Morbidity and Mortality Weekly Report (MMWR)

Pakistan remains one of only three countries worldwide that has never had interrupted wild poliovirus serotype 1 transmission.

Firearm homicide rates in large metro areas and the nation have risen back to rates similar to those seen during 2006-2007. Firearm suicide rates continued to increase, both nationally and in large metro areas overall. Firearm homicides and suicides pose a continuing public health concern in the United States.

In January 2018, the Indiana State Department of Health was notified of a case of Cronobacter sakazakii meningitis in an infant who had been fed exclusively maternal milk.

In 2017, the percentage of children who had a problem for which prescription medication has been taken regularly for ≥3 months increased with increasing age.

Beginning in October 2017, the Arizona Department of Health Services noted an increase in the number of reported cases of coccidioidomycosis.

The unadjusted prevalence of arthritis among adults with prediabetes was 32.0%. The unadjusted prevalence of physical inactivity and obesity among adults with these conditions were 56.5% and 50.1%, respectively.

In 2016, the national prevalences of preexisting and gestational diabetes were 0.86% and 5.96%, respectively. Among 40 jurisdictions, the prevalence of age- and race/ethnicity-standardized preexisting diabetes was stable at 0.8% and increased slightly from 5.2% to 5.6% for gestational diabetes.

Postexposure prophylaxis with hepatitis A vaccine or immune globulin effectively prevents infection with hepatitis A virus when administered within 2 weeks of exposure.

Youths identifying as lesbian, gay, bisexual, or another nonheterosexual identity report more violence victimization, substance use, and suicide risk than do heterosexual youths.

Mouse bioassay is the standard test for botulinum neurotoxin detection. However, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry testing can be 10-100 times more sensitive than MBA but is not yet widely available.

The 2017 hepatitis A outbreaks among persons reporting drug use or experiencing homelessness reinforce the need to vaccinate people at risk for hepatitis A.

November is National Diabetes Month. In the United States, approximately 30 million persons are living with diabetes and 84 million with prediabetes.

During 2012-2016, the percentage of residential care communities located in the West increased from 36.4% to 40.8%.

Tobacco use is the leading preventable cause of cancer and resulted in 3.3 million new cases during 2010-2014.

During 2013-2016, the prevalence of anemia among persons aged ≥65 years increased with increasing age for both men and women.

On September 17, 2017, the Maryland Department of Agriculture was notified by fair and 4-H officials of ill swine at an agricultural fair held September 14-17.

From late May to mid-October 2018, influenza activity in the United States was low; circulating viruses were antigenically similar to cell-propagated reference viruses representing the Northern Hemisphere 2018-19 influenza vaccine composition.

In December 2017, the Colorado Department of Public Health and Environment reported two human Salmonella Enteritidis infections in persons with exposure to pet guinea pigs.

After the 2016 synchronized switch from trivalent oral poliovirus vaccine (OPV) (types 1, 2, and 3) to bivalent OPV (types 1 and 3), transmission of type 2 circulating vaccine-derived polioviruses was detected in countries with subpopulations of children who missed immunization to type 2 poliovirus before the switch.

In the report "Notes from the Field: Exported Case of Sin Nombre Hantavirus Pulmonary Syndrome - Israel, 2017," on page 1129, Maria Morales-Betoulle, PhD; Sara E. Zufan, MPH; and Shannon L.M. Whitmer, PhD, all affiliated with the Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC, should have been included in the author list, and the affiliation for Heather Venkat, DVM, MPH should have been the Arizona Department of Health Services.

During July and August 2017, nine measles cases occurred among vaccinated Israeli soldiers. The primary patient had recently traveled to three countries in Europe with ongoing measles outbreaks. All other cases occurred in his direct contacts. All patients had mild illness; no tertiary cases occurred.

On July 24, 2017, the Ohio Department of Health was notified of a positive rabies test result from a domestic cat in Summit County, a county considered free from terrestrial rabies.

A new CDC analysis found that during 2014-2016 the number of U.S. residents who filled a prescription for preexposure prophylaxis (PrEP) increased substantially, but remained a small fraction of the estimated 1.1 million U.S. residents who could benefit from PrEP.

In the report "National, Regional, State, and Selected Local Area Vaccination Coverage Among AdolescentsAged 13-17 Years - United States, 2017," on page 914, in Table 2, the entry for the column "Difference" and row "≥3 Hepatitis B doses" should have read -2.6 (-4.8 to -0.3).

CDC's Workplace Health Resource Center is a source for reliable evidence and best practices to improve worker health and productivity, address research gaps, and potentially reduce healthcare costs.

In the report "Vaccination Coverage for Selected Vaccines and Exemption Rates Among Children in Kindergarten --- United States, 2017-18 School Year," on page 1121, an incorrect figure was published.

