Emily N Jenkins, Jeremy A W Gold, Kaitlin Benedict, Shawn R Lockhart, Elizabeth L Berkow, Tamia Dixon, Shanita L Shack, Lucy S Witt, Lee H Harrison, Shannon Seopaul, Maria A Correa, Megan Fitzsimons, Yalda Jabarkhyl, Devra Barter, Christopher A Czaja, Helen Johnston, Tiffanie Markus, William Schaffner, Annastasia Gross, Ruth Lynfield, Laura Tourdot, Joelle Nadle, Jeremy Roland, Gabriela Escutia, Alexia Y Zhang, Anita Gellert, Christine Hurley, Brenda L Tesini, Erin C Phipps, Sarah Shrum Davis, Meghan Lyman
{"title":"Population-Based Active Surveillance for Culture-Confirmed Candidemia - 10 Sites, United States, 2017-2021.","authors":"Emily N Jenkins, Jeremy A W Gold, Kaitlin Benedict, Shawn R Lockhart, Elizabeth L Berkow, Tamia Dixon, Shanita L Shack, Lucy S Witt, Lee H Harrison, Shannon Seopaul, Maria A Correa, Megan Fitzsimons, Yalda Jabarkhyl, Devra Barter, Christopher A Czaja, Helen Johnston, Tiffanie Markus, William Schaffner, Annastasia Gross, Ruth Lynfield, Laura Tourdot, Joelle Nadle, Jeremy Roland, Gabriela Escutia, Alexia Y Zhang, Anita Gellert, Christine Hurley, Brenda L Tesini, Erin C Phipps, Sarah Shrum Davis, Meghan Lyman","doi":"10.15585/mmwr.ss7404a1","DOIUrl":"https://doi.org/10.15585/mmwr.ss7404a1","url":null,"abstract":"<p><strong>Problem/condition: </strong>Candidemia, a bloodstream infection caused by Candida spp., is a common cause of health care-associated bloodstream infections in the United States. Candidemia is associated with substantial health care costs, morbidity, and mortality.</p><p><strong>Period covered: </strong>2017-2021.</p><p><strong>Description of system: </strong>CDC's Emerging Infections Program (EIP), a collaboration among CDC, state health departments, and academic partners, was used to conduct active, population-based laboratory surveillance for candidemia at city or county sites located in 10 states (California, Colorado, Connecticut, Georgia, Maryland, Minnesota, New Mexico, New York, Oregon, and Tennessee), representing a combined population of approximately 21.5 million persons, or 7% of the U.S. population in 2019. Connecticut began reporting cases on January 1, 2019, and conducts statewide surveillance. Although candidemia is not a nationally notifiable condition, cases of Candida auris infection are nationally notifiable, and cases of candidemia caused by C. auris could be included in both national case counts and EIP surveillance. A culture-confirmed candidemia case is defined as a positive blood culture for any Candida sp. from a resident in the surveillance catchment area. Subsequent positive blood cultures for Candida within 30 days of the initial positive culture (index date) in the same patient are considered part of the same case. Clinical laboratories serving each catchment area report candidemia cases, and trained surveillance officers abstract information from medical charts for all cases. Corresponding isolates are sent to CDC for species confirmation and antifungal susceptibility testing.</p><p><strong>Results: </strong>A total of 7,381 candidemia cases were identified during the surveillance period (2017-2021). The overall incidence was 7.4 cases per 100,000 population. Across age groups, sexes, racial and ethnic groups, and surveillance sites, incidence was generally stable or increased slightly from 2017 to 2021, with the lowest overall incidence in 2019 (6.8) and the highest in 2021 (7.9). In 2021, candidemia incidence was highest in patients aged ≥65 years (22.7) and infants (aged <1 year) (8.0). Incidence was higher in males (8.7) compared with females (7.0) and higher in non-Hispanic Black or African American (Black) patients (12.8) compared with non-Black patients (5.6). Incidence was highest in Maryland (14.5), followed by Tennessee (10.1) and Georgia (10.0); incidence was lowest in Oregon (4.8). Increases occurred in the percentage of cases classified as health care onset (52.2% in 2017 to 58.0% in 2021). Overall, among 7,381 cases (in 6,235 patients), 63.7% occurred in patients who had a central venous catheter, 80.7% involved recent systemic antibiotic receipt, and 9.0% occurred in patients who had a history of injection drug use. The percentage of cases with a positive SARS-CoV-2 test during the 90 days be","PeriodicalId":48549,"journal":{"name":"Mmwr Surveillance Summaries","volume":"74 4","pages":"1-15"},"PeriodicalIF":37.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Enteric Disease Outbreaks Associated with Animal Contact - Animal Contact Outbreak Surveillance System, United States, 2009-2021.","authors":"Taylor Eisenstein, Marisa Wong, Grace Vahey, Ariana Perez Toepfer, Brigette Gleason, Katharine Benedict","doi":"10.15585/mmwr.ss7403a1","DOIUrl":"10.15585/mmwr.ss7403a1","url":null,"abstract":"<p><strong>Problem/condition: </strong>An estimated 450,000 enteric illnesses, 5,000 hospitalizations, and 76 deaths associated with animal contact occur each year in the United States. Enteric illnesses are diseases that affect the stomach or intestines and cause symptoms, such as diarrhea, nausea, or vomiting, and are typically transmitted from animals to humans through the fecal-oral route. Humans might encounter animal feces or bodily fluids through contact with the animal itself, the animal's environment, or the animal's food or water. Although outbreak-associated illnesses account for a small subset of all enteric illnesses linked to animal contact, data obtained from outbreak surveillance offer insights into the underlying epidemiologic factors contributing to illnesses, including the pathogens, animals, pathogen-animal category pairs, and settings of outbreaks associated with animal contact.