viernes, 30 de octubre de 2015

CDC MMWR News Synopsis for October 29, 2015

MMWR- Morbidity and Mortality Weekly Report
MMWR News Synopsis for October 29, 2015
Human Papillomavirus Vaccination Coverage Among Female Adolescents in Managed Care Plans — United States, 2013

HPV vaccination is cancer prevention, but HPV vaccination coverage by age 13 years is low among girls with health insurance. Increasing delivery of HPV vaccination at the recommended ages of 11 or 12 years, before most adolescents are exposed to the virus, will help ensure adolescents are protected against cancers caused by HPV infections. CDC encourages clinicians to recommend HPV vaccination the same way and same day they recommend other vaccines for adolescents. To determine whether the recommended HPV vaccination series is currently being administered to adolescents with health insurance, CDC and the National Committee for Quality Assurance (NCQA) assessed 2013 data from the Healthcare Effectiveness Data and Information Set (HEDIS). The HEDIS HPV Vaccine for Female Adolescents performance measure evaluates the proportion of female adolescent members in commercial and Medicaid health plans who complete the recommended HPV vaccination series by age 13 years. In 2013, in the United States, the median HPV vaccination coverage level for female adolescents among commercial and Medicaid plans was 12 percent and 19 percent, respectively (ranges = 0 percent–34 percent for commercial plans, 5 percent–52 percent for Medicaid plans). The results of this study indicate that there are significant opportunities for improvement as HPV vaccination coverage among female adolescents was low for both commercial and Medicaid plans.

Active Bacterial Core Surveillance for Legionellosis — United States, 2011–2013

Appropriate use of existing tests and future development of better diagnostics are needed to measure the burden of legionellosis, which has been increasing. According to U.S. surveillance, rates of legionellosis, which includes Legionnaires’ disease and Pontiac fever, increased by 249 percent from 2000-2011. In 2011, legionellosis surveillance was started through CDC’s Active Bacterial Core surveillance (ABCs) to better understand the clinical course, diagnostic tests being used, and differences in rates across population groups. During 2011–2013, ABCs showed that almost half of legionellosis patients required intensive care and almost 1 out of 10 died. Disease incidence was higher among blacks than whites and differed across surveillance sites, with the highest rates in New York and the lowest in California. Laboratory findings indicated that clinicians are relying on urinary antigen testing, which only detects one type of Legionella infection, and are not routinely collecting cultures as is also recommended. ABCs data highlight the severity of the disease, the need to better understand racial and regional differences, and the need for better diagnostic testing to detect infections.
State Medicaid Coverage for Tobacco Cessation Treatments and Barriers to Coverage — United States, 2014–2015

Medicaid enrollees smoke at a higher rate than the general population, and smoking-related disease is an important contributor to Medicaid costs. More smokers would quit if state Medicaid programs covered more proven tobacco cessation treatments and removed barriers to coverage. Comprehensive state Medicaid cessation coverage has the potential to reduce smoking rates, smoking-related disease, and health care costs in the Medicaid population. Efforts to improve state Medicaid coverage to cover all proven tobacco cessation treatments and remove barriers to coverage have shown some progress, but most states still fall short of comprehensive Medicaid cessation coverage. As of June 2015, only nine states cover all nine evidence-based cessation treatments considered in this study for all Medicaid enrollees, up from six states in January 2014. However, all nine states still have some barriers in place for certain treatments. The most common barriers to coverage across all states included prior authorization requirements, limits on duration, annual limits on quit attempts, and required copayments. Removing these barriers increases access to and use of proven cessation treatments.

Notes from the field:
  • Update on Multistate Outbreak of Fungal Infections Associated with Contaminated Methylprednisolone Injections — 2012–2014
  • Outbreak of Escherichia coli O157:H7 Infections Associated with Dairy Education Event Attendance — Whatcom County, Washington, 2015

  • Percentage of Children and Adolescents Aged 0–17 Years with No Usual Place of Health Care, by Race and Hispanic Ethnicity — National Health Interview Survey, United States, 1997–2014

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