2765. Pediatric Mumps during the 2015–2017 Mumps Resurgence in the United States

Abstract Background Numerous mumps outbreaks occurred in the United States over the last decade, with outbreaks affecting young adults on college campuses being among the largest and most widely publicized. However, at least half of mumps cases and outbreaks occurred in other age-groups and settings. We describe reported mumps cases among children and adolescents during 2015 through 2017. Methods The Centers for Disease Control and Prevention (CDC) analyzed reports of confirmed and probable mumps cases in persons aged ≤18 years (defined here as pediatric mumps) transmitted electronically through the Nationally Notifiable Diseases Surveillance System (NNDSS) by the 52 reporting jurisdictions. Results Between January 1, 2015 and December 31, 2017, 49 jurisdictions reported 4,886 pediatric mumps cases (35% of all US reported cases, 13,807); 8 jurisdictions reported >100 cases each, representing 82% of all pediatric cases. Overall, 29 (1%) cases were in infants <1 yr, 406 (8%) were in children aged 1–4 years, 1,408 (29%) in children aged 5–10 years, 1,365 (28%) in adolescents aged 11–14 years, and 1,678 (34%) in adolescents aged 15–18 years. Most (3,548, 73%) cases did not travel outside the state during their exposure period; only 37 (1%) traveled outside the country. Cases in patients aged 1–4 years were more frequently non-outbreak associated (38%) than those in patients <1 years and 5–18 years (24% and 9%, respectively). Among 3,309 (68%) patients with known number of MMR doses received, 81% of those 5–18 years had ≥2 MMR doses, while 67% of those 1–4 years had ≥1 dose. Median time since last MMR dose for patients with 2 doses was 8 years (IQR: 4, 11 years). Four patients had meningitis and 1 had encephalitis; all were ≥10 years old and previously received 2 MMR doses. Of male mumps patients older than 10 years of age (2,113), 46 (2%) reported having orchitis; of these, 33 (72%) had 2 MMR doses. Sixty-four patients were hospitalized and there were no deaths. Conclusion About one-third of cases reported during the recent US mumps resurgence were in children and adolescents. The low rate of mumps complications compared with previous studies suggests mumps complications may not be adequately captured in national surveillance or identified by providers. Providers should remain vigilant that mumps can still occur among fully vaccinated pediatric patients, even those recently vaccinated. Disclosures All authors: No reported disclosures.

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Firearm Injuries Affecting the Pediatric Population

PEDIATRICS ◽

10.1542/peds.89.4.788 ◽

1992 ◽

Vol 89 (4) ◽

pp. 788-790

Author(s):

Keyword(s):

United States ◽

Children And Adolescents ◽

Pediatric Population ◽

Age Groups ◽

Unintentional Injury ◽

The United States ◽

Male Adolescents ◽

Firearm Injuries ◽

Group 2 ◽

Developed Nations

In the United States approximately 30 000 people die from firearm injuries each year. Many more are wounded. In the mid 1980s, more than 3000 of the dead were children and adolescents aged 1 to 19 years.1 In 1989 nearly 4000 firearm deaths were among children 1 to 19 years of age, accounting for 12% of all deaths in that age group.2 All of these deaths or injuries affect other children because the victims who are killed or wounded are frequently relatives, neighbors, or friends. Comparison data for childhood age groups demonstrate that in 1987, 203 children aged 1 to 9 years, 484 children aged 10 to 14 years, and 2705 adolescents aged 15 to 19 years died as a result of firearm injuries.1 Firearm deaths include unintentional injuries, homicides, and suicides. Among the 1- to 9-year-olds, half of the deaths were homicides and half were unintentional. Among the 10- to 14-year-olds, one third of the deaths were homicides, one third were suicides, and one third were unintentional. Among the 15- to 19-year-olds, 48% were homicides, 42% were suicides, and 8% were unintentional.1 Firearm homicides are the leading cause of death for some US subpopulations, such as urban black male adolescents and young adults.3 Table 1 indicates how firearms contributed to the deaths of children and adolescents (homicides, suicides, and all causes) in 1987. Table 2 illustrates the unusual scale of firearm violence affecting young people in the United States compared with other developed nations.4 Firearm injuries are the fourth leading cause of unintentional injury deaths to children younger than 15 years of age in the US.5

