Publications

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bacterial meningitis. 19674397887
field evaluation of thayer-martin medium for identification of meningococcus carriers. 19654955062
evaluation of group c meningococcal polysaccharide vaccine in marine recruits, san diego, california. 19704987716
evaluation of pulsed-field gel electrophoresis in epidemiological investigations of meningococcal disease outbreaks caused by neisseria meningitidis serogroup c.since 1990, the frequency of neisseria meningitidis serogroup c (nmsc) outbreaks in the united states has increased. based on multilocus enzyme electrophoresis (mee), the current molecular subtyping standard, most of the nmsc outbreaks have been caused by isolates of several closely related electrophoretic types (ets) within the et-37 complex. we chose 66 isolates from four well-described nmsc outbreaks that occurred in the united states from 1993 to 1995 to evaluate the potential of pulsed-fiel ...200111136752
disease reporting from an automated laboratory-based reporting system to a state health department via local county health departments.the authors assessed the completeness of disease reporting from a managed care organization's automated laboratory-based reporting system to the california department of health services (cdhs) via local public health departments.200112034915
prevalence of factor h-binding protein variants and nada among meningococcal group b isolates from the united states: implications for the development of a multicomponent group b vaccine.two promising recombinant meningococcal protein vaccines are in development. one contains factor h-binding protein (fhbp) variants (v.) 1 and 2, whereas the other contains v.1 and 4 other antigens discovered by genome mining (5 component [5c]). antibodies against fhbp are bactericidal against strains within a variant group. there are limited data on the prevalence of strains expressing different fhbp variants in the united states.200717436227
increased detection of meningococcal infections in california using a polymerase chain reaction assay. 200818444836
emergence of ciprofloxacin-resistant neisseria meningitidis in north america.we report on three cases of meningococcal disease caused by ciprofloxacin-resistant neisseria meningitidis, one in north dakota and two in minnesota. the cases were caused by the same serogroup b strain. to assess local carriage of resistant n. meningitidis, we conducted a pharyngeal-carriage survey and isolated the resistant strain from one asymptomatic carrier. sequencing of the gene encoding subunit a of dna gyrase (gyra) revealed a mutation associated with fluoroquinolone resistance and sugg ...200919246360
surveillance for invasive meningococcal disease in children, us-mexico border, 2005-2008.we reviewed confirmed cases of pediatric invasive meningococcal disease in tijuana, mexico, and san diego county, california, usa, during 2005-2008. the overall incidence and fatality rate observed in tijuana were similar to those found in the us, and serogroup distribution suggests that most cases in tijuana are vaccine preventable.201121392455
meningitis admitted to a military hospital: a retrospective case series.meningitis is a common admission diagnosis. no case series or descriptive studies on meningitis have recently been published. additionally, no recent data exist on meningitis in the u.s. military health system. we reviewed charts of adult patients admitted to naval medical center san diego between january 2004 and december 2008 with an admission diagnosis of meningitis. charts were excluded if they did not meet our case definition of meningitis, if missing data, or if meningitis was nosocomial o ...201223113452
occupational transmission of neisseria meningitidis --- california, 2009.neisseria meningitidis is a leading cause of bacterial meningitis and sepsis . the case-fatality rate for meningococcal disease is 10%--14%; survivors can experience brain damage, hearing loss, limb loss, and learning disabilities . on december 11, 2009, the california department of public health (cdph) initiated an investigation of two secondary cases of meningococcal disease in a police officer and a respiratory therapist following occupational contact with an unconscious adult. this report de ...201021085089
rapid identification and strain-typing of respiratory pathogens for epidemic surveillance.epidemic respiratory infections are responsible for extensive morbidity and mortality within both military and civilian populations. we describe a high-throughput method to simultaneously identify and genotype species of bacteria from complex mixtures in respiratory samples. the process uses electrospray ionization mass spectrometry and base composition analysis of pcr amplification products from highly conserved genomic regions to identify and determine the relative quantity of pathogenic bacte ...200515911764
