Mmwr Surveillance Summaries最新文献

{"title":"Contributing Factors of Foodborne Illness Outbreaks - National Outbreak Reporting System, United States, 2014-2022.","authors":"Meghan M Holst, Beth C Wittry, Carolyn Crisp, Jeffrey Torres, D J Irving, David Nicholas","doi":"10.15585/mmwr.ss7401a1","DOIUrl":"10.15585/mmwr.ss7401a1","url":null,"abstract":"<p><strong>Problem/condition: </strong>Approximately 800 foodborne illness outbreaks occur in the United States each year. These outbreaks include approximately 15,000 illnesses, 800 hospitalizations, and 20 deaths. Although illnesses from outbreaks account for a small portion of all foodborne illnesses, outbreak investigations reveal how these illnesses originate by offering crucial data through epidemiologic, environmental health, and laboratory analyses and aid in outbreak mitigation and prevention.</p><p><strong>Period covered: </strong>2014-2022.</p><p><strong>Description of system: </strong>The Foodborne Disease Outbreak Surveillance System (FDOSS), via the National Outbreak Reporting System (NORS), captures data from foodborne enteric illness outbreak investigations in the United States. Epidemiology or communicable disease control and environmental health programs of state and local health departments collect and voluntarily report the data to NORS, which is managed by CDC. These data include information about cases (e.g., case counts, symptoms, duration of illness, and health care-seeking behaviors), laboratory specimens, settings of exposure, implicated food items, and contributing factors (i.e., how the outbreak occurred). A foodborne illness outbreak is defined as two or more cases of a similar illness associated with a common exposure (e.g., shared food, venue, or experience). Data collected from an outbreak investigation help the investigator identify contributing factors to the outbreak. Contributing factors are food preparation practices, behaviors, and environmental conditions that lead to pathogens getting into food, growing in food, or surviving in food and are grouped into three categories: contamination (when pathogens and other hazards get into food), proliferation (when pathogens that are already present in food grow), and survival (when pathogens survive a process intended to kill or reduce them).</p><p><strong>Results: </strong>A total of 2,677 (40.5%) foodborne illness outbreaks reported during 2014-2022 with information on contributing factors were included in this analysis. Foodborne outbreak periods were categorized into three time frames: 2014-2016 (first), 2017-2019 (second), and 2020-2022 (third). Of the 2,677 outbreaks, 1,142 (42.7%) occurred during the first time frame, 1,130 outbreaks (42.2%) during the second time frame, and 405 outbreaks (15.1%) during the third time frame. The proportion of bacterial outbreaks increased from the first (41.9%) to the third time frame (48.4%), and the proportion of viral outbreaks decreased (33.3% to 23.2%). Over the three time frames, the proportion of outbreaks with a contamination contributing factor decreased (85.6%, 83.6%, and 81.0%, respectively). The proportion of outbreaks with a proliferation contributing factor category decreased from the first (40.3%) to the second time frame (35.0%), then increased during the third time frame (35.1%), and the proportion of outbreaks","PeriodicalId":48549,"journal":{"name":"Mmwr Surveillance Summaries","volume":"74 1","pages":"1-12"},"PeriodicalIF":37.3,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606677","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":"Intimate Partner Violence-Related Homicides of Hispanic and Latino Persons - National Violent Death Reporting System, United States, 2003-2021.","authors":"Sarah Treves-Kagan, Yanet Ruvalcaba, Daniel T Corry, Colleen M Ray, Vi D Le, Rosalyn D Lee, Carlos Siordia, Melissa C Mercado, Lianne Fuino Estefan, Tatiana M Vera, Megan C Kearns, Laura M Mercer Kollar, Delight E Satter, Ana Penman-Aguilar, José T Montero","doi":"10.15585/mmwr.ss7309a1","DOIUrl":"10.15585/mmwr.ss7309a1","url":null,"abstract":"<p><strong>Problem/condition: </strong>In 2022, homicide was the second leading cause of death for Hispanic and Latino persons aged 15-24 years in the United States, the third leading cause of death for those aged 25-34 years, and the fourth leading cause of death for those aged 1-14 years. The majority of homicides of females, including among Hispanic and Latino persons, occur in the context of intimate partner violence (IPV). This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) on IPV-related homicides of Hispanic and Latino persons in the United States.