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Surveillance Summaries: Mental Health Surveillance Among Children — United States, 2013–2019

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Even before the COVID-19 pandemic, many children and teens experienced mental health challenges, with the most common concerns being attention deficit hyperactivity disorder (ADHD), anxiety, and depression. Using data from 2013-2019, this report finds that about 1 in 11 U.S. children ages 3-17 years were diagnosed with ADHD or anxiety. Depression was common among older teens with 1 in 5 reporting a depressive episode, 1 in 3 reporting feeling sad or hopeless, and nearly 1 in 5 reporting that they seriously considered suicide. Mental disorders can begin in early childhood and affect children across a range of sociodemographic characteristics. Some populations are more affected, and differences are linked to social determinants of health such as poverty, access to education, and geographic area, resulting in health inequities. More information is needed to learn about positive indicators of mental health such as children’s resilience and emotional well-being. Federal agencies are working together to develop ways to better collect, analyze, and use data to promote and protect children’s mental health.

Interim Guidance: 4-Month Rifapentine-Moxifloxacin Regimen for the Treatment of Drug-Susceptible Pulmonary Tuberculosis — United States, 2022

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CDC released new interim guidance for a 4-month daily treatment regimen for people with tuberculosis (TB) in the United States. Shorter treatment regimens for TB disease can be more convenient and help patients finish treatment faster. The 4-month regimen containing rifapentine, moxifloxacin, isoniazid, and pyrazinamide is a new treatment option for people with TB disease in the United States. The new guidance is based on results from a clinical trial sponsored by CDC’s Tuberculosis Trials Consortium and conducted in collaboration with the National Institutes of Health-sponsored AIDS Clinical Trials Group that found this 4-month rifapentine-moxifloxacin regimen was as effective as the standard 6-month regimen for TB treatment. Health care providers can contact their State TB Control Offices and the TB Centers of Excellence for Training, Education, and Medical Consultation for additional information about the new treatment regimen and treating people with TB disease.

Use of Ebola Vaccine: Expansion of Recommendations of the Advisory Committee on Immunization Practices To Include Two Additional Populations — United States, 2021

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The Advisory Committee on Immunization Practices (ACIP) is expanding eligibility for vaccination before exposure to Ebola virus disease (EVD) with the FDA-approved Ebola vaccine ERVEBO® to two additional occupational groups in the U.S. at potential risk of exposure to species Zaire ebolavirus. These two additional groups include healthcare personnel involved in the care and transport of suspect or confirmed EVD patients at Special Pathogens Treatment Centers, and laboratorians or support staff at U.S. Laboratory Response Network facilities that handle specimens that may contain live Ebola virus. In 2019, FDA approved the ERVEBO® vaccine manufactured by Merck for the prevention of species Zaire ebolavirus disease. In 2020, the ACIP recommended preexposure vaccination with ERVEBO® for adults 18 years of age and older in the U.S. in three occupational categories considered at highest risk: those responding to an outbreak of EVD, those working as health care personnel at federally designated Ebola treatment centers in the U.S., or those working as laboratorians or other staff at biosafety level four facilities in the U.S. This report summarizes an expansion of these recommendations to two additional occupational groups: health care personnel involved in the care and transport of suspected or confirmed EVD patients at Special Pathogens Treatment Centers, and laboratorians or support staff at Laboratory Response Network facilities that handle specimens that may contain replication-competent Ebola virus in the U.S. This policy note is intended to inform stakeholders about ACIP’s most recent recommendation to expand eligibility for pre-exposure vaccination with ERVEBO® from three to five occupational groups that are considered at high risk for EVD.

Antigen Test Positivity After COVID-19 Isolation — Yukon-Kuskokwim Delta Region, Alaska, January–February 2022

