Rupa R Patel,Karen W Hoover,Allison Lale,Janet Cabrales,Katrina M Byrd,Athena P Kourtis
In 2023, approximately 39,000 persons received a diagnosis of HIV in the United States. Although HIV preexposure prophylaxis (PrEP) is highly effective in preventing HIV infection, acceptance of, adherence to, and persistence taking the available oral and injectable PrEP regimens have been suboptimal. CDC PrEP guidelines published in 2021 include two oral tenofovir-based regimens and cabotegravir, the only injectable PrEP regimen approved by the Food and Drug Administration (FDA) at that time. In June 2025, FDA approved injectable lenacapavir (LEN), administered every 6 months, as HIV PrEP based on results from two randomized controlled trials (PURPOSE 1 and PURPOSE 2). The CDC PrEP Guidelines Work Group assessed evidence for the efficacy and safety of LEN PrEP using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. The two trials reported LEN efficacy at reducing HIV infection as 100% among females and 96% among a primarily male trial population, compared with the estimated background HIV incidence (or no use of PrEP) over a follow-up of 52 weeks. No significant safety concerns were identified in the trials. The most common adverse events were mild (grade 1) to moderate (grade 2) injection site reactions. Based on a high certainty of evidence for the efficacy and safety of LEN as assessed by the GRADE analysis, subcutaneous injection of LEN every 6 months is strongly recommended as a PrEP option in persons weighing ≥77 lbs (≥35 kg) who would benefit from PrEP. LEN has the potential to improve PrEP adherence and thus enhance HIV prevention in the United States.
{"title":"Clinical Recommendation for the Use of Injectable Lenacapavir as HIV Preexposure Prophylaxis - United States, 2025.","authors":"Rupa R Patel,Karen W Hoover,Allison Lale,Janet Cabrales,Katrina M Byrd,Athena P Kourtis","doi":"10.15585/mmwr.mm7435a1","DOIUrl":"https://doi.org/10.15585/mmwr.mm7435a1","url":null,"abstract":"In 2023, approximately 39,000 persons received a diagnosis of HIV in the United States. Although HIV preexposure prophylaxis (PrEP) is highly effective in preventing HIV infection, acceptance of, adherence to, and persistence taking the available oral and injectable PrEP regimens have been suboptimal. CDC PrEP guidelines published in 2021 include two oral tenofovir-based regimens and cabotegravir, the only injectable PrEP regimen approved by the Food and Drug Administration (FDA) at that time. In June 2025, FDA approved injectable lenacapavir (LEN), administered every 6 months, as HIV PrEP based on results from two randomized controlled trials (PURPOSE 1 and PURPOSE 2). The CDC PrEP Guidelines Work Group assessed evidence for the efficacy and safety of LEN PrEP using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. The two trials reported LEN efficacy at reducing HIV infection as 100% among females and 96% among a primarily male trial population, compared with the estimated background HIV incidence (or no use of PrEP) over a follow-up of 52 weeks. No significant safety concerns were identified in the trials. The most common adverse events were mild (grade 1) to moderate (grade 2) injection site reactions. Based on a high certainty of evidence for the efficacy and safety of LEN as assessed by the GRADE analysis, subcutaneous injection of LEN every 6 months is strongly recommended as a PrEP option in persons weighing ≥77 lbs (≥35 kg) who would benefit from PrEP. LEN has the potential to improve PrEP adherence and thus enhance HIV prevention in the United States.","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"4 6 1","pages":"541-549"},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083395","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: Differences in Suicide Rates, by Race and Ethnicity and Age Group - United States, 2018-2023.","authors":"Deborah M Stone,Alison L Cammack,Eric G