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MMWR – Morbidity and Mortality Weekly Report

1. Evaluation of the HIV Diagnostic Algorithm in Two Studies — United States, 2011–2013

NCHHSTP Media Team

A new CDC analysis finds that a testing process used in four areas identified a substantial number of acute, or very early, infections that would have been missed using the currently-recommended process. In light of recent advances in HIV testing technology, CDC evaluated a testing process which incorporates cutting-edge tests to better identify acute HIV and additional follow-up tests for conflicting results to minimize misdiagnosis. Among people newly diagnosed with HIV infection using this algorithm, 32 percent were detected in the acute phase of infection in a Phoenix, AZ emergency department screening program and 9 percent were in the acute phase in an ongoing testing study in New York City, North Carolina and San Francisco. Following the currently-recommended process, these infections may have been misreported as negative. Early HIV diagnosis, particularly for those in the highly-infectious acute phase of HIV infection, is a critical step towards stopping HIV transmission and starting life-saving treatment and care. CDC will consider these findings as it continues the process of evaluating and refining testing recommendations. In the meantime, researchers call on clinicians to remain vigilant for acute infection and to perform additional, follow-up testing for HIV for patients with conflicting test results.

2. Routine HIV Screening During Intake Medical Evaluation at a County Jail — Atlanta, Georgia, 2011–2012

Melva Robertson
Emory University

An HIV screening project in Atlanta’s Fulton County Jail (FCJ) shows that offering routine HIV testing to inmates upon intake can identify a substantial number of HIV infections among an otherwise hard-to-reach population. Between January 1, 2011 and March 15, 2012, FCJ conducted 12,141 tests and diagnosed 52 new HIV cases. All diagnoses were among black men and women, and nearly 40 percent of newly diagnosed men reported having sex with men before entering the jail. These findings mirror the national HIV epidemic, with African American men and women and men who have sex with men (MSM) hardest-hit. Although CDC recommends all adults and adolescents be tested at least once and that MSM and other high-risk persons be tested more frequently, 31 percent of those newly diagnosed in this study had never been tested and only 15 percent were tested in the past year. Researchers note that HIV diagnosis is the critical first step in accessing care and treatment, and preventing new infections. Without this screening project, many HIV-infected inmates would have been diagnosed much later in the course of their infection, when it was too late to fully benefit from treatment or protect their partners from infection. Linkage to community services is critical, and an opportunity exists for the public health system and community-based organizations to collaborate with jails to ensure access to HIV care and retention in treatment for persons with HIV released from jail.

3. Homemade Chemical Bomb Incidents — 15 States, 2003-2011

CDC Media Relations

Homemade chemical bombs (HCBs) are made from commonly found chemicals. To determine the number of events involving HCBs and describe the factors associated with them, the Agency for Toxic Substances and Disease Registry (ATSDR) analyzed data from its surveillance system that tracks spills and leaks of hazardous substances. The results show that134 events involving HCBs were reported from 15 states and resulted in adverse health effects in 53 persons during 2003–2011. The majority of injured persons were youths, involving cases of respiratory symptoms, burns, and skin irritation. HCBs are hazardous and especially dangerous if detonated in public areas. Increasing awareness of HCBs and their dangers (particularly during summer months) among first-responders, parents, school staff members and others who work with youths might help reduce injuries associated with HCBs. Homemade chemical bombs can cause serious injuries. If someone discovers what they think might be a homemade chemical bomb, they should leave it alone and contact authorities.

4. The Global Polio Eradication Initiative Stop Transmission of Polio (STOP) Program — 1999–2013

CDC Media Relations

The STOP program has aided Global Polio Eradication Initiative  by strengthening the capacity of country-level immunization programs and by allowing at least 1,563 volunteers to gain valuable field experience that prepares them well for subsequent work as staff members of WHO, UNICEF, and other public health agencies.  The STOP program recruits and deploys three types of volunteers: field staff and data managers who work with WHO country teams, and communications officers who work with UNICEF country teams.  All volunteers undergo 10 days of intense technical, security, and cross-cultural training at CDC in Atlanta before being deployed on field assignments for up to 3–5 months. The Stop Transmission of Polio (STOP) program has aided the Global Polio Eradication Initiative (GPEI) by strengthening the capacity of country-level immunization programs by recruiting and deploying volunteers to serve as field staff, data managers and communications officers. 



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