The Pediatric Infectious Disease Journal: September 2016 - Volume 35 - Issue 9 - p 991 doi: 10.1097/INF.0000000000001220

National Latino AIDS Awareness Day is observed each year on October 15 to focus on the continuing and disproportionate impact of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) on the Hispanic or Latino population in the United States.Hispanics or Latinos represent approximately 17% of the U.S. population (1); however, in 2013, they accounted for 21% of all new diagnoses, corresponding to a rate of 18.7 per 100,000 (2).In 2011, an estimated 242,000 Hispanics or Latinos were living with HIV infection in the United States, representing 20% of all such persons.Of these Hispanics or Latinos, an estimated 85% had received a diagnosis of HIV infection, 40% were engaged in HIV medical care, 37% had received a prescription for antiretroviral therapy, and 31% had achieved viral suppression (3).National Latino AIDS Awareness Day is an opportunity to encourage increased HIV prevention activities, such as HIV testing, for Hispanics or Latinos.CDC supports testing, linkage to and engagement in care and treatment, and a range of other efforts to reduce the risk for acquiring or transmitting HIV infection among Hispanics or Latinos.Additional information about CDC resources and activities for National Latino AIDS Awareness Day is available at http://www.cdc.gov/Features/LatinoAIDSAwareness.Additional information about HIV among Hispanics or Latinos is available at http:// www.cdc.gov/hiv/risk/racialethnic/hispanicslatinos.Hispanics or Latinos* represent about 17% of the total U.S. population and are disproportionately affected by human immunodeficiency virus (HIV) infection in the United States (1,2).In 2013, the rate of HIV diagnosis among Hispanics or Latinos (18.7) was nearly three times that of non-Hispanic * Hispanics or Latinos can be of any race.

annual reporting were excluded from this analysis.For 2012, data from all 50 states, DC, and Puerto Rico were summarized.To calculate the number of TB cases that were averted by treating LTBI diagnosed during contact investigations in 2012, an estimated 2.4% (95% confidence interval [CI] = 1.2%-4.7%)cumulative 5-year incidence without treatment (5) was used, discounted for an estimated 80% treatment effectiveness (based on findings of efficacy in clinical trials) (6).Incomplete treatment of LTBI was considered equivalent to no treatment.Missed opportunities for prevention were calculated by projecting the number of missed contacts from patients with no contact elicited or outcomes at each step of the contact investigation by the observed proportions.The projections for completing treatment were discounted by the observed proportions of patients not completing for reasons of death, adverse medication effects, health care provider decisions to discontinue treatment, and development of TB disease.During 2003-2012, the 44 states and Puerto Rico reported 114,003 TB cases in surveillance, accounting for 90.2% of all TB cases reported in the United States and Puerto Rico (1).During this time, the number of index patients in the 44 states and Puerto Rico decreased while the number of contacts listed per index patient with contacts elicited increased from 14.9 to 21.3 contacts for sputum smear-positive index patients (Table 1).The percentage of index patients with no contact elicited decreased overall, from 7.2% in 2003 to 5.1% in 2012 for smear-positive patients and from 18.6% to 11.3%

Dracunculiasis (Guinea worm disease) is caused by Dracunculus medinensis, a parasitic worm.Approximately 1 year after a person acquires infection from contaminated drinking water, the worm emerges through the skin, usually on the lower limb.Pain and secondary bacterial infection can cause temporary or permanent disability that disrupts work and schooling.The campaign to eradicate dracunculiasis worldwide began in 1980 at CDC.In 1986, the World Health Assembly called for dracunculiasis elimination (1), and the global Guinea Worm Eradication Program, led by the Carter Center and supported by the World Health Organization (WHO), United Nations Children's Fund (UNICEF), CDC, and other partners, began assisting ministries of health in countries where dracunculiasis was endemic.In 1986, an estimated 3.5 million cases occurred each year in 20 countries in Africa and Asia (1,2).Since then, although the goal of eradicating dracunculiasis has not been achieved, considerable progress has been made.Compared with the 1986 estimate, the annual number of reported cases in 2015 has been reduced by 99% and cases are confined to four endemic countries.This report updates published (3-5) and unpublished surveillance data reported by ministries of health and describes progress toward dracunculiasis eradication from January 2014 through June 2015.During 2014, a total of 126 cases were reported from four countries (Chad [13 cases], Ethiopia [three], Mali [40], and South Sudan [70]), compared with 148 cases reported in 2013, from the same four countries.The overall 15% reduction in cases during 2013-2014 was less than that experienced in recent years, but the rate of decline increased again to 70% in the first 6 months of 2015 compared with the same period during 2014.Continued active surveillance with aggressive detection and appropriate management of cases are essential program components; however, epidemiologic challenges and civil unrest and insecurity pose potential barriers to eradication.Because the life cycle of D. medinensis is complex, its transmission can be interrupted using several strategies (4).Dracunculiasis can be prevented with four main interventions: 1) educating residents in communities where the disease is endemic, particularly persons from whom worms are emerging, to avoid immersing affected body parts in sources of drinking water; 2) filtering potentially contaminated drinking water through a cloth filter or pipe filter; 3) treating potentially contaminated surface water with the insecticide temephos (Abate) to kill the copepods (small crustaceans that host D. medinensis larvae); and 4) providing safe drinking water from bore-hole or protected hand-dug wells (6).Containment of transmission* is

