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MMWR News Synopsis for November 2, 2018

Prevalence and Trends in Preexisting Diabetes and Gestational Diabetes Among Women with Live Births — United States, 2012-2016

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From 2012 to 2016, there have been slight increases in the percentage of women with diabetes during pregnancy, which can have important short- and long-term health implications for mothers and their babies. A new CDC analysis suggests that diabetes during pregnancy has increased slightly in recent years. Among 40 jurisdictions, the percentage of women diagnosed with diabetes before pregnancy (preexisting diabetes) remained stable at 0.8 percent in 2016, and the percentage of women diagnosed with diabetes during pregnancy (gestational diabetes) increased from 5.2 percent to 5.6 percent. Preexisting diabetes increases risk of birth defects, stillbirth, and being born larger than average. Gestational diabetes increases infants’ risk of being born too large and may put children at risk for future obesity. For mothers, gestational diabetes increases the risk of developing type 2 diabetes in the future. Prepregnancy healthcare and lifestyle interventions may provide opportunities to control, prevent, or reduce health consequences associated with diabetes during pregnancy.

Hepatitis A Virus Outbreaks Associated with Drug Use and Homelessness — California, Kentucky, Michigan, and Utah, 2017

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The 2017 hepatitis A outbreaks among people reporting drug use or experiencing homelessness reinforce a need to vaccinate people at risk for hepatitis A. A CDC analysis of hepatitis A outbreaks in four states during 2017 suggest a shift in the populations most impacted by hepatitis A in the United States and highlight a need to improve vaccination among people at risk. In the past decade, most large outbreaks of hepatitis A were attributed to contaminated commercial food products. In 2017, 1,521 cases of hepatitis A were reported in four states. Transmission primarily occurred (57 percent) between people reporting drug use, experiencing homelessness, or both. Transient housing, economic instability, limited access to health care, and distrust of government services make outbreaks among affected populations difficult to control. Increasing vaccination coverage among everyone at risk might stop ongoing outbreaks and prevent future large outbreaks. More than 7,241 outbreak-associated cases have been reported from 10 states as of October 16, 2018.

Violence Victimization, Substance Use, and Suicide Risk Among Sexual Minority High School Students — United States, 2015–2017

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Violence victimization, substance use, and suicide risk vary among students who identify as gay, lesbian, bisexual, or who are unsure of their sexual identity. Prevention efforts may benefit from acknowledging these differences when tailoring evidence-based prevention strategies to sexual minority youth. Using 2015 and 2017 Youth Risk Behavior Survey data, this study examines the relationship between violence victimization, substance use, and suicide risk by sexual identity. Sexual minority youth (i.e. students who identify as gay, lesbian, or bisexual; or who are not sure of their sexual identity) are at an increased risk of violence victimization, substance use, and suicide risk than their heterosexual peers. All sexual minority youth reported elevated levels of high-risk substance use and suicide risk. Bisexual females and gay, bisexual, and not-sure males reported more violence victimization. Findings underscore how these risks vary among high school students by sexual identity. Programs may benefit from considering these group differences in their prevention efforts. Resources for reporters covering the topics of bullying, suicide, and sexual violence can be found here and additional resources for reporting on sexual violence can be found here.

Update: Recommendations of the Advisory Committee on Immunization Practices for Use of Hepatitis A Vaccine for Postexposure Prophylaxis and for Preexposure Prophylaxis for International Travel

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The Advisory Committee on Immunization Practices updated its recommendations on the use of hepatitis A (HepA) vaccine for postexposure prophylaxis and the use of HepA vaccine in infants prior to international travel. Postexposure prophylaxis (PEP) with HepA vaccine or immune globulin (IG) prevents hepatitis A virus infection (HAV) if given within two weeks of exposure. In February 2018, the Advisory Committee on Immunization Practices (ACIP) approved an update of recommendations for use of HepA vaccine for PEP in healthy persons 12 months and older. In addition to HepA vaccine, IG may be administered to persons over 40 years of age, depending on the provider’s risk assessment. HepA vaccine efficacy and safety in infants and the benefits of protection against HAV before international travel were also reviewed. ACIP recommended that HepA vaccine be administered to infants aged 6–11 months traveling outside the United States when protection against HAV is recommended. The updated recommendations specify new guidance for administering PEP for people over 40, and infants for international travel.

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