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Morbidity and Mortality Weekly Report (MMWR)
Get PDFOpioid use by pregnant women represents a significant public health concern given the association of opioid exposure and adverse maternal and neonatal outcomes, including preterm labor, stillbirth, neonatal abstinence syndrome, and maternal Mortality (1,2). State-level actions are critical to curbing the opioid epidemic through programs and policies to reduce use of prescription opioids and illegal opioids including heroin and illicitly manufactured fentanyl, both of which contribute to the epidemic (3). Hospital discharge data from the 1999-2014 Healthcare Cost and Utilization Project (HCUP) were analyzed to describe U.S. national and state-specific Trends in opioid use disorder documented at delivery hospitalization. Nationally, the prevalence of opioid use disorder more than quadrupled during 1999-2014 (from 1.5 per 1,000 delivery hospitalizations to 6.5; p<0.05). Increasing Trends over time were observed in all 28 states with available data (p<0.05). In 2014, prevalence ranged from 0.7 in the District of Columbia (DC) to 48.6 in Vermont. Continued national, state, and provider efforts to prevent, monitor, and treat opioid use disorder among reproductive-aged and pregnant women are needed. Efforts might include improved access to data in Prescription Drug Monitoring Programs, increased substance abuse screening, use of medication-assisted therapy, and substance abuse treatment referrals
J Infect Dis
No full textIn 2015, the Global Commission for the Certification of Polio Eradication certified the eradication of type 2 wild poliovirus, 1 of 3 wild poliovirus serotypes causing paralytic polio since the beginning of recorded history. This milestone was one of the key criteria prompting the Global Polio Eradication Initiative to begin withdrawal of oral polio vaccines (OPV), beginning with the type 2 component (OPV2), through a globally synchronized initiative in April and May 2016 that called for all OPV using countries and territories to simultaneously switch from use of trivalent OPV (tOPV; containing types 1, 2, and 3 poliovirus) to bivalent OPV (bOPV; containing types 1 and 3 poliovirus), thus withdrawing OPV2. Before the switch, immunization programs globally had been using approximately 2 billion tOPV doses per year to immunize hundreds of millions of children. Thus, the globally synchronized withdrawal of tOPV was an unprecedented achievement in immunization and was part of a crucial strategy for containment of polioviruses. Successful implementation of the switch called for intense global coordination during 2015-2016 on an unprecedented scale among global public health technical agencies and donors, vaccine manufacturers, regulatory agencies, World Health Organization (WHO) and United Nations Children's Fund (UNICEF) regional offices, and national governments. Priority activities included cessation of tOPV production and shipment, national inventories of tOPV, detailed forecasting of tOPV needs, bOPV licensing, scaling up of bOPV production and procurement, developing national operational switch plans, securing funding, establishing oversight and implementation committees and teams, training logisticians and health workers, fostering advocacy and communications, establishing monitoring and validation structures, and implementing waste management strategies. The WHO received confirmation that, by mid May 2016, all 155 countries and territories that had used OPV in 2015 had successfully withdrawn OPV2 by ceasing use of tOPV in their national immunization programs. This article provides an overview of the global efforts and challenges in successfully implementing this unprecedented global initiative, including (1) coordination and tracking of key global planning milestones, (2) guidance facilitating development of country specific plans, (3) challenges for planning and implementing the switch at the global level, and (4) best practices and lessons learned in meeting aggressive switch timelines. Lessons from this monumental public health achievement by countries and partners will likely be drawn upon when bOPV is withdrawn after polio eradication but also could be relevant for other global health initiatives with similarly complex mandates and accelerated timelines.001/World Health Organization/International28838179PMC585409
Morbidity and Mortality Weekly Report (MMWR)
