MMWR News Synopsis for October 26, 2017

Timeliness of Receipt of Early Childhood Vaccinations Among Children of Immigrants — Minnesota, 2016

Doug Schultz
Minnesota Department of Health
651-201-4993
doug.schultz@state.mn.us

This study demonstrates vaccination disparities between children with U.S.-born parents and children with immigrant parents, as well as disparities by mother’s country of birth. Additional studies are needed to identify barriers to vaccination faced by groups with lower vaccination coverage and to inform the development of effective strategies to address these barriers. This study used data from the Minnesota Immunization Information Connection (MIIC) and the Office of Vital Records to measure childhood vaccination coverage and examine coverage differences across selected demographic characteristics at ages 2, 6, 18, and 36 months for children born in Minnesota in 2011 and 2012. Coverage levels were higher for children with two U.S.-born parents compared with children having at least one foreign-born parent at all four ages. When children were divided into groups by mother’s country of birth, some groups were vaccinated at higher rates than were children of U.S.-born mothers (Mexico, Central and South America), and others at much lower rates (Somalia, Eastern Europe). Outreach to groups with lower vaccination rates may be needed to improve vaccination coverage in young children.

Tobacco Use Among Working Adults — United States, 2014–2016

CDC Media Relations
404-639-3286

Proven interventions to prevent and reduce tobacco-product use, particularly current use of multiple products, are critical for working adults. An estimated 32.7 million (22.1 percent) working American adults are currently using some form of tobacco product. Among these tobacco users, 6.9 million currently use two or more types of tobacco products. Tobacco use varied by type of product used, with 15.4 percent using cigarettes, 5.8 percent using other combustible tobacco products (cigars, pipes, water pipes/hookahs, very small cigars, or bidis), 3.6 percent using electronic cigarettes, and 3.0 percent using smokeless tobacco. The use of any tobacco product was higher among males; non-Hispanic whites; people ages 18–24 years; people with no health insurance; and among workers in the construction industry and in the installation, maintenance, and repair occupation. Use of multiple tobacco products was highest among working adults in the accommodation and food services industry and in installation, maintenance, and repair occupations.

Increased Risk for Mother-to-Infant Transmission of Hepatitis C Virus Among Medicaid Recipients ― Wisconsin, 2011–2015

Theresa Watts
University of Wisconsin
631-494-9432
twatts@wisc.edu

Health care providers can protect babies from hepatitis C virus (HCV) infections by testing for, treating, and curing HCV infection among women of childbearing age. Practices for HCV screening of pregnant women and babies born to HCV-infected mothers should be improved to prevent serious but preventable complications among mothers and babies. Increasing injection drug use, suspected to be linked with America’s growing opioid epidemic, has led to rapid increases of new HCV infections among young adults. The rise in new HCV infections among young adults could affect the next generation when the virus is passed from mothers to babies. About 6 percent of babies born to HCV-infected mothers will get the virus. Trends in HCV infection during pregnancy and infant testing were estimated using Wisconsin Medicaid and Public Health Surveillance data. Between 2011 and 2015, among the Wisconsin Medicaid population, the proportion of women who had HCV infection during pregnancy increased 93 percent, from 2.7 to 5.2 per 1,000 births. Of the babies born to women with HCV infection, only 34 percent were tested for HCV per CDC recommendations.

Rapid Field Response to a Cluster of Illnesses and Deaths — Sinoe County, Liberia, April–May, 2017

CDC Media Relations
404-639-3286

The rapid detection and control of the meningococcal disease outbreak in Liberia demonstrates how post-Ebola improvements in public health capacities are contributing to global health security. In April 2017, Liberia’s Ministry of Health reported a cluster of illnesses and deaths from an unknown cause. Within 24 hours, a response was initiated to identify cases, monitor at-risk persons, and prevent additional illnesses. During the 2014 Ebola epidemic, it took the country more than 90 days to coordinate a response. This significant decrease in response time reflects capabilities established during and after Ebola with CDC and partner support. Enhanced in-country laboratory capacity contributed to rapid diagnosis, ruling out Ebola in less than 24 hours, while effective case management and supportive treatment increased survival among patients even before the confirmation of meningococcal disease as the cause. CDC-supported efforts toward strengthening global health security led to effective management and control of this outbreak.

Rapid Laboratory Identification of Neisseria meningitidis Serogroup C as the Cause of an Outbreak — Liberia, 2017

CDC Media Relations
404-639-3286

Rapid laboratory detection and response allowed a cluster of unexplained illness, initially suspected to be Ebola virus disease, to be identified as serogroup C meningococcal disease. This was an unusual outbreak of serogroup C meningococcal disease in a country that typically does not report meningitis outbreaks and that is not in the African meningitis belt. Prompt and accurate detection of outbreaks allows public health officials to respond quickly and implement appropriate control measures. In April 2017, an unexplained cluster of 31 cases and 13 deaths surrounding a funeral was reported in Liberia. Initially suspected as Ebola virus disease in this previously affected country, rapid laboratory detection and response from CDC identified Neisseria meningitidis serogroup C as the cause of the outbreak. This bacterium causes meningococcal disease, which includes meningitis and bloodstream infections. Laboratory confirmation helped Liberian health authorities administer antibiotic prophylaxis to more than 200 people in order to prevent secondary cases of this deadly disease. This was an unusual presentation of serogroup C meningococcal disease with a high case-fatality rate, high prevalence of gastrointestinal symptoms, and low prevalence of fever. This extremely unusual meningococcal disease outbreak in Liberia, a country not in the African meningitis belt, highlights the importance of rapid laboratory confirmation in an outbreak investigation.

Progress Toward Regional Measles Elimination — Worldwide, 2000–2016

CDC Media Relations
404-639-3286

For the first time, there were fewer than 100,000 annual estimated measles deaths in 2016 due to stable measles-containing vaccine (MCV1) coverage, increasing second-dose (MCV2) coverage, and measles vaccination campaigns. Vaccination efforts need to be strengthened in order to reduce these preventable deaths to zero. During 2000–2016, measles vaccination prevented an estimated 20.4 million deaths worldwide. The number of countries providing the second dose of measles-containing vaccine through routine immunization services increased to 85 percent; in 2016, global MCV2 coverage was 64 percent. Also during 2000-2016, annual reported measles cases decreased 87 percent and annual measles deaths decreased 84 percent. Despite advances, the WHO 2015 milestones haven’t been met. Only one WHO region, the Americas, has been declared free of measles. To eliminate measles, countries and their partners need to focus on increasing vaccination coverage through sustained investments in health systems, strengthening surveillance systems, using surveillance data to drive programmatic actions, securing political commitment, raising the visibility of measles elimination goals, and mitigating the threat of decreasing resources once polio eradication is achieved.

Notes from the Field:

• Postexposure Prophylaxis for Rabies After Consumption of a Prepackaged Salad Containing a Bat Carcass — Florida, 2017
• High Volume of Lyme Disease Laboratory Reporting in a Low-Incidence State — Arkansas, 2015–2016
• Postflooding Leptospirosis — Louisiana, 2016

Quick Stats:

• Prevalence of Adults Aged ≥20 Years Who Reported Being Told by a Doctor or Health Professional to Increase Their Physical Activity, by Age Group and Obesity Status — National Health and Nutrition Examination Survey, 2011–2014

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