</p><p><strong>Period covered: </strong>2003-2021.</p><p><strong>Description of system: </strong>NVDRS collects data regarding violent deaths in the United States and links three sources: death certificates, coroner or medical examiner reports, and law enforcement reports. IPV-related homicides include both intimate partner homicides (IPHs) by current or former partners and homicides of corollary victims (e.g., children, family members, and new partners). Findings describe victim and suspect sex, age group, and race and ethnicity; method of injury; type of location where the homicide occurred; precipitating circumstances (i.e., events that contributed to the homicide); and other selected characteristics. Deaths related to each other (e.g., an ex-partner kills the former partner and their new partner) are linked into a single incident. State participation in NVDRS has expanded over time, and the number of states participating has varied by year; data from all available years (2003-2021) and U.S. jurisdictions (49 states, Puerto Rico, and the District of Columbia) were used for this report. Of the 49 states that collect data, all except California and Texas collect data statewide; Puerto Rico and District of Columbia data are jurisdiction wide. Florida was excluded because the data did not meet the completeness threshold for circumstances.</p><p><strong>Results: </strong>NVDRS collected data on 24,581 homicides of Hispanic and Latino persons, and data from all available years (2003-2021) and U.S. jurisdictions (49 states, Puerto Rico, and the District of Columbia) were examined. Among homicides with known circumstances (n = 17,737), a total of 2,444 were classified as IPV-related (13.8%). Nearly half of female homicides (n = 1,453; 48.2%) and 6.7% (n = 991) of male homicides were IPV-related; however, among all Hispanic and Latino homicides, most victims were male (n = 20,627; 83.9%). Among the 2,319 IPV-related homicides with known suspects, 85% (n = 1,205) of suspects were current or former partners for female victims, compared with 26.2% (n = 236) for male Hispanic and Latino victims. Approximately one fifth (71 of 359 [19.8%]) of female IPV-related homicide victims of childbearing age with known pregnancy status were pregnant or ≤1 year postpartum. Approximately 5% of IPV-related homicide victims were identified as Black Hispanic or Latino persons (males: n = ","PeriodicalId":48549,"journal":{"name":"Mmwr Surveillance Summaries","volume":"73 9","pages":"1-17"},"PeriodicalIF":37.3,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11655122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814628","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":"Waterborne Disease Outbreaks Associated with Splash Pads - United States, 1997-2022.","authors":"Hannah Lawinger, Amina Khan, Colleen Lysen, Marydale Oppert, Vince R Hill, Jonathan S Yoder, Virginia A Roberts, Mia C Mattioli, Michele C Hlavsa","doi":"10.15585/mmwr.ss7308a1","DOIUrl":"10.15585/mmwr.ss7308a1","url":null,"abstract":"<p><strong>Problem/condition: </strong>Splash pads are recreational interactive water venues that spray or jet water on users. Splash pads are intended for children aged <5 years and designed so that water typically does not collect in areas accessible to users, thereby minimizing the risk for drowning. Splash pads were first found to be associated with waterborne disease outbreaks in 1997.</p><p><strong>Period covered: </strong>1997-2022.</p><p><strong>Description of system: </strong>Since 1971, waterborne disease outbreaks have been voluntarily reported to CDC by state, local, and territorial health departments using a standard paper form via the Waterborne Disease and Outbreak Surveillance System (WBDOSS). Beginning in 2009, WBDOSS reporting was made available exclusively through the National Outbreak Reporting System, a web-based platform. This report characterizes waterborne disease outbreaks associated with splash pads reported to CDC that occurred during 1997-2022.</p><p><strong>Results: </strong>During 1997-2022, public health officials from 23 states and Puerto Rico reported 60 waterborne disease outbreaks associated with splash pads. These reported outbreaks resulted in 10,611 cases, 152 hospitalizations, 99 emergency department visits, and no reported deaths. The 40 (67%) outbreaks confirmed to be caused, in part, by Cryptosporidium resulted in 9,622 (91%) cases and 123 (81%) hospitalizations. Two outbreaks suspected to be caused by norovirus resulted in 72 (73%) emergency department visits.