Serologic Evidence of Recent Infection with Highly Pathogenic Avian Influenza A(H5) Virus Among Dairy Workers - Michigan and Colorado, June-August 2024.

Since April 2024, sporadic infections with highly pathogenic avian influenza (HPAI) A(H5) viruses have been detected among dairy farm workers in the United States. To date, infections have mostly been detected through worker monitoring, and have been mild despite the possibility of more severe illness. During June-August 2024, CDC collaborated with the Michigan Department of Health and Human Services and the Colorado Department of Public Health and Environment to implement cross-sectional serologic surveys to ascertain the prevalence of recent infection with HPAI A(H5) virus among dairy workers.

Centralized COVID-19 Contact Tracing in a Home-Rule State.

Contact tracing is an evidence-based intervention to control many communicable diseases, including COVID-19. Before the COVID-19 pandemic, contact tracing in Michigan focused on HIV, sexually transmitted infections, and tuberculosis, and it was conducted by state and local health department staff. Within 2 weeks of the first reported COVID-19 cases in Michigan in March 2020, the existing public health workforce was overwhelmed by the need for contact tracing and daily symptom monitoring.

Quantifying the excess risk of infant mortality based on race/ethnicity at the county level to inform Michigan's home visiting outreach plans.

Objective: Michigan's infant mortality rate is consistently higher than the national rate, with persistent and significant racial/ethnic disparities. In Michigan, nine counties account for more than 80% of all infant deaths. A home visiting program serving low-income, first-time mothers in high-risk communities is one strategy to reduce infant mortality.

Pneumococcal and Meningococcal Vaccination among Michigan Children with Sickle Cell Disease.

Objectives: To determine the proportion of Michigan children with sickle cell disease (SCD) who were vaccinated according to pneumococcal vaccination recommendations and, secondarily, to examine uptake of meningococcal vaccine, and to compare up-to-date (UTD) vaccination status between children with and without SCD.

Study Design: Children with SCD who were born in Michigan were matched to controls without SCD using age, sex, race, and zip code. Using data from the state immunization registry, we assessed the significance of SCD status on UTD vaccination in logistic regression models.

Characteristics and Outcomes of Stroke Patients Transferred to Hospitals Participating in the Michigan Coverdell Acute Stroke Registry.

Background: Interhospital transfer of acute stroke patients is becoming increasingly important as regional stroke systems of care continue to evolve. We describe the characteristics and outcomes of stroke cases transferred to hospitals participating in the Michigan Coverdell Stroke Registry.

Methods And Results: Thirty-six hospitals participated in the Michigan registry during 2009 to 2011.

Vaccination with tetanus, diphtheria, and acellular pertussis vaccine of pregnant women enrolled in Medicaid--Michigan, 2011-2013.

In October 2011, the Advisory Committee on Immunization Practices (ACIP) first recommended the routine administration of a tetanus, diphtheria, and acellular pertussis vaccine (Tdap) during pregnancy as a strategy to protect infants from pertussis (also known as whooping cough). This recommendation applied to women previously unvaccinated with Tdap and specified the optimal vaccination time as late second or third trimester (after 20 weeks' gestation). By vaccinating pregnant women, infants, who are at highest risk for mortality and morbidity from pertussis, gain passive immunity from maternal antibodies transferred to them in utero.

Assessment of the completeness and accuracy of case ascertainment in the Michigan Stroke Registry.

Background: Accurate case ascertainment is essential for clinical registries to be valid and representative. We assessed case ascertainment in the Michigan Stroke Registry by linking to a statewide hospital discharge database (Michigan Inpatient Database [MIDB]).

Methods And Results: In 2009, all ischemic stroke cases submitted by 30 registry hospitals were linked to ischemic stroke discharges (International Classification of Diseases, Ninth Revision code 433.

Identifying sickle cell disease cases using administrative claims.

Objective: To develop and test the accuracy of administrative claims method for identifying children with sickle cell disease (SCD) to enable quality of care assessments among children enrolled in Medicaid.

Methods: All administrative claims with an SCD diagnosis were obtained from Michigan Medicaid from 2008 to 2011 for children ≤18 years, representing 1828 individuals. All Medicaid claims were obtained for these children and classified into categories on the basis of SCD care; these classifications were used to develop 37 alternative case definitions for identifying children with SCD.

Compliance with the stroke education performance measure in the Michigan Paul Coverdell National Acute Stroke Registry.

Background And Purpose: Stroke education, 1 of 8 endorsed stroke performance measures, consists of 5 specific subcomponents: risk factors, stroke warning signs, emergency medical service activation, physician follow-up, and discharge medications. We identified predictors of stroke education performance measure compliance in the Michigan Paul Coverdell National Acute Stroke Registry.

Methods: Data were collected on 9609 acute stroke admissions to 20 registry hospitals during 2008 and 2009.

