MMWR Surveillance SummariesMMWR监测摘要
MMWR Surveillance Summaries(英文缩写 MMWR SURVEILL SUMM),ISSN 1545-8636,eISSN 1545-8636,中文译名:MMWR监测摘要 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-11-01 至 2026-10-31，按本站收录文献的发表日期统计。
期刊介绍
历年影响因子趋势
| JCR 数据年份 | 影响因子 | JCR 分区 |
|---|---|---|
| 2021 | 29.095 | Q1 |
| 2022 | 24.900 | Q1 |
| 2023 | 37.300 | Q1 |
| 2024 | 49.800 | Q1 |
| 2025 | 96.900 | Q1 |
MMWR Surveillance Summaries 最新收录文献
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1. Surveillance for Violent Deaths - National Violent Death Reporting System, 50 States, the District of Columbia, and Puerto Rico, 2023.
1. 暴力死亡监测——国家暴力死亡报告系统，50个州、哥伦比亚特区及波多黎各，2023年PMID:日期:2026-10-01In 2023, approximately 23,000 persons died of homicide and 49,000 persons died of suicide in the United States, according to the National Vital Statistics System. This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) on violent deaths and suicides that occurred in the 50 states, the District of Columbia, and Puerto Rico in 2023. 2023. NVDRS collects data from death certificates, coroner and medical examiner records, and law enforcement reports. This report includes data collected from all 50 states, the District of Columbia, and Puerto Rico. Forty-seven states had statewide data, three additional states had data from counties representing a subset of their population (31 California counties, representing 74.1% of its population; 38 Florida counties, representing 59.3% of its population; and 13 Texas counties, representing 62.9% of its population), and the District of Columbia and Puerto Rico had jurisdiction-wide data. NVDRS collates information for each death and links deaths that are related (e.g., multiple homicides, homicide followed by suicide, or multiple suicides) into a single incident. For 2023, NVDRS collected information on 70,133 fatal incidents involving 72,093 deaths. The deaths recorded in NVDRS accounted for 91.6% of all homicides, legal intervention deaths, suicides, unintentional firearm injury deaths, and deaths of undetermined intent in the United States in 2023. In addition, information was collected for 671 fatal incidents involving 730 deaths in Puerto Rico. Data for Puerto Rico were analyzed separately.Of the 72,093 deaths that occurred in the 50 states and the District of Columbia, the majority (62.4%) were suicides, followed by homicides (28.5%), deaths of undetermined intent that might be due to violence (6.9%), legal intervention deaths (1.5%) (i.e., deaths caused by law enforcement and other persons with legal authority to use deadly force acting in the line of duty, excluding legal executions), and unintentional firearm injury deaths (<1.0%). Of the 730 deaths reported for Puerto Rico, 66.4% were homicides and 32.9% were suicides.Demographic patterns and circumstances varied by manner of death. In the 50 states and the District of Columbia, the suicide rate was higher for males than for females (23.5 versus 6.1 per 100,000 population). The suicide rate for males was highest for those aged ≥85 years (53.0), whereas for females, the suicide rate was highest for those aged 45-54 years (8.8). In addition, non-Hispanic American Indian or Alaska Native (AI/AN) persons had the highest suicide rates among all racial and ethnic groups (22.7). Among both males and females, the most common method of injury for suicide was a firearm. Among all suicide decedents for whom circumstances were known, suicide was most often preceded by an intimate partner, mental health, or physical health problem or by a recent or impending crisis.The homicide rate was also higher for males (10.8 per 100,000 population) than for females (2.7). Among all homicide victims, the homicide rate was highest among adults aged 20-24 years (14.1) compared with other age groups. Non-Hispanic Black or African American (Black) males experienced the highest homicide rate of any racial or ethnic group (50.6). Among all homicide victims, the most common method of injury was a firearm. When the relationship between a homicide victim and a suspect was known, the suspect was most frequently an acquaintance or friend for male victims and a current or former intimate partner for female victims. When circumstances were known, homicide was most often precipitated by an argument or conflict, occurred in conjunction with another crime, or, for female victims, was related to intimate partner violence. Nearly all victims of legal intervention deaths were male (95.6%) and the legal intervention death rate was highest among men aged 30-34 years. The legal intervention death rate was highest among AI/AN males, followed by Black males. A firearm was used in most legal intervention deaths. When circumstances were known, the most frequently reported circumstances for legal intervention deaths were the victim's reported use of a weapon, the victim being previously known to authorities, or that the victim reportedly had mental health or substance use problems.Other manners of death included unintentional firearm injury deaths and deaths of undetermined intent. Unintentional firearm injury deaths occurred most frequently among males, non-Hispanic White (White) persons, and persons aged 15-19 years. When circumstances were known, these deaths most frequently occurred while the shooter was playing with a firearm and most often were precipitated by a person unintentionally pulling the trigger. The rate of deaths of undetermined intent was highest among males, particularly among AI/AN and Black males, and among adults aged 35-44 years. Poisoning was the most common method of injury in deaths of undetermined intent, often involving opioids (67% positive among decedents tested).In Puerto Rico, the homicide rate was twice as high as the suicide rate and was 10.7 times higher for males than for females. Firearms were the most common method of injury in homicides. When the relationship between the homicide victim and suspect was known, the suspect was most frequently an acquaintance or friend for male victims and a current or former intimate partner for female victims. Among male homicide victims in Puerto Rico when circumstances were known, the most common precipitating circumstances were drug involvement and the victim previously being known to authorities, whereas among female victims, the most common homicide circumstance was intimate partner violence. The suicide rate in Puerto Rico was also higher for males than for females. The most common suicide method was hanging, strangulation, or suffocation. Depressed mood or currently diagnosed mental health problem were frequent circumstances reported for both male and female suicide decedents. This report summarizes NVDRS data on violent deaths and suicides that occurred in 2023. The suicide rate was highest among AI/AN and White males, whereas the homicide rate was highest among Black males. Intimate partner violence precipitated a large proportion of homicides of females. Mental health and substance use problems, previous awareness of the victim by authorities, intimate partner problems, interpersonal conflicts, and acute life stressors were the primary precipitating circumstances for multiple types of deaths examined. The injury-related deaths described in this report are preventable, and data can guide public health action. NVDRS data are used to monitor the occurrence of these fatal injuries and assist public health agencies in developing, implementing, and evaluating programs, policies, and practices to reduce and prevent deaths. Violent death reporting system data are helping states identify disproportionately affected groups and implement targeted prevention strategies, including youth suicide-focused analyses in Maryland and veteran suicide-focused initiatives in Michigan and Connecticut that guided statewide partnerships, crisis line outreach, and mental health service expansion.