</p><p><strong>Interpretation: </strong>Waterborne pathogens that cause acute gastrointestinal illness can be transmitted by ingesting water contaminated with feces from infected persons. Chlorine is the primary barrier to pathogen transmission in splash pad water. However, Cryptosporidium is tolerant to chlorine and is the most common cause of reported waterborne disease outbreaks associated with splash pads.</p><p><strong>Public health action: </strong>Public health officials and the aquatics sector can use the findings in this report to promote the prevention of splash pad-associated outbreaks (e.g., recommended user behaviors) and guide the construction, operation, and management of splash pads. Public health practitioners and the aquatics sector also can collaborate to voluntarily adopt CDC's Model Aquatic Health Code recommendations to prevent waterborne illness associated with splash pads.</p>","PeriodicalId":48549,"journal":{"name":"Mmwr Surveillance Summaries","volume":"73 8","pages":"1-15"},"PeriodicalIF":37.3,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773887","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":"Abortion Surveillance - United States, 2022.","authors":"Stephanie Ramer, Antoinette T Nguyen, Lisa M Hollier, Jessica Rodenhizer, Lee Warner, Maura K Whiteman","doi":"10.15585/mmwr.ss7307a1","DOIUrl":"10.15585/mmwr.ss7307a1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Problem/condition: &lt;/strong&gt;CDC conducts abortion surveillance to document the number and characteristics of women obtaining legal induced abortions and the number of abortion-related deaths in the United States.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Period covered: &lt;/strong&gt;2022.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Description of system: &lt;/strong&gt;Each year, CDC requests abortion data from the central health agencies for the 50 states, the District of Columbia, and New York City. For 2022, a total of 48 reporting areas voluntarily provided aggregate abortion data to CDC. Of these, 47 reporting areas provided data each year during 2013-2022. Census and natality data were used to calculate abortion rates (number of abortions per 1,000 women aged 15-44 years) and ratios (number of abortions per 1,000 live births), respectively. Abortion-related deaths from 2021 were assessed as part of CDC's Pregnancy Mortality Surveillance System (PMSS).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;For 2022, a total of 613,383 abortions were reported to CDC from 48 reporting areas. Among 47 reporting areas with data each year during 2013-2022, in 2022, a total of 609,360 abortions were reported, the abortion rate was 11.2 abortions per 1,000 women aged 15-44 years, and the abortion ratio was 199 abortions per 1,000 live births. From 2021 to 2022, the total number of abortions decreased 2% (from 622,108 total abortions), the abortion rate decreased 3% (from 11.6 abortions per 1,000 women aged 15-44 years), and the abortion ratio decreased 2% (from 204 abortions per 1,000 live births). From 2013 to 2022, the total number of reported abortions decreased 5% (from 640,154), the abortion rate decreased 10% (from 12.4 abortions per 1,000 women aged 15-44 years), and the abortion ratio increased 1% (from 198 abortions per 1,000 live births).In 2022, women in their 20s accounted for more than half of abortions (56.5%). Women aged 20-24 and 25-29 years accounted for the highest percentages of abortions (28.3% and 28.2%, respectively) and had the highest abortion rates (18.1 and 18.7 abortions per 1,000 women aged 20-24 and 25-29 years, respectively). By contrast, adolescents aged &lt;15 years and women aged ≥40 years accounted for the lowest percentages of abortions (0.2% and 3.6%, respectively) and had the lowest abortion rates (0.4 and 2.5 abortions per 1,000 women aged &lt;15 and ≥40 years, respectively). However, abortion ratios were highest among adolescents (aged ≤19 years) and lowest among women aged 30-39 years.From 2021 to 2022, abortion rates decreased among women aged ≥20 years and did not change among adolescents (aged ≤19 years). Abortion rates decreased from 2013 to 2022 among all age groups, except women aged 30-34 years for whom it increased. The decrease in the abortion rate from 2013 to 2022 was highest among adolescents compared with other age groups. From 2021 to 2022, abortion ratios increased for adolescents and decreased among women aged ≥20 years. From 2013 to 2022, abortion ratios increased among adoles","PeriodicalId":48549,"journal":{"name":"Mmwr Surveillance Summaries","volume":"73 7","pages":"1-28"},"PeriodicalIF":37.