Carbone","doi":"10.15585/mmwr.mm7435a2","DOIUrl":"https://doi.org/10.15585/mmwr.mm7435a2","url":null,"abstract":"","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"6 1","pages":"550-553"},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083420","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: Invasive Group G β-Hemolytic Streptococcus Outbreak at a Long-Term Care Facility - Pennsylvania, 2024.","authors":"Monica Giacomucci,Laxmi Modali,Cara Bicking Kinsey,Kim Warren,Sopio Chochua,Christopher J Gregory,Allison Longenberger","doi":"10.15585/mmwr.mm7434a2","DOIUrl":"https://doi.org/10.15585/mmwr.mm7434a2","url":null,"abstract":"","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"60 1","pages":"538-539"},"PeriodicalIF":0.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145036105","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}
Alissa O'Halloran,Jennifer Whitmill Habeck,Matthew Gilmer,Ryan Threlkel,Shua J Chai,Brenna Hall,Isaac Armistead,Nisha B Alden,James Meek,Kimberly Yousey-Hindes,Kyle P Openo,Lucy S Witt,Maya L Monroe,Patricia A Ryan,Lauren Leegwater,Sue Kim,Melissa McMahon,Ruth Lynfield,Khalil Harbi,Murtada Khalifa,Caroline McCahon,Grant Barney,Bridget J Anderson,Christina B Felsen,Brenda L Tesini,Nancy E Moran,Denise Ingabire-Smith,Melissa Sutton,M Andraya Hendrick,William Schaffner,H Keipp Talbot,Andrea George,Hafsa Zahid,Shikha Garg,Catherine H Bozio
The U.S. 2024-25 influenza season was a high-severity season characterized by co-circulation of influenza A(H1N1)pdm09 and A(H3N2) viruses. Data from the Influenza Hospitalization Surveillance Network covering 9% of the U.S. population, were analyzed to compare laboratory-confirmed influenza-associated hospitalization rates and patient clinical characteristics from the 2024-25 season with data from past seasons. Based on preliminary data from influenza-associated hospital admissions from October 1, 2024, through April 30, 2025, the cumulative influenza-associated hospitalization rate (127.1 influenza-associated hospitalizations per 100,000 population) had surpassed all end-of-season rates during the period beginning with the 2010-11 season. Cumulative 2024-25 season rates were highest among persons aged ≥75 years (598.8). Across age groups, hospitalization rates during the 2024-25 season were 1.8 to 2.8 times higher than median historical rates during the period beginning with the 2010-11 season. Among hospitalized patients, 32.4% had received an influenza vaccine, and 84.8% received antiviral treatment, though children and adolescents aged 5-17 years had the lowest proportion of antiviral receipt (61.6%). Similar to past seasons, most patients hospitalized with influenza during the 2024-25 season (89.1%) had one or more underlying medical conditions, 16.8% were admitted to an intensive care unit, 6.1% received invasive mechanical ventilation, and 3.0% died in hospital. Seasonal influenza viruses can cause severe disease, particularly among persons who are at higher risk for complications. CDC recommends that all persons aged ≥6 months who do not have contraindications receive an annual influenza vaccine and that all hospitalized patients with influenza receive timely antiviral treatment to reduce the risk for complications.
{"title":"Influenza-Associated Hospitalizations During a High Severity Season - Influenza Hospitalization Surveillance Network, United States, 2024-25 Influenza Season.","authors":"Alissa O'Halloran,Jennifer Whitmill Habeck,Matthew Gilmer,Ryan Threlkel,Shua J Chai,Brenna Hall,Isaac Armistead,Nisha B Alden,James Meek,Kimberly Yousey-Hindes,Kyle P Openo,Lucy S Witt,Maya L Monroe,Patricia A Ryan,Lauren Leegwater,Sue Kim,Melissa McMahon,Ruth Lynfield,Khalil Harbi,Murtada Khalifa,Caroline McCahon,Grant Barney,Bridget J Anderson,Christina B Felsen,Brenda L Tesini,Nancy E Moran,Denise Ingabire-Smith,Melissa Sutton,M Andraya Hendrick,William Schaffner,H Keipp Talbot,Andrea George,Hafsa Zahid,Shikha Garg,Catherine H