MMWR- Morbidity and Mortality Weekly Report
MMWR News Synopsis for September 3, 2015
West Nile Virus and Other Nationally Notifiable Arboviral Diseases — United States, 2014
West Nile virus and other arboviruses continue to be a source of severe illness each year for substantial numbers of people in the United States. Maintaining surveillance remains important to identify outbreaks and guide prevention efforts. Arboviruses cause substantial morbidity in the United States each year. In 2014, West Nile virus was the most common cause of neuroinvasive arboviral disease (e.g., encephalitis or meningitis) in the United States, with a national incidence of 0.42 cases per 100,000 population. States with the highest incidence rates included Nebraska, North Dakota, California, South Dakota, Louisiana, and Arizona. La Crosse virus was the most common cause of neuroinvasive arboviral disease among children. Eastern equine encephalitis, while rare, remained the most severe domestic arboviral disease.
Combustible and Smokeless Tobacco Use Among High School Athletes — United States, 2001–2013
Tobacco-free policies that prohibit all tobacco use by players, coaches, referees, and fans on school campuses and at all public recreational facilities — including stadiums, parks, and school gymnasiums — might help make smokeless tobacco use less socially acceptable and reduce its use among student athletes. Current use of combustible tobacco products, including cigarettes and cigars, dropped dramatically from 2001 to 2013 among high school students nationwide (31.5 percent to 19.5 percent), while current use of smokeless tobacco remained unchanged among non-athletes (5.9 percent) and increased among athletes (10 percent to 11.1 percent). Compared to non-athletes, athletes were more likely to use smokeless tobacco but less likely to use combustible tobacco. Athletes might be more likely to use certain tobacco products, such as smokeless tobacco, if they perceive them to be harmless; however, smokeless tobacco use is not safe and is associated with increased risk of pancreatic, esophageal, and oral cancers. Continued implementation of proven interventions is critical to reducing all forms of tobacco use among youth, including increasing tobacco product prices, warning about the dangers of tobacco use, and increasing access to tobacco cessation resources.
Enterovirus and Human Parechovirus Surveillance — United States, 2009–2013
Through the National Enterovirus Surveillance System, CDC tracks reports of enterovirus and human parechovirus types, which can help determine patterns of circulation for individual virus types, interpret trends in enteroviral disease, assist with outbreak recognition, and guide development of new diagnostic tests and therapies. Enteroviruses (EV) and human parechoviruses (HPeV) cause a wide variety of clinical manifestations in humans, ranging from asymptomatic to severe. Some examples include hand, foot, and mouth disease; respiratory illness; aseptic meningitis; acute flaccid paralysis; sepsis; and even death. Numerous types of EV and HPeV are known, and different types can cause different illnesses. The National Enterovirus Surveillance System (NESS) receives reports from public health and clinical laboratories in the U.S. that test for these types. From 2009 to 2013, the most commonly reported types of EV and HPeV were coxsackievirus A6, which caused a large outbreak of hand, foot, and mouth disease in 2011 and 2012 and human parechovirus 3, of which most detections came from a single hospital that routinely tests for it.
Interval between 13-Valent Pneumococcal Conjugate Vaccine and 23-valent Pneumococcal Polysaccharide Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP)
Two pneumococcal vaccines are recommended for adults 65 years or older: pneumococcal conjugate vaccine (PCV13) should be administered first when possible, followed at least one year later by pneumococcal polysaccharide vaccine (PPSV23) for individuals without health conditions that weaken their immune system. On June 25, 2015, the Advisory Committee on Immunization Practices (ACIP) voted to change the recommended interval between two pneumococcal vaccines given in series to adults 65 years or older without health conditions that weaken their immune system. The recommended interval for adults 65 years or older with certain health conditions that place them at increased risk of pneumococcal infections remains the same. Two pneumococcal vaccines are recommended for adults 65 years or older: pneumococcal conjugate vaccine (PCV13) is administered first, when feasible, followed by pneumococcal polysaccharide vaccine (PPSV23). The recent ACIP vote changed the recommended interval between PCV13 followed by PPSV23 from 6-12 months to at least one year for adults 65 years or older without health conditions that weaken their immune system. This change will allow the recommended interval between the two vaccines to be the same for this group of adults, regardless of the order in which the two vaccines are administered. PCV13 and PPSV23 should not be given at the same time.
Licensure of a Diphtheria and Tetanus Toxoids and Acellular Pertussis Adsorbed and Inactivated Poliovirus Vaccine and Guidance for Use As a Booster Dose
A new vaccine is available for immunization against four diseases: diphtheria, tetanus, pertussis (whooping cough), and polio. On March 24, 2015, the Food and Drug Administration approved the use of Quadracel™ (Sanofi Pasteur Inc., Swiftwater, PA) in children 4 through 6 years old. This is the age when children are recommended to get their fifth dose of the diphtheria, tetanus and acellular pertussis (DTaP) vaccine series and their fourth dose of the inactivated poliovirus (IPV) vaccine series. Quadracel™ offers clinicians an additional choice of vaccines to make sure their patients have protection from these life-threatening diseases according to the recommended immunization schedule.
Percentage of Office-Based Physicians with a Basic Electronic Health Record (EHR) System, by State — National Electronic Health Records Survey, United States, 2014