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A review of events that expose children to elemental mercury in the United States

Ciência & Saúde Coletiva ◽

10.1590/s1413-81232010000200035 ◽

2010 ◽

Vol 15 (2) ◽

pp. 585-598 ◽

Cited By ~ 9

Author(s):

Robin Lee ◽

Dan Middleton ◽

Kathleen Caldwell ◽

Steve Dearwent ◽

Steven Jones ◽

...

Keyword(s):

United States ◽

Elemental Mercury ◽

Exposure Period ◽

The United States ◽

Federal State ◽

Toxic Substances ◽

Industrial Property ◽

Control And Prevention ◽

Dental Amalgams ◽

Waste Incinerators

Concern for children exposed to elemental mercury prompted the Agency for Toxic Substances and Disease Registry and the Centers for Disease Control and Prevention to review the sources of elemental mercury exposures in children, describe the location and proportion of children affected, and make recommendations on how to prevent these exposures. In this review, we excluded mercury exposures from coal-burning facilities, dental amalgams, fish consumption, medical waste incinerators, or thimerosal-containing vaccines. We reviewed federal, state, and regional programs with data on mercury releases along with published reports of children exposed to elemental mercury in the United States. We selected all mercury-related events that were documented to expose (or potentially expose) children. Primary exposure locations were at home, at school, and at others such as industrial property not adequately remediated or medical facilities. Exposure to small spills from broken thermometers was the most common scenario; however, reports of such exposures are declining. The information reviewed suggests that most releases do not lead to demonstrable harm if the exposure period is short and the mercury is properly cleaned up. Primary prevention should include health education and policy initiatives.

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COVID-19 and Treatment and Immunization of Children—The Time to Redefine Pediatric Age Groups is Here

Rambam Maimonides Medical Journal ◽

10.5041/rmmj.10433 ◽

2021 ◽

Vol 12 (2) ◽

pp. e0010

Author(s):

Klaus Rose ◽

◽

Jane M. Grant-Kels ◽

Earl B. Ettienne ◽

Oishi Tanjinatus ◽

...

Keyword(s):

United States ◽

Age Groups ◽

Drug Approval ◽

The United States ◽

The Body ◽

Kawasaki Syndrome ◽

Pediatric Age ◽

Prevention And Treatment ◽

Control And Prevention ◽

Inflammatory Syndrome

Children are infected with coronavirus disease 2019 (COVID-19) as often as adults, but with fewer symptoms. During the first wave of the COVID-19 pandemic, multisystem inflammatory syndrome (MIS) in children (MIS-C), with symptoms similar to Kawasaki syndrome, was described in young minors testing positive for COVID-19. The United States (US) Centers for Disease Control and Prevention (CDC) defined MIS-C as occurring in <21-year-olds, triggering hundreds of PubMed-listed papers. However, postpubertal adolescents are no longer children biologically; the term MIS-C is misleading. Furthermore, MIS also occurs in adults, termed MIS-A by the CDC. Acute and delayed inflammations can be triggered by COVID-19. The 18th birthday is an administrative not a biological age limit, whereas the body matures slowly during puberty. This blur in defining children leads to confusion regarding MIS-C/MIS-A. United States and European Union (EU) drug approval is handled separately for children, defined as <18-year-olds, ascribing non-existent physical characteristics up to the 18th birthday. This blur between the administrative and the physiological meanings for the term child is causing flawed demands for pediatric studies in all drugs and vaccines, including those against COVID-19. Effective treatment of all conditions, including COVID-19, should be based on actual physiological need. Now, the flawed definition for children in the development of drugs and vaccines and their approval is negatively impacting prevention and treatment of COVID-19 in minors. This review reveals the necessity for redefining pediatric age groups to rapidly establish recommendations for optimal prevention and treatment in minors.

