MMWR Clinical Pearls

January 2024

Think Horses First

COVID-19 Rebound

A review of studies and one additional randomized controlled trial found that COVID-19 rebound is mild and occurred at similar rates after taking, and not taking, antivirals (e.g. nirmatrelvir/ritonavir (Paxlovid). COVID-19 rebound can occur with or without anti-viral treatment so clinicians should not be deterred from prescribing antiviral treatments in eligible patients.

Don’t Forget Zebras

Mpox

Mpox in the U.S. is usually transmitted by sexual contact. An evaluation of people with nonsexual contact with mpox cases found 10 of 662 (1.5%) experienced mpox symptoms within 21 days of exposure. Nonsexual contacts of patients with mpox should be educated about prevention methods and steps to take if they experience signs or symptoms after exposure.

Opportunities to Improve Clinical Outcomes

Firearm Deaths

About 75% of firearms involved in unintentional injury deaths of children and teens were stored loaded and unlocked and were commonly accessed from nightstands and other sleeping areas. Clinicians can partner with parents and caregivers to promote secure firearm storage.

TB

An infant died of TB disease who was born to a mother who had undiagnosed TB disease during pregnancy. Prenatal care clinicians and fertility specialists should consider TB evaluations for patients with genitourinary symptoms, including infertility, especially in those with TB risk factors, such as being born in or traveling to countries where TB disease is common.

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