MMWR – Morbidity and Mortality Weekly Report

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1. Deaths and Severe Adverse Events Associated with Anesthesia-Assisted Rapid Opioid Detoxification — New York City, 2012

Jean Weinberg
Director of Public Affairs
New York City Department of Health and Mental Hygiene
pressoffice@health.nyc.gov
347-396-4177

The use of anesthesia-assisted rapid opiate detoxification (AAROD) should be avoided in favor of evidence-based options for the management of opioid dependence, such as medication assisted treatment. The New York City Department of Health and Mental Hygiene investigated reports of patients experiencing serious adverse events after AAROD. AAROD is a controversial detoxification method for opioid-users that is associated with a high risk for severe adverse events, including death. Of 75 patients who underwent AAROD at a New York City clinic during January - September 2012, two died and five others were hospitalized with serious complications. As a result of the investigation, the New York State Department of Health, the New York Office of Alcoholism and Substance Abuse Services, and the New York City Department of Health and Mental Hygiene jointly issued a Health Alert recommending that New York health care providers avoid the use of AAROD in favor of evidence-based options for opioid dependence treatment.

2. Influenza Vaccination Coverage Among Health-Care Personnel — 2012–13 Influenza Season, United States

CDC Media Relations
404-639-3286

Influenza vaccination rates among health-care personnel (HCP) can be increased by implementing effective workplace strategies such as education, promotion, and on-site access to vaccination at no cost for multiple days.  Efforts are especially needed to improve vaccination coverage among HCP working in long-term care facilities. HCP can protect themselves, their families, and their patients from seasonal influenza by getting an influenza vaccination every year. Overall, vaccination coverage among HCP was 72 percent for the 2012-13 influenza season, an increase from 66.9 percent in the 2011-12 season. Coverage was higher than the overall rate for HCP working in settings with vaccination requirements (96.5 percent) and for physicians (92.3 percent). Coverage increased over the last three flu seasons among all occupational settings except long-term care facilities, where vaccination of HCP is critical because of their close contact with elderly patients at high risk for serious complications of influenza and less likely to be protected from illness by influenza vaccination. Coverage among HCP can be improved through education, promotion, and easy access to vaccination.

3. Influenza Vaccination Coverage Among Pregnant Women — United States, 2012–13 Influenza Season

CDC Media Relations
404-639-3286

Providers can increase the vaccination rate among pregnant women by recommending and offering influenza vaccination to their pregnant patients.  Providers should inform pregnant women about the risks of influenza to mothers and their babies, and should emphasize the safety and effectiveness of influenza vaccination. Pregnant women and infants younger than 6 months are at high risk for influenza-related severe illness and hospitalization.  Influenza vaccination protects both pregnant women and their newborns, and is recommended for all pregnant women, regardless of trimester, by the Advisory Committee on Immunization Practices (ACIP) and the American College of Obstetricians and Gynecologists (ACOG).  Vaccination coverage among pregnant women was 51 percent for the 2012-13 influenza season, similar to the 2011-12 influenza season. Women who received a recommendation and offer of influenza vaccination from their provider were much more likely to be vaccinated than those who did not receive a recommendation or a recommendation but no offer.

4. Progress in Improving Electronic Reporting of Laboratory Results to Public Health Agencies — United States, 2013

CDC Media Relations
404-639-3286

State and local public health departments have made substantial progress in advancing ELR in recent years.
Electronic reporting of laboratory results to public health agencies can improve public health surveillance for reportable diseases and conditions by making reporting more timely and complete.  CDC has provides funding to 57 state, local, and territorial health departments through the Epidemiology and Laboratory Capacity for Infectious Diseases cooperative agreement to assist with improving electronic laboratory reporting (ELR). CDC and state and large local health departments are collaborating to monitor ELR implementation in the United States by developing data from each jurisdiction.   At the end of July 2013, 54 of the 57 jurisdictions were receiving ELR, and approximately 62 percent of 20 million laboratory reports were being received electronically, compared with 54 percent in 2012. Continued progress will require collaboration between clinical laboratories, Laboratory Information Management System (LIMS) vendors, and public health agencies.

5. Updated Information on the Epidemiology of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Infection and Guidance for the Public, Clinicians, and Public Health Authorities — Worldwide, 2012–2013

CDC Media Relations
404-639-3286

Although no cases have been reported in the United States, cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection continue to be reported by countries in or near the Arabian Peninsula. MERS-CoV was first reported to cause human infection in September 2012.  As of September 20, 2013, 130 cases from eight countries have been reported to WHO; 58 (45 percent) of these cases have been fatal.  All cases have been linked through travel to or residence in Saudi Arabia, Qatar, Jordan, and United Arab Emirates. This report summarizes epidemiologic information about MERS-CoV; provides updates to CDC guidance about travel, patient evaluation, case definitions, and infection control; and describes new guidance for home care and management of patients with MERS-CoV infection. This updated CDC guidance will help health-care providers and state and local health departments prepare for and respond to a possible MERS-CoV case in the United States.

6. Notes from the Field

• Department of Defense Response to a Multistate Outbreak of Fungal Meningitis — United States, October 2012

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES