MMWR News Synopsis for April 13, 2017
Hospitalizations for Crohn’s Disease, United States, 2003–2013
CDC Media Relations
Since Crohn’s disease cannot be prevented, patient-education efforts should focus on increasing awareness of exacerbating factors and medication compliance to prevent multiple hospitalizations. Symptoms of Crohn’s disease include chronic diarrhea, abdominal pain, and rectal bleeding. Symptoms can become severe enough to require hospitalization and surgery. Despite the availability of new medications that were expected to reduce hospitalizations, hospitalization rates for a first-listed diagnosis of Crohn’s disease did not change significantly from 2003 to 2013. During this decade, inpatient surgical procedures for small bowel resection declined, while those for colorectal resection or fistula repairs remained stable. It is unclear whether these trends indicate the beginning of a reversal of the increases in hospitalizations and surgical procedures observed in the years leading up to the study period.
CDC Media Relations
Illicitly manufactured fentanyl is sold on the heroin market and can cause rapidly fatal overdose. Quick administration of naloxone can reverse the effects of fentanyl and other opioid overdoses. The Massachusetts Department of Public Health worked with CDC to investigate the increasing number of opioid overdose deaths in three Massachusetts counties. By interviewing people who use illicit opioids and reviewing medical examiner records of opioid overdose deaths that occurred October 2014 – March 2015, the team found that two-thirds of decedents tested positive for fentanyl; the majority of fentanyl overdose deaths were suspected to involve illicitly made, non-pharmaceutical fentanyl; fentanyl overdoses can progress rapidly within minutes; and naloxone can reverse fentanyl overdoses when administered in time. The team recommends that clinicians test for fentanyl routinely when providing opioid therapy, that education about fentanyl should encourage people using opioids to have naloxone on hand, and to have an observer ready to call 911 if needed.
Use of Video Directly Observed Therapy for Treatment of Latent Tuberculosis Infection — Johnson County, Kansas, 2015
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When a local public health department was overwhelmed following the identification of 50 latent tuberculosis (TB) infection cases, the novel approach of using video directly observed therapy (VDOT) for patients opting for isoniazid and rifapentine 3HP treatment saved resources and led to a 96 percent completion rate. Following the identification of a suburban high school student with pulmonary tuberculosis TB, the local health department in Johnson County, Kansas embarked on a large-scale contact investigation. Emergency preparedness principles influenced the design and execution of multiple testing clinics held at the school. Through the collaborative efforts of the state and local health departments, school officials, and media partners, a successful investigation led to the identification of 50 new latent TB infection cases. The large number of people needing treatment for latent TB overwhelmed local health department staff. As a result, a policy and procedure was developed to allow patients who met eligibility requirements to complete 12-dose weekly 3HP treatment using video directly observed therapy, a tool previously only used for active tuberculosis disease.
Notes from the Field:
- Complications of Mumps During a University Outbreak Among Students Who Had Received 2 Doses of Measles-Mumps-Rubella Vaccine — Iowa, July 2015–May 2016
- Percentage Distribution of Gestational Age in Weeks for Infants Who Survived to Age 1 Year and Infants Who Died Before Age 1 Year — National Vital Statistics System, United States, 2014
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