MMWR. Morbidity and mortality weekly report最新文献

{"title":"Serologic Evidence of Highly Pathogenic Avian Influenza A(H5N1) Virus Infection in a Veterinary Professional Exposed to an Infected Domestic Cat - Los Angeles County, California, December 2024-January 2025.","authors":"Aisling Vaughan, Allison Joyce, Elizabeth Traub, Mellissa Jae, Emily Beeler, Erick Paiva, Kristopher Ananian, Crystal Holiday, Stacie Jefferson, Jessica Richardson, Cortney Munna, Cynthia Chan, Tamerin Scott, Noah Kojima, Tanya Seneviratne, Alexandra Mellis, Sonja J Olsen, Nicole Green, Matt Feaster, Dawn Terashita, Sharon Balter, Min Z Levine, Jamie Middleton, Annabelle de St Maurice","doi":"10.15585/mmwr.mm7517a1","DOIUrl":"10.15585/mmwr.mm7517a1","url":null,"abstract":"<p><p>Since 2021, avian influenza A(H5N1) clade 2.3.4.4b viruses have spread widely among wild birds and domesticated poultry in the United States, with sporadic spillover into mammals. During November 2024-January 2025, 19 domestic cats in Los Angeles County, California, became ill after consumption of commercially purchased raw milk, raw meat, or raw pet food; nine cats tested positive for influenza A(H5N1) virus (clade 2.3.4.4b genotype B3.13). Overall, 139 persons were exposed to the 19 infected cats, and all were monitored for symptoms. Although 30 persons reported influenza-like illness symptoms, none received a positive influenza A(H5) reverse transcription-polymerase chain reaction (RT-PCR) test result. In April 2025, the Los Angeles County Department of Public Health and CDC invited all exposed persons to participate in an influenza A(H5N1) serosurvey to determine whether transmission of influenza A(H5N1) virus occurred, including in those without symptoms. Sera from 25 (18%) of the 139 exposed persons were tested. Among these, antibodies specific to A(H5N1) clade 2.3.4.4.b (antigenically similar to the clade 2.3.4.4.b influenza A[H5N1] virus isolated from the infected cats) were detected in serum from one veterinary professional, who was asymptomatic. This person did not use respiratory or eye protection during the exposure, did not report influenza-like illness after the exposure, and reported no other known risk factors for A(H5N1) infection. These findings represent serologic evidence of possible transmission of influenza A(H5N1) clade 2.3.4.4.b virus from a domestic cat to a human, highlighting concerns about potential cat-to-human transmission of influenza A(H5N1) virus and the importance of infection control practices in veterinary settings.</p>","PeriodicalId":18637,"journal":{"name":"MMWR. Morbidity and mortality weekly report","volume":"75 17","pages":"215-220"},"PeriodicalIF":17.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatal Human Case of Highly Pathogenic Avian Influenza A(H5N5) in a Backyard Flock Owner - Washington, November 2025.","authors":"Lynae Kibiger, Hanna N Oltean, Lisa Leitz, Emma Krause, Debra Barrett, Anna Halloran, Kyle Yomogida, Beth Lipton, Keely Paris, Jared Keirn, Minden Buswell, Allison Black, Pauline Trinh, Theresa Murray, Roberto Bonaccorso, Leticia Banuelos, Ethan Dieringer, Jennifer Lenahan, Emily Spence Davizon, Ellyn P Marder, Jocelyn Mullins, Meagan Kay, Eric J Chow, Sandra J Valenciano, John Lynch, Vanessa Makarewicz, Chloe Bryson-Cahn, Jennifer Hernandez, Kyla Haggith, Valicia Linn, Alex L Greninger, Stephanie Goya, Sierra Gulla, Jennifer Young, Sierra Kerns-Funk, Brianna da Silva Bhatia, Hollianne Bruce, Krista Kniss, Katie Reinhart, Rachel Ohlstein, Shannon Johnson, Christina Schofield, Patrick Smith, Amber Itle, Maura Gibson, Brandi Torrevillas, Azeza Falghoush, Thomas B Waltzek, Kevin Snekvik, Mia Torchetti, Timothy M Uyeki, Scott Lindquist","doi":"10.15585/mmwr.mm7517a2","DOIUrl":"10.15585/mmwr.mm7517a2","url":null,"abstract":"<p><p>Clade 2.3.4.4b influenza A(H5N1) viruses have circulated across migratory bird flyways in the United States since 2022, including in Washington, where backyard flock detections have been reported annually. In November 2025, a Washington resident died from acute respiratory failure after receiving a positive influenza A(H5) test result at a hospital laboratory. Washington Public Health Laboratories confirmed influenza A(H5), and genomic sequencing identified influenza A(H5N5) virus (A6 genotype). Polymerase chain reaction testing detected highly pathogenic avian influenza A(H5) virus clade 2.3.4.4b from an apparently healthy backyard flock of ducks and sediment from a watering basin on the patient's property. Six of eight gene segments from the environmental sample and one duck sample (partial neuraminidase segment) were highly genetically similar to the patient's virus sequence. Although existing wild bird surveillance had not detected influenza A(H5N5) virus (A6) in the U.S. Pacific Flyway, introduction via wild birds into the environment of the backyard flock was likely the source of the patient's exposure. The public health investigation identified approximately 135 exposed persons; symptom monitoring and influenza testing detected no additional cases. The overall risk for avian influenza A remains low among the general U.S. population; however, novel avian influenza A virus infection should be considered in persons with symptoms of influenza and potential exposures.