Morbidity and Mortality Weekly Report最新文献

{"title":"Trends in Suspected Fentanyl-Involved Nonfatal Overdose Emergency Department Visits, by Age Group, Sex, and Race and Ethnicity - United States, October 2020-March 2024.","authors":"Cassandra M Pickens,Joohyun Park,Shannon M Casillas,Stephen Liu,Michael Sheppard,Erin K Stokes,Jean Y Ko,Seung Hee Lee","doi":"10.15585/mmwr.mm7416a2","DOIUrl":"https://doi.org/10.15585/mmwr.mm7416a2","url":null,"abstract":"Fatal overdoses involving synthetic opioids such as fentanyl increased sharply during the past decade. Recent data indicate declines in deaths with illegally manufactured fentanyls detected beginning in mid-2023. However, timely data on nonfatal overdoses involving fentanyl are limited. Emergency department (ED) data from CDC's National Syndromic Surveillance Program during October 2020-March 2024 were analyzed. Quarterly trends in rates of suspected nonfatal overdose of unintentional or undetermined intent involving fentanyl or fentanyl analogs (fentanyl-involved nonfatal overdoses) (i.e., the number of ED visits for fentanyl-involved nonfatal overdose per 10,000 total ED visits) were analyzed overall and by age group, sex, and race and ethnicity. During quarter (Q) 4 (October-December) 2020 to Q3 (July-September) 2023, rates of fentanyl-involved nonfatal overdose ED visits increased 8.7% per quarter, from 1.4 to 3.5 per 10,000 ED visits, then declined 11.0% per quarter, to 2.9 per 10,000 ED visits, from Q3 2023 to Q1 (January-March) 2024. Trends increased among a majority of demographic groups through mid-2023, with the highest rates and the largest increases among non-Hispanic American Indian or Alaska Native persons (e.g., 11.9 per 10,000 ED visits in Q3 2023, and an average quarterly increase of 9.0%, respectively). Providers in EDs have an important role in preventing fentanyl-involved nonfatal overdoses. Buprenorphine, a medication used to treat opioid use disorder that can be initiated in an ED, might benefit persons who use EDs as a main source of medical care. In addition, comprehensive services, including screening and treatment of co-occurring mental health conditions, as well as evidence-based prevention, treatment, and recovery support services, might be initiated in EDs because these might be particularly important in communities at high risk for fentanyl overdoses.","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"48 1","pages":"282-287"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143926510","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":"Interim Evaluation of Respiratory Syncytial Virus Hospitalization Rates Among Infants and Young Children After Introduction of Respiratory Syncytial Virus Prevention Products - United States, October 2024-February 2025.","authors":"Monica E Patton,Heidi L Moline,Michael Whitaker,Ayzsa Tannis,Huong Pham,Ariana P Toepfer,Christopher A Taylor,Leah Goldstein,Arthur Reingold,Pam Daily Kirley,Nisha B Alden,Breanna Kawasaki,James Meek,Daewi Kim,Lucy S Witt,Kyle P Openo,Patricia A Ryan,Erica Mumm,Ruth Lynfield,Yadira Salazar-Sanchez,Francesca Pacheco,Fiona Keating,Bridget J Anderson,Brenda L Tesini,Christina B Felsen,Melissa Sutton,Ann Thomas,William Schaffner,H Keipp Talbot,Khalil Harbi,Emma Doran,Geoffrey A Weinberg,Mary A Staat,Daniel C Payne,Natasha B Halasa,Laura Stewart,Julie A Boom,Leila C Sahni,Eileen J Klein,Janet A Englund,John V Williams,Marian G Michaels,Jennifer E Schuster,Rangaraj Selvarangan,Peter G Szilagyi,Fiona P Havers,Fatimah S Dawood","doi":"10.15585/mmwr.mm7416a1","DOIUrl":"https://doi.org/10.15585/mmwr.mm7416a1","url":null,"abstract":"Maternal respiratory syncytial virus (RSV) vaccine and nirsevimab, a long-acting monoclonal antibody for infants aged 0-7 months and children aged 8-19 months who are at increased risk for severe RSV disease, became widely available for prevention of severe RSV disease among infants and young children during the 2024-25 RSV season. To evaluate the association between availability of these products and infant and child RSV-associated hospitalization rates, the rates among children aged <5 years were compared for the 2024-25 and 2018-20 RSV seasons using data from the RSV-Associated Hospitalization Surveillance Network (RSV-NET) and New Vaccine Surveillance Network (NVSN). Among infants aged 0-7 months (eligible for protection with maternal vaccination or nirsevimab), 2024-25 RSV-associated hospitalization rates were lower compared with 2018-20 pooled rates (estimated relative rate reductions of 43% [RSV-NET: 95% CI = 40%-46%] and 28% [NVSN: 95% CI = 18%-36%]). The largest estimated rate reduction was observed among infants aged 0-2 months (RSV-NET: 52%, 95% CI = 49%-56%; NVSN: 45%, 95% CI = 32%-57%) and during peak hospitalization periods (December-February). These findings support Advisory Committee on Immunization Practices' recommendations for maternal vaccination or nirsevimab to protect against severe RSV disease in infants and highlight the importance of implementing the recommendations to protect infants as early in the RSV season as possible, before peak transmission, and for infants born during the RSV season, within the first week of life, ideally during the birth hospitalization.","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"289 1","pages":"273-281"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143926512","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: Severe Medetomidine Withdrawal Syndrome in Patients Using Illegally Manufactured Opioids - Pittsburgh, Pennsylvania, October 2024-March 2025.","authors":"Simon J Ostrowski,Kenichi Tamama,William J Trautman,Darien L Stratton,Michael J Lynch","doi":"10.15585/mmwr.mm7415a3","DOIUrl":"https://doi.org/10.15585/mmwr.mm7415a3","url":null,"abstract":"","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"23 1","pages":"269-271"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143902954","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: Suspected Medetomidine Withdrawal Syndrome Among Fentanyl-Exposed Patients - Philadelphia, Pennsylvania, September 2024-January 2025.","authors":"Samantha Huo,Kory London,Lauren Murphy,Emily Casey,Philip Durney,Maya Arora,Rita McKeever,Abriana Tasillo,Dennis Goodstein,Brendan Hart,Jeanmarie Perrone","doi":"10.15585/mmwr.mm7415a2","DOIUrl":"https://doi.org/10.15585/mmwr.mm7415a2","url":null,"abstract":"","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"24 1","pages":"266-268"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143902952","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":"Overdoses Involving Medetomidine Mixed with Opioids - Chicago, Illinois, May 2024.","authors":"Amy Nham,John N Le,Shawn A Thomas,Kimberly Gressick,Emily N Ussery,Jean Y Ko,R Matt Gladden,Christina A Mikosz,Joshua G Schier,Alana Vivolo-Kantor,Maria Fiorillo,McKenna McMaster,Darlene Nolasco Magana,Livia Verklan-McInnes,Michael Wahl,Taylor Wood,Axel Adams,Alex Krotulski,Jordan Trecki,Ross Ellison,Roy Gerona,Ponni Arunkumar,Mojde Mir,Leslie M Wise,Emma Betancourt,Kathleen Monty,Jhoanna Gulmatico,Angie Pojas,Ruchi Fitzgerald,Miao Hua","doi":"10.15585/mmwr.mm7415a1","DOIUrl":"https://doi.org/10.15585/mmwr.mm7415a1","url":null,"abstract":"Medetomidine, a nonopioid sedative not approved for use in humans, has periodically been detected in illegally manufactured opioids across North America since 2022. On May 11, 2024, the Chicago Department of Public Health (CDPH) and the Illinois Department of Public Health were alerted by hospitals and the Illinois Poison Center to an increase in emergency medical services responses for suspected opioid-involved overdoses with atypical symptoms, mostly clustered on Chicago's West Side. CDPH and CDC investigated and identified 12 confirmed, 26 probable, and 140 suspected overdoses involving medetomidine mixed with opioids among patients treated at three hospitals in Chicago's West Side during May 11-17, 2024. Medetomidine had not been previously identified in Chicago's illegal drug supply. Fentanyl was identified in all drug samples and blood specimens containing medetomidine. Most patients were male, non-Hispanic Black or African American, and aged 45-64 years; most patients with confirmed cases experienced bradycardia and had no or only a partial response to naloxone. This cluster is the largest reported for confirmed medetomidine-involved overdoses. Multisector surveillance, including by health care providers, toxicology laboratories, and public health personnel, was essential for quickly identifying and responding to new adulterants in the illegal drug supply. Because all specimens and samples in this investigation that contained medetomidine also contained natural or synthetic opioids, administering naloxone for all suspected opioid-involved overdoses remains crucial.","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"19 1","pages":"258-265"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143902953","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":"Measles Update - United States, January 1-April 17, 2025.","authors":"Adria D Mathis,Kelley Raines,Thomas D Filardo,Nicole Wiley,Jessica Leung,Paul A Rota,Diana Martinez,Saroj Rai,Varun Shetty,Nora Holzinger,Emma Stanislawski,Demetre C Daskalakis,Kevin Chatham-Stephens,Manisha Patel,David Sugerman","doi":"10.15585/mmwr.mm7414a1","DOIUrl":"https://doi.org/10.15585/mmwr.mm7414a1","url":null,"abstract":"A multistate measles outbreak, predominantly affecting members of close-knit communities with low measles vaccination coverage in New