MMWR News Synopsis

Racial and Ethnic Disparities in Fetal Deaths – United States, 2015-2017

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Improvements in women’s health, with regular access to quality prenatal care, can potentially reduce the risk of stillbirth for women and families. Many families are affected by stillbirth, which is the loss of a baby at or after 20 weeks of pregnancy. This MMWR report found that Black mothers were more than twice as likely to experience stillbirth compared to Hispanic and White mothers. While the full reason for these racial disparities is not clear, differences in health problems that occur during pregnancy or underlying health conditions may be linked to these differences. Improvements in women’s health, with regular access to quality prenatal care, can potentially reduce the risk of stillbirth for women and families.

Cancers Associated with Human Papillomavirus in American Indian and Alaska Native Populations — United States, 2013–2017

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More than 1,000 Human Papillomavirus (HPV)-associated cancers were reported during 2013-2017 in American Indian/Alaska Native populations; of these, 740 were attributable to the types targeted by the HPV vaccine, which can prevent approximately 92% of HPV-attributable cancers. HPV vaccination is key to preventing cancers caused by HPV. In this report, CDC assessed the incidence of HPV-associated cancers and estimated the annual number of cancers probably caused by HPV among American Indian/Alaska Natives (AI/AN) populations. These data can help identify AI/AN regions with disproportionately high rates of HPV-associated cancers and inform targeted regional vaccination and screening programs in AI/AN communities.

Serial Testing for SARS-CoV-2 and Virus Whole Genome Sequencing Inform Infection Risk at Two Skilled Nursing Facilities with COVID-19 Outbreaks — Minnesota, April–June 2020

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To protect residents and prevent SARS-CoV-2 infection among healthcare workers (HCWs), skilled nursing facilities (SNFs) need enhanced infection prevention and control practices, assured availability of personal protective equipment, reduced barriers to HCW testing, flexible medical leave, and timely result reporting. COVID-19 can spread rapidly in congregate settings such as SNFs. In Minnesota, SNF-associated cases accounted for 8% of almost 50,000 COVID-19 cases reported through July 21, 2020. Testing all residents and staff in SNFs at multiple points in time – also known as serial testing – can identify infections among residents and staff who do not have symptoms to help reduce virus spread. During April 2020, there was an increase in cases and deaths among SNF residents in Minnesota. During April–June 2020, the Minnesota Department of Health (MDH), with CDC assistance, conducted weekly serial testing at two SNFs with COVID-19 outbreaks. Serial facility-wide testing at the two SNFs identified COVID-19 cases among 64% of residents and 33% of healthcare workers (HCWs). The Minnesota Department of Health Public Health Laboratory sequenced the virus genome in specimens collected from HCWs and residents and found high similarities among cases within the same facility, suggesting there was virus spread within each facility. HCW in SNFs are at high-risk for infection during COVID-19 outbreaks and resources must be targeted to support this at-risk workforce.

Preventing COVID-19 Outbreaks in Long-Term Care Facilities Through Preemptive Testing of Residents and Staff Members — Fulton County, Georgia, March–May 2020

Catherine Morrow
Communications Coordinator, Rollins School of Public Health
catherine.a.morrow@emory.edu

Mass testing for SARS-CoV-2, the virus that causes COVID-19, in long-term care facilities (LTCF)—even without a reported case—can identify COVID-19 infections in people who do not have symptoms, or do not yet have symptoms, helping to prevent outbreaks.  During March–May 2020, local health department personnel and the National Guard conducted mass COVID-19 testing of residents and staff members in 28 LTCFs in Fulton County, Georgia (the state’s most populous county and site of the city of Atlanta, the state capital). Facility-wide COVID-19 testing was undertaken either in response to a known case, or preemptively before any cases were identified in the facility.  While there was a higher prevalence of cases found in facilities where testing occurred after identification of an initial case, cases were also identified in more than half of LTCFs where preemptive testing was performed. Early awareness of infections might help facilities prevent potential outbreaks by prioritizing and adhering more strictly to infection prevention and control (IPC) recommendations.

