MMWR News Synopsis

High Prevalence of Hepatitis C Infection Among Adult Patients at Four Urban Emergency Departments — Birmingham, Oakland, Baltimore, and Boston, 2015–2017

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Non-targeted or universal testing in emergency departments may identify a greater number of previously unrecognized hepatitis C virus (HCV) infections, especially among those born after 1965. Given the high hepatitis C prevalence identified in this cohort, this approach could be essential for both infection prevention and hepatitis C elimination. Identifying individuals with HCV infection has become an urgent public health issue because of rising HCV morbidity and mortality and low rates of risk awareness. Emergency departments (EDs) have demonstrated success detecting HCV infection among baby boomers, but targeted strategies to identify HCV infection among younger people who inject drugs has proved challenging. Four EDs – University of Alabama at Birmingham; Highland Hospital, Oakland, California; Johns Hopkins Hospital, Baltimore, Maryland; and Boston University Medical Center, Massachusetts – expanded their screening to all visitors born after 1944, over the age of 17, and unaware of their HCV status. This non-targeted testing strategy identified a significant number of infections among those born after 1965, suggesting this approach may improve rates of hepatitis C testing among high-risk populations by reducing patient and provider stigma associated with identification of behavioral risks for HCV infection. Additionally, the findings underscore the importance of new CDC recommendations that every adult should be tested at least once in their lifetime for this curable infection.

Vital Signs: Postpartum Depressive Symptoms and Provider Discussions About Perinatal Depression — United States, 2018

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Not all women who see a healthcare provider during or after pregnancy are asked about depression. Opportunities to identify and treat women with depression may thus be missed. Mental health conditions such as depression are common during and after pregnancy. Maternal depression affects a woman’s health and well-being and can negatively affect the health of her baby. About 13% of women reported symptoms of depression after giving birth, according to 2018 data from the Pregnancy Risk Assessment Monitoring System. Healthcare providers should be asking all pregnant and postpartum women about symptoms of depression. However, 1 in 5 women were not asked by a healthcare provider about depression during a prenatal healthcare visit, and 1 in 8 women was not asked about depression during a postpartum healthcare visit. Depression can be effectively treated and managed, benefiting both mother and child, but it must be recognized first.

Survival and HIV-Free Survival Among Children Aged ≤3 Years — Eight Sub-Saharan African Countries, 2015–2017

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Focusing on early HIV diagnosis, antiretroviral treatment (ART) initiation and viral suppression among women who may become pregnant and are living with HIV can help reduce mother-to-child transmission (MTCT) and improve child survival. Providing antiretroviral treatment (ART) to women living with HIV before, during, and after pregnancy is critical for preventing mother-to-child transmission (MTCT) of HIV and improving child survival. However, children born to HIV-positive women still have lower survival rates than children born to HIV-negative women, and there is substantial risk for MTCT when maternal ART is not started or started late. A CDC analysis of population-based HIV Impact Assessment survey data from eight sub-Saharan African countries shows that children born to HIV-positive women are less likely to survive (94.7% survival) than children born to HIV-negative women (97.6% survival). HIV-free survival probability (being alive and HIV-negative) in children born to HIV-positive women was 85.3% overall, but differed by timing of maternal HIV treatment: 93.0% when mothers started HIV treatment before pregnancy, 87.8% when mothers started HIV treatment during pregnancy and 53.4% when mothers did not start HIV treatment before or during pregnancy.  National HIV programs should focus efforts to eliminate MTCT on early diagnosis and ART initiation among HIV-positive women, especially before pregnancy.

COVID-19 in Correctional and Detention Facilities — United States, February–April 2020 (Early release May 6, 2020)

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Effects of the COVID-19 Pandemic on Routine Pediatric Vaccine Ordering and Administration — United States, 2020 (Early release May 8, 2020)

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Public Health Response to COVID-19 Cases in Correctional and Detention Facilities — Louisiana, March–April 2020 (Early release May 8, 2020)

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Identification and Monitoring of International Travelers During the Initial Phase of an Outbreak of COVID-19 — California, February 3–March 17, 2020 (Early release May 11, 2020)

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Preliminary Estimate of Excess Mortality During the COVID-19 Outbreak — New York City, March 11–May 2, 2020 (Early release May 11, 2020)

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High SARS-CoV-2 Attack Rate Following Exposure at a Choir Practice — Skagit County, Washington, March 2020 (Early release May 12, 2020)

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• Percentage of Deaths, by Place of Death — National Vital Statistics System, United States, 2000–2018

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