Grace M Jensen,Cyrus Gidfar,Kirsten Weisbeck,Meghan Barnes,Erin Minnerath,Shannon Matzinger,Allison Wheeler
{"title":"Notes from the Field: Wastewater Surveillance for Measles Virus During a Measles Outbreak - Colorado, August 2025.","authors":"Grace M Jensen,Cyrus Gidfar,Kirsten Weisbeck,Meghan Barnes,Erin Minnerath,Shannon Matzinger,Allison Wheeler","doi":"10.15585/mmwr.mm7502a2","DOIUrl":"https://doi.org/10.15585/mmwr.mm7502a2","url":null,"abstract":"","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"29 1","pages":"20-22"},"PeriodicalIF":0.0,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Malia Ireland,Curtis L Fritz,Stacy Holzbauer,Carrie Klumb,Maria Bye,Leah Bauck,Amanda Bakken,Michelle Dethloff,Rebecca Campagna,Mojgan Deldari,Susan Hepp,Ruth Lopez,Sharon Messenger,Christopher Preas,Aimee Rendon,Stephanie Koch-Kumar,Maria Rangel,Kanwaldeep Bains,Jeffrey Bulawit,Samer Al Saghbini,Trinidad Solis,Joe Prado,John Zweifler,Leticia Berber,Rais Vohra,Ignacio A Santana,Salvador Sandoval,Parmjit Sahota,Mark Hendrickson,Megan Black,Gloria Chavez,Andrew Schwab,Pamela A Yager,Michael Niezgoda,Vaughn V Wicker,Crystal M Gigante,Lillian A Orciari,Jesse D Blanton,Sarah C Bonaparte,Rebecca Earnest,Ryan M Wallace
Rabies is an enzootic viral disease in the continental United States and is typically transmitted through the bite of an infected mammal. Infection is almost always fatal if rabies postexposure prophylaxis (PEP) is not received before the onset of symptoms. Bats are the leading source of U.S. human rabies cases. In 2024, CDC identified two U.S. human rabies deaths in September (Minnesota) and November (California) in persons who had a recognized bat encounter but might not have been aware of the potential rabies risk. Neither patient reported the bat encounter to public health officials nor sought medical attention, including PEP, before symptom onset. Health officials conducted risk assessments among 384 persons in Minnesota, North Dakota, and California who had possible contact with either the bats that were presumed to have rabies or the patients while they were infectious; 45 (12%) of these persons were recommended to receive PEP. Bat bites often result in trivialized or inapparent wounds. Anyone with a possible bat exposure, even in the absence of a recognized bite, should immediately report the encounter to a health care provider or to public health officials for risk assessment, consideration of options for bat testing, and PEP administration, if indicated. Increased awareness of the potential risk for rabies after any bat interaction, even without a visible bite wound, might help prevent deaths.
