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Imputed State-level Prevalence of Achieving Goals To Prevent Complications of Diabetes in Adults with Self-Reported Diabetes — United States, 2017–2018

More than 70% of people with diabetes aren’t meeting all their diabetes management goals. Good diabetes management plays a vital role in preventing complications. Effective management of blood glucose (measured by hemoglobin A1C), blood pressure, cholesterol, and avoiding smoking (known as the ABCS) are key to preventing diabetes complications. Previous studies examined the achievement of ABCS among persons with diabetes at the national level. This study is the first to report the state-level prevalence of ABCS goals among adults with self-reported diabetes for all 50 US states and the District of Columbia. Overall, researchers found that in each state, among adults with self-reported diabetes, only 22% to 28% achieved all of the ABCS goals. Public health departments could use these data in their planning efforts to achieve ABCS goal levels and reduce diabetes-related complications at the state level.
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COVID-19 Outbreak in an Amish Community — Ohio, May 2020

Social gatherings are an important part of Amish culture. A series of social gatherings held in an Amish community in rural Ohio likely contributed to the rapid spread of COVID-19. Understanding the social dynamics of close-knit communities and responding with culturally appropriate resources and messages are crucial to slowing the spread of COVID-19. COVID-19 cases have been increasing in rural U.S. communities. Social gatherings can increase the chances of getting and spreading COVID-19. In Amish communities, social gatherings are an important part of the culture. However, a series of social gatherings held during the pandemic likely contributed to the rapid spread of COVID-19 in an Amish community in rural Ohio. In May 2020, after seven COVID-19 cases were identified, increased testing identified an additional 23 people with COVID-19 out of 30 who were tested. COVID-19 outbreaks in communities where social gatherings are common might be prevented by creating strong collaborations and trusting relationships between the community and local health departments, distributing culturally appropriate health messages in plain language that highlight protecting family and community members, and ensuring timely and easy access to testing.
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Mental Health-Related Emergency Department Visits Among Children Aged <18 years During the COVID-19 Pandemic — United States, January 1, 2020–October 17, 2020

From March to October 2020, the proportion of emergency department visits related to children’s mental health increased substantially for school-aged children (5-11 years) and adolescents (12-17 years) compared to 2019. These findings suggest that the COVID-19 pandemic may be having a negative effect on children’s mental health because of disruptions to daily life, anxiety about illness, and social isolation. The report emphasizes that it is critical to continue to monitor indicators of children’s mental health, promote coping strategies and resiliency, and expand access to services to support children’s mental health during the COVID-19 pandemic. Children’s mental health can have both short- and long-term effects on overall health and well-being. Experiencing a disaster may have a negative effect on the mental health and emotional well-being of children aged under 18 years. To assess immediate changes in mental health among children during the pandemic, investigators used data on emergency department visits from CDC’s National Syndromic Surveillance Program (NSSP) from January 1 to October 17, 2020 and compared this information to data collected during the same period in 2019. From March through October, the proportion of mental health-related ED visits increased 24% for children aged 5-11 years and 31% among adolescents aged 12-17 compared to the same period in 2019. Compared to younger children, adolescents aged 12-17 years accounted for the highest proportion of children’s mental health-related ED visits in 2019 and 2020. The increased proportion of children’s mental health-related ED visits from March to October 2020 might have been inflated by the large overall decrease in ED visits as well as by variations in the number of EDs reporting to NSSP. Still, these data likely underestimate the total number of mental health-related health care visits because many mental health visits occur outside of EDs. These findings provide an initial understanding of children’s mental health in the context of the COVID-19 pandemic and highlight the importance of continued monitoring of children’s mental health throughout the pandemic, ensuring the availability and access to mental health services during public health crises, and improving healthy coping strategies and resiliency among children and families. There is a continued need to address emergency mental health care for children during the COVID-19 pandemic in a way that reduces the burden on EDs, which are often the first point of care for children experiencing mental health emergencies. Expanding mental health services, such as mental telehealth and technology-based solutions (e.g., mobile mental health applications), might help address demand for mental health services when other options are limited or unavailable.
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Risk Assessment and Management of COVID-19 Among Travelers Arriving at Designated U.S. Airports, January 17–September 13, 2020

COVID-19 can be spread by people who do not have symptoms, and COVID-19 symptoms can vary from person to person. Programs that rely solely on symptom-based screening to identify people with COVID-19 are not effective. Symptom-based screening programs used at U.S. airports between January 17 and September 13, 2020 detected nine cases despite screening 766,000 travelers. CDC scientists evaluated the results of the U.S. airport screening program for COVID-19. Between January 17 and September 13, 2020, a total of 766,044 travelers were screened, 298 (0.04%) of whom met criteria for public health assessment; 35 (0.005%) were tested for the virus that causes COVID-19, and nine (0.001%) had a positive test result. Travel Health Notices that advised against nonessential travel and entry restrictions may have reduced the number of travelers with COVID-19 who entered the United States early in the pandemic. Airport-based activities may have led travelers to take actions to prevent the spread of COVID-19, including by staying at home for 14 days after arrival. However, the low number of COVID-19 cases detected through symptom-based screening programs highlighted the need for fundamental change in the U.S. border health strategy. Since the symptom-based screening program was stopped on September 14, 2020, the strategy has transitioned to enhancing communication with travelers to promote recommended preventive measures such as wearing masks, reinforcing mechanisms to refer overtly ill travelers to CDC, enhancing public health response capacity at ports of entry, and encouraging predeparture and post-arrival testing.
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Multiple COVID-19 Outbreaks Linked to a Wedding Reception in Rural Maine — August 7–September 14, 2020

