CDC/ACIP [to 1 Dec 2018]
MMWR News Synopsis for Friday November 30, 2018
Implementation of the Treat All Policy Among Persons Living with HIV Enrolled in Care but Not on Antiretroviral Therapy — India, May 2017–June 2018
This report describes India’s implementation of the Treat All policy, which recommends that all people living with HIV (PLHIV) begin antiretroviral treatment as soon as possible after diagnosis. India’s experience suggests that active tracking and tracing of people with HIV infection who are enrolled in HIV care but not on ART, combined with education about the benefits of early HIV treatment, can facilitate ART initiation. India, which has the world’s third largest burden of HIV infection (2.1 million people), adopted Treat All on April 28, 2017. From May 1, 2017, through June 30, 2018, India’s National AIDS Control Organization (NACO), CDC, and other partners conducted activities to facilitate ART initiation among people enrolled in care (but not on ART because of ineligibility based on previous guidelines) at 46 ART centers supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) in the six most populated districts in two states. Among 25,007 people enrolled, 9,898 (40%) initiated ART after the Treat All policy adoption. Of those, 6,315 (64%), including 1,635 (17%) people lost to follow-up while awaiting ART initiation, initiated ART only after they were reached and educated about ART benefits. Active tracking and tracing of people with HIV infection who are enrolled in HIV care but not on ART, combined with education about the benefits of early HIV treatment, can facilitate ART initiation.
Multistate Infestation with an Exotic Disease-Vector Tick Haemaphysalis longicornis — United States, August 2017–September 2018
The Asian longhorned tick (Haemaphysalis longicornis) is new to the United States and can transmit pathogens found in the United States. In August 2017, a tick common to eastern Asia was discovered on a sheep in New Jersey. This tick, known as the Asian longhorned tick or Haemaphysalis longicornis, is not native to the United States. As of October 2, 2018, Asian longhorned ticks have been found in nine states: Arkansas, Connecticut, Maryland, North Carolina, New Jersey, New York, Pennsylvania, Virginia, and West Virginia. While ticks collected in the United States have not been found infected with any pathogens, in other parts of the world the tick can spread viruses, bacteria, and parasites known to infect people and animals, causing severe disease and death. To date, there is no evidence that the tick has spread pathogens to people or animals in the United States. A single female tick can reproduce offspring without mating. As a result, hundreds to thousands of ticks may be found on a single animal or in the surrounding environment.
Outbreak of Dengue Virus Type 2 — American Samoa, November 1, 2016 – October 31, 2018
Dengue continues to be a public health burden throughout the tropics. After recent outbreaks of dengue, chikungunya, and Zika viruses in the U.S. territory of American Samoa, another dengue outbreak occurred starting in late 2016 and lasted through October 2018. During this outbreak, more than 1,000 dengue cases were confirmed, and more than one-third of people with dengue were hospitalized. This outbreak further demonstrates that additional approaches to the control of mosquito-transmitted diseases are urgently needed.
Progress Toward Regional Measles Elimination — Worldwide, 2000–2017
During 2000-2017, increased vaccination coverage with measles-containing vaccine administered through routine immunization programs, supplementary immunization activities, and other global measles elimination efforts contributed to an 83 percent drop in reported measles incidence and an 80 percent reduction in estimated measles mortality. The increasing number of countries verified as having achieved measles elimination indicates progress toward interruption of measles virus transmission globally. Continuing to increase coverage with first dose of measles-containing vaccine (MCV1) and second dose of measles-containing vaccine (MCV2) is critical to both the achievement and sustainability of global and regional measles goals. During 2000-2017, MCV1 coverage increased globally from 72 percent to 85 percent due to routine immunization programs, supplemental immunization activities (SIAs), and other global measles-elimination efforts. Measles vaccination prevented an estimated 21.1 million deaths during this period, with the majority of deaths averted in the WHO African region and among Gavi, the Vaccine Alliance-eligible countries. Estimated MCV2 coverage increased globally from 15 percent in 2000 to 67 percent in 2017, largely due to an increase in the number of countries providing MCV2 nationally from 98 (51%) in 2000 to 167 (86%) in 2017. Despite progress made, global milestones have not been achieved: MCV1 coverage has stagnated for nearly a decade; global MCV2 coverage is only at 67 percent despite steady increases in coverage; and several regions are experiencing a measles resurgence.