November is National Diabetes Month.In the United States, approximately 29 million persons have diabetes, and an additional 86 million adults have prediabetes, putting them at risk for developing type 2 diabetes, heart disease, and stroke (1).Persons with diabetes can take steps to control the disease and prevent complications, and those with prediabetes can prevent or delay the onset of type 2 diabetes through weight loss, healthy eating, and physical activity (1,2).After decades of continued increases, the prevalence of diabetes changed little from 2007-2008 to 2011-2012 (3).CDC and the American Medical Association has launched Prevent Diabetes STAT: Screen, Test, Act Today (http://www.preventdiabetesstat.org).This multiyear initiative includes a toolkit (http://www.cdc.gov/diabetes/prevention/pdf/STAT_toolkit.pdf ) to help persons determine their risk for type 2 diabetes and to guide health care providers on the best methods to screen patients for prediabetes and refer patients at high risk to prevention programs.The CDC-led National Diabetes Prevention Program promotes diabetes prevention programs that focus on lifestyle changes in communities throughout the United States (4).More information about CDCrecognized diabetes prevention programs is available at https://nccd.cdc.gov/DDT_DPRP/Registry.aspx.

November is National Diabetes Month.In the United States, approximately 29 million persons have diabetes, and an additional 86 million adults have prediabetes, putting them at risk for developing type 2 diabetes, heart disease, and stroke (1).Persons with diabetes can take steps to control the disease and prevent complications, and those with prediabetes can prevent or delay the onset of type 2 diabetes through weight loss, healthy eating, and physical activity (1,2).After decades of continued increases, the prevalence of diabetes changed little from 2007-2008 to 2011-2012 (3).CDC and the American Medical Association has launched Prevent Diabetes STAT: Screen, Test, Act Today (http://www.preventdiabetesstat.org).This multiyear initiative includes a toolkit (http://www.cdc.gov/diabetes/prevention/pdf/STAT_toolkit.pdf ) to help persons determine their risk for type 2 diabetes and to guide health care providers on the best methods to screen patients for prediabetes and refer patients at high risk to prevention programs.The CDC-led National Diabetes Prevention Program promotes diabetes prevention programs that focus on lifestyle changes in communities throughout the United States (4).More information about CDCrecognized diabetes prevention programs is available at https://nccd.cdc.gov/DDT_DPRP/Registry.aspx.

National Latino AIDS Awareness Day is observed each year on October 15 to focus on the continuing and disproportionate impact of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) on the Hispanic or Latino population in the United States.Hispanics or Latinos represent approximately 17% of the U.S. population (1); however, in 2013, they accounted for 21% of all new diagnoses, corresponding to a rate of 18.7 per 100,000 (2).In 2011, an estimated 242,000 Hispanics or Latinos were living with HIV infection in the United States, representing 20% of all such persons.Of these Hispanics or Latinos, an estimated 85% had received a diagnosis of HIV infection, 40% were engaged in HIV medical care, 37% had received a prescription for antiretroviral therapy, and 31% had achieved viral suppression (3).National Latino AIDS Awareness Day is an opportunity to encourage increased HIV prevention activities, such as HIV testing, for Hispanics or Latinos.CDC supports testing, linkage to and engagement in care and treatment, and a range of other efforts to reduce the risk for acquiring or transmitting HIV infection among Hispanics or Latinos.Additional information about CDC resources and activities for National Latino AIDS Awareness Day is available at http://www.cdc.gov/Features/LatinoAIDSAwareness.Additional information about HIV among Hispanics or Latinos is available at http:// www.cdc.gov/hiv/risk/racialethnic/hispanicslatinos.Hispanics or Latinos* represent about 17% of the total U.S. population and are disproportionately affected by human immunodeficiency virus (HIV) infection in the United States (1,2).In 2013, the rate of HIV diagnosis among Hispanics or Latinos (18.7) was nearly three times that of non-Hispanic * Hispanics or Latinos can be of any race.

