MMWR News Synopsis for January 11, 2019

Drug Overdose Deaths Among Women Aged 30–64 Years — United States, 1999–2016

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The drug overdose epidemic continues to grow and evolve. From 1999 to 2017, the crude rate of drug overdose deaths among women ages 30–64 years in the United States increased by 260 percent. The rates of overdose deaths increased for all drug categories examined, with a notable increase in rates of deaths involving synthetic opioids (1,643%), heroin (915%), and benzodiazepines (830%). Middle-aged women remain vulnerable to death by drug overdose. CDC examined overdose death rates among women ages 30–64 years during 1999–2017 overall and by drug subcategories. The drug overdose death rate among women ages 30–64 years increased by 260 percent: from 6.7 deaths per 100,000 population (4,314 total drug overdose deaths) in 1999 to 24.3 (18,110 total drug overdose deaths) in 2017. The rates of overdose deaths increased for all drug categories examined, with a notable increase in rates of deaths involving synthetic opioids such as fentanyl (1,643%), heroin (915%), and benzodiazepines (830%).

Evaluation of State-Mandated Reporting of Neonatal Abstinence Syndrome — Six States, 2013–2017

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In six states, mandatory reporting of infants born with neonatal abstinence syndrome (NAS) for public health surveillance improved states’ ability to estimate the number of infants born with NAS and to identify opportunities for opioid-use disorder treatment and prevention for women impacted by the opioid crisis. NAS is a drug withdrawal syndrome that can occur in newborns after in utero exposure to opioids. The latest national data, from 2014, estimate that one baby was born with signs of NAS every 15 minutes in the United States, although rates of NAS vary widely between states. CDC researchers evaluated the impact of laws enacted in six states between 2013 and 2017 that require reporting of all babies born with NAS for public health surveillance. They found that mandated case reporting might improve states’ ability to calculate more timely estimates of the incidence of NAS in their jurisdictions, identify opportunities for prevention, and facilitate linkages to care for mothers and infants.

Emergence of Extensively Drug-Resistant Salmonella Typhi Infections Among Travelers to or from Pakistan — United States, 2016–2018

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All travelers to Pakistan are at risk of getting extensively drug-resistant (XDR) typhoid fever. Travelers to South Asia – including Pakistan, India, and Bangladesh – should take precautions to protect themselves from typhoid fever. Visit your doctor or a travel clinic at least two weeks before travel to discuss your vaccine options, and follow safe food and water guidelines during travel. From 2016 through 2018, typhoid fever was diagnosed in 29 U.S. patients who had recently traveled to Pakistan. Five of these patients were children who had extensively drug-resistant (XDR) Typhi, which can be very difficult to treat. The Salmonella Typhi strain causing this outbreak cannot be successfully treated with most of the antibiotics commonly used to treat typhoid fever. The first known outbreak of XDR typhoid fever began in Pakistan in November 2016 and has spread to multiple districts.

Establishing a Baseline for Cervical Cancer Screening Coverage — India, 2015–2016

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Among women ages 30-49, fewer than one in three Indian women in the age range for screening for cervical cancer reported having been screened. Measuring cervical cancer screening and identifying socioeconomic factors associated with the acceptance of screening can be used to plan targeted interventions, screening campaigns, and evaluation to help India meet the goal of universal cervical cancer screening. Cervical cancer is the second leading cause of new cancer cases among women in India. In 2016, the Ministry of Health and Family Welfare of India recommended population-based cervical cancer screening for all women ages 30-65 years. In 2015-16, for the first time, one of the largest national surveys (over 700,000 women) conducted in India asked reproductive-aged women if they had ever been screened for cervical cancer. Fewer than one in three Indian women (ages 30-49) reported having been screened for cervical cancer. There was substantial geographic variation, and screening rates were higher among women with more education, greater wealth, and who had ever been married.

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Page last reviewed: January 11, 2019