MMWR News Synopsis

Screening for Lung Cancer — 10 States, 2017

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Many adults who meet the criteria to be screened for lung cancer do not report receiving recommended screening. Efforts to educate health care providers and patients might increase appropriate lung cancer screening. Lung cancer is the leading cause of cancer death in the United States. Treatment for lung cancer can be more effective if the cancer is identified at an early stage. This study found that 87.5% of adults who met screening criteria reported not receiving a CT scan to check for lung cancer in the last 12 months. Annual lung cancer screening is recommended for adults age 55-80 years old who currently smoke now or those who have quit within the past 15 years and have a 30 pack-year smoking history. A pack-year is smoking an average of one pack of cigarettes per day for one year.

Fatal Case of Legionnaires’ Disease After Home Exposure to Legionella pneumophila Serogroup 3 — Wisconsin, 2018

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The case described in this report highlights the potential for people at risk for Legionnaires’ disease (such as those with a weakened immune system or chronic lung disease or current/ former smokers) to be exposed to Legionella through home water systems containing the bacteria. It demonstrates the difficulty of removing the bacteria from residential settings. A 2018 investigation conducted by the Wisconsin Department of Health Services, Division of Public Health and staff at a Wisconsin hospital revealed that a Wisconsin resident who died from a case of Legionnaires’ disease that year had acquired the infection from water sources in his/her own home. The patient was immunocompromised, which put him/her at higher risk of contracting the disease. After the identification of Legionella pneumophila in the home, the water heater and water fixtures were cleaned with hot water, chlorine, and vinegar. However, several cultures tested positive for Legionella pneumophila after these efforts, indicating that the bacteria remained in the home’s water system. Evidence regarding the burden of home-associated Legionnaires’ disease and the usefulness and feasibility of testing and remediation in residential settings is limited. Increased efforts to understand the burden and risk associated with residential settings could help inform prevention guidance.

Expansion of HIV Preexposure Prophylaxis to 35 PEPFAR-Supported Early Program Adopters, October 2016–September 2018

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When taken daily, pre-exposure prophylaxis (PrEP) reduces the risk of acquiring HIV. PrEP is an important tool for preventing HIV among key populations or people at substantial risk for HIV infection, including female sex workers, men who have sex with men, transgender women, and people who inject drugs. Pre-exposure prophylaxis (PrEP) is an essential tool in HIV prevention and treatment programs because, when taken daily, it reduces the risk of acquiring HIV. An analysis of implementation and scale-up of PrEP programming among key populations (female sex workers, men who have sex with men, transgender women, and persons who inject drugs) across 35 PEPFAR-supported countries and regions reveals an increase in the number of clients taking PrEP. The report also highlights critical factors to successful PrEP implementation in six “early adopter” programs. Key factors include active engagement by community advocates, governments, and other partners; including PrEP services in national treatment and prevention guidelines; standardized, routine provider training; and the ability of governments to procure PrEP.

Update: Public Health Response to the Coronavirus Disease 2019 Outbreak — United States, February 24, 2020

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• Syndromic Surveillance Used To Monitor Emergency Department Visits During a Synthetic Cannabinoid Overdose Outbreak — Connecticut, August 2018

Tracking the symptoms of patients who go to emergency departments — also known as syndromic surveillance — can serve as a near-real-time early warning system for emerging public health concerns and can also be used to improve public health authorities’ situational awareness about suspected drug overdoses. In 2018, the Connecticut Department of Public Health was able to use syndromic surveillance to rapidly determine the magnitude of an outbreak of synthetic cannabinoid overdoses and provide timely information to state and local health departments. On the morning of August 15, 2018, the Connecticut Department of Public Health (CTDPH) learned from media reports about multiple people found unresponsive in a city park in New Haven County after using synthetic cannabinoids (SCs), manmade psychoactive substances that can cause unpredictable and sometimes severe health effects. Within 20 minutes of receiving the first media report, CTDPH developed a syndrome definition to identify emergency department (ED) visits for suspected SC overdoses and, by midday, 25 suspected outbreak-related ED visits were identified. By 5 p.m. the next day, the number had increased to 55, all in New Haven County. After the outbreak, additional analyses identified 72 outbreak-related ED visits for suspected SC overdose. The U.S. Drug Enforcement Agency determined that SCs implicated in this outbreak contained a substance called AMB-FUBINACA. Since this outbreak, CTDPH created additional syndrome definitions to help detect future drug overdose-related events and developed additional tools to facilitate near real-time data analysis.

• Percentage of Children Aged <18 Years Who Received a Well-Child Checkup in the Past 12 Months, by Age Group and Year — National Health Interview Survey, United States, 2008 and 2018

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