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2. Causes of Death Among Stillbirths and Children Aged <5 Years in Africa and South Asia - Child Health and Mortality Prevention Surveillance, Seven Countries, 2016-2024.
2. 非洲和南亚死产和5岁以下儿童的死亡原因——2016-2024年七个国家的儿童健康和死亡率预防监测PMID:日期:2026-09-10Sub-Saharan Africa and South Asia have the highest rates of stillbirths and rates of death among children aged <5 years, with many countries in those regions unlikely to meet the 2030 goal of ending preventable deaths among newborns and children aged <5 years. Conventional mortality surveillance (determining cause of death through interviews with family members or caregivers [i.e., verbal autopsy] and vital registration) in areas with high mortality often lacks laboratory confirmation of causes and incompletely identifies maternal contributors and comorbid conditions, providing information that is insufficiently specific to guide prevention efforts. December 2016-December 2024. The Child Health and Mortality Prevention Surveillance (CHAMPS) network generates standardized, laboratory-confirmed data on causes and preventability of deaths among neonates, infants, and children aged <5 years and stillbirths in areas with high mortality. During 2016-2024, CHAMPS operated in seven countries (Bangladesh, Ethiopia, Kenya, Mali, Mozambique, Sierra Leone, and South Africa) through population-defined catchment areas. Eligibility required residence in a CHAMPS catchment area for ≥4 months before death or, for children aged <4 months, since birth. Deaths were investigated using a standardized postmortem approach that included minimally invasive tissue sampling (MITS), laboratory investigations (conventional and molecular microbiology and histopathology), interviews with family members or caregivers (i.e., verbal autopsy), and pediatric and maternal clinical record abstraction. Multidisciplinary determination of cause-of-death (DeCoDe) panels integrated evidence to assign causes (including multiple causes per death) and assess preventability. During 2016-2024, a total of 18,784 eligible deaths were identified; families consented to CHAMPS enrollment for 15,612 (83.1%) of these deaths. MITS was completed for 9,415 deaths and DeCoDe was completed for 8,500 (90.3% of MITS-investigated deaths); a total of 3,199 (37.6%) were stillbirths; 3,230 (38.0%) were neonatal deaths; and 2,071 (24.4%) were deaths of infants (aged 28 days to <12 months) and children (aged ≥12 to <60 months). Stillbirths were predominantly attributed to perinatal asphyxia or hypoxia (79.1%), often with maternal hypertensive disorders, placental abnormalities, chorioamnionitis, and other medical conditions (e.g., diabetes). Neonatal deaths involved preterm complications (39.7%); asphyxia or hypoxia (37.7%), which often is linked to maternal and intrapartum care; and sepsis (36.5%), commonly resulting from infection with Klebsiella pneumoniae and Acinetobacter baumannii. Among infants and children, leading causes of death included lower respiratory infections (37.4%), sepsis (36.9%), malnutrition (27.3%), malaria (22.1%), and diarrheal disease (17.3%). Multiple conditions in the causal chain were common among neonates (44.3% with two or more conditions) and infants and children (67.9% with two or more conditions). Postmortem anthropometry indicated high levels of moderate or severe undernutrition among infants and children; among those with available measurements, nonmutually exclusive anthropometric indicators included underweight (61.3%), wasting (61.3%), and stunting (43.0%), according to the World Health Organization's Child Growth Standards. Among neonatal, infant, and child deaths (excluding stillbirths), infection contributed to 3,146 (59.3%) deaths. Among neonatal, infant, and child deaths with one or more pathogens identified in the causal chain (n = 2,749), 44.5% were polymicrobial, with gram-negative bacteria predominating. Main maternal conditions, most commonly placental complications and hypertensive disorders of pregnancy, were assigned for 71.1% of stillbirths and 58.2% of neonatal deaths. Of 7,558 deaths with a preventability assessment, 6,103 (80.7%) were considered preventable or possibly preventable through improvements in already available maternal, newborn, and child health interventions; primary opportunities included strengthened antenatal care, obstetric management, and infection control. CHAMPS complements conventional mortality surveillance by providing standardized, laboratory-confirmed, postmortem evidence on causes and preventability of stillbirths and of deaths among neonates, infants, and children aged <5 years across areas with high mortality. Findings demonstrate that preventable infections, suboptimal antenatal care, intrapartum complications, preterm birth, and malnutrition account for most deaths and also involve maternal and health care system factors. The predominance of infections caused by gram-negative bacteria highlights the need to strengthen infection prevention and control and to develop preventive tools, including vaccines. Four of every five deaths were potentially preventable with timely implementation of established maternal, newborn, and child health interventions. CHAMPS demonstrates that high-precision postmortem MITS is feasible in resource-constrained settings and provides data critical to improve maternal and child health planning, practice, and policy. Certain components of CHAMPS (e.g., standardized MITS training, targeted diagnostics, and multidisciplinary review) could be adapted to strengthen routine surveillance and mortality review systems where feasible.
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3. Active Surveillance for Invasive Mold Disease - Four Hospitals, Atlanta, Georgia, 2020-2024.
