Von Stein DL, Barger A, Hennenfent A
… +38 more, Ramaekers R, Mandi A, Teno K, Brust K, Simmons J, Mohr N, Veach L, Kumar S, Afroze A, McCutchen E, Bartling A, Pentella M, Nelson M, Craft J, Hetzler R, Thoreson A, Coppedge A, Jarvis S, Miller J, Todres AM, Wickline JL, Tarrant S, Sayyad L, Krapiunaya I, Schuh A, Whitesell A, Kuotu GC, McNamara K, Cornish N, Schwedhelm S, Vasa A, Hewlett A, Galloway S, Kofman AD, Sadigh KS, Kruse R, Knust B, Donahue M
MMWR Morb Mortal Wkly Rep
· 2025 Apr · PMID 40179054
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Shakya M, Chu HY, Englund JA
… +11 more, Briggs-Hagen M, Carone M, Kuntz JL, Lockwood T, Midgley CM, Schmidt MA, Starita L, Weil AA, Wiegand RE, Naleway AL, Plumb ID
MMWR Morb Mortal Wkly Rep
· 2025 Apr · PMID 40179048
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Human metapneumovirus (hMPV) is an important cause of respiratory illness. However, information about hMPV incidence, patient characteristics, and symptoms outside hospital settings is limited. During June 2022-March 202...Human metapneumovirus (hMPV) is an important cause of respiratory illness. However, information about hMPV incidence, patient characteristics, and symptoms outside hospital settings is limited. During June 2022-March 2024, participants aged 6 months-49 years who were enrolled in the CASCADIA community-based cohort study submitted weekly illness surveys and nasal swabs, and completed follow-up illness surveys. Swabs collected 0-3 days before reporting new or worsening symptoms were tested for hMPV and other respiratory viruses by multiplex polymerase chain reaction. Incidence was analyzed using an exponential survival model. Among 3,549 participants, 306 had symptomatic hMPV infection, representing an average of 7.5 cases per 100 persons per year (95% CI = 6.7-8.4). Incidence was highest during January-March (adjusted hazard ratio [aHR] = 4.3; 95% CI = 3.0-6.0) compared with October-December, and among those aged 2-4 years (aHR = 5.8; 95% CI = 3.8-9.0) compared with those aged ≥40 years. The most frequently reported symptoms were cough (80.4%) and nasal congestion (71.9%). Among 252 (82.4%) participants who completed a post-illness follow-up survey, 68 (27.0%) missed work, school, or child care facility attendance. Together, these findings indicate that hMPV is a common cause of respiratory illness during late winter to spring, particularly among young children, and frequently disrupts daily activities. Understanding hMPV epidemiology can guide surveillance definitions, clinical testing, and prioritization of prevention strategies.
Jobe NB, Rose E, Winn AK
… +3 more, Goldstein L, Schneider ZD, Silk BJ
MMWR Morb Mortal Wkly Rep
· 2025 Apr · PMID 40179043
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Human metapneumovirus (hMPV) infections cause acute respiratory illness and lower respiratory tract disease. Respiratory syncytial virus (RSV) is a closely related virus within the Pneumoviridae family, and hMPV and RSV...Human metapneumovirus (hMPV) infections cause acute respiratory illness and lower respiratory tract disease. Respiratory syncytial virus (RSV) is a closely related virus within the Pneumoviridae family, and hMPV and RSV infections are associated with similar clinical manifestations. Although no specific antiviral therapies or vaccines exist for hMPV, vaccines and monoclonal antibody products are available to protect against severe RSV disease. This report summarizes hMPV circulation relative to the timing of RSV epidemics before, during, and after the COVID-19 pandemic. Polymerase chain reaction testing results reported to the National Respiratory and Enteric Virus Surveillance System during July 2014-June 2024, were analyzed. Before the COVID-19 pandemic, the median hMPV season onset, peak, and offset occurred in early January, late March, and early June, respectively (median duration = 21 weeks). The 2021-22 season was atypically long (35 weeks); seasonality reverted to more typical patterns during the 2022-23 and 2023-24 seasons. In the two COVID-19 pandemic seasons (2021-22 and 2022-23) and one postpandemic season (2023-24), RSV offsets occurred earlier in January (2021-22 and 2022-23) or March (2023-24) than before the pandemic, when the median offsets occurred in April. The annual interval from peak RSV to peak hMPV circulation increased from a prepandemic median of 11.5 weeks (range = 2-17 weeks) to 19 weeks (range = 19-20 weeks) during and after the pandemic. Fewer than 5 weeks of cocirculation of RSV and hMPV occurred in most regions during the 2022-23 and 2023-24 seasons. Real-time surveillance of RSV and hMPV co-circulation patterns can help guide clinician-directed testing and supportive care, optimize the use of prevention products, prompt detection of and response to outbreaks, and help ensure health care system preparedness for seasonal increases in illnesses.