{"title":"Human Rabies Deaths - Minnesota and California, 2024.","authors":"Malia Ireland,Curtis L Fritz,Stacy Holzbauer,Carrie Klumb,Maria Bye,Leah Bauck,Amanda Bakken,Michelle Dethloff,Rebecca Campagna,Mojgan Deldari,Susan Hepp,Ruth Lopez,Sharon Messenger,Christopher Preas,Aimee Rendon,Stephanie Koch-Kumar,Maria Rangel,Kanwaldeep Bains,Jeffrey Bulawit,Samer Al Saghbini,Trinidad Solis,Joe Prado,John Zweifler,Leticia Berber,Rais Vohra,Ignacio A Santana,Salvador Sandoval,Parmjit Sahota,Mark Hendrickson,Megan Black,Gloria Chavez,Andrew Schwab,Pamela A Yager,Michael Niezgoda,Vaughn V Wicker,Crystal M Gigante,Lillian A Orciari,Jesse D Blanton,Sarah C Bonaparte,Rebecca Earnest,Ryan M Wallace","doi":"10.15585/mmwr.mm7502a4","DOIUrl":"https://doi.org/10.15585/mmwr.mm7502a4","url":null,"abstract":"Rabies is an enzootic viral disease in the continental United States and is typically transmitted through the bite of an infected mammal. Infection is almost always fatal if rabies postexposure prophylaxis (PEP) is not received before the onset of symptoms. Bats are the leading source of U.S. human rabies cases. In 2024, CDC identified two U.S. human rabies deaths in September (Minnesota) and November (California) in persons who had a recognized bat encounter but might not have been aware of the potential rabies risk. Neither patient reported the bat encounter to public health officials nor sought medical attention, including PEP, before symptom onset. Health officials conducted risk assessments among 384 persons in Minnesota, North Dakota, and California who had possible contact with either the bats that were presumed to have rabies or the patients while they were infectious; 45 (12%) of these persons were recommended to receive PEP. Bat bites often result in trivialized or inapparent wounds. Anyone with a possible bat exposure, even in the absence of a recognized bite, should immediately report the encounter to a health care provider or to public health officials for risk assessment, consideration of options for bat testing, and PEP administration, if indicated. Increased awareness of the potential risk for rabies after any bat interaction, even without a visible bite wound, might help prevent deaths.","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"5 1","pages":"28-31"},"PeriodicalIF":0.0,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Notes from the Field: Retrospective Analysis of Wild-Type Measles Virus in Wastewater During a Measles Outbreak - Oregon, March 24-September 22, 2024.","authors":"Rebecca Falender,Melissa Sutton,Paul Cieslak,Juventila Liko,David Mickle,Christine Kelly,Tyler Radniecki","doi":"10.15585/mmwr.mm7502a1","DOIUrl":"https://doi.org/10.15585/mmwr.mm7502a1","url":null,"abstract":"","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"41 1","pages":"16-19"},"PeriodicalIF":0.0,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alexandra Barger,Sara F Margrey,Allison W Siu,Ryan Wallace,Rebecca Earnest,Molly Frankel,Hermella Eshete,Carolyn Swisshelm,Eli Shiltz,Kimberly Wright,Arminda Allen,Lillian A Orciari,Crystal M Gigante,Rene Condori,Pamela Yager,Michael Niezgoda,Panayampalli S Satheshkumar,Douglas Thoroughman,Kathleen Winter,Kelly Giesbrecht
Human rabies cases are rare in the United States; most result from domestic wildlife exposure. U.S. residents can acquire rabies abroad, typically through contact with dogs in areas where dog-maintained rabies is endemic. In November 2024, a man from Haiti was admitted to a Kentucky hospital with an 8-day history of progressive lower extremity pain and weakness. Soon after admission, he experienced hypersalivation, dysphagia, agitation, and eventually, respiratory failure requiring invasive mechanical ventilation. Ten days after admission, he was transferred to a referral hospital in Ohio, where his condition further deteriorated. Despite early consideration of rabies in the differential diagnosis, testing was delayed until late in the clinical course while other diagnostic possibilities were pursued. Rabies testing was initiated on the 29th hospital day and was confirmed 5 days later; the patient died that day. Phylogenetic analysis of the nucleoprotein gene supported acquisition of a dog-maintained rabies virus variant in Haiti. In total, 709 possible contacts during the patient's infectious period underwent risk assessment; 60 (8%) were recommended to receive rabies postexposure prophylaxis (PEP) because of exposure to saliva. Before the patient's rabies diagnosis, standard precautions were used inconsistently during his care; among 60 persons recommended to receive PEP, 52 (88%) were health care workers. Earlier rabies diagnosis and regular adherence to standard infection control precautions, recommended for all patient care, might have reduced health care-associated exposures. This case underscores the importance of early public health consultation upon clinical suspicion of rabies and universal adherence to standard precautions.
