Mmwr Surveillance Summaries最新文献

{"title":"Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years - Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2016.","authors":"Matthew J Maenner,&nbsp;Kelly A Shaw,&nbsp;Jon Baio,&nbsp;Anita Washington,&nbsp;Mary Patrick,&nbsp;Monica DiRienzo,&nbsp;Deborah L Christensen,&nbsp;Lisa D Wiggins,&nbsp;Sydney Pettygrove,&nbsp;Jennifer G Andrews,&nbsp;Maya Lopez,&nbsp;Allison Hudson,&nbsp;Thaer Baroud,&nbsp;Yvette Schwenk,&nbsp;Tiffany White,&nbsp;Cordelia Robinson Rosenberg,&nbsp;Li-Ching Lee,&nbsp;Rebecca A Harrington,&nbsp;Margaret Huston,&nbsp;Amy Hewitt,&nbsp;Amy Esler,&nbsp;Jennifer Hall-Lande,&nbsp;Jenny N Poynter,&nbsp;Libby Hallas-Muchow,&nbsp;John N Constantino,&nbsp;Robert T Fitzgerald,&nbsp;Walter Zahorodny,&nbsp;Josephine Shenouda,&nbsp;Julie L Daniels,&nbsp;Zachary Warren,&nbsp;Alison Vehorn,&nbsp;Angelica Salinas,&nbsp;Maureen S Durkin,&nbsp;Patricia M Dietz","doi":"10.15585/mmwr.ss6904a1","DOIUrl":"https://doi.org/10.15585/mmwr.ss6904a1","url":null,"abstract":"<p><strong>Problem/condition: </strong>Autism spectrum disorder (ASD).</p><p><strong>Period covered: </strong>2016.</p><p><strong>Description of system: </strong>The Autism and Developmental Disabilities Monitoring (ADDM) Network is an active surveillance program that provides estimates of the prevalence of ASD among children aged 8 years whose parents or guardians live in 11 ADDM Network sites in the United States (Arizona, Arkansas, Colorado, Georgia, Maryland, Minnesota, Missouri, New Jersey, North Carolina, Tennessee, and Wisconsin). Surveillance is conducted in two phases. The first phase involves review and abstraction of comprehensive evaluations that were completed by medical and educational service providers in the community. In the second phase, experienced clinicians who systematically review all abstracted information determine ASD case status. The case definition is based on ASD criteria described in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.</p><p><strong>Results: </strong>For 2016, across all 11 sites, ASD prevalence was 18.5 per 1,000 (one in 54) children aged 8 years, and ASD was 4.3 times as prevalent among boys as among girls. ASD prevalence varied by site, ranging from 13.1 (Colorado) to 31.4 (New Jersey). Prevalence estimates were approximately identical for non-Hispanic white (white), non-Hispanic black (black), and Asian/Pacific Islander children (18.5, 18.3, and 17.9, respectively) but lower for Hispanic children (15.4). Among children with ASD for whom data on intellectual or cognitive functioning were available, 33% were classified as having intellectual disability (intelligence quotient [IQ] ≤70); this percentage was higher among girls than boys (39% versus 32%) and among black and Hispanic than white children (47%, 36%, and 27%, respectively) [corrected]. Black children with ASD were less likely to have a first evaluation by age 36 months than were white children with ASD (40% versus 45%). The overall median age at earliest known ASD diagnosis (51 months) was similar by sex and racial and ethnic groups; however, black children with IQ ≤70 had a later median age at ASD diagnosis than white children with IQ ≤70 (48 months versus 42 months).</p><p><strong>Interpretation: </strong>The prevalence of ASD varied considerably across sites and was higher than previous estimates since 2014. Although no overall difference in ASD prevalence between black and white children aged 8 years was observed, the disparities for black children persisted in early evaluation and diagnosis of ASD. Hispanic children also continue to be identified as having ASD less frequently than white or black children.</p><p><strong>Public health action: </strong>These findings highlight the variability in the evaluation and detection of ASD across communities and between sociodemographic groups. Continued efforts are needed for early and equitable identification of ASD and timely enrollment in services.</p>","PeriodicalId":48549,"journal":{"name":"Mmwr Surveillance Summaries","volume":"69 4","pages":"1-12"},"PeriodicalIF":24.9,"publicationDate":"2020-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7119644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37772201","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":"Early Identification of Autism Spectrum Disorder Among Children Aged 4 Years - Early Autism and Developmental Disabilities Monitoring Network, Six Sites, United States, 2016.","authors":"Kelly A Shaw,&nbsp;Matthew J Maenner,&nbsp;Jon Baio,&nbsp;Anita Washington,&nbsp;Deborah L Christensen,&nbsp;Lisa D Wiggins,&nbsp;Sydney Pettygrove,&nbsp;Jennifer G Andrews,&nbsp;Tiffany White,&nbsp;Cordelia Robinson Rosenberg,&nbsp;John N Constantino,&nbsp;Robert T Fitzgerald,&nbsp;Walter Zahorodny,&nbsp;Josephine Shenouda,&nbsp;Julie L Daniels,&nbsp;Angelica Salinas,&nbsp;Maureen S Durkin,&nbsp;Patricia M Dietz","doi":"10.15585/mmwr.ss6903a1","DOIUrl":"https://doi.org/10.15585/mmwr.ss6903a1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Problem/condition: &lt;/strong&gt;Autism spectrum disorder (ASD).