Almendares OM, Fritschmann B, Selvarangan R
… +10 more, Lee BR, Edens C, Diaz M, Whitaker B, Tilsworth S, Porter J, Sagar N, Schuster JE, Goldman JL, Kirking HL
MMWR Morb Mortal Wkly Rep
· 2024 Dec · PMID 39700068
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Abdirizak F, Winn AK, Parikh R
… +7 more, Scobie HM, Lu X, Vega E, Almendares O, Kirking HL, Rose EB, Silk BJ
MMWR Morb Mortal Wkly Rep
· 2024 Dec · PMID 39700057
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Human adenoviruses (HAdVs) are typically associated with mild respiratory illnesses, although severe disease and outbreaks in congregate settings occur. The National Adenovirus Type Reporting System (NATRS) is a passive,...Human adenoviruses (HAdVs) are typically associated with mild respiratory illnesses, although severe disease and outbreaks in congregate settings occur. The National Adenovirus Type Reporting System (NATRS) is a passive, laboratory-based surveillance system that monitors trends in circulation of HAdV types in the United States. This report summarizes the distribution of HAdV types reported to NATRS during 2017-2023. During this 7-year period, 2,241 HAdV specimens with typing results were reported to NATRS. The number of specimens with HAdV typing results reported varied annually during 2017-2019 (range = 389-562) and declined during 2020-2023 (range = 58-356). During 2017-2023, six HAdV types (1-4, 7, and 14) accounted for 88.3% of typed specimens reported; 17.0% of specimens were identified as outbreak-related. An increase in type 41 reporting was associated with a hepatitis cluster during 2021-2022. Reporting to NATRS has declined since the COVID-19 pandemic, despite continued HAdV circulation reported through passive laboratory surveillance to the National Respiratory and Enteric Virus Surveillance System. Enhanced participation in NATRS is needed to improve monitoring of circulating HAdV types.
Schillie S, Loehr J, Chen WH
… +4 more, Moser CA, Cooper G, Isenhour C, McNamara LA
MMWR Morb Mortal Wkly Rep
· 2024 Dec · PMID 39666647
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Two meningococcal serogroup B vaccines are licensed for use in the United States. In August 2024, the Food and Drug Administration (FDA) changed the label for the meningococcal serogroup B MenB-4C vaccine (Bexsero) from...Two meningococcal serogroup B vaccines are licensed for use in the United States. In August 2024, the Food and Drug Administration (FDA) changed the label for the meningococcal serogroup B MenB-4C vaccine (Bexsero) from a 2-dose schedule (intervals of 0 and ≥1 month) to a 2-dose schedule (0 and 6 months) and added a 3-dose schedule (0, 1-2, and 6 months), based on new immunogenicity data. On October 24, 2024, the Advisory Committee on Immunization Practices (ACIP) voted to update its recommendations for the MenB-4C dosing interval and schedule to align with the new FDA label. ACIP recommends extending the interval for the 2-dose series of MenB-4C from 0 and ≥1 month to 0 and 6 months for healthy adolescents and young adults aged 16-23 years based on shared clinical decision-making and has added a recommendation for a 3-dose series with doses administered at 0, 1-2, and 6 months for persons aged ≥10 years at increased risk. The updated ACIP recommendations for MenB-4C align with existing ACIP recommendations for the other FDA-licensed meningococcal serogroup B vaccine, MenB-FHbp (Trumenba).
Hardy CM, Rathee M, Chaudhury S
… +4 more, Wadood MZ, Ather F, Henderson E, Martinez M
MMWR Morb Mortal Wkly Rep
· 2024 Dec · PMID 39666643
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Since the Global Polio Eradication Initiative began in 1988, wild poliovirus (WPV) types 2 and 3 have been eradicated, and annual polio case numbers have decreased by >99.9%. WPV type 1 (WPV1) transmission remains endemi...Since the Global Polio Eradication Initiative began in 1988, wild poliovirus (WPV) types 2 and 3 have been eradicated, and annual polio case numbers have decreased by >99.9%. WPV type 1 (WPV1) transmission remains endemic in Afghanistan and Pakistan, two countries that share a 1,600-mile (2,600-km) border. This report describes immunization and surveillance activities and progress toward polio eradication in Afghanistan during January 2023-September 2024. As of November 1, Afghanistan reported 23 WPV1 cases in 2024, with onset during January-September 30, 2024. During the 3 previous years, 12 WPV1 cases were reported, including six during 2023. In August 2021, the Taliban took control nationwide and allowed increased geographic access for poliovirus vaccination campaigns. Multiple challenges have affected polio eradication activities in Afghanistan, including mandated repatriation of approximately 1 million Afghans by Pakistan beginning in late 2023, the ongoing humanitarian crisis that limits international agency effectiveness, polio program constraints imposed by authorities, and increased restrictions on female participation in vaccination activities. House-to-house vaccination coverage reached 90%-98% of children during June-July 2024. Beginning in 2021, authorities had progressively lifted restrictions on house-to-house campaigns, but abruptly reverted to national restrictions in September 2024. Both nationwide house-to-house activities and strengthening of the routine childhood immunization program would help ensure that every vulnerable child is vaccinated and provide a pathway to polio eradication in Afghanistan.
