MMWR News Synopsis

Friday, June 19, 2020

Heat-Related Deaths — United States, 2004–2018

CDC Media Relations

Deaths due to natural heat exposure represent a continuing public health concern in the United States. From 2004 through 2018, an average 702 heat-related deaths occurred in the United States each year. Natural heat exposure was also a contributing cause for deaths due to certain chronic medical conditions and other external causes, including alcohol poisoning and drug overdoses. Understanding patterns in heat-related deaths, based on underlying chronic disease and age/gender characteristics, could assist CDC and its public health partners in developing evidence-based surveillance and intervention strategies. Preparedness and response initiatives that limit heat exposure during periods of extreme heat can help reduce the number of heat-related deaths.

Detection of Ciprofloxacin-Resistant, β-Lactamase–Producing Neisseria meningitidis Serogroup Y Isolates — United States, 2019–2020

CDC Media Relations

A novel, antibiotic-resistant strain of Neisseria meningitidis bacteria, which cause meningococcal disease, has been detected in the United States. Meningococcal disease is a life-threatening illness requiring prompt antibiotic treatment for patients and antibiotic prophylaxis for their close contacts. Resistance to the antibiotics used for meningococcal disease treatment and prophylaxis, including penicillin and ciprofloxacin, has been rare in the United States. However, 11 meningococcal disease cases reported in the United States during 2019–2020 had serogroup Y isolates containing a gene associated with penicillin resistance and a mutation associated with ciprofloxacin resistance. An additional 22 cases reported during 2013–2020 contained the gene associated with penicillin resistance. Clinicians should determine if their patient’s meningococcal infection can be successfully treated with penicillin before using penicillin or ampicillin for treatment. In states experiencing these resistant cases of meningococcal disease, clinicians should consider testing which antibiotics will work to determine the best one for prophylaxis. However, susceptibility testing should not delay administering prophylaxis.

Outbreak of Severe Hypoglycemia After Ingestion of a Male Enhancement Supplement — Virginia, August–November 2019

Full Name: John W. Downs MD MPH
Title: Fellow in Medical Toxicology, Virginia Poison Center, Virginia Commonwealth University Health System
Office Phone: 804-628-2514
Cell Phone: 703-655-5801
Email Address:

Consumers who purchase and use over-the-counter male enhancement supplements are at risk for life-threatening complications due to undeclared prescription ingredients. Consumers may believe that any product sold over the counter has been approved by the Food and Drug Administration (FDA) for purchase, but this is often not the case. Over-the-counter medications for male sexual enhancement are often sold as dietary supplements, but may contain undeclared prescription drugs such as sildenafil, the active ingredient in Viagra.  These medications can have life-threatening effects. A recent outbreak of severe hypoglycemia (low blood sugar) in Virginia was found to be due to undeclared glyburide, a medication for the treatment of diabetes. Actions taken by the Virginia Department of Health and Department of Agriculture and Consumer Services helped to remove the product from the market and protect the public.

Progress Toward Rubella Elimination — Western Pacific Region, 2000–2019

CDC Media Relations

While rubella cases in the Western Pacific Region reached a low of 2.1 cases per million population in 2017, outbreaks in China and Japan in 2018-2019 resulted in the regional incidence rising to 18.4 cases per million in 2019, a resurgence driven by transmission among unvaccinated young adults and men age 30-55. In the WHO Western Pacific Region (WPR), introduction and vaccination with rubella-containing vaccine improved significantly during 2000–2019 with coverage rising from 11% to 96%. Since 1970, more than 84 million people in WPR were vaccinated through supplemental activities in 27 countries. While rubella cases reached a low of 2.1 cases per million population in 2017, outbreaks in China and Japan in 2018–2019 resulted in the regional incidence rising to 18.4 cases per million in 2019, a resurgence driven by transmission among unvaccinated young adults and men aged 30-55, which spilled over into other genders and ages, including pregnant women. Rubella is preventable through vaccination, but infection of an unprotected woman during pregnancy can cause miscarriage, fetal death, and a set of birth defects known as congenital rubella syndrome.

Public Attitudes, Behaviors, and Beliefs Related to COVID-19, Stay-at-Home Orders, Nonessential Business Closures, and Public Health Guidance — United States, New York City, and Los Angeles, May 5–12, 2020 (Early release June 12, 2020)

Coronavirus Disease 2019 Case Surveillance — United States, January 22–May 30, 2020 (Early release June 15, 2020)



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: June 17, 2020