Severe Manifestations of Monkeypox among People who are Immunocompromised Due to HIV or Other Conditions - Health Alert Network (HAN) No. 475

2 days 5 hours ago
The purpose of this Centers for Disease Control and Prevention (CDC) Health Alert Network (HAN) Health Advisory is to inform healthcare providers that 1. Severe manifestations of monkeypox have been observed in the United States in the current outbreak. 2. People who are immunocompromised due to HIV or other conditions are at higher risk for severe manifestations of monkeypox than people who are immunocompetent. 3. Because people with HIV-associated immunocompromise are at risk for severe manifestations of monkeypox, the HIV status of all sexually active adults and adolescents with suspected or confirmed monkeypox should be determined. 4. There are diagnostic and clinical management strategies that may help address severe manifestations of monkeypox.

Severe Respiratory Illnesses Associated with Rhinoviruses and/or Enteroviruses Including EV-D68 - Multistate, 2022 - Health Alert Network (HAN) No. 474

3 weeks 1 day ago
Healthcare providers and hospitals in several regions of the United States notified the Centers for Disease Control and Prevention (CDC) during August 2022 about increases in pediatric hospitalizations in patients with severe respiratory illness who also tested positive for rhinovirus (RV) and/or enterovirus (EV). RVs and EVs can have clinically similar presentations and are indistinguishable from one another on multiplex assays often used in clinical settings. Upon further typing, some specimens have been positive for enterovirus D68 (EV-D68). Concurrently, pediatric acute respiratory illness sentinel surveillance sites are reporting a higher proportion of EV-D68 positivity in children who are RV/EV positive compared to previous years. Although it primarily causes acute respiratory illness, EV-D68 has been associated with acute flaccid myelitis (AFM), a rare but serious neurologic complication involving limb weakness.

Variant Influenza Virus Infections: Recommendations for Identification, Treatment, and Prevention for Summer and Fall 2022 - Health Alert Network (HAN) No. 473

1 month ago
The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to provide updates on recent variant1 influenza virus infections and summarize CDC's recommendations for identification, treatment, and prevention of variant influenza virus infection for the summer and fall of 2022.

Update for Clinicians on Monkeypox in People with HIV, Children and Adolescents, and People who are Pregnant or Breastfeeding - Health Alert Network (HAN) No. 472

2 months ago
As of July 29, 2022, the Centers for Disease Control and Prevention (CDC) and state and local public health partners are reporting 5,189 cases of Monkeypox virus infections in the United States across 47 states, Washington, D.C., and Puerto Rico. CDC is also reporting multiple outbreaks of monkeypox have also been reported globally in 72 countries that do not normally report monkeypox activity. On Friday, July 22, CDC reported the first two cases of monkeypox in children in the United States during the current outbreak. This Health Alert Network (HAN) Health Update serves to alert clinicians to clinical considerations for preventing, diagnosing, and managing monkeypox in people with HIV, children, adolescents, and people who are pregnant or breastfeeding.

Update for Clinicians on Testing and Treatment for Monkeypox - Health Alert Network (HAN) No. 471

2 months ago
As of July 28, 2022, the Centers for Disease Control and Prevention (CDC) and state and local public health partners are reporting 4,907 cases of monkeypox in the United States across 46 states, Washington, D.C., and Puerto Rico. CDC is also tracking multiple clusters of monkeypox that have been reported globally, including in 71 countries that normally do not report monkeypox. This Health Alert Network (HAN) Health Update serves to alert clinicians on commercial testing capability, collecting clinical specimens for testing, and using TPOXX® (tecovirimat) for treating monkeypox.

Melioidosis Locally Endemic in Areas of the Mississippi Gulf Coast after Burkholderia pseudomallei Isolated in Soil and Water and Linked to Two Cases - Mississippi, 2020 and 2022 - Health Alert Network (HAN) No. 470

2 months ago
The Centers for Disease Control and Prevention (CDC) identified the bacterium Burkholderia pseudomallei (B. pseudomallei) for the first time in the environment in the continental United States. This bacterium causes a rare and serious disease called melioidosis. B. pseudomallei was identified through environmental sampling of soil and water in the Gulf Coast region of southern Mississippi during an investigation of two human melioidosis cases.

Recent Reports of Human Parechovirus (PeV) in the United States-2022 - Health Alert Network (HAN) No. 469

2 months 2 weeks ago
The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to inform clinicians and public health departments that parechovirus (PeV) is currently circulating in the United States. Since May 2022, CDC has received reports from healthcare providers in multiple states of PeV infections in neonates and young infants. Parechoviruses are a group of viruses known to cause a spectrum of disease in humans. Clinicians are encouraged to include PeV in the differential diagnoses of infants presenting with fever, sepsis-like syndrome, or neurologic illness (seizures, meningitis) without another known cause and to test for PeV in children with signs and symptoms compatible with PeV infection (see below). Commercial laboratory assays, multiplex platforms for meningitis and encephalitis, and testing through state public health laboratories (SPHLs) are available to test cerebrospinal fluid (CSF) for PeV to confirm a diagnosis. CDC laboratory support is also available for testing and typing patient specimens.

