MMWR News Synopsis for November 2, 2017

Incidence of End-Stage Renal Disease Attributed to Diabetes Among Persons with Diagnosed Diabetes — United States and Puerto Rico, 2000–2014

CDC Media Relations
404-639-3286

Most people with kidney disease are unaware of their condition. Diabetes and high blood pressure are major risk factors for kidney disease and kidney failure. Early detection and better management of kidney disease in people with diabetes can slow progression to kidney failure and improve health outcomes. In adults with diabetes, effective interventions to improve blood sugar and blood pressure control might prevent or delay the onset of kidney disease. Kidney failure treated with dialysis or a kidney transplant is called end-stage renal disease (ESRD). ESRD is a costly and disabling condition often resulting in premature death. However, during 2000–2014, kidney failure from diabetes among U.S. adults with diabetes decreased by 33 percent, and it declined significantly in most states, the District of Columbia, and Puerto Rico. No state experienced an increase in kidney failure from diabetes. Continued awareness and interventions to reduce risk factors for kidney failure, improve diabetes care, and prevent type 2 diabetes might sustain these positive trends.

Vaccination Coverage Among Children Aged 19–35 Months — United States, 2016

CDC Media Relations
404-639-3286

CDC encourages parents to protect their children from vaccine-preventable diseases by ensuring their children receive all recommended vaccines on schedule. Vaccination is the best way to reduce illness and death from vaccine-preventable diseases in young children. Data from the 2016 National Immunization Survey-Child (NIS-Child) were used to assess vaccination coverage with recommended vaccines among children aged 19–35 months in the United States. Based on the data, coverage with recommended vaccines for children aged 19–35 months continues to be high and stable, but remains below 90 percent for vaccines that require booster doses during the second year of life and for more recently recommended vaccines. Differences in coverage by race/ethnicity, poverty status, and insurance status indicate that improvements are needed in the immunization safety net (that is, access to and delivery of age-appropriate immunization to all children, regardless of insurance or financial status).

Progress in Childhood Vaccination Data in Immunization Information Systems — United States, 2013–2016

CDC Media Relations
404-639-3286

Incremental progress in four Immunization Information System (IIS) priority areas was noted since 2013, but continued effort is needed to implement these critical functionalities among all IISs. IISs are computerized, population-based systems that consolidate vaccination data from providers for clinical and public health use. Data from 2013–2016 were analyzed to assess progress made in four priority areas: 1) pediatric data completeness, 2) bidirectional data exchange with electronic health records, 3) pediatric clinical decision support for immunizations, and 4) ability to generate jurisdictional and provider-level vaccination coverage estimates. Progress was noted since 2013, but continued effort is needed to implement these functionalities among all IISs. Success in these priority areas bolsters public health practitioners’ ability to attain high childhood vaccination coverage and prepares IISs to develop more advanced functionalities. Success also supports the achievement of federal immunization objectives, including using IISs as supplemental sampling frames for vaccination coverage surveys.

Harmful Algal Bloom–Associated Illnesses in Humans and Dogs Identified Through a Pilot Surveillance System — New York, 2015

Gary Holmes
New York State Health Department
518-402-7650

People should not swim or recreate in water that have visible harmful algal blooms (HABs). This is consistent with the New York State recreational guidance, which has a “know it, avoid it, report it “message. In 2015, the New York State Department of Health (NYSDOH) implemented a pilot surveillance system for HAB-associated illnesses in 16 New York counties. Activities included the collection of HAB reports; illness reports; poison control center data; syndromic surveillance data; and increased outreach to the public, health care providers, and veterinarians. A total of 51 illnesses were reported, including 35 HAB-associated illness reports that met the CDC case definition; 32 occurred in humans and three in dogs. Despite focusing only on a subset of New York counties, this pilot surveillance project led to a fivefold increase in annual reporting, suggesting that HAB-associated illnesses might be more widespread than previously recognized. Lack of active surveillance probably results in an underestimation of adverse health effects caused from algal blooms.

Update on Vaccine-Derived Polioviruses — Worldwide, January 2016–June 2017

CDC Media Relations
404-639-3286

Vaccine-derived polioviruses will continue to cause rare outbreaks and infect individuals with immune deficiencies until all use of oral poliovirus vaccine can cease after wild poliovirus transmission is eradicated. Vaccine-derived polioviruses (VDPVs) are strains genetically divergent from the oral poliovirus vaccine (OPV) that fall into three categories: 1) circulating VDPVs (cVDPVs) from outbreaks, 2) immunodeficiency-associated VDPVs (iVDPVs) from patients with primary immunodeficiencies, and 3) ambiguous VDPVs (aVDPVs) that cannot be more definitively identified. During January 2016–June 2017, new cVDPV outbreaks were identified in the Democratic Republic of the Congo and Syria, and residual cVDPV2 circulation was detected in Nigeria and Pakistan. Fourteen newly identified persons in 10 countries were found to excrete iVDPVs. Because >94 percent of cVDPVs since 2006 and 69 percent of iVDPVs since OPV introduction are type 2, WHO coordinated worldwide replacement of trivalent OPV with bivalent OPV (types 1 and 3) in April 2016.

Implementation of Rotavirus Surveillance and Vaccine Introduction — World Health Organization African Region Countries, 2007–2016

CDC Media Relations
404-639-3286

Rotavirus vaccines have been rapidly implemented in the majority of countries in the WHO African region and their use has resulted in substantial declines in the burden of severe rotavirus disease. Rotavirus is a leading cause of severe childhood diarrhea globally, estimated to have caused 120,000 deaths among children ages <5 years in sub-Saharan Africa in 2013. In 2009, the World Health Organization (WHO) recommended routine rotavirus vaccination of all children worldwide. As of December 2016, 31 of 47 (66 percent) countries in the WHO African Region had introduced rotavirus vaccination into their national schedules, with an overall coverage of 77 percent for a full vaccine series. In 12 countries with available data before and after rotavirus vaccine introduction, the proportion of childhood diarrhea hospitalizations that were rotavirus-positive declined 33 percent, from 39 percent to 26 percent. These results support introduction of rotavirus vaccine in the remaining countries in the region and continuation of rotavirus surveillance to monitor impact.

Notes from the Field:

• None

Quick Stats:

• Age-Adjusted Percentage of Adults Aged ≥45 Years Who Were Limited in Any Way Because of Difficulty Remembering or Periods of Confusion, by Race/Ethnicity — United States, 2014–2016

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