Morbidity and Mortality Weekly Report最新文献

{"title":"Clade Ib Mpox Outbreak - Kenya, July 2024-February 2025.","authors":"Pius Mutuku,Ahmed Abade,Maurice Owiny,Zephania Irura,Abdi Roba,Hilary Limo,Amy Herman-Roloff,Naomi Lucchi,Nancy Bowen,Ahmed Fidhow,Daniel Lang'at,Jonas Z Hines","doi":"10.15585/mmwr.mm7422a2","DOIUrl":"https://doi.org/10.15585/mmwr.mm7422a2","url":null,"abstract":"Since July 2024, Kenya has been experiencing an mpox outbreak caused by clade Ib Monkeypox virus (MPXV), a newly recognized variant that has spread from the Democratic Republic of the Congo to multiple countries within and outside of Africa. This report describes the characteristics of laboratory-confirmed clade Ib mpox cases in Kenya during the first 7 months of the outbreak. Among 447 suspected cases during July 2024-February 2025, a total of 48 (10.7%) were confirmed by polymerase chain reaction testing. Most confirmed cases occurred along a highway from the Indian Ocean port in Mombasa to Malaba at the Ugandan border, a transportation corridor that links Kenya to other East and Central African countries. Among the 48 confirmed cases, 27 (56.3%) occurred among persons associated with the transportation corridor, including truck drivers (12; 25.0%), sex workers (eight; 16.7%), and persons employed at or near trucking stopovers (seven; 14.6%). Sexual transmission was suspected in 30 (62.5%) cases, based on the patient's history or locations of the lesions; 11 (22.9%) patients also had HIV infection, one of whom died. Clade Ib MPXV in Kenya appears to be primarily sexually transmitted and concentrated in specific groups at high risk for infection. Public health measures, including vaccination, might be most effective if they focus on these specific groups and geographic areas.","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"42 1","pages":"379-384"},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144320088","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":"Use of JYNNEOS (Smallpox and Mpox Vaccine, Live, Nonreplicating) for Persons Aged ≥18 Years at Risk for Mpox During an Mpox Outbreak: Recommendations of the Advisory Committee on Immunization Practices - United States, 2023.","authors":"Agam K Rao,Faisal S Minhaj,Rosalind J Carter,Jonathan Duffy,Panayampalli S Satheshkumar,Kevin P Delaney,Laura A S Quilter,Rachel E Kachur,Catherine McLean,Danielle L Moulia,David T Kuhar,Marie A de Perio,Ian H Spicknall,Beth P Bell,Pablo J Sánchez,Christina L Hutson,Amanda C Cohn","doi":"10.15585/mmwr.mm7422a3","DOIUrl":"https://doi.org/10.15585/mmwr.mm7422a3","url":null,"abstract":"Since the worldwide eradication of smallpox in 1980, orthopoxvirus vaccines had been used nearly exclusively by persons at risk for occupational exposure to orthopoxviruses, including Monkeypox virus, the virus that causes mpox. However, during recent years, the epidemiology of mpox has been changing in countries where the animal reservoirs are believed to live and where endemic transmission has been known to occur for decades. CDC issues outbreak-specific vaccination recommendations based on the epidemiology at the time specific cases or clusters are identified; however, because of the increased risk for U.S. mpox outbreaks, the Advisory Committee on Immunization Practices (ACIP) reviewed results from a previously performed modified Grading of Recommendations Assessment, Development, and Evaluation of the 2-dose JYNNEOS (smallpox and mpox vaccine, live, nonreplicating) vaccination series and an Evidence to Recommendations (EtR) framework addressing multiple domains (e.g., benefits, harms, and target population values and preferences). Based on this assessment, ACIP recommended the use of JYNNEOS (a live, replication-deficient vaccinia virus vaccine) for persons aged ≥18 years at risk for mpox during an mpox outbreak (irrespective of clade). Because the cause of future mpox outbreaks and the populations affected by these outbreaks remain uncertain, public health authorities will continue to issue outbreak-specific vaccination guidance when outbreaks occur. A clade IIb mpox outbreak that began in 2022 continued to cause substantial morbidity and mortality >1 year later. Although CDC had issued outbreak-specific vaccination guidance, it was anticipated that the outbreak would be protracted. For this reason, ACIP reviewed a second EtR framework about outbreaks and in 2023 recommended JYNNEOS for persons aged ≥18 years at risk for acquiring mpox during the multinational clade IIb outbreak. As of 2025, cases continue to occur; however, the future need for the recommendation will be reassessed as the outbreak