meningococcal disease in los angeles county, california, and among men in the county jails.from january through march 1993, there were 54 cases of meningococcal disease in los angeles county, california, of which 9 occurred among men incarcerated in the county's jail system, which was 40 percent above capacity at the time. several of the 45 patients from the community had had contact with men recently released from a county jail.19968778600
human immunity to the meningococcus. i. the role of humoral antibodies.susceptibility to systemic meningococcal disease is related to a selective deficiency of humoral antibodies to pathogenic strains of meningococci. in a study of the age-specific incidence of meningococcal meningitis in the united states, it was found that the proportion of individuals with serum bactericidal activity to meningococci of serogroups a, b, and c was reciprocally related to the incidence of disease. the prevalence of bactericidal activity was highest at birth and among adults, and lo ...19694977280
meningococcal infections.in los angeles, a substantial increase in the number of infections due to neisseria meningitidis has been noted. more alarming has been an associated mortality rate of 21%. the prompt recognition of meningococcal disease based on a high index of suspicion and the early institution of effective antibiotic treatment are essential for preventing complications and reducing mortality.19892735025
risk factors associated with a school-related outbreak of serogroup c meningococcal disease.an outbreak of neisseria meningitidis sero-group c disease occurred in four eighth grade students and in a younger sibling of another eighth grade student attending an intermediate school (seventh and eighth grades) in santa clara county, ca. four cases had onset within 3 days in january, 1989, with the fifth case occurring approximately 10 days later. a case-control study was performed to determine risk factors associated with serogroup c meningococcal infection (disease or carriage) in this ei ...19902114607
laboratory-acquired meningococcemia--california and massachusetts.although neisseria meningitidis is commonly isolated in clinical laboratories, laboratory-acquired infection is rare (1). this report describes two fatal cases of meningococcal infection in laboratory workers; both of these cases probably were laboratory acquired.19911898759
fatal meningococcal disease in a laboratory worker--california, 2012.occupationally acquired meningococcal disease is rare. adherence to recommendations for safe handling of neisseria meningitidis in the laboratory greatly reduces the risk for transmission to laboratory workers. a california microbiologist developed fatal serogroup b meningococcal disease after working with n. meningitidis patient isolates in a research laboratory (laboratory a). the california department of public health (cdph), the local health department, the california division of occupationa ...201425188495
notes from the field: outbreak of serogroup b meningococcal disease at a university - california, 2016.on january 31, 2016, the santa clara county public health department (sccphd) was notified of a suspected case of meningococcal disease in a university undergraduate student. by february 2, two additional suspected cases had been reported in undergraduate students living on the same campus. the index patient (patient a) required intensive care, whereas patients b and c had milder illness; there were no deaths. all three patients were part of overlapping social networks and had attended the same ...201627227576
outbreak of serogroup c meningococcal disease primarily affecting men who have sex with men - southern california, 2016.during march 4-august 11, 2016, 25 outbreak-associated cases of meningococcal disease, including two deaths (8% case-fatality ratio), were reported in southern california. twenty-four of the cases were caused by serogroup c neisseria meningitidis (nmc) and one by n. meningitidis with an undetermined serogroup (figure). on june 24, 2016, in response to this increase in nmc cases, primarily among men who have sex with men (msm) in los angeles county, the city of long beach, and orange county, the ...201627606798
laboratory-acquired lethal infections by potential bioweapons pathogens including ebola in 2014.researchers studying both cellular and viral disease agents in the laboratory have become infected since the early days of microbiology 150 years ago. however, in the early 21st century, new concerns about bioweapons being used to generate terror and also with a series of newly emerging or newly understood disease-causing microbes have resulted in infections and deaths of workers studying these microbes in the laboratory, generally to gain understanding and to develop treatments and vaccines. he ...201525790490
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