</p>","PeriodicalId":18637,"journal":{"name":"MMWR. Morbidity and mortality weekly report","volume":"75 17","pages":"221-225"},"PeriodicalIF":17.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147840015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Notes from the Field: Increase in Eastern Equine Encephalitis Virus Activity - Vermont, 2023-2024.","authors":"Katherine M Strelau, Emily Pareles, Patsy Kelso, Christine Matusevich, Patti Casey, Eliza Doncaster, Kaitlynn Levine, Carolyn V Gould, J Erin Staples, Kelly A Fitzpatrick, Kristen L Burkhalter, Cynthia Roxanne Connelly, Natalie A Kwit","doi":"10.15585/mmwr.mm7516a2","DOIUrl":"https://doi.org/10.15585/mmwr.mm7516a2","url":null,"abstract":"<p><p>Eastern equine encephalitis (EEE) virus (EEEV) is a mosquitoborne alphavirus maintained in an enzootic cycle with mosquitoes and birds. EEEV can be transmitted to humans and susceptible animals by mosquitoes that bite both mammals and birds. EEEV causes severe neuroinvasive disease in humans; although an EEE vaccine is available for horses, no human vaccine is currently licensed, and treatment is supportive. Approximately one third of human cases are fatal, and many survivors experience long-term neurologic sequelae (1). In the United States, a majority of EEE cases occur in states along the Atlantic Coast, Gulf Coast, and Great Lakes. EEEV was first detected in Vermont during a 2010 serosurvey of hunter-harvested deer and moose (2,3). After a 2011 outbreak of EEEV on a Vermont emu farm (4), statewide mosquito surveillance for EEEV was implemented in 2012. During 2012-2022, two human and four animal EEE cases were reported to the Vermont Department of Health (VDH). During 2023-2024, EEEV activity in mammals and mosquitoes increased, prompting targeted outreach in affected areas. This report describes EEEV activity in Vermont during 2023-2024 based on human and equine cases and mosquito surveillance data.</p>","PeriodicalId":18637,"journal":{"name":"MMWR. Morbidity and mortality weekly report","volume":"75 16","pages":"211-213"},"PeriodicalIF":17.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147817398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large Tuberculosis Outbreaks - United States, 2017-2023.","authors":"Kala M Raz, Maryam B Haddad, Sandy P Althomsons, Lauren Cowan, J Steve Kammerer, Chee Kin Lam, Clinton J McDaniel, James Posey, Sarah Talarico, William L Walker, Noah G Schwartz, Jonathan M Wortham","doi":"10.15585/mmwr.mm7516a1","DOIUrl":"https://doi.org/10.15585/mmwr.mm7516a1","url":null,"abstract":"<p><p>During 2017-2023, based on an analysis of national genomic and tuberculosis (TB) case surveillance data, 50 large TB outbreaks (10 or more related TB cases in a 3-year period) involving 1,092 cases were identified in 23 states. Compared with 61,993 other persons who received a diagnosis of TB during this period, persons included in large outbreaks were more frequently U.S.-born (79% versus 26%), and a higher percentage reported substance use (27% versus 12%), homelessness (9% versus 5%), and incarceration (11% versus 3%). Approximately one fourth of these large outbreak-related cases were identified through contact tracing; these cases less commonly had clinical markers of highly infectious disease (23%) than did large outbreak-related cases identified through other methods (including evaluation associated with symptoms, targeted testing, or incidental findings) (61%), suggesting that contact tracing might have facilitated earlier diagnosis. Among the 50 large outbreaks, 34 (68%) were primarily associated with family or social networks, and 13 (26%) were primarily associated with congregate settings. Maintaining state and local public health capacity for outbreak detection, prevention, and response is essential, even in low-incidence jurisdictions. Effective outbreak responses must overcome barriers to diagnosis and treatment associated with homelessness and substance use and include efforts to build trust with affected communities. Procedures to promptly identify and isolate persons with infectious TB remain critical in congregate settings.</p>","PeriodicalId":18637,"journal":{"name":"MMWR. Morbidity and mortality weekly report","volume":"75 16","pages":"205-210"},"PeriodicalIF":17.