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MMWR Morb Mortal Wkly Rep ; 69(33): 1139-1143, 2020 Aug 21.
Article in English | MEDLINE | ID: mdl-32817597


Preventing coronavirus disease 2019 (COVID-19) in correctional and detention facilities* can be challenging because of population-dense housing, varied access to hygiene facilities and supplies, and limited space for isolation and quarantine (1). Incarcerated and detained populations have a high prevalence of chronic diseases, increasing their risk for severe COVID-19-associated illness and making early detection critical (2,3). Correctional and detention facilities are not closed systems; SARS-CoV-2, the virus that causes COVID-19, can be transmitted to and from the surrounding community through staff member and visitor movements as well as entry, transfer, and release of incarcerated and detained persons (1). To better understand SARS-CoV-2 prevalence in these settings, CDC requested data from 15 jurisdictions describing results of mass testing events among incarcerated and detained persons and cases identified through earlier symptom-based testing. Six jurisdictions reported SARS-CoV-2 prevalence of 0%-86.8% (median = 29.3%) from mass testing events in 16 adult facilities. Before mass testing, 15 of the 16 facilities had identified at least one COVID-19 case among incarcerated or detained persons using symptom-based testing, and mass testing increased the total number of known cases from 642 to 8,239. Case surveillance from symptom-based testing has likely underestimated SARS-CoV-2 prevalence in correctional and detention facilities. Broad-based testing can provide a more accurate assessment of prevalence and generate data to help control transmission (4).

Clinical Laboratory Techniques/statistics & numerical data , Coronavirus Infections/epidemiology , Disease Outbreaks/prevention & control , Mass Screening , Pneumonia, Viral/epidemiology , Prisons , COVID-19 , COVID-19 Testing , Coronavirus Infections/diagnosis , Coronavirus Infections/prevention & control , Housing/statistics & numerical data , Humans , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Prevalence , United States/epidemiology
Am J Prev Med ; 32(3): 239-43, 2007 Mar.
Article in English | MEDLINE | ID: mdl-17236744


BACKGROUND: As tuberculosis incidence declines in the United States, a new tool for TB control efforts is Mycobacterium tuberculosis genotyping. Colorado, Iowa, Montana, New Hampshire, West Virginia, and Wisconsin began routine genotyping of all culture-confirmed TB cases in October 2000. METHODS: M. tuberculosis isolates from cases reported October 2000 through December 2003 were genotyped by spoligotyping, mycobacterial interspersed repetitive units, and IS6110-based restriction fragment length polymorphism methods. Genotyping results were linked to demographic variables from national surveillance records. Patients who were in genotype clusters were interviewed and their records reviewed to determine possible transmission links among clustered patients. Final analysis was completed during April 2004 through June 2005. RESULTS: Of 971 reported TB cases, 774 (80%) were culture-confirmed, of which 728 (94%) were genotyped. Most genotyped isolates (634 [87%]) were unique. Within 36 clusters linking 94 individuals, four clusters involved both U.S.- and foreign-born individuals. For eight clusters, genotyping results led to the discovery of previously unsuspected transmission. Transmission links between individuals were established in 21 (58%) of the 36 clusters. CONCLUSIONS: In these six low-incidence states, most isolates had unique genotypes, suggesting that most cases arose from activation of latent infection. Few TB clusters involved the foreign-born. For 58% of genotype clusters, epidemiologic investigation ascertained that clustering represented recent M. tuberculosis transmission.

Mycobacterium tuberculosis/genetics , Tuberculosis/microbiology , Cluster Analysis , Colorado/epidemiology , Genotype , Humans , Incidence , Iowa/epidemiology , Montana/epidemiology , Mycobacterium tuberculosis/isolation & purification , New Hampshire/epidemiology , Polymorphism, Restriction Fragment Length , Population Surveillance , Risk Assessment , Risk Factors , Tuberculosis/epidemiology , Tuberculosis/prevention & control , Tuberculosis/transmission , West Virginia/epidemiology , Wisconsin/epidemiology
Public Health Rep ; 120(3): 224-9, 2005.
Article in English | MEDLINE | ID: mdl-16134561


States are required to provide a public health screening for all newly arrived refugees in the United States. In 1997, a comprehensive program was created to include both a physical examination and a mental health screening. This article provides a complete description of the mental health screening process, including two illustrative cases, and reports information about the refugees who participated in the program. Ten percent of screened refugees were offered mental health referrals; of those, 37% followed up. Refugees who presented for treatment reported a higher number of symptoms upon screening compared with those who were offered referrals but did not follow up. Psychiatric evaluation confirmed that those who screened positive and presented for treatment were experiencing a high level of suffering and qualified for mental health diagnoses. The findings support inclusion of a mental health screening as part of the public health screening.

Mass Screening/legislation & jurisprudence , Mental Disorders/diagnosis , Public Health Administration , Refugees/legislation & jurisprudence , Refugees/psychology , Adolescent , Adult , Anxiety/diagnosis , Anxiety/epidemiology , Child , Clinical Protocols , Colorado/epidemiology , Depression/diagnosis , Depression/epidemiology , Female , Humans , Male , Mass Screening/methods , Medical History Taking , Mental Disorders/classification , Mental Disorders/epidemiology , Mental Disorders/therapy , Mental Health Services , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/epidemiology , Warfare