Bozio","doi":"10.15585/mmwr.mm7434a1","DOIUrl":"https://doi.org/10.15585/mmwr.mm7434a1","url":null,"abstract":"The U.S. 2024-25 influenza season was a high-severity season characterized by co-circulation of influenza A(H1N1)pdm09 and A(H3N2) viruses. Data from the Influenza Hospitalization Surveillance Network covering 9% of the U.S. population, were analyzed to compare laboratory-confirmed influenza-associated hospitalization rates and patient clinical characteristics from the 2024-25 season with data from past seasons. Based on preliminary data from influenza-associated hospital admissions from October 1, 2024, through April 30, 2025, the cumulative influenza-associated hospitalization rate (127.1 influenza-associated hospitalizations per 100,000 population) had surpassed all end-of-season rates during the period beginning with the 2010-11 season. Cumulative 2024-25 season rates were highest among persons aged ≥75 years (598.8). Across age groups, hospitalization rates during the 2024-25 season were 1.8 to 2.8 times higher than median historical rates during the period beginning with the 2010-11 season. Among hospitalized patients, 32.4% had received an influenza vaccine, and 84.8% received antiviral treatment, though children and adolescents aged 5-17 years had the lowest proportion of antiviral receipt (61.6%). Similar to past seasons, most patients hospitalized with influenza during the 2024-25 season (89.1%) had one or more underlying medical conditions, 16.8% were admitted to an intensive care unit, 6.1% received invasive mechanical ventilation, and 3.0% died in hospital. Seasonal influenza viruses can cause severe disease, particularly among persons who are at higher risk for complications. CDC recommends that all persons aged ≥6 months who do not have contraindications receive an annual influenza vaccine and that all hospitalized patients with influenza receive timely antiviral treatment to reduce the risk for complications.","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"35 1","pages":"529-537"},"PeriodicalIF":0.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145036106","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}
Susan J Ching,Ga On Jung,Angela Osuna,Theresa Casey,Hui Xia,Karina Bostwick,Amol H Patadia,Lauren M Sweet,Oscar Gallardo-Huizar,Thomas F Gibbons,Joseph E Marcus
Viral and allergic conjunctivitis are more common than bacterial conjunctivitis in healthy immunocompetent adults. Neisseria meningitidis is an uncommon cause of bacterial conjunctivitis. During February-May 2025, an outbreak of 41 meningococcal conjunctivitis cases occurred among healthy, communally housed, military trainees at Joint Base San Antonio-Lackland in San Antonio, Texas; all had received the quadrivalent meningococcal vaccine. One patient was hospitalized with periorbital cellulitis and received intravenous antibiotics; all other patients were treated successfully with topical antibiotics. Whole genome sequencing of isolates from the first two cases suggested that the organism was unencapsulated (nongroupable) and that the cases were related. After the identification of two cases of N. meningitidis conjunctivitis among military trainees within a 3-week period in February 2025, an investigation was initiated by the base health surveillance team. Investigation of basic trainee hygiene and cleaning practices found that all protocols were followed; no source for the outbreak was found. When outbreaks of mucopurulent conjunctivitis occur in congregate living settings, culturing exudate can identify outbreak etiology, and whole genome sequencing can help guide treatment and response. Previous studies indicated that systemic antimicrobial therapy might be needed to prevent invasive infections of N. meningitidis cases; findings from this investigation suggest that nongroupable N. meningitidis conjunctivitis in otherwise healthy persons might be successfully treated with topical antimicrobials.