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Period covered: &lt;/strong&gt;2016.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Description of system: &lt;/strong&gt;The Early Autism and Developmental Disabilities Monitoring (Early ADDM) Network, a subset of the overall ADDM Network, is an active surveillance program that estimates ASD prevalence and monitors early identification of ASD among children aged 4 years. Children included in surveillance year 2016 were born in 2012 and had a parent or guardian who lived in the surveillance area in Arizona, Colorado, Missouri, New Jersey, North Carolina, or Wisconsin, at any time during 2016. Children were identified from records of community sources including general pediatric health clinics, special education programs, and early intervention programs. Data from comprehensive evaluations performed by community professionals were abstracted and reviewed by trained clinicians using a standardized ASD surveillance case definition with criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In 2016, the overall ASD prevalence was 15.6 per 1,000 (one in 64) children aged 4 years for Early ADDM Network sites. Prevalence varied from 8.8 per 1,000 in Missouri to 25.3 per 1,000 in New Jersey. At every site, prevalence was higher among boys than among girls, with an overall male-to-female prevalence ratio of 3.5 (95% confidence interval [CI] = 3.1-4.1). Prevalence of ASD between non-Hispanic white (white) and non-Hispanic black (black) children was similar at each site (overall prevalence ratio: 0.9; 95% CI = 0.8-1.1). The prevalence of ASD using DSM-5 criteria was lower than the prevalence using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria at one of four sites that used criteria from both editions. Among sites where ≥60% of children aged 4 years had information about intellectual disability (intelligence quotient ≤70 or examiner's statement of intellectual disability documented in an evaluation), 53% of children with ASD had co-occurring intellectual disability. Of all children aged 4 years with ASD, 84% had a first evaluation at age ≤36 months and 71% of children who met the surveillance case definition had a previous ASD diagnosis from a community provider. Median age at first evaluation and diagnosis for this age group was 26 months and 33 months, respectively. Cumulative incidence of autism diagnoses received by age 48 months was higher for children aged 4 years than for those aged 8 years identified in Early ADDM Network surveillance areas in 2016.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interpretation: &lt;/strong&gt;In 2016, the overall prevalence of ASD in the Early ADDM Network using DSM-5 criteria (15.6 per 1,000 children aged 4 years) was higher than the 2014 estimate using DSM-5 criteria (14.1 per 1,000). Children born in 2012 had a higher cumulative incidence of ASD diagnoses by age 48 months compared w","PeriodicalId":48549,"journal":{"name":"Mmwr Surveillance Summaries","volume":"69 3","pages":"1-11"},"PeriodicalIF":24.9,"publicationDate":"2020-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7119643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37773267","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":"National Toxic Substances Incidents Program - Nine States, 2010-2014.","authors":"Natalia Melnikova,&nbsp;Jennifer Wu,&nbsp;Patricia Ruiz,&nbsp;Maureen F Orr","doi":"10.15585/mmwr.ss6902a1","DOIUrl":"https://doi.org/10.15585/mmwr.ss6902a1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Problem/condition: &lt;/strong&gt;Every year in the United States, thousands of toxic substance incidents harm workers, first responders, and the public with the potential for catastrophic consequences. Surveillance data enable public health and safety professionals to understand the patterns and causes of these incidents, which can improve prevention efforts and preparation for future incidents.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Period covered: &lt;/strong&gt;2010-2014.