MMWR News Synopsis

Vital Signs: Characteristics of Drug Overdose Deaths Involving Opioids and Stimulants — 24 States and the District of Columbia, January–June 2019

CDC Media Relations
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Nearly 85% of overdose deaths in 24 states and the District of Columbia during January–June 2019 involved illicitly manufactured fentanyls (IMFs; includes both fentanyl and illicit fentanyl analogs), heroin, cocaine, or methamphetamine (alone or in combination). Overdose prevention, treatment, and response strategies may need to be adapted to address use of multiple drugs, specifically the combination of opioids and stimulants. More than 80% of overdose deaths involved opioids, and 3 out of 4 opioid overdose deaths involved IMFs. IMFs, heroin, cocaine, or methamphetamine (alone or in combination) were involved in nearly 85% of overdose deaths. More than 3 out of 5 overdose deaths involved at least one potential opportunity to link people to care before an overdose or to implement life-saving actions when an overdose occurred. These opportunities can be targeted to both prevent overdoses and improve response to overdoses to prevent deaths.

Timing of State and Territorial COVID-19 Stay-at-Home Orders and Changes in Population Movement — United States, March 1–May 31, 2020

CDC Media Relations
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Population movement decreased in most counties during the early months of the COVID-19 pandemic while stay-at-home orders were in place and increased after those orders were relaxed. The period after the first state relaxed a stay-at-home order was associated with increased population movement in states or territories that had not relaxed a stay-at-home order during the same period. These findings suggest that implementing certain public health policies in one area may also influence behaviors in other areas. In March 2020, U.S. state and territories began implementing various policies to slow the spread of COVID-19, including issuing stay-at-home orders. These orders were intended to reduce close contact with people outside the household by reducing movement in the population. CDC and the Georgia Tech Research Institute studied changes in population movement relative to stay-at-home orders issued during March 1–May 31, 2020, by all 50 states, the District of Columbia, and five U.S. territories. Researchers sought to identify the broader effects of these stay-at-home orders using publicly accessible, anonymized location data from mobile devices. During this period, 42 states and territories issued mandatory stay-at-home orders. This resulted in decreased movement within roughly 98% of urban and rural counties that were assessed.

Nonfatal Occupational Injuries to Younger Workers — United States, 2012–2018

CDC Media Relations
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Young workers, aged 15-24 experience higher rates of job-related injury compared to adult workers. A comprehensive public health strategy for protecting young workers requires designing and maintaining safer worksites, legislation and enforcement, and education and training. CDC researchers analyzed 2012–2018 data from the occupational supplement to the National Electronic Injury Surveillance System (NEISS-Work) and for 2018 from the Survey of Occupational Injuries and Illnesses (SOII) for injuries to workers ages 15–17 years, 18–19 years, 20–24 years, and 25–44 years. During 2012–2018, an estimated 12 million occupational injuries to workers ages 15–44 years were treated in hospital emergency departments. During this period, an estimated 3.2 million workers between the ages of 15 and 24 were treated in hospital emergency departments for work-related injuries. The highest injury rate occurred among workers aged 18–19 years. Across all age groups, the highest percentage of injuries requiring at least one day away from work occurred to workers in the trade, transportation, and utilities industry with the exception that the leisure and hospitality industry contributed to the highest percentage of injuries to workers aged 15-17.

Hydroxychloroquine and Chloroquine Prescribing Patterns by Provider Specialty Following Initial Reports of Potential Benefit for COVID-19 Treatment — United States, January–June 2020