{"title":"Outbreak of Neisseria meningitidis Conjunctivitis in Military Trainees - Texas, February-May 2025.","authors":"Susan J Ching,Ga On Jung,Angela Osuna,Theresa Casey,Hui Xia,Karina Bostwick,Amol H Patadia,Lauren M Sweet,Oscar Gallardo-Huizar,Thomas F Gibbons,Joseph E Marcus","doi":"10.15585/mmwr.mm7433a1","DOIUrl":"https://doi.org/10.15585/mmwr.mm7433a1","url":null,"abstract":"Viral and allergic conjunctivitis are more common than bacterial conjunctivitis in healthy immunocompetent adults. Neisseria meningitidis is an uncommon cause of bacterial conjunctivitis. During February-May 2025, an outbreak of 41 meningococcal conjunctivitis cases occurred among healthy, communally housed, military trainees at Joint Base San Antonio-Lackland in San Antonio, Texas; all had received the quadrivalent meningococcal vaccine. One patient was hospitalized with periorbital cellulitis and received intravenous antibiotics; all other patients were treated successfully with topical antibiotics. Whole genome sequencing of isolates from the first two cases suggested that the organism was unencapsulated (nongroupable) and that the cases were related. After the identification of two cases of N. meningitidis conjunctivitis among military trainees within a 3-week period in February 2025, an investigation was initiated by the base health surveillance team. Investigation of basic trainee hygiene and cleaning practices found that all protocols were followed; no source for the outbreak was found. When outbreaks of mucopurulent conjunctivitis occur in congregate living settings, culturing exudate can identify outbreak etiology, and whole genome sequencing can help guide treatment and response. Previous studies indicated that systemic antimicrobial therapy might be needed to prevent invasive infections of N. meningitidis cases; findings from this investigation suggest that nongroupable N. meningitidis conjunctivitis in otherwise healthy persons might be successfully treated with topical antimicrobials.","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"39 1","pages":"516-521"},"PeriodicalIF":0.0,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144995772","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}
Farrell A Tobolowsky,Eric Morris,Lina Castro,Tina Schaff,Monica Jacinto,Joseph P Clement,Min Z Levine,Julia C Frederick,Feng Liu,Crystal Holiday,Marie K Kirby,C Todd Davis,Krista Kniss,Sonja J Olsen,Rahil Ryder,Debra A Wadford,Godfred Masinde,George Han,A Danielle Iuliano,Seema Jain
In response to a highly pathogenic avian influenza (HPAI) A(H5N1) outbreak in U.S. dairy cows detected in March 2024, with subsequent identification of human cases, the San Francisco Department of Public Health instituted enhanced influenza surveillance (influenza A virus subtyping of a sample of specimens weekly) in June 2024. As of January 1, 2025, 37 human cases of influenza A(H5N1) had been detected in California, none of which occurred in San Francisco. On January 9, 2025, enhanced surveillance detected a human influenza A(H5N1) virus genotype B3.13 infection in a school-aged child in San Francisco with mild illness. Case investigation and contact tracing were conducted to ascertain exposures and detect possible human-to-human transmission. Activities comprised a household visit that included an environmental assessment, close contact interviews and surveys, and molecular and serologic testing. Sixty-seven close contacts (household, school, and health care) were identified. Upper respiratory tract specimens collected from seven asymptomatic household contacts and four symptomatic school contacts all tested negative for influenza virus by real-time reverse transcription-polymerase chain reaction (rRT-PCR). Although antibodies against influenza A(H5N1) were detected in the index patient, serologic testing of a convenience sample of nine close contacts identified no detectable A(H5)-specific antibodies. Despite an extensive investigation, the infection source remains unknown; no human-to-human transmission was identified among close contacts by rRT-PCR and serologic testing. Continued enhanced surveillance and timely subtyping of a subset of influenza A-positive specimens are essential components of a comprehensive strategy to detect human novel influenza A virus infections, including among persons without known exposures to A(H5N1) viruses.
