A high proportion of positive results was found in fecal specimens from mice and rats tested by R... more A high proportion of positive results was found in fecal specimens from mice and rats tested by Rotazyme II enzyme-linked immunosorbent assay, but the presence of virus could not be confirmed. Positive specimens and nonautoclaved rodent diet contained a substance that apparently attached nonspecifically to the antibody-coated beads used in the test and reacted directly with the substrate. Pretreatment of the beads with 0.1% bovine serum albumin eliminated this nonspecific activity.
The global burden of infectious diseases and the increased attention to natural, accidental, and ... more The global burden of infectious diseases and the increased attention to natural, accidental, and deliberate biological threats has resulted in significant investment in infectious disease research. Translating the results of these studies to inform prevention, detection, and response efforts often can be challenging, especially if prior relationships and communications have not been established with decision-makers. Whatever scientific information is shared with decision-makers before, during, and after public health emergencies is highly dependent on the individuals or organizations who are communicating with policy-makers. This article briefly describes the landscape of stakeholders involved in information-sharing before and during emergencies. We identify critical gaps in translation of scientific expertise and results, and biosafety and biosecurity measures to public health policy and practice with a focus on One Health and zoonotic diseases. Finally, we conclude by exploring wa...
The seasonality of human influenza in tropical regions is not well understood. Although H5N1 has ... more The seasonality of human influenza in tropical regions is not well understood. Although H5N1 has caused over 250 human deaths worldwide, and several studies have evaluated environmental risk factors for H5N1 in poultry, there has been no systematic study of climate or seasonality of influenza A/H5N1 in either humans or poultry. In order to better understand influenza seasonality, a secondary data analysis was conducted on human influenza A/H5N1 cases in Egypt (n=50), using cases reported to the World Health Organization through May 1, 2008. In addition, the distribution of human cases was compared to reported poultry outbreaks in these countries. Usual regression methods were determined to be inappropriate since the pattern of seasonality of H5N1 was unknown and the H5N1-climate dataset violated key assumptions of these methods. Instead, Fourier analysis was used to determine the pattern of seasonality of cases and to assess the contributions of weather variables. This method allowe...
The majority of emerging zoonoses originate in wildlife, and many are caused by viruses. However,... more The majority of emerging zoonoses originate in wildlife, and many are caused by viruses. However, there are no rigorous estimates of total viral diversity (here termed “virodiversity”) for any wildlife species, despite the utility of this to future surveillance and control of emerging zoonoses. In this case study, we repeatedly sampled a mammalian wildlife host known to harbor emerging zoonotic pathogens (the Indian Flying Fox, Pteropus giganteus ) and used PCR with degenerate viral family-level primers to discover and analyze the occurrence patterns of 55 viruses from nine viral families. We then adapted statistical techniques used to estimate biodiversity in vertebrates and plants and estimated the total viral richness of these nine families in P. giganteus to be 58 viruses. Our analyses demonstrate proof-of-concept of a strategy for estimating viral richness and provide the first statistically supported estimate of the number of undiscovered viruses in a mammalian host. We used a...
The identification of undiagnosed disease outbreaks is critical for mobilizing efforts to prevent... more The identification of undiagnosed disease outbreaks is critical for mobilizing efforts to prevent widespread transmission of novel virulent pathogens. Recent developments in online surveillance systems allow for the rapid communication of the earliest reports of emerging infectious diseases and tracking of their spread. The efficacy of these programs, however, is inhibited by the anecdotal nature of informal reporting and uncertainty of pathogen identity in the early stages of emergence. We developed theory to connect disease outbreaks of known aetiology in a network using an array of properties including symptoms, seasonality and case-fatality ratio. We tested the method with 125 reports of outbreaks of 10 known infectious diseases causing encephalitis in South Asia, and showed that different diseases frequently form distinct clusters within the networks. The approach correctly identified unknown disease outbreaks with an average sensitivity of 76 per cent and specificity of 88 per...
Information on the rates and factors associated with influenza vaccinations, although limited, is... more Information on the rates and factors associated with influenza vaccinations, although limited, is important because it can inform the development of effective vaccination campaigns in a university medical center setting. A study was conducted in 2011 to identify individual and organizational level barriers and facilitators to influenza vaccination among clinical and nonclinical personnel (N = 428) from a major university medical center. Seventy-one percent of clinical personnel (n = 170) reported pandemic H1N1 vaccination compared with 27% of nonclinical personnel (n = 258), even though vaccine was made widely available to all personnel at no cost. Similarly, disparate rates between clinical and nonclinical personnel were noted for the 2009/2010 seasonal influenza vaccine (82% vs 42%, respectively) and 2010/2011 combination (pandemic plus seasonal) influenza vaccine (73% vs 28%, respectively). Factors associated with pandemic vaccination in nonclinical personnel included the following: high level of influenza-related knowledge, concern regarding influenza contagion, history of previous influenza vaccinations or influenza illness, participation in vaccine-related training, and awareness of the institution's written pandemic plan. For clinicians, past history of seasonal influenza vaccination was associated with pandemic vaccination. For all participants, taking any 1 or more of the 3 influenza vaccines available in 2009 to 2011 was associated with intent to take a hypothetical future novel pandemic vaccine (odds ratio, 6.7; 95% confidence interval: 4.32-10.44; P < .001). Most of the risk factors associated with lack of vaccination uptake are amenable to organizational strategies.
