Chas DeBolt's research while affiliated with Washington State Department of Health and other places

Publications (13)

Article
Background and objectives: Between December 31, 2018, and April 26, 2019, 72 confirmed cases of measles were identified in Clark County. Our objective was to estimate the economic burden of the measles outbreak from a societal perspective, including public health response costs as well as direct medical costs and productivity losses of affected in...
Article
Between July 2018 and May 2019, Corynebacterium diphtheriae was isolated from eight patients with non-respiratory infections, seven of whom experienced homelessness and had stayed at shelters in King County, WA, USA. All isolates were microbiologically identified as nontoxigenic C. diphtheriae biovar mitis. Whole-genome sequencing confirmed that al...
Preprint
Full-text available
In 2016/2017, Washington State experienced a mumps outbreak despite high childhood vaccination rates, with cases more frequently detected among school-aged children and members of the Marshallese community. Sequencing 166 mumps genomes revealed that mumps was introduced into Washington approximately 13 times, primarily from Arkansas, sparking multi...
Article
Full-text available
Importance Human prion disease surveillance is critical to detect possible cases of variant Creutzfeldt-Jakob disease and other acquired forms of prion disease in the United States. Results are presented here that describe 12 years of surveillance in Washington, the only US state that has reported the presence of classic bovine spongiform encephalo...
Article
Full-text available
Meningococcal disease is a sudden-onset, life-threatening illness caused by the bacterium Neisseria meningitidis. Prompt empiric antibiotic treatment can reduce morbidity and mortality among patients, and antibiotic prophylaxis can prevent secondary disease in close contacts. Historically, N. meningitidis isolates in the United States have largely...
Article
Full-text available
We describe the contact investigation for an early confirmed case of coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in the United States. Contacts of the case-patient were identified, actively monitored for symptoms, interviewed for a detailed exposure history, and tested for SARS-CoV-2 infec...
Article
An outbreak of novel coronavirus (2019-nCoV) that began in Wuhan, China, has spread rapidly, with cases now confirmed in multiple countries. We report the first case of 2019-nCoV infection confirmed in the United States and describe the identification, diagnosis, clinical course, and management of the case, including the patient's initial mild symp...
Article
These articles present the current measles outbreaks in the United States, something that could seriously affect nonimmune transplant recipients.
Article
Full-text available
From September 2015 to March 2018, CDC confirmed four cases of cutaneous diphtheria caused by toxin-producing Corynebacterium diphtheriae in patients from Minnesota (two), Washington (one), and New Mexico (one). All patients had recently returned to the United States after travel to countries where diphtheria is endemic. C. diphtheriae infection wa...
Article
Context: During January 2016 to June 2017, US health departments (HDs) reported 150 mumps outbreaks. Most occurred among populations with high 2-dose measles, mumps, and rubella (MMR) vaccine coverage, prompting the Advisory Committee on Immunization Practices to examine the evidence for use of a third dose of MMR vaccine. Objective: To evaluate...
Article
Objectives: To estimate costs of labor and materials by the University of Washington (UW) and state and local public health departments (PHDs) to respond to the February to June 2017 UW mumps outbreak, where 42 cases were identified among students (primarily sorority and fraternity members), staff, and associated community members. Design: We ap...
Article
Full-text available
In late September 2016, the Americas became the first region in the world to have eliminated endemic transmission of measles virus. Several other countries have also verified measles elimination, and countries in all six World Health Organization regions have adopted measles elimination goals. The public health strategies used to respond to measles...