The U.S. Department of Health and Human Services, CDC, state and local health departments, and other partners will observe National Influenza Vaccination Week (NIVW) during December 6-12, 2015, with educational and promotional activities across the country.

National Latino AIDS Awareness Day is observed each year on October 15 to focus on the continuing and disproportionate impact of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) on the Hispanic or Latino population in the United States.Hispanics or Latinos represent approximately 17% of the U.S. population (1); however, in 2013, they accounted for 21% of all new diagnoses, corresponding to a rate of 18.7 per 100,000 (2).In 2011, an estimated 242,000 Hispanics or Latinos were living with HIV infection in the United States, representing 20% of all such persons.Of these Hispanics or Latinos, an estimated 85% had received a diagnosis of HIV infection, 40% were engaged in HIV medical care, 37% had received a prescription for antiretroviral therapy, and 31% had achieved viral suppression (3).National Latino AIDS Awareness Day is an opportunity to encourage increased HIV prevention activities, such as HIV testing, for Hispanics or Latinos.CDC supports testing, linkage to and engagement in care and treatment, and a range of other efforts to reduce the risk for acquiring or transmitting HIV infection among Hispanics or Latinos.Additional information about CDC resources and activities for National Latino AIDS Awareness Day is available at http://www.cdc.gov/Features/LatinoAIDSAwareness.Additional information about HIV among Hispanics or Latinos is available at http:// www.cdc.gov/hiv/risk/racialethnic/hispanicslatinos.Hispanics or Latinos* represent about 17% of the total U.S. population and are disproportionately affected by human immunodeficiency virus (HIV) infection in the United States (1,2).In 2013, the rate of HIV diagnosis among Hispanics or Latinos (18.7) was nearly three times that of non-Hispanic * Hispanics or Latinos can be of any race.

Dracunculiasis (Guinea worm disease) is caused by Dracunculus medinensis, a parasitic worm.Approximately 1 year after a person acquires infection from contaminated drinking water, the worm emerges through the skin, usually on the lower limb.Pain and secondary bacterial infection can cause temporary or permanent disability that disrupts work and schooling.The campaign to eradicate dracunculiasis worldwide began in 1980 at CDC.In 1986, the World Health Assembly called for dracunculiasis elimination (1), and the global Guinea Worm Eradication Program, led by the Carter Center and supported by the World Health Organization (WHO), United Nations Children's Fund (UNICEF), CDC, and other partners, began assisting ministries of health in countries where dracunculiasis was endemic.In 1986, an estimated 3.5 million cases occurred each year in 20 countries in Africa and Asia (1,2).Since then, although the goal of eradicating dracunculiasis has not been achieved, considerable progress has been made.Compared with the 1986 estimate, the annual number of reported cases in 2015 has been reduced by 99% and cases are confined to four endemic countries.This report updates published (3-5) and unpublished surveillance data reported by ministries of health and describes progress toward dracunculiasis eradication from January 2014 through June 2015.During 2014, a total of 126 cases were reported from four countries (Chad [13 cases], Ethiopia [three], Mali [40], and South Sudan [70]), compared with 148 cases reported in 2013, from the same four countries.The overall 15% reduction in cases during 2013-2014 was less than that experienced in recent years, but the rate of decline increased again to 70% in the first 6 months of 2015 compared with the same period during 2014.Continued active surveillance with aggressive detection and appropriate management of cases are essential program components; however, epidemiologic challenges and civil unrest and insecurity pose potential barriers to eradication.Because the life cycle of D. medinensis is complex, its transmission can be interrupted using several strategies (4).Dracunculiasis can be prevented with four main interventions: 1) educating residents in communities where the disease is endemic, particularly persons from whom worms are emerging, to avoid immersing affected body parts in sources of drinking water; 2) filtering potentially contaminated drinking water through a cloth filter or pipe filter; 3) treating potentially contaminated surface water with the insecticide temephos (Abate) to kill the copepods (small crustaceans that host D. medinensis larvae); and 4) providing safe drinking water from bore-hole or protected hand-dug wells (6).Containment of transmission* is

Sponsored by the American Cancer Society, the Great American Smokeout is an annual event that encourages smokers to make a plan to quit, or to plan in advance and quit smoking on that day, in an effort to stop smoking permanently (1).The 40th annual Great American Smokeout will be held on November 19, 2015.In the more than 50 years since the first Surgeon General's report on smoking and health, cigarette smoking among U.S. adults has been reduced by half.However, since 1964, an estimated 20 million persons have died because of smoking, which is the leading preventable cause of disease, disability, and death in the United States (2).About two out of three adult smokers want to quit smoking cigarettes, and more than half made a quit attempt in the preceding year (2).However, in 2014, an estimated 16.8% (approximately 40 million) of U.S. adults still smoke (3).Getting effective help through counseling and medications can increase the chances of quitting by as much as three-fold (4).