Scobie HM, Allison J, Masters N
… +9 more, Toomey M, Blake I, Johnston JM, Teshale E, Lawrence R, Ohlsen E, Bruden D, Fischer M, McLaughlin J
MMWR Morb Mortal Wkly Rep
· 2025 Mar · PMID 40146667
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Hepatitis C virus is a leading cause of chronic liver disease, hepatocellular carcinoma, and liver-related death and is targeted for global elimination as a public health threat by 2030. Universal screening is recommende...Hepatitis C virus is a leading cause of chronic liver disease, hepatocellular carcinoma, and liver-related death and is targeted for global elimination as a public health threat by 2030. Universal screening is recommended for all adults aged ≥18 years and pregnant women during each pregnancy; periodic risk-based screening also is recommended. Persons with current infection should be linked to antiviral treatment, which usually results in a virologic cure within 8-12 weeks. To assess progress toward elimination, epidemiologic trends in newly reported chronic hepatitis C cases were assessed among adult Alaska residents during 2016-2023. Overall, 5,352 confirmed chronic hepatitis C cases were newly reported among adults aged ≥18 years. The average annual rate (cases per 100,000 population) was 121 and decreased a relative 30% from 142 during 2016-2019 to 99 during 2020-2023. Statistically significant decreases occurred for most groups. Groups with higher average rates included males, adults aged 18-39 years, residents of rural areas, and American Indian or Alaska Native persons. Hepatitis C surveillance can help monitor trends in health outcomes and identify groups needing tailored testing and treatment interventions toward hepatitis C elimination.
Lundstrom EW, Macmadu A, Steege AL
… +1 more, Groenewold M
MMWR Morb Mortal Wkly Rep
· 2025 Mar · PMID 40146666
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The proportion of synthetic opioid overdose deaths co-involving stimulants has increased in the United States in recent years. Although persons who use opioids have reported increasing stimulant co-use to maintain workpl...The proportion of synthetic opioid overdose deaths co-involving stimulants has increased in the United States in recent years. Although persons who use opioids have reported increasing stimulant co-use to maintain workplace productivity and alertness, occupational patterns of co-involvement in fatal overdose have not been systematically investigated. In an exploratory study, data on overdose deaths involving synthetic opioids (e.g., fentanyl) from the 2022 National Vital Statistics System were analyzed to characterize patterns of stimulant co-involvement among U.S. residents aged 15-64 years, stratified by decedents' usual occupation and industry. Of 69,893 fatal synthetic opioid overdoses, 53.6% involved stimulants. Occupation and industry groups with the highest percentages of synthetic opioid overdose deaths co-involving psychostimulants with abuse potential (psychostimulants) were typically physically demanding (e.g., construction and extraction occupations), whereas categories with highest percentages of cocaine co-involvement were generally less physically strenuous (e.g., business and financial occupations); these patterns might reflect differences in desired drug effects, cost, and geographic availability. Work-related interventions might be useful in preventing the development of substance use disorder by decreasing rates of occupational injuries and workplace stress, connecting workers with substance use disorder to treatment resources, and reducing fatal overdose through harm reduction.