{"title":"Imported Human Rabies - Kentucky and Ohio, 2024.","authors":"Alexandra Barger,Sara F Margrey,Allison W Siu,Ryan Wallace,Rebecca Earnest,Molly Frankel,Hermella Eshete,Carolyn Swisshelm,Eli Shiltz,Kimberly Wright,Arminda Allen,Lillian A Orciari,Crystal M Gigante,Rene Condori,Pamela Yager,Michael Niezgoda,Panayampalli S Satheshkumar,Douglas Thoroughman,Kathleen Winter,Kelly Giesbrecht","doi":"10.15585/mmwr.mm7502a3","DOIUrl":"https://doi.org/10.15585/mmwr.mm7502a3","url":null,"abstract":"Human rabies cases are rare in the United States; most result from domestic wildlife exposure. U.S. residents can acquire rabies abroad, typically through contact with dogs in areas where dog-maintained rabies is endemic. In November 2024, a man from Haiti was admitted to a Kentucky hospital with an 8-day history of progressive lower extremity pain and weakness. Soon after admission, he experienced hypersalivation, dysphagia, agitation, and eventually, respiratory failure requiring invasive mechanical ventilation. Ten days after admission, he was transferred to a referral hospital in Ohio, where his condition further deteriorated. Despite early consideration of rabies in the differential diagnosis, testing was delayed until late in the clinical course while other diagnostic possibilities were pursued. Rabies testing was initiated on the 29th hospital day and was confirmed 5 days later; the patient died that day. Phylogenetic analysis of the nucleoprotein gene supported acquisition of a dog-maintained rabies virus variant in Haiti. In total, 709 possible contacts during the patient's infectious period underwent risk assessment; 60 (8%) were recommended to receive rabies postexposure prophylaxis (PEP) because of exposure to saliva. Before the patient's rabies diagnosis, standard precautions were used inconsistently during his care; among 60 persons recommended to receive PEP, 52 (88%) were health care workers. Earlier rabies diagnosis and regular adherence to standard infection control precautions, recommended for all patient care, might have reduced health care-associated exposures. This case underscores the importance of early public health consultation upon clinical suspicion of rabies and universal adherence to standard precautions.","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"177 1","pages":"23-27"},"PeriodicalIF":0.0,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K A Kamanani Conklin,Jasmine Y Nakayama,Miriam E Van Dyke,Kim G Harley,Hannah R Thompson
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.
{"title":"Leisure-Time Physical Activity Among Women of Reproductive Age - United States, 2022 and 2024.","authors":"K A Kamanani Conklin,Jasmine Y Nakayama,Miriam E Van Dyke,Kim G Harley,Hannah R Thompson","doi":"10.15585/mmwr.mm7441a2","DOIUrl":"https://doi.org/10.15585/mmwr.mm7441a2","url":null,"abstract":"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.","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"147 1","pages":"634-639"},"PeriodicalIF":0.0,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145777303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jacek M Mazurek,Katelynn E Dodd,Girija Syamlal,David J Blackley,David N Weissman
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.
{"title":"Coal Workers' Pneumoconiosis-Associated Deaths - United States, 2020-2023.","authors":"Jacek M Mazurek,Katelynn E Dodd,Girija Syamlal,David J Blackley,David N Weissman","doi":"10.15585/mmwr.mm7441a1","DOIUrl":"https://doi.org/10.15585/mmwr.mm7441a1","url":null,"abstract":"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.","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"155 1","pages":"627-633"},"PeriodicalIF":0.0,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145777445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stephanie A Irving,Elizabeth A K Rowley,Sean Chickery,Karthik Natarajan,Nicola P Klein,Shaun J Grannis,Toan C Ong,Sarah W Ball,Malini B DeSilva,Kristin Dascomb,Allison L Naleway,Melissa S Stockwell,Ashley B Stephens,Ousseny Zerbo,John Hansen,Lawrence Block,Karen B Jacobson,Brian E Dixon,Colin Rogerson,Tom Duszynski,Michelle A Barron,David Mayer,Catia Chavez,Zachary A Weber,Sarah E Reese,Inih Essien,Tamara Sheffield,Daniel Bride,Julie Arndorfer,Josh Van Otterloo,Padma Koppolu,Josephine Mak,Amber Kautz,Jennifer DeCuir,Ryan E Wiegand,Amanda B Payne,Ruth Link-Gelles
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.