Citations

... Moreover, vaccination rates in Clark County have been 10%-14% below the national average (88%) since 2013. The measles outbreak in 2019 was estimated to cost US $3.3 million to $3.5 million in labor, direct medical costs, and productivity losses [48]. It is likely that the cost of the Clark County measles outbreak could have been mitigated or reduced with adequate vaccination [47]. ...
... Recently, the epidemiological situation of C. diphtheriae infections has changed, and increasing numbers of infections caused by C. diphtheriae strains that do not produce diphtheria toxin (non-toxigenic strains) have been recorded in some countries with high anti-diphtheria vaccination coverage. A significant percentage of these cases have covered invasive infections, including bacteremia, sepsis and endocarditis [2,51,[54][55][56][57]. Invasive non-toxigenic C. diphtheriae infections are related to a high mortality rate, reaching over 40%. ...
... There was a case reported in which CIP was administered for IMD close contacts before antibiotic susceptibility result was available, but CIP resistance was later confirmed and the patient was switched to the remaining agents in the chemoprophylaxis recommendation (Kawasaki et al., 2018). The hot-spot region of the gyrA in CIPresistant meningococci is codon 91 in the quinolone resistancedetermining region (QRDR), (Alcala et al., 2004;Singhal et al., 2007;Enriquez et al., 2008;Strahilevitz et al., 2008;Wu et al., 2009;Du Plessis et al., 2010;Hong et al., 2013;Chen et al., 2015;Bukovski et al., 2016;Tsang et al., 2017;Gorla et al., 2018;Kawasaki et al., 2018;Chen et al., 2020;McNamara et al., 2020;Zhao et al., 2020), thus a rapid and accurate diagnostic tool to detect such mutations is needed for maintaining efficacious treatment for close contacts of IMD in clinical microbiology laboratories. ...
... This finding is similar to findings from early contact investigations in Europe and Asia [14][15][16][17], but in contrast to other data suggesting a much higher secondary attack rate [18]. It is possible that asymptomatic secondary cases could have developed in persons from whom respiratory samples were not collected [19,20], or that secondary cases could have developed without being detected in respiratory samples (for instance, if the timing of shedding did not align with the timing of sample collection) [12]; follow-up serology could help to rule out some of these possibilities [21]. The low number of secondary cases could also be related to the quick isolation of most of these travel-associated case patients, as found in studies of MERS-CoV [22,23]. ...
... Remdesivir is a broad-spectrum antiviral drug with antiviral efficacy in vitro against SARS-CoV-2 by inhibiting viral replication ). According to Holshue et al. (2020), the first instance in the USA (reported in Washington State) was treated with an intravenous injection of remdesivir, which alleviated symptoms and had no adverse effects. In randomized controlled clinical studies, remdesivir was shown to be superior to placebo in decreasing the time to recovery in patients hospitalized with mild-to-severe COVID-19 infection (Beigel et al. 2020;Goldman et al. 2020). ...
... There are multiple recent outbreaks of measles around the world. Since 2017, the number of measles cases increased 300% in the first 3 months of 2019 and multiple outbreaks in the United States [78][79][80][81]. There were reports of the occurrence of measles outbreak in relation to mass gathering events such as an international youth sporting event in USA resulting in cases in eight states [23], and the occurrence of measles among attendees of a church gathering and in the 2010 Taizé festival in France [21,22]. ...
... Measles vaccine coverage in the US is high: 90.8% of children received at least one measles, mumps, and rubella (MMR) vaccine by 24 months old [1]. Due to high vaccine coverage [2,3], in 2000, the World Health Organization (WHO) declared measles eliminated from the United States (US) [4]. ...
... Because of high population coverage with diphtheria toxoid-containing vaccines, few diphtheria cases are reported in the United States. The most recently reported toxigenic infections were cutaneous and associated with international travel (1)(2)(3)(4). ...
... Breakthrough infections among previously immunized people are a common problem in countries with high vaccination coverage; moreover, measles elimination has been sustained over several decades and appears to occur when vaccinated groups are not exposed to measles, which might induce natural boosting [11][12][13][14]. While implementing ORI activities in highly vaccinated populations with low measles incidences, targeted campaigns could be of greater benefit [15,16] and differentiating primary or secondary vaccine failure is important for strategies to control measles in settings in which the disease has been eliminated [17]. The aim of this study was to investigate the changes in and correlations between neutralizing antibody titers and avidity over time after ORI among three populations, specifically those with natural infection, those seropositive after being vaccinated with two doses of the measles-mumps-rubella (MMR) vaccine, and those who were seronegative after two doses of the vaccine. ...