Thompson JM, Lundstrom EW, Hein LD
… +27 more, Beesley CA, Marston CK, Zaayenga R, Gulvik CA, Paisie TK, Hand J, Dowell CH, Feldmann K, Blackburn D, Schrodt CA, Bower WA, DeBord KM, Richardson BT, Haydel D, Haynes L, Yu PA, Yu Y, Cocco A, Bell-Do M, Bacon M, Antonini J, Burton N, Weiner ZP, Hoffmaster AR, de Perio MA, Cossaboom CM, Sokol T
MMWR Morb Mortal Wkly Rep
· 2026 Jan · PMID 41468309
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In September 2024, the ninth documented case of welder's anthrax was identified in a previously healthy male welder, aged 18 years, from Louisiana, who was hospitalized with pneumonia and respiratory failure requiring in...In September 2024, the ninth documented case of welder's anthrax was identified in a previously healthy male welder, aged 18 years, from Louisiana, who was hospitalized with pneumonia and respiratory failure requiring intubation and mechanical ventilation. Welder's anthrax is a recently described life-threatening pneumonia caused by infection with anthrax toxin-producing Bacillus cereus group bacteria; risk factors for infection are not well-understood. Eight previous cases (six fatal) were reported among welders or metalworkers from Louisiana and Texas. A coordinated state and federal response facilitated use of the anthrax antitoxin obiltoxaximab (Anthim), which was administered in combination with recommended multidrug antimicrobial therapy for inhalation anthrax, including bactericidal agents and protein synthesis inhibitors. The patient's clinical condition improved rapidly after administration of obiltoxaximab and antimicrobials and drainage of a pleural effusion. He was discharged with a tailored antibiotic regimen after a 26-day hospitalization; all of his pulmonary symptoms had resolved by his 3-month follow-up visit. An environmental investigation identified anthrax toxin genes in 28 (11.4%) of 245 soil and nonporous surface samples collected from the patient's worksite; however, this investigation did not clearly identify host or occupational factors that contributed to his illness. Enhanced workplace safety protocols and improved engineering and administrative controls could minimize exposure to dust and welding fumes and potentially decrease environmental exposure to infectious disease agents among metalworkers. Welder's anthrax should be considered in the differential diagnosis of pneumonia among welders and metalworkers, particularly those who live in or have worked in the southern United States. Health care providers should consult with CDC as soon as welder's anthrax is suspected to facilitate release of anthrax countermeasures, including antitoxins such as obiltoxaximab, as adjunctive therapy.
MMWR Morb Mortal Wkly Rep
· 2025 Dec · PMID 41411198
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Coal workers' pneumoconiosis (CWP) is a preventable, progressive occupational lung disease caused by inhaling respirable coal mine dust, a complex mixture commonly containing coal, crystalline silica, and other silicate...Coal workers' pneumoconiosis (CWP) is a preventable, progressive occupational lung disease caused by inhaling respirable coal mine dust, a complex mixture commonly containing coal, crystalline silica, and other silicate minerals. Early pneumoconiosis can be asymptomatic, but advanced disease often leads to disability and premature death. To describe CWP-associated mortality among U.S. residents aged ≥15 years by industry and occupation, CDC conducted an exploratory analysis of National Vital Statistics System multiple cause-of-death data for 2020-2023, the most recent years that include information on decedents' usual industry and occupation. During 2020-2023, CWP was listed on the death certificate of 1,754 decedents (age-adjusted CWP-associated death rate = 1.3 per 1 million). By industry group, the highest number of CWP-associated deaths occurred among workers in the mining industry (1,255). The highest proportionate mortality ratios (PMRs) were among persons employed in the mining industry (PMR = 50.0) and the construction and extraction occupations (6.2). Among workers employed in the mining industry, the highest PMR was among underground mining machine operators (164.6). The continuing occurrence of CWP-associated deaths underscores the potential value of a comprehensive prevention program (maintaining efforts to control occupational coal mine dust exposures, combined with early disease detection efforts and medical care) and supports potential benefits of ongoing surveillance.