3. 侵袭性霉菌病的主动监测——佐治亚州亚特兰大市四家医院，2020-2024年PMID:日期:2026-07-30Invasive mold diseases (IMDs) are rare, life-threatening infections that primarily affect persons with immunocompromising conditions. The most common molds associated with IMDs are Aspergillus spp., Mucorales (e.g., Mucor spp., Rhizomucor spp., and Rhizopus spp.), Fusarium spp., and Scedosporium spp. IMDs can affect the lungs, sinuses, skin, central nervous system, or multiple body sites. 2020-2024. IMD is not a nationally notifiable condition. CDC conducts active, laboratory-based IMD surveillance through the Georgia Emerging Infections Program at three laboratories that serve four Atlanta, Georgia, hospitals: two academic hospitals and their associated outpatient clinics, one federal hospital, and one community hospital. Identifying and classifying IMD cases is challenging because 1) symptoms often are nonspecific and 2) the presence of mold growth in clinical cultures might indicate infection, colonization, or laboratory contamination.Potential IMD cases were identified through a review of records from laboratories serving the hospitals included in this surveillance system to identify patients who received positive results from mold cultures or Aspergillus galactomannan tests, which detect the presence of galactomannan, a compound found in Aspergillus fungi, in serum or bronchoalveolar lavage fluid specimens. Potential cases in these patients were classified as proven or probable cases using established National Institute of Allergy and Infectious Diseases Mycoses Study Group (MSG) criteria that consider laboratory findings (e.g., histopathologic evidence of angioinvasive mold infection or a fungal culture from a normally sterile body site), clinical or radiologic features supporting IMD classification (e.g., chest computed tomography or bronchoscopy results suggestive of fungal disease, sinonasal signs, or central nervous system imaging results), and host factors that predispose patients to IMD (e.g., recent history of neutropenia, hematologic malignancy, transplantation receipt, and use of certain immunosuppressive medications). Potential cases that did not meet the laboratory, clinical, and host-factor criteria for MSG-proven or MSG-probable cases could be categorized as surveillance cases if treating clinicians diagnosed IMD in a patient and initiated treatment with antifungal therapy effective against mold or if the patient died within 3 days of specimen collection. During 2020-2024, a total of 968 unique patients with potential IMD were identified across four Atlanta hospitals and their associated outpatient clinics. Of those, 449 (46%) were classified as having IMD, including 89 (20%) MSG-proven, 142 (32%) MSG-probable, and 218 (49%) surveillance cases. Among patients with IMD, 58 (13%) had a current or recent COVID-19 diagnosis. Information on bed count was available for three of the four hospitals. At the two academic hospitals, the pooled average annual IMD incidence was 4.8 inpatient cases per 100 inpatient beds and 14.0 intensive care unit (ICU) cases per 100 ICU beds. At the community hospital, the average annual incidence was 2.8 inpatient cases per 100 inpatient beds and 10.2 ICU cases per 100 ICU beds.Among 449 patients with IMD, the largest percentage were aged 45-64 years (43%), followed by ≥65 years (39%), 19-44 years (18%). Patients aged 1-18 years and <1 year each accounted for <1% of IMD cases. Pulmonary infections were most common (68%), followed by cutaneous or deep tissue (nonfacial) infections (11%), sinus or nasal infections (10%), and central nervous system infections (excluding eyes) (9%); less frequent sites of infection included soft tissue (2%), blood (1%), bone (1%), and eye (1%). The most common fungal species identified among IMD cases were Aspergillus spp. (n = 319 [71%]), most commonly Aspergillus fumigatus (n = 94 [21%]). Fusarium spp. were the second most common (n = 20 [4%]), followed by Mucorales (n = 17 [4%]), and Scedosporium spp. (n = 12 [3%]). Aspergillus spp., Scedosporium spp., and Curvularia spp. were most commonly associated with pulmonary infections. Mucorales genera were more commonly associated with sinus, nasal, or facial infections and Fusarium spp. with cutaneous or deep tissue infections. Among patients with IMD, 65% (n = 292) had at least one MSG host factor that predisposes patients to IMD, and 53% (n = 238) had at least one MSG clinical criterion supporting IMD classification, suggesting that surveillance based only on classic host risk factors or typical clinical findings might miss a substantial proportion of IMD cases.A total of 363 (81%) of 449 patients with IMD received antifungal treatment effective against molds, most commonly isavuconazole (n = 178 [40%]), followed by voriconazole (n = 142 [32%]) and amphotericin B (n = 93 [21%]). Overall, 43% of patients with IMD were admitted to an ICU during the 2 weeks preceding specimen collection, and 50% of patients with IMD required intubation and mechanical ventilation; the 90-day all-cause mortality rate, excluding 2024 cases, was 45% (157 of 349). Indicators of severe illness were more common among IMD patients with a current or recent COVID-19 diagnosis than among those without COVID-19, including higher frequency of ICU admission during the 2 weeks preceding specimen collection (66% [38 of 58] versus 39% [154 of 391]; p<0.001) and increased 90-day all-cause mortality (66% [35 of 53] versus 41% [122 of 296]; p<0.001). IMDs are severe infections associated with frequent ICU admission and high mortality rates, especially among patients with a current or recent COVID-19 diagnosis. The findings from this report could serve as benchmark data in establishing baseline IMD rates for future surveillance to detect outbreaks in health care settings. More than one third of IMD cases (35%) occurred in patients without MSG host factors, underscoring the need for clinicians and surveillance efforts to consider the possibility of IMDs among patients without classic host risk factors for infection. Health care providers should be vigilant for IMDs as a life-threatening complication among persons with immunocompromising conditions or critical illness. Continued surveillance could help identify emerging populations at risk for IMD, facilitate earlier recognition and treatment, and support detection of health care-associated outbreaks.
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4. Surveillance for Candida auris - United States, 2022-2024.
