MMWR. Morbidity and mortality weekly report最新文献

A sudden unexpected infant death (SUID) is defined as the sudden and unexpected death of an infant (a child aged <1 year) whose cause of death was not obvious before investigation. Pillows used to support infants during feeding, often referred to as nursing pillows, have been identified as a potential hazard in sleep spaces for infants. Georgia county-level Child Death Review (CDR) data from the Pediatric National Fatality Review Case Reporting System were analyzed to ascertain whether nursing pillows were found in the sleep space of infants who died of SUID. Among 1,685 SUID cases in Georgia during 2013-2022, a nursing pillow was found in the sleep space of 84 (5%) infants. Among these, 86% of infants who died with a nursing pillow present were aged <4 months, 40% were aged <2 months, and 55% were Black or African American. A total of 56% of the deaths occurred in an adult bed, and all but one (99%) occurred in association with bed sharing. Among the 84 deaths, the nursing pillow was found under the infant in 58 (69.1%) cases, next to the infant in 14 (16.7%) cases, on top of the infant in two (2.4%) cases, and tangled around the infant in one (1.2%) case. This analysis indicates that nursing pillows are being used in ways other than their intended use as an aid in feeding. Since April 2025, newly manufactured nursing pillows must have labels indicating the potential risk associated with using them in infants' sleep spaces; however, many nursing pillows in use or still on the market lack such labeling. Warning consumers of risks associated with using nursing pillows in infant sleep environments, in addition to continued education and outreach about safe infant sleep, could help reduce SUIDs.

Economic hardship can limit the ability of workers to prevent and address adverse health conditions. Using 2022 and 2023 Behavioral Risk Factor Surveillance System data, this exploratory analysis assessed economic hardship measures and self-rated health among currently employed and recently unemployed (<12 months) U.S. adults. Measures of economic hardship were 1) employment instability, 2) food insecurity, 3) housing insecurity, 4) utility insecurity, 5) lack of reliable transportation, 6) receipt of food stamps or Supplemental Nutrition Assistance Program benefits, 7) lack sof health insurance, and 8) cost as a barrier to needed medical care. Overall, 6.9% of currently or recently employed U.S. adults in 36 states and the U.S. Virgin Islands had high levels of economic hardship (reporting at least four of eight economic hardship indicators), and 12.5% reported having fair or poor health. High levels of economic hardship were more common among persons who were recently unemployed, were aged 18-49 years, were female, were Hispanic or Latino (Hispanic) or non-Hispanic Black or African American, had a high school education or less, or had a household income <$50,000 per year than among all workers combined. Fair or poor self-rated health was most common among workers who were Hispanic or were from lower educational attainment and income categories. By occupational group, the prevalence of high levels of economic hardship was highest in farming, fishing, and forestry (18.5%); building and grounds cleaning and maintenance (18.2%); and food preparation and serving (16.0%) and was lowest in the legal occupations (1.2%). Among occupational groups, the prevalence of fair or poor health generally increased with the prevalence of high economic hardship, and almost every occupational group with a high level of economic hardship had a statistically significantly elevated prevalence of fair or poor health compared with that among all workers combined. Given associations between unmet economic needs and health, these findings can be used by policymakers to identify groups of workers with disproportionate economic hardships and develop strategies to enhance economic security and health for all workers.

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.

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.

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.