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Modeling of COVID-19 Transmission Dynamics on US Population: Inter-transfer Infection in Age Groups, Mutant Variants, and Vaccination Strategies

10.1101/2021.09.25.21264118 ◽

2021 ◽

Author(s):

Jyotirmoy Roy ◽

Samuel Heath ◽

Doraiswami Ramkrishna ◽

Shiyan Wang

Keyword(s):

United States ◽

Large Fraction ◽

Age Groups ◽

The United States ◽

Vaccination Strategies ◽

Health Authorities ◽

Mutant Variant ◽

High Infection ◽

Control And Prevention ◽

Vaccine Distribution

The in-depth understanding of the dynamics of COVID-19 transmission among different age groups is of great interest for governments and health authorities so that strategies can be devised to reduce the pandemic's detrimental effects. We developed the SIRDV-Virulence epidemiological model based on a population balance equation to study the effect of mutants of the virus and the effect of vaccination strategies on mitigating the transmission among the population in the United States. Based on the available data from the Centers for Disease Control and Prevention (CDC), we obtain the key parameters governing the dynamic evolution of the spread of the COVID-19 pandemic. In the context studied, the results show that a large fraction of infected cases comes from the adult and children populations in the presence of a mutant variant of COVID-19 with high infection rates. We further investigate the optimum vaccine distribution strategy among different age groups. Given the current situation in the United States, the results show that prioritizing children and adult vaccinations over that of seniors can contain the spread of the active cases, thereby preventing the healthcare system from being overwhelmed and minimizing subsequent deaths. The model suggests that the only option to curb the effects of this pandemic is to reduce the population of unvaccinated individuals. A higher fraction of 'Anti/Non-vaxxers' can lead to the resurgence of the pandemic.

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Pediatric Head Injuries and Deaths From Bicycling in the United States

PEDIATRICS ◽

10.1542/peds.98.5.868 ◽

1996 ◽

Vol 98 (5) ◽

pp. 868-870 ◽

Cited By ~ 1

Author(s):

Daniel M. Sosin ◽

Jeffrey J. Sacks ◽

Kevin W. Webb

Keyword(s):

United States ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Head Injury ◽

Children And Adolescents ◽

Head Injuries ◽

Age Groups ◽

The United States ◽

Injury Surveillance System ◽

Bicycle Helmets

Objective. To estimate the potential benefit of increasing bicycle helmet use among children and adolescents in the United States. Design. All bicycle-related deaths (Multiple Cause-of-Death Public Use Data Tapes, 1989 through 1992) and bicycle-related injuries treated in sampled emergency departments (National Electronic Injury Surveillance System, 1989 through 1993) were used to calculate traumatic brain injury-associated death and head injury rates per 1 000 000 US residents. Preventable injuries and deaths were estimated by calculating the populationattributable risk of head injury due to nonuse of bicycle helmets. Patients. US residents aged 0 through 19 years who were injured or who died as a result of a bicycle crash. Results. An average of 247 traumatic brain injury deaths and 140 000 head injuries among children and adolescents younger than 20 years were related to bicycle crashes each year in the United States. As many as 184 deaths and 116 000 head injuries might have been prevented annually if these riders had worn helmets. An additional 19 000 mouth and chin injuries were treated each year. The youngest age groups had the highest proportions of both head and mouth injuries. Conclusion. There continues to be a need to advocate for greater use of bicycle helmets, particularly among young children. Helmet design changes should be considered to prevent mouth injuries.

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SURVEILLANCE OF ASSISTED REPRODUCTIVE TECHNOLOGY IN THE UNITED STATES

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462399015135 ◽

1999 ◽

Vol 15 (1) ◽

pp. 11-14 ◽

Cited By ~ 2

Author(s):

Susan F. Meikle ◽

Isabella Danel ◽

Lynne S. Wilcox

Keyword(s):

United States ◽

Disease Control ◽

Success Rate ◽

Assisted Reproductive Technology ◽

Surveillance System ◽

The United States ◽

Reproductive Technology ◽

The Public ◽

Control And Prevention ◽

Public Report

The Centers for Disease Control and Prevention published the first Assisted Reproductive Technology (ART) Pregnancy Success Rate Report in 1997. This article presents a description of the law that initiated the public report, a description of the surveillance system used to accumulate data for the report, and some of the results from ART cycles intitiated in 1995.