Community gatherings, such as weddings, birthday parties, church events, and funerals, can create a superspreader event in which one person infects many others. A wedding reception held in rural Maine led to COVID-19 outbreaks in the local community as well as in a long-term care facility and a correctional facility located in other counties. Overall, 177 COVID-19 cases were linked to the wedding reception, including seven hospitalizations and seven deaths. In mid-August 2020, Maine Center for Disease Control and Prevention (MeCDC) initiated an outbreak investigation following reports of positive COVID-19 tests from five people who attended the same wedding reception on August 7. Investigators identified 30 cases linked to the wedding venue, as well as an additional 27 cases occurring in the surrounding community. Even though the wedding venue had signs posted at the entrance instructing visitors to wear masks, guests did not follow this requirement or stay six feet apart – and staff members did not enforce these measures (although all staff members did wear masks). In addition to the outbreak in the surrounding community, transmission at the wedding reception led to outbreaks at a long-term care facility located 100 miles away and at a correctional facility located more than 200 miles away. At the long-term care facility, 38 additional people were infected; three residents were hospitalized and six died. At the correctional facility, 82 additional people were infected, but no one was hospitalized or died. These findings highlight the importance of following recommended measures to slow the spread of COVID-19, even in communities where rates of spread are low. People should avoid large gatherings, stay six feet apart from others, wear masks that cover the nose and mouth in public, stay home when sick, and self-quarantine after exposure to a person with COVID-19.
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Declines in SARS-CoV-2 Transmission, Hospitalizations, and Mortality After Implementation of Statewide Mitigation Measures— Delaware, March–June 2020 (Early release November 6, 2020)

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Characteristics of Hospitalized COVID-19 Patients Discharged and Experiencing Same-Hospital Readmission — United States, March–August 2020 (Early release November 9, 2020)

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Progress Toward Regional Measles Elimination — Worldwide, 2000–2019

Progress toward measles elimination targets has stalled leading to the highest number of new infections reported in 23 years (during 2017-2019) and a tragic rise in measles deaths. Measles vaccination has saved more than 25.5 million lives globally since 2000, but progress has stalled leading to record-high increases in the number of new infections and measles deaths. New data show worldwide measles deaths climbed 50% from 2016 to 2019 claiming an estimated 207,500 lives in 2019, all preventable deaths. Reported measles cases in 2019 represents the highest number reported (869,770) in 23 years, with increases in all WHO regions. Of the 184 countries reporting 2019 data, just nine countries accounted for 73% of all reported measles cases worldwide. To regain progress, countries must reach and maintain ≥95% coverage with measles-containing vaccine, quickly identify missed children, and close growing immunity gaps due to recent disruptions in immunization services during the COVID-19 pandemic.
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Routine Vaccination Coverage — Worldwide, 2019

To advance progress towards achieving global immunization goals, especially in the midst of the COVID-19 pandemic, country-specific, well-tailored strategies are urgently needed to identify and vaccinate unimmunized and under-immunized children, particularly those living in remote rural, urban poor, and conflict-affected communities. Since 1974, substantial progress in improving vaccination coverage has been made worldwide. Though large gains in immunization coverage were achieved during 2000–2010, coverage with established vaccines has not increased since 2010 and progress is uneven around the globe. During 2010–2019, the number of zero-dose children (infants not receiving the first dose of diphtheria, tetanus, and pertussis-containing vaccine) increased in the Americas, African, and Western Pacific regions. Disruptions to global vaccination efforts due to the COVID-19 pandemic has further threatened progress towards achieving global immunization goals. Country-specific strategies to monitor immunization program setbacks, implement catch-up vaccination policies and strategies, and intensify routine immunization services will be necessary to improve coverage, close immunity gaps widened by the pandemic, and protect children from vaccine preventable diseases.
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Surveillance Summaries: Multistate Investigations of Salmonella, Shiga Toxin-Producing Escherichia coli, and Listeria monocytogenes infections — United States, 2016

Multistate foodborne outbreak investigations require substantial resources at the federal, state, and local levels and are critical for providing insights into gaps in food safety that help focus prevention strategies. Salmonella, Shiga toxin–producing Escherichia coli (STEC), and Listeria monocytogenes are the leading causes of multistate foodborne disease outbreaks in the United States. For each possible multistate outbreak, CDC facilitates rapid responses with state and local health officials and federal agencies to examine the available data and determine what action is warranted. A new report summarizes all of the possible and confirmed multistate outbreaks that CDC helped investigate in 2016. CDC coordinated outbreak investigations each week during 2016. Of the 118 possible outbreaks investigated, 50 were determined to be outbreaks and 39 were solved. While sprouts were the most common food source implicated in solved outbreaks, outbreaks linked to chicken caused the highest number of illnesses. Responding to multistate outbreaks quickly and effectively and applying lessons learned can prevent additional outbreak-associated illnesses and save lives.
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• Death Rates from Unintentional Falls Among Persons ≥65 Years, by Age Group — National Vital Statistics System, 1999–2018

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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.