jueves, 25 de agosto de 2016

CDC MMWR News Synopsis for August 25, 2016

MMWR- Morbidity and Mortality Weekly Report
MMWR News Synopsis for August 25, 2016

National Fentanyl Seizures and Changes in Synthetic Opioid-Involved Overdose Deaths — 27 States, 2013–2014

Urgent public health action is needed to prevent and reduce sharp increases in fentanyl-involved overdose deaths likely driven by sharp increases in the production of illicitly made fentanyl and its distribution in heroin markets and through counterfeit prescription pills. From 2013 to 2014, eight of the 27 states reporting data experienced sharp increases in synthetic opioid-involved overdose deaths. This spike in overdose deaths likely was driven by substantial increases in the production and distribution of illicitly made fentanyl. Illicitly made fentanyl is primarily being mixed with or sold as heroin and is increasingly sold in counterfeit prescription pills. Law enforcement fentanyl submissions from 2015 indicate the problem is worsening and spreading to additional states. Urgent public health action is needed to: 1) improve timeliness of opioid surveillance to facilitate faster identification and response to spikes in fentanyl overdoses; 2) expand evidence-based harm reduction and naloxone access, with a focus on people using heroin; and 3) implement programs that increase linkage and access to medication-assisted treatment, with a focus on people using heroin.

Increase in Fentanyl-Related Overdose Deaths — Ohio and Florida, 2010–2015

There is a close relationship between overdose deaths from fentanyl and law enforcement reports of illicitly manufactured fentanyl (IMF). During 2010-2015, Ohio and Florida reported significant increases in fentanyl-involved overdose deaths likely tied to parallel increases in IMF distributed in these two states. Fentanyl is 50 to 100 times more potent than morphine, and IMF is often sold as or mixed with heroin.Collaborative multidisciplinary strategies from public health agencies, harm reduction communities, emergency medical services, law enforcement, and providers of treatment services for substance use disorders might have the highest impact on reducing IMF-related deaths.

National, Regional, State, and Selected Local Area Vaccination Coverage among Adolescents Aged 13–17 Years — United States, 2015

HPV vaccination could prevent over 90 percent of cancers caused by HPV infections, but many preteens and teens are not getting HPV vaccine during the same visit they get other routinely recommended vaccines. While it is occurring at a slow pace, HPV vaccination is becoming more routine. Six out of 10 teen girls (63 percent) and five out of 10 teen boys (50 percent) in the United States have started the HPV vaccination series (i.e., received at least one dose of HPV vaccine), according to data from the 2015 National Immunization Survey-Teen (NIS-Teen). Between 2014 and 2015, there was a small increase in the percentage of girls receiving one or more doses of HPV vaccine and a larger increase in the percentage of boys receiving one or more doses of HPV vaccine. While a higher percentage of girls are getting HPV vaccine compared with boys, the gap is beginning to narrow. In comparison with HPV vaccination, about eight out of 10 girls and boys have received the Tdap (86 percent) and meningococcal vaccines (81 percent). This difference highlights missed opportunities to give HPV vaccine during the same visit that other vaccines are given.

Fractional-Dose Inactivated Poliovirus Vaccination Campaign — Telangana State, India, June 2016

It is possible to plan and implement a mass vaccination campaign using intradermal IPV within 14 days of a reported poliovirus isolation or outbreak. Strong government leadership and well-coordinated support from the Global Polio Eradication Initiative are critical elements to reach a high proportion of targeted children.The government of India and the Global Polio Eradication Initiative conducted a mass vaccination campaign that for the first time used an intradermal one-fifth dose of inactivated poliovirus vaccine (IPV). This campaign was conducted within 14 days of reported isolation of vaccine-derived poliovirus type 2 in Telangana, India. Over six days, more than 300,000 children were vaccinated. A post-campaign survey showed that 94 percent of children were vaccinated with IPV.

Notes from the Field

  • Outbreak of Listeriosis Associated with Packaged Salad — United States and Canada, 2015–2016
  • Cluster of Tuberculosis Among Marshallese Persons Residing in Arkansas — 2014–2015


  • Percentage of Adults Aged ≥45 Years with Activity Limitations, by Age Group and Type of Limitation — National Health Interview Survey, United States, 2000–2015

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