Harold S. Margolis's research while affiliated with Centers for Disease Control and Prevention and other places
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Publications (266)
The incidence and spread of dengue virus (DENV) have increased rapidly in recent decades. Dengue is underreported in Africa, but recent outbreaks and seroprevalence data suggest that DENV is widespread there. A lack of ongoing surveillance limits knowledge about its spatial reach and hinders disease control planning. We sought to add data on dengue...
A wide range of research has promised new tools for forecasting infectious disease dynamics, but little of that research is currently being applied in practice, because tools do not address key public health needs, do not produce probabilistic forecasts, have not been evaluated on external data, or do not provide sufficient forecast skill to be use...
Dengue was first reported in Puerto Rico in 1899 and sporadically thereafter. Following outbreaks in 1963 and 1969, the Centers for Disease Control and Prevention has worked closely with the Puerto Rico Department of Health to monitor and reduce the public health burden of dengue. During that time, evolving epidemiologic scenarios have provided opp...
Background:
Public health responses to outbreaks of dengue, chikungunya, and Zika virus have been stymied by the inability to control the primary vector, Aedes aegypti mosquitos. Consequently, the need for novel approaches to Aedes vector control is urgent. Placement of three autocidal gravid ovitraps (AGO traps) in ~85% of homes in a community wa...
Supplementary material.
(DOCX)
Dengue is a mosquito-borne viral illness that causes a variety of health outcomes, from a mild acute febrile illness to potentially fatal severe dengue. Between 2005 and 2010, the annual number of suspected dengue cases reported to the Passive Dengue Surveillance System (PDSS) in Puerto Rico ranged from 2,346 in 2006 to 22,496 in 2010. Like other p...
Dengue is one of the most important mosquito-borne diseases in tropical and subtropical regions of the world. Laboratory diagnosis is often expensive or unavailable in some endemic areas, making clinical diagnosis important for case management. In order to develop and validate the Mahidol dengue clinical score (MDCS), a predictive of dengue among c...
Identifying etiologies of acute febrile illnesses (AFI) is challenging due to non-specific presentation and limited availability of diagnostics. Prospective AFI studies provide a methodology to describe the syndrome by age and etiology, findings that can be used to develop case definitions and multiplexed diagnostics to optimize management. We cond...
Purpose of Review
By all measures, the morbidity and mortality due to dengue are continuing to worsen worldwide. Although both early and recent studies have demonstrated regional differences in how dengue affects local populations, these findings were to varying extents related to disparate surveillance approaches.
Recent Findings
Recent studies h...
After chikungunya virus (CHIKV) transmission was detected in Puerto Rico in May 2014, multiple surveillance systems were used to describe epidemiologic trends and CHIKV-associated disease. Of 28 327 cases reported via passive surveillance, 6472 were tested for evidence of CHIKV infection, and results for 4399 (68%) were positive. Of 250 participant...
ICD-9 codes used to review death certificates and medical records to identify individuals that died following a dengue-like acute febrile illness.
(PDF)
Background
Dengue is a leading cause of morbidity throughout the tropics; however, accurate population-based estimates of mortality rates are not available.
Methods/Principal Findings
We established the Enhanced Fatal Acute Febrile Illness Surveillance System (EFASS) to estimate dengue mortality rates in Puerto Rico. Healthcare professionals submi...
Surgical Pathology and Autopsy Report (SPAR) Form used by forensic pathologists to document autopsy findings from individuals that died following a dengue-like acute febrile illness.
(PDF)
STROBE Checklist.
(DOCX)
Background:
International travel can expose travellers to pathogens not commonly found in their countries of residence, like dengue virus. Travellers and the clinicians who advise and treat them have unique needs for understanding the geographic extent of risk for dengue. Specifically, they should assess the need for prevention measures before tra...
Background
Prior to 2010, the clinical management of dengue in Puerto Rico was shown to be inconsistent with World Health Organization guidelines. A four-hour classroom-style course on dengue clinical management was developed in 2009 and mandated in 2010 for Puerto Rico medical licensure. Fifty physicians were trained as ‘master trainers’ and gave...
