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

2 years 4 months 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

2 years 4 months 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.

Source Implicated in Fatal Case in Georgia: Multistate Outbreak of Non-travel Associated Burkholderia pseudomallei Infections (Melioidosis) in Four Patients: Georgia, Kansas, Minnesota, and Texas-2021 - Health Alert Network (HAN) No. 455

2 years 5 months ago
Testing at the Centers for Disease Control and Prevention (CDC) has identified the bacterial DNA of Burkholderia pseudomallei in an aromatherapy room spray in the home of the Georgia resident who was infected with and died from Burkholderia pseudomallei infection (melioidosis) in July 2021. This Georgia patient was the fourth melioidosis case in a cluster since March 2021 that involved three other patients in Kansas, Minnesota, and Texas, as described previously in HAN Health Update 448: New Case Identified: Multistate Investigation of Non-travel Associated Burkholderia pseudomallei Infections (Melioidosis) in Four Patients: Georgia, Kansas, Minnesota, and Texas-2021 that CDC issued on August 9, 2021.

Expansion of Recall of LeadCare Blood Lead Tests Due to Risk of Falsely Low Results - Health Alert Network (HAN) No. 454

2 years 5 months ago
Magellan Diagnostics, Inc. and the U.S. Food and Drug Administration (FDA) have issued notifications about the expansion of Magellan Diagnostics' recall of LeadCare II, LeadCare Plus, and LeadCare Ultra Blood Lead Tests, which were distributed from October 27, 2020, to August 19, 2021. Additional LeadCare II product lots, including lots previously reported to be unaffected, were recalled due to a significant risk of falsely low results. The use of these devices may cause serious injuries because they might underestimate blood lead levels. FDA has identified this as a Class I recall, the most serious type of recall. The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Update to notify healthcare providers and state and local health departments about the expansion of the recall notice and to recommend appropriate follow-up actions in the shortage of LeadCare Lead Tests. This HAN Health Update is an update to HAN Health Advisory 445: Recall of LeadCare Blood Lead Tests Due to Risk of Falsely Low Results that CDC issued on July 6, 2021.

COVID-19 Vaccination for Pregnant People to Prevent Serious Illness, Deaths, and Adverse Pregnancy Outcomes from COVID-19 - Health Alert Network (HAN) No. 453

2 years 5 months ago
The Centers for Disease Control and Prevention (CDC) recommends urgent action to increase Coronavirus Disease 2019 (COVID-19) vaccination among people who are pregnant, recently pregnant (including those who are lactating), who are trying to become pregnant now, or who might become pregnant in the future. CDC strongly recommends COVID-19 vaccination either before or during pregnancy because the benefits of vaccination outweigh known or potential risks. As of September 27, 2021, more than 125,000 laboratory-confirmed COVID-19 cases have been reported in pregnant people, including more than 22,000 hospitalized cases and 161 deaths.1 The highest number of COVID-19-related deaths in pregnant people (n=22) in a single month of the pandemic was reported in August 2021. Data from the COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) in 2021 indicate that approximately 97% of pregnant people hospitalized (either for illness or for labor and delivery) with confirmed SARS-CoV-2 infection were unvaccinated.2 In addition to the risks of severe illness and death for pregnant and recently pregnant people, there is an increased risk for adverse pregnancy and neonatal outcomes, including preterm birth and admission of their neonate(s) to an intensive care unit (ICU). Other adverse pregnancy outcomes, such as stillbirth, have been reported. Despite the known risks of COVID-19, as of September 18, 2021, 31.0% of pregnant people were fully vaccinated before or during their pregnancy.3 In addition, there are racial and ethnic disparities in vaccination coverage for pregnant people. Healthcare providers should communicate the risks of COVID-19, the benefits of vaccination, and information on the safety and effectiveness of COVID-19 vaccination in pregnancy. Healthcare providers should strongly recommend that people who are pregnant, recently pregnant (including those who are lactating), who are trying to become pregnant now, or who might become pregnant in the future receive one of the authorized or approved COVID-19 vaccines as soon as possible.

Guidance for Clinicians Caring for Individuals Recently Evacuated from Afghanistan - Health Alert Network (HAN) No. 452

2 years 6 months ago
The Centers for Disease Control and Prevention (CDC) recommends that clinicians be on alert for cases of measles that meet the case definition, as well as other infectious diseases, including mumps, leishmaniasis, and malaria, among evacuees (including both Afghan nationals and U.S. citizens) from Afghanistan. Clinicians should immediately notify their local or state health department of any suspected cases of measles. Clinicians should also recommend the measles, mumps, and rubella (MMR) vaccine for unvaccinated patients. Measles is an extremely contagious infectious disease; around 9 out of 10 people who are close contacts and who are not protected will become infected following exposure to measles virus. As of September 20, 2021, CDC has been notified of 16 confirmed cases of measles and 4 cases of mumps among Afghan nationals and U.S. citizens, recently arriving from Afghanistan and continued vigilance is needed. In addition to MMR vaccination, CDC recommends that evacuees are also up to date on vaccinations for varicella, polio, COVID-19, and seasonal influenza.

