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MMWR News Synopsis for May 18, 2017

Using Molecular Characterization to Support Investigations of Aquatic Facility–Associated Outbreaks of Cryptosporidiosis — Alabama, Arizona, and Ohio, 2016

CDC Media Relations

When heading to the water this summer – especially to swimming pools and water playgrounds – swimmers should take a few simple steps to help protect loved ones and themselves from germs that cause diarrhea. Preliminary data show U.S. cryptosporidiosis (better known as “crypto”) outbreaks linked to swimming have doubled since 2014. At least 32 outbreaks of cryptosporidiosis linked to swimming pools or water playgrounds were detected in the United States in 2016, compared with 16 outbreaks in 2014. In 2016, Alabama, Arizona, Ohio and other states investigated and controlled outbreaks of diarrhea caused by Cryptosporidium. The outbreaks highlight the ongoing challenges that treated recreational water venues such as pools and water playgrounds have with Cryptosporidium, because it is hard to kill and just a small amount can make people sick.

Inhalational Chlorine Injuries at Public Aquatic Venues — California, 2008–2015

CDC Media Relations

Improper mixing of pool chemicals can result in high concentrations that sicken bathers who inhale the fumes. Pool employees should ensure proper equipment maintenance and operation to prevent these toxic exposures. Numerous bathers at a public recreational swimming venues in California were sickened and transported to an emergency department when inappropriate mixing of pool chemicals resulted in a release of toxic chlorine gas. Investigators determined that an unknown equipment failure allowed the mixing of these chemicals in high enough concentrations to create a toxic chlorine gas cloud. Similar incidents have occurred over the past several years in California, where human error and/or equipment failure allowed pool chemicals to mix at high concentrations and release a toxic chlorine gas cloud. A combination of engineering controls and pool employee oversight can prevent or minimize toxic chlorine gas releases at recreational swimming venues.

Disparities in Diabetes Deaths Among Children and Adolescents — United States, 2000–2014

CDC Media Relations

Child and adolescent deaths from diabetes are potentially preventable. Disparities by race/ethnicity persist. Diabetes death rates among children and adolescents have not changed in the past 14 years, although disparities in diabetes deaths by race/ethnicity have persisted. Despite the higher prevalence of diabetes among non-Hispanic white youths, non-Hispanic black youth are twice as likely to die from diabetes compared to non-Hispanic whites and three times as likely compared to Hispanics. This study represents the first report to examine diabetes deaths among Hispanic children and adolescents. Diabetes is a serious chronic disease and can lead to death from acute complications. In the U.S. approximately 1 out of 1 million youth die from diabetes.

Hepatitis B Surface Antigen Screening Among Pregnant Women and Care of Infants of Hepatitis B Surface Antigen-Positive Mothers — Guam, 2014

National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention

Routine prenatal screening for hepatitis B virus (HBV) in pregnant women and prompt administration of post-exposure prophylaxis to newborns born to mothers who test positive is critically important to prevent this major mode of HBV transmission and to protect infants from this dangerous infection. HBV infection is widespread in the U.S. territory of Guam. CDC researchers analyzed data from medical records of pregnant women who delivered live born infants at the largest delivery hospital in Guam in 2014 to assess the prevalence of HBV screening and infection among pregnant women. Among 899 women with available data, 18 (2%) tested positive for hepatitis B surface antigen (HBsAg), an indicator of HBV infection. The 2 percent HBsAg positivity prevalence from this analysis is more than twice the maternal prevalence estimate for the continental United States (0.9%). Because most of the HBsAg-positive women were born before hepatitis B vaccines was introduced into Guam’s infant vaccination schedule, the risk of perinatal HBV transmission is expected to decrease in future years. However, the findings from this study underscore how vital prenatal HBsAG screening is to ensure positive cases are identified. When given within 12 hours of birth, post-exposure prophylaxis is 85 percent to 95 percent effective in preventing HBV transmission.

Updated Recommendations for Use of MenB-FHbp Serogroup B Meningococcal Vaccine — Advisory Committee on Immunization Practices, 2016

CDC Media Relations

If vaccinating with MenB-FHbp – including during serogroup B meningococcal disease outbreaks – ACIP recommends that three doses of MenB-FHbp be administered at 0, 1–2, and 6 months for people at increased risk of meningococcal disease. ACIP recommends that two doses of MenB-FHbp should be administered at 0 and 6 months when given to healthy adolescents who are not at increased risk for meningococcal disease. Recommendations regarding use of MenB-4C vaccine (Bexsero) are unchanged. Either MenB vaccine can be used when indicated; however, they are not interchangeable and the same product must be used for all doses in a series. Two serogroup B meningococcal (MenB) vaccines are currently licensed for use among people aged 10–25 years in the United States: MenB-FHbp (trade name, Trumenba) and MenB-4C (trade name, Bexsero). Changes to the dosage and administration of MenB-FHbp vaccines were recently approved by FDA to include both a three-dose series (administered at 0, 1–2, and 6 months) and a two-dose series (administered at 0 and 6 months). For people at increased risk for meningococcal disease and for use during serogroup B meningococcal disease outbreaks, ACIP recommends that three doses of MenB-FHbp be administered at 0, 1–2, and 6 months. When given to healthy adolescents who are not at increased risk for meningococcal disease, ACIP recommends that 2 doses of MenB-FHbp should be administered at 0 and 6 months.

Notes from the Field:

  • Ongoing Transmission of Candida auris in Health Care Facilities — United States, June 2016–May 2017

Quick Stats:

  • Percentage of Adults Aged ≥65 Years Who Saw Selected Types of Health Professionals in the Past 12 Months, by Diagnosed Diabetes Status — National Health Interview Survey, 2015



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