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Description of system: &lt;/strong&gt;In 2010, the Agency for Toxic Substances and Disease Registry (ATSDR) initiated the National Toxic Substance Incidents Program (NTSIP), and it was retired in 2014. Nine state health departments participated in NTSIP surveillance: California, Louisiana, North Carolina, New York, Missouri, Oregon, Tennessee, Utah, and Wisconsin. The states conducted surveillance on acute toxic substance incidents, defined as an uncontrolled or illegal acute (lasting &lt;72 hours) release of any toxic substance including chemical, biologic, radiologic, and medical materials. Surveillance focused on associated morbidity and mortality and public health actions. This report presents an overview of NTSIP and summarizes incidents and injuries from the nine participating states during 2010-2014.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;During 2010-2014, participating state health departments reported 22,342 incidents, of which 13,529 (60.6%) met the case definition for acute toxic substance incidents, and included 6,635 injuries among 5,134 injured persons, of whom 190 died. A trend analysis of the three states participating the entire time showed a decrease in the number of incidents with injuries. NTSIP incidents were 1.8 times more likely and injured persons were 10 times more likely to be associated with fixed facilities than transportation. Natural gas, carbon monoxide, ammonia, and chemicals used in illegal methamphetamine production were the most frequent substances in fixed-facility incidents. Sodium and potassium hydroxide, hydrochloric acid, natural gas, and sulfuric acid were the most frequent substances in transportation-related incidents. Carbon monoxide was the most frequent substance in incidents with a large number of injured persons, and chemicals used in illegal methamphetamine production were the most frequent substance in incidents involving decontamination. Incidents most frequently occurred during normal business days (Monday through Friday) and hours (6:00 a.m.-5:59 p.m.) and warmer months (March-August). The transportation and warehousing industry sector had the largest number of incidents (4,476); however, most injured persons were injured in their private residences (1,141) or in the industry sectors of manufacturing (668), educational services (606), and real estate rental and leasing (425). The most frequently injured persons were members of the public (43.6%), including students. Injured first responders, particularly police, frequently were not wearing any chemic","PeriodicalId":48549,"journal":{"name":"Mmwr Surveillance Summaries","volume":"69 2","pages":"1-10"},"PeriodicalIF":24.9,"publicationDate":"2020-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7093087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37754483","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":"Opioid Prescribing Behaviors - Prescription Behavior Surveillance System, 11 States, 2010-2016.","authors":"Gail K Strickler,&nbsp;Peter W Kreiner,&nbsp;John F Halpin,&nbsp;Erin Doyle,&nbsp;Leonard J Paulozzi","doi":"10.15585/mmwr.ss6901a1","DOIUrl":"https://doi.org/10.15585/mmwr.ss6901a1","url":null,"abstract":"<p><strong>Problem/condition: </strong>In 2017, a total of 70,237 persons in the United States died from a drug overdose, and 67.8% of these deaths involved an opioid. Historically, the opioid overdose epidemic in the United States has been closely associated with a parallel increase in opioid prescribing and with widespread misuse of these medications. National and state policy makers have introduced multiple measures to attempt to assess and control the opioid overdose epidemic since 2010, including improvements in surveillance systems.</p><p><strong>Period covered: </strong>2010-2016 DESCRIPTION OF SYSTEM: The Prescription Behavior Surveillance System (PBSS) was created in 2011. Its goal was to track rates of prescribing of controlled substances and possible misuse of such drugs using data from selected state prescription drug monitoring programs (PDMP). PBSS data measure prescribing behaviors for prescription opioids using multiple measures calculated from PDMP data including 1) opioid prescribing, 2) average daily opioid dosage, 3) proportion of patients with daily opioid dosages ≥90 morphine milligram equivalents, 4) overlapping opioid prescriptions, 5) overlapping opioid and benzodiazepine prescriptions, and 6) multiple-provider episodes. For this analysis, PBSS data were available for 2010-2016 from 11 states representing approximately 38.0% of the U.S.</p><p><strong>Population: </strong>Average quarterly percent changes (AQPC) in the rates of opioid prescribing and possible opioid misuse measures were calculated for each state.