MMWR – Morbidity and Mortality Weekly Report

MMWR News Synopsis for January 23, 2014

Fatal Hemophagocytic Lymphohistiocytosis Associated with Locally Acquired Dengue Virus Infection — New Mexico and Texas, 2012
Prevalence and Predictors of Viral Suppression Among Persons with Diagnosed HIV Infection Retained in Care — Georgia, 2010
Trends in Uninsured Clients Visiting Health Centers Funded by the Title X Family Planning Program — Massachusetts, 2005–2012
Notes from the Field

No MMWR telebriefing scheduled for January 23, 2014

Click here for the full MMWR articles.

1. Fatal Hemophagocytic Lymphohistiocytosis Associated with Locally Acquired Dengue Virus Infection — New Mexico and Texas, 2012

Dengue may be under recognized in the United States; clinicians should request diagnostic testing of suspected dengue cases and report confirmed cases to state and local health departments. This report describes a woman who was infected with dengue virus in the southern United States and died from a rare complication of dengue called hemophagocytic lymphohistiocytosis. The woman was initially diagnosed with West Nile fever and was not suspected of having dengue because the symptoms are sometimes associated with bleeding. Most people with dengue will not have severe bleeding, which is diagnostically linked with the disease. This case may suggest that there are more unrecognized cases of dengue in the United States. Although dengue outbreaks have recently occurred in Florida, Texas and Hawaii, the largest disease burden in the 50 United States will continue to be in travelers. Individuals who travel to areas where dengue is common should protect themselves from mosquito bites to reduce their risk of infection.

2. Prevalence and Predictors of Viral Suppression Among Persons with Diagnosed HIV Infection Retained in Care — Georgia, 2010

Not all persons with HIV who are receiving and remain in medical care achieve the goal of viral suppression, and fewer persons diagnosed with early stage disease achieve viral suppression compared with persons diagnosed with late stage disease. Health-care providers and community-based organizations should implement the national HIV treatment guidelines by initiating antiretroviral therapy (ART) at any stage of disease and explain to patients the benefits of taking ART earlier and regularly to achieve viral suppression. Early diagnosis of HIV infection and treatment to achieve viral suppression can benefit patients by improving their health status and the community by reducing HIV transmission. This analysis in Georgia, however, found that some persons who receive and remain in care don’t achieve viral suppression. In addition, the analysis found fewer persons diagnosed with early stage disease achieved viral suppression compared with persons diagnosed with late stage disease.

3. Trends in Uninsured Clients Visiting Health Centers Funded by the Title X Family Planning Program — Massachusetts, 2005–2012

In Massachusetts, publicly funded family planning organizations still played an important role in providing services to large numbers of insured and uninsured clients 6 years after legislation was passed expanding health care coverage.When health care coverage is high, who seeks care from publicly funded health care centers? This study examined the health insurance status of patients seen at Massachusetts organizations that received federal funds to provide family planning services between 2005-2012, the period when the state enacted legislation to make health care coverage nearly universal. The study found that the health organizations’ total patient population decreased slightly during the period. The percentage of uninsured patients decreased dramatically, from 59 percent to 36 percent. The results suggest that, 6 years into health care reform in the state of Massachusetts, publicly funded health organizations were the providers of choice for many insured patients and a safety net for uninsured patients.