CDC Media Relations
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Following the latest clinical guidance on use of hydroxychloroquine (HCQ) and chloroquine (CQ) will help limit potential adverse events and ensure there is ample supply of these medications for patients who need them for approved purposes. HCQ and CQ are medications that are approved to prevent and treat malaria and treat autoimmune diseases. However, these medications have known risks for adverse events, including life-threatening arrythmias (i.e., irregular heartbeats). On March 20, the Food and Drug Administration (FDA) issued an emergency use authorization (EUA) for chloroquine phosphate and hydroxychloroquine sulfate in the Strategic National Stockpile to be used by licensed health care providers to treat patients hospitalized with COVID-19 when the providers determine the potential benefit outweighs the potential risk to the patient. Due to data suggesting that the effectiveness was unclear and the drugs’ potential benefits do not outweigh their risks, the FDA issued a caution in April and rescinded its EUA in June. This report shows a significant increase in new prescriptions for HCQ/CQ across the United States in March and April 2020. Primary care prescribers provided more than half (54%) of new prescriptions dispensed at outpatient retail pharmacies in that period. Compared to 2019, there was a more than 80-fold increase in new outpatient prescriptions in March 2020 by providers who had not commonly prescribed HCQ/CQ in the past. Prescribing decreased in May and June 2020. It is important for providers to pay close attention to updated clinical guidance on the use of HCQ/CQ. This may be especially important for providers who commonly do not prescribe HCQ/CQ.

Preventing and Mitigating SARS-CoV-2 Transmission — Four Overnight Camps, Maine, June–August 2020 (Early release August 26, 2020)

CDC Media Relations
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Seroprevalence of SARS-CoV-2 Among Frontline Health Care Personnel in a Multistate Hospital Network — 13 Academic Medical Centers, April–June 2020 (Early release August 31, 2020)

CDC News Media (Early release August 31, 2020)
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Evaluation of CDC’s Hemophilia Surveillance Program — Universal Data Collection (1998-2011) and Community Counts (2011-2019), United States

CDC Media Relations
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CDC has successfully developed, implemented, and maintained a surveillance program for hemophilia that since 1998 has directly informed public health and clinical guidelines and practices to prevent or reduce hemophilia-related complications. This program can serve as a model for conducting surveillance of other complex chronic diseases. This report is the first comprehensive summary of CDC’s hemophilia surveillance program. Hemophilia, a group of genetic disorders characterized by deficiencies in blood clotting proteins, is associated with lifelong illness, excess premature death, and extensive healthcare needs throughout the lifespan. For over a decade, the Universal Data Collection (UDC) surveillance system (1998-2011) and the expanded next-generation Community Counts system (2011- ) have collected high quality clinical and laboratory data on the largest and most representative sample of individuals with hemophilia in the United States and worldwide. Data generated from these systems have directly informed public health and clinical guidelines and practices to prevent or reduce hemophilia-related complications.

• Phenibut Exposures Reported to Poison Centers — United States, 2009-2019

Addy Hatch
Washington State University
Director of Outreach and Communication
(509) 324-7340
(509) 879-5732
addy.hatch@wsu.edu

Phenibut is an anti-anxiety drug that is not approved for use in the United States. Even so, it is available online, advertised as a treatment for anxiety, relaxation, and sleep. Phenibut exposures reported to United States poison centers rose dramatically from 2009 to 2019. Exposures were associated with serious health effects, including death. Phenibut (b-Phenyl-g-aminobutyric acid) is a sedative hypnotic used to treat anxiety. Developed in Russia in the 1960s, phenibut is currently not approved for use in the United States but is available online, advertised as a treatment for anxiety, relaxation and sleep. Phenibut use and misuse can cause sedation, respiratory depression, and reduced levels of consciousness, as well as withdrawal symptoms of anxiety, agitation, and acute psychosis, which have been observed with chronic, prolonged use and then cessation. United States poison center data indicate a total of 1,320 phenibut-related exposures from 2009-2019, with a sharp increase from 2015-2019. One in 8 reported exposures (12.6%) were life-threatening or resulted in significant disability, and three deaths were reported over the study period. The emerging popularity and dangers of phenibut are cause for concern. Increasing awareness of this drug and its clinical effects is important both for clinicians who may be treating these patients and for focused educational efforts by public health.

• QuickStats: Prevalence of Past or Present Infection with Hepatitis B Virus Among Adults Aged ≥18 Years, by Race and Hispanic Origin — National Health and Nutrition Examination Survey, 1999–2018

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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.