Association Between CMS Quality Ratings and COVID-19 Outbreaks in Nursing Homes — West Virginia, March 17–June 11, 2020

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Investigation of COVID-19 outbreaks in West Virginia nursing homes showed that the risk for outbreaks were significantly higher among low quality nursing homes (based on quality ratings from the Centers for Medicare and Medicaid Services [CMS] Five-Star Quality Ratings) compared with high quality nursing homes. Health departments could use CMS star ratings to identify nursing homes at greater risk for COVID-19 outbreaks. Nursing homes are high-risk settings for COVID-19 outbreaks. On April 17, 2020, West Virginia became the first state to mandate and conduct COVID-19 testing for all nursing home residents and staff members to identify and reduce spread of COVID-19 in these settings. CMS publishes Five-Star Quality Ratings of all CMS-certified nursing homes; these quality ratings are based on onsite facility health inspections, nursing staff levels, and quality of care measures and may be associated with a facility’s risk for COVID-19 outbreaks. During March–June 2020, 14 (11%) of 123 West Virginia nursing homes experienced COVID-19 outbreaks. After adjusting for county COVID-19 incidence and the number of facility residents, odds of a COVID-19 outbreak were significantly lower in higher-quality nursing homes, based on star rating. The odds of a COVID-19 outbreak in 1-star–rated nursing homes (lowest quality) were more than seven times higher than in 2- to 3-star–rated facilities, and more than 17 times higher than in 4- to 5-star-rated nursing homes (highest quality). Rapid and early deployment of infection prevention and control (IPC) strategies, such as visitor restrictions, universal face masking, staff education, symptom screening, preparing outbreak plans, and serial testing might successfully prevent or contain outbreaks. It is possible that lower-rated nursing homes struggle to implement effective IPC measures for COVID-19 and might require additional assistance.

Decreased Influenza Activity During the COVID-19 Pandemic — United States, Australia, Chile, and South Africa, 2020

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Getting a flu vaccine offers the best protection against flu during any flu season, and it is more important than ever during 2020-2021 because of the ongoing COVID-19 pandemic. Data in this report suggest that actions to stop the spread of SARS-CoV-2, the virus that causes COVID-19, such as school closure, wearing a mask, or staying six feet apart from others, could reduce the impact of flu this fall and winter in the United States if widely practiced. However, it’s impossible to say with certainty what will happen during the upcoming flu season, making it important to prepare for both flu and COVID-19.

E-cigarette Use Among Middle and High School Students — United States, 2020

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E-cigarette Unit Sales, by Product and Flavor Type — United States, 2014–2020

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Transmission Dynamics of COVID-19 Outbreaks Associated with Child Care Facilities — Salt Lake City, Utah, April–July 2020

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SARS-CoV-2–Associated Deaths Among Persons Aged <21 Years — United States, February 12–July 31, 2020

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Progress Toward Poliovirus Containment Implementation — Worldwide, 2019–2020

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Despite challenges faced during 2019–2020, including the COVID-19 pandemic, the global poliovirus containment program continues to work toward important milestones, including activities required for certification of poliovirus-essential facilities. Two of the three wild poliovirus (WPV2 and WPV3) types have been eradicated globally, and only type one remains in Afghanistan and Pakistan with 176 cases reported in 2019. To prevent reintroduction of eradicated WPVs into communities, WPV3 and WPV2 must be contained under strict biorisk management measures, including reporting national poliovirus 2 (PV2) inventories annually; destroying unneeded PV materials; and, if retaining PV2 or WPV3 materials, establishing national authorities for containment and an auditing process for poliovirus-essential facilities. To maintain progress, all WHO Member States are urged to adhere to the agreed containment resolutions, including officially establishing legally empowered national authorities for containment and submission of polio-virus essential facility Certificates of Participation.

• Prevalence of Complete Tooth Loss Among Adults Aged ≥65 Years, by Federal Poverty Level — National Health and Nutrition Examination Survey, United States, 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.