在2023年9月至2024年8月期间，美国18岁以下儿童和青少年中约有38,000例与covid -19相关的住院治疗，比率约为每10万名儿童53例，从每10万名6个月以下儿童600例到每10万名5-17岁儿童和青少年21例不等。2024年6月27日，免疫实践咨询委员会建议所有年龄≥6个月的人接种2024-2025年COVID-19疫苗，该疫苗针对欧米克隆JN.1和JN.1衍生亚谱系。在cdc资助的SARS-CoV-2、流感和其他呼吸道病毒虚拟网络（VISION）中，研究人员采用检测阴性病例对照设计，评估2024-2025年COVID-19疫苗在2024年8月29日至2025年9月2日期间对COVID-19相关急诊科或急诊（ED/UC）访问的疫苗有效性（VE），研究对象为9个月至4岁的免疫功能正常儿童和5-17岁的儿童和青少年。一个覆盖九个州的多站点电子健康记录网络。在9个月至4岁的儿童中，在接种疫苗后的头7-179天内，与covid -19相关的ED/UC就诊的VE估计为76% （95% CI = 58%-87%）。在5-17岁的儿童和青少年中，在接种疫苗后的头7-179天内，与covid -19相关的ED/UC就诊的VE估计为56% （95% CI = 35%-70%）。这些研究结果表明，与未接种2024-2025剂量相比，接种2024-2025剂量的COVID-19疫苗可为儿童提供额外的保护，以防止与COVID-19相关的ED/UC遭遇。
{"title":"Effectiveness of 2024-2025 COVID-19 Vaccines in Children in the United States - VISION, August 29, 2024-September 2, 2025.","authors":"Stephanie A Irving,Elizabeth A K Rowley,Sean Chickery,Karthik Natarajan,Nicola P Klein,Shaun J Grannis,Toan C Ong,Sarah W Ball,Malini B DeSilva,Kristin Dascomb,Allison L Naleway,Melissa S Stockwell,Ashley B Stephens,Ousseny Zerbo,John Hansen,Lawrence Block,Karen B Jacobson,Brian E Dixon,Colin Rogerson,Tom Duszynski,Michelle A Barron,David Mayer,Catia Chavez,Zachary A Weber,Sarah E Reese,Inih Essien,Tamara Sheffield,Daniel Bride,Julie Arndorfer,Josh Van Otterloo,Padma Koppolu,Josephine Mak,Amber Kautz,Jennifer DeCuir,Ryan E Wiegand,Amanda B Payne,Ruth Link-Gelles","doi":"10.15585/mmwr.mm7440a1","DOIUrl":"https://doi.org/10.15585/mmwr.mm7440a1","url":null,"abstract":"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.","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"8 1","pages":"607-614"},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145728487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sarah Lim,Paula Snippes Vagnone,Natalie C Marshall,Christine Lees,Jennifer L Dale,Becky Smith,Elizabeth Palavecino,Ruth Lynfield,Annastasia Gross,Krista Knowles,Ayelet Michael-Gayego,Violeta Temper,Jacob Strahilevitz,Yonatan Oster,Daniel Grupel,Dan Reshef,Yair Motro,Petrus J van der Walt,Matthew A Croxen,Stephanie W Smith,Bonita Lee,Graham A Tipples,Bobby Warren,Jacob Moran-Gilad
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.
