MMWR. Morbidity and mortality weekly report
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MMWR Morb. Mortal. Wkly. Rep. · Apr 2016
Reduced Disparities in Birth Rates Among Teens Aged 15-19 Years - United States, 2006-2007 and 2013-2014.
Teen childbearing can have negative health, economic, and social consequences for mothers and their children (1) and costs the United States approximately $9.4 billion annually (2). During 1991-2014, the birth rate among teens aged 15-19 years in the United States declined 61%, from 61.8 to 24.2 births per 1,000, the lowest rate ever recorded (3). Nonetheless, in 2014, the teen birth rate remained approximately twice as high for Hispanic and non-Hispanic black (black) teens compared with non-Hispanic white (white) teens (3), and geographic and socioeconomic disparities remain (3,4), irrespective of race/ethnicity. ⋯ From 2006-2007 to 2013-2014, significant declines in teen birth rates and birth rate ratios were noted nationally and in many states. At the county level, teen birth rates for 2013-2014 ranged from 3.1 to 119.0 per 1,000 females aged 15-19 years; ACS data indicated unemployment was higher, and education attainment and family income were lower in counties with higher teen birth rates. State and county data can be used to understand disparities in teen births and implement community-level interventions that address the social and structural conditions associated with high teen birth rates.
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MMWR Morb. Mortal. Wkly. Rep. · Apr 2016
Patterns in Zika Virus Testing and Infection, by Report of Symptoms and Pregnancy Status - United States, January 3-March 5, 2016.
CDC recommends Zika virus testing for potentially exposed persons with signs or symptoms consistent with Zika virus disease, and recommends that health care providers offer testing to asymptomatic pregnant women within 12 weeks of exposure. During January 3-March 5, 2016, Zika virus testing was performed for 4,534 persons who traveled to or moved from areas with active Zika virus transmission; 3,335 (73.6%) were pregnant women. Among persons who received testing, 1,541 (34.0%) reported at least one Zika virus-associated sign or symptom (e.g., fever, rash, arthralgia, or conjunctivitis), 436 (9.6%) reported at least one other clinical sign or symptom only, and 2,557 (56.4%) reported no signs or symptoms. ⋯ Among the 2,557 asymptomatic persons who received testing, 2,425 (94.8%) were pregnant women, seven (0.3%) of whom had confirmed Zika virus infection. Although risk for Zika virus infection might vary based on exposure-related factors (e.g., location and duration of travel), in the current setting in U. S. states, where there is no local transmission, most asymptomatic pregnant women who receive testing do not have Zika virus infection.
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MMWR Morb. Mortal. Wkly. Rep. · Apr 2016
Varying Estimates of Sepsis Mortality Using Death Certificates and Administrative Codes--United States, 1999-2014.
Sepsis is a clinical syndrome caused by a dysregulated host response to infection (1). Because there is no confirmatory diagnostic test, the diagnosis of sepsis is based on evidence of infection and clinical judgement. Both death certificates and health services utilization data (administrative claims) have been used to assess sepsis incidence and mortality, but estimates vary depending on the surveillance definition and data source. ⋯ During 2004-2009, using data rounded to thousands, the annual range of published sepsis-related mortality estimates based on administrative claims data was 15% to 140% higher (range = 168,000-381,000) than annual estimates generated using death certificate data (multiple causes) (range = 146,000-159,000). Differences in sepsis-related mortality reported using death certificates and administrative claims data might be explained by limitations inherent in each data source. These findings underscore the need for a reliable sepsis surveillance definition based on objective clinical data to more accurately track national sepsis trends and enable objective assessment of the impact of efforts to increase sepsis awareness and prevention.
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MMWR Morb. Mortal. Wkly. Rep. · Apr 2016
Vital Signs: Preparing for Local Mosquito-Borne Transmission of Zika Virus--United States, 2016.
Widespread Zika virus transmission in the Region of the Americas since 2015 has heightened the urgency of preparing for the possibility of expansion of mosquito-borne transmission of Zika virus during the 2016 mosquito season. CDC and other U. S. government agencies have been working with state and local government partners on prevention and early detection of Zika virus infection and will increase these activities during April as part of their preparation for the anticipated emergence of mosquito-borne transmission of Zika virus in the continental United States.
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MMWR Morb. Mortal. Wkly. Rep. · Apr 2016
Estimating Contraceptive Needs and Increasing Access to Contraception in Response to the Zika Virus Disease Outbreak--Puerto Rico, 2016.
Zika virus is a flavivirus transmitted primarily by Aedes species mosquitoes. Increasing evidence links Zika virus infection during pregnancy to adverse pregnancy and birth outcomes, including pregnancy loss, intrauterine growth restriction, eye defects, congenital brain abnormalities, and other fetal abnormalities. The virus has also been determined to be sexually transmitted. ⋯ CDC and other federal and local partners are seeking to expand access to contraception for these persons. Such efforts have the potential to increase contraceptive access and use, reduce unintended pregnancies, and lead to fewer adverse pregnancy and birth outcomes associated with Zika virus infection during pregnancy. The assessment of challenges and resources related to contraceptive access in Puerto Rico might be a useful model for other areas with active transmission of Zika virus.