentially rabid animal, such as a bite. Previous studies have reported that rabies PEP is often inappropriately administered. Health professional education was proposed as one potential solution to address inappropriate PEP use. We assessed baseline knowledge, knowledge gain, and knowledge retention among health professionals in Arizona of rabies epidemiology and appropriate PEP administration. Maricopa County Department of Public Health created an online rabies PEP continuing education module and measured knowledge before and after module completion using a 10-question test. The same test was administered three times (pretest, posttest, and retention test at ≥3 months). To assess knowledge gain and retention, we compared median scores using nonparametric methods. A total of 302 respondents completed the pretest (median score, 60%) and posttest (median score, 90%; p < .001); ...

Zoonoses and Public Health, 2019

Leptospirosis is a bacterial zoonosis that affects many mammals, including humans and dogs; dogs ... more Leptospirosis is a bacterial zoonosis that affects many mammals, including humans and dogs; dogs can transmit the bacteria to humans, but the frequency of transmission and highest risk exposures are poorly understood. During 2016-2017, the

Journal of Public Health Management and Practice, 2018

Objective: To generate estimates of the direct costs of mounting simultaneous emergency preparedn... more Objective: To generate estimates of the direct costs of mounting simultaneous emergency preparedness and response activities to respond to 3 major public health events. Design: A cost analysis was performed from the perspective of the public health department using real-time activity diaries and retrospective time and activity self-reporting, wage and fringe benefit data, and financial records to track costs. Setting: Maricopa County Department of Public Health (MCDPH) in Arizona. The nation's third largest local public health jurisdiction, MCDPH is the only local health agency serving Maricopa's more than 4 000 000 residents. Responses analyzed included activities related to a measles outbreak with 2 confirmed cases, enhanced surveillance activities surrounding Super

MMWR. Morbidity and Mortality Weekly Report, 2017

Open Forum Infectious Diseases, 2016

Transfusion, 2017

BACKGROUND-St. Louis encephalitis virus is a mosquito-borne flavivirus that infrequently causes e... more BACKGROUND-St. Louis encephalitis virus is a mosquito-borne flavivirus that infrequently causes epidemic central nervous system infections. In the United States, blood donors are not screened for St. Louis encephalitis virus infection, and transmission through blood transfusion has not been reported. During September 2015, St. Louis encephalitis virus infection was confirmed in an Arizona kidney transplant recipient. An investigation was initiated to determine the infection source. STUDY DESIGN AND METHODS-The patient was interviewed, and medical records were reviewed. To determine the likelihood of mosquito-borne infection, mosquito surveillance data collected at patient and blood donor residences in timeframes consistent with their possible exposure periods were reviewed. To investigate other routes of exposure, organ and blood donor and recipient specimens were obtained and tested for evidence of St. Louis encephalitis virus infection.

MMWR. Morbidity and mortality weekly report, May 26, 2017

MMWR. Morbidity and Mortality Weekly Report, 2015

On January 23, 2015, the Maricopa County Department of Public Health (MCDPH) was notified of a su... more On January 23, 2015, the Maricopa County Department of Public Health (MCDPH) was notified of a suspected measles case in a nurse, a woman aged 48 years. On January 11, the nurse had contact with a patient with laboratory-confirmed measles associated with the Disneyland theme park-related outbreak in California (1). On January 21, she developed a fever (103°F [39.4°C]), on January 23 she experienced cough and coryza, and on January 24, she developed a rash. The patient was instructed to isolate herself at home. On January 26, serum, a nasopharyngeal swab, and a urine specimen were collected. The following day, measles infection was diagnosed by real time reverse transcription polymerase chain reaction testing of the nasopharyngeal swab and urine specimen and by detection of measles-specific immunoglobulin (Ig)M and IgG in serum by enzyme-linked immunosorbent assay. Because of her symptoms and laboratory results, the patient was considered to be infectious. The case patient had documentation of receipt of 2 doses of measles-mumps-rubella (MMR) vaccine in 1991 and 1992. In 2006, the patient had received negative measles IgG serology test results; however, according to recommendations of the Advisory Committee on Immunization Practices, she was presumed to be immune because she had received two MMR doses (2). The presence of measles IgG (index standard ratio = 8.2, with ≥1.1 considered seropositive) 2 days after rash onset suggested secondary vaccine failure (waning of vaccine-induced immunity, rather than failure to develop an immune response to administered vaccine [i.e., primary vaccine failure]). Symptoms in these patients range from typical measles to a much milder, modified illness (3). Secondary measles vaccine failure is uncommon, and although measles transmission from such persons has been documented (4), it is not believed to contribute significantly to spread (5).

MMWR. Morbidity and mortality weekly report, Jan 29, 2015

Background: Based on evidence that healthcare worker (HCW) influenza vaccination decreases patien... more Background: Based on evidence that healthcare worker (HCW) influenza vaccination decreases patient morbidity and mortality due to influenza, we surveyed Maricopa County HCW attitudes and practices regarding influenza vaccination and working while ill during the 2010-2011 season. Methods: Maricopa County Department of Public Health, which serves 4 million residents, worked with a contractor in May and June, 2011 to develop and administer a standardized survey of Maricopa County HCWs ≥ 18 years of age. At least 3 contacts were made; 2 by phone and subsequent attempts were made by email, mail, or fax. A representative sample of 3 HCW groups; providers (MD, DO, NP, PA), nurses (RN, LPN, CNA), and technicians (RT, PT, OT, pharmacy) were interviewed primarily by phone. Chi-square tests were used for comparison of categorical variables. Results: A total of 1171 (405 providers, 402 nurses, and 364 technicians) eligible HCWs completed the survey. Of 1164 who answered the question, 714 (61.3%...

Background: During September 1315, 2011, hospital B reported 3 pertussis cases, including 2 confi... more Background: During September 1315, 2011, hospital B reported 3 pertussis cases, including 2 confirmed by Bordetella pertussis isolation among infants discharged <30 days previously from a 71-bed neonatal intensive care unit (NICU A). We investigated NICU A to determine the extent of the outbreak, factors contributing to health care-associated transmission, and outbreak costs. Methods: Case definition was a cough >14 days during July 28September 19 in a NICU-associated person. We observed NICU A practices and interviewed the parents of 35 hospitalized infants and 35 health care workers (HCW) furloughed for cough illness. Costs were calculated using HCW wages, time furloughed, the provision of vaccine, chemoprophylaxis and diagnostic testing, and NICU A labor costs. Results: We identified 15 case-patients; 5 infants (aged 115 weeks; 5 female), 10 HCWs (aged 3250 years; 6 female). The index patient was an infant aged 7 weeks (gestational age 28 weeks) who experienced apnea on Jul...