4. 耳念珠菌监测——美国，2022-2024年PMID:日期:2026-07-02Candida auris is an emerging yeast that is frequently resistant to antifungal drugs. C. auris can cause invasive infections associated with high mortality and can colonize patients asymptomatically, which facilitates transmission in health care settings. Since it was first reported in the United States in 2016, C. auris has been identified in multiple states, with increasing numbers of cases reported annually. Monitoring national trends in cases identified through clinical testing and screening for colonization is critical to guide infection prevention and control efforts. 2022-2024. State and jurisdictional health departments voluntarily report clinical and screening C. auris cases to CDC using standardized case definitions of the Council of State and Territorial Epidemiologists. Clinical cases are defined as detection of C. auris from specimens collected for diagnostic purposes; screening cases are defined as detection from colonization screening swabs. Cases were reported to CDC through the Research Electronic Data Capture (REDCap) or Data Collation and Integration for Public Health Event Response (DCIPHER) platforms. Data included patient age and sex, case type, specimen type (for clinical cases), health care facility type, Antimicrobial Resistance Laboratory Network geographic region, and specimen collection date. Analyses were descriptive and limited to cases with specimens collected during 2022-2024. During 2022-2024, a total of 13,507 clinical C. auris cases were reported to CDC, increasing from 2,882 in 2022 to 4,428 in 2023 and 6,197 in 2024, with smaller annual percentage increases over time (53.7% from 2022 to 2023 and 39.9% from 2023 to 2024). Most clinical cases occurred among adults aged ≥45 years (87.8%) and among males (61.0%). The most common specimen types among all clinical cases were urine (31.5%) and blood (30.2%); by year, the proportion of blood as the specimen type was 34.4% in 2022, 30.2% in 2023, and 25.6% in 2024. Most clinical cases were identified through specimens collected in acute care hospitals (76.6%) and long-term acute care hospitals (17.8%).During the same period, a total of 27,853 screening cases were reported to CDC, increasing from 6,226 in 2022 to 9,195 in 2023 and 12,432 in 2024. Screening cases most frequently occurred among adults aged ≥45 years (90.0%) and males (57.9%). Among cases with known facility type, the proportion of specimens collected in acute care hospitals increased from 24.7% in 2022 to 50.7% in 2024, whereas the proportion of specimens collected in long-term acute care hospitals decreased from 56.1% to 35.7% during the same period. The number of clinical and screening C. auris cases reported to CDC increased during 2022-2024, indicating ongoing transmission in U.S. health care settings. Although annual percentage increases in clinical cases declined over time, absolute case counts reported to CDC continued to rise. The increasing proportion of screening cases with specimens collected in acute care hospitals might reflect increased use of screening in acute care hospitals, including screening at admission. Because of increases in the number of reported C. auris cases, sustained infection prevention and control efforts in health care facilities, including adherence to transmission-based precautions, environmental disinfection with agents effective against C. auris, and communication of C. auris status during patient transfers remain essential to preventing clinical infections and colonization. Because this pathogen is frequently resistant to antifungal drugs, continued investment in laboratory capacity and surveillance, including antifungal susceptibility testing and screening of patients at high risk for C. auris infection, can support timely detection and guide prevention strategies. Ongoing public health coordination at federal, state, and local levels is critical to limit further spread and to address emerging antifungal drug resistance.
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5. Foodborne Disease Outbreaks Associated with Marine Toxins - Foodborne Disease Outbreak Surveillance System, United States, 2011-2023.
PMID:日期:2026-06-18Marine toxins cause most of the noninfectious outbreaks reported to CDC's Foodborne Disease Outbreak Surveillance System (FDOSS) each year. Certain marine toxins are produced by algae that accumulate in aquatic animals through the food chain, whereas others appear as a result of improper food storage and are therefore preventable. Overgrowths of toxin-producing algae (harmful algal blooms) have occurred on both U.S. coasts; the historical geographic range for some species (e.g., Gambierdiscus in tropical and subtropical regions) have expanded. Marine toxins that cause foodborne illness are tasteless, odorless, resistant to cooking or freezing, and can produce a complex variety of gastrointestinal, neurologic, and neuropsychologic symptoms. Among persons with severe illness resulting from ingestion of marine toxins, cardiovascular and respiratory manifestations can result in hospitalization and death. Analyzing these outbreaks provides insight into their incidence, severity, and key characteristics, which can be used to guide food safety and foodborne illness prevention efforts. 2011-2023. Via FDOSS, CDC collects data on foodborne disease outbreaks from local, state, and territorial health departments in the United States. Foodborne disease outbreaks are defined as two or more cases of similar illness associated with a common food exposure; outbreak etiologies and food sources can be reported as confirmed or suspected. Since 2009, health departments have voluntarily reported foodborne disease outbreaks to FDOSS through CDC's web-based National Outbreak Reporting System. During 2011-2023, a total of 402 foodborne disease outbreaks caused by marine toxins were reported to FDOSS. These outbreaks resulted in 1,280 illnesses, 96 hospitalizations, and one death. The national rate of these reported outbreaks was 1.2 outbreaks per 1 million population. Outbreaks were reported by 32 states; Washington, DC; and Puerto Rico. Hawaii (25.3 outbreaks per 1 million population), Puerto Rico (16.5), Florida (6.3), and Alaska (5.4) had the highest reported rates. A food source was identified in 396 (99%) outbreaks, of which 379 (96%) implicated fish. Among 313 outbreak investigations in which the food importation status was known, 219 (70%) of the implicated foods were not imported. Of the 377 outbreaks in which a single location of food preparation was identified, private homes were reported in 193 (51%) outbreaks and sit-down dining restaurants were reported in 130 (34%) outbreaks.Nearly all outbreak reports (95%) implicated scombroid toxin (192 outbreaks, 597 illnesses, and six hospitalizations) or ciguatoxin (189 outbreaks, 619 illnesses, and 67 hospitalizations). For the 192 scombroid toxin