</p><p><strong>Results and interpretation: </strong>Opioid prescribing rates declined in all 11 states during 2010-2016 (range: 14.9% to 33.0%). Daily dosage declined least (AQPC: -0.4%) in Idaho and Maine, and most (AQPC: -1.6%) in Florida. The percentage of patients with high daily dosage had AQPCs ranging from -0.4% in Idaho to -2.3% in Louisiana. Multiple-provider episode rates declined by at least 62% in the seven states with available data. Variations in trends across the 11 states might reflect differences in state policies and possible differential effects of similar policies.</p><p><strong>Public health actions: </strong>Use of PDMP data from individual states enables a more detailed examination of trends in opioid prescribing behaviors and indicators of possible misuse than is feasible with national commercially available prescription data. Comparison of opioid prescribing trends among states can be used to monitor the temporal association of national or state policy interventions and might help public health policymakers recognize changes in the use or possible misuse of controlled prescription drugs over time and allow for prompt intervention through amended or new opioid-related policies.</p>","PeriodicalId":48549,"journal":{"name":"Mmwr Surveillance Summaries","volume":"69 1","pages":"1-14"},"PeriodicalIF":24.9,"publicationDate":"2020-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7011442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37594191","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":"Population-Based Active Surveillance for Culture-Confirmed Candidemia — Four Sites, United States, 2012–2016","authors":"Mitsuru Toda, Sabrina R. Williams, Elizabeth L Berkow, M. Farley, L. Harrison, Lindsay Bonner, Kaytlynn Marceaux, R. Hollick, Alexia Y. Zhang, W. Schaffner, S. Lockhart, Brendan R. Jackson, S. Vallabhaneni","doi":"10.15585/mmwr.ss6808a1","DOIUrl":"https://doi.org/10.15585/mmwr.ss6808a1","url":null,"abstract":"Problem/Condition Candidemia is a bloodstream infection (BSI) caused by yeasts in the genus Candida. Candidemia is one of the most common health care–associated BSIs in the United States, with all-cause in-hospital mortality of up to 30%. Period Covered 2012–2016. Description of System CDC’s Emerging Infections Program (EIP), a collaboration among CDC, state health departments, and academic partners that was established in 1995, was used to conduct active, population-based laboratory surveillance for candidemia in 22 counties in four states (Georgia, Maryland, Oregon, and Tennessee) with a combined population of approximately 8 million persons. Laboratories serving the catchment areas were recruited to report candidemia cases to the local EIP program staff. A case was defined as a blood culture that was positive for a Candida species collected from a surveillance area resident during 2012–2016. Isolates were sent to CDC for species confirmation and antifungal susceptibility testing. Any subsequent blood cultures with Candida within 30 days of the initial positive culture in the same patient were considered part of the same case. Trained surveillance officers collected clinical information from the medical chart for all cases, and isolates were sent to CDC for species confirmation and antifungal susceptibility testing. Results Across all sites and surveillance years (2012–2016), 3,492 cases of candidemia were identified. The crude candidemia incidence averaged across sites and years during 2012–2016 was 8.7 per 100,000 population; important differences in incidence were found by site, age group, sex, and race. The crude annual incidence was the highest in Maryland (14.1 per 100,000 population) and lowest in Oregon (4.0 per 100,000 population). The crude annual incidence of candidemia was highest among adults aged ≥65 years (25.5 per 100,000 population) followed by infants aged &lt;1 year (15.8). The crude annual incidence was higher among males (9.4) than among females (8.0) and was approximately 2 times greater among blacks than among nonblacks (13.7 versus 5.8). Ninety-six percent of cases occurred in patients who were hospitalized at the time of or during the week after having a positive culture. One third of cases occurred in patients who had undergone a surgical procedure in the 90 days before the candidemia diagnosis, 77% occurred in patients who had received systemic antibiotics in the 14 days before the diagnosis, and 73% occurred in patients who had had a central venous catheter (CVC) in place within 2 days before the diagnosis. Ten percent were in patients who had used injection drugs in the past 12 months. The median time from admission to candidemia diagnosis was 5 days (interquartile range [IQR]: 0–16 days). Among 