为应对2024年3月在美国奶牛中发现的高致病性禽流感（HPAI） a （H5N1）暴发，以及随后发现的人类病例，旧金山公共卫生部于2024年6月加强了流感监测（每周对样本样本进行甲型流感病毒亚型分型）。截至2025年1月1日，加利福尼亚州已发现37例甲型H5N1流感人间病例，其中没有一例发生在旧金山。2025年1月9日，加强监测在旧金山一名病情轻微的学龄儿童中发现了人类甲型H5N1病毒基因型B3.13感染。进行了病例调查和接触者追踪，以确定接触并发现可能的人际传播。活动包括家访，其中包括环境评估、密切接触者访谈和调查以及分子和血清学检测。确定了67名密切接触者（家庭、学校和卫生保健机构）。从7名无症状家庭接触者和4名有症状学校接触者采集的上呼吸道标本经实时逆转录聚合酶链反应（rRT-PCR）检测均为流感病毒阴性。虽然在指数患者中检测到甲型H5N1流感抗体，但对9名密切接触者的方便样本进行血清学检测未发现可检测到的甲型H5流感特异性抗体。尽管进行了广泛调查，但感染源仍然未知；通过rRT-PCR和血清学检测未发现密切接触者之间的人际传播。继续加强监测和及时对甲型流感阳性标本亚群进行分型是发现人类新型甲型流感病毒感染的综合战略的重要组成部分，包括在没有已知接触过甲型H5N1病毒的人群中。
{"title":"Highly Pathogenic Avian Influenza A(H5N1) Virus Infection in a Child with No Known Exposure - San Francisco, California, December 2024-January 2025.","authors":"Farrell A Tobolowsky,Eric Morris,Lina Castro,Tina Schaff,Monica Jacinto,Joseph P Clement,Min Z Levine,Julia C Frederick,Feng Liu,Crystal Holiday,Marie K Kirby,C Todd Davis,Krista Kniss,Sonja J Olsen,Rahil Ryder,Debra A Wadford,Godfred Masinde,George Han,A Danielle Iuliano,Seema Jain","doi":"10.15585/mmwr.mm7433a2","DOIUrl":"https://doi.org/10.15585/mmwr.mm7433a2","url":null,"abstract":"In response to a highly pathogenic avian influenza (HPAI) A(H5N1) outbreak in U.S. dairy cows detected in March 2024, with subsequent identification of human cases, the San Francisco Department of Public Health instituted enhanced influenza surveillance (influenza A virus subtyping of a sample of specimens weekly) in June 2024. As of January 1, 2025, 37 human cases of influenza A(H5N1) had been detected in California, none of which occurred in San Francisco. On January 9, 2025, enhanced surveillance detected a human influenza A(H5N1) virus genotype B3.13 infection in a school-aged child in San Francisco with mild illness. Case investigation and contact tracing were conducted to ascertain exposures and detect possible human-to-human transmission. Activities comprised a household visit that included an environmental assessment, close contact interviews and surveys, and molecular and serologic testing. Sixty-seven close contacts (household, school, and health care) were identified. Upper respiratory tract specimens collected from seven asymptomatic household contacts and four symptomatic school contacts all tested negative for influenza virus by real-time reverse transcription-polymerase chain reaction (rRT-PCR). Although antibodies against influenza A(H5N1) were detected in the index patient, serologic testing of a convenience sample of nine close contacts identified no detectable A(H5)-specific antibodies. Despite an extensive investigation, the infection source remains unknown; no human-to-human transmission was identified among close contacts by rRT-PCR and serologic testing. Continued enhanced surveillance and timely subtyping of a subset of influenza A-positive specimens are essential components of a comprehensive strategy to detect human novel influenza A virus infections, including among persons without known exposures to A(H5N1) viruses.","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"22 1","pages":"522-527"},"PeriodicalIF":0.0,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144995770","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}
Robert M Rodriguez,Jesus R Torres,Brian Chinnock,Efrat Kean,Kristin L Rising,Christopher Conn,Michael Gottlieb,Shwetha Sekar,Perla Gomez,Lorenia Olivera,Stephanie A Eucker,Sofia DiFulvio,Christopher Alvarez,Melanie F Molina,Shaokui Ge,Vijaya Arun Kumar
Current models of vaccination coverage screening and surveillance might miss underserved populations whose only health care access occurs in emergency departments (EDs). During April-December 2024, a survey of non-critically ill adult patients evaluated in 10 EDs in eight U.S. cities across five states was conducted to ascertain patients' vaccination knowledge, self-reported vaccination coverage, and willingness to receive vaccines in an ED. Among 4,326 patients approached by the research team, 3,285 (75.9%) agreed to participate. Non-Hispanic Black or African American (Black), non-Hispanic White, and Hispanic or Latino (Hispanic) persons each accounted for approximately 30% of participants; 17.9% spoke Spanish as their primary language; 7.8% had unstable or marginal housing; and 21.0% lacked a source of primary health care. Approximately one half (49.4%) had not heard of one or more CDC-recommended vaccines for their age group, and 85.9% had not received one or more of the recommended vaccines. Factors associated with not being up to date with recommended vaccinations included non-Hispanic Black race and ethnicity (adjusted odds ratio [aOR] = 1.93; 95% CI = 1.32-2.85), lack of primary health care (aOR = 2.91; 95% CI = 1.74-5.13), and lack of health insurance (aOR = 3.01; 95% CI = 1.27-8.82). Among 2,821 participants who were not up to date with recommended vaccines, 46.4% said that they would accept one or more missing vaccines if they could be provided during their ED visit, and 86.7% of these persons said they would accept all missing vaccines. The primary reasons for missed vaccine doses were that the participant was unaware of or had not been offered the vaccines. EDs could be explored as additional sites to offer vaccination screening, recommendations, counseling, and referrals to increase vaccination coverage among underserved populations.
