MMWR News Synopsis
Friday, August 28, 2020
- Nonfatal Drug and Polydrug Overdoses Treated in Emergency Departments — 29 States, 2018–2019
- Support for Transition from Adolescent to Adult Health Care Among Adolescents With and Without Mental, Behavioral, and Developmental Disorders — United States, 2016–2017
- Progress Toward Hepatitis B and Hepatitis C Elimination by Using a Catalytic Funding Model — Tashkent, Uzbekistan, December 6, 2019–March 15, 2020
- COVID-19 Among American Indian and Alaska Native Persons — 23 States, January 31–July 3, 2020 (Early release August 19, 2020)
- Limited Secondary Transmission of SARS-CoV-2 in Child Care Programs — Rhode Island, June 1–July 31, 2020 (Early release August 21, 2020)
- Primary Indicators to Systematically Monitor COVID-19 Mitigation and Response — Kentucky, May 19–July 15, 2020 (Early release, August 25, 2020)
- Notes from the Field
CDC Media Relations
This analysis examined suspected nonfatal drug overdoses treated in emergency departments (EDs) from 2018-2019 in 29 states. Rates increased for suspected overdoses involving opioids, cocaine, amphetamines, and both opioids and amphetamines. These increases in overdose rates underscore the need for continued surveillance and timely interventions to prevent repeat overdoses, including opportunities to link persons to care and treatment options. From 2018–2019, rates of suspected nonfatal drug overdoses treated in EDs involving opioids, cocaine, and amphetamines increased 9.7%, 11.0%, and 18.3%, respectively. Rates of suspected overdoses involving both opioids and amphetamines increased 37.3%. Opioids were involved in 40.2% of all nonfatal drug overdoses treated in the ED in 2019. Additionally, 23.6% of overdoses involving cocaine, 17.1% of amphetamines, and 18.7% of benzodiazepines also involved opioids. These findings highlight the importance of continued surveillance and expanded prevention, treatment, and response efforts. This includes linkage to treatment; harm reduction services and community-based programs for people who use drugs; expanding overdose prevention efforts, including increased naloxone provision, to people who use stimulants; addressing the illicit drug supply; and identifying specific risk factors for populations using these drugs.
Support for Transition from Adolescent to Adult Health Care Among Adolescents With and Without Mental, Behavioral, and Developmental Disorders — United States, 2016–2017
CDC Media Relations
This report found that only 1 in 6 adolescents with mental, behavioral, or developmental disorders (MBDD) received the recommended support from their health care provider to help them transition from pediatric health care to adult health care. Using parent-reported data from the 2016 and 2017 National Survey of Children’s Health (NSCH), this study found that most adolescents did not receive the recommended transition planning from their healthcare team to assist with the switch from pediatric to adult health care providers. Only about 1 in 6 adolescents (aged 12–17 years) with MBDDs received the recommended transition planning. Adolescents with depression and anxiety were more likely than their peers without MBDDs to receive transition planning, whereas adolescents with some developmental disorders, such as autism spectrum disorder (ASD) and developmental delay, were less likely than their peers without MBDDs to receive the recommended transition planning. The American Academy of Pediatrics recommends transition planning for all adolescents starting at age 12 years that includes the healthcare provider speaking with the adolescent separate from family members, discussing the transition to adult care, and helping adolescents build skills so they can take charge of their own care.
Progress Toward Hepatitis B and Hepatitis C Elimination by Using a Catalytic Funding Model — Tashkent, Uzbekistan, December 6, 2019–March 15, 2020
CDC Media Relations
Viral Hepatitis is a deadly disease responsible for over 1 million deaths per year. The World Health Organization (WHO) has set hepatitis elimination targets of 90% reduction in incidence and 65% reduction in mortality worldwide by 2030. The main barrier to achieving elimination is funding, particularly for low and middle-income countries, but innovative financing models may be able to overcome that challenge and achieve elimination. Hepatitis is one of the most ubiquitous and deadly infectious diseases globally, with over 300 million people actively infected with Hepatitis B or Hepatitis C, resulting in approximately 1.3 million deaths per year – 1 person every 24 seconds. Most of these deaths are preventable through vaccines and treatments for Hepatitis B and curative therapies for Hepatitis C. The World Health Organization has set targets to eliminate hepatitis by 2030, but the main barrier to achieving these targets is funding for testing and treatment, particularly for low and middle-income countries. With traditional funding sources unavailable, countries must develop innovative financing mechanisms to achieve elimination. In December 2019 the Center for Disease Analysis Foundation initiated a pilot program to test an innovative funding mechanism for financing HBV and HCV elimination programs, especially among low- and middle-income countries. Catalytic funding is a mechanism by which the total cost of a program is paid for by multiple funding sources but is begun with upfront capital that is significantly less than the total program cost. In this model, upfront costs are covered by a relatively small catalytic investment. Ongoing costs, including those for testing and treatment, are covered by payments from 80% of the enrolled patients, who purchase medications at a small premium that subsidizes the 20% who cannot afford treatment and so receive free medication.