Rodriguez DM, Madewell ZJ, Torres JM
… +7 more, Rivera A, Wong JM, Santiago GA, Rivera-Amill V, Paz-Bailey G, Marzan-Rodriguez M, Adams LE
MMWR Morb Mortal Wkly Rep
· 2024 Dec · PMID 39666586
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Dengue is a mosquitoborne viral illness that can cause acute febrile illness, severe disease, or death. Worldwide, the number of dengue cases is increasing. During the last dengue outbreaks in Puerto Rico throughout 2010...Dengue is a mosquitoborne viral illness that can cause acute febrile illness, severe disease, or death. Worldwide, the number of dengue cases is increasing. During the last dengue outbreaks in Puerto Rico throughout 2010-2013, dengue virus (DENV) serotype 1 (DENV-1) predominated, and the largest proportion of cases occurred among adolescents and young adults aged 10-19 years. Dengue case data from January 1, 2010-November 4, 2024, were obtained from the Puerto Rico Department of Health. Bivariate analyses were conducted to evaluate the distribution of cases by patient age, DENV serotype, and hospitalization status during three periods: 2010-2019, 2020-2022, and 2023-2024. During 2023-2024, the median age of dengue cases increased to 26 years (95% CI = 25-27 years) compared with that during 2020-2022 (17 years; 95% CI = 17-18 years) and 2010-2019 (19 years; 95% CI = 19-19 years). After >10 years of DENV-1 predominance, the proportions of DENV serotypes 2 (DENV-2) and 3 (DENV-3) increased significantly during 2023-2024, with DENV-3 replacing DENV-1 as the predominant serotype. In addition, the proportion of dengue patients who were hospitalized increased from 35.7% (2010-2019) to 53.5% (2023-2024). The current dengue outbreak in Puerto Rico marks a shift in serotype predominance to DENV-3 and increasing percentages of cases in older age groups (61.7% in adults aged ≥20 years), although a high proportion of cases still occur among adolescents aged 10-19 years (29.5%). The current dengue outbreak also has a higher rate of hospitalizations than those in previous years. Understanding the changing epidemiology of dengue is crucial to guiding public health strategies for dengue control, including clinical management, surveillance and health care system resilience, and public outreach and education.
Sandul AL, Rapposelli K, Nyendak M
… +1 more, Kim M
MMWR Morb Mortal Wkly Rep
· 2024 Dec · PMID 39636783
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Hepatitis B (HepB) vaccines have demonstrated safety, immunogenicity, and efficacy during the past 4 decades (1,2). The Advisory Committee on Immunization Practices recommends universal HepB vaccination for adults aged 1...Hepatitis B (HepB) vaccines have demonstrated safety, immunogenicity, and efficacy during the past 4 decades (1,2). The Advisory Committee on Immunization Practices recommends universal HepB vaccination for adults aged 19-59 years, including pregnant persons, and adults aged ≥60 years with risk factors for hepatitis B. Adults aged ≥60 years without known risk factors for hepatitis B may also receive HepB vaccines (2).