Dengue is major public health problem, globally. Timely verification of suspected dengue outbreaks allows for public health
response leading to initiation of appropriate clinical care. Because the clinical presentation of dengue is non-specific,
dengue diagnosis would benefit from a sensitive rapid diagnostic test (RDT). We evaluated the diagnostic...
Background:
IgM anti-dengue virus (DENV) seroconversion has been the reference standard for dengue diagnosis. However, paired specimens are rarely obtained and the time interval for this testing negates its utility in guiding clinical case management. Presence of DENV viremia and appearance of IgM during the febrile phase of dengue provides the fr...
Dengue, a mosquito-borne viral illness caused by dengue virus types (DENV)-1 to DENV-4, is endemic in Puerto Rico. Severe dengue usually occurs in individuals previously infected with DENV or among infants born to previously infected mothers. To describe clinical features of dengue in infants, we retrospectively characterized dengue patients aged <...
During the 2013 dengue epidemic in Luanda, Angola, 811 dengue rapid diagnostic test-positive cases were reported to the Ministry of Health. To better understand the magnitude of the epidemic and identify risk factors for dengue virus (DENV) infection, we conducted cluster surveys around households of case-patients and randomly selected households 6...
Dengue appears to be endemic in Africa with a number of reported outbreaks. In February 2013, several individuals with dengue-like illnesses and negative malaria blood smears were identified in Mombasa, Kenya. Dengue was laboratory confirmed and an investigation was conducted to estimate the magnitude of local transmission including a serologic sur...
Chikungunya and dengue are mosquito-borne, viral, acute febrile illnesses that can be difficult to distinguish clinically. Whereas dengue is endemic in many countries in the Caribbean and the Americas, the first locally acquired chikungunya case in the Western Hemisphere was reported from the Caribbean island of St. Martin in December 2013 and was...
Autochthonous dengue virus transmission has occurred in the continental United States with increased frequency during the last decade; the principal vector, Aedes aegypti, has expanded its geographic distribution in the southern United States. Dengue, a potentially fatal arboviral disease, is underreported, and US clinicians encountering patients w...
Background:
Dengue has been endemic in Puerto Rico for four decades, but little is known about other acute febrile illnesses (AFI) on the differential diagnosis of dengue. To study this, an AFI surveillance study was implemented at a Sentinel Enhanced Dengue Surveillance Site consisting of a teaching hospital and a small rural hospital in Puerto...
An expert conference on Dengue in Africa was held in Accra, Ghana, in February 2013 to consider key questions regarding the possible expansion of dengue in Africa. Four key action points were highlighted to advance our understanding of the epidemiology of dengue in Africa. First, dengue diagnostic tools must be made more widely available in the hea...
Author Summary
Dengue is the most common mosquito-borne viral disease in the world, and caused an estimated 390 million infections and 96 million cases in the tropics and subtropics in 2010. Over the last decade, the number of cases of dengue and the severity of dengue virus infections have increased in the Americas, including the Caribbean, yet li...
Commercially available diagnostic test kits for detection of dengue virus (DENV) non-structural protein 1 (NS1) and anti-DENV IgM were evaluated for their sensitivity and specificity and other performance characteristics by a diagnostic laboratory network developed by World Health Organization (WHO), the UNICEF/UNDP/World Bank/WHO Special Programme...
Brief Summary:
Dengue is a potentially fatal acute febrile illness that is increasingly being detected in travelers returning from the tropics to the United States. The incidence of dengue in the Americas has increased roughly 30-fold in the past three decades, and dengue is the most common cause of fever in travelers returning from South-central...
Of 53,633 suspected dengue cases reported to a passive dengue surveillance system in Puerto Rico during 2005-2010, 949 individuals were reported on more than one occasion and 21 had laboratory-confirmed dengue on two separate occasions. Median time between episodes was 2.9 years (range: 62 days-5.3 years). Seventeen (81%) individuals with sequentia...
Dengue is the most significant arthropod-borne viral infection of humans. Persons infected with dengue viruses (DENV) have subclinical or clinically apparent infections ranging from undifferentiated fever to dengue hemorrhagic fever/shock syndrome. Although recent studies estimated that the Indian subcontinent has the greatest burden of DENV infect...