Conklin KAK, Nakayama JY, Van Dyke ME
… +2 more, Harley KG, Thompson HR
MMWR Morb Mortal Wkly Rep
· 2025 Dec · PMID 41411190
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Physical activity has numerous health benefits, including for women of reproductive age (18-44 years), among whom it can prevent chronic disease, including osteoporosis, and improve maternal health. Understanding the pre...Physical activity has numerous health benefits, including for women of reproductive age (18-44 years), among whom it can prevent chronic disease, including osteoporosis, and improve maternal health. Understanding the prevalence of leisure-time physical activity among different sociodemographic groups of women of reproductive age can help guide public health interventions and messaging. Data from the 2022 and 2024 National Health Interview Survey were used to examine the prevalences of self-reported leisure-time physical activity and meeting recommendations in the Physical Activity Guidelines for Americans, 2nd edition, among 10,981 women aged 18-44 years by race and ethnicity, age, and educational attainment. Overall, an estimated 25.1% of women aged 18-44 years reported leisure time activity meeting recommendations for both aerobic and muscle-strengthening physical activity, 27.1% reported leisure time activity meeting only the aerobic activity recommendation, and 6.1% reported leisure time activity meeting only the muscle-strengthening activity recommendation. An estimated 47.2% of women reported leisure-time physical activity insufficient to meet either recommendation (including those reporting no leisure time physical activity). Prevalences of reported aerobic and muscle-strengthening physical activity varied by race and ethnicity, age, and educational attainment: higher percentages of younger women (women aged 18-24 years), non-Hispanic White (White) women, and women with higher levels of educational attainment met both recommendations than did older women (women aged 30-34 or 40-44 years), women who are not White, and those with less educational attainment. Given the benefits of physical activity for maternal, physical, and mental health, addressing possible population-specific barriers to physical activity among women of reproductive age could be an important strategy for improving health outcomes.
Irving SA, Rowley EAK, Chickery S
… +34 more, Natarajan K, Klein NP, Grannis SJ, Ong TC, Ball SW, DeSilva MB, Dascomb K, Naleway AL, Stockwell MS, Stephens AB, Zerbo O, Hansen J, Block L, Jacobson KB, Dixon BE, Rogerson C, Duszynski T, Barron MA, Mayer D, Chavez C, Weber ZA, Reese SE, Essien I, Sheffield T, Bride D, Arndorfer J, Van Otterloo J, Koppolu P, Mak J, Kautz A, DeCuir J, Wiegand RE, Payne AB, Link-Gelles R
MMWR Morb Mortal Wkly Rep
· 2025 Dec · PMID 41379943
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During September 2023-August 2024, approximately 38,000 COVID-19-associated hospitalizations occurred among children and adolescents aged <18 years in the United States, a rate of approximately 53 per 100,000 children, r...During September 2023-August 2024, approximately 38,000 COVID-19-associated hospitalizations occurred among children and adolescents aged <18 years in the United States, a rate of approximately 53 per 100,000 children, ranging from 600 per 100,000 children aged <6 months to 21 per 100,000 children and adolescents aged 5-17 years. On June 27, 2024, the Advisory Committee on Immunization Practices recommended that all persons aged ≥6 months receive a 2024-2025 COVID-19 vaccine, which targeted Omicron JN.1 and JN.1-derived sublineages. Investigators used a test-negative case-control design to estimate vaccine effectiveness (VE) of 2024-2025 COVID-19 vaccines against COVID-19-associated emergency department or urgent care (ED/UC) visits during August 29, 2024-September 2, 2025, among immunocompetent children aged 9 months-4 years and children and adolescents aged 5-17 years in the CDC-funded Virtual SARS-CoV-2, Influenza, and Other respiratory viruses Network (VISION), a multisite electronic health record-based network in nine states. Among children aged 9 months-4 years, VE against COVID-19-associated ED/UC visits was estimated at 76% (95% CI = 58%-87%) during the first 7-179 days after vaccination. Among children and adolescents aged 5-17 years, VE against COVID-19-associated ED/UC visits was an estimated 56% (95% CI = 35%-70%) during the first 7-179 days after vaccination. These findings suggest that vaccination with a 2024-2025 COVID-19 vaccine dose provided children with additional protection against COVID-19-associated ED/UC encounters compared with no 2024-2025 dose.