Tanz LJ, Stewart A, Gladden RM
… +3 more, Ko JY, Owens L, O'Donnell J
MMWR Morb Mortal Wkly Rep
· 2024 Dec · PMID 39636782
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During 2023, approximately 72,000, or nearly seven in 10, drug overdose deaths in the United States were estimated to involve illegally manufactured fentanyls (IMFs). Carfentanil, a fentanyl analog 100 times more potent...During 2023, approximately 72,000, or nearly seven in 10, drug overdose deaths in the United States were estimated to involve illegally manufactured fentanyls (IMFs). Carfentanil, a fentanyl analog 100 times more potent than fentanyl, has reemerged in the U.S. drug supply. Using CDC's State Unintentional Drug Overdose Reporting System data, this report describes trends in overdose deaths during January 2021-June 2024, overall and with IMFs detected, by U.S. Census Bureau region, and in deaths with carfentanil detected, in 45 states and the District of Columbia (DC). Numbers of deaths with carfentanil detected by state during January 2023-June 2024 in 49 states and DC are also reported. The number of overdose deaths with IMFs detected declined from 2022 to 2023 in the Northeast (3.2% decline), Midwest (7.8%), and South (2.8%) regions; deaths in the West increased 33.9%. The percentage of deaths with IMFs detected was steady at approximately 70%-80% in the Northeast, Midwest, and South. In contrast, the percentage of deaths with IMFs detected in the West increased from 48.5% during January-March 2021 to 66.5% during April-June 2024. Overdose deaths with carfentanil detected increased approximately sevenfold, from 29 during January-June 2023 to 238 during January-June 2024; during January 2023-June 2024, overdose deaths with carfentanil detected were reported in 37 states. Overdose prevention efforts that address the widespread presence of IMFs, including carfentanil, and can rapidly adapt to other potent opioids in the drug supply might result in lasting reductions in overdose deaths across the entire United States.
Steele-Baser M, Brown AL, D'Angelo DV
… +4 more, Basile KC, Lee RD, Nguyen AT, Cassell CH
MMWR Morb Mortal Wkly Rep
· 2024 Dec · PMID 39636764
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Intimate partner violence (IPV) can include emotional, physical, or sexual violence. IPV during pregnancy is a preventable cause of injury and death with negative short- and long-term impacts for pregnant women, infants,...Intimate partner violence (IPV) can include emotional, physical, or sexual violence. IPV during pregnancy is a preventable cause of injury and death with negative short- and long-term impacts for pregnant women, infants, and families. Using data from the 2016-2022 Pregnancy Risk Assessment Monitoring System in nine U.S. jurisdictions, CDC examined associations between IPV during pregnancy among women with a recent live birth and the following outcomes: prenatal care initiation, health conditions during pregnancy (gestational diabetes, pregnancy-related hypertension, and depression), substance use during pregnancy, and infant birth outcomes. Overall, 5.4% of women reported IPV during pregnancy. Emotional IPV was most prevalent (5.2%), followed by physical (1.5%) and sexual (1.0%) IPV. All types were associated with delayed or no prenatal care; depression during pregnancy; cigarette smoking, alcohol use, marijuana or illicit substance use during pregnancy; and having an infant with low birth weight. Physical, sexual, and any IPV were associated with having a preterm birth. Physical IPV was associated with pregnancy-related hypertension. Evidence-based prevention and intervention strategies that address multiple types of IPV are important for supporting healthy parents and families because they might reduce pregnancy complications, depression and substance use during pregnancy, and adverse infant outcomes.
Peck ME, Davis S, Odoyo-June E
… +33 more, Mwangi J, Oyugi E, Hoang T, Canda M, Seleme J, Bock M, Ndeikemona L, Dladla S, Machava R, Nyagonde N, Mashauri A, Awor AC, Alamo S, Chituwo O, Chisenga T, Malaba R, Mutseta M, Angumua C, Nkwoh KT, Ricketts J, Gordon-Johnson KA, Adamu V, Adamu-Oyegun S, Benson JM, Bunga S, Farach N, Castaneda C, Bonilla L, Premjee S, Demeke HB, Djomand G, Toledo C, Bhatia R
MMWR Morb Mortal Wkly Rep
· 2024 Nov · PMID 39602421
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Oral pre-exposure prophylaxis (PrEP) reduces HIV acquisition risk from sex by 99% and from injection drug use by ≥74% when used as recommended. The Joint United Nations Programme on HIV/AIDS (UNAIDS) has set a goal of 21...Oral pre-exposure prophylaxis (PrEP) reduces HIV acquisition risk from sex by 99% and from injection drug use by ≥74% when used as recommended. The Joint United Nations Programme on HIV/AIDS (UNAIDS) has set a goal of 21.2 million persons using (initiating or continuing) PrEP globally in 2025. In 2016, CDC, with the U.S. President's Emergency Plan for AIDS Relief, joined ministries of health to implement PrEP globally. PrEP is beneficial for persons at substantial risk for acquiring HIV, including but not limited to key populations, which include female sex workers, men who have sex with men, persons in prisons and other enclosed settings, persons who inject drugs, and transgender persons. Annual country targets were used to guide scale-up. In 2023, CDC supported 856,816 PrEP initiations, which represents nearly one quarter of the 3.5 million persons globally who either initiated or continued PrEP that year. During 2017-2023, CDC supported PrEP initiations for 2,278,743 persons, 96.0% of whom were in sub-Saharan Africa. More than one half (64.0%) were female and 44.9% were aged 15-24 years. Overall, CDC achieved 118.7% of its PrEP initiation targets for the 7-year period. Among PrEP initiations for key populations, the majority in sub-Saharan Africa were female sex workers, whereas in Southeast Asia, Eurasia, and the Americas, the majority were men who have sex with men. Continued rapid scale-up is needed to meet the UNAIDS goal to end HIV as a public health threat.