An expert conference on Dengue in Africa was held in Accra, Ghana, in February 2013 to consider key questions regarding the possible expansion of dengue in Africa. Four key action points were highlighted to advance our understanding of the epidemiology of dengue in Africa. First, dengue diagnostic tools must be made more widely available in the hea...
Hemophagocytic lymphohistiocytosis (HLH) is a rare, potentially fatal hematologic syndrome characterized by hyperinflammation due to uncontrolled proliferation of activated lymphocytes, resulting in prolonged fever, pancytopenia, jaundice, and hepatosplenomegaly. While infection with Epstein Barr virus (EBV) is the most common recognized cause of i...
Checklist prepared to indicate the specific page in which each part of the study can be found in this manuscript.
(DOCX)
Performance of the CDC DENV-1–4 Real Time RT-PCR Assay using different viral RNA extraction methods. Viral RNA from serial dilutions of stock quantitated DENV-1–4 was extracted using several viral RNA extraction kits. The lowest virus titer detected is indicated in genome copy equivalents per mL (GCE/mL).
(DOCX)
Two flowcharts were created to indicate the diagnostic algorithm used in the Retrospective and Prospective studies in which the performance of the CDC DENV-1–4 Real Time RT-PCR Assay was evaluated.
(PDF)
DENV E gene amplification and sequencing primers. List of all primer sequences used for E gene amplification and sequencing. Corresponding serotype, specific primer function and final concentration per reaction are indicated. Every primer is labeled with serotype and genome position. Reverse primers are labeled (cD).
(DOCX)
Assay performance in fresh vs. frozen samples. Moderate (black circle) and low (black square) positive concentrations of laboratory-adapted DENV strains diluted in serum were frozen at −80°C for 24 hrs and subject to five consecutive freeze/thaw cycles. Detection measurements are shown in CT values and error bars indicate standard deviation. Dashed...
Dengue is an acute illness caused by the positive-strand RNA dengue virus (DENV). There are four genetically distinct DENVs (DENV-1-4) that cause disease in tropical and subtropical countries. Most patients are viremic when they present with symptoms; therefore, RT-PCR has been increasingly used in dengue diagnosis. The CDC DENV-1-4 RT-PCR Assay ha...
STROBE checklist.
(DOC)
Dengue is the most important vector-borne viral disease worldwide and a major cause of childhood fever burden in Sri Lanka, which has experienced a number of large epidemics in the past decade. Despite this, data on the burden and transmission of dengue virus in the Indian Subcontinent are lacking. As part of a longitudinal fever surveillance study...
Neglected tropical diseases (NTDs) have
been recently identified as significant public
health problems in Texas and elsewhere in
the American South. A one-day forum on the
landscape of research and development and
the hidden burden of NTDs in Texas
explored the next steps to coordinate advocacy,
public health, and research into a
cogent health poli...
Summary of epidemiologic data from previous dengue epidemics in Puerto Rico.
(DOCX)
Flow diagram of data sources, diagnostic test results, and sub-analyses of suspected dengue cases, Puerto Rico, 2010. A: Data sources and diagnostic test results. B: Sub-analyses using RT-PCR-positive specimens. PDSS = Passive Dengue Surveillance System; PrivLab = private diagnostic laboratories; NDSS = National Disease Surveillance System; EDSS =...
Objective
To enhance arboviral surveillance and laboratory capacity to establish a surveillance baseline for the emerging threat of Dengue fever in the Arizona-Mexico border region.
Introduction
West Nile Virus (WNV) and dengue virus (DENV) are both arboviruses which are transmitted to humans by an infected mosquito bite during blood-meal feeding....
Dengue is a potentially fatal acute febrile illness (AFI) caused by four mosquito-transmitted dengue viruses (DENV-1-4) that are endemic in Puerto Rico. In January 2010, the number of suspected dengue cases reported to the passive dengue surveillance system exceeded the epidemic threshold and an epidemic was declared soon after.
To characterize the...