Lim S, Vagnone PS, Marshall NC
… +21 more, Lees C, Dale JL, Smith B, Palavecino E, Lynfield R, Gross A, Knowles K, Michael-Gayego A, Temper V, Strahilevitz J, Oster Y, Grupel D, Reshef D, Motro Y, van der Walt PJ, Croxen MA, Smith SW, Lee B, Tipples GA, Warren B, Moran-Gilad J
MMWR Morb Mortal Wkly Rep
· 2025 Dec · PMID 41379940
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Contaminated nonsterile ultrasound gels have been implicated in outbreaks of Burkholderia infections associated with improper infection control practices before or during percutaneous procedures. In August 2024, the Minn...Contaminated nonsterile ultrasound gels have been implicated in outbreaks of Burkholderia infections associated with improper infection control practices before or during percutaneous procedures. In August 2024, the Minnesota Department of Health Public Health Laboratory noticed an increase in Paraburkholderia fungorum or Paraburkholderia species identified from referred clinical isolates. All isolates were recovered from blood cultures, and whole genome sequencing (WGS) confirmed that the isolates were genetically related. Because P. fungorum is not an established human pathogen and has rarely been reported in clinical specimens, an investigation was initiated, which was later joined by collaborators in Canada and Israel after similar observations in those countries. Forty-two patients from the United States, Canada, and Israel with genetically linked P. fungorum isolated from clinical specimens collected during May 2023-April 2025 were identified. Positive cultures were associated with the use of nonsterile ultrasound gel. Based on medical record review, treating clinicians deemed the isolate a culture contaminant in most cases; one patient had a confirmed invasive P. fungorum infection. WGS confirmed the relatedness of isolates from all three countries, including isolates cultured from clinical specimens as well as from nonsterile ultrasound gel products. Review of local practices revealed use of nonsterile ultrasound gel during point-of-care percutaneous procedures, including drawing blood, placing intravenous catheters, and paracentesis. This investigation underscores the continued importance of sterile gel use during percutaneous procedures and highlights the value of collaboration and shared WGS data for the investigation of international outbreaks.
Klumb C, Ireland M, Miller B
… +12 more, Jopp E, Lempelius B, Rovira A, Naikare H, Bauer C, Harry K, Cunningham SA, Liu G, Czeck TF, Wallace R, Hoefs B, Holzbauer S
MMWR Morb Mortal Wkly Rep
· 2025 Dec · PMID 41379771
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Rabies clusters in domestic livestock are rare but can result in human exposure and economic loss for farmers. During a 4-week period in May 2024, five of 35 steers on a Minnesota dairy farm developed neurologic signs co...Rabies clusters in domestic livestock are rare but can result in human exposure and economic loss for farmers. During a 4-week period in May 2024, five of 35 steers on a Minnesota dairy farm developed neurologic signs consistent with rabies. Three clinically ill steers were euthanized, and brain specimens were submitted for rabies testing. Direct fluorescent antibody testing and whole genome sequencing confirmed rabies virus (North Central Skunk variant) in all three steers. After identification of the first two rabid steers, the remaining animals were quarantined for 120 days and vaccinated against rabies; three additional steers became ill during quarantine and were euthanized. The Minnesota Department of Health and Minnesota Board of Animal Health investigated human and animal exposures through interviews and site visits. Five persons were recommended to receive rabies postexposure prophylaxis because of known or potential exposures. The outbreak likely resulted from a single rabid skunk biting multiple cattle housed in a small pen, although steer-to-steer transmission cannot be ruled out. In addition to the loss of livestock, direct medical and veterinary costs associated with this outbreak totaled approximately $35,000. Preventive vaccination of cattle should be considered in areas with high activity of terrestrial rabies (i.e., rabies in land-based animals), presence of high-value livestock, and potential for human exposure.
