MMWR News Synopsis

Articles

Surveillance Summaries: Demographic, Behavioral, and Clinical Characteristics of Persons Seeking Care at Sexually Transmitted Disease Clinics — 14 Sites, STD Surveillance Network, United States, 2010–2018

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Data indicate that the demographics of people visiting sexually transmitted disease (STD) clinics have shifted in the last decade. Monitoring and understanding these changes can help public health partners adapt programs and services to meet the needs of the people they serve. CDC’s STD Surveillance Network (SSuN) data, gathered from 14 STD clinics in five U.S. cities, indicate that during 2010-2018 the demographics of patients attending these STD clinics changed considerably. STD clinics saw an increase in unique patient visits among people who identified as gay, bisexual, and other men who have sex with men; and transgender. Overall visits declined, as did visits by female patients, especially those aged 15-24 years. The findings point to a growing role for STD clinics in providing STD and HIV prevention and treatment services to gay/bisexual men and transgender populations. While this report does not examine the factors behind the trends reported, other research indicates that gay/bisexual men may see STD clinics as providers of culturally competent, confidential, and expert sexual health information. These data also raise questions about how adolescent and young females are accessing sexual health services, as well as questions about the impact of factors like reduced funding for STD programs on service delivery.

Progress Toward Global Eradication of Dracunculiasis, January 2020–June 2021

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With only 27 human cases of dracunculiasis (Guinea worm disease) reported in 2020 and a reduction in dog infections in Chad, the goal of eradicating this parasitic and painful disease is within reach. However, animal infections (especially in Chad) and impeded access to community members and their dogs because of civil unrest and insecurity in Mali and South Sudan continue to be the greatest challenges to global eradication efforts. Dracunculiasis is a parasitic infection targeted for eradication. Annual human cases declined from about 3.5 million in 1986 in 20 countries to 27 cases in 2020 in six countries — Angola, Chad, Ethiopia, Mali, South Sudan, and importations into Cameroon. Dog infections have been reported since 2012, particularly in Chad. Chad reported a 60% reduction in dog infections between January and June 2021 and the same period of 2020. Mali, Ethiopia, and Cameroon also have reported a few dog infections. Other infected animals have been reported in various countries in small numbers, including cats and baboons.

National Surveillance for Acute Flaccid Myelitis — United States, 2018–2020

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An anticipated increase in cases of acute flaccid myelitis (AFM) in 2020 did not occur, likely because of the precautions taken to slow the COVID-19 pandemic. While it is unclear when or if another increase in AFM might occur, clinicians should be vigilant for potential signs and symptoms of AFM such as acute flaccid limb weakness, particularly in patients with recent fever or respiratory illness. The number of cases of AFM — a rare but serious neurologic condition that mainly affects children — remained low in 2019 and 2020, with 47 and 32 reported cases, respectively. In comparison, there were 238 cases reported in 2018, the latest peak year observed in the United States. Viruses, including enteroviruses, play a role in AFM, and data suggest that increased activity of enteroviruses, particularly enterovirus D-68 (EV-D68), contributed to the increase in AFM cases seen every other year (2014, 2016, and 2018). Based on this biennial pattern, another increase in AFM cases was expected in 2020. However, this did not occur, likely because the prevention measures implemented to stop the spread of COVID-19 — such as school closures, social distancing, mask wearing, and handwashing — also prevented the spread of other respiratory viruses, including enteroviruses. In addition, the cases in 2019 and 2020 differed from those in 2018, suggesting different viral causes. For example, the 2019-2020 AFM patients were slightly older (median age of 6.6 and 9.2 years in 2019 and 2020, versus 5.3 years in 2018), more likely to have impairment in their legs rather than arms, and less likely to have a fever before the weakness started. It is unclear when or if another increase in AFM might occur, but regardless of cause, early recognition and hospitalization of patients suspected to have AFM is critical.

Laboratory-Confirmed COVID-19 Among Adults Hospitalized with COVID-19-Like Illness with Infection-Induced or mRNA Vaccine-Induced SARS-CoV-2 Immunity — Nine States, January–September 2021

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The Advisory Committee on Immunization Practices’ Interim Recommendations for Additional Primary and Booster Doses of COVID-19 Vaccines — United States, 2021

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Effectiveness of 2-Dose Vaccination with mRNA COVID-19 Vaccines Against COVID-19–Associated Hospitalizations Among Immunocompromised Adults — Nine States, January–September 2021

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• Infant Mortality Rates for Metropolitan and Nonmetropolitan Counties, by Single Race and Hispanic Origin — National Vital Statistics System, United States, 2019

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