Availability of Naloxone in 2 Underserved Urban Communities in Georgia.

In 2016, unintentional injuries became the third leading cause of death in the United States. In 2018, 54% of 103 672 unintentional injury deaths were due to drug overdoses among adults 19 to 64 years of age. In Georgia, opioid overdose deaths continued to increase, despite a 2014 state law for naloxone use to prevent deaths, and a 2017 amendment for more widespread community use without a prescription.

Vaccination differences among U.S. adults by their self-identified sexual orientation, National Health Interview Survey, 2013-2015.

Introduction: Very few studies have explored the associations between self-identified sexual orientation and comprehensive vaccination coverage. Most of the previous studies that reported health disparities among lesbian, gay and bisexual populations were not based on a nationally representative sample of U.S.

Public Health Agency Responses and Opportunities to Protect Against Health Impacts of Climate Change Among US Populations with Multiple Vulnerabilities.

During the past several decades, unprecedented global changes in climate have given rise to an increase in extreme weather and other climate events and their consequences such as heavy rainfall, hurricanes, flooding, heat waves, wildfires, and air pollution. These climate effects have direct impacts on human health such as premature death, injuries, exacerbation of health conditions, disruption of mental well-being, as well as indirect impacts through food- and water-related infections and illnesses. While all populations are at risk for these adverse health outcomes, some populations are at greater risk because of multiple vulnerabilities resulting from increased exposure to risk-prone areas, increased sensitivity due to underlying health conditions, and limited adaptive capacity primarily because of a lack of economic resources to respond adequately.

Value of a small control group for estimating intervention effectiveness: results from simulations of immunization effectiveness studies.

Aim: To improve evidence for public health practice, the conduct of effectiveness studies by practitioners is needed and may be stimulated if knowledge that smaller than usual samples may provide the same reliability of intervention effect size as larger samples.

Materials & Methods: We examined reliability of intervention effect using computerized simulations of 2000 hypothetical immunization effectiveness studies from an actual study population and by small (30 and 60) and larger (100 and 200) control groups compared with an intervention group of 200 participants.

Results & Conclusion: Across simulated studies, the mean intervention effect (14%) and effect sizes were equivalent regardless of control group size and equal to the actual study effect.

Protection of racial/ethnic minority populations during an influenza pandemic.

Racial/ethnic minority populations experience worse health outcomes than do other groups during and after disasters. Evidence for a differential impact from pandemic influenza includes both higher rates of underlying health conditions in minority populations, increasing their risk of influenza-related complications, and larger socioeconomic (e.g.

Protecting vulnerable populations from pandemic influenza in the United States: a strategic imperative.

Protecting vulnerable populations from pandemic influenza is a strategic imperative. The US national strategy for pandemic influenza preparedness and response assigns roles to governments, businesses, civic and community-based organizations, individuals, and families. Because influenza is highly contagious, inadequate preparedness or untimely response in vulnerable populations increases the risk of infection for the general population.

Public health surveillance for suspected smallpox in the United States, 2003-2005: results of a national survey.

In 2005, a Web-based survey of chief epidemiologists of 50 states, the District of Columbia, 9 large cities, and 8 territories examined the status of US smallpox surveillance after the Council of State and Territorial Epidemiologists recommended that smallpox be reportable. Of 55 respondents, 95% reported state or territory laws or regulations governing smallpox reporting; 70% of states required laboratories to report variola virus. All respondents could investigate reported suspected patients; 70%-89% would investigate initially by telephone or fax.

Performance of an algorithm for assessing smallpox risk among patients with rashes that may be confused with smallpox.

After the 2001 anthrax bioterror attacks, the Centers for Disease Control and Prevention developed an algorithm to evaluate patients rapidly for suspected smallpox. A prospective, multicenter study examined the performance of this algorithm in assessing patients with an acute, generalized vesicular or pustular rash (AGVPR) admitted to emergency departments and inpatient units of 12 acute-care hospitals in 6 states. Of 26,747 patients (3.

Measles hospitalizations, United States, 1985-2002.

Cases of measles that require hospitalization are a good marker of the burden of clinically severe measles in the United States. Measles hospitalizations routinely are monitored by the National Notifiable Disease Surveillance System (NNDSS). Our objectives were to describe measles hospitalizations reported to the NNDSS in 1985-2002, to use hospital discharge data from independent data sets (the National Hospital Discharge Survey [NHDS] [data available for 1985-1999] and the Health Care Investment Analysts [HCIA] hospital discharge database [data available for 1985-1996]) to provide additional estimates of total measles hospitalizations, and to compare trends in measles-associated hospitalizations.

Evaluation of the measles clinical case definition.

An accurate system of identifying and classifying suspected measles cases is critical for the measles surveillance system in the United States. To examine the performance of the clinical case definition in predicting laboratory confirmation of suspected cases of measles, we reviewed 4 studies conducted between 1981 and 1994. A clinical case definition was examined that included a generalized maculopapular rash, fever (>or=38.

Elimination of measles and of disparities in measles childhood vaccine coverage among racial and ethnic minority populations in the United States.

The gap in measles vaccine coverage between white and nonwhite children was as large as 18% in 1970. During the measles epidemic of 1989-1991, attack rates among nonwhite children <5 years of age were 4- to 7-fold higher than rates among white children. Because of the epidemic and of the known disparity in vaccine coverage and risk of disease, a dual strategy to eliminate measles in the United States was implemented: universal interventions likely to reach the majority of children and targeted interventions more likely to reach nonwhite children.

Persistence of vaccine-induced antibody to measles 26-33 years after vaccination.

Because measles-specific antibody titer after vaccination is lower than after natural infection, there is concern that vaccinated persons may gradually lose protection from measles. To examine the persistence of vaccine-induced antibody, participants of a vaccine study in 1971, with documentation of antibody 1-7 years after vaccination, were followed up in 1997-1999 to determine the presence and titer of measles antibody. Of the 56 participants (77% were 2-dose recipients), all had antibodies detected by the plaque reduction neutralization (PRN) antibody assay an average of 26-33 years after the first or second dose of measles vaccine; 92% had a PRN titer considered protective (>1 : 120).

Vaccination levels associated with lack of measles transmission among preschool-aged populations in the United States, 1989-1991.

Knowledge of the minimum level of vaccination capable of preventing measles transmission in an age group is helpful for establishing program targets for measles elimination. In 1990, during the measles resurgence in the United States, one-half of cases occurred in children aged <5 years. Although estimated population immunity among persons >or=6 years of age was 93%, immunity was lower and varied widely among preschool-aged children.

Population immunity to measles in the United States, 1999.

To estimate population immunity, we examined measles immunity among residents of the United States in 1999 from serological and vaccine coverage surveys. For persons aged >or=20 years, serological data from the third National Health and Nutrition Examination Survey (1988-1994) were used. For persons <20 years of age, immunity was estimated from results of the National Immunization Survey (1994-1998), state surveys of school entrants (1990-2000), and vaccine coverage surveys of adolescents (1997).