</p><p><strong>Period covered: </strong>2009-2021.</p><p><strong>Description of system: </strong>The Animal Contact Outbreak Surveillance System (ACOSS) was launched in 2009 in conjunction with the National Outbreak Reporting System (NORS), a web-based platform that includes reports of foodborne and waterborne outbreaks as well as enteric disease outbreaks transmitted by contact with environmental sources, infected persons or animals, or unknown modes. ACOSS encompasses animal contact outbreaks that are reported to CDC through NORS. Local, state, and territorial health departments voluntarily report animal contact outbreaks, which are defined as two or more enteric illnesses associated with a common animal source. Outbreaks can involve single or multiple states; CDC staff typically report multistate outbreaks on behalf of state and territorial health departments. ACOSS defines an animal source as an animal (including domestic and wild animals); an animal's feces or bodily fluids (except milk and other fluids consumed as food, which are defined as foodborne sources); an animal's fur, hair, feathers, scales, or skin; an animal's food; or an animal's environment, which includes places in which it lives and roams.</p><p><strong>Results: </strong>During 2009-2021, a total of 557 animal contact outbreaks of enteric disease were reported in the United States through ACOSS, accounting for 14,377 illnesses, 2,656 hospitalizations, and 22 deaths. Exposures were reported in all 50 states, Washington, DC, and Puerto Rico. During the period there were 393 single-state outbreaks and 164 multistate outbreaks. Although multistate outbreaks comprised 29% of all outbreaks reported through ACOSS, they accounted for 80% of illnesses, 88% of hospitalizations, and 82% of deaths. Among 474 outbreaks with a confirmed single etiology, Salmonella was the most common cause of outbreaks (248 outbreaks [52%]); these outbreaks accounted for the most outbreak-associated illnesses (11,822 [85%]), hospitalizations (2,393 [91%]), and deaths (17 [77%]). Cryptosporidium (108 outbreaks [2","PeriodicalId":48549,"journal":{"name":"Mmwr Surveillance Summaries","volume":"74 3","pages":"1-12"},"PeriodicalIF":37.3,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kelly A Shaw, Susan Williams, Mary E Patrick, Miguel Valencia-Prado, Maureen S Durkin, Ellen M Howerton, Christine M Ladd-Acosta, Elise T Pas, Amanda V Bakian, Paige Bartholomew, Nancy Nieves-Muñoz, Kate Sidwell, Amy Alford, Deborah A Bilder, Monica DiRienzo, Robert T Fitzgerald, Sarah M Furnier, Allison E Hudson, Olivia M Pokoski, Lindsay Shea, Sarah C Tinker, Zachary Warren, Walter Zahorodny, Hilcon Agosto-Rosa, Joshua Anbar, Katheleen Y Chavez, Amy Esler, Allison Forkner, Andrea Grzybowski, Azza Hagel Agib, Libby Hallas, Maya Lopez, Sandy Magaña, Ruby H N Nguyen, Jaylaan Parker, Karen Pierce, Tyra Protho, Hilda Torres, Sandra B Vanegas, Alison Vehorn, Minyu Zhang, Jennifer Andrews, Felicia Greer, Jennifer Hall-Lande, Dedria McArthur, Madison Mitamura, Angel J Montes, Sydney Pettygrove, Josephine Shenouda, Carolyn Skowyra, Anita Washington, Matthew J Maenner
{"title":"Prevalence and Early Identification of Autism Spectrum Disorder Among Children Aged 4 and 8 Years - Autism and Developmental Disabilities Monitoring Network, 16 Sites, United States, 2022.","authors":"Kelly A Shaw, Susan Williams, Mary E Patrick, Miguel Valencia-Prado, Maureen S Durkin, Ellen M Howerton, Christine M Ladd-Acosta, Elise T Pas, Amanda V Bakian, Paige Bartholomew, Nancy Nieves-Muñoz, Kate Sidwell, Amy Alford, Deborah A Bilder, Monica DiRienzo, Robert T Fitzgerald, Sarah M Furnier, Allison E Hudson, Olivia M Pokoski, Lindsay Shea, Sarah C Tinker, Zachary Warren, Walter Zahorodny, Hilcon Agosto-Rosa, Joshua Anbar, Katheleen Y Chavez, Amy Esler, Allison Forkner, Andrea Grzybowski, Azza Hagel Agib, Libby Hallas, Maya Lopez, Sandy Magaña, Ruby H N Nguyen, Jaylaan Parker, Karen Pierce, Tyra Protho, Hilda Torres, Sandra B Vanegas, Alison Vehorn, Minyu Zhang, Jennifer Andrews, Felicia Greer, Jennifer Hall-Lande, Dedria McArthur, Madison Mitamura, Angel J Montes, Sydney Pettygrove, Josephine Shenouda, Carolyn Skowyra, Anita Washington, Matthew J Maenner","doi":"10.15585/mmwr.ss7402a1","DOIUrl":"https://doi.org/10.15585/mmwr.ss7402a1","url":null,"abstract":"<p><strong>Problem/condition: </strong>Autism spectrum disorder (ASD).</p><p><strong>Period covered: </strong>2022.