evolves. Mpox vaccination is not routinely recommended for health care personnel during mpox outbreaks, including during the ongoing clade IIb outbreak.","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"15 1","pages":"385-392"},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144320087","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":"Clade II Mpox Infections Among Cruise Ship Passengers and Crew Members - United States, 2024.","authors":"Nancy Ortiz,Luis R Rodriguez,Mecca McPherson,Kristen Pringle,Agam K Rao,Alexandra Tuttle,Christine M Hughes,Rachel E Kachur,Laura A S Quilter,Alida Gertz,Francisco Alvarado-Ramy,Clive Brown,Sundari Mase,Kara Tardivel","doi":"10.15585/mmwr.mm7422a1","DOIUrl":"https://doi.org/10.15585/mmwr.mm7422a1","url":null,"abstract":"During the global clade II mpox outbreak, cases have disproportionately affected gay, bisexual, and other men who have sex with men (MSM). Cruise ship travel-associated mpox infections have not been previously described. During January 25-April 18, 2024, CDC was notified of eight mpox cases among cruise travelers on four ships: four among crew members and four among passengers. Seven cases were laboratory-confirmed as clade II Monkeypox virus. All exposure histories indicated male-to-male sexual contact. No patients were hospitalized, and none died. Crew members with mpox received their diagnoses on board and were isolated while infectious. Contacts were identified, monitored, and assessed for mpox postexposure prophylaxis (mpox vaccination). No crew members with mpox had been vaccinated against mpox. Passengers with mpox received their diagnoses after cruising on voyages marketed to gay and bisexual men, with symptom onset dates suggesting voyage exposures. For one cruise ship, two of the three reports of mpox among passengers were received after health departments were notified of potential cruise-associated exposures, and letters were sent to other passengers. Three of the four passengers with mpox had received 2 doses of JYNNEOS vaccine in 2022. Cruise lines should consider educating crew members on symptoms, risks, and preventive measures related to mpox and working with medical personnel to facilitate mpox vaccination as preexposure prophylaxis for eligible crew members. Cruise passengers who are eligible, predominantly MSM, should receive mpox vaccine before cruise travel. For cruise voyages marketed to gay and bisexual men, having mpox vaccine available on board would facilitate timely postexposure prophylaxis, if indicated; mpox prevention messaging and education before and during a voyage are also recommended.","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"44 1","pages":"373-378"},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144320091","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":"Elevated Blood Lead Levels in a Pregnant Woman and her Family from Traditional Kansa (Bronze) and Pital (Brass) Metalware - New York City, 2024.","authors":"Paromita Hore,Kolapo Alex-Oni,Slavenka Sedlar,Nevila Bardhi,Jacqueline Ehrlich","doi":"10.15585/mmwr.mm7418a1","DOIUrl":"https://doi.org/10.15585/mmwr.mm7418a1","url":null,"abstract":"Lead exposure, even at low levels, can cause detrimental health effects across all ages. The New York City (NYC) Department of Health and Mental Hygiene receives blood lead results for NYC residents who are tested for lead and routinely conducts investigations to determine sources of lead exposure. In July 2024, blood lead surveillance activities in NYC revealed high levels of lead in traditional kansa (bronze) and pital (brass) metalware from Nepal. Use of these metalware items for preparing and serving food and drinks was associated with blood lead levels above the Council of State and Territorial Epidemiologists' blood lead reference value of 3.5 μg/dL in a pregnant woman, her spouse, and their child (range = 6-18.7 μg/dL). Clinicians and public health professionals should be aware that traditional metalware from around the world can contain high levels of lead, and when used to prepare or serve food and drinks, can be communal sources of lead exposure.","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"137 1","pages":"298-301"},"PeriodicalIF":0.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144122101","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: HeatRisk Forecasts and Emergency Department Visits for Heat-Related Illness - New York, May-September 2024.","authors":"Neil A Muscatiello,Wanhsiang Hsu,Heather Aydin-Ghormoz,Charlene Weng,Vajeera Dorabawila,Kathleen F Bush,Ambarish Vaidyanathan","doi":"10.15585/mmwr.mm7418a2","DOIUrl":"https://doi.org/10.15585/mmwr.mm7418a2","url":null,"abstract":"","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"137 1","pages":"302-304"},"PeriodicalIF":0.