No full textIdentifying HIV-infected persons who are unaware of their human immunodeficiency Virus (HIV) infection status, linking them to care, and reducing health disparities are important national HIV Prevention goals (1). Gay, bisexual, and other men who have sex with men (collectively referred to as MSM) accounted for 70% of HIV infection diagnoses in the United States in 2016, despite representing only 2% of the population (2,3). African American or black (black) MSM accounted for 38% of all new diagnoses of HIV infection among MSM (2). Nearly two thirds (63%) of all U.S. black MSM with diagnosed HIV infection reside in the southern United States (2), making targeted HIV Prevention activities for black MSM in this region critical. Analysis of CDC-funded HIV tTesting data for black MSM submitted by 20 health departments in the southern United States in 2016 revealed that although black MSM received 6% of the HIV tests provided, they accounted for 36% of the new diagnoses in non-health care facilities. Among those who received new diagnoses, 67% were linked to HIV medical care within 90 days of Diagnosis, which is below the 2020 national goal of linking at least 85% of persons with newly diagnosed HIV infection to care within 30 days (1). Black MSM in the southern United States are the group most affected by HIV, but only a small percentage of CDC tests in the southern United States are provided to this group. Increasing awareness of HIV status through HIV tTesting, especially among black MSM in the southern United States, is essential for reducing the risk for Transmission and addressing disparities. HIV tTesting programs in the southern United States can reach more black MSM by conducting targeted risk-based tTesting in non-health care settings and by routine screening in agencies that also provide health care services to black MSM
Arthropod-borne virus information exchange Number 39, September 1980
Get PDFSOMETHING NEW! A SPECIAL SECTION ON VIRAL HEMORRHAGIC FEVERSWith increasing recognition of the public health importance of the viral hemorrhagic fevers, the leading workers in this field have seen the need to keep one another apprised of their findings on a current basis. They have considered distributing a "newsletter" of their own, patterned after our highly successful "Arthropod-borne Virus Information Exchange." However, in our judgement, there seems to be little need for this duplication of effort and expense, since the "Info-Exchange" has long embraced the hemorrhagic fever viruses, even the nonarboviral arenaviruses.To assure this group of workers that their reports are truly welcome, we have set up a separate section for the hemorrhagic fevers, and if it meets with your favor, we'll continue to do so in the future.198
J Infect Dis
No full textBackground.We present an empirical economic cost analysis of the April 2016 switch from trivalent (tOPV) to bivalent (bOPV) oral polio vaccine at the national-level and 3 provinces (Bali, West Sumatera and Nusa Tenggara) for Indonesia\u2019s Expanded Program on Immunization.Methods.Data on the quantity and prices of resources used in the 4 World Health Organization guideline phases of the switch were collected at the national-level and in each of the sampled provinces, cities/districts, and health facilities. Costs were calculated as the sum of the value of resources reportedly used in each sampled unit by switch phase.Results.Estimated national-level costs were 9062 to 4576 to 3488 to 4 076 446 (Bali, minimum cost scenario) to $28 120 700 (West Sumatera, maximum cost scenario).Conclusions.Our findings suggest that the majority of tPOV to bOPV switch costs were borne at the subnational level. Considerable variation in reported costs among health system levels surveyed indicates a need for flexibility in budgeting for globally synchronized public health activities.201728838204PMC5853418686
Active Bacterial Core Surveillance (ABCs) Report Emerging Infections Program Network: group B streptococcus, 2004
Get PDFABCs Areas: California (3 county San Francisco Bay area); Colorado (children < 1 year in 5 county Denver area); Connecticut (children < 1 year); Georgia (20 county Metro area); Maryland; Minnesota; New Mexico; New York (15 county Rochester and Albany areas); Oregon (3 county Portland area); Tennessee (11 urban counties)ABCs Population: The surveillance areas represent 26,996,898 persons and 454,883 live births. Source: National Center for Health Statistics bridged-race vintage 2004 postcensal file and 2003 state vital recordsABCs Case Definition: Invasive group B streptococcal disease: isolation of group B streptococcus from a normally sterile site in a resident of a surveillance area in 2004. Early-onset cases occur at < 7 days of age and late-onset occur between 7 and 89 days of age..Citation: Centers for Disease Control and Prevention. 2005. Active Bacterial Core Surveillance Report, Emerging Infections Program Network, Group B Streptococcus, 2004.Dec 2005 File \u2013 05 Jan 2005Publication date from document properties.gbs04.pd