2,662 cases that were treated in adults aged &gt;18 years, 34% were treated with fluconazole alone, 30% with echinocandins alone, and 34% with both. The all-cause, in-hospital case-fatality ratio was 25% for any time after admissi","PeriodicalId":48549,"journal":{"name":"Mmwr Surveillance Summaries","volume":"20 1","pages":"1 - 15"},"PeriodicalIF":24.9,"publicationDate":"2019-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81683118","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":"Surveillance for Coccidioidomycosis — United States, 2011–2017","authors":"Kaitlin Benedict, O. McCotter, Shane Brady, K. Komatsu, Gail L. Sondermeyer Cooksey, Alyssa Nguyen, Seemalata Jain, D. Vugia, Brendan R. Jackson","doi":"10.15585/mmwr.ss6807a1","DOIUrl":"https://doi.org/10.15585/mmwr.ss6807a1","url":null,"abstract":"Problem/Condition Coccidioidomycosis (Valley fever) is an infection caused by the environmental fungus Coccidioides spp., which typically causes respiratory illness but also can lead to disseminated disease. This fungus typically lives in soils in warm, arid regions, including the southwestern United States. Reporting Period 2011–2017. Description of System Coccidioidomycosis has been nationally notifiable since 1995 and is reportable in 26 states and the District of Columbia (DC), where laboratories and physicians notify local and state public health departments about possible coccidioidomycosis cases. Health department staff determine which cases qualify as confirmed cases according to the definition established by Council of State and Territorial Epidemiologists and voluntarily submit basic case information to CDC through the National Notifiable Diseases Surveillance System. Results During 2011–2017, a total of 95,371 coccidioidomycosis cases from 26 states and DC were reported to CDC. The number of cases decreased from 2011 (22,634 cases) to 2014 (8,232 cases) and subsequently increased to 14,364 cases in 2017; >95% of cases were reported from Arizona and California. Reported incidence in Arizona decreased from 261 per 100,000 persons in 2011 to 101 in 2017, whereas California incidence increased from 15.7 to 18.2, and other state incidence rates stayed relatively constant. Patient demographic characteristics were largely consistent with previous years, with an overall predominance among males and among adults aged >60 years in Arizona and adults aged 40–59 years in California. Interpretation Coccidioidomycosis remains an important national public health problem with a well-established geographic focus. The reasons for the changing trends in reported cases are unclear but might include environmental factors (e.g., temperature and precipitation), surveillance artifacts, land use changes, and changes in the population at risk for the infection. Public Health Action Health care providers should consider a diagnosis of coccidioidomycosis in patients who live or work in or have traveled to areas with known geographic risk for Coccidioides and be aware that those areas might be broader than previously recognized. Coccidioidomycosis surveillance provides important information about the epidemiology of the disease but is incomplete both in terms of geographic coverage and data availability. Expanding surveillance to additional states could help identify emerging areas that pose a risk for locally acquired infections. In Arizona and California, where most cases occur, collecting systematic enhanced data, such as more detailed patient characteristics and disease severity, could help clarify the reasons behind the recent changes in incidence and identify additional opportunities for focused prevention and educational efforts.","PeriodicalId":48549,"journal":{"name":"Mmwr Surveillance Summaries","volume":"31 1","pages":"1 - 15"},"PeriodicalIF":24.9,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78704000","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":"Babesiosis Surveillance - United States, 2011-2015.","authors":"Elizabeth B Gray,&nbsp;Barbara L Herwaldt","doi":"10.15585/mmwr.ss6806a1","DOIUrl":"https://doi.org/10.15585/mmwr.ss6806a1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Problem/condition: &lt;/strong&gt;Babesiosis is caused by parasites of the genus Babesia, which are transmitted in nature by the bite of an infected tick. Babesiosis can be life threatening, particularly for persons who are asplenic, immunocompromised, or elderly.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Period covered: &lt;/strong&gt;2011-2015.