MMWR News Synopsis for Friday, January 4, 2019

Behavioral and Clinical Characteristics of American Indian/Alaska Native Adults in HIV Care — Medical Monitoring Project, United States, 2011–2015

CDC Media Relations
404-639-3286

To improve the health of American Indian/Alaskan Native (AI/AN) people with HIV infection, it is important that healthcare providers, tribal organizations, and state and local health departments consider sociodemographic and behavioral barriers to achieving viral suppression, and design care plans that seek to eliminate those barriers. The number of diagnoses of HIV infection among American Indians and Alaska Natives increased by 70 percent from 2011 to 2016. To get a better understanding of the sociodemographic, behavioral, and clinical characteristics of AI/AN people with HIV infection who receive care, CDC analyzed 2011–2015 data from the Medical Monitoring Project. The analysis indicated that 76 percent of AI/AN people with HIV infection achieved viral suppression at their most recent viral load test, a level below the national HIV prevention goal of 80 percent but comparable to or better than other racial/ethnic groups. The analysis also found high prevalence of self-reported poverty, depression, stigma, and alcohol use among AI/AN people with HIV infection who receive care – all of which can be barriers to achieving or maintaining viral suppression.

Human Rabies — Virginia, 2017

CDC Media Relations
404-639-3286

While human rabies deaths are rare in the United States, they are still highly prevalent in many other countries. Travelers to other countries should consult the CDC Yellow Book and their medical provider prior to travels to countries where rabies is present, particularly if they are engaging in activities that will put them in close proximity to animals such as dogs, cats, and wildlife. A 65-year-old Virginia resident died from rabies after being bitten by a puppy while vacationing in India. Rabies is a highly lethal virus, but is preventable when medical care and vaccination are sought shortly after an exposure. Unfortunately, the victim did not seek medical care after the bite, and six weeks later developed the first signs of rabies after returning to her home in Virginia. Despite intensive medical care, the victim passed away. Rabies is primarily transmitted by bites from animals when virus in the saliva is introduced into a victim’s body. In very rare occasions, non-bite transmission may occur when saliva infects fresh open wounds or mucous membranes (such as the eyes or mouth). A public health investigation identified 72 hospital staff with suspected exposures to infectious materials; all were advised to receive vaccination.

Wound Botulism Outbreak Among Persons Who Use Black Tar Heroin — San Diego County, California, 2017–2018

Jose Alvarez
Communications Specialist
County Communications Office
County of San Diego, 1600 Pacific Highway, Suite 208, San Diego CA 92101
Desk: (619) 515-6635
Cell: (619) 964-1526

Wound botulism disease is a rare but serious disease related to black tar heroin use. It is likely underdiagnosed among heroin users because the symptoms appear similar to opioid intoxication, overdose, and other neurologic syndromes. Increased heroin use is tied to the national opioid abuse epidemic. Typically, one case of wound botulism is reported in San Diego County annually. However, an outbreak of nine cases of wound botulism was reported in San Diego County in nine months (Sept. 2017 through May 2018). Symptoms of the disease include blurred or double vision, drooping eyelids, slurred speech, difficulty breathing or swallowing, and muscle weakness or paralysis. Prompt treatment with botulism antitoxin can save lives. Wound botulism is a rare but serious illness most often caused by contaminated black tar heroin. As opioid misuse increases, more awareness is needed on the risks and symptoms of wound botulism.

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Formal Publication of December 21 Early Release:

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Page last reviewed: January 4, 2019