Respiratory syncytial virus (RSV) is a leading cause of intensive care unit (ICU) admission and respiratory failure among infants (children aged <1 year) in the United States. In August 2023, CDC's Advisory Committee on...Respiratory syncytial virus (RSV) is a leading cause of intensive care unit (ICU) admission and respiratory failure among infants (children aged <1 year) in the United States. In August 2023, CDC's Advisory Committee on Immunization Practices recommended nirsevimab, a long-acting monoclonal antibody, to protect against RSV-associated lower respiratory tract infection among all infants aged <8 months born during or entering their first RSV season. Following licensure, nirsevimab effectiveness has been demonstrated against RSV-associated infant hospitalization, but evidence regarding effectiveness against RSV-associated critical illness is limited. In a 27-hospital case-control investigation, nirsevimab effectiveness against both RSV-associated infant ICU admission and acute respiratory failure (illness requiring continuous positive airway pressure, bilevel positive airway pressure, or invasive mechanical ventilation) after hospital admission was evaluated during December 1, 2024-April 15, 2025. Among 457 case-patients who received a positive RSV test result and 302 control patients who received a negative RSV test result admitted to an ICU with respiratory symptoms, 14% and 45%, respectively, had received nirsevimab ≥7 days before symptom onset. Nirsevimab was 80% effective (95% CI = 70%-86%) against RSV-associated ICU admission and 83% effective (95% CI = 74%-90%) against acute respiratory failure when received a median of 52 days (IQR = 32-89 days) and 50 days (IQR = 32-86 days) before onset for each respective endpoint. These estimates support the recommendation for use of nirsevimab as a prevention strategy to protect infants against severe outcomes from RSV infection.
Earnest R, Carter KK, Margrey SF
… +35 more, Wicker VV, Betz R, Reik R, Shiltz E, Khalil B, Palinski B, Jordan B, Dodson D, Epson E, Fritz CL, Stoltey J, Sikola A, Garcia R, Roy M, Annambhotla P, Basavaraju SV, Bonaparte SC, Cash-Goldwasser S, Kracalik I, McCormick DW, Minhaj FS, Orciari LA, Satheshkumar PS, Yager P, Crum DA, Koffarnus N, Beddo M, Baker M, Phipps EC, Oltean H, Schnitzler H, Gigante CM, Wallace RM, Stobierski MG, Hahn C
MMWR Morb Mortal Wkly Rep
· 2025 Dec · PMID 41343342
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Although rabies virus is typically transmitted through mammalian animal bites or scratches, human-to-human transmission has occurred through organ and tissue transplantation. From 1978 to 2013, three transplant-transmitt...Although rabies virus is typically transmitted through mammalian animal bites or scratches, human-to-human transmission has occurred through organ and tissue transplantation. From 1978 to 2013, three transplant-transmitted rabies events in the United States affected nine tissue or organ recipients. Rabies is almost always fatal without timely receipt of postexposure prophylaxis (PEP). In January 2025, clinicians in Ohio notified the Ohio Department of Health and CDC of a suspected case of rabies in a kidney transplant recipient who died 51 days after receiving the transplant. CDC confirmed the recipient's rabies diagnosis. Investigation revealed that the deceased donor had been scratched by a skunk approximately 6 weeks before death. No other organs from that donor were transplanted; however, three persons received cornea tissue grafts. While investigation of the donor's rabies status was ongoing, the cornea recipients underwent precautionary graft removal and received PEP. None developed signs or symptoms compatible with rabies. CDC detected rabies virus RNA in an archived sample of the donor's kidney, confirming organ-derived transmission. Investigation identified 370 persons with possible exposures to the donor or kidney recipient; 357 (96%) completed risk assessments. Among those who completed risk assessments, 46 (13%) were recommended to receive PEP. Early consultation with public health officials might prevent rabies-infected organ and tissue donation or lead to prompt PEP for transplant recipients. The risk for rabies should be considered among donors who have received rabies-susceptible animal bites or scratches within the previous year, particularly those donors with acute encephalopathy.
