MMWR News Synopsis for September 27, 2018

Children with Heart Conditions and Their Special Health Care Needs — United States, 2016

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Based on parent-reported data, about 1 in 77 U.S. children currently have heart conditions, nearly 60 percent of whom have special health care needs. Children with heart conditions, such as congenital heart defects, often need specialized medical care and other treatments. However, little is known about the number of U.S. children living with heart conditions or their special health care needs. CDC used data from the 2016 National Survey of Children’s Health to address this knowledge gap. Based on parent-reported information, 1 in 77 U.S. children had a heart condition in 2016. This adds up to nearly 900,000 children living with different types of heart conditions. Compared to children without a heart condition, children with a current heart condition were more likely to have special health care needs including need for medications, physical or speech therapies, more health care or educational services, functional limitations, and treatment for developmental or behavioral problems.

Influenza Vaccination Coverage Among Health Care Personnel — United States, 2017–18 Influenza Season

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CDC, the Advisory Committee on Immunization Practices (ACIP), and the Healthcare Infection Control Practices Advisory Committee recommend that all healthcare workers get an annual flu vaccine. If you work in health care and get the flu, you can spread it to others even if you don’t feel sick. By getting vaccinated, you help protect yourself, your family at home, and your patients. CDC, ACIP, and the Healthcare Infection Control Practices Advisory Committee recommend all health care workers receive an annual flu vaccine. Vaccinating healthcare workers can a) reduce influenza-related morbidity and mortality among health care workers, b) reduce work absences, and c) help protect patients. Flu vaccination coverage during the 2017-2018 flu season was 78.4 percent among healthcare workers, which is a 15 percentage-point increase from the 2010-2011 flu season. However, estimates have stayed relatively similar during the past four seasons. Coverage was consistently higher among healthcare workers in hospital settings and lowest among healthcare workers in long-term-care settings.

Influenza and Tdap Vaccination Coverage Among Pregnant Women — United States, April 2018 

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Many pregnant women are unvaccinated. They and their babies continue to be vulnerable to influenza and pertussis infections with potentially serious complications including hospitalization and death. Doctors are encouraged to strongly recommend vaccines that their pregnant patients need, and either administer needed vaccines or refer patients to a vaccination provider. CDC and the Advisory Committee on Immunization Practices (ACIP) recommend two vaccines for pregnant women: 1) a flu vaccine for women who are or might be pregnant during the flu season and 2) a Tdap (tetanus, diphtheria, and acellular pertussis) vaccine during every pregnancy, between 27 and 36 weeks gestation (preferably earlier in this period). To assess influenza and Tdap vaccination coverage among pregnant women during the 2017–18 influenza season, CDC analyzed data from an Internet panel survey. Only about half (49.1 percent) of women reported receiving influenza vaccine before or during their pregnancy. Additionally, a little over half (54.4 percent) reported receiving Tdap during their pregnancy. Women who reported receiving a provider offer of vaccination had higher vaccination coverage than women who received a recommendation but no offer and women who did not receive a recommendation.

Meningococcal Disease Surveillance in Men Who Have Sex with Men — United States, 2015–2016

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Men who have sex with men (MSM), including those with HIV, have increased meningococcal disease rates compared to non-MSM. Identifying MSM among meningococcal disease patients and improving collection of data on HIV status for all cases will help researchers understand the epidemiology and risk factors for meningococcal disease among MSM. Studies have shown that MSM are at increased risk for meningococcal disease in the United States. However, until now, researchers have not well described the epidemiology of disease in this group because gender of sex partners and/or sexual orientation have not historically been collected through routine meningococcal disease surveillance. From 2015-2016, 271 meningococcal disease cases were reported in men ages ≥18 years; among them, sufficient information to identify MSM status was available for 124 (45.8 percent). Overall, 48 (17.7 percent) cases occurred in MSM. MSM, including those with HIV, have increased meningococcal disease rates compared to non-MSM. During investigations of meningococcal disease, CDC encourages state and local health departments to assess HIV status of all patients and identify MSM among male patients ages ≥16 years.

Multidrug-Resistant Aspergillus fumigatus Carrying Mutations Linked to Environmental Fungicide Exposure — Three States, 2010–2017

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Clinicians and public health personnel should be aware that treatment-resistant Aspergillus fumigatus infections are possible even in patients not previously given triazole medications. Aspergillus fumigatus resistant to all triazole medications is emerging in the United States, and clinicians and public health personnel should be aware that resistant infections are possible even in patients not previously exposed to these medications. This report identified seven patients with this type of resistance; four had no known exposure to antifungal medications. A. fumigatus infections occur in over 10,000 U.S. hospitalizations annually and are usually treated with triazole antifungal medicines. Even with triazole treatment, these infections can cause death in more than half of infected patients with weakened immune systems. Infections with resistant strains of A. fumigatus can be even harder to treat. The A. fumigatus strains described in this article carried resistance markers associated with environmental fungicide use rather than previous patient exposure to antifungals. Further research is needed to determine how widespread this resistance is.

Barriers to Receipt of Prenatal Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis Vaccine (Tdap) Among Mothers of Infants Aged <4 Months with Pertussis — California, 2016

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Getting immunized against whooping cough at the earliest opportunity during 27-36 weeks gestation of each pregnancy is the best way to protect young infants against this disease. Prenatal care providers should make a strong recommendation for Tdap to all pregnant women. If Tdap is not stocked onsite, providers should make every effort to refer patients to an accessible site covered by the mother’s insurance and then follow up to ensure she is immunized. Infants are at highest risk for hospitalization and death due to whooping cough (pertussis). To protect newborns, CDC recommends that all pregnant women be immunized against whooping cough as early as possible during 27-36 weeks gestation of each pregnancy. This California study showed that only 30 percent of mothers whose infants developed pertussis were appropriately vaccinated. Women whose prenatal clinics stocked Tdap vaccine were more likely to be vaccinated. Women with Medicaid insurance were less likely to be vaccinated than were those with private insurance, even when treated in clinics that stocked Tdap vaccine.

Current Tobacco Smoking, Quit Attempts, and Knowledge About Smoking Risks Among Persons Aged ≥15 Years — 28 Countries, 2008–2016

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Implementation of proven tobacco control interventions, including strategies that increased knowledge about the health risks of tobacco use, might help reduce tobacco use and curb the estimated 1 billion tobacco-related deaths projected to occur in the 21st century. Approximately 80 percent of the world’s 1.1 billion tobacco smokers reside in low- and middle-income countries. Studies have shown that increasing knowledge about the adverse health effects of smoking can contribute to decreases in smoking and to increases in cessation attempts and successful cessation. CDC analyzed 2008–2016 Global Adult Tobacco Survey data from 28 countries to assess tobacco smoking prevalence, quit attempts, and knowledge about tobacco smoking risks among people who are 15 years or older. The study found that current tobacco smoking prevalence was high among many of the countries assessed and, in most of them, fewer than half of current smokers had made a quit attempt in the past year. Although an overall knowledge of the health risks associated with smoking was high across most of these countries, opportunities to increase this knowledge remain.

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Page last reviewed: September 27, 2018