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Description of system: &lt;/strong&gt;CDC has conducted surveillance for babesiosis in the United States since January 2011, when babesiosis became a nationally notifiable condition. Health departments in states in which babesiosis is reportable voluntarily notify CDC of cases through the National Notifiable Diseases Surveillance System (NNDSS) and submit supplemental case information by using a babesiosis-specific case report form (CRF). As of 2015, babesiosis was a reportable condition in 33 states compared with 22 states in 2011.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;For the 2011-2015 surveillance period, CDC was notified of 7,612 cases of babesiosis (6,277 confirmed [82.5%] and 1,335 probable [17.5%]). Case counts varied from year to year (1,126 cases for 2011, 909 for 2012, 1,761 for 2013, 1,742 for 2014, and 2,074 for 2015). Cases were reported among residents of 27 states. However, 7,194 cases (94.5%) occurred among residents of seven states with well-documented foci of tickborne transmission (i.e., Connecticut, Massachusetts, Minnesota, New Jersey, New York, Rhode Island, and Wisconsin). Maine (152 cases) and New Hampshire (149 cases) were the only other states that reported &gt;100 cases for the 5-year period, and both states also reported increasing numbers of cases over time. The median age of the 7,173 patients with available information was 63 years (range: &lt;1-99 years; interquartile range: 51-73 years); 4,156 (57.9%) were aged ≥60 years, and 15 (&lt;1%) were aged &lt;1 year. The proportion of patients with symptom onset during June-August was &gt;70% for each of the 5 surveillance years. Approximately half (3,004 of 6,404 [46.9%]) of the patients with available data were hospitalized at least overnight. Hospitalization rates ranged from 16.0% among patients aged 10-19 years (16 of 100) to 72.6% among those aged ≥80 years (552 of 760). Hospitalizations were reported significantly more often among patients who were asplenic than among patients who were not (106 of 126 [84.1%] versus 643 of 1,396 [46.1%]). Fifty-one cases of babesiosis among recipients of blood transfusions were classified by the reporting health department as transfusion associated. The median intervals from the earliest date associated with each case of babesiosis to the initial report via NNDSS and submission of supplemental CRF data to CDC were approximately 3 months and 1 year, respectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interpretation: &lt;/strong&gt;For the first 5 years of babesiosis surveillance, the reported cases occurred most frequently during June-August in the Northeast and upper Midwest. Maine and New Hampshire reported increasing numbers of cases over time, which suggest","PeriodicalId":48549,"journal":{"name":"Mmwr Surveillance Summaries","volume":"68 6","pages":"1-11"},"PeriodicalIF":24.9,"publicationDate":"2019-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37012717","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":"Malaria Surveillance - United States, 2016.","authors":"Kimberly E Mace,&nbsp;Paul M Arguin,&nbsp;Naomi W Lucchi,&nbsp;Kathrine R Tan","doi":"10.15585/mmwr.ss6805a1","DOIUrl":"https://doi.org/10.15585/mmwr.ss6805a1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Problem/condition: &lt;/strong&gt;Malaria in humans is caused by intraerythrocytic protozoa of the genus Plasmodium. These parasites are transmitted by the bite of an infective female Anopheles species mosquito. The majority of malaria infections in the United States occur among persons who have traveled to regions with ongoing malaria transmission. However, malaria is occasionally acquired by persons who have not traveled out of the country through exposure to infected blood products, congenital transmission, laboratory exposure, or local mosquitoborne transmission. Malaria surveillance in the United States is conducted to provide information on its occurrence (e.g., temporal, geographic, and demographic), guide prevention and treatment recommendations for travelers and patients, and facilitate transmission control measures if locally acquired cases are identified.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Period covered: &lt;/strong&gt;This report summarizes confirmed malaria cases in persons with onset of illness in 2016 and summarizes trends in previous years.