MMWR. Morbidity and mortality weekly report最新文献

In April 2024, CDC's PulseNet identified a cluster of seven Salmonella Cotham cases from five states. Isolates were highly related by whole genome sequencing (WGS), and one patient reported contact with a pet bearded dragon. CDC initiated a multistate investigation and as of December 10, 2024, an additional 19 cases had been identified, for a total of 26 confirmed cases from 13 states; state public health partners identified one probable case in an additional state for a total of 27 cases. Eighteen of 25 cases (72%) were among persons who reported contact with a bearded dragon or lizard. Children aged <5 years, especially infants, were disproportionately affected, accounting for 17 (65%) of the 26 confirmed cases; most had bearded dragons in the home without direct animal contact. WGS of two bearded dragon specimens collected in 2024 and three bearded dragon specimens collected during 2012-2014 confirmed genetic relatedness of this rare Salmonella strain and continued circulation among commercially sold bearded dragons. CDC implemented a One Health approach in response, working with pet industry representatives to disseminate information about biosecurity best practices to bearded dragon suppliers and retailers. Investigators contacted a common bearded dragon supplier identified in the traceback investigation to share biosecurity and prevention recommendations. CDC used social media and a website investigation notice to inform the public, recommending that caregivers prevent young children from indirect reptile contact by restricting reptiles from roaming freely, separating reptiles and supplies from food preparation areas, and washing hands and changing clothes after handling reptiles and before holding infants.

Respiratory syncytial virus (RSV) is the leading cause of infant hospitalization in the United States. A new RSV monoclonal antibody (nirsevimab) for infants and an RSV vaccine for pregnant women were recommended by the Advisory Committee on Immunization Practices in August and September 2023, respectively, to protect infants against RSV infection. Sufficient data have become available to allow estimates of infant RSV immunization coverage through administration of these products. Among infants born during October 2023-March 2024, infant RSV immunization coverage was estimated by summing the total number of infants who received nirsevimab and the number of women of childbearing age who received RSV vaccine, as reported to immunization information systems (IISs) in 33 U.S. states and the District of Columbia (DC), and dividing by the total number of live births, obtained from CDC Wide-ranging Online Data for Epidemiologic Research (WONDER) natality data. Across 33 states and DC, an estimated 29% of infants born during October 2023-March 2024 were immunized against RSV during the 2023-24 respiratory virus season, including 19% through infant receipt of nirsevimab and 10% through maternal RSV vaccination. Infant RSV immunization coverage through nirsevimab or maternal vaccination ranged from an estimated 11% to 53% by state. Among infants who received nirsevimab, 38% received it within the first week of life (0-6 days after birth). Continued efforts are needed to increase RSV immunization coverage among infants and pregnant women.

Exposure to a rabid animal is a life-threatening emergency because infection is almost always fatal if rabies postexposure prophylaxis (PEP) is not initiated promptly. In August 2024, the Maryland Department of Health was notified that an aggressive feral cat had been captured and euthanized and had subsequently received a positive test result for rabies. The cat was part of a group of approximately 20 local feral cats and kittens that was receiving no, or little, human care (i.e., an unmanaged cat colony). Cecil County (Maryland) Health Department and the Maryland Department of Health coordinated with Cecil County Animal Services, Cecil County Emergency Services, and CDC to identify and interview persons potentially exposed to the rabid cat, which included a novel use of reverse 911 messaging. Three persons were identified who had been exposed, and all received PEP. No human rabies cases occurred. Three additional cats from the colony were captured and euthanized; their rabies test results were negative. Unmanaged cat colonies pose public health risks, and extensive resources might be required to prevent negative health outcomes. Cat colony management, including activities to maintain high rabies vaccination coverage within colonies, can help to mitigate these risks. A better understanding of urban cat ecology and its role in rabies transmission and human exposure is needed.

