MMWR News Synopsis Template
Friday, March 13, 2020
- Investigation of Presumptive HIV Transmission Associated with Hospitalization Using Nucleotide Sequence Analysis — New York, 2017
- Screening for Alcohol Use and Brief Counseling of Adults — 13 States and the District of Columbia, 2017
- Vital Signs: Colorectal Cancer Screening Test Use — United States, 2018
- Notes from the Field
Investigation of Presumptive HIV Transmission Associated with Hospitalization Using Nucleotide Sequence Analysis — New York, 2017
Office Phone: (518)474-7354, ext 1,
Healthcare associated transmission of HIV is rare in the United States. However, investigations of acute HIV infection in people with recent healthcare exposure and no traditional risk factors should consider whether healthcare-associated transmission likely occurred. Healthcare-associated transmission of HIV is rare in the United States. Adherence to standard precautions, including recommended injection safety measures, can help to prevent spread of bloodborne pathogens, including HIV, in healthcare settings. This report described an investigation of an acute HIV infection in a person without traditional risk factors for HIV who received care in a hospital and several other healthcare settings. In this incident, epidemiologic and nucleotide sequence data provided support for likely healthcare-associated transmission.
Screening for Alcohol Use and Brief Counseling of Adults — 13 States and the District of Columbia, 2017
CDC Media Relations
Use of validated tools to screen all adults for excessive alcohol use – including binge drinking –can help healthcare providers advise adults who drink too much. Advice should include the impact of excessive alcohol use on the patient’s health and helping interested patients take steps to reduce their drinking. Binge drinking increases the risk for injuries, fetal-alcohol-spectrum disorders, and some chronic diseases like breast cancer. This report found that although 81% of US adults in 13 states and the District of Colombia reported being asked by their healthcare provider about alcohol use, only about 38% reported being asked about binge drinking during a routine check-up in the last two years. Binge drinking is five or more drinks on an occasion for men and four or more drinks for women. Among adults who reported being asked about their alcohol use at checkup in the past two years and currently binge drinking, 4 out of 5 patients were not counseled to reduce their drinking at that checkup. Routine alcohol screening and brief counseling has been shown to be effective at reducing binge drinking and is recommended for all adults.
Vital Signs: Colorectal Cancer Screening Test Use — United States, 2018
CDC Media Relations
Colorectal cancer screening is recommended for adults of average risk beginning at age 50. Yet only 1 in 2 adults are up to date with colorectal cancer screening by their early 50s (ages 50–54). People younger than 50 years need to be informed about the benefit of screening so that screening can start promptly at age 50 years. There’s a reason colorectal cancer is the second largest cancer killer in the U.S.: Many people wait too long to get screened. Colorectal cancer is highly preventable, and screening for colorectal cancer is recommended for adults of average risk beginning at age 50. On-time screening can prevent or detect colorectal cancer early when treatment is more effective. Yet only 1 in 2 adults are up to date with colorectal cancer screening by their early 50s (ages 50–54), compared to more than 4 in 5 in their early 70s, according to the latest Vital Signs report by the Centers for Disease Control and Prevention. Many kinds of colorectal cancer screening tests can be done in the clinic or at home. It is important for adults to discuss best and preferred options with their health care provider.
- Opioid-Involved Overdose Deaths with Fentanyl or Fentanyl Analogs Detected — 28 States and the District of Columbia, July 2016–December 2018
Overdose deaths involving the fentanyl analogs carfentanil, furanylfentanyl, acrylfentanyl, and cyclopropylfentanyl declined and contributed to overall declines in opioid-involved overdose deaths during 2018 among a subset of states. However, overdose deaths involving fentanyl increased over time. There are indications that fentanyl analogs may be reemerging, suggesting a continued need to test for fentanyl analogs. Opioid-involved overdose deaths linked to illicitly manufactured fentanyl have rapidly increased since 2013. During July 2016–December 2018, 26,104 opioid overdose deaths were reported in 10 states participating in CDC’s State Unintentional Drug Overdose Reporting System (SUDORS), including 5,803 overdose deaths in which at least one fentanyl analog was detected. The five most commonly detected fentanyl analogs were acetylfentanyl, carfentanil, furanylfentanyl, cyclopropylfentanyl, and acrylfentanyl. The declines in overdose deaths with fentanyl analogs detected, and increases in deaths with fentanyl detected, suggests a shift away from illicit fentanyl analog distribution to distribution of illicitly manufactured fentanyl. Recent reports, however, indicate that some fentanyl analogs might be reemerging. Tracking specific drugs involved in overdose deaths is critical because the risk for overdose for fentanyl and fentanyl analogs varies substantially.
- Carbapenemase-Producing Klebsiella pneumoniae in a Ventilator-Capable Skilled Nursing Facility — Maricopa County, Arizona, July–November 2018
Following CDC infection control recommendations in nursing homes helps prevent the spread of antibiotic-resistant germs among this vulnerable population. This includes washing hands or using hand sanitizer before and after physical contact with nursing home residents and housing residents with the same antibiotic-resistant germ in neighboring rooms so nursing staff are less likely to pass the germ to other residents. Maricopa County Department of Public Health (MCDPH) in Arizona investigated a cluster of two genetically similar antibiotic-resistant bacterial infections in residents of the ventilator-capable unit of a nursing home to look for healthcare-associated bacterial spread. Nursing home staff worked with MCDPH to screen ventilator-capable unit residents for the bacteria. Three residents were colonized with the antibiotic-resistant bacteria, further suggesting healthcare-associated spread. After a facility site visit, MCDPH recommended improvement of hand hygiene practices and housing residents with the antibiotic-resistant bacteria in the same or neighboring rooms to decrease the risk of staff spreading the bacteria to others. Ventilator-capable unit residents were re-screened 8 weeks later. No new residents were colonized with the antibiotic-resistant bacteria, suggesting that the implemented public health recommendations helped to prevent healthcare-associated spread.
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