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MMWR – Morbidity and Mortality Weekly Report

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1. National and State Vaccination Coverage Among Adolescents Aged 13–17 Years — United States, 2012

CDC Media Relations

Large and increasing coverage differences between Tdap and other vaccines recommended for adolescents show that many valuable opportunities are being missed to vaccinate boys and girls, especially against HPV infection. Providers should administer recommended HPV and meningococcal vaccinations to boys and girls during the same visits when Tdap is given. Since 2009, the yearly national vaccination coverage estimate among teens for one dose of meningococcal conjugate vaccine has been lower than the estimate for one dose of Tdap vaccine, and the difference in coverage between the two vaccines is widening. Among females, vaccination coverage estimates for HPV vaccination remained low and did not increase at all from 2011 to 2012.   National Healthy People 2020 coverage targets for teens were met or exceeded by 36 states for Tdap vaccination and by 12 states for meningococcal vaccination, but no state met the HPV vaccination target set for female teens. These findings indicate that health care providers are missing opportunities to administer recommended HPV and meningococcal vaccinations to boys and girls during visits when Tdap is given.

2. Multidrug-Resistant Bacteroides fragilis — Seattle, Washington, 2013

Aley Kalapila, MD
Division of Allergy and Infectious Diseases
University of Washington Affiliated Hospitals
Office: 206-616-7217

Patients and healthcare workers should have a heightened awareness of infections caused by multidrug resistant organisms, especially among returning travelers who have received inpatient medical care outside the United States.  This awareness can help to ensure prompt implementation of proper infection control measures and to get patients onto the right antibiotics as soon as possible.  An American patient who was recently hospitalized overseas and then returned to the United States was found to have an infection with a multi-drug resistant strain of the bacteria Bacteroides fragilis. These bacteria are part of normal bowel flora for all humans and are usually susceptible to a broad spectrum of antibiotics, including carbapenems and metronidazole. Reported rates of resistance to these drugs in the United States are on the order of <1%. Fortunately, the patient responded to treatment with alternative drugs.  This case highlights the importance of vigilance for new kinds of drug-resistant bacteria, especially in those who have been admitted to hospitals overseas.

3. CDC Grand Rounds: Public Health Practices to Include Persons with Disabilities

CDC Media Relations

It is critical to include people with disabilities in mainstream health programs and services that meet their needs as a person, regardless of their disability.  When children and adults with disabilities receive needed programs, services and health care throughout their life, they can reach their full potential, have an improved quality of life, and experience independence in their community. People with disabilities have the same health needs as people without disabilities – for example, to eat well, be active, manage a chronic condition such as arthritis, or receive medical checkups.  Unfortunately, people with disabilities find it more difficult than people without disabilities to access health and public health services, which can lead to dramatically poorer overall health and increased rates of smoking, obesity, and chronic conditions.  This is an issue any American community faces, as about 16 percent of adults in the U.S. have a serious limitation in functioning and national disability-associated health-care expenditures were estimated to be over one-quarter of all national health expenditures in 2006 ($400 billion).  People with disabilities can have an improved quality of life when receiving necessary health programs.

4. Notes from the Field

  • Recurrent Outbreak of Campylobacter jejuni Infections Associated with a Raw Milk Dairy — Pennsylvania, April–May 2013
  • Nonpharmaceutical Acetyl Fentanyl Overdose Fatalities — Rhode Island, March–May 2013



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