The Arkansas Department of Health (ADH or commonly Health Department within the state) is a department of the government of Arkansas under the Governor of Arkansas. It is responsible for protecting health and well-being for all Arkansans. ADH is a unified health department, with a central office coordinating among 94 local health units.The ADH is a cabinet level agency in the executive branch of government responsible for implementation of the rules and regulations promulgated by the Arkansas State Board of Health. The Board of Health nominates the Director of ADH. Each county has a County Health Officer, appointed by the county judge and approved by the Board..
Wednesday, October 22, 2025: 11:30 AM Background: Serious adverse events (SAEs) related to ceftriaxone, a widely used cephalosporin antibiotic, are considered rare. After a 2024 SAE cluster in Alabama, the Centers for Disease Control and Prevention (CDC), with state/local partners and the US Food and Drug Administration (FDA), conducted a nationwide investigation of SAEs, including deaths, among patients who received ceftriaxone.Table.Clinical summary of serious adverse event cases (n=26), September 2024–June 2025Abbreviations: SAE: serious adverse event, ACH: acute care hospital, ED: emergency department, OP: outpatient clinic, F: female, M: male, Pt: patient (used when sex not reported); NR: not reported, NOS: not otherwise specified, EKG: electrocardiogram, PEA: pulseless electrical activity, IV: intravenous, IM: intramuscular, N/A: not applicable, PMH: past medical history, CA: cancer, CAD: coronary artery disease, CHF: congestive heart failure, CKD/ESRD: chronic kidney disease or end stage renal disease; COPD: chronic obstructive pulmonary disease, DM: diabetes mellitus, HTN: hypertension, HLD: hyperlipidemia, dx: disease CPR: cardiopulmonary resuscitation.Figure 1a-b.Epidemic curve: Frequency of reported serious adverse event cases following ceftriaxone administration from September 2024 to June 2025, by event month and US region (a) or ceftriaxone manufacturer (b), n=26Figure includes SAEs meeting CDC case definition: Adverse events following injectable ceftriaxone exposure, occurring after September 1, 2024, which: 1) occurred within 6 hours after receipt of injectable ceftriaxone in a non-ICU setting, 2) resulted in death or required cardiopulmonary resuscitation (CPR), and 3) were not attributed by the treating provider(s) to a cause other than ceftriaxone administration (such as known infection, other underlying medical condition, or exposure to a medication or medical product other than ceftriaxone). Figure 1a (left) displays epidemic curve by US Census Bureau region, reflecting case-patient state of residence. Southern region includes AL, AR, DC, DE, FL, GA, KY, LA, MD, MS, NC, OK, SC, TN, TX, VA, WV. Figure 1b (right) displays epidemic curve by the ceftriaxone product reported as administered to case-patient or present in the facility at the time of adverse event. Abbreviations: NR: not reported, US: United States. (R Core Team, 2024). Methods: CDC issued a national call for cases, defined as death or cardiopulmonary resuscitation within 6 hours of ceftriaxone receipt in non-intensive care settings without other apparent cause, occurring after Sep 1, 2024. Health departments collected clinical data for analysis at CDC. We further classified cases as anaphylaxis-type if determined by treating provider to be allergic or if involved two or more of: hypotension, respiratory compromise, cutaneous manifestations, and gastrointestinal symptoms. For SAEs reported Dec 2024-Jan 2025, FDA collected available ceftriaxone/diluent for testing and requested internal product investigations by manufacturers.Figure 2.Medications (other than ceftriaxone) prescribed proximal and prior to serious adverse event, by individual case-patient, n=23Abbreviations: ARB: angiotensin receptor blocker, ACE: angiotensin-converting enzyme, NSAID: non-steroidal anti-inflammatory drugs. Results: We report 26 cases (65% outpatient; 35% inpatient), including 12 deaths, from 22 healthcare facilities across 15 states from Sep 1, 2024 to Jun 30, 2025 (Figure 1a). Case-patients had a median age of 70 years (IQR: 60-81) and received 1g (n=15, 58%), 2g (n=9, 35%), or unspecified (n=2, 7%) ceftriaxone doses via intravenous (IV) push (n=15, 58%), IV infusion (n=9, 35%), or intramuscular injection (n=2, 7%). Presentations varied (Table); 69% (n=18) were anaphylaxis-type. Prior ceftriaxone exposure (n=16, 62%), cardiac comorbidities (n=20, 77%), and/or concurrent use of antihypertensives (n=17, 65%, Figure 2) were common. Product exposures included 22 lots from 6 ceftriaxone manufacturers (Figure 1b). FDA testing of ceftriaxone (5 lots, 4 manufacturers) and lidocaine diluent (3 lots, 2 manufacturers) found no evidence of tampering, adulteration, endotoxin, or purity/potency issues. Manufacturers (n=4) did not report product anomalies. Conclusion: SAEs, including deaths, can occur after ceftriaxone use. This investigation did not identify a common-source etiology, nor a link to a specific ceftriaxone product. Providers in all settings should monitor for SAEs, including anaphylaxis, and report to the FDA MedWatch Program. Disclosures: All Authors: No reported disclosures