Mexico, Oklahoma, and Texas began in January 2025. As of April 17, a total of 800 cases have been reported in the United States in 2025; 654 (82%) cases in New Mexico, Oklahoma, and Texas have been associated with the ongoing outbreak. These cases represent an approximately 180% increase over the 285 measles cases reported in the United States during all of 2024, and the second highest annual case count in the United States in 25 years. Overall, 771 (96%) patients have been unvaccinated or had unknown vaccination status (77% were unvaccinated, and 14% had unknown vaccination status when excluding 590 cases reported by Texas, which requires explicit consent by law [i.e., opt-in] to enroll in the Texas Immunization Registry), 85 (11%) patients have been hospitalized, and three patients have died. Among 48 (6%) internationally imported cases, 44 (92%) occurred among U.S. residents. Endemic measles was declared eliminated in the United States in 2000 as a direct result of high 2-dose childhood coverage with the measles, mumps, and rubella (MMR) vaccine. However, measles cases and outbreaks continue to occur when travelers with measles return to the United States while they are infectious; larger U.S. outbreaks typically follow importation into close-knit communities with low vaccination coverage. Nationally, risk for widespread measles transmission remains low because of high population-level immunity. To prepare for and prevent measles cases and outbreaks, public health departments should continue working with trusted community messengers on culturally competent community engagement, education, vaccination efforts, and other community infection prevention approaches (e.g., case isolation, contact monitoring, and post-exposure prophylaxis) and coordinating with health care facilities and schools. Increasing national and local MMR vaccination coverage is essential to preventing measles cases and outbreaks.","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"24 1","pages":"232-238"},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876469","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":"Investigation of Lead and Chromium Exposure After Consumption of Contaminated Cinnamon-Containing Applesauce - United States, November 2023-April 2024.","authors":"Alyssa N Troeschel,Melanie C Buser,Andrea Winquist,Perri Ruckart,Michael Yeh,David Kuai,Arthur Chang,Audrey F Pennington,Jelonia T Rumph,Madison R Smith,Marisol Valenzuela Lara,Natalie Cataldo,Kailey Lewis,Katherine Arnold,Stic Harris,David C Nicholas,Megan Hughes,Teresa Wortmann,Ed Norman,Melanie D Napier,Jamaica Dillard,Johnni Daniel","doi":"10.15585/mmwr.mm7414a2","DOIUrl":"https://doi.org/10.15585/mmwr.mm7414a2","url":null,"abstract":"Although lead poisoning can cause detrimental health effects, it is largely preventable. Common exposure sources include contaminated soil, water, and lead-based paint in homes built before the 1978 ban on residential lead-containing paint. In North Carolina, testing for lead is encouraged for all children at ages 1 and 2 years, and is required for children covered by Medicaid. In October 2023, routine pediatric blood lead testing and follow-up investigations conducted by the North Carolina Department of Health and Human Services identified four asymptomatic cases of lead poisoning associated with consumption of cinnamon-containing applesauce packaged in pouches. The Food and Drug Administration (FDA) identified lead in the cinnamon as the source of contamination; chromium was later also detected in the cinnamon. FDA alerted the public on October 28, and the distributor initiated a voluntary recall the following day. To estimate the impact of the event and characterize reported cases, CDC initiated a national call for cases (defined as a blood lead level [BLL] ≥3.5 μg/dL in a person of any age in ≤3 months after consuming a recalled cinnamon-containing applesauce product). During November 22, 2023-April 12, 2024, a total of 44 U.S. states, the District of Columbia, and Puerto Rico reported 566 cases (55% in children aged <2 years, including 20% that were temporally associated with symptoms). The median maximum venous BLL was 7.2 μg/dL (range = 3.5-39.3 μg/dL). The hundreds of children poisoned by this incident highlight the importance of preventing toxic metal contamination of food and promoting routine childhood blood lead testing and follow-up to identify lead exposure sources. Clinicians and public health practitioners should be aware of the potential for exposure to toxic metals from less common sources, including food.","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"42 1","pages":"239-244"},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876491","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":"Tobacco-Related