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Description of system: &lt;/strong&gt;Malaria cases diagnosed by blood film microscopy, polymerase chain reaction, or rapid diagnostic tests are reported to local and state health departments by health care providers or laboratory staff members. Case investigations are conducted by local and state health departments, and reports are transmitted to CDC through the National Malaria Surveillance System (NMSS), the National Notifiable Diseases Surveillance System (NNDSS), or direct CDC consultations. CDC reference laboratories provide diagnostic assistance and conduct antimalarial drug resistance marker testing on blood samples submitted by health care providers or local or state health departments. This report summarizes data from the integration of all NMSS and NNDSS cases, CDC reference laboratory reports, and CDC clinical consultations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;CDC received reports of 2,078 confirmed malaria cases with onset of symptoms in 2016, including two congenital cases, three cryptic cases, and one case acquired through blood transfusion. The number of malaria cases diagnosed in the United States has been increasing since the mid-1970s. However, in 2015 a decrease occurred in the number of cases, specifically from the region of West Africa, likely due to altered travel related to the Ebola virus disease outbreak. The number of confirmed malaria cases in 2016 represents a 36% increase compared with 2015, and the 2016 total is 153 more cases than in 2011, which previously had the highest number of cases (1,925 cases). In 2016, a total of 1,729 cases originated from Africa, and 1,061 (61.4%) of these came from West Africa. P. falciparum accounted for the majority of the infections (1,419 [68.2%]), followed by P. vivax (251 [12.1%]). Fewer than 2% of patients were infected by two species (23 [1.1%]). The infecting species was not reported or was undetermined in 10.8% of cases. CDC provided diagnos","PeriodicalId":48549,"journal":{"name":"Mmwr Surveillance Summaries","volume":"68 5","pages":"1-35"},"PeriodicalIF":24.9,"publicationDate":"2019-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37248924","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":"Assisted Reproductive Technology Surveillance - United States, 2016.","authors":"Saswati Sunderam,&nbsp;Dmitry M Kissin,&nbsp;Yujia Zhang,&nbsp;Suzanne G Folger,&nbsp;Sheree L Boulet,&nbsp;Lee Warner,&nbsp;William M Callaghan,&nbsp;Wanda D Barfield","doi":"10.15585/mmwr.ss6804a1","DOIUrl":"10.15585/mmwr.ss6804a1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Problem/condition: &lt;/strong&gt;Since the first U.S. infant conceived with assisted reproductive technology (ART) was born in 1981, both the use of ART and the number of fertility clinics providing ART services have increased steadily in the United States. ART includes fertility treatments in which eggs or embryos are handled in the laboratory (i.e., in vitro fertilization [IVF] and related procedures). Although the majority of infants conceived through ART are singletons, women who undergo ART procedures are more likely than women who conceive naturally to deliver multiple-birth infants. Multiple births pose substantial risks for both mothers and infants, including obstetric complications, preterm delivery (&lt;37 weeks), and low birthweight (&lt;2,500 g). This report provides state-specific information for the United States (including the District of Columbia and Puerto Rico) on ART procedures performed in 2016 and compares birth outcomes that occurred in 2016 (resulting from ART procedures performed in 2015 and 2016) with outcomes for all infants born in the United States in 2016.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Period covered: &lt;/strong&gt;2016.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Description of system: &lt;/strong&gt;In 1995, CDC began collecting data on ART procedures performed in fertility clinics in the United States as mandated by the Fertility Clinic Success Rate and Certification Act of 1992 (FCSRCA) (Public Law 102-493 [October 24, 1992]). Data are collected through the National ART Surveillance System (NASS), a web-based data collection system developed by CDC. This report includes data from 52 reporting areas (the 50 states, the District of Columbia, and Puerto Rico).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In 2016, a total of 197,706 ART procedures (range: 162 in Wyoming to 24,030 in California) with the intent to transfer at least one embryo were performed in 463 U.S. fertility clinics and reported to CDC. These procedures resulted in 65,964 live-birth deliveries (range: 57 in Puerto Rico to 8,638 in California) and 76,892 infants born (range: 74 in Alaska to 9,885 in California). Nationally, the number of ART procedures performed per 1 million women of reproductive age (15-44 years), a proxy measure of the ART use rate, was 3,075. ART use rates exceeded the national rate in 14 reporting areas (Connecticut, Delaware, the District of