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147817305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaccination Coverage by Age 24 Months Among Children Born in 2021 and 2022 - National Immunization Survey-Child, United States, 2022-2024.","authors":"Holly A Hill, David Yankey, Laurie D Elam-Evans, Yi Mu, Michael Chen, Shannon Stokley, Georgina Peacock, James A Singleton","doi":"10.15585/mmwr.mm7511a2","DOIUrl":"10.15585/mmwr.mm7511a2","url":null,"abstract":"<p><p>The National Immunization Survey-Child monitors coverage with recommended routine childhood vaccines. For data collected in survey year 2024, which include children born in 2021 and 2022, the household response rate (23.4%) and availability of adequate provider data for children with completed interviews (51.4%) were comparable to those from earlier survey years. For most vaccines, coverage by age 24 months was similar among children born in 2021 and 2022 and those born in 2019 and 2020. Declines in coverage of 1-2 percentage points were observed for the primary series of Haemophilus influenzae type b conjugate vaccine, the birth dose of hepatitis B vaccine, ≥4 doses of pneumococcal conjugate vaccine, and rotavirus vaccine. Coverage with ≥2 doses of influenza vaccine by age 24 months decreased from 61.0% among children born during 2019-2020 to 53.5% among those born during 2021-2022. Coverage was lower among Vaccines for Children (VFC) program-eligible children than among those who were not VFC-eligible and differed substantially by jurisdiction. Compared with non-Hispanic White children, coverage with many vaccines was lower among non-Hispanic Black or African American and Hispanic or Latino children; coverage was highest among non-Hispanic Asian children. Coverage was also lower among children living in poverty and those living in more rural areas. Maintaining high levels of vaccination and improving coverage among groups and in areas in which rates have declined could help protect children from vaccine-preventable morbidity and mortality. The Community Preventive Services Task Force recommends several interventions to increase vaccination, including standing orders for vaccination, immunization information systems, and vaccination programs in organized child care centers and in Special Supplemental Nutrition Program for Woman, Infants, and Children settings. Other factors demonstrated to be effective include strong provider recommendations, targeted messages from credible and trusted sources, and increased participation in the VFC program.</p>","PeriodicalId":18637,"journal":{"name":"MMWR. Morbidity and mortality weekly report","volume":"75 11","pages":"146-155"},"PeriodicalIF":17.3,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13020856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147521405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multicounty Outbreak of Salmonella Agbeni Linked to Ice in a Cooler at a County Fair - Illinois, August 2024.","authors":"Katherine E Houser","doi":"10.15585/mmwr.mm7507a1","DOIUrl":"10.15585/mmwr.mm7507a1","url":null,"abstract":"<p><p>On August 5, 2024, the Brown County (Illinois) Health Department (BCHD) was informed by the county sheriff that numerous potential jurors being screened for an upcoming trial had reported recently experiencing a gastrointestinal illness. One week later, on August 12, a laboratory-confirmed case of Salmonella enterica serotype Agbeni infection was reported to BCHD by the Illinois Department of Public Health. Investigation by BCHD identified seven laboratory-confirmed and six probable cases of S. enterica serotype Agbeni illness across five Illinois counties. All persons who became ill had attended the Brown County fair in rural Illinois during July 30-August 4 and reported drinking beer served from a cooler in the fair's beer tent. No other common food or environmental exposures were identified. The cooler containing the beer was reused for multiple days and not cleaned. A generative artificial intelligence tool (ChatGPT 4.0, OpenAI; 2024) was used to assist with hypothesis generation during the investigation, supplementing traditional epidemiologic methods and contributing to identification of a shared, nonfood vehicle of transmission. This outbreak highlights the role of standardized hygiene protocols for cooler sanitation and beverage storage and handling at public events.