MMWR News Synopsis

Patterns and Characteristics of Methamphetamine Use Among Adults — United States, 2015–2018

CDC Media Relations
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In the U.S. during 2015-2018 more than 1.6 million adults, on average, used methamphetamine each year. Among people who used methamphetamine in the past year, 52.9% had a methamphetamine use disorder and 22.3% reported injecting methamphetamine. Substance use and mental illness were common among those who used methamphetamine in the past year. This report uses self-reported data from the 2015-2018 National Surveys on Drug Use and Health (NSDUH) to estimate methamphetamine use rates in the U.S. and to identify characteristics associated with past-year use. Among adults ages 18 years and older in the U.S., an estimated 1.6 million reported methamphetamine use in 2015-2018. Identifying characteristics associated with methamphetamine use provides new insights into populations to prioritize for prevention and response efforts. Substance use and mental illness were common among those who used methamphetamine. Additional efforts to support prevention and response capacity in communities, expand linkages to care for substance use and mental health, and enhance collaborations between public health and public safety are needed to combat rising methamphetamine availability and related health harms.

Nonfatal Violent Workplace Crime Characteristics and Rates by Occupation — United States, 2007–2015

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More than 1 in 5 nonfatal violent crimes reported by people aged 16 years and older occurred in workplaces, with rates varying by occupation and worker characteristic. According to a new NIOSH study, 22% of nonfatal violent crimes reported by people aged 16 years and older occurred in workplaces. Occupations with the highest rates of violent workplace crimes included protective services (e.g., first responders); community and social services; healthcare practitioners and technicians; healthcare support occupations; education, training, and library occupations; and transportation occupations. At work, violent crimes against women were more often committed by people they knew, whereas crimes against men were more often perpetrated by strangers. As a result, violence prevention programs might benefit from having approaches tailored to specific worker groups based on offender-victim relationships. Violence-prevention training should emphasize how employers and workers can recognize and mitigate the risk of violence in the workplace.

Tuberculosis Preventive Treatment Scale-Up Among Antiretroviral Therapy Patients — 16 Countries Supported by the U.S. President’s Emergency Plan for AIDS Relief, 2017–2019

CDC Media Relations
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Tuberculosis preventive treatment (TPT), recommended by the World Health Organization, decreases morbidity and mortality among people living with HIV. The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has committed to providing TPT to all eligible people receiving antiretroviral therapy (ART) by 2021. A recent CDC analysis of data from 16 PEPFAR-supported countries from April 2017 to March 2019 shows substantial improvements in tuberculosis (TB) symptom screening and TB preventive treatment (TPT) implementation among patients receiving ART. During this time, the number of TPT courses initiated per reporting period increased 32%, and completion of TPT increased 56%. Overall, nearly 2 million ART patients started TPT and over 1 million completed the six-month course. These increases are notable considering that in 2017, fewer than 1 million of the estimated 21.3 million ART patients started TPT worldwide. Although there has been progress toward TPT programmatic scale up, reaching global targets across all PEPFAR-supported countries will require high-quality data, reliable estimates of TPT-eligible populations, and identifying and overcoming barriers to TPT initiation and completion.

Genotyping and Subtyping Cryptosporidium To Identify Risk Factors and Transmission Patterns — Nebraska, 2015–2017

Leah Bucco-White
Communications Manager
Office phone: 402-471-9356
Leah.Bucco-White@nebraska.gov

Through the use of DNA fingerprinting, public health officials are able to identify common (and sometimes rare) species and subtypes of Cryptosporidium, a parasite that can cause prolonged watery diarrhea. This information can help identify how a patient became infected, particularly in cases linked to an outbreak. This report highlights the link between childcare facilities and C. hominis cryptosporidiosis cases and the link between C. parvum cryptosporidiosis cases and animals. C. parvum cryptosporidiosis cases occurred more frequently among those living in rural settings. Enhanced public health tracking for cryptosporidiosis is important to increase knowledge about risk factors and transmission patterns, and effectively prevent the spread of this parasite.