Sponsored by the American Cancer Society, the Great American Smokeout is an annual event that encourages smokers to make a plan to quit, or to plan in advance and quit smoking on that day, in an effort to stop smoking permanently (1).The 40th annual Great American Smokeout will be held on November 19, 2015.In the more than 50 years since the first Surgeon General's report on smoking and health, cigarette smoking among U.S. adults has been reduced by half.However, since 1964, an estimated 20 million persons have died because of smoking, which is the leading preventable cause of disease, disability, and death in the United States (2).About two out of three adult smokers want to quit smoking cigarettes, and more than half made a quit attempt in the preceding year (2).However, in 2014, an estimated 16.8% (approximately 40 million) of U.S. adults still smoke (3).Getting effective help through counseling and medications can increase the chances of quitting by as much as three-fold (4).

Epilepsy is a brain disorder characterized by recurrent seizures; an estimated 2.9 million persons in the United States have active epilepsy (1).A seizure is a brief change in normal brain activity that changes awareness, behavior, or body movement.More than 30 different types of seizures have been described (2).A report in this issue characterizes seizures in children and adolescents aged 6-17 years in the United States.Because seizures can affect anyone, members of the public need to know how to safely assist a person having a seizure.Not all seizures are emergencies, and most will end within a few minutes.The first response to witnessing a seizure should be to remain calm and provide care and comfort.A person with a convulsive seizure might cry out, fall, stiffen, shake, or lose awareness.If possible, the person should be helped to sit safely or should be guided gently to the floor.Once on the floor, a person should be turned on the side to keep the airway clear; nearby objects should be moved to prevent injury, and the head should be cushioned.A person witnessing a seizure in someone should call 911 if a seizure lasts more than 5 minutes, causes an injury, occurs in a person with another known condition (e.g., pregnancy or low blood sugar in diabetes), or causes a person to have difficulty breathing or waking after the seizure is over.CDC works to improve the health and well-being of persons with epilepsy and to educate the public about this disorder (3).Additional information about providing first aid for seizures is available at http://www.cdc.gov/epilepsy/basics/first-aid.

World AIDS Day, observed on December 1, draws attention to the current status of the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic worldwide.This year's theme is World AIDS 2015: The Time to Act is Now.The first cases of AIDS were reported more than 30 years ago, in the June 5, 1981 issue of MMWR.At the end of 2014, approximately 36.9 million persons worldwide were living with HIV infection (1).Although AIDS-related deaths have decreased by 42% since 2004, an estimated 1.2 million persons died from AIDS in 2014 (1).Global efforts, including the U.S. President's Emergency Plan for AIDS Relief (in which CDC is a principal agency), have resulted in approximately 13.5 million persons in low-and middle-income countries receiving antiretroviral therapy (ART) for HIV infection in 2014 (2).Globally, approximately 15 million persons are on ART (1).An estimated 1.2 million persons in the United States and Puerto Rico are living with HIV infection (3) and approximately 50,000 persons become infected with HIV each year (4).

Abbreviation: CI = confidence interval.* Used cigarettes or cigars on one or more days, but did not use marijuana during the 30 days preceding the surveys.† Used marijuana one or more times, but did not use cigarettes or cigars during the 30 days preceding the surveys.§ Used cigarettes or cigars on one or more days, or used marijuana one or more times during the 30 days preceding the surveys.¶ Students with missing data for cigarette use, cigar use, marijuana use, or sex and students who did not self-identify as non-Hispanic black, non-Hispanic white, or Hispanic were excluded from the analysis.** Significant linear trend during 1997-2013 (p<0.01).† † Significant quadratic trend during 1997-2013 (p<0.01).

