MMWR News Synopsis

Articles

Health Status and Health Care Use Among Adolescents Identified With and Without Autism in Early Childhood — Four U.S. Sites, 2018-2020

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Adolescents with autism spectrum disorder (ASD) have greater physical difficulties, poorer physical and mental health, and experience greater gaps in health care use and health care transition planning compared with adolescents without ASD. Adolescents aged 12-16 years with ASD diagnosed in childhood were more likely than adolescents from the general population to have physical difficulties (such as difficulty using their hands for things like using a spoon or holding a pencil), sleep problems, and additional mental health or other conditions such as attention-deficit/hyperactivity disorder (ADHD) or anxiety. Adolescents with ASD were also more likely to receive mental health services than adolescents without ASD, and more likely to have an unmet health care need where they needed medical, dental, vision, or mental health care but were unable to get it. In both groups of adolescents (those with ASD and those from the general population), only a small percentage received the recommended guidance for transitioning from pediatric to adult health care. However, adolescents with ASD were less likely to receive any form of transition guidance than those without ASD. This study serves as a reminder of the importance of close communication between a child’s caregivers and providers to start the discussion around transition planning as soon as the child reaches adolescence.

Emergency Department Visits for Tick Bites — United States, January 2017–December

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Analysis of emergency-department (ED) visits for tick bites from 2017-2019 showed that these visits occur each year, particularly during the spring and early summer and in the Northeast. The resulting Tick Bite Data Tracker is an interactive dashboard that shows ED visits for tick bites on a week-by-week basis and lets people across the country know when they are most at risk. Investigators used data from CDC’s National Syndromic Surveillance Program (NSSP) to examine ED visits for tick bites during January 2017–December 2019 by sex, age group, U.S. region, and seasonality. During this three-year  period, there were nearly 150,000 visits for tick bites identified. Rates were highest in the Northeast and among pediatric patients. There was a large peak in tick bites during the spring and early summer followed by a smaller peak in the fall. Tick bites are not monitored by current surveillance systems because tick bite is not a reportable condition to health departments. This analysis shows the value of tracking emergency department visits for tick bites as a new and efficient method for understanding past trends and current/imminent risk of tick bites by region. This analysis also indicates that educational campaigns providing information to the public about how to safely remove ticks at home might reduce healthcare burden, associated healthcare costs, and personal risk of exposure to tickborne diseases. The public-facing dashboard developed from this analysis allows healthcare providers, public health practitioners, and the general public access to timely data that can drive tick bite prevention efforts.

COVID-19 Outbreak Among Farmworkers — Okanogan County, Washington, May–August 2020

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A new study finds major differences in risk of COVID-19 among farmworkers in central Washington state based on job roles and housing settings. Employees who primarily worked indoors in large groups were found to have a higher risk of COVID-19 than workers who worked alone, in smaller groups, or outdoors. In response to a COVID-19 outbreak during May to August 2020, Okanogan County Public Health and the Washington State Department of Health reviewed previous symptom screening and testing of employees at a fruit grower and conducted one-time SARS-CoV-2 screening testing on-site. Although the investigation did not directly study transmission patterns, the significant differences in the incidence of COVID-19 across job roles suggested that workplace transmission contributed to the outbreak. Employees who worked primarily indoors, sorting and packing fruit in large groups, had a higher risk of COVID-19 than employees who worked alone or in smaller groups and partially outdoors. The study also found that the incidence of COVID-19 was higher among orchard employees living in the community than among employees staying in congregate, temporary housing. Information on employees’ race and ethnicity was not available for this study. However, nationally, 83% of farmworkers identify as Hispanic. Preventive measures, such as physical distancing, worksite infection control, improved access to testing, and outreach to increase vaccination uptake can help prevent COVID-19 outbreaks among farmworkers.

COVID-19 Among Workers in the Seafood Processing Industry: Implications for Prevention Measures — Alaska, March–October 2020

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In May 2020, Alaska required specific COVID-19 prevention measures for seafood processors, whose employees work in crowded worksites and often live in congregate housing. Through a review of COVID-19 cases and outbreaks in the seafood processing industry during summer and early fall of 2020, Alaska state personnel and CDC field assignees identified additional prevention measures that might further reduce risks to this population. Following numerous COVID-19 outbreaks, Alaska state personnel and CDC field assignees analyzed the state’s case investigation data on laboratory-confirmed SARS-CoV-2 cases in workers in the seafood processing industry from March 1 to October 13, 2020. Their findings indicate that state-required prevention measures, including entry testing and quarantine, likely prevented potential importations of COVID-19 into remote seafood processing facilities because workers who tested positive outside of a facility completed isolation off-site. Incorporating additional measures, such as serial testing and restricting working during quarantine, might make the revised measures more successful in reducing the risk to seafood processors and the communities in which they operate. Vaccination of this essential workforce is important and underway.

Linked Clusters of SARS-CoV-2 Variant B.1.351 — Maryland, January–February 2021

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A Maryland investigation describes the first identified linked clusters of people with no link to international travel likely infected by the B.1.351 variant of the virus that causes COVID-19. Past research suggests that immunity from prior infection or vaccination may offer less protection against this variant of the virus. Important steps to identify and control the spread of variants of concern like B.1.351 include expanding genetic surveillance programs, completing contact investigations for COVID-19 cases, and employing prevention strategies such as vaccination, masking, and physical distancing. In late January 2021, a clinical laboratory notified the Maryland Department of Health (MDH) that the B.1351 variant was identified in a specimen collected from a Maryland resident with COVID-19. To limit spread of COVID-19, MDH used contact tracing to identify the source of infection and any linked infections among other people. The investigation identified two linked clusters. One cluster occurred in a workplace with confined working conditions where employees worked while experiencing COVID-19 symptoms. The other cluster occurred at an indoor social gathering attended by an employee of that workplace where participants took their masks off to eat together. Three more specimens from these clusters were sequenced, and all were of the B.1.351 lineage. Among employees of the workplace, attendees of the gathering, and close contacts, 17 infected people infected were identified. Among the 17 patients linked to these clusters, none reported recent international travel or contact with international travelers. Two of the people infected had received one dose of a two-dose COVID-19 vaccine series, and one person who was infected had COVID-19 five months earlier. Two of the 17 people were hospitalized, and one of the hospitalized patients died. Neither of these hospitalized patients had been vaccinated nor had they shown evidence of previous infection.

Postvaccination SARS-CoV-2 Infections Among Skilled Nursing Facility Residents and Staff Members — Chicago, Illinois, December 2020–March 2021 (Early Release April 21, 2021)

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COVID-19 Outbreak Associated with a SARS-CoV-2 R.1 Lineage Variant in a Skilled Nursing Facility After Vaccination Program — Kentucky, March 2021 (Early Release April 21, 2021)

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Health Care Utilization and Clinical Characteristics of Nonhospitalized Adults in an Integrated Health Care System 28–180 Days After COVID-19 Diagnosis — Georgia, May 2020–March 2021 (Early Release April 23, 2021)

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Updated Recommendations from the Advisory Committee on Immunization Practices for Use of Janssen (Johnson & Johnson) COVID-19 Vaccine After Reports of Thrombosis with Thrombocytopenia Syndrome Among Vaccine Recipients — United States, April 2021 (Early Release April 27, 2021)

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• Percentage of Adults Aged ≥18 Years with Arthritis, by Sex and Age Group — National Health Interview Survey, United States, 2019

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