National Enteric Disease Surveillance : Salmonella annual report,\ua02016
Get PDFThe Laboratory-based Enteric Disease Surveillance (LEDS) system contributes to the understanding of human salmonellosis in the United States by collecting reports of infections from state and regional public health laboratories. Reporting to LEDS is voluntary; the number of laboratories submitting reports varies somewhat from year to year, although almost all laboratories report every year. Diagnosing Salmonella infections based on results from culture-independent diagnostic tests (CIDTs) has become more common in recent years (1). Cases confirmed only by CIDT provide no serotype information and are listed in the \u201cUnknown serotype\u201d category. Occasionally, more than one isolate is reported from a single episode of infection in a person; this report includes only one isolate of a given Salmonella serotype per person within a 30-day period.Data in this report are current as of February 28, 2018.CS 290910-A2016-Salmonella-report-508.pdf201
Health Promot Pract
Get PDFBackgroundConcussions are responsible for numerous emergency department visits and hospitalizations among children annually. However, there remains a great deal of confusion about how to prevent and manage concussions in youth. To teach children aged 6 to 8 years about concussion safety, the Centers for Disease Control and Prevention (CDC) created a mobile gaming application called HEADS UP Rocket Blades. This report introduces the game and presents findings on its evaluation.MethodsThe aim of the game is to teach children what a concussion is, its commons signs and symptoms, how to prevent one, and what to do if one occurs. An early version of the game went through two rounds of usability testing with children and parents to obtain initial impressions and make improvements.ResultsThe first round of usability testing focused on the mechanics of the game. Based on feedback from this session, CDC and the developers simplified the messaging and adjusted the game\u2019s level of difficulty. The second round focused on the gaming experience. The children indicated that they enjoyed playing, and nearly all were able to relay at least one learning objective.ConclusionsParents and children rated Rocket Blades as a good learning tool and indicated that they would download it for personal use.CC999999/ImCDC/Intramural CDC HHSUnited States
J Immunol Methods
Get PDFBackground:CD4+ T-lymphocyte count testing at the point-of-care (POC) may improve linkage to care of persons diagnosed with HIV-1 infection, but the accuracy of POC devices when operated by lay-counselors in the era of task-shifting is unknown. We examined the accuracy of Alere\u2019s Pima\u2122 POC device on both capillary and venous blood when performed by lay-counselors and laboratory technicians.Methods:In Phase I, we compared the perfomance of POC against FACSCalibur\u2122 for 280 venous specimens by laboratory technicians. In Phase II we compared POC performance by lay-counselors versus laboratory technicians using 147 paired capillary and venous specimens, and compared these to FACSCalibur\u2122. Statistical analyses included Bland-Altman analyses, concordance correlation coefficient, sensitivity, and specificity at treatment eligibility thresholds of 200, 350, and 500 cells/\u3bcl.Results:Phase I: POC sensitivity and specificity were 93.0% and 84.1% at 500 cells/\u3bcl, respectively. Phase II: Good agreement was observed for venous POC results from both lay-counselors (concordance correlation coefficient (CCC) = 0.873, bias 1286.4 cells/\u3bcl) and laboratory technicians (CCC = 0.920, bias 1265.7 cells/\u3bcl). Capillary POC had good correlation: lay-counselors (CCC = 0.902, bias 1271.2 cells/\u3bcl), laboratory technicians (CCC = 0.918, bias 1263.0 cells/\u3bcl). Misclassification at the 500 cells/\u3bcl threshold for venous blood was 13.6% and 10.2% for lay-counselors and laboratory technicians and 12.2% for capillary blood in both groups. POC tended to under-classify the CD4 values with increasingly negative bias at higher CD4 values.Conclusions:Pima\u2122 results were comparable to FACSCalibur\u2122 for both venous and capillary specimens when operated by lay-counselors. POC CD4 testing has the potential to improve linkage to HIV care without burdening laboratory technicians in resource-limited settings.CC999999/Intramural CDC HHSUnited States