In June 2016, a physician in northwestern Indiana reported a high prevalence of clinically diagnosed Lyme disease among his patients. To further evaluate these findings, the Indiana State Department of Health and CDC conducted a laboratory investigation using specimens from some of the patients.

In January 2018, a patient admitted to a Delaware hospital tested positive for hantavirus immunoglobulin M and immunoglobulin G antibodies by enzyme-linked immunosorbent assay testing.

During 2016-2017, an outbreak of 47 mumps cases occurred in the Denver metropolitan area, mostly among members of a Marshallese community. Public health response included early active surveillance, public education, and prompt implementation of MMR vaccination clinics.

Approximately 20% of employer health care spending is associated with modifiable health risks in the U.S. workforce. Among surveyed U.S. adults, approximately 8% reported consistent use of a hearing protection device (HPD) at loud athletic or entertainment events; women and older adults were less likely to use an HPD, whereas adults with hearing impairment, or who had a hearing-impaired household member or some college education were significantly more likely to use an HPD.

During 2013-2016, 36.0% of youths aged 2-19 years consumed fast food on a given day.

On November 1, 2016, a point prevalence survey was conducted at a Chicago skilled nursing facility with ventilated residents to understand the prevalence of carbapenemase-producing organisms in health care facilities in the Chicago region. The survey identified 20 patients with Verona integron-encoded metallo-beta-lactamase-producing carbapenem-resistant Pseudomonas aeruginosa.

In November 2017, CDC confirmed Sin Nombre virus (SNV) infection in a previously healthy man aged 47 years who was admitted to a hospital in Israel after returning from a trip to the western United States. SNV is a species of hantavirus transmitted to humans primarily through contact with the infected urine or droppings of a deer mouse (Peromyscus maniculatus),

On December 14, 2017, a school nurse notified the Johnson County Department of Health and Environment in Kansas that a student's pregnant mother had received a diagnosis of rubella.

In 2017, coverage with most recommended vaccines among children aged 19-35 months remained stable and high but was lower in more rural areas and among uninsured or Medicaid-insured children. A small but increasing proportion of children received no vaccines by age 24 months.

The prevalence of diagnosed human immunodeficiency virus (HIV) infection among Hispanics/Latinos in the United States is approximately twice that of non-Hispanic whites. Describing Hispanics/Latinos with HIV infection in medical care by sex could inform service delivery.

National Latinx AIDS Awareness Day, October 15, is observed each year to focus on the continuing and disproportionate impact of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) on Hispanics/Latinos in the United States.

Vaccination coverage rates among children in kindergarten remains high.

World Arthritis Day, October 12, 2018, encourages organizations and persons to work toward increasing awareness about arthritis and other conditions. National Mental Illness Awareness Week is October 7-13, 2018, and seeks to educate the public, combat stigma, and provide support to those affected by mental illness.

There were 68 congenital syphilis cases in New York City during 2010-2016, that might have been prevented by prenatal syphilis screening and prompt treatment early during pregnancy.

The 2018 outbreak season is noteworthy for multiple outbreaks of cyclosporiasis associated with different fresh produce items and the large number of reported cases. In 2018, two multistate outbreaks resulted in 761 laboratory-confirmed cases.

A 2017 outbreak investigation of Salmonella Chailey infections found frozen, precut coconut to be the source of the outbreak.

Occupational risk factors for carpal tunnel syndrome were assessed in various industries in California to determine where the highest need for mitigation lies.

In August 2017, the North Carolina Department of Public Health (NCDPH) was notified of a suspected La Crosse virus (LACV) encephalitis case in a boy aged 2 years from western North Carolina. The following day, NCDPH was notified that the patient's brother, aged 11 years, was also ill with symptoms consistent with viral meningoencephalitis. Laboratory testing confirmed that both siblings had evidence of recent LACV infection.

Approximately 10 million adults with arthritis have symptoms of either anxiety or depression, with approximately one in five experiencing symptoms of anxiety and approximately one in 10 experiencing symptoms of depression.

In October 2017, at the request of a Missouri bullet manufacturing, CDC's National Institute for Occupational Safety and Health conducted a health hazard evaluation to determine routes and extent of lead exposure. Their findings indicated elevated blood lead levels among almost all employees and air lead conentrations below federal guidelines and recommended a workplace lead control program be used.

Although three out of four health care workers are getting their annual flu vaccination, there are still health care workers who are vulnerable to flu and its potentially serious complications.

Many pregnant women are unvaccinated, and they and their babies continue to be vulnerable to influenza and pertussis infection and potentially serious complications, including hospitalization and death.

Aspergillus fumigatus strains resistant to all triazole antifungal medications are emerging in the United States in patients and the environment.

In October 2017, the New York State Department of Health was alerted by Albany-area infectious disease physicians about local cases of blastomycosis that included multiple severe infections in the state health department's Capital District, an area where Blastomyces spp. fungi are not considered endemic.