Barriers and facilitators for utilization of genetic counseling and risk assessment services in young female breast cancer survivors.

Introduction. Women diagnosed with breast cancer at a young age are more likely to carry a cancer predisposing genetic mutation. Per the current NCCN recommendations, women diagnosed under age 50 should be referred to cancer genetic counseling for further risk evaluation.

Fast-food consumption and obesity among Michigan adults.

Introduction: Consumption of meals eaten away from home, especially from fast-food restaurants, has increased in the United States since the 1970s. The main objective of this study was to examine the frequency and characteristics of fast-food consumption among adults in Michigan and obesity prevalence.

Methods: We analyzed data from 12 questions about fast-food consumption that were included on the 2005 Michigan Behavioral Risk Factor Survey, a population-based telephone survey of Michigan adults, using univariate and bivariate analyses and multivariate logistic regression, and compared these data with data on Michigan obesity prevalence.

The impact of dog walking on leisure-time physical activity: results from a population-based survey of Michigan adults.

Background: The extent to which dog walking promotes leisure-time physical activity (LTPA) remains unresolved. We describe the characteristics of people who walk their dog, and assess the impact on LTPA.

Methods: Information on dog ownership, dog walking patterns, total walking activity and LTPA were assessed in the 2005 Michigan Behavioral Risk Factor Survey.

An examination of EPPM predictions when threat is perceived externally: an asthma intervention with school workers.

Little research informs the use of the Extended Parallel Process Model (EPPM) of persuasion when threat and efficacy judgments are rendered for someone other than the message recipient. Nevertheless, a wide range of health promotion consists of influencing such judgments. Two studies examine the utility of using the EPPM in a context involving threats to others.

Lack of association between stroke symptom knowledge and intent to call 911: a population-based survey.

Background And Purpose: Excessive prehospital delay between acute stroke onset and hospital arrival is an ongoing problem. Translating knowledge of stroke warning signs into appropriate action is critical to decrease prehospital delay. Our objectives were to estimate the proportion of Michigan adults who would react appropriately by calling 911 when presented with hypothetical stroke-related scenarios and to examine the association between knowledge of warning signs and calling 911.

Asthma surveillance using Medicaid administrative data: a call for a national framework.

Connecticut, Michigan, and New York have successfully used Medicaid administrative data to conduct surveillance of asthma prevalence, related health service utilization and costs, and quality of asthma care. Since these assessments utilize beneficiary-level data, a wide range of population-based summaries is feasible. Opportunities exist to build upon the collective experiences of these three states to establish a national framework for asthma surveillance using Medicaid administrative data.

Racial disparities in knowledge of stroke and heart attack risk factors and warning signs among Michigan adults.

Objective: To describe the level of knowledge regarding risk factors and warning signs for stroke and heart attack among White and African American adults in Michigan and to quantify racial disparities.

Methods: Knowledge of stroke and heart attack risk factors and warning signs was assessed by using data from the 2004 Michigan Behavioral Risk Factor Survey. Prevalence estimates of knowledge were generated, and statistical differences in knowledge between Whites and African Americans were assessed.

Knowledge of tissue plasminogen activator for acute stroke among Michigan adults.

Background And Purpose: Although tissue plasminogen activator (tPA) is an effective therapy for acute ischemic stroke, treatment rates remain low. Efforts to address the underuse of tPA include public education to increase the recognition of stroke symptoms and the awareness of tPA treatment. Our objective was to determine the level of knowledge about tPA treatment for acute stroke among a representative sample of Michigan adults.

Slow-onset asthma deaths have more eosinophils and health care utilization than rapid-onset deaths.

Rationale: Patients with fatal asthma have been hypothesized as representing two distinct subgroups according to the onset of symptoms prior to death.

Objectives: To determine if these two groups may be reliably identified and determine if they differ clinically and pathologically.

Methods: Patients with autopsies, 2-34 years of age, dying from asthma were classified slow-onset (Type 1) or rapid-onset (Type 2).

A review of potential state and local policies to reduce asthma disparities.

Although policies promoting asthma-friendly communities should reduce asthma disparities, not much is known about the status of policy implementation or effectiveness. We review the efforts of state and local agencies to identify and target asthma disparities for reduction, as evidenced by written laws and policy documents and use of funding. Policies targeting health care, homes, schools, and workplaces hold promise for creating asthma-friendly communities; however, the scope and reach of these activities must be increased to have statewide or national impact.

Investigating asthma deaths among children and young adults: Michigan Asthma Mortality Review.

Objective: We developed a surveillance system to investigate asthma deaths in children and young adults.

Methods: A rapid asthma death notification and investigation system for Michigan was developed to identify interventions to prevent future deaths among people aged 2-34 years. Multidisciplinary panels to determine causal factors and recommend preventative actions reviewed information from death certificates, autopsies, next-of-kin interviews, and medical records.