</p>","PeriodicalId":18637,"journal":{"name":"MMWR. Morbidity and mortality weekly report","volume":"75 7","pages":"93-97"},"PeriodicalIF":17.3,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12944811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147307266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Respiratory Virus Activity - United States, July 1, 2024-June 30, 2025.","authors":"Benjamin J Silk, Mila M Prill, Amber K Winn, Monica E Patton, Heidi L Moline, Michael Melgar, Kevin C Ma, Clinton R Paden, Lydia J Atherton, Diba Khan, Christopher A Taylor, Ayzsa Tannis, Kadam Patel, Leah A Goldstein, Krista Kniss, Angiezel Merced-Morales, Natalie Thornburg, Fatimah S Dawood","doi":"10.15585/mmwr.mm7506a2","DOIUrl":"10.15585/mmwr.mm7506a2","url":null,"abstract":"<p><p>Respiratory viruses are common causes of upper and lower respiratory tract illness and can also result in hospitalization and death. CDC conducts national surveillance using multiple systems to monitor ongoing and seasonal changes in the activity of selected respiratory viruses. This report summarizes U.S. trends in endemic respiratory virus activity during July 2024-June 2025. For SARS-CoV-2 and respiratory syncytial virus (RSV), national and regional trends; population-based hospitalization rates; vital records death counts; and preliminary estimates of associated illnesses, outpatient visits, hospitalizations, and deaths are described, as well as genetic characterization of circulating SARS-CoV-2 viruses. Some viruses, including SARS-CoV-2, showed bimodal peaks in positive laboratory test results, whereas others, including RSV and influenza viruses, were characterized by a single peak. The highest COVID-19-associated hospitalization rates were reported among adults aged ≥75 years (932.6 per 100,000 persons), infants aged <6 months (285.6), and adults aged 65-74 years (274.4). RSV-associated hospitalization rates were highest among infants aged <12 months (1,116.7 per 100,000; 95% CI = 1,078.4-1,157.9), children aged 12-23 months (770.6; 95% CI = 743.1-800.3), and adults aged ≥75 years (426.9; 95% CI = 366.6-510.8). COVID-19 was associated with an estimated 290,000-450,000 hospitalizations and 34,000-53,000 deaths; RSV was associated with 190,000-350,000 hospitalizations and 10,000-23,000 deaths. All circulating SARS-CoV-2 lineages were Omicron JN.1 descendants. Staying up to date with recommended COVID-19, RSV, and influenza vaccinations remains important to reducing the risk for severe disease caused by these viruses.</p>","PeriodicalId":18637,"journal":{"name":"MMWR. Morbidity and mortality weekly report","volume":"75 6","pages":"77-84"},"PeriodicalIF":17.3,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12919848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146227328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 Antiviral Prescription Receipt Among Outpatients Aged ≥65 Years - United States, June 1, 2023-September 30, 2025.","authors":"Julia Raykin, Ilia Rochin, Ryan Wiegand, Victoria Soto, Afua Nyame-Mireku, Amy Chung, Josephine Mak, Tegan Boehmer, Pragna Patel","doi":"10.15585/mmwr.mm7506a1","DOIUrl":"10.15585/mmwr.mm7506a1","url":null,"abstract":"<p><p>Adults aged ≥65 years have the highest rates of COVID-19-related hospitalization. Despite the proven benefit of COVID-19 antivirals in preventing severe outcomes, data suggest that their use is low among older adults. To assess factors associated with receipt of an antiviral prescription among adults aged ≥65 years examined in outpatient settings who received a positive SARS-CoV-2 test result or COVID-19 diagnosis during June 1, 2023-September 30, 2025, multivariate logistic regression analysis of Truveta real-time deidentified electronic health record data was performed. The percentage of COVID-19 outpatients aged ≥65 years who received an antiviral prescription was lower in spring 2024 (21%), fall-winter 2024-25 (23%), spring 2025 (16%), and summer 2025 (19%) than during other seasons (range = 37%-38%). Among those persons who received a prescription, 99% received it within 7 days of a positive SARS-CoV-2 test result or COVID-19 diagnosis, and 80% were prescribed nirmatrelvir/ritonavir. Among adults aged ≥65 years, the odds of receiving an antiviral prescription were higher among those aged 75-84 and ≥85 years (adjusted odds ratio [aOR] = 1.09 and 1.11, respectively), Asian (aOR = 1.42) or Hispanic or Latino persons (aOR = 1.24), and those who had received ≥1 COVID-19 vaccine dose (aOR = 1.73) than among adults in other age, racial, ethnic, and vaccination status groups. Persons with at least one comorbidity and rural residents had lower odds of receiving an antiviral prescription. Persons with COVID-19 had higher odds of receiving a COVID-19 antiviral prescription in summer 2024 (aOR = 1.05) compared with other analytic periods. Odds of prescribing were lower during periods of lower COVID-19 incidence. Antivirals might be underprescribed among adults aged ≥65 years, and prescribing rates vary temporally. Encouraging annual COVID-19 vaccination and increased prescribing of antivirals among adults aged ≥65 years with COVID-19 could reduce the risk for severe illness and hospitalization in this population.