MMWR News Synopsis

Articles

Geographic Differences in Sex-Specific Chronic Obstructive Pulmonary Disease Mortality Rates Trends Among Adults Aged ≥25 Years — United States, 1999–2019

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Overall chronic obstructive pulmonary disease (COPD) death rates did not change among women from 1999 to 2019; death rates increased for women residing in the Midwest and those living in small metropolitan or non-metropolitan areas. Although men had higher COPD death rates than women, rates decreased among men overall and among all regional and urban-rural subgroups. To examine trends in COPD death rates among adults aged 25 years and older, CDC analyzed death certificate data from 1999–2019 by sex, urban-rural status, region, and state. Region-specific patterns in COPD mortality in 2019 were similar in men and women (e.g., highest in the Midwest and South), and urban-rural disparities became more pronounced in both women and men during the past 20 years. Efforts are needed to continue the decreasing trend in COPD mortality rates among men and improve the trend among women. Findings highlight several important geographical areas to focus COPD prevention (e.g., smoking cessation), early diagnosis, treatment (e.g., medication and oxygen therapy), and management strategies (e.g., pulmonary rehabilitation).

Use of a Modified Preexposure Prophylaxis Vaccination Schedule to Prevent Human Rabies: Recommendations of the Advisory Committee on Immunization Practices — United States, 2022

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The Advisory Committee on Immunization Practices (ACIP) has updated its recommendations to prevent infections with rabies in people. These recommendations include fewer vaccine doses in the primary vaccination schedule, a one-time check of rabies antibody level (titer) or a vaccine booster dose for certain people, redefined risk categories, a standardized minimum cut-off for rabies titer, and additional guidance for vaccination of people who have weakened immune systems. Rabies is a deadly disease that continues to be a public health concern. It can largely be prevented through rabies vaccines, most of which are given after someone comes in contact with a rabid animal. However, some groups of people at higher risk of rabies exposure should get a rabies vaccine before a rabies exposure takes place, called preexposure prophylaxis or PrEP. This report explains the most recent updates by ACIP to recommendations to prevent rabies. The updated PrEP recommendations include fewer vaccine doses in the primary vaccination schedule, a one-time titer or booster dose for certain people to ensure long-term protection, redefined risk categories, a standardized minimum cut-off for rabies antibody level (titer), and additional guidance for people who have weakened immune systems. The revised recommendations might make PrEP more accessible and affordable, encouraging more people who are at risk for rabies to get rabies vaccination to protect themselves.

West Nile Virus and Other Domestic Nationally Notifiable Arboviral Diseases — United States, 2020

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Mosquito- and tickborne disease outbreaks occur every year in the United States, particularly in the warmer spring and summer months. People can protect themselves by using EPA-registered insect repellent whenever they go outside. Arboviruses (viruses spread by mosquitoes or ticks) cause severe illness in the United States. In 2020, there were 884 reported cases of domestic arboviral diseases. While West Nile virus (WNV) continued to be the most common cause of domestic arboviral disease, there were fewer neuroinvasive disease cases reported in 2020 compared to the average from 2010–2019. In contrast, there was an increase in neuroinvasive disease cases caused by other arboviruses (e.g., La Crosse and St. Louis encephalitis virus). Cases with reported meningitis, encephalitis, acute flaccid paralysis, or unspecified neurologic presentation were classified as neuroinvasive disease. Although the COVID-19 pandemic likely impacted the number of cases reported, it is challenging to determine the true impact, as other factors (e.g., weather, human behavior) influence the occurrence of arboviral diseases. The best way to prevent arboviral infections is to prevent mosquito and tick bites.

Effectiveness of a COVID-19 Additional Primary or Booster Vaccine Dose in Preventing SARS-CoV-2 Infection Among Nursing Home Residents During Widespread Circulation of the Omicron Variant — United States, February 14–March 27, 2022

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A study of approximately 15,000 nursing homes found that residents who received additional primary or booster doses of COVID-19 vaccines (i.e., 3 or more doses if the primary series was mRNA vaccine) had greater protection against infection with the Omicron variant of the virus that causes COVID-19 than residents who only received 2 doses of an mRNA vaccine (Pfizer-BioNTech or Moderna) or 1 dose of a Janssen (Johnson & Johnson) vaccine. All nursing home residents, staff, and visitors should stay up to date on COVID-19 vaccinations, including receiving an additional primary dose, if recommended, and booster doses when eligible. Nursing home residents have experienced disproportionally high levels of COVID-19-associated severe disease and death. Little is known about the effectiveness of an additional primary or booster dose of COVID-19 vaccine (i.e., 3 or more doses if the primary series was mRNA vaccine) against infection in this population, especially against the Omicron variant. For people who are immunocompromised, the third primary dose is the final dose of the primary series of an mRNA COVID-19 vaccine, while the booster is the shot that comes at least 3 months later. Getting a booster enhances or restores protection against COVID-19, which may have decreased over time. The nursing home residents who received an additional primary or booster dose had an approximately 47% lower rate of infection compared with those who had received 2 doses of an mRNA vaccine or 1 dose of a Janssen vaccine. By March 2022, 65% of nursing home residents had received an additional primary or booster dose. Efforts to maximize vaccination coverage, including additional primary doses, if recommended, and booster doses, when eligible, among nursing home residents are necessary. Such efforts should be in conjunction with other COVID-19 prevention strategies, including infection control, testing, and vaccination of nursing home staff members and visitors.

Previously Released: Acute Hepatitis and Adenovirus Infection Among Children — Alabama, October 2021−February 2022

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• Content

• Percentage of Adults ≥18 Years Who Met the Federal Guidelines for Muscle-Strengthening Physical Activity, by Age Group and Sex— National Health Interview Survey, United States, 2020

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