outbreaks, the jurisdictions reporting the highest number of outbreaks were New York (43 [22%]), Florida (38 [20%]), California (23 [12%]), and Hawaii (18 [9%]). Of the 189 scombroid toxin outbreak reports with a reported food source, the majority (76%) implicated tuna. Of the 131 scombroid toxin outbreak reports with information on importation status, 70 (53%) implicated imported foods. Of the 181 scombroid toxin outbreak reports with a single location of food preparation, sit-down dining restaurants were identified in 104 (57%) outbreaks.Of the 189 ciguatoxin outbreaks, Florida reported 88 (47%) outbreaks, Puerto Rico reported 55 (29%), and Hawaii reported 18 (10%). Of the 187 ciguatoxin outbreak reports with a reported food source, 58 (31%) implicated barracuda, 25 (13%) implicated grouper, and 22 (12%) implicated amberjack. The majority (87%) of the 164 ciguatoxin outbreak reports with a known importation status reported foods that were domestically caught. Of the 178 ciguatoxin outbreak reports with a single location of food preparation, private homes were identified in 142 (80%) outbreaks.Shellfish-associated toxins caused 13 outbreaks, including paralytic shellfish poisoning in six (46%) outbreaks, neurotoxic shellfish poisoning in four (31%) outbreaks, and amnesic shellfish poisoning, diarrhetic shellfish poisoning, and unknown shellfish poisoning each associated with one (8%) outbreak. These outbreaks resulted in 40 illnesses and nine hospitalizations. Florida reported five (38%) of these 13 outbreaks and Alaska reported four (31%). Of the 13 total shellfish-associated outbreaks, mussels were implicated in four outbreaks (31%), sea snails in four (31%), and clams in three (23%). None of these outbreak investigations implicated imported shellfish. Of the 11 shellfish-associated toxin outbreaks with a reported single food preparation location, private homes were identified in eight (73%) outbreaks. Characterizing marine toxin outbreaks reported to FDOSS can guide opportunities for prevention. Scombroid toxin and ciguatoxin caused the most reported outbreaks, illnesses, and hospitalizations of all marine toxins, indicating they are important targets for public health intervention. More than half of scombroid toxin outbreaks were caused by imported fish and fish prepared in sit-down dining restaurants. Most ciguatoxin outbreaks were caused by reef fish, fish that were not imported, and fish prepared in private homes. Outbreaks attributed to shellfish-associated toxins were caused by shellfish that were not imported and were prepared in private homes. Outbreaks caused by ciguatoxin and those associated with shellfish-associated toxins were predominantly reported by jurisdictions where toxin-producing algal species are endemic and often implicated recreationally caught fish and shellfish. Geographic expansion, increasing frequency, and increasing intensity of harmful algal blooms in U.S. coastal waters might increase the presence of ciguatoxin and shellfish-associated toxins in aquatic animals. The varying characteristics of outbreaks caused by marine toxins highlight the need for tailored prevention measures that account for both environmental conditions and consumer behaviors. The findings in this report can be used by public health practitioners to guide food safety prevention efforts and raise awareness about marine toxins and associated illnesses. Prevention of outbreaks resulting from scombroid toxin from both imported and domestic fish involves maintaining temperature control of seafood below 40°F (4.4°C) from catch to consumption. Understanding the needs and practices of recreational harvesters could help public health officials craft targeted communications about safer practices for harvest location and affected aquatic species. Reducing the harvesting of reef fish and shellfish from high-risk areas, especially during and immediately after harmful algal blooms, might prevent illnesses from these toxins.
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6. Brucellosis Surveillance - United States, 2010-2024.
6. 布鲁氏菌病监测——美国，2010-2024年PMID:日期:2026-06-04Brucellosis is a zoonotic disease caused by bacteria of the Brucella genus, and humans can acquire the disease from infected animals or their by-products. This report on U.S. brucellosis cases is the first since the adoption of the 2010 Council of State and Territorial Epidemiologists' (CSTE) brucellosis case definition. 2010-2024. Data from the National Notifiable Diseases Surveillance System (NNDSS), information from supplemental case report forms (CRFs), and data from analyses of clinical specimen testing by CDC during 2010-2024 were analyzed. The 2010 CSTE brucellosis case definition was used to determine case status using supplemental CRFs submitted for cases reported through NNDSS. During 2010-2024, a total of 1,796 confirmed and probable cases of brucellosis were reported to CDC through NNDSS. A total of 878 of 1,796 (49%) cases also had a supplemental CRF submitted. Of these, 503 (57%) cases met the 2010 CSTE brucellosis confirmed or probable case definition on the basis of clinical and laboratory data submitted on the supplemental CRF; 383 cases (76%) were confirmed and 120 (24%) were probable. Among persons with brucellosis cases meeting the CSTE definition, 308 (61%) reported any travel, and of those, 245 (80%) reported only international travel during the 6 months before symptom onset. The most frequently reported exposures among persons with international travel were consumption of unpasteurized dairy products or undercooked meat (n = 195 [73%]). Among persons without international travel, the most frequently reported exposures were animal contact (n = 116 [62%]), particularly skinning and slaughtering wild animals (n = 47 [41%]) and hunting wild animals (n = 46 [40%]). The lack of adequate clinical or laboratory data led to the exclusion of nearly half of the supplemental CRFs from this analysis. However, the following recognized exposures to Brucella were identified in cases with adequate information: 1) consumption of unpasteurized dairy products or undercooked meat, particularly those produced outside the United States or meat from wild animals, and 2) animal contact, especially skinning and slaughtering of wild animals. Findings suggest ongoing public health messaging to reduce exposures from unpasteurized dairy products and undercooked meat, and to promote safe field dressing practices among hunters. For hunters and other persons who skin or slaughter wild animals, safe field dressing practices might help reduce infection risk. Increasing brucellosis awareness among populations at risk for infection, health care providers, and public health officials will strengthen prevention and surveillance efforts and ultimately improve patient outcomes.
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7. Tetanus Surveillance - United States, 2009-2023.