目前的疫苗接种覆盖筛查和监测模式可能会错过服务不足的人群，他们唯一的卫生保健途径是在急诊室（EDs）。在2024年4月至12月期间，对美国5个州8个城市10个急诊科评估的非危重症成年患者进行了调查，以确定患者的疫苗接种知识、自我报告的疫苗接种覆盖率以及在急诊科接种疫苗的意愿。在研究小组接触的4326名患者中，3285名（75.9%）同意参与。非西班牙裔黑人或非裔美国人（黑人）、非西班牙裔白人和西班牙裔或拉丁裔（西班牙裔）人各占约30%的参与者；17.9%的人以西班牙语为主要语言；7.8%的住房不稳定或处于边缘；21.0%缺乏初级卫生保健来源。大约一半（49.4%）的人没有听说过一种或多种cdc推荐的疫苗，85.9%的人没有接种过一种或多种推荐的疫苗。与未及时接种推荐疫苗相关的因素包括非西班牙裔黑人种族和民族(调整后优势比[aOR] = 1.93；95% CI = 1.32-2.85)，缺乏初级卫生保健(aOR = 2.91；95% CI = 1.74-5.13)，以及缺乏医疗保险(aOR = 3.01；95% ci = 1.27-8.82)。在2,821名没有及时接种推荐疫苗的受访者中，46.4%表示如果在急诊科就诊时可以提供一种或多种缺失疫苗，他们会接受，其中86.7%表示会接受所有缺失疫苗。错过疫苗剂量的主要原因是参与者不知道或没有提供疫苗。可以探索急诊室作为提供疫苗接种筛查、建议、咨询和转诊的额外站点，以增加服务不足人群的疫苗接种覆盖率。
{"title":"Emergency Department Survey of Vaccination Knowledge, Vaccination Coverage, and Willingness to Receive Vaccines in an Emergency Department Among Underserved Populations - Eight U.S. Cities, April-December, 2024.","authors":"Robert M Rodriguez,Jesus R Torres,Brian Chinnock,Efrat Kean,Kristin L Rising,Christopher Conn,Michael Gottlieb,Shwetha Sekar,Perla Gomez,Lorenia Olivera,Stephanie A Eucker,Sofia DiFulvio,Christopher Alvarez,Melanie F Molina,Shaokui Ge,Vijaya Arun Kumar","doi":"10.15585/mmwr.mm7429a1","DOIUrl":"https://doi.org/10.15585/mmwr.mm7429a1","url":null,"abstract":"Current models of vaccination coverage screening and surveillance might miss underserved populations whose only health care access occurs in emergency departments (EDs). During April-December 2024, a survey of non-critically ill adult patients evaluated in 10 EDs in eight U.S. cities across five states was conducted to ascertain patients' vaccination knowledge, self-reported vaccination coverage, and willingness to receive vaccines in an ED. Among 4,326 patients approached by the research team, 3,285 (75.9%) agreed to participate. Non-Hispanic Black or African American (Black), non-Hispanic White, and Hispanic or Latino (Hispanic) persons each accounted for approximately 30% of participants; 17.9% spoke Spanish as their primary language; 7.8% had unstable or marginal housing; and 21.0% lacked a source of primary health care. Approximately one half (49.4%) had not heard of one or more CDC-recommended vaccines for their age group, and 85.9% had not received one or more of the recommended vaccines. Factors associated with not being up to date with recommended vaccinations included non-Hispanic Black race and ethnicity (adjusted odds ratio [aOR] = 1.93; 95% CI = 1.32-2.85), lack of primary health care (aOR = 2.91; 95% CI = 1.74-5.13), and lack of health insurance (aOR = 3.01; 95% CI = 1.27-8.82). Among 2,821 participants who were not up to date with recommended vaccines, 46.4% said that they would accept one or more missing vaccines if they could be provided during their ED visit, and 86.7% of these persons said they would accept all missing vaccines. The primary reasons for missed vaccine doses were that the participant was unaware of or had not been offered the vaccines. EDs could be explored as additional sites to offer vaccination screening, recommendations, counseling, and referrals to increase vaccination coverage among underserved populations.","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"17 1","pages":"456-462"},"PeriodicalIF":0.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796994","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}