Sequencing of dengue virus type 1 (DENV-1) strains isolated in Key West/Monroe County, Florida, indicate endemic transmission for >2 years of a distinct and predominant sublineage of the American-African genotype. DENV-1 strains isolated elsewhere in Florida grouped within a separate Central American lineage. Findings indicate endemic transmission...
Table showing the dengue virus type 1 (DENV-1) envelope gene reverse transcription PCR and another showing DENV-1 strains used in a study of the genetic relatedness of dengue viruses in Key West, Florida, USA, 2009–2010.
Dengue is endemic in the U.S. Virgin Islands, but no outbreaks have been reported since 2005. In November 2012, a school nurse in St. Croix reported suspected dengue in 27 (7%) of 369 students and staff members to the Virgin Islands Department of Health (VIDOH) and the CDC Dengue Branch in Puerto Rico. Four of 12 patient specimens sent to the CDC D...
There is an urgent need to field test dengue vaccines to determine their role in the control of the disease. Our aims were to study dengue epidemiology and prepare the site for a dengue vaccine efficacy trial.
We performed a prospective cohort study of children in primary schools in central Thailand from 2006 through 2009. We assessed the epidemiol...
The number of cases and severity of disease associated with dengue infection in Sri Lanka has been increasing since 1989, when the first epidemic of dengue hemorrhagic fever was recorded. We identified a new dengue virus 1 strain circulating in Sri Lanka that coincided with the 2009 dengue epidemic.
Reported incidence of dengue has increased worldwide in recent decades, but little is known about its incidence in Africa. During 1960-2010, a total of 22 countries in Africa reported sporadic cases or outbreaks of dengue; 12 other countries in Africa reported dengue only in travelers. The presence of disease and high prevalence of antibody to deng...
Robust disease burden estimates are important for decision-making concerning introduction of new vaccines. Dengue is a major public health problem in the tropics but robust disease burden estimates are lacking. We conducted a two-sample, capture-recapture study in the largest province in Cambodia to determine disease under-recognition to the Nation...
Dengue vaccines are currently in development and policymakers need appropriate economic studies to determine their potential financial and public health impact. We searched five databases (PubMed, EMBASE, LILAC, EconLit, and WHOLIS) to identify health economics studies of dengue. Forty-three manuscripts were identified that provided primary data: 3...
Richard Mahoney and colleagues summarize two recent meetings convened by the Pediatric Dengue Vaccine Initiative and the Developing Countries' Vaccine Regulators Network on regulatory issues that need to be addressed before licensing dengue vaccines.
We acknowledge the comments by N. Miller ( 1) on our estimates of the potential dengue vaccine demand among international travelers. ( 2) We agree that the number of travelers in 2015-20 would be the appropriate baseline from which to generate vaccine demand for this group and would be comparable to what we used for dengue endemic countries. While...
A dengue vaccine is likely to be available within the next 3-5 years and we estimated vaccine doses needed for dengue endemic countries (public and private markets) and non-endemic countries (travelers market) in the first 5 years after initial licensure. Calculations were based on 2015-2020 population projections for Asian and Americas endemic cou...
Dengue is an arthropod-borne flavivirus that comprises four distinct serotypes (DEN-1, DEN-2, DEN-3 and DEN-4) that constitute an antigenic complex of the genus flavivirus, family Flaviviridae. Infection by one serotype induces life-long immunity against reinfection by the same serotype, but only transient and partial protection against infection w...
Dengue fever and dengue haemorrhagic fever are important arthropod-borne viral diseases. Each year, there are ∼50 million dengue infections and ∼500,000 individuals are hospitalized with dengue haemorrhagic fever, mainly in Southeast Asia, the Pacific and the Americas. Illness is produced by any of the four dengue virus serotypes. A global strategy...
BACKGROUND: Dengue vaccines are now in late-stage development, and evaluation and robust estimates of dengue disease burden are needed to facilitate further development and introduction. In Cambodia, the national dengue case-definition only allows reporting of children less than 16 years of age, and little is known about dengue burden in rural area...
STROBE Checklist
(0.09 MB DOC)