COVID-19 Among American Indian and Alaska Native Persons — 23 States, January 31–July 3, 2020 (Early release August 19, 2020)
CDC Media Relations
Limited Secondary Transmission of SARS-CoV-2 in Child Care Programs — Rhode Island, June 1–July 31, 2020 (Early release August 21, 2020)
CDC Media Relations
Primary Indicators to Systematically Monitor COVID-19 Mitigation and Response — Kentucky, May 19–July 15, 2020 (Early release, August 25, 2020)
CDC Media Relations
- Universal Statewide Laboratory Testing for SARS-CoV-2 in Nursing Homes — West Virginia, April 21–May 8, 2020
Although universal testing for SARS-CoV-2 is resource intensive, it has proven essential to slowing the spread of COVID-19 in nursing homes and decreased the impact of the pandemic on this higher-risk population in West Virginia. During March 17–April 16, 2020, seven nursing homes in West Virginia reported 307 COVID-19 cases among both residents and staff members. Four facilities reported outbreaks involving 20–40 residents. On April 17, the governor of West Virginia issued an executive order directing the West Virginia Bureau for Public Health (WVBPH) to coordinate testing all residents and staff of all 123 West Virginia nursing homes for COVID-19, regardless of symptoms. Before this executive order, residents and staff were tested only if they showed symptoms. Universal testing identified a small number of new cases and outbreaks and likely prevented ongoing spread and larger outbreaks. Following universal testing, nursing homes screened staff members and residents daily and tested anyone with signs or symptoms of COVID-19. The testing likely prevented the occurrence of ongoing transmission and larger outbreaks, had the asymptomatic infections gone undetected.
- Candida auris and Carbapenemase-Producing Organism Prevalence in a Pediatric Hospital Providing Long-Term Transitional Care — Chicago, Illinois, 2019
Candida auris and carbapenemase-producing organisms (CPO), two germs with known drug-resistance, are common among patients in adult long-term acute-care hospitals (LTACHs) in the Chicago region. A survey conducted by the Chicago Department of Public Health did not identify C. auris and only rarely identified CPO among children in a similar pediatric hospital in the region. Although the prevalence of C. auris colonization among adults is well characterized, prevalence has not been described among pediatric populations in Chicago, and limited data exist on CPO colonization among children outside of intensive care units (ICUs). To assess C. auris and CPO colonization among children, the Chicago Department of Public Health conducted a point prevalence survey in a 49-bed pediatric hospital providing long-term transitional care from pediatric ICUs. This survey did not identify any colonizations with C. auris and found that CPOs were rare at this pediatric hospital. Because this survey includes only one facility in a region, additional evaluations in similar pediatric health care settings should be conducted to improve understanding of C. auris and CPO prevalence among this population.
- CDC Polio Surge Response to Expanding Outbreaks of Type 2 Circulating Vaccine-Derived Poliovirus — Africa and Philippines, September 2019–March 2020
In response to increasing outbreaks of type 2 circulating vaccine-derived poliovirus, CDC expanded in-country technical assistance in September of 2019 and deployed a total of 108 responders to 13 countries over 6 months. Despite substantial progress toward polio eradication made over the last decade, outbreaks of type 2 circulating vaccine-derived poliovirus have recently been steadily increasing. As of August 2, 2020, there have already been 236 cases worldwide, compared to 358 and 71 cases globally in all of 2019 and 2018, respectively. In response to the spike in 2019, CDC’s Emergency Operations Center stood up the Polio Surge in September 2019 sending 108 trained deployers to 13 countries with active outbreaks or those at high risk in the African region and the Philippines. The onset of the COVID-19 pandemic in March 2020 required that all deployers return home early. When CDC travel restrictions are lifted, polio surge deployments can resume to provide critical technical field support.
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