A high proportion of positive results was found in fecal specimens from mice and rats tested by R... more A high proportion of positive results was found in fecal specimens from mice and rats tested by Rotazyme II enzyme-linked immunosorbent assay, but the presence of virus could not be confirmed. Positive specimens and nonautoclaved rodent diet contained a substance that apparently attached nonspecifically to the antibody-coated beads used in the test and reacted directly with the substrate. Pretreatment of the beads with 0.1% bovine serum albumin eliminated this nonspecific activity.
The global burden of infectious diseases and the increased attention to natural, accidental, and ... more The global burden of infectious diseases and the increased attention to natural, accidental, and deliberate biological threats has resulted in significant investment in infectious disease research. Translating the results of these studies to inform prevention, detection, and response efforts often can be challenging, especially if prior relationships and communications have not been established with decision-makers. Whatever scientific information is shared with decision-makers before, during, and after public health emergencies is highly dependent on the individuals or organizations who are communicating with policy-makers. This article briefly describes the landscape of stakeholders involved in information-sharing before and during emergencies. We identify critical gaps in translation of scientific expertise and results, and biosafety and biosecurity measures to public health policy and practice with a focus on One Health and zoonotic diseases. Finally, we conclude by exploring wa...
The seasonality of human influenza in tropical regions is not well understood. Although H5N1 has ... more The seasonality of human influenza in tropical regions is not well understood. Although H5N1 has caused over 250 human deaths worldwide, and several studies have evaluated environmental risk factors for H5N1 in poultry, there has been no systematic study of climate or seasonality of influenza A/H5N1 in either humans or poultry. In order to better understand influenza seasonality, a secondary data analysis was conducted on human influenza A/H5N1 cases in Egypt (n=50), using cases reported to the World Health Organization through May 1, 2008. In addition, the distribution of human cases was compared to reported poultry outbreaks in these countries. Usual regression methods were determined to be inappropriate since the pattern of seasonality of H5N1 was unknown and the H5N1-climate dataset violated key assumptions of these methods. Instead, Fourier analysis was used to determine the pattern of seasonality of cases and to assess the contributions of weather variables. This method allowe...
The majority of emerging zoonoses originate in wildlife, and many are caused by viruses. However,... more The majority of emerging zoonoses originate in wildlife, and many are caused by viruses. However, there are no rigorous estimates of total viral diversity (here termed “virodiversity”) for any wildlife species, despite the utility of this to future surveillance and control of emerging zoonoses. In this case study, we repeatedly sampled a mammalian wildlife host known to harbor emerging zoonotic pathogens (the Indian Flying Fox, Pteropus giganteus ) and used PCR with degenerate viral family-level primers to discover and analyze the occurrence patterns of 55 viruses from nine viral families. We then adapted statistical techniques used to estimate biodiversity in vertebrates and plants and estimated the total viral richness of these nine families in P. giganteus to be 58 viruses. Our analyses demonstrate proof-of-concept of a strategy for estimating viral richness and provide the first statistically supported estimate of the number of undiscovered viruses in a mammalian host. We used a...
The identification of undiagnosed disease outbreaks is critical for mobilizing efforts to prevent... more The identification of undiagnosed disease outbreaks is critical for mobilizing efforts to prevent widespread transmission of novel virulent pathogens. Recent developments in online surveillance systems allow for the rapid communication of the earliest reports of emerging infectious diseases and tracking of their spread. The efficacy of these programs, however, is inhibited by the anecdotal nature of informal reporting and uncertainty of pathogen identity in the early stages of emergence. We developed theory to connect disease outbreaks of known aetiology in a network using an array of properties including symptoms, seasonality and case-fatality ratio. We tested the method with 125 reports of outbreaks of 10 known infectious diseases causing encephalitis in South Asia, and showed that different diseases frequently form distinct clusters within the networks. The approach correctly identified unknown disease outbreaks with an average sensitivity of 76 per cent and specificity of 88 per...
Information on the rates and factors associated with influenza vaccinations, although limited, is... more Information on the rates and factors associated with influenza vaccinations, although limited, is important because it can inform the development of effective vaccination campaigns in a university medical center setting. A study was conducted in 2011 to identify individual and organizational level barriers and facilitators to influenza vaccination among clinical and nonclinical personnel (N = 428) from a major university medical center. Seventy-one percent of clinical personnel (n = 170) reported pandemic H1N1 vaccination compared with 27% of nonclinical personnel (n = 258), even though vaccine was made widely available to all personnel at no cost. Similarly, disparate rates between clinical and nonclinical personnel were noted for the 2009/2010 seasonal influenza vaccine (82% vs 42%, respectively) and 2010/2011 combination (pandemic plus seasonal) influenza vaccine (73% vs 28%, respectively). Factors associated with pandemic vaccination in nonclinical personnel included the following: high level of influenza-related knowledge, concern regarding influenza contagion, history of previous influenza vaccinations or influenza illness, participation in vaccine-related training, and awareness of the institution's written pandemic plan. For clinicians, past history of seasonal influenza vaccination was associated with pandemic vaccination. For all participants, taking any 1 or more of the 3 influenza vaccines available in 2009 to 2011 was associated with intent to take a hypothetical future novel pandemic vaccine (odds ratio, 6.7; 95% confidence interval: 4.32-10.44; P < .001). Most of the risk factors associated with lack of vaccination uptake are amenable to organizational strategies.
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Papers by Stephen Morse