MMWR News Synopsis

Friday, November 8, 2019

Vital Signs: Estimated Proportion of Adult Health Problems Attributable to Adverse Childhood Experiences and Implications for Prevention — 25 States, 2015–2017


Lung Cancer Incidence in Metropolitan and Nonmetropolitan Counties — United States, 2007–2016

CDC Media Relations

Increased use of proven population-based lung cancer prevention and control strategies, particularly among men and women living in nonmetropolitan areas, might help to reduce disparities in the decline of lung cancer incidence. A new CDC study found that while lung cancer incidence rates decreased overall during the 10-year period from 2007–2016, the rate of decline differed in certain groups. Rates decreased more in nonmetropolitan than metropolitan counties; more among males than females; and more among middle-aged adults than older adults. The smallest decrease occurred among females living in nonmetropolitan counties. Accelerating use of proven strategies to reduce exposure to lung cancer risk factors, particularly among females living in nonmetropolitan areas, might prevent lung cancer and decrease disparities. Additionally, public health programs focused on cancer survivorship can reduce lung cancer stigma by educating the public and addressing lung cancer survivor’s needs.

Vital Signs: Estimated Proportion of Adult Health Problems Attributable to Adverse Childhood Experiences and Implications for Prevention — 25 States, 2015–2017

Surveillance Summaries

Rural Americans are dying more frequently from preventable cancers, heart disease, unintentional injuries, chronic lower respiratory disease, and strokes than do their urban counterparts. Potentially preventable deaths from the five leading causes of death occurred more often among people in the most rural counties than in the most urban counties during 2010–2017. The gap in the percentages of preventable deaths between rural and urban counties widened over the eight-year study period for cancer, heart disease, and chronic lower respiratory disease. This gap remained relatively stable for stroke and decreased for unintentional injuries. However, the decrease in the gap for unintentional injuries occurred because preventable deaths in urban areas have risen sharply, in large part due to the opioid crisis. Prevention efforts must be prioritized to reduce risks that tend to be higher among Americans living in rural areas, such as cigarette smoking and obesity.

Notes from the Field

Health care personnel at a West Virginia hospital reported skin, eye, and upper respiratory symptoms possibly from a common exposure related to construction activities. The hospital conducted an extensive investigation, but no source was identified and the symptoms subsided. From November 8 to December 25, 2017, health care personnel at a West Virginia hospital reported unexplained symptoms to the hospital’s management and occupational health clinic. Symptoms included nasal congestion, rash, itchy eyes, coughing, and wheezing, prompting concern about a common exposure possibly related to construction activities. Affected staff members often reported improvement hours to days after leaving the hospital, suggesting a potential exposure to an environmental irritant. No hospital patients were affected, and no cause of the symptoms was identified by environmental sampling. CDC investigators found that from November 1, 2017 toJanuary 12, 2018, 114 people reported to the occupational health clinic with some reporting multiple times.

Two cases of botulism, a potentially fatal illness, highlight the risk associated with consuming uneviscerated, salt-cured fish and the importance of early recognition and treatment of botulism. Consuming uneviscerated (organs not removed) salt-cured fish can lead to botulism, a severe paralytic illness caused by botulinum toxin. In October 2018, a mother age 55 years and her daughter age 30 years were admitted to a New Jersey hospital with severe abdominal pain, vomiting, and diarrhea. Botulism was suspected after both women reported recently eating fesikh, a traditional Egyptian dish of uneviscerated mullet fish that is fermented and salt-cured. Fesikh has been previously linked to foodborne botulism outbreaks. After consultation with CDC, both patients were administered heptavalent botulism antitoxin and symptoms improved. These cases illustrate the importance of early recognition and treatment of botulism, which can be fatal if not treated promptly, and the risk of severe illness from uneviscerated, salt-cured fish dishes.



CDC works 24/7 protecting America’s health, safety and security. Whether diseases start at home or abroad, are curable or preventable, chronic or acute, or from human activity or deliberate attack, CDC responds to America’s most pressing health threats. CDC is headquartered in Atlanta and has experts located throughout the United States and the world.

Page last reviewed: November 7, 2019