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MMWR – Morbidity and Mortality Weekly Report

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1. West Nile Virus and Other Arboviral Diseases — United States, 2013

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West Nile virus and other arboviruses continue to be a source of severe illness each year for substantial numbers of persons in the United States. Maintaining surveillance remains important to identify outbreaks and guide prevention efforts. Arboviruses continue to cause substantial morbidity in the United States. In 2013, West Nile virus was the most common cause of neuroinvasive arboviral disease in the United States, with a national incidence of 0.40 per 100,000 population. States with the highest incidence rates included North Dakota (8.9 per 100,000), South Dakota (6.8), Nebraska (2.9) and Wyoming (2.8). La Crosse virus was the most common cause of neuroinvasive arboviral disease among children. There was a substantial increase in the number of reported Jamestown Canyon virus disease cases compared to previous years, with several states reporting cases for the first time. Eastern equine encephalitis, while rare, remained the most severe domestic arboviral disease.

2. Use of MenACWY-CRM Vaccine in Children Aged 2–23 Months at Increased Risk for Meningococcal Disease: Recommendations of the Advisory Committee on Immunization Practices, 2013

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The meningococcal vaccine known as MenACWY-CRM, or Menveo, is now an additional option for protecting infants aged 2 through 23 months who are at increased risk of meningococcal disease. During its October 2013 meeting, ACIP recommended use of a third meningococcal conjugate vaccine, MenACWY-CRM (Menveo, Novartis), as an additional option for vaccinating infants aged 2 through 23 months at increased risk for meningococcal disease. This report summarizes information on MenACWY-CRM administration in infants and provides recommendations for vaccine use in infants aged 2 through 23 months who are at increased risk of meningococcal disease.

3. Notes from the Field: Excess Fentanyl-Related Overdose Deaths — Rhode Island, November 2013–March 2014

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CDC is collaborating with the Rhode Island Department of Health in identifying potential strategies for prevention and first response intervention to address a recently identified increase in fentanyl-related drug overdose deaths. The Rhode Island Department of Health (RIDOH) requested CDC’s assistance in describing recent fentanyl-related drug overdose deaths (ODs). It was found that fentanyl-related ODs accounted for 31.5 percent of all unintentional ODs reported between November 1, 2013 and March 31, 2014. Most people who died did not have active fentanyl prescriptions; the fentanyl appeared to originate from illicit sources. CDC collaborated with RIDOH in developing an emergency regulation that orders all RI emergency departments report opioid overdose cases within 48 hours to RIDOH. The recommendation was made that RIDOH continue and expand its efforts to make naloxone (Narcan) – a prescription drug that helps reverse the effects of opioids – accessible for prior drug overdose patients and their families. Additional research will identify strategies for prevention and first-response intervention for at-risk populations.

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