Alfego D, Hernandez-Romieu AC, Briggs-Hagen M
… +9 more, Dietz S, Gillim L, Dale SE, Grover A, Albrecht J, Sesok-Pizzini D, Eisenberg M, Gregory CO, Poirier B
MMWR Morb Mortal Wkly Rep
· 2024 Nov · PMID 39602409
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In most persons, human parvovirus B19 (B19) causes a mild respiratory illness, but infection can result in adverse health outcomes in persons who are pregnant, immunocompromised, or who have chronic hemolytic blood disor...In most persons, human parvovirus B19 (B19) causes a mild respiratory illness, but infection can result in adverse health outcomes in persons who are pregnant, immunocompromised, or who have chronic hemolytic blood disorders. During the first quarter of 2024, several European countries reported increases in B19 activity. In the United States, there is no routine surveillance for B19. To assess increases in B19 activity in the United States, trends in testing and results from two independent populations were examined: 1) the presence of immunoglobulin (Ig) M antibodies, a marker of recent infection, in clinical specimens ordered by physicians and 2) B19 nucleic acid amplification testing (NAAT) in pooled donor source plasma from a large commercial laboratory during 2018-2024. The proportion of IgM-positive clinical specimens reached 9.9% in the second quarter (Q2) of 2024 after remaining <1.5% during 2020-2023 and was higher than Q2 peaks in 2018 (3.8%, p<0.001) and 2019 (5.1%, p<0.001). The prevalence of B19-NAAT-positive donor pools (512 donations per pool) reached 20% in June 2024 after remaining <2% during 2020-2023 and was higher than peaks in 2018 (6.7%, p<0.001) and 2019 (7.3%, p<0.001). Considering the B19 activity increase in the United States in 2024, promotion of measures to prevent respiratory viruses and monitor for adverse B19-related outcomes by health care providers and public health authorities might reduce adverse health outcomes in pregnant persons and others at increased risk.
Kjemtrup AM, Hacker JK, Monroe M
… +14 more, Williams V, Lines C, Lopez K, Paddock CD, Carpenter A, Salzer JS, Villalba JA, Bhatnagar J, Shah S, Iniguez-Stevens E, Efthemeou TC, Hernandez V, Vugia DJ, Kramer VL
MMWR Morb Mortal Wkly Rep
· 2024 Nov · PMID 39602374
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Rocky Mountain spotted fever (RMSF) is a tickborne disease endemic in areas of the Americas. Persistent high incidence of the disease exists in northern Mexico, perpetuated by local populations of brown dog ticks (Rhipic...Rocky Mountain spotted fever (RMSF) is a tickborne disease endemic in areas of the Americas. Persistent high incidence of the disease exists in northern Mexico, perpetuated by local populations of brown dog ticks (Rhipicephalus sanguineus sensu lato) and free-roaming dogs. Six cases of RMSF caused by Rickettsia rickettsii, including three deaths, were reported to the California Department of Public Health during July 2023-January 2024. All six patients were eventually determined to have had exposure to R. rickettsii in Tecate, Mexico, a municipality on the U.S. border that had not been previously described as a high-risk RMSF area. Identification and reporting of the cases were complicated by challenges in diagnosis. The serious nature of the disease and delays in initiating appropriate treatment can result in life-threatening consequences. Epidemiologic collaborations among local, state, federal, and international public health agencies were essential to identifying Tecate as the location of exposure. Further collaborations will be important for directing future prevention measures. Increased health care provider awareness of RMSF is critical on both sides of the border to facilitate earlier diagnosis and initiation of appropriate treatment.