Publications by authors named "Kavin M Patel"

4 Publications

  • Page 1 of 1

Strategies to increase uptake of maternal pertussis vaccination.

Expert Rev Vaccines 2021 Jul 21:1-18. Epub 2021 Jul 21.

Department of Internal Medicine, Infectious Disease, Yale School of Medicine, New Haven, Connecticut, USA.

Introduction: Pertussis is a highly contagious respiratory disease that results in disproportionate morbidity and mortality in infants who have yet to receive the primary diphtheria-tetanus-pertussis vaccine series. In the preceding decades numerous countries began to pursue either prenatal vaccination of pregnant women or postpartum vaccination of caregivers to protect infants. Despite proven benefit, maternal uptake of pertussis vaccine continues to remain suboptimal.

Areas Covered: Many studies have been conducted to address the suboptimal uptake of maternal pertussis vaccination. This systematic review was undertaken to systematically identify those studies, highlight the most successful strategies and find the knowledge gaps that need to be filled over the coming years to improve vaccine uptake. Twenty-five studies were identified from six different databases.

Expert Opinion: Five different interventions were shown to be successful in promoting uptake of pertussis vaccination: (1) standing orders, (2) opt-in orders, (3) provider education, (4) on-site vaccination and (5) interactive patient education. Three major knowledge gaps were also identified that need to be filled over the coming years: (1) lack of studies in low- and middle-income countries, (2) lack of studies targeting midwives and/or home birth and (3) lack of studies on the process of vaccine communication.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/14760584.2021.1940146DOI Listing
July 2021

Babesiosis-associated Splenic Rupture: Case Series From a Hyperendemic Region.

Clin Infect Dis 2019 09;69(7):1212-1217

Department of Medicine, Rhode Island Hospital and Alpert Medical School of Brown University, Providence.

Background: Spontaneous splenic rupture is an increasingly reported complication of babesiosis and has been described as a severe complication.

Methods: We performed a retrospective chart review in a high-prevalence area to identify 7 cases of babesiosis-related splenic rupture between 2014 and 2016.

Results: Splenic rupture occurred in approximately 1% of babesiosis cases. Compared to cases without splenic rupture, these patients were younger (by >10 years), healthier (most with ≤1 comorbidity), had a lower degree of parasitemia (<10%), and were less likely to have end-organ dysfunction other than their splenic involvement.

Conclusions: Younger, healthier patients may be more prone to develop splenic rupture, as splenic histiocytes engage in more robust erythrophagocytosis, leading to pathological mechanical strain and rupture.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/cid/ciy1060DOI Listing
September 2019

Group A streptococcus acute otitis media progressing to neuroinvasive disease in adults.

IDCases 2018 23;12:161-164. Epub 2018 May 23.

Department of Infectious Disease, Rhode Island Hospital and Alpert Medical School of Brown, Providence, RI, United States.

Acute otitis media affects 700 million people each year with children being disproportionately affected relative to adults. Group A streptococcus is a pathogen implicated in a broad array of human pathology. It is, however, a rare cause of acute otitis media and neuroinvasive disease in older adults with only 2-3 cases occurring per year in the United States. We describe two such cases from a single institution in Rhode Island in 2017. The clinical presentation, neuroimaging and management are reviewed. The mechanism of intracranial spread may have involved dehiscence of the bony tegmen of the roof of the middle ear cavity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.idcr.2018.05.012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6011036PMC
May 2018

First confirmed case of Powassan neuroinvasive disease in Rhode Island.

IDCases 2018 23;12:84-87. Epub 2018 Mar 23.

Department of Infectious Disease, Rhode Island Hospital and Alpert Medical School of Brown University, United States.

The Powassan Virus is the arthropod-borne vector responsible for Powassan neuroinvasive disease. The virus was first isolated in 1958 and has been responsible for approximately 100 cases of neuroinvasive disease. Rates of infection have been on the rise over the past decade with numerous states reporting their first confirmed case; New Jersey, New Hampshire and Connecticut all reported their first case within the last five years. We present here the first confirmed case of Powassan neuroinvasive disease in the nearby state of Rhode Island. A previously healthy 81-year-old female with known tick exposure presented with fever, altered sensorium, seizures and focal neurological deficits. After an extensive work-up that was largely unrevealing Powassan encephalitis was suspected. The diagnosis was confirmed with serological testing consisting of Powassan IgM enzyme-linked immunosorbent assay and Powassan plaque reduction neutralization testing. The case study provides evidence for the increasing spread of Powassan neuroinvasive disease and reinforces the importance of requesting focused testing for Powassan Virus in patients from an endemic area with a clinically compatible syndrome.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.idcr.2018.03.016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6010959PMC
March 2018
-->