Elizabeth Beshearse

Centers for Disease Control and Prevention

Author Statistics

Papers

Citation

H-Index

i-10 index

Research Trends

Author Order

Document Type

Co-Authors

Allison C. Brown

National Center for Emerging and Zoonotic Infectious Diseases

Preeta K. Kutty

Centers for Disease Control and Prevention

Natalie J. Thornburg

Centers for Disease Control and Prevention

L. Clifford McDonald

Centers for Disease Control and Prevention

Lisa A. Mills

Eagle Mount

Megan M. Stumpf

University of Colorado Anschutz Medical Campus

Paige Gable

Centers for Disease Control and Prevention

Arie H. Havelaar

University of Florida

Jennifer L. Harcourt

Centers for Disease Control and Prevention

Alison Laufer Halpin

Centers for Disease Control and Prevention

Cooperative Institutions

Centers for Disease Control and Prevention

188

National Center for Emerging and Zoonotic Infectious Diseases

Epidemic Intelligence Service

National Center for Immunization and Respiratory Diseases

Emory University

CDC Foundation

Texas Department of State Health Services

Center for Surveillance, Epidemiology, and Laboratory Services

New York Proton Center

Waterborne Environmental (United States)

Author Statistics

Papers

Citation

H-Index

i-10 index

Research Field

Estimate of Burden and Direct Healthcare Cost of Infectious Waterborne Disease in the United States

Emerging infectious diseases (2020)

Sarah A. Collier Li Deng E. A. Adam Katharine M. Benedict Elizabeth Beshearse

Abstract Provision of safe drinking water in the United States is a great public health achievement. However, new waterborne disease challenges have emerged (e.g., aging infrastructure, chlorine-tolerant and biofilm-related pathogens, increased recreational water use). Comprehensive estimates of the health burden for all water exposure routes (ingestion, contact, inhalation) and sources (drinking, recreational, environmental) are needed. We estimated total illnesses, emergency department (ED) visits, hospitalizations, deaths, and direct healthcare costs for 17 waterborne infectious diseases. About 7.15 million waterborne illnesses occur annually (95% credible interval [CrI] 3.88 million–12.0 million), results in 601,000 ED visits (95% CrI 364,000–866,000), 118,000 hospitalizations (95% CrI 86,800–150,000), and 6,630 deaths (95% CrI 4,520–8,870) and incurring US $3.33 billion (95% CrI 1.37 billion–8.77 billion) in direct healthcare costs. Otitis externa and norovirus infection were the most common illnesses. Most hospitalizations and deaths were caused by biofilm-associated pathogens (nontuberculous mycobacteria, Pseudomonas, Legionella), costing US $2.39 billion annually.

Legionella

Waterborne diseases

10.3201/eid2701.190676

Cite

Citations (237)

Second Nationwide Tuberculosis Outbreak Caused by Bone Allografts Containing Live Cells — United States, 2023

MMWR Morbidity and Mortality Weekly Report (2024)

Jonathan M. Wortham Maryam B. Haddad Rebekah J. Stewart Pallavi Annambhotla Sridhar V. Basavaraju

During July 7-11, 2023, CDC received reports of two patients in different states with a tuberculosis (TB) diagnosis following spinal surgical procedures that used bone allografts containing live cells from the same deceased donor. An outbreak associated with a similar product manufactured by the same tissue establishment (i.e., manufacturer) occurred in 2021. Because of concern that these cases represented a second outbreak, CDC and the Food and Drug Administration worked with the tissue establishment to determine that this product was obtained from a donor different from the one implicated in the 2021 outbreak and learned that the bone allograft product was distributed to 13 health care facilities in seven states. Notifications to all seven states occurred on July 12. As of December 20, 2023, five of 36 surgical bone allograft recipients received laboratory-confirmed TB disease diagnoses; two patients died of TB. Whole-genome sequencing demonstrated close genetic relatedness between positive Mycobacterium tuberculosis cultures from surgical recipients and unused product. Although the bone product had tested negative by nucleic acid amplification testing before distribution, M. tuberculosis culture of unused product was not performed until after the outbreak was recognized. The public health response prevented up to 53 additional surgical procedures using allografts from that donor; additional measures to protect patients from tissue-transmitted M. tuberculosis are urgently needed.