Pregnant women with late latent or latent of unknown duration syphilis are recommended to receive three doses of benzathine penicillin G each 9 or fewer days apart; data on interval variations are limited. We found no significant difference in risk of congenital syphilis between 9-day and 6-8 day dosing intervals. Summary Among pregnant women with late latent or latent of unknown duration syphilis, there was no difference in risk of congenital syphilis between 9-day and 6-8 day maternal treatment dosing intervals. ### Competing Interest Statement The authors have declared no competing interest. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This activity was reviewed by CDC and conducted consistent with applicable federal law and policy (45 C.F.R. part 46.102(l)(2), 42 U.S.C. Sect. 241(d); 5 U.S.C. Sect. 552a). It was deemed public health surveillance and exempt from IRB. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes These data are collected under relevant provisions of the Public Health Service Act and are protected at CDC by an Assurance of Confidentiality (Section 308(d) of the Public Health Service Act, 42 U.S.C. 242 m(d))(), which prohibits use or disclosure of any identifiable or potentially identifiable information collected under the Assurance for purposes other than those set out in the Assurance. Requests for access will be considered on a case by case basis, and inquiries should be directed to setnet{at}cdc.gov. Centers for Disease Control and Prevention, https://ror.org/042twtr12, This study was performed as regular work of the Centers for Disease Control and Prevention (CDC) and is supported by the Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases Cooperative Agreements (CDC-RFA-CK19-1904 and CDC-RFA-CK24-0002), Division of Birth Defects and Infant Disorders Cooperative Agreement (CDC-RFA-DD-23-0003), and through contractual mechanisms, including the Local Health Department Initiative to Chickasaw Health Consulting (200-2021-F-12655).
BACKGROUND:Prescription Drug Monitoring Programs (PDMPs) are databases for controlled substances dispensed from retail pharmacies. Although all 50 states operate their own PDMP, only a few have assessed the accuracy of the data being reported, and none have formally published their results. OBJECTIVE:The objectives of this study were to determine the accuracy of prescriptions reported to the Arkansas PDMP and investigate possible associations between pharmacy characteristics and error reporting. METHODS:Between 2022 and 2023, Arkansas pharmacies (n = 680) were audited to assess the accuracy of reported prescription data. Prescriptions from each pharmacy were compared to the data reported to the PDMP and assessed for errors ranging in severity from minor to severe. Data were analyzed to determine the accuracy rate of reported prescriptions. Negative binomial and logistic regression analyses were utilized to identify associations between pharmacy characteristics and the number or severity of errors reported. RESULTS:A total of 1,081 (1.9%) errors were found during prescription evaluation. Of the errors found, 369 (34.1%) were considered minor, 582 (53.8%) intermediate, and 130 (12%) were severe. Independent pharmacies were associated with reporting a higher number of errors compared to chain pharmacies (IRR:1.34, 95% CI:1.16-1.56). Pharmacies that internally reported data had higher odds of severe errors compared to pharmacies reporting externally (OR:2.69, 95% CI:1.22-5.90). Rurality of the pharmacy did not have a significant impact on error reporting. CONCLUSION:Overall, the study results suggest that data reported to the Arkansas PDMP are accurate, supporting the idea that PDMP data correctly represent the scheduled prescription medications being dispensed to the public. The findings indicate pharmacy characteristics that may have an impact on the number or severity of errors reported. For ongoing quality assurance, the Arkansas PDMP will continue to monitor data accuracy through quarterly audits.