COVID-19 in a Long-Term Care Facility — King County, Washington, February 27–March 9, 2020 (Early Release, March 18, 2020)

CDC Media Relations
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Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) — United States, February 12–March 16, 2020 (Early Release March 18, 2020)

CDC Media Relations
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Public Health Responses to COVID-19 Outbreaks on Cruise Ships — Worldwide, February–March 2020 (Early Release March 23, 2020)

CDC Media Relations
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• Early Identification of Autism Spectrum Disorder Among Children Aged 4 Years — Early Autism and Developmental Disabilities Monitoring Network, Six Sites, United States, 2016

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More children are being evaluated for and diagnosed with autism at an earlier age than previously reported. These are positive findings because the younger children are when they receive a developmental evaluation or autism diagnosis, the sooner they can begin to receive needed services. Communities are getting better at finding children with autism at younger ages. Data from the Early Autism and Developmental Disabilities Monitoring Network found that 74% of 4-year-old children with autism in 2014 received a developmental evaluation by 36 months of age. This increased to 84% of 4-year-old children with autism in 2016. In addition, more children who were born in 2012 received an autism spectrum disorder (ASD) diagnosis by 4 years of age compared to children born in 2008.

• Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2016

CDC Media Relations
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Data from the Autism and Developmental Disabilities Monitoring (ADDM) Network found that about 1.85% or 1 in 54 8-year-old children in 2016 were identified with autism spectrum disorder (ASD), based on tracking in 11 communities across the United States. These findings indicate that there continue to be many children living with autism who need services and support, now and as they grow into adolescence and adulthood. However, this report also offers good news that screening and awareness continue to identify children who will benefit from services. Communities are getting better at identifying children with autism, especially black children. For the first time, data from the ADDM Network found no overall difference in the number of black children identified with autism compared to white children. However, some differences between groups still exist:

• Hispanic children with autism continue to be identified at lower rates compared to white or black children;
• Black and Hispanic children with autism received evaluations later than white children with autism; and
• Black and Hispanic children with autism and intellectual disability were diagnosed later than white children with autism and intellectual disability.

Certain groups of children may not be getting the services they need to reach their full potential. More work is needed to improve identification of children with autism within these communities.

• Ongoing Cluster of Highly Related Disseminated Gonococcal Infections — Southwest Michigan, 2019

Gonorrhea is a sexually transmitted infection. In rare cases, gonoccal infection spreads to various parts of the body and causes serious complications. In addition to prevention, early diagnosis and treatment may prevent severe disease and complications. Gonorrhea is a sexually transmitted infection that rarely can spread to varous parts of the body. Clusters of disseminated gonococcaliInfections (DGI) are uncommon. Thirteen confirmed and three probable cases of DGI were reported during August 12–December 18, 2019 in Kalamazoo County and two bordering southwestern Michigan counties. Although each patient named between zero and five sex or needle-sharing partners for a total of 27 partners, interviews did not reveal direct sex or needle contact between cases within the cluster. Nearly all were hospitalized and required surgery. Some needed prolonged antibiotic treatment. The clinical severity, high relatedness of isolates, and reported methamphetamine use among patients raise unique questions about host and pathogen factors that warrant further investigation.

• Nationwide Hepatitis E Outbreak Concentrated in Informal Settlements — Namibia, 2017–2020

A hepatitis E outbreak in Namibia has developed into the first reported nationwide outbreak. The Namibia Ministry of Health and Social Services (MoHSS) declared the hepatitis E outbreak on December 14, 2017. The outbreak has developed into a national, protracted epidemic, mainly in informal settlements with poor water, sanitation, and hygiene conditions. Hepatitis E is spread by fecally contaminated water and spreads rapidly in areas without adequate sanitation. From December 14, 2017 to February 2, 2020, a total of 7,247 HEV cases were detected. The majority of cases (59%) occurred in males, people aged 20-29 years (39%), and in the informal settlements in Khomas and Erongo regions (84%). Sixty-one deaths were reported nationally; 24 of these deaths (39%) occurred among pregnant or post-partum women.

• Percentage of Adults Who Had a Severe Headache or Migraine in the Past 3 Months, by Sex and Age Group — National Health Interview Survey, United States, 2018

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