10.15585/mmwr.mm725253a1

Cite

Citations (11)

Severe acute respiratory coronavirus virus 2 (SARS-CoV-2) outbreak investigation in a hospital emergency department—California, December 2020–January 2021

Infection Control and Hospital Epidemiology (2022)

Ruoran Li Elizabeth Beshearse Deborah E. Malden Holly Truong Vit Kraushaar

We describe a large outbreak of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) involving an acute-care hospital emergency department during December 2020 and January 2021, in which 27 healthcare personnel worked while infectious, resulting in multiple opportunities for SARS-CoV-2 transmission to patients and other healthcare personnel. We provide recommendations for improving infection prevention and control.

Coronavirus

Acute care

2019-20 coronavirus outbreak

10.1017/ice.2022.39

Cite

Citations (0)

Absence of SARS-CoV-2 infections among patients with end-stage renal disease following facility-wide testing in four outpatient hemodialysis facilities

American Journal of Infection Control (2021)

Wendy Wilson Ana C. Bardossy Paige Gable Carolyn Herzig Elizabeth Beshearse

Facility-wide testing performed at 4 outpatient hemodialysis facilities in the absence of an outbreak or escalating community incidence did not identify new SARS-CoV-2 infections and illustrated key logistical considerations essential to successful implementation of SARS-CoV-2 screening. Facilities could consider prioritizing facility-wide SARS-CoV-2 testing during suspicion of an outbreak in the facility or escalating community spread without robust infection control strategies in place. Being prepared to address operational considerations will enhance implementation of facility-wide testing in the outpatient dialysis setting.

Outpatient clinic

10.1016/j.ajic.2021.07.022

Cite

Citations (0)

Using the Classical Model for Source Attribution of Pathogen-Caused Illnesses

International series in management science/operations research/International series in operations research & management science (2021)

Elizabeth Beshearse Gabriela F. Nane Arie H. Havelaar

Expert elicitation

10.1007/978-3-030-46474-5_16

Cite

Citations (0)

Multistate Outbreak of Melioidosis Associated with Imported Aromatherapy Spray

New England Journal of Medicine (2022)

Jay E. Gee William A. Bower Amber Kunkel Julia K. Petras Jenna R. Gettings

Melioidosis, caused by the bacterium Burkholderia pseudomallei, is an uncommon infection that is typically associated with exposure to soil and water in tropical and subtropical environments. It is rarely diagnosed in the continental United States. Patients with melioidosis in the United States commonly report travel to regions where melioidosis is endemic. We report a cluster of four non-travel-associated cases of melioidosis in Georgia, Kansas, Minnesota, and Texas. These cases were caused by the same strain of B. pseudomallei that was linked to an aromatherapy spray product imported from a melioidosis-endemic area.

Melioidosis

Burkholderia pseudomallei

10.1056/nejmoa2116130

Cite

Citations (56)

Infectious Period of Severe Acute Respiratory Syndrome Coronavirus 2 in 17 Nursing Home Residents—Arkansas, June–August 2020

Open Forum Infectious Diseases (2021)

Diya Surie J. Huang Allison C. Brown Paige Gable Caitlin Biedron

Abstract Background To estimate the infectious period of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in older adults with underlying conditions, we assessed duration of coronavirus disease 2019 (COVID-19) symptoms, reverse-transcription polymerase chain reaction (RT-PCR) positivity, and culture positivity among nursing home residents. Methods We enrolled residents within 15 days of their first positive SARS-CoV-2 test (diagnosis) at an Arkansas facility from July 7 to 15, 2020 and instead them for 42 days. Every 3 days for 21 days and then weekly, we assessed COVID-19 symptoms, collected specimens (oropharyngeal, anterior nares, and saliva), and reviewed medical charts. Blood for serology was collected on days 0, 6, 12, 21, and 42. Infectivity was defined by positive culture. Duration of culture positivity was compared with duration of COVID-19 symptoms and RT-PCR positivity. Data were summarized using measures of central tendency, frequencies, and proportions. Results We enrolled 17 of 39 (44%) eligible residents. Median participant age was 82 years (range, 58–97 years). All had ≥3 underlying conditions. Median duration of RT-PCR positivity was 22 days (interquartile range [IQR], 8–31 days) from diagnosis; median duration of symptoms was 42 days (IQR, 28–49 days). Of 9 (53%) participants with any culture-positive specimens, 1 (11%) severely immunocompromised participant remained culture-positive 19 days from diagnosis; 8 of 9 (89%) were culture-positive ≤8 days from diagnosis. Seroconversion occurred in 12 of 12 (100%) surviving participants with ≥1 blood specimen; all participants were culture-negative before seroconversion. Conclusions Duration of infectivity was considerably shorter than duration of symptoms and RT-PCR positivity. Severe immunocompromise may prolong SARS-CoV-2 infectivity. Seroconversion indicated noninfectivity in this cohort.

