Mobile Version - March - April 2018

From the Director Dr. Jonathan Mermin

Surprising to many, tuberculosis (TB) is still one of the world's deadliest diseases. In 2016, 1.7 million people died of TB-related diseases worldwide; and TB is still the leading cause of death for people with HIV. We have made progress in the United States with a total of 9,272 TB cases reported in 2016, a 3.6% decrease from 2015. However, if we are to eliminate TB domestically and globally this century, we must do more. On World TB Day, March 24, we take the opportunity to communicate, energize, and motivate people to talk about Mycobacterium tuberculosis. This year's theme, "Wanted: Leaders for a TB Free United States. We can make history. End TB." asks us to take action and to be leaders in the elimination of TB. New resources and materials as well as information on how you can help make history are available on the World TB Day 2018 website.

Infectious Disease Trends among Persons Who Inject Drugs

Last month, CDC published two articles on infectious disease trends among persons who inject drugs (PWID). One study, based on CDC's National HIV Behavioral Surveillance, focused on HIV infection and HIV-associated behaviors among PWID in 20 selected metropolitan statistical areas. It found that in 2015, the prevalence of HIV among PWID was 7% compared to 11% in 2012. Despite this decrease, other study data show a cause for concern. Among the HIV-negative participants, 27% receptively shared syringes, 67% had condomless vaginal sex, 22% had condomless heterosexual anal sex, and 45% had more than one opposite sex partner. The second study looked at National Inpatient Sample hospital discharge data to identify trends in infective endocarditis (IE), central nervous system (CNS) abscesses, and osteomyelitis, among PWID. The study found an increase in the number of primary hospitalization discharge diagnoses for IE among persons aged ≤39 years from 2009 to 2013. Secondary diagnoses of hepatitis B, C, and D viruses and substance-related disorders increased among those hospitalized for IE, CNS abscess, and osteomyelitis. These analyses highlight the ongoing need for risk-reduction and prevention services among PWID, such as greater access to HIV testing, behavioral intervention, sterile injection equipment, education regarding injection drug use, and treatment for substance use disorder.

STD Treatment and Prevention for Providers

CDC recently released an updated version of Syphilis: A Provider's Guide to Treatment and Prevention. This complement to CDC's STD Treatment Guidelines was created to help educate physicians and healthcare providers on the diagnosis, treatment, and prevention of syphilis. The updated guide contains images of typical and atypical primary and secondary syphilis symptoms and expands on information in the treatment guidelines to help address diagnostic challenges. It also includes need-to-know details about syphilis signs and symptoms by stage; the diagnosis of neurosyphilis, ocular syphilis, and congenital syphilis; information needed to diagnose and stage syphilis; syphilis prevention messages; and where to go for more information.