</p>","PeriodicalId":18637,"journal":{"name":"MMWR. Morbidity and mortality weekly report","volume":"75 6","pages":"69-76"},"PeriodicalIF":17.3,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12919849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146227400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional Increases in Incidence of Coccidioidomycosis (Valley Fever) - Arizona, 2005-2022.","authors":"Sophia E Kruger, Irene Ruberto, Thomas Williamson, Justin V Remais, Alexandra K Heaney, Jennifer R Head","doi":"10.15585/mmwr.mm7506a3","DOIUrl":"10.15585/mmwr.mm7506a3","url":null,"abstract":"<p><p>Incidence of coccidioidomycosis (Valley fever), a fungal infection caused by inhalation of Coccidioides species spores, has increased substantially across the southwestern United States in association with increasing aridity, warming temperatures, and precipitation volatility. Arizona and California report >95% of U.S. coccidioidomycosis cases, and incidence in Arizona has increased statewide. Patterns within Arizona's distinct climatological regions have not been characterized, especially in regions outside the known zone of persistently high levels of disease occurrence (hyperendemicity) in the southwest Sonoran Desert region. In this study, surveillance data reported to the Arizona Department of Health Services since 2005 were used to calculate coccidioidomycosis incidence within six ecological regions. During 2005-2022, annual incidence approximately doubled in Arizona, with >95% of cases reported from the Sonoran Desert region. Although the Plateaus and Mojave Desert regions (in the northern parts of the state) reported <1.5% of Arizona cases during this period, these regions experienced the highest relative increases in incidence from the 2005-2007 period to the 2020-2022 period. During 2020-2022, coccidioidomycosis incidence in the Plateaus region was 6.61 times the incidence during 2005-2007 (95% CI = 4.22-10.30), and in the Mojave Desert region, incidence was 4.50 times that during 2005-2007 (95% CI = 3.45-5.89). The Plateau and Mojave regions also reported the highest relative increases in incidence from the 2014-2016 period to the 2020-2022 period. Large relative incidence increases in northern regions, including cooler and wetter regions generally considered less suitable for Coccidioides species establishment and transmission, necessitate targeted public health messaging in these areas and support ongoing investigation into the causes of these increases.</p>","PeriodicalId":18637,"journal":{"name":"MMWR. Morbidity and mortality weekly report","volume":"75 6","pages":"85-91"},"PeriodicalIF":17.3,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12919847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146227341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pseudo-Outbreak of Purpureocillium lilacinum Skin Infections at a Dermatology Clinic - Washington, 2024.","authors":"Kyle S Yomogida, Emily Laskowski, Lisa Hannah, Elizabeth Sajewski, Paige Gable, Heather Moulton-Meissner, Kristen Clancy, Marissa Howard, Mitsuru Toda, Anastasia P Litvintseva, Lindsay A Parnell, Brian Schwem, Kimberly L McKinney, Amy L Valderrama, Kiran M Perkins, Samia N Naccache, Dallas J Smith","doi":"10.15585/mmwr.mm7505a2","DOIUrl":"10.15585/mmwr.mm7505a2","url":null,"abstract":"<p><p>In April 2024, a Washington dermatology clinic reported multiple cases of atypical fungal skin infections caused by the environmental mold Purpureocillium lilacinum to Clallam County Public Health. P. lilacinum most frequently causes skin infections among immunocompromised persons but can occasionally infect immunocompetent persons. The diagnoses were made on the basis of swab specimens collected from patients' skin to diagnose a fungal skin infection, rather than from a biopsy or skin scraping, as is recommended. An investigation by the Washington State Department of Health and CDC revealed this to be a pseudo-outbreak caused by contaminated saline, ultimately affecting 22 patients during January-October 2024. The investigation found that the clinic had refilled and reused saline squeeze bottles during skin swab collection. This resulted in contamination of the saline with P. lilacinum, which was transferred to the skin when swab specimens were obtained. Whole genome sequencing confirmed that P. lilacinum isolates from patient swab specimens were closely related to environmental isolates from the contaminated bottles. The clinic discontinued use of refillable squeeze bottles in January 2025 and transitioned to single-use saline packets, after which no further cases were reported. This investigation underscores the importance of proper diagnostic specimen collection procedures and infection prevention and control practices in clinical settings.</p>","PeriodicalId":18637,"journal":{"name":"MMWR. Morbidity and mortality weekly report","volume":"75 5","pages":"64-67"},"PeriodicalIF":17.3,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12900387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146181025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}