MMWR News Synopsis

Articles

Public Health Surveillance and Reporting for Human Toxoplasmosis — Six States, 2021 

CDC Media Relations
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A review of state surveillance systems for toxoplasmosis found that case definitions are not standardized across states, which makes it hard to know how much disease there is in the United States, what the sources are, or who is affected. Toxoplasmosis, a disease caused by the parasite Toxoplasma gondii, is generally mild or asymptomatic in people with healthy immune systems but can be severe in people with weakened immune systems. Women who are infected during or shortly before pregnancy can pass the infection to their fetuses, potentially resulting in a range of adverse outcomes. Based on estimates from 2011 to 2014, around 11% of the U.S. population has been infected. Toxoplasmosis is not a nationally notifiable illness in the United States, so no standardized national-level surveillance data are available. It is, however, a reportable disease in eight states. This review sought to better understand how toxoplasmosis surveillance data are collected and utilized in states where the disease is currently reportable. Case definitions varied across states, highlighting the need for a standardized surveillance case definition. Standardized case definitions are important so that cases are classified and counted consistently, regardless of jurisdiction, making it easier to compile or compare data across states. As a result of this review, the participating states are pursuing the creation of a standardized surveillance case definition, which would be available to any state that wants to make toxoplasmosis a reportable disease.

Pediatric HIV Case Identification Across 22 PEPFAR-Supported Countries during the COVID-19 Pandemic, October 2019–September 2020 

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Data from 22 countries supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) show reduced pediatric HIV testing and diagnoses during the COVID-19 pandemic. However, some testing strategies increased, suggesting these strategies reduced the impact of the COVID-19 pandemic on pediatric HIV case identification. During 2020, an estimated 150,000 children aged 0-14 years acquired HIV globally. Case identification is the first step to ensuring children living with HIV are linked to life-saving treatment, achieve viral suppression, and live long, healthy lives.  In this study, changes in HIV testing and diagnoses in children aged 0-14 years were assessed in 22 PEPFAR-supported countries during October 2019-September 2020. During the first 3 months of the COVID-19 pandemic, HIV testing and case identification among children in these countries decreased by 40% and 29%, respectively. Although outpatient testing decreased, testing increased for other strategies, including mobile testing, facility-based index testing (offering an HIV test to partners and biological children of HIV-positive individuals), and testing children with signs or symptoms of malnutrition, suggesting these strategies can be used to reduce the impact of the COVID-19 pandemic on pediatric case identification. To sustain and accelerate progress toward global targets for controlling HIV, HIV programs can use programmatic, surveillance, and financial data to determine the optimal mix of testing strategies during the COVID-19 pandemic.

Safety Monitoring of COVID-19 mRNA Vaccine First Booster Doses Among Persons Aged ≥12 Years with Presumed Immunocompromise Status — United States, January 12, 2022–March 28, 2022 

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A new CDC study found that among people aged 12 years or older with weakened immune systems, reactions were less frequently reported to v-safe after the first mRNA booster (dose 4) than after dose 3 of the primary series. In the United States, during January 12, 2022–March 28, 2022, more than 500,000 people aged 12 years and older received a fourth dose. Serious reactions after the first mRNA booster (dose 4) were rare. People aged 12 years and older with weakened immune systems should receive a first booster (dose 4) at least 3 months after a 3-dose primary COVID-19 vaccination series and a second booster (dose 5) at least 4 months after the first booster (dose 4). People with moderate-to-severe immunocompromising conditions are at risk for severe COVID-19, and their immune response to COVID-19 vaccination might not be as robust as the response in people who have healthy immune systems. The Advisory Committee on Immunization Practices recommends that immunocompromised people aged 12 years and older complete a 3-dose primary mRNA COVID-19 vaccination series followed by a first booster dose (dose 4) at least 3 months after dose 3 and a second booster dose (dose 5) at least 4 months after dose 4. To characterize the safety of a booster dose among people with weakened immune systems aged 12 years and older, CDC reviewed reports received to v-safe and VAERS during the week after receipt of a first mRNA COVID-19 booster dose (dose 4). Data identified no unusual or unexpected patterns of adverse events. Mild-to-moderate reactions, such as injection site pain, fatigue, headache, and muscle pain, following their first booster dose were similar to those among people with healthy immune systems. Reactions were less common following the booster dose (dose 4) than following the last dose of a primary series (dose 3). CDC will continue to monitor vaccine safety and provide updates as needed to guide COVID-19 vaccination recommendations.

Previously Released: Rapid Diagnostic Testing for Response to the Monkeypox Outbreak — Laboratory Response Network, United States, May 17–June 30, 2022 

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• Outbreak of Salmonella Enteritidis at a Correctional Facility Using Mechanically Separated Chicken — Nebraska, 2022 Mechanically separated chicken products are more often contaminated with Salmonella bacteria compared to other poultry products and pose a greater food safety risk if handled improperly. Providing greater oversight of food safety procedures can reduce the likelihood of foodborne illness in correctional settings.

• Percentage of Uninsured Adults Aged 18−64 Years, by Race, Hispanic Origin, and Selected Asian Subgroups — National Health Interview Survey, United States, 2019−2020

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