Solid organ transplant recipients (SOTRs) experience elevated cancer risk from immunosuppression and underlying medical conditions. Medical management has improved over time, and SOTRs are living longer. We used registry data covering 693,718 SOTRs in the United States (US) to evaluate population-level cancer trends during 1995-2021. Compared with SOTRs in 1995-2003, those in 2013-2021 were living at older ages and were followed at a longer time since their transplant. Based on 65,081 cancers, cancer incidence in SOTRs was higher during 2013-2021 than 1995-2003 (unadjusted incidence rate ratio [IRR], 1.29; 95% confidence interval [95% CI], 1.26-1.32). However, cancer incidence was lower in 2013-2021 after adjustment for age (IRR, 0.93; 95% CI, 0.91-0.95) and multivariable adjustment (0.93, 0.90-0.96). Results for the 6 most common cancer types showed varying trends during 1995-2021. Overall cancer incidence was higher in SOTRs than in the US general population during 1995-2021 and, most recently, in 2013-2021 (standardized incidence ratio, 1.66; 95% CI, 1.64-1.67). In conclusion, after accounting for age, there was an encouraging decline in cancer incidence among US SOTRs during 1995-2021. However, incidence remained elevated compared with the general population in 2013-2021. Measures are needed to reduce the cancer burden as SOTRs live longer after transplantation and the population ages.
Background/Objectives: Alpha-gal syndrome (AGS) is an allergic condition that results in delayed symptoms in response to exposure to mammalian products. There is limited research on which healthcare professionals (HCPs) are diagnosing AGS, types of symptoms, time to reactions, and products that induce allergic responses in AGS. This survey study aimed to further identify the patient journey and characterize reactions for people with AGS. Methods: Adult patients with HCP-diagnosed AGS took a survey offered through social media and support organizations. Questions included diagnosing HCP type, time from exposure to symptom onset, and type of symptoms by body system. Results: Survey participants (n = 3437) were mostly white (95.8%) and female (81.5%), ranging from 18 to 86 years old, with a mean time from onset to diagnosis of 4.3 years. Most were diagnosed by an allergist (53.6%) or primary care doctor (30.7%). Participants reported gastrointestinal (86.2%), skin (83.5%), respiratory (59.8%), cardiovascular (41.3%), emotional (38.2%), motor (23.7%), and nervous system (23.3%) symptoms. Symptoms were most often reported at 4-6 h post-exposure (49.8%) and 6-8 h (28.6%), with a range from 0 min to 8+ hours. Products eliciting reactions included mammalian products (beef 97.7%, pork 87.2%, dairy 66.9%, gelatin 61.3%), prescription (41.3%) or over-the-counter medications (36.4%), and personal care products (42.0%). Most participants managed their reactions at home, and without epinephrine. Conclusions: This study demonstrates that patients with AGS may experience symptoms due to exposures from mammalian meat and a broad range of mammalian ingredient-containing products, including medications, personal care products, and dairy, with a wide range of body systems impacted. These results may be useful for educating patients and healthcare professionals to improve the accuracy and speed of AGS diagnosis.