Dulski TM, Montgomery F, Ramos JM
… +14 more, Rosenbaum ER, Boyanton BL, Cox CM, Dahl S, Kitchens C, Paul T, Kahler A, Roundtree A, Mattioli M, Hlavsa MC, Ali IK, Roy S, Haston JC, Patil N
MMWR Morb Mortal Wkly Rep
· 2025 Mar · PMID 40146665
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A fatal case of primary amebic meningoencephalitis (PAM), an infection caused by Naegleria fowleri, was diagnosed in Arkansas in a young child in September 2023. A public health investigation was completed, with epidemio...A fatal case of primary amebic meningoencephalitis (PAM), an infection caused by Naegleria fowleri, was diagnosed in Arkansas in a young child in September 2023. A public health investigation was completed, with epidemiologic, laboratory, and environmental data suggesting that a splash pad (an interactive water play venue that sprays or jets water on users and has little or no standing water) with inadequately disinfected water was the most likely site of the patient's N. fowleri exposure. This case is the third occurrence of splash pad-associated PAM reported in the United States; all three cases involved inadequately disinfected water. PAM should be considered in patients with acute meningoencephalitis and a history of recent possible exposure to fresh water, including treated recreational water (e.g., in splash pads or pools), via the nasal passages. Proper design, construction, operation, and management of splash pads can help prevent illnesses, including N. fowleri infections. Increased awareness, collaboration, and communication among clinicians, hospitals, laboratories, CDC, health departments, the aquatics sector, and the public can help support N. fowleri infection identification, treatment, prevention, and control efforts.
Besera G, Annor FB, Swedo EA
… +12 more, Chiang LF, Charania SN, Mndzebele P, Li MJ, Hegle J, Laterra A, Cree RA, Nzuza-Motsa N, Mkhonta T, Mills K, Felton S, Massetti GM
MMWR Morb Mortal Wkly Rep
· 2025 Mar · PMID 40111942
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Eswatini has made substantial progress responding to its HIV epidemic and reducing violence against children. However, adolescent girls and young women with disabilities might be at increased risk for experiencing violen...Eswatini has made substantial progress responding to its HIV epidemic and reducing violence against children. However, adolescent girls and young women with disabilities might be at increased risk for experiencing violence and for HIV infection, compared with those without disabilities. Data from the 2022 Eswatini Violence Against Children and Youth Survey were analyzed to compare HIV infection and violence-related measures by functional disability status (e.g., difficulties in performing functional activities such as seeing, walking, or communicating) among adolescent girls and young women. In 2022, in Eswatini, 14.0% of adolescent girls and young women aged 13-24 years had a reported functional disability. Compared with those without a functional disability, adolescent girls and young women with a functional disability had higher lifetime prevalences of experiencing sexual, physical, and emotional violence. They were also more likely to know where to seek help for experiences of violence. After adjusting for sociodemographic characteristics, HIV testing and infection status, HIV risk factors, sexual risk behaviors, and HIV treatment and prevention services did not differ by functional disability status. Prioritizing accessible, disability-inclusive prevention programs and services might help reduce experiences of violence among adolescent girls and young women with disabilities. Partnering with disability-led and disability-serving organizations and directly with adolescent girls and young women with disabilities to plan and implement programs and services that are disability-inclusive could help ensure that adolescent girls and young women with disabilities are aware of and can access these resources.
Mudoola D, Thekkur P, Nsonga J
… +13 more, Mande R, Berger SD, Turyahabwe S, Muchuro S, Namuwenge P, Sekadde M, Lukoye D, Luzze H, Dongo JP, Date A, Dlodlo RA, Ferroussier-Davis O, Charles M
MMWR Morb Mortal Wkly Rep
· 2025 Mar · PMID 40111922
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To help achieve the End TB Strategy target of a 90% reduction in tuberculosis (TB) incidence by 2030, member states of the United Nations High-Level Meetings on TB called for improving provision of TB preventive treatmen...To help achieve the End TB Strategy target of a 90% reduction in tuberculosis (TB) incidence by 2030, member states of the United Nations High-Level Meetings on TB called for improving provision of TB preventive treatment (TPT) for household contacts of persons with TB, who are at increased risk for infection and disease. However, TPT use among household contacts worldwide remained at 21% in 2023. The International Union Against Tuberculosis and Lung Disease, the Uganda Ministry of Health, and CDC piloted a comprehensive approach for increasing case finding and TPT coverage among household contacts of persons with TB. During November 1, 2023-September 30, 2024, a total of 521 index patients with TB disease were registered at six health facilities in Uganda. Home visits to index patients identified 1,913 household contacts, 1,739 (91.0%) of whom underwent TB symptom screening at home; 321 (18.5%) reported TB symptoms. Of 309 (96.3%) persons with TB symptoms who were further evaluated, 284 (91.9%) provided a sputum specimen for laboratory testing, including 270 (84.1% of those with symptoms) who did so during the home visit; 214 (69.3%) underwent chest radiography. Overall, 80 TB cases were diagnosed; in 61 (76.3%) persons, the diagnosis was based on radiographic findings. Among 1,496 HHCs eligible for TPT, 1,239 (82.8%) initiated treatment and 1,178 (95.1%) completed it. Global scale-up of this approach might help reach global TB elimination goals.