PMID:日期:2026-04-16Tetanus is a serious but vaccine-preventable disease caused by the toxin produced by germinated spores of Clostridium tetani bacteria. Despite substantial declines in incidence resulting from immunization, cases continue to occur, particularly among unvaccinated and undervaccinated populations. 2009-2023. The National Notifiable Diseases Surveillance System uses national surveillance to identify cases of tetanus using the Council of State and Territorial Epidemiologists' tetanus case definition. Tetanus cases identified through clinical diagnosis are reported to CDC by state health departments. Detailed tetanus-specific case information is requested, which includes tetanus toxoid-containing vaccine (TTCV) vaccination history, wound history, medical care before tetanus disease onset, and the clinical course of illness, including death. During 2009-2023, a total of 402 tetanus cases and 37 associated deaths were reported from 47 states and the District of Columbia, with a mean annual tetanus incidence of 0.08 cases and 0.008 deaths per 1 million population. More than half (62.2%) of all reported tetanus cases occurred in males. Incidence was higher among males than females for all persons aged <65 years and higher among women than men for adults aged ≥80 years. Women aged ≥80 years had the highest overall tetanus incidence (0.27 cases per 1 million population). The overall case-fatality rate among persons with tetanus with known vital status was 12.4% (37 of 299), with deaths predominantly affecting older adults. A total of 45.0% of persons with tetanus who had a substantial wound sought medical care before disease onset. Among patients with wounds eligible for tetanus post-exposure prophylaxis, 2.3% received tetanus immune globulin (TIG) and 26% received TTCV per recommendations. Among persons whose vaccination history was known, a substantial proportion (43.9%) had not received any TTCV doses, highlighting substantial gaps in coverage. Despite being preventable through vaccination, tetanus continues to occur among persons of all age groups in the United States. Overall, males have higher incidence compared with females; the highest incidence is among older women. Approximately 1 in 10 persons who develop tetanus will die, with the highest mortality and case-fatality rates among older adults. Multiple efforts might reduce the incidence of tetanus, including clinicians' assessing for and offering routine tetanus vaccination for children and decennial tetanus boosters for adults. In addition, persons with significant wounds should seek timely medical care, and clinicians should provide recommended wound care, including identifying tetanus-prone wounds and the need for and administration of TTCV and TIG. Because C. tetani is ubiquitous in the environment, continued surveillance and vaccination efforts are crucial to monitor trends, identify opportunities to prevent tetanus cases, and reduce tetanus incidence in the United States.
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8. Surveillance for Violent Deaths - National Violent Death Reporting System, 50 States, the District of Columbia, and Puerto Rico, 2022.
PMID:日期:2025-06-12In 2022, approximately 24,000 persons died of homicide and approximately 49,000 persons died of suicide in the United States, according to the National Vital Statistics System. This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) on suicides, homicides, legal intervention deaths, unintentional firearm injury deaths, and deaths of undetermined intent that occurred in the 50 states, the District of Columbia, and Puerto Rico in 2022. Results are reported by sex, age group, race and ethnicity, method of injury, type of location where the injury occurred, circumstances of injury, and other selected characteristics. In contrast to the 2021 NVDRS report, which collected data from a subset of states and included suicide data for persons aged ≥10 years, this report includes data from all 50 states, the District of Columbia, and Puerto Rico, and includes suicide data for all ages. 2022. NVDRS collects data from death certificates, coroner and medical examiner reports, and law enforcement reports. This report includes data collected for violent deaths and suicides that occurred in 2022. Data were collected from all 50 states, the District of Columbia, and Puerto Rico. A total of 47 states had statewide data, three states had data from counties representing a subset of their population (32 California counties, representing 68% of its population; 32 Florida counties, representing 70% of its population; and 13 Texas counties, representing 63% of its population), and the District of Columbia and Puerto Rico had jurisdiction-wide data. NVDRS collates information for each death and links deaths that are related (e.g., multiple homicides, homicide followed by suicide, or multiple suicides) into a single incident. For 2022, NVDRS collected information on 72,127 fatal incidents involving 74,148 deaths that occurred in all 50 states and the District of Columbia. In addition, data were collected for 727 fatal incidents involving 809 deaths in Puerto Rico, which were analyzed separately. Of the 74,148 deaths that occurred in 50 states and the District of Columbia, the majority (60.6%) were suicides, followed by homicides (30.2%), deaths of undetermined intent (7.1%), legal intervention deaths (1.4%) (i.e., deaths caused by law enforcement and other persons with legal authority to use deadly force acting in the line of duty, excluding legal executions, without denoting the lawfulness or legality of the circumstances surrounding the death), and unintentional firearm injury deaths (<1.0%). Of the 809 deaths that occurred in Puerto Rico, 73.9% were homicides and 23.5% were suicides.Demographic patterns and circumstances varied by manner of death. In the 50 states and the District of Columbia, the suicide rate was higher for males than for females (23.7 versus 6.1 per 100,000 population). The suicide rate for males was highest for those aged ≥85 years (56.6), whereas for females, the suicide rate was highest for those aged 45-54 years (8.9). In addition, non-Hispanic American Indian or Alaska Native (AI/AN) persons had the highest suicide rates among all racial and ethnic groups (24.3). Among both males and females, the most common method of injury for suicide was a firearm. Among all suicide victims, when circumstances were known (83.5%), suicide was most often preceded by a mental health or substance use-related problem or treatment, suicidal thoughts or plans, a recent or impending crisis, or depressed mood.The homicide rate was higher for males than for females. Among all homicide victims, the homicide rate was highest among persons aged 20-24 years compared with other age groups. Non-Hispanic Black or African American (Black) males experienced the highest homicide rate of any racial or ethnic group. Among all homicide victims, the most common method of injury was a firearm. When the relationship between a homicide victim and a suspect was known, the suspect was most frequently an acquaintance or friend for male victims and a current or former intimate partner for female victims. Homicide most often was precipitated by an argument or conflict, occurred in conjunction with another crime, or, for female victims, was related to intimate partner violence. Nearly all legal intervention deaths were among males, and the legal intervention death rate was highest among males aged 30-34 years. The legal intervention death rate was highest among AI/AN males, followed by Black males. A firearm was used in most legal intervention deaths. When circumstances were known for legal intervention deaths, the most frequent circumstances reported were the victim used a weapon in the incident and the victim was previously known to authorities.Other causes of death included unintentional firearm injury deaths and deaths of undetermined intent. Unintentional firearm injury deaths were most frequently experienced by males, non-Hispanic White (White) persons, and persons aged 15-19 years. These deaths most frequently occurred