MMWR News Synopsis for June 1, 2017

Amanita phalloides Mushroom Poisonings — Northern California, December 2016

Rachael Kagan
Director of Communications, San Francisco Department of Public Health
Cell phone: 415-420-5017
Email: rachael.kagan@sfdph.org

Wild-picked or foraged mushrooms should be evaluated by a trained mycologist before eating to avoid possible toxicity from Amanita phalloides. In December 2016, fourteen cases of Amanita phalloides “death cap” mushroom poisoning were identified by the California Poison Control System (CPCS) among people who had eaten foraged wild mushrooms. The large case number is thought to be related to increased growth in mushrooms after an increase in rainfall and warm weather at the end of northern California’s autumn season. All patients had delayed gastrointestinal manifestations of intoxication leading to dehydration and all developed hepatotoxicity. CPCS strongly advises against eating foraged mushrooms without their being evaluated by a trained mycologist. In addition, health care providers should be aware of potential toxicity of A. phalloides and contact their local poison control center for assistance if they see patients who are ill after eating foraged mushrooms.

Strategies for Preventing HIV Infection Among HIV-Uninfected Women Attempting Conception with HIV-Infected Men — United States

CDC Media Relations
404-639-3286

While insemination with HIV-uninfected donor sperm remains an option for achieving conception among couples in which the male partner is HIV-infected and the female partner is uninfected, couples who want to conceive a biologic child together can consider using HAART, PrEP, and “sperm washing” in combination with timed intercourse, insemination, or IVF. In a comprehensive scientific update, CDC outlines the best strategies for preventing transmission from an HIV-infected male partner to his uninfected female partner while attempting conception. This new resource can help providers improve counseling for assisting conception among HIV-discordant couples. Based on available science, for discordant couples in which the male partner is HIV-infected and the female partner is uninfected, insemination with HIV-uninfected donor sperm remains an option for achieving conception. However, for couples who want to conceive a biologic child together, several risk-reduction strategies are available. One strategy is viral suppression with HIV medications for the male partner (highly-active antiretroviral therapy, or HAART), with condomless sex around the time of ovulation, while the female partner takes daily oral HIV medication to prevent infection (pre-exposure prophylaxis, or PrEP). Alternatively, combining HAART and PrEP use among the male and female partner, respectively, with “sperm washing” and subsequent intrauterine insemination or in vitro fertilization can further reduce risk. Because each method carries a unique risk profile and degree of effectiveness, which may be affected by underlying fertility factors, patients should discuss all options with a medical provider who can help them select a treatment plan.

Trends in Prevalence of Advanced HIV Disease at Antiretroviral Therapy Enrollment — 10 Countries, 2004–2015

CDC Media Relations
404-639-3286

While people with HIV in multiple low- and middle-income countries are increasingly starting treatment earlier, many still do not begin treatment until their disease has reached an advanced stage. This puts their health at risk and greatly increases their chances of transmitting HIV to others. A CDC study of 10 countries in Africa, Asia, and the Caribbean suggests that in most of them, more people with HIV are starting treatment before they reach advanced stages of infection. From 2004-2015, the percentage of people who started HIV treatment at later stages decreased significantly in Mozambique, Namibia, and Haiti. Five other countries also experienced declines. However, at least a third of people with HIV in these 10 countries still began treatment too late in 2015. The research sheds light on approaches countries can take to ensure more people with HIV begin treatment sooner, including earlier testing and connecting people to care. Research shows that early and effective HIV treatment improves the health of people living with HIV and reduces transmission of the disease.

Notes from the Field:

• Automated Misidentification as Francisella tularensis — Idaho, 2016

Quick Stats:

• Age-Adjusted Rate of Motor Vehicle Traffic Deaths, by Urbanization of County of Residence — 2005 and 2015 (Holly Hedegaard, MD, hdh6@cdc.gov, 301-458-4460).

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

CDC works 24/7 protecting America’s health, safety, and security. Whether diseases start at home or abroad, are curable or preventable, chronic or acute, stem from human error or deliberate attack, CDC is committed to respond to America’s most pressing health challenges.