MMWR News Synopsis for March 22, 2018

Tuberculosis – United States, 2017

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Eliminating tuberculosis (TB) in the United States requires a continued effort to control TB disease as well as expanded testing and treatment of latent TB infection. Preliminary 2017 U.S. data show the lowest number of reported TB cases on record.  New, expanded approaches are needed to accelerate progress towards TB elimination. Data from CDC’s National TB Surveillance System show a total of 9,093 U.S. TB cases in 2017, indicating slight declines in TB cases (-1.8 percent) and TB rates (-2.5 percent) compared to 2016. The preliminary data bring the overall annual TB rate for 2017 down slightly to approximately 2.8 cases per 100,000 people (compared to 2.9 in 2016). However, the rate is 28 times higher than the goal for TB elimination. Epidemiologic modeling suggests that at continued slow rates of decline, TB elimination will not be achieved in this century. In order to achieve TB elimination, continued and expanded efforts to control both active TB and latent TB infection are necessary.

Preliminary Incidence and Trends of Infections with Pathogens Transmitted Commonly Through Food — Foodborne Diseases Active Surveillance Network, 10 U.S. Sites, 2006–2017

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The number of infections diagnosed by newer type culture-independent diagnostic tests, or CIDT, is increasing. The overall number of Campylobacter, Listeria, Salmonella, Shigella, Vibrio, and Yersinia infections diagnosed by CIDT nearly doubled in 2017 compared with the 2014-2016 average. CIDTs are revealing many infections that would not have been diagnosed before because of limited testing, such as infections caused by Cyclospora, Yersinia, Vibrio, and Shiga-toxin producing E. coli non-O157. However, CIDTs also challenge our ability to find outbreaks and monitor disease trends because they do not provide certain information, such as subtype and antimicrobial susceptibility, needed to characterize organisms that cause infections. This information can be obtained only if a CIDT-positive specimen is cultured. Documenting trends in foodborne illness – identifying which illnesses are decreasing and which are increasing – provides important information needed to help reduce foodborne illness. This year’s FoodNet report summarizes 2017 preliminary surveillance data and describes trends since 2006 for Campylobacter, Cryptosporidium, Cyclospora, Listeria, Salmonella, Shiga toxin-producing Escherichia coli (STEC), Shigella, Vibrio, and Yersinia. The findings in this report suggest targeted control measures are effective in reducing infections. For instance, the declines in Salmonella Typhimurium and Heidelberg might be due to industry efforts to vaccinate poultry flocks against these serotypes and the U.S. Department of Agriculture Food Safety and Inspection Service’s implementation of measures to decrease Salmonella in poultry products.

Characteristics of and Precipitating Circumstances Surrounding Suicide Among Persons Aged 10–17 Years — Utah, 2011–2015

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Comprehensive and coordinated suicide prevention efforts that address multiple precipitating circumstances are needed to help prevent youth suicide. The Utah Department of Health invited CDC to assist with an investigation of suicides among youth aged 10–17 years during 2011–2015 to identify precipitating factors. During 2011–2015 in Utah, 150 youths died by suicide. Approximately three quarters of deaths were male and aged 15–17 years. The unadjusted suicide rate per 100,000 youths increased by 136.2% during 2011-2015, from 4.7 per 100,000 (2011) to 11.1 (2015), whereas nationwide, this rate increased 23.5%, from 3.4 to 4.1. Where data was available, more than two thirds of those who died by suicide had multiple precipitating circumstances including mental health diagnosis, depressed mood, recent crisis, and history of suicidal ideation or attempt.

Initial Public Health Laboratory Response After Hurricane Maria — Puerto Rico, 2017

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CDC worked closely with PRDOH, and other federal, state, and non-governmental partners to provide technical support and aid in reestablishing laboratory operations during the emergency response to Hurricane Maria. Hurricane Maria severely affected public services in Puerto Rico, including the operation of the Puerto Rico Department of Health (PRDOH) which provides critical laboratory testing and surveillance for diseases and other health hazards. The PRDOH prioritized repair of the public health laboratories during the post-hurricane response and requested clinical testing assistance as well as structural and safety assessments from CDC.

Bleeding and Blood Disorders in Clients of Voluntary Medical Male Circumcision for HIV Prevention — Eastern and Southern Africa, 2015-2016

CDC Media Relations
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A new CDC analysis of data from eight African countries shows the importance of screening for bleeding disorders before voluntary medical male circumcision (VMMC). Prompt detection and management of bleeding complications is required, as is maintenance of a surveillance system to monitor adverse events. A new CDC analysis of VMMC data from eight African countries revealed that bleeding resulting in hospitalization for three or more days was the most commonly reported adverse event during 2015-2016. CDC, through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), supported development of tools to screen for bleeding disorders and correctly manage adverse events. VMMC reduces risk of HIV in men by approximately 60 percent and is a key component of HIV prevention programs in Eastern and Southern Africa. As of September 2017, PEPFAR had supported 15.2 million VMMC procedures in 14 countries.

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Page last reviewed: March 22, 2018