MMWR News Synopsis

Vital Signs: Prescription Opioid Pain Reliever Use During Pregnancy — 34 U.S. Jurisdictions, 2019

CDC Media Relations
404-639-3286

Healthcare providers should discuss risks and benefits of opioid therapy for chronic pain; screen all pregnant women for substance use and misuse, including prescription opioids; and provide referral and treatment as indicated. New findings from CDC’s Pregnancy Risk Assessment Monitoring System (PRAMS) and two additional maternal and infant health surveys reveal that approximately 7% of women reported using prescription opioids during pregnancy. Among these women,  1 in 5 reported misuse of prescription opioids, defined as getting them from a non-healthcare source or using them for a reason other than to relieve pain. Among women who used a prescription opioid during pregnancy, 27% wanted to cut down or stop using and 32% reported not being counseled by a healthcare provider about the potential effects of prescription opioid use on their baby. These findings indicate the need for improved provider counseling about opioid use, as well as screening for opioid use and misuse in pregnant patients.

Update on Immunodeficiency-Associated Vaccine-Derived Polioviruses — Worldwide, July 2018–December 2019

CDC Media Relations
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While the incidence of type 2 immunodeficiency-associated vaccine-derived polioviruse (iVDPV) infections has declined since 2016, identifying and treating all people shedding poliovirus by screening patients with primary immunodeficiencies is required to help prevent new infections and help achieve and maintain eradication of all polioviruses. A healthy person stops shedding poliovirus within six weeks of receiving oral polio vaccine (OPV). However, people with certain conditions that weaken their immune system (i.e., primary antibody or combined antibody and cellular immunodeficiency disorders) do not mount an adequate immune response from OPV. As a result, people with these conditions can have prolonged infections in their intestines after receiving OPV, which can lead to paralysis in these individuals or lead them to shed a mutated version of the virus that can spread in a community. Polio eradication programs must strengthen surveillance beyond current pilot health centers with expanded participation of specialized physicians treating patients with primary immunodeficiencies. This will identify possible iVDPV infections among these patients before paralysis occurs. With continued progress in the development of antiviral medications effective against polioviruses, identifying and treating all people shedding poliovirus is needed to help prevent new infections and achieve and maintain eradication of all polioviruses.

Mumps Cases Disproportionately Affecting Men Who Have Sex with Men and Persons Living with HIV Infection — Chicago, Illinois, 2018

CDC Media Relations
404-639-3286

Using data analyzed across both space and time, known as spatiotemporal analysis, can help identify clusters of people with mumps in real time to target public health response efforts. During January 1–March 2, 2018, the number of mumps cases reported to the Chicago Department of Public Health (CDPH) among adults doubled compared with the same period in 2017. In response, CDPH collected additional data from patients with mumps to help determine who was being affected and how it spread. Additionally, CDPH used spatiotemporal analysis, an innovative method for detecting infectious disease outbreaks, which helped identify a cluster of cases in a 9 square-mile area within six adjacent communities. The majority of people affected in this cluster were men who have sex with men, and this area was visited by many other people with mumps diagnoses. These findings show how spatiotemporal analysis can help inform public health response efforts in real time.

Detection and Genetic Characterization of Community-Based SARS-CoV-2 Infections — New York City, March 2020

Contact: Patrick Gallahue
Title: Press Secretary
Office Phone: 347-396-4061
Cell Phone: 646-891-9003
Email Address: pgallahue@health.nyc.gov

Before an outbreak, partnering with health care facilities and developing the systems needed for rapid implementation of surveillance, along with genetic sequencing, can help inform timely public health response strategies. In March 2020, the New York City (NYC) Department of Health and Mental Hygiene (DOHMH) partnered with six NYC emergency departments (EDs) to determine if local transmission of SARS-CoV-2 was occurring. Additionally, genetic sequencing was performed to determine the probable geographic origin of SARS-CoV-2. Data collected from emergency departments and from the DOHMH syndromic surveillance system were used to calculate the estimated prevalence and undetected cases of COVID-19 among people in the target population. The finding suggest probable introductions of SARS-CoV-2 from Europe, from other U.S. locations, and local introductions from within New York. Additionally, the calculations suggest that many COVID-19 cases went undetected in NYC, likely due to limited testing availability and strict testing criteria during this time in the pandemic.

Symptom profiles of COVID-19 cases — United States, January–April 2020

CDC Media Relations
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Clinicians and public health professionals should be aware of the wide range of symptoms that COVID-19 can cause so they can promptly identify patients with COVID-19. During January-April, 2020, a sample of U.S. patients with COVID-19 reported a range of symptoms. This sample included patients who were and were not hospitalized. Patients commonly reported fever, cough, or shortness of breath along with gastrointestinal symptoms (i.e., vomiting, stomach pain, nausea, or diarrhea) and other symptoms such as chills, muscle aches (myalgia), headache, and fatigue. More than two-thirds of hospitalized adult patients reported all three typical symptoms of COVID-19 (fever, cough, and shortness of breath) compared to nearly one-third of patients who were not hospitalized.

Policy Note: Continuation of Mosquito Surveillance and Control during Public Health Emergencies and Natural Disasters

CDC Media Relations
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CDC and the U.S. Environmental Protection Agency (EPA) strongly recommend the continuation of mosquito surveillance and integrated pest management during mosquito-borne disease outbreaks, non-mosquito related public health emergencies, and natural disasters. CDC supports EPA’s science-based review of mosquito control adulticides and larvicides for registration and use in the United States that ensures, when applied following the EPA label, that these pesticides will not cause unreasonable adverse effects and will benefit human health. CDC and EPA had two primary reasons for writing this policy statement: (1) State, tribal, local, and territorial public health and mosquito control organizations play a critical role in protecting the public from mosquito-borne diseases. CDC and EPA were concerned that mosquito surveillance and control activities would be curtailed or deemed non-priority because of the pandemic or because of natural disasters (e.g. hurricane or flooding). Because mosquito-borne diseases threaten every state and territory, and because many people are spending more time outside, we were concerned about the increased threat of mosquito-borne diseases in communities across the United States. (2) There is increasing sentiment in the United States in many communities to not use insecticides for mosquito control. CDC and EPA recommend use of an Integrated Pest Management approach that uses a combination of non-chemical and chemical methods to kill mosquito adults and larvae. This is especially true during periods when adult flying mosquitoes are infected with virus (e.g., West Nile virus or dengue) and making people sick.

• QuickStats: Percentage of Adults Who Volunteered or Worked in a Hospital, Medical Clinic, Doctor’s Office, Dentist’s Office, Nursing Home, or Some Other Health Care Facility, by Sex, Race, and Hispanic Origin — National Health Interview Survey, United States, 2016–2018

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

CDC works 24/7 protecting America’s health, safety and security. Whether diseases start at home or abroad, are curable or preventable, chronic or acute, or from human activity or deliberate attack, CDC responds to America’s most pressing health threats. CDC is headquartered in Atlanta and has experts located throughout the United States and the world.