{"title":"Detection of Paraburkholderia in Clinical Specimens Associated with Use of Nonsterile Ultrasound Gel for Percutaneous Procedures - United States, Canada, and Israel, May 2023⎯April 2025.","authors":"Sarah Lim,Paula Snippes Vagnone,Natalie C Marshall,Christine Lees,Jennifer L Dale,Becky Smith,Elizabeth Palavecino,Ruth Lynfield,Annastasia Gross,Krista Knowles,Ayelet Michael-Gayego,Violeta Temper,Jacob Strahilevitz,Yonatan Oster,Daniel Grupel,Dan Reshef,Yair Motro,Petrus J van der Walt,Matthew A Croxen,Stephanie W Smith,Bonita Lee,Graham A Tipples,Bobby Warren,Jacob Moran-Gilad","doi":"10.15585/mmwr.mm7440a2","DOIUrl":"https://doi.org/10.15585/mmwr.mm7440a2","url":null,"abstract":"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.","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"150 1","pages":"615-621"},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145728596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carrie Klumb,Malia Ireland,Bonnie Miller,Erik Jopp,Betsy Lempelius,Albert Rovira,Hemant Naikare,Carly Bauer,Katie Harry,Scott A Cunningham,Gongping Liu,Thomas F Czeck,Ryan Wallace,Brian Hoefs,Stacy Holzbauer
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.
{"title":"Rabies Cluster Among Steers on a Dairy Farm - Minnesota, 2024.","authors":"Carrie Klumb,Malia Ireland,Bonnie Miller,Erik Jopp,Betsy Lempelius,Albert Rovira,Hemant Naikare,Carly Bauer,Katie Harry,Scott A Cunningham,Gongping Liu,Thomas F Czeck,Ryan Wallace,Brian Hoefs,Stacy Holzbauer","doi":"10.15585/mmwr.mm7440a3","DOIUrl":"https://doi.org/10.15585/mmwr.mm7440a3","url":null,"abstract":"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.","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"26 1","pages":"622-625"},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145728488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rebecca Earnest,Kris K Carter,Sara F Margrey,Vaughn V Wicker,Rebecca Betz,Rebecca Reik,Eli Shiltz,Basmah Khalil,Brandon Palinski,Barbara Jordan,Daniel Dodson,Erin Epson,Curtis L Fritz,Juliet Stoltey,Alison Sikola,Ricardo Garcia,Monika Roy,Pallavi Annambhotla,Sridhar V Basavaraju,Sarah C Bonaparte,Shama Cash-Goldwasser,Ian Kracalik,David W McCormick,Faisal S Minhaj,Lillian A Orciari,Panayampalli S Satheshkumar,Pamela Yager,David A Crum,Nathan Koffarnus,Monica Beddo,Molly Baker,Erin C Phipps,Hanna Oltean,Hannah Schnitzler,Crystal M Gigante,Ryan M Wallace,Mary Grace Stobierski,Christine Hahn
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.
{"title":"Human-to-Human Rabies Transmission via Solid Organ Transplantation from a Donor with Undiagnosed Rabies - United States, October 2024-February 2025.","authors":"Rebecca Earnest,Kris K Carter,Sara F Margrey,Vaughn V Wicker,Rebecca Betz,Rebecca Reik,Eli Shiltz,Basmah Khalil,Brandon Palinski,Barbara Jordan,Daniel Dodson,Erin Epson,Curtis L Fritz,Juliet Stoltey,Alison Sikola,Ricardo Garcia,Monika Roy,Pallavi Annambhotla,Sridhar V Basavaraju,Sarah C Bonaparte,Shama Cash-Goldwasser,Ian Kracalik,David W McCormick,Faisal S Minhaj,Lillian A Orciari,Panayampalli S Satheshkumar,Pamela Yager,David A Crum,Nathan Koffarnus,Monica Beddo,Molly Baker,Erin C Phipps,Hanna Oltean,Hannah Schnitzler,Crystal M Gigante,Ryan M Wallace,Mary Grace Stobierski,Christine Hahn","doi":"10.15585/mmwr.mm7439a1","DOIUrl":"https://doi.org/10.15585/mmwr.mm7439a1","url":null,"abstract":"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.","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"155 1","pages":"600-605"},"PeriodicalIF":0.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145674144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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