Three vaccines are recommended for routine administration to adolescents by the Advisory Committee on Immunization Practices: tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap); quadrivalent meningococcal conjugate vaccine (MenACWY); and human papillomavirus (HPV) vaccine. Data from the 2024 National Immunization Survey-Teen were analyzed to determine national, state, and selected local area vaccination coverage in 2024. Household response rate (21.0%) and receipt of adequate provider data for adolescents with completed interviews (42.8%) were comparable to prior survey years. Among 16,325 adolescents aged 13-17 years with adequate provider data included in the survey, coverage with ≥1 Tdap dose increased from 89.0% in 2023 to 91.3% in 2024; coverage with ≥1 MenACWY dose increased from 88.4% to 90.1%. HPV vaccination coverage remained stable for the third consecutive year; 78.2% of adolescents had received ≥1 dose, and 62.9% were up to date with the HPV vaccination series. Coverage with ≥1 Tdap dose was ≥90% in 39 states, with ≥1 MenACWY dose was ≥90% in 30 states, and with ≥1 dose of HPV vaccine was ≥80% in 26 states and the District of Columbia. Since 2016, lower HPV vaccination coverage in nonmetropolitan statistical areas (MSAs) compared with that in MSA principal cities has persisted, with an 11 percentage point difference in coverage with ≥1 HPV vaccine dose and percentage of adolescents up to date with HPV vaccination in 2024. Health care providers can support adolescent health by discussing and recommending vaccines, as well as reviewing patient records to ascertain whether adolescents are up to date with recommended vaccines.

Foodborne botulism is a rare and potentially fatal illness caused by ingestion of food containing botulinum neurotoxin produced by the bacterium Clostridium botulinum or other neurotoxigenic Clostridium species. C. botulinum can grow in improperly prepared or stored food items such as home-canned or home-preserved vegetables. On June 25, 2024, the Fresno County Department of Public Health and California Department of Public Health, in collaboration with CDC and two local hospitals, initiated an investigation of a foodborne botulism outbreak linked to two related family gatherings in Fresno County, California. A total of 31 persons attended one or both gatherings. Eight attendees had symptoms compatible with botulism and received botulism antitoxin; five of eight had botulinum neurotoxin type A (BoNT/A) detected in serum. Patients had hospital stays ranging from 2 to 42 days, six patients were admitted to an intensive care unit, and two required invasive mechanical ventilation; all survived. Epidemiologic investigation identified home-preserved prickly pear cactus pads (nopales) included in a homemade salad and served at both events as a food item of interest; laboratory testing confirmed the nopales salad as the source of BoNT/A. This foodborne botulism outbreak is the first reported to be linked to home canning of nopales, a popular vegetable used in traditional Mexican cuisine. Rapid public health coordination is essential for responses to foodborne botulism outbreaks. Enhancing community and clinician awareness of foodborne botulism by increasing access to culturally and linguistically accessible home food preservation and canning guidelines might help prevent future outbreaks.

Mycoplasma pneumoniae is a common bacterial cause of respiratory infection and a leading cause of childhood community-acquired pneumonia (CAP). Increases in M. pneumoniae infection occur every 3-5 years. In the United States, M. pneumoniae prevalence decreased during and immediately after the COVID-19 pandemic. Information from 42 U.S. children's hospitals that provided information to the Pediatric Health Information System, a database of clinical and resource use information, was used to identify discharge diagnostic codes for 2018-2024 indicating M. pneumoniae infection. M. pneumoniae-associated CAP incidence among children aged ≤18 years was significantly higher in 2024 (12.5 per 1,000 hospitalizations) than during 2018-2023 (2.1). During the study period, an M. pneumoniae diagnostic code was listed in 11.5% of pediatric CAP hospitalizations, peaking at 53.8% in July 2024. Among pediatric M. pneumoniae CAP cases, the highest percentage occurred among children aged 6-12 years (42.6%), followed by children aged 2-5 years (25.7%) and 13-18 years (21.1%). The lowest occurred among those aged 12-23 months (6.4%) and 0-11 months (4.2%). M. pneumoniae infections in 2024 were not more severe than 2018-2023 infections, as assessed by length of hospitalization and percentage of patients admitted to an intensive care unit. The increase in M. pneumoniae infections in the United States in 2024 might be higher than previous periodic increases because the susceptible population was larger after sustained low incidence during and immediately after the COVID-19 pandemic. Health care providers should be aware of the periodicity of M. pneumoniae CAP and consider testing for this pathogen as a cause of respiratory illness among children of all ages.