MMWR- Morbidity and Mortality Weekly Report
MMWR News Synopsis for June 18, 2015
State Legislation, Regulations, and Hospital Guidelines for Newborn Screening for Critical Congenital Heart Defects — United States, 2011–2014
Forty-three states have taken action on newborn screening for critical congenital heart defects (CCHD) through statute, regulations, or hospital guidelines. Of those 43 states, 32 (74 percent) are collecting or planning to collect CCHD screening data. Through these actions, more newborns with CCHD may be detected, treated and able to live fully. CCHDs are birth defects that require treatment during the first year of life. Without timely detection, CCHDs could lead to disability or death. Newborn screening for CCHD allows for the possibility of early identification and treatment. State mandates for newborn screening for CCHD will likely increase the number of newborns screened and cases detected, leading to more lives saved. In 2014, CDC collaborated with key partners to assess states’ actions for adopting newborn screening for CCHD. Data collection at the state level is important for surveillance, monitoring outcomes, and evaluation of CCHD newborn screening programs.
Update on Vaccine-Derived Polioviruses — Worldwide, January 2014–March 2015
Polio eradication means the cessation of all poliovirus circulation. Circulating vaccine-derived polioviruses (cVDPVs) are biologically equivalent to wild polioviruses, emerge in settings of low type-specific population immunity, and can circulate indefinitely.Immunodeficiency-associated VDPVs (iVDPVs) will continue to emerge as long as oral polio vaccine (OPV) is used. The WHO strategic plan to shift from trivalent OPV to bivalent OPV by 2016 will include introduction of at least one routine dose of inactivated polio vaccine (IPV) worldwide, setting the stage for a subsequent total worldwide shift from OPV to IPV. Vaccine-derived polioviruses (VDPVs), recognized by their high genetic divergence from the OPV strains, fall into three categories: 1) cVDPVs from outbreaks, 2) iVDPVs from patients with primary immunodeficiencies, and 3) ambiguous VDPVs (aVDPVs) that cannot be more definitively identified. During January 2014–March 2015, new cVDPV outbreaks were identified in Madagascar and South Sudan; outbreaks in Afghanistan and Somalia stopped; outbreaks in Nigeria and Pakistan had nearly stopped. Nine newly identified persons in seven countries were found to excrete iVDPVs. Because >97% of cVDPVs since 2006 and 65% of iVDPVs since 1962 are type 2, WHO plans coordinated worldwide replacement of trivalent OPV with bivalent OPV (types 1 and 3) by April 2016, preceded by introduction of at least one dose of IPV.
Yellow Fever Vaccine Booster Doses: Recommendations of the Advisory Committee on Immunization Practices, 2015
The Advisory Committee on Immunization Practices (ACIP) no longer recommends booster doses of yellow fever vaccine for most travelers, stating that a single dose of yellow fever vaccine provides long-lasting protection and is adequate for most travelers. On February 26, 2015, the ACIP voted that a single dose of yellow fever vaccine provides long-lasting protection and is adequate for most travelers. This recommendation was established based on reviewing available information about the safety and long-term protection offered by yellow fever vaccine. The World Health Organization made similar recommendations in 2013, stating one dose of yellow fever vaccine is sufficient to provide lifelong protection. The current recommendations from ACIP, however, note certain people who should receive additional dose(s) of yellow fever vaccine because of an impaired immune response to the vaccine or because they will be at increased risk for yellow fever disease.
Opioid Overdose Prevention Programs Providing Naloxone to Laypersons — United States, 2014
Organizations training and providing naloxone kits to laypersons can reach large numbers of people who may witness an overdose, result in many reported overdose reversals, and may help prevent opioid drug overdose deaths. In 2013, 43,982 drug overdose deaths were reported including, 16,235 associated with prescription opioid analgesics (e.g., oxycodone), and 8,257 with heroin. Since 1996, an increasing number of organizations provide laypersons (including persons who use drugs, their families and friends) with training and kits containing naloxone, which reverses the potentially fatal respiratory depression caused by heroin and other opioids. As of June 2014, 30 U.S. states and the District of Columbia had at least one organization providing training and naloxone kits to laypersons. From 1996 through June 2014, these organizations provided naloxone kits to 152,283 laypersons and received reports of 26,463 overdose reversals. Most laypersons who reported using naloxone to reverse an overdose were persons who use drugs. Many of the reported reversals involved heroin overdoses.
Coccidioidomycosis in a State Where it is Not Known to be Endemic — Missouri, 2004–2013
Surveillance for coccidioidomycosis is needed in non-endemic states to discover if locally acquired cases are occurring. The incidence of reported coccidioidomycosis is increasing nationally, both in states where the disease is known to be endemic and those where it is not. This is the first study of the epidemiology of coccidioidomycosis in a state without endemic disease. We found a significant increase in reported coccidioidomycosis in Missouri during 2004-2013 when the incidence per 100,000 population increased from 0.05 to 0.28. Nearly half of patients had traveled to an area where coccidioidomycosis is endemic, whereas about a quarter of patients did not report such travel. Additional studies will be required to ascertain whether truly endemic cases exist in Missouri. For persons living in areas where coccidioidomycosis is not believed to be endemic, more stringent requirements for laboratory diagnosis of coccidioidomycosis might be appropriate.
Notes from the Field:
Tick-Borne Relapsing Fever Outbreak at an Outdoor Education Camp — Arizona, 2014
Update: Silicosis Mortality — United States, 1999–2013