Lamere L, Cope J, Breazu R
… +10 more, Peña S, Chang M, Ackelsberg J, Pillendla D, Smith OA, Than QP, Zaibaq P, Gibbons-Burgener S, Wozniak RJ, Taylor E
MMWR Morb Mortal Wkly Rep
· 2025 Nov · PMID 41296617
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Cosmetic botulinum neurotoxin (BoNT) can be used to temporarily diminish facial wrinkles (1); however, injection for this purpose occasionally results in localized paralytic effects, even when BoNT that is approved by th...Cosmetic botulinum neurotoxin (BoNT) can be used to temporarily diminish facial wrinkles (1); however, injection for this purpose occasionally results in localized paralytic effects, even when BoNT that is approved by the Food and Drug Administration (FDA) and purchased from authorized sources is administered by licensed and trained medical professionals. Rarely, improperly procured or administered BoNT can lead to severe illness. During May-June 2025, hospital clinicians and health departments in New York, Texas, and Wisconsin each alerted CDC about a person in their jurisdiction who experienced severe illness after self-injecting cosmetic BoNT that was purchased online.* None of the three patients met their state's requirements for purchasing or administering BoNT; no link was reported among the patients. This report describes the patients' characteristics, treatment, and outcomes. This activity was reviewed by CDC, deemed not research, and conducted consistent with applicable federal law and CDC policy..
Barrall AL, Stewart L, Higa J
… +10 more, Jenkins E, Whitney B, Adcock B, Pickett A, Swift B, Aminabadi P, Zamora K, Shelton S, Neil KP, Gieraltowski L
MMWR Morb Mortal Wkly Rep
· 2025 Nov · PMID 41296615
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Outbreaks of Shiga toxin-producing Escherichia coli (STEC) O157 infections are associated primarily with beef and fresh vegetables, particularly leafy greens* (1). Only one reported STEC O157 outbreak in the United State...Outbreaks of Shiga toxin-producing Escherichia coli (STEC) O157 infections are associated primarily with beef and fresh vegetables, particularly leafy greens* (1). Only one reported STEC O157 outbreak in the United States has been linked to tree nuts, specifically a 2011 outbreak in Michigan, Minnesota, and Wisconsin associated with in-shell hazelnuts (2). On March 25, 2024, the Washington State Department of Health alerted CDC to seven STEC O157 infections in Washington and California after determining that the isolates were highly genetically related by whole genome sequencing (WGS) (3).
Olmsted KE, Ramsey-Omonua T, Thomas ES
… +4 more, Lee JT, Owens L, Graitcer S, Mells J
MMWR Morb Mortal Wkly Rep
· 2025 Nov · PMID 41264520
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Respiratory syncytial virus (RSV), the leading cause of hospitalization among U.S. infants, results in 50,000-80,000 associated hospitalizations and 100-300 deaths among children aged <5 years each year (1). In 2023, the...Respiratory syncytial virus (RSV), the leading cause of hospitalization among U.S. infants, results in 50,000-80,000 associated hospitalizations and 100-300 deaths among children aged <5 years each year (1). In 2023, the Advisory Committee on Immunization Practices (ACIP) recommended two options for preventing severe RSV in infants: maternal RSV vaccination during pregnancy (2) or administration of nirsevimab, a long-acting monoclonal antibody to infants (1). Nirsevimab is recommended for infants aged <8 months during their first RSV season (October-March in most of the United States); ideally, it should be administered during the birth hospitalization or within the first week of life. In September 2023, ACIP passed a resolution to add nirsevimab to the Vaccines for Children (VFC) Program, a public-private partnership that provides CDC-purchased vaccines to VFC-eligible children (those who are uninsured or underinsured, insured through Medicaid, or who are American Indian or Alaska Native) at no cost. Approximately one half (52.2%) of U.S. children aged 19-35 months are VFC-eligible, and among those, 93.4% are insured by Medicaid (3). Medicaid-insured infants have a higher incidence of severe RSV infection than do privately insured infants (4). Providers enrolled in the VFC program are able to administer nirsevimab at no cost to eligible children. Enrollment of birthing hospitals in VFC thus has the potential to expand infant immunization against RSV. This report describes enrollment of U.S. birthing hospitals (those with more than one birth during the previous year or at least one registered maternity bed) in the VFC program since the introduction of nirsevimab.
Russ S, Nogareda F, Regan AK
… +33 more, Benedetti E, Pasinovich M, Voto C, Chilver M, Stocks N, Sullivan SG, Cheng AC, Blyth CC, Hassall J, de Almeida WAF, de Paula Júnior FJ, de Melo Araújo AC, Vergara N, Rodríguez Ferrari PC, Fasce RA, Saavedra C, Penayo E, Gómez S, Domínguez C, Anglemyer A, Wood T, Huang QS, Walaza S, Zwane P, Wolter N, Goñi N, Tairovich J, Silvera E, Couto P, Jara J, Kondor RJ, Azziz-Baumgartner E, Chard AN
MMWR Morb Mortal Wkly Rep
· 2025 Sep · PMID 40996960
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Seasonal influenza vaccination provides important protection from influenza illness and associated potential complications. Monitoring seasonal influenza vaccine effectiveness (VE) in Southern Hemisphere countries can ap...Seasonal influenza vaccination provides important protection from influenza illness and associated potential complications. Monitoring seasonal influenza vaccine effectiveness (VE) in Southern Hemisphere countries can apprise health authorities in Northern Hemisphere countries about the potential protection provided from vaccination. Using data from influenza-like illness (ILI) and severe acute respiratory infection (SARI) sentinel surveillance networks in eight Southern Hemisphere countries, investigators estimated interim VE against influenza-associated outpatient visits and hospitalization using a test-negative case-control study design. During March-September 2025, Australia and South Africa identified 2,122 patients with ILI; Argentina, Australia, Brazil, Chile, New Zealand, Paraguay, and Uruguay identified 42,752 patients with SARI. Overall, 21.3% of patients with ILI and 15.9% of patients with SARI were vaccinated against influenza. Adjusted VE against influenza-associated outpatient visits and hospitalization was 50.4% and 49.7%, respectively, for any influenza virus, and 45.4% and 46.1%, respectively, for influenza A viruses. Adjusted VE against hospitalization with the predominant influenza subtype, A(H1N1)pdm09, was 41.6%. These interim estimates suggest that vaccination reduced medically attended influenza-associated illness by approximately one half in eight Southern Hemisphere countries. Health authorities should prioritize vaccination of all eligible persons ≥6 months to reduce incidence of influenza disease.
Reinhart K, Huang S, Kniss K
… +2 more, Reed C, Budd A
MMWR Morb Mortal Wkly Rep
· 2025 Sep · PMID 40996933
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Influenza-associated deaths among children aged <18 years have been nationally notifiable since 2004. The highest number of pediatric deaths reported during a single season since reporting of influenza-associated pediatr...Influenza-associated deaths among children aged <18 years have been nationally notifiable since 2004. The highest number of pediatric deaths reported during a single season since reporting of influenza-associated pediatric deaths began (excluding the 2009-10 influenza A[H1N1]pmd09 pandemic) occurred during the 2024-25 season. Through September 13, 2025, a total of 280 influenza-associated pediatric deaths were reported, representing a national rate of 3.8 deaths per 1 million children. The median age at death was 7 years, and 56% of children who died had at least one underlying medical condition. Influenza A viruses were associated with 240 (86%) of the deaths. Forty percent of children who died were treated with influenza antiviral medications. Among the 208 pediatric decedents with available data who were eligible for influenza vaccine, 89% were not fully vaccinated. CDC recommends that all persons aged ≥6 months who do not have contraindications receive the influenza vaccine each year, ideally by the end of October.