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741000","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":"Laboratory-Confirmed Influenza-Associated Hospitalizations Among Children and Adults - Influenza Hospitalization Surveillance Network, United States, 2010-2023.","authors":"Angelle Naquin, Alissa O'Halloran, Dawud Ujamaa, Devi Sundaresan, Svetlana Masalovich, Charisse N Cummings, Kameela Noah, Seema Jain, Pam Daily Kirley, Nisha B Alden, Elizabeth Austin, James Meek, Kimberly Yousey-Hindes, Kyle Openo, Lucy Witt, Maya L Monroe, Justin Henderson, Val Tellez Nunez, Ruth Lynfield, Melissa McMahon, Yomei P Shaw, Caroline McCahon, Nancy Spina, Kerianne Engesser, Brenda L Tesini, Maria A Gaitan, Eli Shiltz, Krista Lung, Melissa Sutton, M Andraya Hendrick, William Schaffner, H Keipp Talbot, Andrea George, Hafsa Zahid, Carrie Reed, Shikha Garg, Catherine H Bozio","doi":"10.15585/mmwr.ss7706a1","DOIUrl":"10.15585/mmwr.ss7706a1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Problem/condition: &lt;/strong&gt;Seasonal influenza accounts for 9.3 million-41 million illnesses, 100,000-710,000 hospitalizations, and 4,900-51,000 deaths annually in the United States. Since 2003, the Influenza Hospitalization Surveillance Network (FluSurv-NET) has been conducting population-based surveillance for laboratory-confirmed influenza-associated hospitalizations in the United States, including weekly rate estimations and descriptions of clinical characteristics and outcomes for hospitalized patients. However, a comprehensive summary of trends in hospitalization rates and clinical data collected from the surveillance platform has not been available.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Reporting period: &lt;/strong&gt;2010-11 through 2022-23 influenza seasons.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Description of system: &lt;/strong&gt;FluSurv-NET conducts population-based surveillance for laboratory-confirmed influenza-associated hospitalizations among children and adults. During the reporting period, the surveillance network included 13-16 participating sites each influenza season, with prespecified geographic catchment areas that covered 27 million-29 million persons and included an estimated 8.8%-9.5% of the U.S. population. A case was defined as a person residing in the catchment area within one of the participating states who had a positive influenza laboratory test result within 14 days before or at any time during their hospitalization. Each site abstracted case data from hospital medical records into a standardized case report form, with selected variables submitted to CDC on a weekly basis for rate estimations. Weekly and cumulative laboratory-confirmed influenza-associated hospitalization rates per 100,000 population were calculated for each season from 2010-11 through 2022-23 and stratified by patient age (0-4 years, 5-17 years, 18-49 years, 50-64 years, and ≥65 years), sex, race and ethnicity, influenza type, and influenza A subtype. During the 2020-21 season, only the overall influenza hospitalization rate was reported because case counts were insufficient to estimate stratified rates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;During the 2010-11 to 2022-23 influenza seasons, laboratory-confirmed influenza-associated hospitalization rates varied significantly across seasons. Before the COVID-19 pandemic, hospitalization rates per 100,000 population ranged from 8.7 (2011-12) to 102.9 (2017-18) and had consistent seasonality. After SARS-CoV-2 emerged, the hospitalization rate for 2020-21 was 0.8, and the rate did not return to recent prepandemic levels until 2022-23. Inconsistent seasonality also was observed during 2020-21 through 2022-23, with influenza activity being very low during 2020-21, extending later than usual during 2021-22, and occurring early during 2022-23. Molecular assays, particularly multiplex standard molecular assays, were the most common influenza test type in recent seasons, increasing from 12% during 2017-18 for both pediatric and adult cases to 43% and 55% durin","PeriodicalId":48549,"journal":{"name":"Mmwr Surveillance Summaries","volume":"73 6","pages":"1-18"},"PeriodicalIF":37.3,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548437","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":"Surveillance for Violent Deaths - National Violent Death Reporting System, 48 States, the District of Columbia, and Puerto Rico, 2021.","authors":"Brenda L Nguyen, Bridget H Lyons, Kaitlin Forsberg, Rebecca F Wilson, Grace S Liu, Carter J Betz, Janet M Blair","doi":"10.15585/mmwr.ss7305a1","DOIUrl":"10.15585/mmwr.ss7305a1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Problem/condition: &lt;/strong&gt;In 2021, approximately 75,000 persons died of violence-related injuries in the United States. This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) on violent deaths that occurred in 48 states, the District of Columbia, and Puerto Rico in 2021. Results are reported by sex, age group, race and ethnicity, method of injury, type of location where the injury occurred, circumstances of injury, and other selected characteristics. This report introduces additional incident and circumstance variables, which now include child victim-specific circumstance information. This report also incorporates new U.S. Census Bureau race and ethnicity categories, which now account for more than one race and Native Hawaiian or other Pacific Islander categories and include updated denominators to calculate rates for these populations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Period covered: &lt;/strong&gt;2021.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Description of system: &lt;/strong&gt;NVDRS collects data regarding violent deaths from death certificates, coroner and medical examiner records, and law enforcement reports. This report includes data collected for violent deaths that occurred in 2021. Data were collected from 48 states (all states with exception of Florida and Hawaii), the District of Columbia, and Puerto Rico. Forty-six states had statewide data, two additional states had data from counties representing a subset of their population (31 California counties, representing 64% of its population, and 13 Texas counties, representing 63% of its population), and the District of Columbia and Puerto Rico had jurisdiction-wide data. NVDRS collates information for each violent death and links deaths that are related (e.g., multiple homicides, homicide followed by suicide, or multiple suicides) into a single incident.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;For 2021, NVDRS collected information on 68,866 fatal incidents involving 70,688 deaths that occurred in 48 states (46 states collecting statewide data, 31 California counties, and 13 Texas counties), and the District of Columbia. The deaths captured in NVDRS accounted for 86.5% of all homicides, legal intervention deaths, suicides, unintentional firearm injury deaths, and deaths of undetermined intent in the United States in 2021. In addition, information was collected for 816 fatal incidents involving 880 deaths in Puerto Rico. Data for Puerto Rico were analyzed separately. Of the 70,688 deaths, the majority (58.2%) were suicides, followed by homicides (31.5%), deaths of undetermined intent that might be due to violence (8.2%), legal intervention deaths (1.3%) (i.e., deaths caused by law enforcement and other persons with legal authority to use deadly force acting in the line of duty, excluding legal executions), and unintentional firearm injury deaths (&lt;1.0%). The term \"legal intervention\" is a classification incorporated into the International Classification of Diseases, Tenth Revision, and does not denote the la","PeriodicalId":48549,"journal":{"name":"Mmwr Surveillance Summaries","volume":"73 5","pages":"1-44"},"PeriodicalIF":37.3,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11262823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564863","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":"Progress Toward Tuberculosis Elimination and Tuberculosis Program Performance - National Tuberculosis Indicators Project, 2016-2022.","authors":"Rachel Woodruff, Robert Pratt, Maureen Kolasa","doi":"10.15585/mmwr.ss7304a1","DOIUrl":"10.15585/mmwr.ss7304a1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Problem/condition: &lt;/strong&gt;Elimination of tuberculosis (TB) is defined as reducing TB disease incidence in the United States to less than 1 case per million persons per year. In 2022, TB incidence in the United States was 2.5 TB cases per 100,000 persons. CDC's TB program developed a set of national TB indicators to evaluate progress toward TB elimination through monitoring performance of state and city TB program activities. Examining TB indicator data enables state- and city-level TB programs to identify areas for program evaluation and improvement activities. These data also help CDC identify states and cities that might benefit from technical assistance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Period covered: &lt;/strong&gt;The 5-year period for which the most recent data were available for each of five indicators: 1) overall TB incidence (2018-2022), 2) TB incidence among non-U.S.