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Initial economic damage from the COVID-19 pandemic in the United States is more widespread across ages and geographies than initial mortality impacts

Proceedings of the National Academy of Sciences ◽

10.1073/pnas.2014279117 ◽

2020 ◽

Vol 117 (45) ◽

pp. 27934-27939 ◽

Cited By ~ 2

Author(s):

Maria Polyakova ◽

Geoffrey Kocks ◽

Victoria Udalova ◽

Amy Finkelstein

Keyword(s):

United States ◽

New York ◽

Excess Mortality ◽

Age Groups ◽

The United States ◽

Economic Damage ◽

Monthly Data ◽

Policy Responses ◽

All Cause Mortality ◽

Control And Prevention

The economic and mortality impacts of the COVID-19 pandemic have been widely discussed, but there is limited evidence on their relationship across demographic and geographic groups. We use publicly available monthly data from January 2011 through April 2020 on all-cause death counts from the Centers for Disease Control and Prevention and employment from the Current Population Survey to estimate excess all-cause mortality and employment displacement in April 2020 in the United States. We report results nationally and separately by state and by age group. Nationally, excess all-cause mortality was 2.4 per 10,000 individuals (about 30% higher than reported COVID deaths in April) and employment displacement was 9.9 per 100 individuals. Across age groups 25 y and older, excess mortality was negatively correlated with economic damage; excess mortality was largest among the oldest (individuals 85 y and over: 39.0 per 10,000), while employment displacement was largest among the youngest (individuals 25 to 44 y: 11.6 per 100 individuals). Across states, employment displacement was positively correlated with excess mortality (correlation = 0.29). However, mortality was highly concentrated geographically, with the top two states (New York and New Jersey) each experiencing over 10 excess deaths per 10,000 and accounting for about half of national excess mortality. By contrast, employment displacement was more geographically spread, with the states with the largest point estimates (Nevada and Michigan) each experiencing over 16 percentage points employment displacement but accounting for only 7% of the national displacement. These results suggest that policy responses may differentially affect generations and geographies.

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Geospatial analysis of nonmedical vaccine exemptions and pertussis outbreaks in the United States

Proceedings of the National Academy of Sciences ◽

10.1073/pnas.1700240114 ◽

2017 ◽

Vol 114 (27) ◽

pp. 7101-7105 ◽

Cited By ~ 14

Author(s):

Carlin Aloe ◽

Martin Kulldorff ◽

Barry R. Bloom

Keyword(s):

United States ◽

Children And Adolescents ◽

Age Groups ◽

The United States ◽

Geospatial Analysis ◽

Community Level ◽

Scan Statistics ◽

Waning Immunity

Because of increased numbers of recorded pertussis cases in the United States, this study sought to understand the role of nonmedical vaccine exemptions and waning immunity may have had on the resurgence of pertussis in the United States at the community level. We used geospatial scan statistics, SaTScan, version 9.4, to analyze nonmedical vaccine exemptions of children entering kindergarten in 2011 and 2012 and reported pertussis cases in 2012 for children in age groups 5 years and younger and 10 to 14 years. Eight statistically significant clusters of nonmedical vaccine exemptions in kindergarteners and 11 statistically significant clusters of pertussis cases in children and adolescents were identified and geospatially linked. Forty-five percent of the counties in the study had high rates of nonmedical vaccine exemptions. The proportion of kindergarteners with nonmedical vaccine exemptions was 2.8 times larger in the identified exemption clusters. In addition, 31 counties had geographic clusters of high rates of pertussis in children ages 10 to 14 years old, consistent with waning immunity. Our findings are consistent with the view that geographic clusters of nonmedical vaccine exemptions and waning immunity may have been factors contributing to community-level pertussis outbreaks.

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