Zhu S, Harriman K, Liu C
… +45 more, Kraushaar V, Hoover C, Shim K, Brummitt SI, Limas J, Garvey K, McNary J, Gao NJ, Ryder R, Stavig B, Schapiro J, Morales C, Wadford DA, Howard H, Heffelfinger J, Campagna R, Iniguez-Stevens E, Gharibi H, Lopez D, Esbenshade L, Ptomey P, Trivedi KK, Herrera JA, Locke J, Moss N, Rzucidlo P, Hernandez K, Nguyen M, Paul S, Mateo J, Del Carmen Luna C, Chang Y, Rangel M, DeLeon K, Masood A, Papasozomenos T, Moua P, Reinhart K, Kniss K, Davis CT, Kirby MK, Pan E, Murray EL, Los Angeles County H5 Response Team, California Department of Public Health H5 Laboratory Response Team
MMWR Morb Mortal Wkly Rep
· 2025 Mar · PMID 40080512
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Persons who work closely with dairy cows, poultry, or other animals with suspected or confirmed infection with highly pathogenic avian influenza (HPAI) A(H5N1) viruses are at increased risk for infection. In September 20...Persons who work closely with dairy cows, poultry, or other animals with suspected or confirmed infection with highly pathogenic avian influenza (HPAI) A(H5N1) viruses are at increased risk for infection. In September 2024, the California Department of Public Health was notified of the first human case of HPAI A(H5N1) in California through monitoring of workers on farms with infected cows. During September 30-December 24, 2024, a total of 38 persons received positive test results for HPAI A(H5N1) viruses in California; 37 were dairy farm workers with occupational exposure to sick cows, and one was a child aged <18 years with an undetermined exposure, the first pediatric HPAI A(H5N1) case reported in the United States. All patients had mild illness. The identification of cases associated with occupational exposure to HPAI A(H5N1) viruses on dairy farms highlights the continued risk for persons who work with infected animals. The pediatric case was identified through routine surveillance. Given recent increases in the prevalence of HPAI A(H5N1) viruses among some animal populations, public health agencies should continue to investigate cases of HPAI A(H5N1) in humans as part of control measures, pandemic preparedness, to identify concerning genetic changes, and to prevent and detect potential human-to-human transmission of the virus. To date, no human-to-human transmission of HPAI A(H5N1) virus has been identified in the United States.
Naumann RB, West BA, Barry V
… +2 more, Matthews S, Lee R
MMWR Morb Mortal Wkly Rep
· 2025 Mar · PMID 40080454
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Road traffic deaths are preventable but remain a major public health problem. Crashes cause more than 40,000 deaths annually in the United States, and traffic-related pedestrian deaths have increased rapidly. To examine...Road traffic deaths are preventable but remain a major public health problem. Crashes cause more than 40,000 deaths annually in the United States, and traffic-related pedestrian deaths have increased rapidly. To examine change in pedestrian and overall traffic death rates (deaths per 100,000 population) within an international context, CDC analyzed 2013-2022 data from the United States and 27 other high-income countries in the International Road Traffic and Accident Database, as well as early 2023 U.S. estimates. Between 2013 and 2022, U.S. pedestrian death rates increased 50% (from 1.55 to 2.33 per 100,000 population), while other countries generally experienced decreases (median decrease = 24.7%). During this period, overall U.S. traffic death rates increased 22.5% (from 10.41 to 12.76), but decreased by a median of 19.4% in 27 other high-income countries. Among all countries examined, the United States had the highest pedestrian death rates overall and among persons aged 15-24 and 25-64 years. Projected 2023 U.S. estimates suggest a potential decline in pedestrian (2%) and overall traffic (4%) deaths, compared with those in 2022. Accelerated adoption of a Safe System approach, focused on creating safer roadways and vehicles, establishing safer speeds, supporting safer road users, and improving post-crash care, can help reduce U.S. pedestrian and overall traffic deaths.