Updated Case-finding Guidance: Monkeypox Outbreak-United States, 2022 - Health Alert Network (HAN) No. 468

3 months 2 weeks ago
Since May 2022, monkeypox cases, which have historically been rare in the United States, have been identified in 18 states and territories among both persons returning from international travel and their close contacts domestically. Globally, more than 1,600 cases have been reported from more than 30 countries; the case count continues to rise daily. In the United States, evidence of person-to-person disease transmission in multiple states and reports of clinical cases with some uncharacteristic features have raised concern that some cases are not being recognized and tested. This Health Alert Network (HAN) Health Update serves to alert clinicians to clinical presentations of monkeypox seen so far in the United States and to provide updated and expanded case definitions intended to encourage testing for monkeypox among persons presenting for care with relevant history, signs, and symptoms. In addition, this Health Update provides an update to a HAN Health Advisory that the Centers for Disease Control and Prevention (CDC) issued May 20, 2022 titled Monkeypox Virus Infection in the United States and Other Non-endemic Countries-2022. In people with epidemiologic risk factors, rashes initially considered characteristic of more common infections (e.g., varicella zoster, herpes, syphilis) should be carefully evaluated for concurrent characteristic monkeypox rash (see images and links to below) and considered for testing.

COVID-19 Rebound After Paxlovid Treatment - Health Alert Network (HAN) No. 467

4 months 1 week ago
The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to update healthcare providers, public health departments, and the public on the potential for recurrence of COVID-19 or "COVID-19 rebound." Paxlovid continues to be recommended for early-stage treatment of mild to moderate COVID-19 among persons at high risk for progression to severe disease. Paxlovid treatment helps prevent hospitalization and death due to COVID-19. COVID-19 rebound has been reported to occur between 2 and 8 days after initial recovery and is characterized by a recurrence of COVID-19 symptoms or a new positive viral test after having tested negative. A brief return of symptoms may be part of the natural history of SARS-CoV-2 (the virus that causes COVID-19) infection in some persons, independent of treatment with Paxlovid and regardless of vaccination status. Limited information currently available from case reports suggests that persons treated with Paxlovid who experience COVID-19 rebound have had mild illness; there are no reports of severe disease. There is currently no evidence that additional treatment is needed with Paxlovid or other anti-SARS-CoV-2 therapies in cases where COVID-19 rebound is suspected.

Monkeypox Virus Infection in the United States and Other Non-endemic Countries-2022 - Health Alert Network (HAN) No. 466

4 months 1 week ago
The Massachusetts Department of Public Health and the Centers for Disease Control and Prevention (CDC) are investigating a confirmed case of monkeypox in the United States. On May 17, 2022, skin lesions that had several features suspicious for monkeypox-firm, well circumscribed, deep-seated, and umbilicated lesions-on a Massachusetts resident prompted specialized Laboratory Response Network (LRN) testing of swab specimens collected from the resident; preliminary testing confirmed the presence of DNA consistent with an orthopoxvirus using Orthopoxvirus generic and non-variola Orthopoxvirus real-time polymerase chain reaction (PCR) assays. This group of viruses includes monkeypox virus (the causative agent of monkeypox). Testing at CDC on May 18 confirmed the patient was infected with a West African strain of monkeypox virus. The patient is currently isolated and does not pose a risk to the public.

Updated Recommendations for Adenovirus Testing and Reporting of Children with Acute Hepatitis of Unknown Etiology - Health Alert Network (HAN) No. 465

4 months 3 weeks ago
The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Update to provide clinicians and public health authorities with updated information about an epidemiologic investigation of pediatric cases of hepatitis of unknown etiology in the United States. This investigation focuses on collecting information to describe the epidemiology, etiology, clinical presentation, severity, and risk factors related to illness and to identify any relationship between adenovirus infection or other factors and hepatitis. As of May 5, 2022, CDC and state partners are investigating 109 children with hepatitis of unknown origin across 25 states and territories, more than half of whom have tested positive for adenovirus with more than 90% hospitalized, 14% with liver transplants, and five deaths under investigation. Because this investigation is ongoing and includes reviewing cases of hepatitis of unknown cause with onset since October 2021, patients under investigation are not limited to current or newly diagnosed pediatric hepatitis illnesses.

Highly Pathogenic Avian Influenza A(H5N1) Virus: Recommendations for Human Health Investigations and Response - Health Alert Network (HAN) No. 464

5 months ago
A person has tested positive for avian influenza A(H5) virus (H5 bird flu) in the U.S., as confirmed by the Centers for Disease Control and Prevention (CDC) and reported by the Colorado Department of Public Health and Environment on April 28, 2022. This case occurred in a person who had direct exposure to poultry and who was involved in the culling (depopulating) of poultry with presumptive H5N1 bird flu.

Updated Information on Availability and Use of Treatments for Outpatients with Mild to Moderate COVID-19 Who are at Increased Risk for Severe Outcomes of COVID-19 - Health Alert Network (HAN) No. 463

5 months ago
The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to update healthcare providers, public health departments, and the public about the availability and use of recommended therapies for COVID-19 and to advise against using unproven treatments that have known or potential harms for outpatients with mild to moderate COVID-19. For patients with mild to moderate COVID-19 who are not hospitalized and who are at increased risk for severe COVID-19 outcomes, several treatment optionsexternal icon are now widely available and accessible.

Recommendations for Adenovirus Testing and Reporting of Children with Acute Hepatitis of Unknown Etiology - Health Alert Network (HAN) No. 462

5 months 1 week ago
The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to notify clinicians and public health authorities of a cluster of children identified with hepatitis and adenovirus infection. In November 2021, clinicians at a large children's hospital in Alabama notified CDC of five pediatric patients with significant liver injury, including three with acute liver failure, who also tested positive for adenovirus. All children were previously healthy. None had COVID-19. Case-finding efforts at this hospital identified four additional pediatric patients with hepatitis and adenovirus infection for a total of nine patients admitted from October 2021 through February 2022; all five that were sequenced had adenovirus type 41 infection identified. In two patients, plasma samples were negative for adenovirus by quantitative polymerase chain reaction (qPCR), but both patients were positive when retested using whole blood. Two patients required liver transplant; no patients died. A possible association between pediatric hepatitis and adenovirus infection is currently under investigation. Cases of pediatric hepatitis in children who tested negative for hepatitis viruses A, B, C, D, and E were reported earlier this month in the United Kingdom, including some with adenovirus infection.

Using Therapeutics to Prevent and Treat COVID-19 - Health Alert Network (HAN) No. 461

9 months ago
The SARS-CoV-2 Omicron variant has quickly become the dominant variant of concern in the United States and is present in all 50 states. The Centers for Disease Control and Prevention (CDC) recommends that eligible individuals should get all vaccines and booster shots as the best preventive measure available against severe disease, hospitalizations, and death due to COVID-19. Therapeutics are also available for preventing and treating COVID-19 in specific at-risk populations. These therapeutics differ in efficacy, route of administration, risk profile, and whether they are authorized by the U.S Food and Drug Administration (FDA) for adults only or adults and certain pediatric populations. Some therapeutics are in short supply, but availability is expected to increase in the coming months. This Health Alert Network (HAN) Health Advisory serves to familiarize healthcare providers with available therapeutics, understand how and when to prescribe and prioritize them, and recognize contraindications.

Rapid Increase of Omicron Variant Infections in the United States: Management of Healthcare Personnel with SARS-CoV-2 Infection or Exposure - Health Alert Network (HAN) No. 460

9 months 1 week ago
Due to the increased transmissibility of the SARS-CoV-2 Omicron variant and concerns about potential impacts on the healthcare system, the Centers for Disease Control and Prevention (CDC) is updating recommendations to enhance protection for healthcare personnel, patients, and visitors, and ensure adequate staffing in healthcare facilities. The guidance is based on the limited information currently available about the Omicron variant and will be updated as needed as new information becomes available.

New SARS-CoV-2 Variant of Concern Identified: Omicron (B.1.1.529) Variant - Health Alert Network (HAN) No. 459

9 months 4 weeks ago
Omicron, a new SARS-CoV-2 variant, has been identified in many countries and categorized as a Variant of Concern by the U.S. government and the World Health Organization (WHO). Because little is known about Omicron currently, it is important for the public health and medical communities as well as the general public to remain vigilant to reduce potential exposure. This Health Alert Network (HAN) Health Advisory summarizes current knowledge about Omicron and provides recommendations on how to detect the Omicron variant within the United States as soon as possible to mitigate its spread.

Update: Expansion of Recall of LeadCare Blood Lead Tests Due to Risk of Falsely Low Results - Health Alert Network (HAN) No. 457

10 months 3 weeks ago
The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Update as an update to HAN Update 454: Expansion of Recall of LeadCare Blood Lead Tests Due to Risk of Falsely Low Results that CDC issued on October 14, 2021. The purpose of this HAN Update is to clarify options for retesting children who were tested with the recalled LeadCare lead test kits. The information in this HAN Update remains the same as HAN Update 454, except for the new information added below in bold in the Recommendations for Clinicians section.

Source Identified and Case Definition Established: Multistate Investigation of Non-travel Associated Burkholderia pseudomallei Infections (Melioidosis) in Four Patients: Georgia, Kansas, Minnesota, and Texas - 2021 - Health Alert Network (HAN) No. 456

10 months 4 weeks ago
Whole genome sequencing (WGS) at the Centers for Disease Control and Prevention (CDC) confirmed that the strain of Burkholderia pseudomallei in bottles of aromatherapy room spray matches the bacterial strain that sickened all four patients. The outbreak strain was identified in a bottle of "Lavender & Chamomile" scented room spray found in the home of the Georgia resident who was infected and died from B. pseudomallei infection (melioidosis) in July 2021. That same outbreak strain was also identified in an unopened bottle of the same scented product recalled from a Walmart store in a different state.
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