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A CDC study of people living in southwest Alaska found that following infection with the COVID-19 virus, slightly more than half of people with follow-up testing had a positive antigen test five to nine days after symptoms began or, for those without symptoms, after the first positive test result. The proportion of positive results declined with time since infection, and negative follow-up antigen test results were more likely if there were no reported symptoms, a documented previous infection, or if the person was vaccinated. The Yukon-Kuskokwim Health Corporation (YKHC) provides health care and public health services to approximately 27,000 people in an area of southwest Alaska that includes 50 remote communities. During January 1–February 9, 2022, 3,502 infections with the virus that causes COVID-19 were reported to YKHC. People with a positive test result were eligible to receive a follow-up BinaxNOW antigen test between 5 and 9 days after symptom onset (or, in people who reported no symptoms, after the first positive test result). In total, 729 people had a follow-up BinaxNOW rapid antigen test during this period, of whom 54% had a positive test result. A positive test result was more likely if symptoms were reported (64%) than if no symptoms were reported (21%). The proportion of positive antigen tests declined with the number of days since the first positive test result and, among people who reported symptoms, since symptom onset. A negative antigen test was more likely if there were no reported symptoms, if the person had received a primary COVID-19 vaccine series, or if there was documented previous infection. These findings are consistent with recommendations for people with COVID-19 to continue taking precautions until 10 days after symptom onset or a first positive test. Such precautions include wearing well-fitting masks when around others and avoiding close contact with people at increased risk for severe illness, even if ending isolation after 5 days.

Results From a Test-To-Release From Isolation Strategy Among Fully Vaccinated National Football League Players and Staff Members With COVID-19 — United States, December 14–19, 2021

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In December 2021, the National Football League (NFL) updated its testing protocols, which allowed fully vaccinated players and staff  with COVID-19 to return to work after meeting clinical and testing criteria., Nearly half (46%) of vaccinated adults tested through RT-PCR testing received a negative test or had a low amount of viral genetic material after 5 days of isolation post-COVID-19 diagnosis. By day 10, 84% tested negative or had a low amount of viral genetic material. While the proportion of people still testing positive decreased daily, some individuals had positive COVID-19 test results after day 5. Although a positive RT-PCR test result does not necessarily indicate infectiousness, these data indicate that patients with COVID-19 should continue mask-wearing for 10 days after symptom onset, or if asymptomatic, 10 days after initial positive test result. In December 2021, a period when the Omicron variant was widely circulating, the NFL and the National Football League Players Association (NFLPA) adjusted their COVID-19 test-to-release isolation strategy. This strategy allowed fully vaccinated infected players and staff to return to work after meeting clinical and testing criteria. The updated protocol allowed fully vaccinated people to return to work once asymptomatic or if experiencing improving symptoms for at least 24 hours, and after two negative or high cycle-threshold (Ct; higher Ct values mean less viral genetic material detected) results from one of two reverse-transcription polymerase chain reaction (RT-PCR) tests. Overall, 75% (130 of 173) of those tested for release from isolation during the study period met the NFL-NFLPA protocol criteria before 10 days, with the median interval of 7 days to receive a first negative or Ct ≥35 test result. While the proportion of people with positive tests decreased over time, some individuals had positive COVID-19 test results after day 5; thus, these findings are consistent with recommendations for people with COVID-19 to continue taking precautions, including wearing masks and not being around people at increased risk for severe illness, for 10 days after symptom onset or initial test positivity if asymptomatic.

Changes in Suicide Rates — United States, 2019 and 2020

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From 2019 to 2020, suicide rates decreased by 3% overall, with declines among both females (8%) and males (2%). However, changes in suicide rates were uneven, with rates increasing among some groups. Using 2019–2020 data from the National Vital Statistics System, CDC analyzed changes in suicide rates by demographic characteristics, mechanism of injury, county urbanization level, and state. Despite overall declines, suicide rates increased among 25–34-year-olds, Hispanic males, and non-Hispanic multiracial females. Overall suicide rates declined in large metropolitan areas and in seven states. Rates of suicide by fall, poisoning, and suffocation declined. The second consecutive year of declining suicide rates in the U.S. is encouraging, yet suicide rates remain high. Suicide is preventable. A comprehensive approach that uses data to drive decision-making, implements prevention strategies with the best available evidence, and targets the multiple risk and protective factors associated with suicide, especially in disproportionately affected populations, is urgently needed in all states to build on the progress of declining suicide rates in 2019 and 2020.

Previously Released: Pediatric Emergency Department Visits Before and During the COVID-19 Pandemic— United States, January 2019–January 2022

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Previously Released: Changes in Pediatric Emergency Department Visits Associated with Mental Health Conditions Before and During the COVID-19 Pandemic — United States, January 2019–January 2022

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• Age-Adjusted Suicide Rates for Males and Females, by Race and Ethnicity — National Vital Statistics System, United States, 1999–2020

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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.