while the shooter was playing with a firearm or were precipitated by a person unintentionally pulling the trigger. The rate of deaths of undetermined intent was highest among males, particularly among AI/AN and Black males, and among adults aged 35-44 years. Poisoning was the most common method in deaths of undetermined intent, and opioids were detected in approximately 70% of decedents tested for those substances.In Puerto Rico, the homicide rate was 11.5 times higher for males than for females. Firearms were the most common method of injury in homicides (93.6%). When the relationship between the homicide victim and suspect was known, the suspect was most frequently a person known to the victim, but the exact relationship was unclear for male victims and was a current or former intimate partner for female victims. Among male victims, the most common precipitating circumstance was the victim was previously known to authorities (47.1%), whereas among female victims, the most common circumstance was intimate partner violence (29.8%). The suicide rate in Puerto Rico was also higher for males than for females. The most common method for suicide was hanging, strangulation, or suffocation (62.3%). A depressed mood or currently diagnosed mental health problem were frequent circumstances reported for both male and female suicide decedents. This report provides a detailed summary of data from NVDRS on violent deaths and suicides that occurred in 2022, the first year for which data from all 50 states, the District of Columbia, and Puerto Rico met the NVDRS national data set inclusion criteria. States with large numbers of deaths that meet the NVDRS case definition (California, Florida, and Texas) are moving toward statewide coverage rather than including only a subset of deaths that occurred in their state. The suicide rate was highest among AI/AN and White males, whereas the homicide rate was highest among Black and AI/AN males. Intimate partner violence precipitated a large proportion of homicides among females. Mental health and substance use problems, previous awareness of the victim by authorities, intimate partner problems, interpersonal conflicts, and acute life stressors were primary precipitating circumstances for multiple types of deaths examined. These findings increase the knowledge base about the circumstances associated with these deaths and can assist public health authorities and their partners in developing and informing effective, data-driven approaches to violence prevention. The injury-related deaths described in this report are preventable, and data can inform public health action. NVDRS data are used to monitor the occurrence of these fatal injuries and assist public health agencies in developing, implementing, and evaluating programs, policies, and practices to reduce and prevent deaths. States and jurisdictions have used their Violent Death Reporting System data to inform violence prevention efforts and highlight where additional focus is needed. The findings in this report can be used to enhance prevention efforts.
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9. Population-Based Active Surveillance for Culture-Confirmed Candidemia - 10 Sites, United States, 2017-2021.
9. 基于人群的培养确诊念珠菌血症主动监测——美国10个监测点，2017-2021年PMID:日期:2025-05-29Candidemia, a bloodstream infection caused by Candida spp., is a common cause of health care-associated bloodstream infections in the United States. Candidemia is associated with substantial health care costs, morbidity, and mortality. 2017-2021. CDC's Emerging Infections Program (EIP), a collaboration among CDC, state health departments, and academic partners, was used to conduct active, population-based laboratory surveillance for candidemia at city or county sites located in 10 states (California, Colorado, Connecticut, Georgia, Maryland, Minnesota, New Mexico, New York, Oregon, and Tennessee), representing a combined population of approximately 21.5 million persons, or 7% of the U.S. population in 2019. Connecticut began reporting cases on January 1, 2019, and conducts statewide surveillance. Although candidemia is not a nationally notifiable condition, cases of Candida auris infection are nationally notifiable, and cases of candidemia caused by C. auris could be included in both national case counts and EIP surveillance. A culture-confirmed candidemia case is defined as a positive blood culture for any Candida sp. from a resident in the surveillance catchment area. Subsequent positive blood cultures for Candida within 30 days of the initial positive culture (index date) in the same patient are considered part of the same case. Clinical laboratories serving each catchment area report candidemia cases, and trained surveillance officers abstract information from medical charts for all cases. Corresponding isolates are sent to CDC for species confirmation and antifungal susceptibility testing. A total of 7,381 candidemia cases were identified during the surveillance period (2017-2021). The overall incidence was 7.4 cases per 100,000 population. Across age groups, sexes, racial and ethnic groups, and surveillance sites, incidence was generally stable or increased slightly from 2017 to 2021, with the lowest overall incidence in 2019 (6.8) and the highest in 2021 (7.9). In 2021, candidemia incidence was highest in patients aged ≥65 years (22.7) and infants (aged <1 year) (8.0). Incidence was higher in males (8.7) compared with females (7.0) and higher in non-Hispanic Black or African American (Black) patients (12.8) compared with non-Black patients (5.6). Incidence was highest in Maryland (14.5), followed by Tennessee (10.1) and Georgia (10.0); incidence was lowest in Oregon (4.8). Increases occurred in the percentage of cases classified as health care onset (52.2% in 2017 to 58.0% in 2021). Overall, among 7,381 cases (in 6,235 patients), 63.7% occurred in patients who had a central venous catheter, 80.7% involved recent systemic antibiotic receipt, and 9.0% occurred in patients who had a history of injection drug use. The percentage of cases with a positive SARS-CoV-2 test during the 90 days before or after the index date increased from 10.4% in 2020 to 17.7% in 2021. From 2017 to 2021, the percentage of cases involving an intensive care unit stay before the index date increased from 38.3% to 44.9%. Echinocandins (e.g., micafungin) were used as treatment in 49.8% of cases, and azoles were used in 47.7%. The all-cause in-hospital mortality rate was 32.6%; this increased from 26.8% in 2019 to 36.1% in 2021. Overall, Candida albicans accounted for 37.1% of cases, followed by Candida glabrata (30.4%) and Candida parapsilosis (13.5%); however, C. glabrata was the most frequent species in California (38.4%) and Maryland (32.9%). Candida auris infections accounted for 0.4% of cases. Among 6,576 Candida isolates for which interpretive breakpoints exist and isolates were available for testing, 5.6% were fluconazole resistant, and <1% were echinocandin resistant. Antifungal resistance was stable for all antifungals tested across years. Candidemia remains an important health care-associated infection. The disproportionate incidence among older adults, males, and Black patients is consistent with previous reports, and the overall incidence of candidemia has not changed substantially compared with previous EIP findings based on data collected during 2012-2016 (8.7 per 100,000 population). The higher mortality rate associated with candidemia during 2020-2021 likely reflects consequences of the COVID-19 pandemic, including strained health care systems and an increased population of patients who were susceptible to candidemia because of COVID-19-related critical illness. Strict implementation of measures to prevent health care-associated bloodstream infections is important to help prevent candidemia cases. Health care officials and providers should be vigilant for candidemia as a complication of critical illness. Continued surveillance is needed to monitor for emerging populations at risk for candidemia and changes in antifungal resistance patterns, which can help guide antifungal treatment selection.
