MMWR News Synopsis

Articles

Extreme Heat Exposure: Access and Barriers to Cooling Centers — Maricopa and Yuma Counties, Arizona, 2010–2020

CDC Media Relations
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Extreme heat events are becoming more frequent and intense, which can lead to increased heat-related illness (HRI). Cooling centers, air-conditioned buildings designated as safe locations during extreme heat, can help reduce heat exposure when air conditioning access is limited in a home or workplace. Comprehensive solutions, including cooling centers, will be increasingly necessary to protect populations at higher risk of HRI during periods of extreme heat. Excessive heat warnings are an adaptive measure of heat risk sensitive to daytime and overnight temperature and humidity relative to normal conditions for a locality at that time of year, the duration of heat, and whether temperatures are at levels that pose elevated risks of heat-related health effects. Extreme heat events are becoming more frequent and intense and will continue to worsen in the coming decades due to climate change. Extreme heat exposure can lead to increases in heat effects. During 2010–2020, heat exposure and HRI increased in Maricopa and Yuma Counties, Arizona. Heat-related hospitalizations were higher for adults aged 65 years or older than those younger than 65 years. There are several factors that have limited cooling center use, including limited transportation access to cooling centers; lack of knowledge of the existence and locations of cooling centers; and limited cooling center hours during extreme heat. To improve access, public health departments can enhance communication campaigns to increase awareness of the benefits and locations of cooling centers and open cooling centers in locations of high social vulnerability. Cooling center managers can increase hours of operation and provide multilingual communications materials. Local jurisdictions can also extend cooling center access in locations such as libraries or enhance public-private partnerships with businesses to expand access during extreme heat events.

Genetic Characterization of Novel Oral Polio Vaccine Type 2 Viruses During Initial Use Phase Under Emergency Use Listing — Worldwide, March–October 2021

CDC Media Relations
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Following the administration of more than 111 million doses of novel oral poliovirus vaccine type 2 (nOPV2), a tool developed to stop circulating vaccine-derived poliovirus type 2 outbreaks, a new study confirmed the superior genetic stability of nOPV2 compared with Sabin monovalent type 2.To respond to outbreaks of type 2 circulating vaccine-derived poliovirus (cVDPV2), the World Health Organization authorized nOPV2 for use under a mechanism known as Emergency Use Listing (EUL). The EUL requires enhanced data collection to ensure vaccine safety and effectiveness, including global genomic surveillance, to monitor the genetic stability of the novel vaccine. During the initial use phase (March–October 2021), more than 111 million doses of nOPV2 were administered worldwide. Analyses of samples from nOPV2 recipients and from environmental surveillance sites in areas where nOPV2 was used confirmed the superior genetic stability of nOPV2 compared with Sabin monovalent type 2 vaccine. nOPV2 was designed to reduce the risk of cVDPV2 outbreaks, which account for more than 90% of all outbreaks worldwide that can occur with traditional OPV type 2 use in areas with underperforming vaccination campaigns and low immunization coverage. These data suggest that nOPV2 will be an important tool in the eradication of poliomyelitis.

COVID-19 Cases and Hospitalizations Among Medicare Beneficiaries With and Without Disabilities — United States, January 1, 2020–November 20, 2021

CDC Media Relations
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A new CDC study shows that rates of COVID-19 hospitalization among disability-eligible Medicare beneficiaries at least 18 years of age were almost 50% higher than rates among age-eligible (65 years and older without a disability) beneficiaries. Implementing and increasing access to COVID-19 prevention and treatment strategies, including activities that support equitable vaccine access in the face of the substantial challenges that older adults and people with disability face, are critical to reducing severe COVID-19–associated outcomes among people in these groups. Adults with Medicare-eligible disabilities are at increased risk for severe illness from COVID-19. CDC assessed COVID-19 cases and hospitalizations during January 2020–November 2021 among Medicare beneficiaries aged 18 years and older who were either eligible because of a disability (disability-eligible) or only eligible because of age 65 years and older (age-eligible). COVID-19 case and hospitalization rates were higher in the disability-eligible group compared with the age-eligible group. American Indian/Alaska Native people had the highest disability-eligible and age-eligible hospitalization rates. The higher hospitalization rates among disability-eligible Medicare recipients are likely due to lower vaccination access and coverage among persons with disabilities and the high prevalence of underlying conditions that increase the risk for severe outcomes. Collection of disability status as a core demographic variable in public health surveillance data and identification, as well as the addition of disability questions in other existing data sources can guide research and development of interventions for persons with disabilities.