</p><p><strong>Description of system: </strong>The Autism and Developmental Disabilities Monitoring Network is an active surveillance program that estimates prevalence and characteristics of ASD and monitors timing of ASD identification among children aged 4 and 8 years. In 2022, a total of 16 sites (located in Arizona, Arkansas, California, Georgia, Indiana, Maryland, Minnesota, Missouri, New Jersey, Pennsylvania, Puerto Rico, Tennessee, Texas [two sites: Austin and Laredo], Utah, and Wisconsin) conducted surveillance for ASD among children aged 4 and 8 years and suspected ASD among children aged 4 years. Surveillance included children who lived in the surveillance area at any time during 2022. Children were classified as having ASD if they ever received 1) an ASD diagnostic statement in a comprehensive developmental evaluation, 2) autism special education eligibility, or 3) an ASD International Classification of Diseases, Ninth Revision (ICD-9) code in the 299 range or International Classification of Diseases, Tenth Revision (ICD-10) code of F84.0, F84.3, F84.5, F84.8, or F84.9. Children aged 4 years were classified as having suspected ASD if they did not meet the case definition for ASD but had an evaluator's suspicion of ASD documented in a comprehensive developmental evaluation.</p><p><strong>Results: </strong>Among children aged 8 years in 2022, ASD prevalence was 32.2 per 1,000 children (one in 31) across the 16 sites, ranging from 9.7 in Texas (Laredo) to 53.1 in California. The overall observed prevalence estimate was similar to estimates calculated using Bayesian hierarchical and random effects models. ASD was 3.4 times as prevalent among boys (49.2) than girls (14.3). Overall, ASD prevalence was lower among non-Hispanic White (White) children (27.7) than among Asian or Pacific Islander (A/PI) (38.2), American Indian or Alaska Native (AI/AN) (37.5), non-Hispanic Black or African American (Black) (36.6), Hispanic or Latino (Hispanic) (33.0), and multiracial children (31.9). No association was observed between ASD prevalence and neighborhood median household income (MHI) at 11 sites; higher ASD prevalence was associated with lower neighborhood MHI at five sites.Record abstraction was completed for 15 of the 16 sites for 8,613 children aged 8 years who met the ASD case definition. Of these 8,613 children, 68.4% had a documented diagnostic statement of ASD, 67.3% had a documented autism special education eligibility, and 68.9% had a documented ASD ICD-9 or ICD-10 code. All three elements of the ASD case definition were present for 34.6% of children aged 8 years with ASD.Among 5,292 (61.4% of 8,613) children aged 8 years with ASD with information on cognitive ability, 39.6% were classified as having an intellectual disability. Intellectual disability was present among 52.8% of Black, 50.0% of AI/AN, 43.9% of A/PI, 38.8% of Hispa","PeriodicalId":48549,"journal":{"name":"Mmwr Surveillance Summaries","volume":"74 2","pages":"1-22"},"PeriodicalIF":37.3,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054715","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}
Meghan M Holst, Beth C Wittry, Carolyn Crisp, Jeffrey Torres, D J Irving, David Nicholas
{"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}
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
{"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}
Hannah Lawinger, Amina Khan, Colleen Lysen, Marydale Oppert, Vince R Hill, Jonathan S Yoder, Virginia A Roberts, Mia C Mattioli, Michele C Hlavsa
{"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}
Stephanie Ramer, Antoinette T Nguyen, Lisa M Hollier, Jessica Rodenhizer, Lee Warner, Maura K Whiteman
{"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":"<p><strong>Problem/condition: </strong>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.</p><p><strong>Period covered: </strong>2022.</p><p><strong>Description of system: </strong>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).</p><p><strong>Results: </strong>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 <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 <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}
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
{"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":"<p><strong>Problem/condition: </strong>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.</p><p><strong>Reporting period: </strong>2010-11 through 2022-23 influenza seasons.</p><p><strong>Description of system: </strong>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.</p><p><strong>Results: </strong>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}
Brenda L Nguyen, Bridget H Lyons, Kaitlin Forsberg, Rebecca F Wilson, Grace S Liu, Carter J Betz, Janet M Blair
{"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":"<p><strong>Problem/condition: </strong>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.</p><p><strong>Period covered: </strong>2021.</p><p><strong>Description of system: </strong>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.</p><p><strong>Results: </strong>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 (<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":"<p><strong>Problem/condition: </strong>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.</p><p><strong>Period covered: </strong>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).</p><p><strong>Description of system: </strong>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].</p><p><strong>Results: </strong>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}