Fazal A, Harker EJ, Neelam V
… +80 more, Olson SM, Rolfes MA, Reinhart K, Kniss K, Frutos A, Leonard J, Reed C, Dugan VG, Safi H, Dulski TM, Stanley-Downs A, Bhatti A, Armistead I, Rao S, Torres-Diaz C, Thomas A, Weigel A, Patten M, Sinner M, Nims D, Mattingly C, Gosack V, Voris A, Redkey J, Scaggs Huang FA, DeCesaris D, Tuggle C, Betters KA, Hand J, Krueger A, Potter DZ, Kim C, Park R, Hong S, Edelman HE, Kim S, Henderson J, McMahon M, Sanders J, Hunstad DA, Doran EL, Harbi K, Julian D, Ball H, Dreisig J, Thomas D, Faybusovich J, Shaw YP, Eisenberg N, Chaturvedi R, Faulstich A, Wester RE, Gowie DL, Fisher N, Sutton M, Boktor SW, Long JM, Marshall P, Berns AL, McAda L, Winders S, Gomez Pinedo P, Murray J, Westbrook T, Unutzer A, Lindquist S, Haupt TE, Baum K, Wilson-Murphy M, Glaser C, Harriman K, Antoon JW, Van Haren KP, Randolph AG, Silverman A, de St Maurice A, Ellington S, Uyeki TM, Garg S, CDC Influenza-Associated Encephalopathy Collaborators
MMWR Morb Mortal Wkly Rep
· 2025 Sep · PMID 40996921
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In January 2025, CDC received several reports of deaths among children aged <18 years with a severe form of influenza-associated encephalopathy (IAE) termed acute necrotizing encephalopathy (ANE). Because no national sur...In January 2025, CDC received several reports of deaths among children aged <18 years with a severe form of influenza-associated encephalopathy (IAE) termed acute necrotizing encephalopathy (ANE). Because no national surveillance for IAE currently exists, CDC requested notification of U.S. pediatric IAE cases from clinicians and health departments during the 2024-25 influenza season, a high-severity season with a record number of pediatric influenza-associated deaths. Among 192 reports of suspected IAE submitted to CDC, 109 (57%) were categorized as IAE, 37 (34%) of which were subcategorized as ANE, and 72 (66%) as other IAE; 82 reports did not meet IAE criteria and were categorized as other influenza-associated neurologic disease. The median age of children with IAE was 5 years and 55% were previously healthy, 74% were admitted to an intensive care unit, and 19% died; 41% of children with ANE died. Only 16% of children with IAE who were vaccination-eligible had received the 2024-25 influenza vaccine. Health care providers should consider IAE in children with encephalopathy or altered level of consciousness and a recent or current febrile illness when influenza viruses are circulating. Annual influenza vaccination is recommended for all children aged ≥6 months to prevent influenza and associated complications, potentially including severe neurologic disease such as IAE and ANE.
Patel RR, Hoover KW, Lale A
… +3 more, Cabrales J, Byrd KM, Kourtis AP
MMWR Morb Mortal Wkly Rep
· 2025 Sep · PMID 40966169
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In 2023, approximately 39,000 persons received a diagnosis of HIV in the United States. Although HIV preexposure prophylaxis (PrEP) is highly effective in preventing HIV infection, acceptance of, adherence to, and persis...In 2023, approximately 39,000 persons received a diagnosis of HIV in the United States. Although HIV preexposure prophylaxis (PrEP) is highly effective in preventing HIV infection, acceptance of, adherence to, and persistence taking the available oral and injectable PrEP regimens have been suboptimal. CDC PrEP guidelines published in 2021 include two oral tenofovir-based regimens and cabotegravir, the only injectable PrEP regimen approved by the Food and Drug Administration (FDA) at that time. In June 2025, FDA approved injectable lenacapavir (LEN), administered every 6 months, as HIV PrEP based on results from two randomized controlled trials (PURPOSE 1 and PURPOSE 2). The CDC PrEP Guidelines Work Group assessed evidence for the efficacy and safety of LEN PrEP using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. The two trials reported LEN efficacy at reducing HIV infection as 100% among females and 96% among a primarily male trial population, compared with the estimated background HIV incidence (or no use of PrEP) over a follow-up of 52 weeks. No significant safety concerns were identified in the trials. The most common adverse events were mild (grade 1) to moderate (grade 2) injection site reactions. Based on a high certainty of evidence for the efficacy and safety of LEN as assessed by the GRADE analysis, subcutaneous injection of LEN every 6 months is strongly recommended as a PrEP option in persons weighing ≥77 lbs (≥35 kg) who would benefit from PrEP. LEN has the potential to improve PrEP adherence and thus enhance HIV prevention in the United States.