Columbia, Hawaii, Illinois, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Utah, and Virginia). ART use exceeded 1.5 times the national rate in nine states, including three (Illinois, Massachusetts, and New Jersey) that also had comprehensive mandated health insurance coverage for ART procedures (i.e., coverage for at least four oocyte retrievals). Nationally, among ART transfer procedures for patients using fresh embryos from their own eggs, the average number of embryos transferred increased with increasing age (1.5 among women aged &lt;35 years, 1.7 among women aged 35-37 years, and 2.2 among women aged &gt;37 years). ","PeriodicalId":48549,"journal":{"name":"Mmwr Surveillance Summaries","volume":"68 4","pages":"1-23"},"PeriodicalIF":24.9,"publicationDate":"2019-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6493873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40547700","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":"Cyclosporiasis Surveillance - United States, 2011-2015.","authors":"Shannon M Casillas,&nbsp;Rebecca L Hall,&nbsp;Barbara L Herwaldt","doi":"10.15585/mmwr.ss6803a1","DOIUrl":"https://doi.org/10.15585/mmwr.ss6803a1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Problem/condition: &lt;/strong&gt;Cyclosporiasis is an intestinal illness caused by the parasite Cyclospora cayetanensis, which is transmissible by ingestion of fecally contaminated food or water. Cyclosporiasis is most common in tropical and subtropical regions of the world. In the United States, foodborne outbreaks of cyclosporiasis have been linked to various types of imported fresh produce (e.g., basil, raspberries, and snow peas). Validated molecular typing tools, which could facilitate detection and investigation of outbreaks, are not yet available for C. cayetanensis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Period covered: &lt;/strong&gt;2011-2015.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Description of system: &lt;/strong&gt;CDC has been conducting national surveillance for cyclosporiasis since it became a nationally notifiable disease in January 1999. As of 2015, cyclosporiasis was a reportable condition in 42 states, the District of Columbia, and New York City (NYC). Health departments voluntarily notify CDC of cases of cyclosporiasis through the National Notifiable Diseases Surveillance System and submit additional case information using the CDC cyclosporiasis case report form or the Cyclosporiasis National Hypothesis Generating Questionnaire (CNHGQ).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;For the 2011-2015 surveillance period, CDC was notified by 37 states and NYC of 2,207 cases of cyclosporiasis, including 1,988 confirmed cases (90.1%) and 219 probable cases (9.9%). The annual number of reported cases ranged from 130 in 2012 to 798 in 2013; the annual population-adjusted incidence rate ranged from 0.05 cases per 100,000 persons in 2012 to 0.29 in 2013. A total of 415 patients (18.8%) had a documented history of international travel during the 14 days before illness onset, 1,384 (62.7%) did not have a history of international travel, and 408 (18.5%) had an unknown travel history. Among the 1,359 domestically acquired cases with available information about illness onset, 1,263 (92.9%) occurred among persons who became ill during May-August. During 2011-2015, a total of 10 outbreaks of cyclosporiasis associated with 438 reported cases were investigated; a median of 21 cases were reported per outbreak (range: eight to 162). A food vehicle of infection (i.e., a food item or ingredient thereof) was identified (or suspected) for at least five of the 10 outbreaks; the food vehicles included a berry salad (one outbreak), cilantro imported from Mexico (at least three outbreaks), and a prepackaged salad mix from Mexico (one outbreak).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interpretation: &lt;/strong&gt;Cyclosporiasis continues to be a U.S. public health concern, with seasonal increases in reported cases during spring and summer months. The majority of cases reported for this 5-year surveillance period occurred among persons without a history of international travel who became ill during May-August. Many of the seemingly sporadic domestically acquired cases might have been associated with identified or unidentified outbreaks; however, those","PeriodicalId":48549,"journal":{"name":"Mmwr Surveillance Summaries","volume":"68 3","pages":"1-16"},"PeriodicalIF":24.9,"publicationDate":"2019-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6476303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37165933","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}