-born persons (2018-2022), 3) percentage of persons with drug susceptibility results reported (2018-2022), 4) percentage of contacts to sputum acid-fast bacillus (AFB) smear-positive TB patients with newly diagnosed latent TB infection (LTBI) who completed treatment (2017-2021), and 5) percentage of patients with completion of TB therapy within 12 months (2016-2020).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Description of system: &lt;/strong&gt;The National TB Indicators Project (NTIP) is a web-based performance monitoring tool that uses national TB surveillance data reported through the National TB Surveillance System and the Aggregate Reports for TB Program Evaluation. NTIP was developed to facilitate the use of existing data to help TB program staff members prioritize activities, monitor progress, and focus program improvement efforts. The following five indicators were selected for this report because of their importance in Federal TB funding allocation and in accelerating the decline in TB cases: 1) overall TB incidence in the United States, 2) TB incidence among non-U.S.-born persons, 3) percentage of persons with drug susceptibility results reported, 4) percentage of contacts to sputum AFB smear-positive TB cases who completed treatment for LTBI, and 5) percentage of patients with completion of TB therapy within 12 months. For this report, 52 TB programs (50 states, the District of Columbia, and New York City) were categorized into terciles based on the 5-year average number of TB cases reported to National TB Surveillance System. This grouping allows comparison of TB programs that have similar numbers of TB cases and allocates a similar number of TB programs to each category. The following formula was used to calculate the relative change by TB program for each indicator: [(% from year 5 - % from year 1 ÷ % from year 1) × 100].&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;During the 5-year period for which the most recent data were available, most TB programs had improvements in reducing overall TB incidence (71.2%) and increasing the percentage of contacts receiving a diagnosis of LTBI who completed LTBI treatment (55.8%)","PeriodicalId":48549,"journal":{"name":"Mmwr Surveillance Summaries","volume":"73 4","pages":"1-18"},"PeriodicalIF":37.3,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11166372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248751","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":"Sentinel Enhanced Dengue Surveillance System - Puerto Rico, 2012-2022.","authors":"Zachary J Madewell, Alfonso C Hernandez-Romieu, Joshua M Wong, Laura D Zambrano, Hannah R Volkman, Janice Perez-Padilla, Dania M Rodriguez, Olga Lorenzi, Carla Espinet, Jorge Munoz-Jordan, Verónica M Frasqueri-Quintana, Vanessa Rivera-Amill, Luisa I Alvarado-Domenech, Diego Sainz, Jorge Bertran, Gabriela Paz-Bailey, Laura E Adams","doi":"10.15585/mmwr.ss7303a1","DOIUrl":"10.15585/mmwr.ss7303a1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Problem/condition: &lt;/strong&gt;Dengue is the most prevalent mosquitoborne viral illness worldwide and is endemic in Puerto Rico. Dengue's clinical spectrum can range from mild, undifferentiated febrile illness to hemorrhagic manifestations, shock, multiorgan failure, and death in severe cases. The disease presentation is nonspecific; therefore, various other illnesses (e.g., arboviral and respiratory pathogens) can cause similar clinical symptoms. Enhanced surveillance is necessary to determine disease prevalence, to characterize the epidemiology of severe disease, and to evaluate diagnostic and treatment practices to improve patient outcomes. The Sentinel Enhanced Dengue Surveillance System (SEDSS) was established to monitor trends of dengue and dengue-like acute febrile illnesses (AFIs), characterize the clinical course of disease, and serve as an early warning system for viral infections with epidemic potential.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Reporting period: &lt;/strong&gt;May 2012-December 2022.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Description of system: &lt;/strong&gt;SEDSS conducts enhanced surveillance for dengue and other relevant AFIs in Puerto Rico. This report includes aggregated data collected from May 2012 through December 2022. SEDSS was launched in May 2012 with patients with AFIs from five health care facilities enrolled. The facilities included two emergency departments in tertiary acute care hospitals in the San Juan-Caguas-Guaynabo metropolitan area and Ponce, two secondary acute care hospitals in Carolina and Guayama, and one outpatient acute care clinic in Ponce. Patients arriving at any SEDSS site were eligible for enrollment if they reported having fever within the past 7 days. During the Zika epidemic (June 2016-June 2018), patients were eligible for enrollment if they had either rash and conjunctivitis, rash and arthralgia, or fever. Eligibility was expanded in April 2020 to include reported cough or shortness of breath within the past 14 days. Blood, urine, nasopharyngeal, and oropharyngeal specimens were collected at enrollment from all participants who consented. Diagnostic testing for dengue virus (DENV) serotypes 1-4, chikungunya virus, Zika virus, influenza A and B viruses, SARS-CoV-2, and five other respiratory viruses was performed by the CDC laboratory in San Juan.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;During May 2012-December 2022, a total of 43,608 participants with diagnosed AFI were enrolled in SEDSS; a majority of participants (45.0%) were from Ponce. During the surveillance period, there were 1,432 confirmed or probable cases of dengue, 2,293 confirmed or probable cases of chikungunya, and 1,918 confirmed or probable cases of Zika. The epidemic curves of the three arboviruses indicate dengue is endemic; outbreaks of chikungunya and Zika were sporadic, with case counts peaking in late 2014 and 2016, respectively. The majority of commonly identified respiratory pathogens were influenza A virus (3,756), SARS-CoV-2 (1,586), human adenovirus (1,550), respirat","PeriodicalId":48549,"journal":{"name":"Mmwr Surveillance Summaries","volume":"73 3","pages":"1-29"},"PeriodicalIF":37.3,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11152364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141162634","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":"Preventable Premature Deaths from the Five Leading Causes of Death in Nonmetropolitan and Metropolitan Counties, United States, 2010-2022.","authors":"Macarena C García, Lauren M Rossen, Kevin Matthews, Gery Guy, Katrina F Trivers, Cheryll C Thomas, Linda Schieb, Michael F Iademarco","doi":"10.15585/mmwr.ss7302a1","DOIUrl":"10.15585/mmwr.ss7302a1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Problem/condition: &lt;/strong&gt;A 2019 report quantified the higher percentage of potentially excess (preventable) deaths in U.S. nonmetropolitan areas compared with metropolitan areas during 2010-2017. In that report, CDC compared national, regional, and state estimates of preventable premature deaths from the five leading causes of death in nonmetropolitan and metropolitan counties during 2010-2017. This report provides estimates of preventable premature deaths for additional years (2010-2022).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Period covered: &lt;/strong&gt;2010-2022.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Description of system: &lt;/strong&gt;Mortality data for U.S. residents from the National Vital Statistics System were used to calculate preventable premature deaths from the five leading causes of death among persons aged &lt;80 years. CDC's National Center for Health Statistics urban-rural classification scheme for counties was used to categorize the deaths according to the urban-rural county classification level of the decedent's county of residence (1: large central metropolitan [most urban], 2: large fringe metropolitan, 3: medium metropolitan, 4: small metropolitan, 5: micropolitan, and 6: noncore [most rural]). Preventable premature deaths were defined as deaths among persons aged &lt;80 years that exceeded the number expected if the death rates for each cause in all states were equivalent to those in the benchmark states (i.e., the three states with the lowest rates). Preventable premature deaths were calculated separately for the six urban-rural county categories nationally, the 10 U.S. Department of Health and Human Services public health regions, and the 50 states and the District of Columbia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;During 2010-2022, the percentage of preventable premature deaths among persons aged &lt;80 years in the United States increased for unintentional injury (e.g., unintentional poisoning including drug overdose, unintentional motor vehicle traffic crash, unintentional drowning, and unintentional fall) and stroke, decreased for cancer and chronic lower respiratory disease (CLRD), and remained stable for heart disease. The percentages of preventable premature deaths from the five leading causes of death were higher in rural counties in all years during 2010-2022. When assessed by the six urban-rural county classifications, percentages