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10. Enteric Disease Outbreaks Associated with Animal Contact - Animal Contact Outbreak Surveillance System, United States, 2009-2021.
PMID:日期:2025-05-22An estimated 450,000 enteric illnesses, 5,000 hospitalizations, and 76 deaths associated with animal contact occur each year in the United States. Enteric illnesses are diseases that affect the stomach or intestines and cause symptoms, such as diarrhea, nausea, or vomiting, and are typically transmitted from animals to humans through the fecal-oral route. Humans might encounter animal feces or bodily fluids through contact with the animal itself, the animal's environment, or the animal's food or water. Although outbreak-associated illnesses account for a small subset of all enteric illnesses linked to animal contact, data obtained from outbreak surveillance offer insights into the underlying epidemiologic factors contributing to illnesses, including the pathogens, animals, pathogen-animal category pairs, and settings of outbreaks associated with animal contact. 2009-2021. The Animal Contact Outbreak Surveillance System (ACOSS) was launched in 2009 in conjunction with the National Outbreak Reporting System (NORS), a web-based platform that includes reports of foodborne and waterborne outbreaks as well as enteric disease outbreaks transmitted by contact with environmental sources, infected persons or animals, or unknown modes. ACOSS encompasses animal contact outbreaks that are reported to CDC through NORS. Local, state, and territorial health departments voluntarily report animal contact outbreaks, which are defined as two or more enteric illnesses associated with a common animal source. Outbreaks can involve single or multiple states; CDC staff typically report multistate outbreaks on behalf of state and territorial health departments. ACOSS defines an animal source as an animal (including domestic and wild animals); an animal's feces or bodily fluids (except milk and other fluids consumed as food, which are defined as foodborne sources); an animal's fur, hair, feathers, scales, or skin; an animal's food; or an animal's environment, which includes places in which it lives and roams. During 2009-2021, a total of 557 animal contact outbreaks of enteric disease were reported in the United States through ACOSS, accounting for 14,377 illnesses, 2,656 hospitalizations, and 22 deaths. Exposures were reported in all 50 states, Washington, DC, and Puerto Rico. During the period there were 393 single-state outbreaks and 164 multistate outbreaks. Although multistate outbreaks comprised 29% of all outbreaks reported through ACOSS, they accounted for 80% of illnesses, 88% of hospitalizations, and 82% of deaths. Among 474 outbreaks with a confirmed single etiology, Salmonella was the most common cause of outbreaks (248 outbreaks [52%]); these outbreaks accounted for the most outbreak-associated illnesses (11,822 [85%]), hospitalizations (2,393 [91%]), and deaths (17 [77%]). Cryptosporidium (108 outbreaks [23%]) was the second leading cause of confirmed, single etiology outbreaks, followed by Escherichia coli (63 [13%]) and Campylobacter (52 [11%]). The most common exposure locations among outbreaks with a single location reported were private home (168 [40%]) and farm or dairy (89 [21%]). Among 467 outbreaks for which an animal source could be attributed to a single animal category, ruminants (171 [37%]) were the most implicated animal category (with 75% of ruminant outbreaks attributed to cattle), followed by poultry (155 [33%]) and turtles (39 [12%]). Poultry were associated with the most outbreak-associated illnesses (9,095 [66% of illnesses resulting from outbreaks attributed to a single animal category]), hospitalizations (1,804 [70%]), and deaths (15 [83%]). Most outbreaks (130 [84% of all poultry outbreaks]) attributed to poultry had private home reported as at least one of the exposure locations (i.e., backyard poultry) and were responsible for nearly all poultry-associated illnesses (8,897 [98%]). The most common confirmed pathogen-animal pair was Salmonella and poultry (132 outbreaks), followed by Cryptosporidium and ruminants (88), and Salmonella and turtles (37). Salmonella and poultry accounted for the highest number of outbreak-associated illnesses (8,965), hospitalizations (1,790), and deaths (15). Animal contact outbreaks of enteric disease reported through ACOSS provide insights into the animals and etiologies causing outbreak-associated enteric illnesses as well as other outbreak characteristics, such as settings in which outbreaks occur. These findings can guide public health actions, developed in collaboration with specific populations (e.g., backyard poultry owners) and including interventions tailored to settings, such as private homes and farms or dairies, that are more commonly associated with animal contact outbreaks. The high proportion of outbreaks occurring in private homes identifies a potential gap in proper hygiene and enteric disease prevention knowledge among animal owners, including owners of backyard poultry, which might be considered by owners to be pets rather than livestock. Settings and populations linked to ruminants, poultry, and turtles (particularly cattle, backyard poultry, and small turtles, respectively) are important targets for public health interventions because of the high number of outbreaks and outbreak-associated illnesses associated with these animal sources. Furthermore, the disproportionate impact of multistate outbreaks reiterates the importance of a collaborative national response but also might reflect limited resources to investigate or report animal contact outbreaks at state and local levels. Public health partners should continue to report animal contact outbreaks through ACOSS to inform evidence-based interventions tailored to specific animals, pathogens, populations, and settings. Strengthening the capacity of local, state, and territorial health departments to investigate and report animal contact outbreaks is critical to improving surveillance of animal contact outbreaks. Close collaboration between state, local, and Federal public health and agricultural partners nationwide is also key in investigating and responding to multistate outbreaks. An integrated One Health approach that leverages the expertise of animal, environmental, and public health partners can facilitate successful public health interventions aimed at preventing animal contact outbreaks.