Increases in Availability of Cannabis Products Containing Delta-8 THC and Reported Cases of Adverse Events - Health Alert Network (HAN) No. 451

2 years 6 months ago
The purpose of this Health Alert Network (HAN) Health Advisory is to alert public health departments, healthcare professionals, first responders, poison control centers, laboratories, and the public to the increased availability of cannabis products containing delta-8 tetrahydrocannabinol (THC) and the potential for adverse events due to insufficient labeling of products containing THC and cannabidiol (CBD).

Hurricane Ida-Clinical Guidance for Carbon Monoxide (CO) Poisoning - Health Alert Network (HAN) No. 450

2 years 7 months ago
The Centers for Disease Control and Prevention (CDC) is reminding healthcare professionals seeing patients from areas that will be affected by severe storms, hurricanes, high winds, and flooding to maintain a high index of suspicion for carbon monoxide (CO) poisoning. Other people who may be exposed to the same CO source may need to be identified and evaluated. The signs and symptoms of CO exposure are variable and nonspecific. A tension-type headache is the most common symptom of mild CO poisoning. Other common symptoms of CO poisoning are dizziness, weakness, drowsiness, upset stomach, vomiting, chest pain, and confusion. Clinical manifestations of severe CO poisoning include cardiovascular and neurological effects: tachycardia, tachypnea, hypotension, metabolic acidosis, dysrhythmias, myocardial ischemia or infarction, noncardiogenic pulmonary edema, irritability, impaired memory, cognitive and sensory disturbances, ataxia, altered or loss of consciousness, seizures, coma, and death, although any organ system might be involved. Although CO poisoning can be fatal, children, pregnant women, the unborn, persons with sickle cell disease, older adults, and persons with chronic illness (e.g., heart or lung disease) are particularly high risk.

Rapid Increase in Ivermectin Prescriptions and Reports of Severe Illness Associated with Use of Products Containing Ivermectin to Prevent or Treat COVID-19 - Health Alert Network (HAN) No. 449

2 years 7 months ago
Ivermectin is a U.S. Food and Drug Administration (FDA)-approved prescription medication used to treat certain infections caused by internal and external parasites. When used as prescribed for approved indications, it is generally safe and well tolerated. During the COVID-19 pandemic, ivermectin dispensing by retail pharmacies has increased, as has use of veterinary formulations available over the counter but not intended for human use. FDA has cautioned about the potential risks of use for prevention or treatment of COVID-19. Ivermectin is not authorized or approved by FDA for prevention or treatment of COVID-19. The National Institutes of Health's (NIH) COVID-19 Treatment Guidelines Panel has also determined that there are currently insufficient data to recommend ivermectin for treatment of COVID-19. ClinicalTrials.govexternal icon has listings of ongoing clinical trials that might provide more information about these hypothesized uses in the future. Adverse effects associated with ivermectin misuse and overdose are increasing, as shown by a rise in calls to poison control centers reporting overdoses and more people experiencing adverse effects.

New Case Identified: Multistate Investigation of Non-travel Associated Burkholderia pseudomallei Infections (Melioidosis) in Four Patients: Georgia, Kansas, Minnesota, and Texas-2021 - Health Alert Network (HAN) No. 448

2 years 7 months ago
The Georgia Department of Public Health, with assistance from the Centers for Disease Control and Prevention (CDC), is investigating a fatal case of Burkholderia pseudomallei infection (i.e., melioidosis) identified in late July 2021. Based on genomic analysis, this case in Georgia closely matches the three cases previously identified in Kansas, Minnesota, and Texas in 2021, indicating they all most likely share a common source of exposure. The Kansas Department of Health and Environment, the Minnesota Department of Health, and the Texas Department of State Health Services continue to investigate the three previous cases with assistance from CDC. The four cases include both children and adults. Two cases are female, and two cases are male. The first case, which was fatal, was identified in March 2021 in Kansas. The second and third cases, both identified in May 2021 in Minnesota and Texas, were hospitalized for extended periods of time before being discharged to transitional care facilities. The most recent case died in the hospital and was identified post-mortem in late July 2021 in Georgia. None of the cases had a history of traveling outside of the continental United States. Symptoms of melioidosis are varied and nonspecific, and may include pneumonia, abscess formation, and blood infections. Due to its nonspecific symptoms, melioidosis can initially be mistaken for other diseases such as tuberculosis, which can delay proper treatment. B. pseudomallei may also be misidentified by some automated identification methods in laboratory settings. This Health Alert Network (HAN) Health Update serves as an update to HAN Health Advisory Multistate Investigation of Non-travel Associated Burkholderia pseudomallei Infections (Melioidosis) in Three Patients: Kansas, Texas, and Minnesota-2021 that CDC issued on June 30, 2021.

Vaccination to Prevent COVID-19 Outbreaks with Current and Emergent Variants - United States, 2021 - Health Alert Network (HAN) No. 447

2 years 8 months ago
The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network Health Advisory to notify public health practitioners and clinicians about the urgent need to increase COVID-19 vaccination coverage (i.e., the percentage of the population fully vaccinated) across the United States to prevent surges in new infections that could increase COVID-19 related morbidity and mortality, overwhelm healthcare capacity, and widen existing COVID-19-related health disparities. Increasing vaccination coverage is especially urgent in areas where current coverage is low. Unvaccinated persons account for the majority of new COVID-19 infections, hospitalizations, and deaths. Currently circulating SARS-CoV-2 variants of concern, especially the highly infectious Delta variant (B.1.617.2), are accelerating spread of infection. Unvaccinated and partially vaccinated people need to practice all recommended prevention measures until fully vaccinated. In areas with substantial and high transmission, CDC recommends that fully vaccinated individuals wear a mask in public indoor settings to help prevent the spread of Delta and protect others.

Potential Exposure to Person with Confirmed Human Monkeypox Infection - United States, 2021 - Health Alert Network (HAN) No. 446

2 years 8 months ago
The Centers for Disease Control and Prevention (CDC), in collaboration with the Texas Department of State Health Services and Dallas County Health and Human Services, is investigating a single case of monkeypox virus infection in a U.S. citizen who resides in the United States and recently returned from travel to Nigeria. The patient traveled to Dallas from Lagos, Nigeria, via Atlanta on two separate flights during July 8-9, 2021. The patient presented to an emergency department in Dallas, Texas on July 13 for complaints of a rash that began on July 7, one day prior to travel. Testing at Dallas County and CDC confirmed the presence of monkeypox virus. CDC is working with the airlines to share information with state and local health officials to contact airline passengers and others who may have been in contact with the patient during two flights: Lagos, Nigeria, to Atlanta on July 8, with arrival on July 9; and Atlanta to Dallas on July 9. CDC is issuing this health advisory to ask clinicians to consider a diagnosis of monkeypox in people who present with a febrile prodrome followed by rash and who may have had direct or indirect contact with the patient.

Recall of LeadCare® Blood Lead Tests Due to Risk of Falsely Low Results - Health Alert Network (HAN) No. 445

2 years 8 months ago
Magellan Diagnostics, Inc. and the U.S. Food and Drug Administration (FDA) have issued a recall notice concerning the use of some LeadCare® Blood Lead Tests (certain LeadCare II, LeadCare Plus, and LeadCare Ultra test kit lots). These lots were distributed between October 27, 2020, and June 15, 2021. The use of these devices may cause serious injuries because they might underestimate blood lead levels. The FDA has identified this as a Class I recall, the most serious type of recall. The purpose of this Centers for Disease Control and Prevention (CDC) Health Alert Network (HAN) Health Advisory is to notify healthcare providers and state and local health departments about this recall notice and to recommend appropriate follow-up actions.

Multistate Investigation of Non-travel Associated Burkholderia pseudomallei Infections (Melioidosis) in Three Patients: Kansas, Texas, and Minnesota-2021 - Health Alert Network (HAN) No. 444

2 years 8 months ago
The Kansas Department of Health and Environment, the Texas Department of State Health Services, and the Minnesota Department of Health, with assistance from the Centers for Disease Control and Prevention (CDC), are investigating three cases of Burkholderia pseudomallei (melioidosis) infections. Based on genomic analysis, these three cases (one male, two females; two adults and one child) may share a potential common source of exposure. The first case, identified in March 2021, was fatal. Two other patients were identified in May 2021, one of whom is still hospitalized. One has been discharged to a transitional care unit. None of the patients' families reported a history of traveling outside of the continental United States.

Increased Interseasonal Respiratory Syncytial Virus (RSV) Activity in Parts of the Southern United States - Health Alert Network (HAN) No. 443

2 years 9 months ago
The Centers for Disease Control and Prevention (CDC) is issuing this health advisory to notify clinicians and caregivers about increased interseasonal respiratory syncytial virus (RSV) activity across parts of the Southern United States. Due to this increased activity, CDC encourages broader testing for RSV among patients presenting with acute respiratory illness who test negative for SARS-CoV-2, the virus that causes COVID-19. RSV can be associated with severe disease in young children and older adults. This health advisory also serves as a reminder to healthcare personnel, childcare providers, and staff of long-term care facilities to avoid reporting to work while acutely ill - even if they test negative for SARS-CoV-2.

Cases of Cerebral Venous Sinus Thrombosis with Thrombocytopenia after Receipt of the Johnson & Johnson COVID-19 Vaccine - Health Alert Network (HAN) No. 442

2 years 11 months ago
As of April 12, 2021, approximately 6.85 million doses of the Johnson & Johnson (J&J) COVID-19 vaccine (Janssen) have been administered in the United States. The Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA) are reviewing data involving six U.S. cases of a rare type of blood clot in individuals after receiving the J&J COVID-19 vaccine that were reported to the Vaccine Adverse Events Reporting System (VAERS). In these cases, a type of blood clot called cerebral venous sinus thrombosis (CVST) was seen in combination with low levels of blood platelets (thrombocytopenia). All six cases occurred among women aged 18-48 years. The interval from vaccine receipt to symptom onset ranged from 6-13 days. One patient died. Providers should maintain a high index of suspension for symptoms that might represent serious thrombotic events or thrombocytopenia in patients who have recently received the J&J COVID-19 vaccine. When these specific type of blood clots are observed following J&J COVID-19 vaccination, treatment is different from the treatment that might typically be administered for blood clots. Based on studies conducted among the patients diagnosed with immune thrombotic thrombocytopenia after the AstraZeneca COVID-19 vaccine in Europe, the pathogenesis of these rare and unusual adverse events after vaccination may be associated with platelet-activating antibodies against platelet factor-4 (PF4), a type of protein. Usually, the anticoagulant drug called heparin is used to treat blood clots. In this setting, the use of heparin may be harmful, and alternative treatments need to be given.

Acute Non-Viral Hepatitis of Unknown Etiology Potentially Associated with an Alkaline Water Product - Health Alert Network (HAN) No. 441

2 years 11 months ago
Five cases of acute non-viral hepatitis of unknown etiology in children were reported to the Southern Nevada Health District (SNHD) between November and December 2020. The Centers for Disease Control and Prevention (CDC) is assisting the SNHD in investigating a potential link between these illnesses and the consumption of an alkaline water product called "Real Water" and other possible etiologies. The purpose of this Health Alert Network (HAN) Advisory is to advise clinicians and health departments to have a high index of suspicion for cases of acute non-viral hepatitis and to report any cases to their local health authority.

2021 Winter Storms-Clinical Guidance for Carbon Monoxide (CO) Poisoning - Health Alert Network (HAN) No. 440

3 years 1 month ago
The Centers for Disease Control and Prevention (CDC) is reminding healthcare professionals seeing patients from the areas affected by recent winter storms to maintain a high index of suspicion for carbon monoxide (CO) poisoning. Other people who may be exposed to the same CO source may need to be identified and evaluated. The signs and symptoms of CO exposure are variable and nonspecific. A tension-type headache is the most common symptom of mild CO poisoning. Other common symptoms of CO poisoning are dizziness, weakness, drowsiness, upset stomach, vomiting, chest pain, and confusion.

Extensively Drug-Resistant Salmonella Typhi Infections Among U.S. Residents Without International Travel - Health Alert Network (HAN) No. 439

3 years 1 month ago
Typhoid fever is a systemic illness caused by the bacterium Salmonella enterica serotype Typhi (Typhi). Most people in the United States diagnosed with typhoid fever acquired it during international travel, but some acquired it in the United States. The disease is treated with antibiotics; without appropriate antibiotic treatment,12-30% of people with typhoid fever will die. Typhi is transmitted through contaminated food and water and person-to-person contact. CDC recommends vaccination for people traveling to places where typhoid fever is common. Because typhoid fever vaccines are not 100% effective, travelers should always practice safe eating and drinking habits to help prevent infection.

Increase in Fatal Drug Overdoses Across the United States Driven by Synthetic Opioids Before and During the COVID-19 Pandemic - Health Alert Network (HAN) No. 438

3 years 3 months ago
The purpose of this Health Alert Network (HAN) Advisory is to alert public health departments, healthcare professionals, first responders, harm reduction organizations, laboratories, and medical examiners and coroners to- (1) substantial increases in drug overdose deaths across the United States, primarily driven by rapid increases in overdose deaths involving synthetic opioids excluding methadone (hereafter referred to as synthetic opioids), likely illicitly manufactured fentanyl; (2) a concerning acceleration of the increase in drug overdose deaths, with the largest increase recorded from March 2020 to May 2020,coinciding with the implementation of widespread mitigation measures for the COVID-19 pandemic; (3) the changing geographic distribution of overdose deaths involving synthetic opioids, with the largest percentage increases occurring in states in the western United States; (4) significant increases in overdose deaths involving psychostimulants with abuse potential (hereafter referred to as psychostimulants) such as methamphetamine; and (5) recommendations for communities when responding to the evolving overdose crisis.
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