MMWR News Synopsis for October 19, 2017

Update: Interim Guidance for the Diagnosis, Evaluation and Management of Infants with Possible Congenital Zika Virus Infection — United States, October 2017

CDC Media Relations
404-639-3286

CDC’s updated interim clinical guidance for infants born to mothers with possible Zika virus infection during pregnancy will provide helpful, interpretable information for families and their healthcare providers. The Centers for Disease Control and Prevention (CDC) issued updated interim clinical guidance for health care providers caring for infants born to mothers with possible Zika virus infection during pregnancy. This update includes information that has become available since the August 2016 release of the previous guidance. Zika virus continues to be a public health threat to pregnant women and their infants, although at lower levels than during the recent epidemic in the Americas. The updated guidance is intended to provide helpful, interpretable information for families and their healthcare providers.

HIV Testing, Linkage to HIV Medical Care, and Interviews for Partner Services Among Women — 61 Health Department Jurisdictions, United States, Puerto Rico, and the U.S. Virgin Islands, 2015

CDC Media Relations
404-639-3286

To reduce and eventually eliminate HIV infection among women in the United States, HIV testing programs need to improve early linkage to HIV medical care among HIV-positive women who are not in care – even if it is not the first time they are diagnosed with HIV infection. A new analysis showed that six in 10 women who tested positive for HIV infection via CDC-funded HIV tests had already been diagnosed with HIV infection through a previous test. The vast majority (87 percent) of women who were previously diagnosed were not in HIV medical care at the time of testing, suggesting they were never linked to care or had fallen out of care. Black women were significantly less likely than white women to be linked to HIV medical care within 90 days of the current test. HIV testing is essential – not only to identify new infections, but also to link people with new or previous diagnoses to medical care to achieve viral suppression. To reduce and eventually eliminate HIV infection among women in the United States, HIV testing programs need to improve early linkage to HIV medical care among HIV-positive women who are not in care – even if it is not the first time they are diagnosed with HIV infection.

Tdap Vaccination Coverage During Pregnancy — Selected Sites, United States, 2006–2015

Gina DiGravio
Boston University School of Medicine
617-638-8480
ginad@bu.edu

Tdap vaccination during pregnancy has increased between 2006 and 2017, from <1% in the years before the recommendation to 53% in 2015. However, this coverage is far short of the ACIP recommendation that every woman receive Tdap vaccine during each pregnancy. Since 2012 the Advisory Committee on Immunization Practices has recommended Tdap vaccination during each pregnancy. From 2006 through 2015, Tdap vaccination coverage in pregnant women participating  in the Birth Defects Study of the Slone Epidemiology Center at Boston University increased from <1% before 2010 to 28% in 2013 and reached 53% in 2015. Although Tdap coverage has increased in recent years, Tdap vaccine coverage remains far below the recommendation that every woman be vaccinated during each pregnancy. Increasing vaccination coverage during pregnancy could help reduce the impact of pertussis on infant morbidity and mortality.

Knowledge, Attitudes, and Practices Related to Ebola Virus Disease at the End of a National Epidemic — Guinea, August 2015

CDC Media Relations
404-639-3286

Regional variations in Ebola-related KAP in Guinea, after more than one year of a massive epidemic, reinforce the need for targeted health communication strategies during epidemic response. The findings also highlight the importance of health promotion efforts to prevent sporadic transmission or future outbreaks of Ebola, including messages that aim to address misconceptions about transmission and prevention and to address stigma that survivors might face as they recover from a devastating disease, rebuild their lives, and reintegrate into communities. Efforts to improve the public’s knowledge, attitudes, and practices (KAP) about Ebola Virus Disease (Ebola) were important in controlling the 2014–2016 Ebola epidemic in Guinea, Sierra Leone, and Liberia. A national survey conducted in Guinea in August 2015 found regional variations in Ebola-related KAP.  Results suggest that tailoring health communication by region might be more effective than a uniform, national approach. Most participants understood key aspects of Ebola transmission and prevention and intended to use safer burial practices for relatives with suspected Ebola. However, misconceptions about Ebola transmission were widespread, and many participants expressed concern about being near Ebola survivors.

Reporting Deaths Among Children Aged <5 Years After the Ebola Virus Disease Epidemic — Bombali District, Sierra Leone, 2015–2016

CDC Media Relations
404-639-3286

Child mortality surveillance in settings with limited vital registration can be strengthened by using multiple data sources, which together capture community and facility deaths. Mortality surveillance and national death reporting are limited in Sierra Leone, a country with one of the highest mortality rates in the world among children ages <5 years. To inform efforts to strengthen surveillance of stillbirths and deaths in children ages <5 years, multiple surveillance streams in Bombali Sebora chiefdom were retrospectively reviewed. Analysis of multiple death reporting streams, including the 1-1-7 phone alert system established during the Ebola virus disease outbreak, improved collection of data about deaths among children ages <5 years and stillbirths. Community-based reporting strategies, such as phone alerts, can be implemented in countries with incomplete death registration to supplement vital events records and strengthen child mortality surveillance.

Notes from the Field:

• Counterfeit Percocet–Related Overdose Cluster — Georgia, June 2017

Quick Stats:

• Infant Mortality Rate, by Urbanization Level — National Vital Statistics System, United States, 2007 and 2015

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