of preventable premature deaths in the most rural counties (noncore) were consistently higher than in the most urban counties (large central metropolitan and fringe metropolitan) for the five leading causes of death during the study period.During 2010-2022, preventable premature deaths from heart disease increased most in noncore (+9.5%) and micropolitan counties (+9.1%) and decreased most in large central metropolitan counties (-10.2%). Preventable premature deaths from cancer decreased in all county categories, with the largest decreases in large central metropolitan and large fringe metropolitan counties (-100.0%; benchmark achieved in bot","PeriodicalId":48549,"journal":{"name":"Mmwr Surveillance Summaries","volume":"73 2","pages":"1-11"},"PeriodicalIF":37.3,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11065459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856572","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":"Surveillance of Waterborne Disease Outbreaks Associated with Drinking Water - United States, 2015-2020.","authors":"Jasen M Kunz, Hannah Lawinger, Shanna Miko, Megan Gerdes, Muhammad Thuneibat, Elizabeth Hannapel, Virginia A Roberts","doi":"10.15585/mmwr.ss7301a1","DOIUrl":"10.15585/mmwr.ss7301a1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Problem/condition: &lt;/strong&gt;Public health agencies in U.S. states, territories, and freely associated states investigate and voluntarily report waterborne disease outbreaks to CDC through the National Outbreak Reporting System (NORS). This report summarizes NORS drinking water outbreak epidemiologic, laboratory, and environmental data, including data for both public and private drinking water systems. The report presents outbreak-contributing factors (i.e., practices and factors that lead to outbreaks) and, for the first time, categorizes outbreaks as biofilm pathogen or enteric illness associated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Period covered: &lt;/strong&gt;2015-2020.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Description of system: &lt;/strong&gt;CDC launched NORS in 2009 as a web-based platform into which public health departments voluntarily enter outbreak information. Through NORS, CDC collects reports of enteric disease outbreaks caused by bacterial, viral, parasitic, chemical, toxin, and unknown agents as well as foodborne and waterborne outbreaks of nonenteric disease. Data provided by NORS users, when known, for drinking water outbreaks include 1) the number of cases, hospitalizations, and deaths; 2) the etiologic agent (confirmed or suspected); 3) the implicated type of water system (e.g., community or individual or private); 4) the setting of exposure (e.g., hospital or health care facility; hotel, motel, lodge, or inn; or private residence); and 5) relevant epidemiologic and environmental data needed to describe the outbreak and characterize contributing factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;During 2015-2020, public health officials from 28 states voluntarily reported 214 outbreaks associated with drinking water and 454 contributing factor types. The reported etiologies included 187 (87%) biofilm associated, 24 (11%) enteric illness associated, two (1%) unknown, and one (&lt;1%) chemical or toxin. A total of 172 (80%) outbreaks were linked to water from public water systems, 22 (10%) to unknown water systems, 17 (8%) to individual or private systems, and two (0.9%) to other systems; one (0.5%) system type was not reported. Drinking water-associated outbreaks resulted in at least 2,140 cases of illness, 563 hospitalizations (26% of cases), and 88 deaths (4% of cases). Individual or private water systems were implicated in 944 (43%) cases, 52 (9%) hospitalizations, and 14 (16%) deaths.Enteric illness-associated pathogens were implicated in 1,299 (61%) of all illnesses, and 10 (2%) hospitalizations. No deaths were reported. Among these illnesses, three pathogens (norovirus, Shigella, and Campylobacter) or multiple etiologies including these pathogens resulted in 1,225 (94%) cases. The drinking water source was identified most often (n = 34; 7%) as the contributing factor in enteric disease outbreaks. When water source (e.g., groundwater) was known (n = 14), wells were identified in 13 (93%) of enteric disease outbreaks.Most biofilm-related outbreak reports implicated Legionella (n =","PeriodicalId":48549,"journal":{"name":"Mmwr Surveillance Summaries","volume":"73 1","pages":"1-23"},"PeriodicalIF":37.3,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111922","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}