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144122093","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":"Estimated Current and Future Congenital Rubella Syndrome Incidence with and Without Rubella Vaccine Introduction - 19 Countries, 2019-2055.","authors":"Emmaculate Lebo,Emilia Vynnycky,James P Alexander,Matthew J Ferrari,Amy K Winter,Kurt Frey,Timoleon Papadopoulos,Gavin B Grant,Patrick O'Connor,Susan E Reef,Natasha S Crowcroft,Laura A Zimmerman","doi":"10.15585/mmwr.mm7418a3","DOIUrl":"https://doi.org/10.15585/mmwr.mm7418a3","url":null,"abstract":"Rubella is a leading cause of vaccine-preventable birth defects. Rubella virus infection during early pregnancy can result in miscarriage, fetal death, stillbirth, or a constellation of birth defects known as congenital rubella syndrome (CRS). This report describes current and future estimated CRS incidence in countries that have not yet introduced rubella-containing vaccine (RCV) into their national childhood immunization schedules and the estimated effect of implementing a recent recommendation to introduce RCV into these programs even if population coverage with measles-containing vaccine is <80%. During 2000-2022, the number of countries that introduced RCV increased from 99 (52%) of 191 in 2000 to 175 (90%) of 194 in 2022. By the end of 2023, 19 lower- and middle-income countries had not yet introduced RCV. In 2019, an estimated 24,000 CRS cases occurred in these countries, representing 75% of the estimated 32,000 cases worldwide. In a modeling study estimating the effect of RCV introduction in these countries during 2025-2055, an estimated 1.03 million CRS cases are projected to occur without RCV. In contrast, fewer than 60,000 cases are estimated if RCV is introduced with catch-up and follow-up supplementary immunization activities, averting more than an estimated 986,000 CRS cases over 30 years. Based in part on these estimates, in September 2024, the World Health Organization Strategic Advisory Group of Experts on Immunization recommended removing the ≥80% coverage threshold and instituting universal RCV introduction in these countries. RCV introduction in these 19 countries during 2025-2030 could rapidly accelerate progress toward rubella and CRS elimination worldwide.","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"137 1","pages":"305-311"},"PeriodicalIF":0.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144122040","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":"Cave-Associated Histoplasmosis Outbreak Among Travelers Returning from Costa Rica - Georgia, Texas, and Washington, December 2024-January 2025.","authors":"Ria R Ghai,Elizabeth T Sajewski,Mitchell Blass,Hayley Belles,Hope Dishman,Julie Gabel,BreeAnna Dell,Mariah Harper,Hanna N Oltean,Olivia Smith,Emeka Ogwuegbu,Saad Zaheer,Alexander Jordan,Meghan Lyman,Ian Hennessee,Mitsuru Toda","doi":"10.15585/mmwr.mm7417a1","DOIUrl":"https://doi.org/10.15585/mmwr.mm7417a1","url":null,"abstract":"Histoplasmosis is a fungal infection that primarily affects the lungs. The condition is caused by Histoplasma organisms, which are often found in soil contaminated with bird or bat droppings. On January 17, 2025, a Georgia infectious disease physician notified CDC of suspected histoplasmosis cases among 12 members of an extended family from households in Georgia, Texas, and Washington. The ill family members included six adults aged 42-49 years and six children aged 8-16 years. They had recently returned from Costa Rica, where they toured a cave linked to a previous histoplasmosis outbreak (1).","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"14 1","pages":"289-292"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065852","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: Multistate Outbreak of Salmonella enterica I 4:I:- Infections Linked to Charcuterie-Style Meats - United States, 2023-2024.","authors":"Angelo Lodato,Andrea Cote,Joshua Rounds,Laurie K Stewart,Anna E Pickett,Megan E Cahill,Lorrie L B Martin,Jennifer K Adams,Lauren Gollarza,Zachary D McCormic","doi":"10.15585/mmwr.mm7417a2","DOIUrl":"https://doi.org/10.15585/mmwr.mm7417a2","url":null,"abstract":"","PeriodicalId":18931,"journal":{"name":"Morbidity and Mortality Weekly Report","volume":"53 1","pages":"293-295"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065853","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":"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}