title: Prevalence and factors associated with herpes simplex virus type 2 infection in patients attending a Baltimore City emergency department.
abstract: OBJECTIVE
  Herpes simplex virus type 2 (HSV-2) is a common sexually transmitted disease, but there is limited data on its epidemiology among urban populations. The urban Emergency Department (ED) is a potential venue for surveillance as it predominantly serves an inner city minority population. We evaluate the seroprevalence and factors associated with HSV-2 infection among patients attending the Johns Hopkins Hospital Adult Emergency Department (JHH ED).
  
  
  METHODS
  An identity unlinked-serosurvey was conducted between 6/2007 and 9/2007 in the JHH ED; sera were tested by the Focus HerpeSelect ELISA. Prevalence risk ratios (PRR) were used to determine factors associated with HSV-2 infection.
  
  
  RESULTS
  Of 3,408 serum samples, 1,853 (54.4%) were seropositive for HSV-2. Females (adjPRR  = 1.47, 95% CI 1.38-1.56), non-Hispanic blacks (adjPRR  = 2.03, 95% CI 1.82-2.27), single (adjPRR  = 1.15, 95% CI 1.07-1.25), divorced (adjPRR  = 1.28, 95% CI 1.15-1.41), and unemployed patients (adjPRR  = 1.13, 95% CI 1.05-1.21) had significantly higher rates of HSV-2 infection. Though certain zip codes had significantly higher seroprevalence of HSV-2, this effect was completely attenuated when controlling for age and gender.
  
  
  CONCLUSIONS
  Seroprevalence of HSV-2 in the JHH ED was higher than U.S. national estimates; however, factors associated with HSV-2 infection were similar. The high seroprevalence of HSV-2 in this urban ED highlights the need for targeted testing and treatment. Cross-sectional serosurveys in the urban ED may help to examine the epidemiology of HSV-2.
authors.affiliation: Division of Intramural Research, NIAID, NIH, Baltimore, Maryland, United States of America.
authors.forename: Eshan U
authors.initials: EU
authors.lastname: Patel
authors.affiliation: Division of Intramural Research, NIAID, NIH, Baltimore, Maryland, United States of America.
authors.forename: Melanie A
authors.initials: MA
authors.lastname: Frank
authors.affiliation: Department of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America.
authors.forename: Yu-Hsiang
authors.initials: YH
authors.lastname: Hsieh
authors.affiliation: Department of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Rothman
authors.affiliation: Department of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America.
authors.forename: Amy E O
authors.initials: AE
authors.lastname: Baker
authors.affiliation: Department of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America.
authors.forename: Chadd K
authors.initials: CK
authors.lastname: Kraus
authors.affiliation: Department of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America.
authors.forename: Judy
authors.initials: J
authors.lastname: Shahan
authors.affiliation: Department of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America.
authors.forename: Charlotte A
authors.initials: CA
authors.lastname: Gaydos
authors.affiliation: Department of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America.
authors.forename: Gabor D
authors.initials: GD
authors.lastname: Kelen
authors.affiliation: Division of Intramural Research, NIAID, NIH, Baltimore, Maryland, United States of America; Department of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America.
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Quinn
authors.affiliation: Division of Intramural Research, NIAID, NIH, Baltimore, Maryland, United States of America; Department of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America.
authors.forename: Oliver
authors.initials: O
authors.lastname: Laeyendecker
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood; D015142:Baltimore / Q000453:epidemiology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006561:Herpes Simplex / Q000453:epidemiology* / Q000821:virology; D018258:Herpesvirus 2, Human / Q000302:isolation & purification*; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006786:Hospitals, Urban / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D017057:Medically Uninsured; D006278:Medicare; D008875:Middle Aged; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D017678:Sex Distribution; D012959:Socioeconomic Factors; D014481:United States; D014505:Urban Population; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral