MMWR News Synopsis for October 5, 2017

CDC/ACIP [to 7 October 2017]

MMWR News Synopsis for October 5, 2017
:: Retention in Medical Care Among Insured Children with Diagnosed HIV – United States, 2010-2014
A significant proportion of HIV-diagnosed children might not be receiving the recommended frequency of medical care. An estimated 2,477 children ages 12 and younger were living with diagnosed HIV in the United States in 2014. U.S. Department of Health and Human Services pediatric HIV treatment guidelines recommend medical assessments every three to four months for the first two years of antiretroviral therapy, and suggest that there is value in maintaining this frequency for all HIV-diagnosed children. CDC researchers analyzed insurance claims data to evaluate retention in medical care for children with diagnosed HIV and found that 60 percent of the Medicaid cohort and 69 percent of the commercial claims cohort were retained care during a two-year period between 2010 and 2014. The proportions of children retained in care for both groups were similar to those described in analyses conducted with insurance claims for adults with diagnosed HIV. Further investigation into the causes of non-retention in pediatric HIV care is indicated to identify possible ways to improve medical care consistency for children living with HIV.

Human Adenovirus Surveillance — United States, 2003-2016
CDC initiated the National Adenovirus Type Reporting System (NATRS) in 2014 to monitor trends in circulating human adenovirus types in the United States, which can be useful to inform diagnostic and surveillance activities by clinicians and public health practitioners. Human adenoviruses (HAdVs) are associated with a wide spectrum of clinical illness including respiratory illness, gastroenteritis, and conjunctivitis. More than 60 HAdV genotypes have been identified to date. Severity of HAdV illness can range from asymptomatic infections to severe illness and death. Although cases are frequently reported sporadically, outbreaks of HAdV have been reported globally in a variety of settings. CDC initiated the NATRS in 2014 to monitor trends in circulating HAdV types in the United States. Year-to-year fluctuations in HAdV types circulating in the U.S. varied considerably during the surveillance period. Surveillance for circulating HAdV types in the U.S. can be useful to inform diagnostic and surveillance activities by clinicians and public health practitioners.

Update: Influenza Activity — United States and Worldwide, May 21-September 23, 2017
CDC recommends yearly influenza vaccination for all people 6 months of age and older who do not have contraindications. Vaccination by the end of October is recommended, if possible, but should continue throughout the influenza season as long as influenza viruses are circulating and unexpired vaccine is available. While a yearly influenza vaccination is the best way to prevent influenza, treatment with influenza antiviral medications as soon as possible after the onset of illness is recommended for patients with confirmed or suspected influenza who have severe, complicated, or progressive illness; who require hospitalization; or who are at high risk for influenza complications. Antiviral drugs work best when started within two days of getting sick. Although summer influenza activity in the United States was low, seasonal and novel influenza cases and outbreaks occurred during summer months. Clinicians should remain vigilant in considering novel influenza virus infections in people with influenza-like illness and swine or poultry exposure, or with severe acute respiratory infection after travel to areas where avian influenza viruses have been detected. There was low-level seasonal influenza activity from May 21 to September 23, 2017, in the United States. Influenza B viruses predominated from late May through late June, and influenza A viruses predominated beginning in early July. Influenza A H1N1pdm09, influenza A H3N2, and influenza B viruses were detected in the United States and worldwide. Typical seasonal patterns of influenza activity were seen in Southern Hemisphere countries. The majority of the influenza viruses from the United States and other countries analyzed at CDC were similar to the reference viruses representing the recommended components for the 2017-18 vaccine.