Joshua R Moore,Taylor Breeyear,Camden D Gowler,Richard Moore,Sydney Will,Dianne Brewer,Taylor Swankie,Sara Beaver,Ashley Vaughn
{"title":"Notes from the Field: Hepatitis B Virus Transmission Associated with Assisted Blood Glucose Monitoring in a Skilled Nursing Facility - North Carolina, 2024.","authors":"Joshua R Moore,Taylor Breeyear,Camden D Gowler,Richard Moore,Sydney Will,Dianne Brewer,Taylor Swankie,Sara Beaver,Ashley Vaughn","doi":"10.15585/mmwr.mm7429a2","DOIUrl":"https://doi.org/10.15585/mmwr.mm7429a2","url":null,"abstract":"","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"156 1","pages":"463-464"},"PeriodicalIF":0.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796966","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}
Aisling M Vaughan,Dina Kamel,Michelle Chang,Laura Saucier,Susan P Montgomery,Elizabeth Wendt,Alicia H Chang,Shamim Islam,Aaron Nagiel,Betty Situ,Jamie Middleton,Dawn Terashita,Sharon Balter,Joy E Gibson,Jemma Alarcón
Baylisascaris procyonis (raccoon roundworm), a parasite commonly found in raccoons (Procyon lotor), can cause severe disease in humans when it invades visceral organs or the ocular and central nervous systems. Without prompt treatment, B. procyonis infection can lead to serious complications and death. During September 2024, the Los Angeles County Department of Public Health was notified of two unrelated pediatric patients with neurologic signs and symptoms consistent with baylisascariasis, including behavioral change, lethargy, and gait instability. The first case occurred in an adolescent aged 14 years who had received a previous diagnosis of autism spectrum disorder and had a history of pica (i.e., ingestion of nonfood items); the second case occurred in a previously healthy child aged 15 months. Both were treated with albendazole and corticosteroids. The first patient returned to baseline neurologic status, but delays in diagnosis and treatment of the second patient resulted in severe neurologic sequelae. Epidemiologic investigations identified raccoon feces that had fallen from a rooftop latrine (i.e., a communal raccoon defecation site) as the possible source of exposure for the adolescent. No source of exposure was identified for the younger child. B. procyonis infection should be suspected and prompt treatment considered in patients with neurologic symptoms and cerebrospinal fluid or peripheral blood eosinophilia (>1,000 eosinophils/mL of blood), especially young children or persons with developmental disabilities or pica. In addition, the public should be aware of exposure prevention strategies, including preventing raccoon activity around properties, avoiding exposure to raccoon feces, and safely removing raccoon latrines.