O'Halloran A, Habeck JW, Gilmer M
… +32 more, Threlkel R, Chai SJ, Hall B, Armistead I, Alden NB, Meek J, Yousey-Hindes K, Openo KP, Witt LS, Monroe ML, Ryan PA, Leegwater L, Kim S, McMahon M, Lynfield R, Harbi K, Khalifa M, McCahon C, Barney G, Anderson BJ, Felsen CB, Tesini BL, Moran NE, Ingabire-Smith D, Sutton M, Hendrick MA, Schaffner W, Talbot HK, George A, Zahid H, Garg S, Bozio CH
MMWR Morb Mortal Wkly Rep
· 2025 Sep · PMID 40934142
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The U.S. 2024-25 influenza season was a high-severity season characterized by co-circulation of influenza A(H1N1)pdm09 and A(H3N2) viruses. Data from the Influenza Hospitalization Surveillance Network covering 9% of the...The U.S. 2024-25 influenza season was a high-severity season characterized by co-circulation of influenza A(H1N1)pdm09 and A(H3N2) viruses. Data from the Influenza Hospitalization Surveillance Network covering 9% of the U.S. population, were analyzed to compare laboratory-confirmed influenza-associated hospitalization rates and patient clinical characteristics from the 2024-25 season with data from past seasons. Based on preliminary data from influenza-associated hospital admissions from October 1, 2024, through April 30, 2025, the cumulative influenza-associated hospitalization rate (127.1 influenza-associated hospitalizations per 100,000 population) had surpassed all end-of-season rates during the period beginning with the 2010-11 season. Cumulative 2024-25 season rates were highest among persons aged ≥75 years (598.8). Across age groups, hospitalization rates during the 2024-25 season were 1.8 to 2.8 times higher than median historical rates during the period beginning with the 2010-11 season. Among hospitalized patients, 32.4% had received an influenza vaccine, and 84.8% received antiviral treatment, though children and adolescents aged 5-17 years had the lowest proportion of antiviral receipt (61.6%). Similar to past seasons, most patients hospitalized with influenza during the 2024-25 season (89.1%) had one or more underlying medical conditions, 16.8% were admitted to an intensive care unit, 6.1% received invasive mechanical ventilation, and 3.0% died in hospital. Seasonal influenza viruses can cause severe disease, particularly among persons who are at higher risk for complications. CDC recommends that all persons aged ≥6 months who do not have contraindications receive an annual influenza vaccine and that all hospitalized patients with influenza receive timely antiviral treatment to reduce the risk for complications.
Tobolowsky FA, Morris E, Castro L
… +17 more, Schaff T, Jacinto M, Clement JP, Levine MZ, Frederick JC, Liu F, Holiday C, Kirby MK, Davis CT, Kniss K, Olsen SJ, Ryder R, Wadford DA, Masinde G, Han G, Iuliano AD, Jain S
In response to a highly pathogenic avian influenza (HPAI) A(H5N1) outbreak in U.S. dairy cows detected in March 2024, with subsequent identification of human cases, the San Francisco Department of Public Health institute...In response to a highly pathogenic avian influenza (HPAI) A(H5N1) outbreak in U.S. dairy cows detected in March 2024, with subsequent identification of human cases, the San Francisco Department of Public Health instituted enhanced influenza surveillance (influenza A virus subtyping of a sample of specimens weekly) in June 2024. As of January 1, 2025, 37 human cases of influenza A(H5N1) had been detected in California, none of which occurred in San Francisco. On January 9, 2025, enhanced surveillance detected a human influenza A(H5N1) virus genotype B3.13 infection in a school-aged child in San Francisco with mild illness. Case investigation and contact tracing were conducted to ascertain exposures and detect possible human-to-human transmission. Activities comprised a household visit that included an environmental assessment, close contact interviews and surveys, and molecular and serologic testing. Sixty-seven close contacts (household, school, and health care) were identified. Upper respiratory tract specimens collected from seven asymptomatic household contacts and four symptomatic school contacts all tested negative for influenza virus by real-time reverse transcription-polymerase chain reaction (rRT-PCR). Although antibodies against influenza A(H5N1) were detected in the index patient, serologic testing of a convenience sample of nine close contacts identified no detectable A(H5)-specific antibodies. Despite an extensive investigation, the infection source remains unknown; no human-to-human transmission was identified among close contacts by rRT-PCR and serologic testing. Continued enhanced surveillance and timely subtyping of a subset of influenza A-positive specimens are essential components of a comprehensive strategy to detect human novel influenza A virus infections, including among persons without known exposures to A(H5N1) viruses.