Clinical Services and Tobacco-Free Policies in Behavioral Health Treatment Facilities - United States, 2023.","authors":"Brenna VanFrank,Emilia Pasalic,Briana Oliver,Kevin Caron,Karuna Nerurkar,Kristy Marynak,Ahmed Jamal,Krishna Palipudi,Margaret Mahoney,Anna Schecter,Chanel Recasner,Elizabeth Hazelwood,Naomi Tomoyasu","doi":"10.15585/mmwr.mm7414a3","DOIUrl":"https://doi.org/10.15585/mmwr.mm7414a3","url":null,"abstract":"Evidence-based cessation treatments and tobacco-free policies support and increase smoking cessation, which has positive physical health impacts and is associated with positive behavioral health outcomes. Implementation of these strategies in substance use and mental health treatment facilities (behavioral health treatment facilities) could help decrease tobacco use among persons with behavioral health conditions. Data from the 2023 National Substance Use and Mental Health Services Survey were analyzed to ascertain the number and percentage of behavioral health treatment facilities that offered tobacco-related clinical services and had tobacco-free policies. In 2023, tobacco cessation counseling was the most commonly offered cessation service in facilities treating mental health conditions (53.1%) and substance use disorders (69.9%). Fewer than one half of facilities offered nicotine replacement therapy (35.0% of mental health and 40.2% of substance use facilities) or non-nicotine cessation medication (33.6% of mental health and 35.3% of substance use facilities). Policies prohibiting both smoking and vaping were reported by 53.9% of mental health and 33.9% of substance use facilities. Among facilities with a tobacco-free policy, 64.4% of mental health and 81.8% of substance use facilities offered at least one cessation service. Opportunities remain to improve cessation supports in behavioral health treatment facilities, including tobacco-free policies and integrated tobacco cessation treatment services. These strategies could help decrease tobacco-related disease and improve behavioral health outcomes.","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"41 1","pages":"245-251"},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876468","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: Assessment of Awareness, Use, and Access Barriers to Cooling Centers in Maricopa County, Arizona - August 1-September 15, 2023.","authors":"Aaron Gettel,Meaghan Batchelor,Jessica Bell,Heather L Walker,Kathryn G Burr,June Vutrano,Angela Moreth,Jessica R White,Rebecca Sunenshine,Ariella P Dale,Jackie Ward,Nicole M Jarrett","doi":"10.15585/mmwr.mm7414a4","DOIUrl":"https://doi.org/10.15585/mmwr.mm7414a4","url":null,"abstract":"","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"8 1","pages":"252-255"},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876470","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":"Outbreak of Cyclosporiasis Among Patrons of a Mexican-Style Restaurant - Limestone County, Alabama, May-June 2023.","authors":"Justine Goetzman,Adyneshia Carter,Ana Oliveira,L Amanda Ingram","doi":"10.15585/mmwr.mm7413a1","DOIUrl":"https://doi.org/10.15585/mmwr.mm7413a1","url":null,"abstract":"In early June 2023, the Alabama Department of Public Health identified five laboratory-confirmed cyclosporiasis case reports with a common patient exposure of eating at one Mexican-style restaurant. Common signs of cyclosporiasis include diarrhea, abdominal cramps, nausea, and loss of appetite. Although most illnesses are self-limited, antibiotic treatment can prevent relapsing illness. Onset of illness for the initial five patients occurred during May 26-30. An outbreak investigation was initiated on June 7. Routine case investigations and case finding through the restaurant's food delivery service contact list identified 42 additional cases. Multivariable analysis of case-control study data revealed that illness was associated with consumption of cilantro (odds ratio = 40.9; 95% CI = 6.4-808.6). The cilantro was traced back to a Texas firm with no identified food manufacturing license that sourced the product from Mexico. The outbreak and its investigation demonstrate the ongoing need for regulatory controls of produce suppliers, documentation and review of business licenses, and increasing public awareness of food safety and outbreaks. Distribution of potentially contaminated products via improper supply chain channels remains a public health challenge. Avoiding infection in the United States involves preventing contaminated produce from reaching local retailers and consumers.","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"30 1","pages":"217-221"},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143849467","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}