Problem/Condition: An estimated 50,000 persons die annually in the United States as a result of violence-related injuries.This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) regarding violent deaths from 16 states for 2007.Results are reported by sex, age group, race/ethnicity, marital status, location of injury, method of injury, circumstances of injury, and other selected characteristics. ReportingPeriod Covered: 2007.Description of System: NVDRS collects data regarding violent deaths obtained from death certificates, coroner/medical examiner reports, and law enforcement reports.NVDRS began operation in 2003 with seven states (Alaska, Maryland, Massachusetts, New Jersey, Oregon, South Carolina, and Virginia) participating; six states (Colorado, Georgia, North Carolina, Oklahoma, Rhode Island, and Wisconsin) joined in 2004, four (California, Kentucky, New Mexico, and Utah) in 2005, and two states (Ohio and Michigan) were funded to begin data collection in 2010, totaling 19 states.This report includes data from 16 states that collected statewide data in 2007.California data are not included in this report because NVDRS data are collected only in a limited number of California cities and counties rather than statewide.Ohio and Michigan are excluded because they did not begin data collection until 2010.Results: For 2007, a total of 15,882 fatal incidents involving 16,319 deaths occurred in the 16 NVDRS states included in this report.The majority (56.6%) of deaths was suicides, followed by homicides and deaths involving legal intervention (i.e., deaths caused by police and other persons with legal authority to use deadly force, excluding legal executions) (28.0%), deaths of undetermined intent (14.7%), and unintentional firearm deaths (0.7%).Suicides occurred at higher rates among males, American Indians/Alaska Natives, non-Hispanic whites, and persons aged 45-54 years.Suicides occurred most often in a house or apartment and involved the use of firearms.Suicides were precipitated primarily by mental-health, intimate-partner, or physical-health problems, or by a crisis during the preceding 2 weeks.Homicides occurred at higher rates among males and persons aged 20-24 years; rates were highest among non-Hispanic black males.The majority of homicides involved the use of a firearm and occurred in a house or apartment or on a street/highway.Homicides were precipitated primarily by arguments and interpersonal conflicts or in conjunction with another crime.Other manners of death and special situations or populations also are highlighted in this report. Interpretation:This report provides a detailed summary of data from NVDRS for 2007.The results indicate that violent deaths resulting from self-inflicted or interpersonal violence disproportionately affected adults aged <55 years, males, and certain minority populations.For homicides and suicides, relationship problems, interpersonal conflicts, mental-health problems, and recent crises were among the primary precipitating factors.Because additional information might be reported subsequently as participating states update their findings, the data provided in this report are preliminary. Public Health Action:For the occurrence of violent deaths in the United States to be better understood and ultimately prevented, accurate, timely, and comprehensive surveillance data are necessary.NVDRS data can be used to monitor the occurrence of violence-related fatal injuries and assist public health authorities in the development, implementation, and evaluation of programs and policies to reduce and prevent violent deaths at the national, state, and local levels.The continued development and expansion of NVDRS is essential to CDC's efforts to reduce the personal, familial, and societal costs of violence.Further efforts are needed to increase the number of states participating in NVDRS, with an ultimate goal of full national representation. MMWR May 14, 2010this gap in national surveillance; it is the first system to provide detailed information on circumstances precipitating violent deaths, the first to link multiple source documents to enable researchers to understand each death more completely, and the first to link multiple deaths that are related to one another (e.g., multiple homicides, suicide pacts, and cases of homicide followed by the suicide of the suspected perpetrator).NVDRS began operation in 2003 with seven states (Alaska, Maryland, Massachusetts, New Jersey, Oregon, South Carolina, and Virginia) participating; six states (Colorado, Georgia, North Carolina, Oklahoma, Rhode Island, and Wisconsin) joined in 2004, four (California, Kentucky, New Mexico, and Utah) in 2005, and two states (Ohio and Michigan) were funded to begin data collection in 2010, totaling 19 states (Figure).CDC provides funding for state participation and anticipates that NVDRS will expand to include all 50 states, the District of Columbia, and U.S. territories.This report summarizes data for 2007 concerning deaths meeting NVDRS inclusion criteria from 16 states that collected statewide data (approximately 26% of the U.S. population).California data are not included in this report because NVDRS data are collected only in a limited number of California cities and counties rather than statewide.Ohio and Michigan were excluded because they did not begin data collection until 2010.Because additional information might be reported subsequently as participating states update their findings, the data provided in this report are preliminary.Annual updates of NVDRS data also are available through a web-based query system at http://wisqars.cdc.gov:8080/nvdrs/nvdrsDisplay.jsp.

The Pediatric Infectious Disease Journal: October 2009 - Volume 28 - Issue 10 - p 859 doi: 10.1097/INF.0b013e3181b87b2c