{"title":"Baylisascariasis (Raccoon Roundworm Infection) in Two Unrelated Children - Los Angeles County, California, 2024.","authors":"Aisling M Vaughan,Dina Kamel,Michelle Chang,Laura Saucier,Susan P Montgomery,Elizabeth Wendt,Alicia H Chang,Shamim Islam,Aaron Nagiel,Betty Situ,Jamie Middleton,Dawn Terashita,Sharon Balter,Joy E Gibson,Jemma Alarcón","doi":"10.15585/mmwr.mm7428a1","DOIUrl":"https://doi.org/10.15585/mmwr.mm7428a1","url":null,"abstract":"Baylisascaris procyonis (raccoon roundworm), a parasite commonly found in raccoons (Procyon lotor), can cause severe disease in humans when it invades visceral organs or the ocular and central nervous systems. Without prompt treatment, B. procyonis infection can lead to serious complications and death. During September 2024, the Los Angeles County Department of Public Health was notified of two unrelated pediatric patients with neurologic signs and symptoms consistent with baylisascariasis, including behavioral change, lethargy, and gait instability. The first case occurred in an adolescent aged 14 years who had received a previous diagnosis of autism spectrum disorder and had a history of pica (i.e., ingestion of nonfood items); the second case occurred in a previously healthy child aged 15 months. Both were treated with albendazole and corticosteroids. The first patient returned to baseline neurologic status, but delays in diagnosis and treatment of the second patient resulted in severe neurologic sequelae. Epidemiologic investigations identified raccoon feces that had fallen from a rooftop latrine (i.e., a communal raccoon defecation site) as the possible source of exposure for the adolescent. No source of exposure was identified for the younger child. B. procyonis infection should be suspected and prompt treatment considered in patients with neurologic symptoms and cerebrospinal fluid or peripheral blood eosinophilia (>1,000 eosinophils/mL of blood), especially young children or persons with developmental disabilities or pica. In addition, the public should be aware of exposure prevention strategies, including preventing raccoon activity around properties, avoiding exposure to raccoon feces, and safely removing raccoon latrines.","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"26 1","pages":"444-449"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144756013","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}
Hailey TenHarmsel,Laurel Harduar Morano,Kenneth D Rosenman
Persons who work near farmland are at risk for exposure to pesticides applied on adjoining agricultural areas. Michigan regulations allow solar panel placement on farmland and open areas near farmland. Nonagricultural workers, including construction workers installing or maintaining solar panels, working in open areas on or adjacent to farmland might be exposed to pesticides yet have little knowledge of the possible health effects. Reports to Michigan's state pesticide surveillance program from hospitals, emergency departments, the state's poison center, and emergency service companies identified two separate events, the first in August 2023 and the second in May 2024, when workers installing solar panels experienced illness after pesticide exposures. In these two events, a total of 10 solar panel installation workers reported symptoms temporally related to nearby agriculture pesticide applications. Pesticide applicator adherence to product label instructions is critical to preventing bystander exposure. Increasing awareness of the potential for pesticide exposure among nonagricultural workers near farmland might reduce risk. Employers of nonagricultural workers who are working in rural areas should be aware of agricultural activity surrounding their worksites and should consider contacting farmers to determine pesticide application schedules so that nonagricultural workers can be advised to avoid the area or wear protective equipment during application times. Local poison control centers can provide guidance on management of acute exposures.
{"title":"Solar Panel Installation Workers Exposed to Pesticides During Two Agricultural Applications - Michigan, August 2023 and May 2024.","authors":"Hailey TenHarmsel,Laurel Harduar Morano,Kenneth D Rosenman","doi":"10.15585/mmwr.mm7428a2","DOIUrl":"https://doi.org/10.15585/mmwr.mm7428a2","url":null,"abstract":"Persons who work near farmland are at risk for exposure to pesticides applied on adjoining agricultural areas. Michigan regulations allow solar panel placement on farmland and open areas near farmland. Nonagricultural workers, including construction workers installing or maintaining solar panels, working in open areas on or adjacent to farmland might be exposed to pesticides yet have little knowledge of the possible health effects. Reports to Michigan's state pesticide surveillance program from hospitals, emergency departments, the state's poison center, and emergency service companies identified two separate events, the first in August 2023 and the second in May 2024, when workers installing solar panels experienced illness after pesticide exposures. In these two events, a total of 10 solar panel installation workers reported symptoms temporally related to nearby agriculture pesticide applications. Pesticide applicator adherence to product label instructions is critical to preventing bystander exposure. Increasing awareness of the potential for pesticide exposure among nonagricultural workers near farmland might reduce risk. Employers of nonagricultural workers who are working in rural areas should be aware of agricultural activity surrounding their worksites and should consider contacting farmers to determine pesticide application schedules so that nonagricultural workers can be advised to avoid the area or wear protective equipment during application times. Local poison control centers can provide guidance on management of acute exposures.","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"217 1","pages":"450-454"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144756315","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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