Interquartile range

Seroconversion

10.1093/ofid/ofab048

Cite

Citations (12)

COVID-19 Case Investigations Among Federally Quarantined Evacuees From Wuhan, China, and Exposed Personnel at a US Military Base, United States, February 5-21, 2020

Public Health Reports (2021)

Meagan Chuey Rebekah J. Stewart Maroya Walters Emily J. Curren Susan L. Hills

In February 2020, during the early days of the COVID-19 pandemic, 232 evacuees from Wuhan, China, were placed under federal 14-day quarantine upon arrival at a US military base in San Diego, California. We describe the monitoring of evacuees and responders for symptoms of COVID-19, case and contact investigations, infection control procedures, and lessons learned to inform future quarantine protocols for evacuated people from a hot spot resulting from a novel pathogen. Thirteen (5.6%) evacuees had COVID-19-compatible symptoms and 2 (0.9%) had laboratory-confirmed SARS-CoV-2. Two case investigations identified 43 contacts; 3 (7.0%) contacts had symptoms but tested negative for SARS-CoV-2 infection. Daily symptom and temperature screening of evacuees and enacted infection control procedures resulted in rapid case identification and isolation and no detected secondary transmission among evacuees or responders. Lessons learned highlight the challenges associated with public health response to a novel pathogen and the evolution of mitigation strategies as knowledge of the pathogen evolves.

Pandemic

Isolation

2019-20 coronavirus outbreak

Disease Control

10.1177/00333549211063469

Cite

Citations (0)

Longitudinal serologic and viral testing post–SARS-CoV-2 infection and post-receipt of mRNA COVID-19 vaccine in a nursing home cohort—Georgia, October 2020‒April 2021

medRxiv (Cold Spring Harbor Laboratory) (2022)

Farrell Tobolowsky Michelle A. Waltenburg Erin D. Moritz Melia Haile Juliana DaSilva

Abstract Importance There are limited data describing SARS-CoV-2–specific immune responses and their durability following infection and vaccination in nursing home residents. Objective To evaluate the quantitative titers and durability of binding antibodies detected after SARS-CoV-2 infection and subsequent COVID-19 vaccination. Design A prospective longitudinal evaluation included nine visits over 150 days; visits included questionnaire administration, blood collection for serology, and paired anterior nasal specimen collection for testing by BinaxNOW™ COVID-19 Ag Card (BinaxNOW), reverse transcription polymerase chain reaction (RT-PCR), and viral culture. Setting A nursing home during and after a SARS-CoV-2 outbreak. Participants 11 consenting SARS-CoV-2–positive nursing home residents. Main Outcomes and Measures SARS-CoV-2 testing (BinaxNOW™, RT-PCR, viral culture); quantitative titers of binding SARS-CoV-2 antibodies post-infection and post-vaccination (beginning after the first dose of the primary series). Results Of 10 participants with post-infection serology results, 9 (90%) had detectable Pan-Ig, IgG, and IgA antibodies and 8 (80%) had detectable IgM antibodies. At first antibody detection post-infection, two-thirds (6/9, 67%) of participants were RT-PCR–positive but none were culture positive. Ten participants received vaccination; all had detectable Pan-Ig, IgG, and IgA antibodies through their final observation ≤90 days post-first dose. Post-vaccination geometric means of IgG titers were 10–200-fold higher than post-infection. Conclusions and Relevance Nursing home residents in this cohort mounted robust immune responses to SARS-CoV-2 post-infection and post-vaccination. The augmented antibody responses post-vaccination are potential indicators of enhanced protection that vaccination may confer on previously infected nursing home residents.

Antibody titer

10.1101/2021.12.28.21268458

Cite

Citations (0)

Comparison of outpatient antibiotic prescriptions among older adults in IQVIA Xponent and publicly available Medicare Part D data, 2018

Antimicrobial Stewardship & Healthcare Epidemiology (2023)

Elizabeth Beshearse Katryna A Gouin Katherine E. Fleming‐Dutra Sharon Tsay Lauri A. Hicks

Abstract The distributions of antibiotic prescriptions by geography, antibiotic class, and prescriber specialty are similar in the US Centers for Medicare and Medicaid Services (CMS) Part D Prescriber Public Use Files and IQVIA Xponent dataset. Public health organizations and healthcare systems can use these data to track antibiotic use and guide antibiotic stewardship interventions for older adults.

Specialty

Antimicrobial Stewardship

Antibiotic Stewardship

10.1017/ash.2022.332

Cite

Citations (0)