The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency, under the Department of Health and Human Services, and is headquartered in Atlanta, Georgia.The agency's main goal is the protection of public health and safety through the control and prevention of disease, injury, and disability in the US and worldwide. The CDC focuses national attention on developing and applying disease control and prevention. It especially focuses its attention on infectious disease, food borne pathogens, environmental health, occupational safety and health, health promotion, injury prevention and educational activities designed to improve the health of United States citizens. The CDC also conducts research and provides information on non-infectious diseases, such as obesity and diabetes, and is a founding member of the International Association of National Public Health Institutes.The current Director of the CDC is Rochelle Walensky. The Director reports to the United States Secretary of Health and Human Services.
Pandemic isolation, economic stress, and other stressors may have increased risk for intimate partner violence (IPV) among caregivers raising children. This study examined reported experiences of IPV, associated risk and protective factors, and other correlates among caregivers surveyed as part of a larger study of child and family well-being during the COVID-19 pandemic. We analyzed results from two waves of a nationwide, cross-sectional survey of caregivers of children under the age of 18 during the pandemic (February 2021 and July 2021). The survey collected information from 5,816 participants about their experiences both before and during the pandemic. Of relevance were questions about experiences of IPV in the home, adverse childhood experiences (ACEs), levels of distress, coping mechanisms, employment changes, and parenting behaviors. Close to one quarter (23.5
Abstract Background While access and quality issues in immunization services are well documented, determinants related to social norms and the roles of male and female caregivers remain underexplored in Ghana. This study examined social and behavioral barriers to childhood immunization to inform a family-based intervention to strengthen household engagement in immunization decision-making and improve childhood immunization. Methods A qualitative study was conducted in the Kpone Katamanso district of the Greater Accra Region, Ghana, in April 2023. Data was collected in English, Ga, and Twi through 10 key informant interviews with healthcare workers, 10 in-depth interviews with mothers of fully and under-vaccinated children, and eight focus group discussions with mothers (n=30) and fathers (n=24) of children under two years. Transcripts were coded and analyzed inductively to identify major themes. Results Six themes emerged: (1) diverse household immunization decision-making structures; (2) mothers as the primary actors in vaccination; (3) contrasting perceptions of fathers’ versus mothers’ availability; (4) potential to increase fathers’ engagement through improved knowledge and community influencers; (5) differing interpersonal communication experiences with healthcare workers; and (6) health system barriers disproportionately affecting mothers. Social norms and limited male involvement constrained mothers’ time, autonomy, and support, while healthcare barriers, such as staff shortages, indirect costs, and vaccine stockouts, further impeded access. Conclusion Findings highlight both demand- and supply-side barriers to childhood immunization. The differential valuation of mothers’ versus fathers’ time emerged as a key structural barrier. Promoting male engagement, strengthening interpersonal communication between caregivers and health workers, and addressing health system barriers may improve immunization uptake and advance family-centered immunization strategies in Ghana.
Using a large US hospital database, we described 13 177 candidemia-associated hospitalizations during 2016-2024. In 2024, Candida glabrata surpassed Candida albicans, and Candida auris, previously rare, ranked fifth. These findings underscore the importance of ongoing surveillance and adherence to guidelines for candidemia treatment and testing.
Dengue remains a major public health challenge, particularly in endemic areas like Puerto Rico, where its economic burden is substantial. This study aimed to update the economic burden of dengue in Puerto Rico using recent data from patients, hospitals, and insurance companies, providing a clearer picture of the current situation. We estimated the total number of dengue cases with fever who sought care by adjusting for underreporting through a robust statistical framework linking island-wide passive surveillance data to sentinel acute febrile illness surveillance. We obtained cost data from hospitals and conducted interviews with a random sample of people diagnosed with dengue (n = 101) from December 2021–November 2022, collecting detailed information on direct medical costs, non-medical costs, and indirect costs. We analyzed median, epidemic and long-term dengue incidence patterns from 2010–2023. We conducted a cost-of-illness analysis using Bayesian multiplier methods to adjust for underreporting, followed by a bottom-up costing approach during a typical median incidence year and an epidemic year to illustrate the current economic burden of dengue in Puerto Rico. In the median incidence year (2014), from 597 reported dengue cases we estimated 4500 [95
BACKGROUND:Modified vaccinia Ankara-Bavarian Nordic (MVA-BN) is a third-generation, replication-deficient, smallpox and mpox vaccine that is prepared in liquid and lyophilised formulations. DR Congo reports the highest number of mpox cases annually. Safety data on MVA-BN are available from high-income countries, but comprehensive safety evaluations of MVA-BN are limited in the African continent. METHODS:From Feb 23 to Aug 29, 2017, and from Aug 15 to Sept 17, 2019, 1600 adult (aged 18 years and older) health-care personnel (eg, physicians, nurses, and technicians) at risk for mpox in the Tshuapa province and in Kinshasa were enrolled in an investigational prospective cohort study to evaluate safety of the two-dose MVA-BN vaccine series. Participants were excluded if they were pregnant, acutely ill, involved in another research study or had vaccine administration in the past 28 days, or had conditions that could have put the participant at an unacceptable risk. 1000 (62·5%) participants were administered the liquid formulation and 600 (37·5%) participants were administered the reconstituted lyophilised formulation. Vaccine doses were given on study days 0 and 28 and participants followed up at specified timepoints for up to 2 years for serological monitoring (14, 28, 42, 180, 365, 545, and 730 days). Participants were evaluated for immediate vaccine reactions, given adverse event diaries to document specific adverse events for 7 days following vaccine administration, and asked about potential adverse events at later timepoints up to the 2-year mark. The primary outcome was to assess the safety of MVA-BN for up to 2 years across formulations in a population at increased risk of mpox. This study is registered with ClinicalTrials.gov (NCT02977715). FINDINGS:There was no significant difference in the risk of an adverse event between the liquid formulation (488 [49·0%] of 995 participants) and lyophilised formulation (315 [53·7%] of 586 participants; adjusted risk ratio [aRR] 1·08 [95% CI 0·98-1·19]) within 7 days after vaccination. Within 7 days of vaccine administration, participants had similar proportions of local injection-site reactions between the liquid (356 [35·7%] of 995 participants) and lyophilised (213 [36·3%] of 586 participants) formulations, but those who received the lyophilised formulation had a higher risk for systemic symptoms than those who received the liquid formulation (aRR 1·20 [95% CI 1·05-1·37]). 18 serious adverse events, including 17 deaths and one stillbirth, occurred within the 2-year study period; safety monitors (two board-certified physicians: one in the USA and one in DR Congo) deemed none of the events were causally associated with vaccine administration. 14 pregnancies occurred within 1 month of vaccination and 13 resulted in the birth of healthy infants. INTERPRETATION:This study adds to the growing body of literature on the safety of MVA-BN in different populations. Although limited by incomplete grading of specific adverse events, low numbers of pregnant participants, and differences in health-care access and infrastructure, the data from this cohort in DR Congo do show good safety outcomes for up to 2 years with both liquid and lyophilised vaccine formulations. Because MVA-BN vaccination campaigns are crucial to clade I and clade II mpox outbreak responses, the data from this study supporting safety of MVA-BN in this population are key to build vaccine confidence. FUNDING:US Centers for Disease Control and Prevention and the US Biomedical Advanced Research and Development Authority. TRANSLATION:For the French translation of the abstract see Supplementary Materials section.
