MMWR News Synopsis

Articles

Surveillance Summaries: Surveillance for Violent Deaths — National Violent Death Reporting System, 42 States, the District of Columbia, and Puerto Rico, 2019

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In 2019, the suicide rate was highest among American Indian/Alaska Native people and White males; the homicide rate was highest among Black males. Violence is preventable, and data can guide public health action. This report provides a detailed summary of data from the National Violent Death Reporting System (NVDRS) on violent deaths that occurred in 2019. The suicide rate was highest among American Indian/Alaska native people and White males, whereas the homicide rate was highest among Black males. Mental health problems, intimate partner problems, interpersonal conflicts, and acute life stressors were primary circumstances for multiple types of violent death. NVDRS data are used to monitor violence-related fatal injuries and assist public health authorities in developing, implementing, and evaluating programs, policies, and practices to reduce and prevent violent deaths.

Factors Associated with Use of HIV Prevention and Health Care Among Transgender Women — Seven Urban Areas, 2019–2020

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New CDC data highlight the need to address factors that contribute to disparities in HIV and provide gender-affirming HIV services for transgender women in the United States. CDC analyzed data collected in seven U.S. urban areas to better understand the factors associated with HIV prevention and care use among transgender women. Researchers found that certain factors, including low income (44%), severe food insecurity (40%), and experiencing homelessness (39%), were common and associated with lower receipt of HIV prevention and treatment services. Having a usual source of health care or a provider with whom one was comfortable discussing gender-related issues was associated with HIV testing, pre-exposure prophylaxis use, and viral suppression – which play key roles in HIV prevention. Addressing the underlying factors that contribute to disparities in HIV and providing gender-affirming health care are critical to reaching more transgender women with HIV prevention and care services.

Modifiable Risk Factors for Alzheimer Disease and Related Dementias Among Adults Aged ≥45 Years — United States, 2019

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The impact of some risk factors for Alzheimer disease and related dementias (ADRD) can be reduced through behavioral change, such as getting more exercise. Among U.S. adults aged 45 years and older, the most common of these modifiable risk factors were high blood pressure and not meeting the aerobic physical activity guideline. Adults with subjective cognitive decline (SCD), an early indicator of possible future ADRD, were more likely to report having almost all modifiable risk factors and a higher number of risk factors than those without SCD. This study examined the status of eight potential modifiable risk factors for ADRD: high blood pressure, not meeting the aerobic physical activity guideline, obesity, diabetes, depression, current cigarette smoking, hearing loss, and binge drinking. Among adults aged 45 years and older, the most common risk factors were high blood pressure (49.9%) and not meeting the aerobic physical activity guideline (49.7%). In 2021, the National Plan to Address Alzheimer’s Disease included a goal to reduce the risk for ADRD. Implementing evidence-based strategies that address modifiable risk factors can help achieve the National Plan’s new goal to reduce the risk of ADRD while promoting healthy aging.

Rabies in a Dog Imported from Azerbaijan — Pennsylvania, 2021

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After a rabies virus infection was confirmed in a dog imported into the United States from Azerbaijan, seven other animals in the shipment of rescue animals were found to not be adequately vaccinated against rabies despite having valid rabies vaccination certificates. This investigation shows that regulations requiring vaccination certificates alone cannot prevent importation of rabies in dogs and additional measures are needed. The strain of rabies virus normally found in dogs was eliminated in the United States in 2007. However, it is still common in dogs around the world. In fact, nearly all of the 60,000 annual rabies illnesses in people are thought to result from contact with rabid dogs. Importation of an infected dog presents a risk for re-introduction of the dog rabies virus variant. Regulations are in place to govern the importation of animals into the United States. This report shows that stronger dog importation measures would be necessary to prevent the entry of rabies-infected dogs from countries deemed high risk for the dog rabies virus variant. This report discusses a case of rabies detected in a dog after it was imported into the U.S. from Azerbaijan in June 2021. Later tests showed that seven of 32 dogs in the same shipment were not properly vaccinated despite having valid rabies vaccination certificates and appearing healthy. This shows that regulations requiring vaccination certificates alone do not sufficiently prevent rabies importation in dogs.

• Escherichia coli O157:H7 Outbreak in Children With Clostridioides difficile Colonization Associated With an Improperly Treated Swimming Pool — Pennsylvania, June 2021Clostridioides difficile is a germ (bacterium) that sometimes causes severe diarrhea and colitis (inflammation of the colon). Children should only be tested for Clostridioides difficile when indicated per clinical guidance, especially in the context of gastrointestinal outbreaks where at least one other pathogen has been identified. This article summarizes an outbreak of gastrointestinal illness among children who swam at a community pool in Pennsylvania. Investigation findings support the recommendation for individuals with diarrhea to abstain from swimming and for recreational waters to be properly treated and maintained. They also provide insight into the importance of diagnostic stewardship for Clostridioides difficile among children, especially if another pathogen is identified, given the fact that some children may carry Clostridioides difficile without having symptoms. Finally, the article highlights the importance of using available clinical and epidemiologic data to carefully interpret lab results when multiple pathogens are identified during the course of an outbreak investigation.

• Percentage of Adults Aged ≥18 Years Who Felt That Crime Makes It Unsafe to Walk, by Sex and Age Group — National Health Interview Survey, United States, 2020

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