Previously Released: Trends in Acute Hepatitis of Unspecified Etiology and Adenovirus Stool Testing Results in Children — United States, 2017–2022

CDC Media Relations
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• COVID-19–Associated Mortality Risk Among Long-Term Care Facility Residents and Community-Dwelling Adults Aged ≥65 Years — Illinois, December 2020 and January 2022The COVID-19-associated death rate among Illinois long-term care facility (LTCF) residents aged 65 years and older declined markedly from December 2020 to January 2022. This study reinforces the effectiveness of COVID-19 prevention and control strategies, including vaccination, in reducing COVID-19-associated deaths among LTCF residents. Nonvaccine interventions, including screening staff members for COVID-19 symptoms, restricting visitors, and rapidly identifying new cases through a combination of testing, also played a critical role. Adults aged 65 years and older are at increased risk for severe illness and death from COVID-19. The communal nature of LTCFs and the vulnerability of the LTCF population (often with underlying chronic conditions, cognitive and physical impairments, immunocompromised status, or other disabilities), further increases the risk for COVID-19 infection, hospitalization, and death in this group. This report estimates COVID-19-associated death rates among Illinois LTCF residents 65 years and older and death rates of adults in the same age group but living in the community during December 2020 (pre-COVID-19 vaccines) and January 2022 (1-year post-availability of COVID-19 vaccines). In January 2022, 91% of LTCF residents and 85% of the group living in the community were fully vaccinated, and the proportion of those boosted within these two groups was 75% and 61%, respectively. Findings show that COVID-19 death rates for LTCF residents declined by 69% when looking at COVID-19-related deaths in December 2020 (pre-vaccination) versus January 2022 (post-vaccination). Among those aged 65 years and older, in December 2020, about 16 LTCF residents died for each community resident’s death. By January 2022, about 5 LTCF residents died for each community resident’s death. These findings reinforce that COVID-19 prevention and control strategies, including vaccination, can substantially reduce COVID-19–associated mortality among LTCF residents.
• Diagnosis and Investigation of Pneumonic Plague During a Respiratory Disease Pandemic — Wyoming, 2021Rapid identification and diagnosis of plague, an infectious disease caused by the bacteria Yersinia pestis, is crucial for effective patient treatment and public health response. This investigation highlights challenges associated with diagnosing and treating rare illnesses during a pandemic, when symptoms are similar to those of the pandemic illness.In September 2021, the Wyoming Department of Health was notified of a suspected case of pneumonic plague, a rare but serious disease that is usually fatal without treatment and can spread between people through infected droplets. COVID-19 was initially suspected as the cause of illness in the patient, who was hospitalized for cough, difficulty breathing, and coughing up blood. An infectious disease specialist recommended testing for Y. pestis because the patient had exposure to two ill pet cats. The Wyoming Department of Health confirmed the patient had plague through laboratory diagnosis and identified 22 close contacts, including 19 health care workers, to receive post-exposure prophylaxis. This investigation highlights challenges associated with diagnosing and treating a rare illness whose symptoms mimic those of a pandemic illness, and the importance of animal contact history during patient intake. Clinicians should be aware of the possibility of plague in patients with compatible symptoms and exposure history in areas where plague is known to be present.

• Percentage Distribution of Heat-Related Deaths, by Age Group — National Vital Statistics System, United States, 2018–2020

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