MMWR Morb Mortal Wkly Rep
· 2025 Mar · PMID 40048397
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Idiopathic pulmonary fibrosis (IPF), a progressive lung disease characterized by scarring and worsening lung function, has a poor prognosis. A recent systematic review estimated that 21% of IPF deaths might be attributab...Idiopathic pulmonary fibrosis (IPF), a progressive lung disease characterized by scarring and worsening lung function, has a poor prognosis. A recent systematic review estimated that 21% of IPF deaths might be attributable to occupational exposures. To describe IPF mortality among U.S. residents aged ≥15 years who were ever employed, by industry and occupation, CDC conducted an exploratory analysis of 2020-2022 multiple cause-of-death data. During 2020-2022, a total of 67,843 (39,712 [59%] male and 28,131 [41%] female) decedents had IPF, suggesting that during this 3-year period, 8,340 IPF deaths in males and 5,908 deaths in females might have been associated with occupational exposures. By industry group, the highest proportionate mortality ratios among males were among those employed in utilities (1.15) and among females, were among those employed in public administration (1.12). By occupation group, the highest IPF mortality rates among males were among community and social services workers (1.23) and among females among farming, fishing, and forestry workers (1.24). Estimates of elevated IPF mortality among workers in specific industries and occupations warrant confirmation, control of known exposure-related risk factors, and continued surveillance to better understand the full range of occupational exposures that might increase risk for developing IPF.
Frutos AM, Cleary S, Reeves EL
… +53 more, Ahmad HM, Price AM, Self WH, Zhu Y, Safdar B, Peltan ID, Gibbs KW, Exline MC, Lauring AS, Ball SW, DeSilva M, Tartof SY, Dascomb K, Irving SA, Klein NP, Dixon BE, Ong TC, Vaughn IA, House SL, Faryar KA, Nowalk MP, Gaglani M, Wernli KJ, Murugan V, Williams OL, Selvarangan R, Weinberg GA, Staat MA, Halasa NB, Sahni LC, Michaels MG, Englund JA, Kirby MK, Surie D, Dawood FS, Clopper BR, Moline HL, Link-Gelles R, Payne AB, Harker E, Wielgosz K, Weber ZA, Yang DH, Lewis NM, DeCuir J, Olson SM, Chung JR, Flannery B, Grohskopf LA, Reed C, Garg S, Ellington S, CDC Influenza Vaccine Effectiveness Collaborators
MMWR Morb Mortal Wkly Rep
· 2025 Feb · PMID 40014791
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Annual influenza vaccination is recommended for all persons aged ≥6 months in the United States. Interim influenza vaccine effectiveness (VE) was calculated among patients with acute respiratory illness-associated outpat...Annual influenza vaccination is recommended for all persons aged ≥6 months in the United States. Interim influenza vaccine effectiveness (VE) was calculated among patients with acute respiratory illness-associated outpatient visits and hospitalizations from four VE networks during the 2024-25 influenza season (October 2024-February 2025). Among children and adolescents aged <18 years, VE against any influenza was 32%, 59%, and 60% in the outpatient setting in three networks, and against influenza-associated hospitalization was 63% and 78% in two networks. Among adults aged ≥18 years, VE in the outpatient setting was 36% and 54% in two networks and was 41% and 55% against hospitalization in two networks. Preliminary estimates indicate that receipt of the 2024-2025 influenza vaccine reduced the likelihood of medically attended influenza and influenza-associated hospitalization. CDC recommends annual receipt of an age-appropriate influenza vaccine by all eligible persons aged ≥6 months as long as influenza viruses continue to circulate locally.