Concurrent Outbreaks of Hepatitis A, Invasive Meningococcal Disease, and Mpox, Florida, USA, 2021-2022.

In 2022, concurrent outbreaks of hepatitis A, invasive meningococcal disease (IMD), and mpox were identified in Florida, USA, primarily among men who have sex with men. The hepatitis A outbreak (153 cases) was associated with hepatitis A virus genotype IA. The IMD outbreak (44 cases) was associated with Neisseria meningitidis serogroup C, sequence type 11, clonal complex 11. The mpox outbreak in Florida (2,845 cases) was part of a global epidemic. The hepatitis A and IMD outbreaks were concentrated in Central Florida and peaked during March--June, whereas mpox cases were more heavily concentrated in South Florida and had peak incidence in August. HIV infection was more common (52%) among mpox cases than among hepatitis A (21%) or IMD (34%) cases. Where feasible, vaccination against hepatitis A, meningococcal disease, and mpox should be encouraged among at-risk groups and offered along with program services that target those groups.

Trends in Patient's Use of Sexual Health Services During COVID-19 in a Network of STD Clinics, STD Surveillance Network, 2019 to 2021.

BACKGROUND: The initial years of the COVID-19 pandemic disrupted sexual health care clinic's services. We describe use patterns by patient characteristics, and the use of telehealth (TH) services among a network of sexually transmitted disease (STD) clinics. METHODS: Data were collected using a survey to assess the impact of COVID-19 from March to December 2020 among 7 jurisdictions who contribute STD visit-level data as part of the STD Surveillance Network. As a complement to the survey, retrospective data from January 2019 to December 2021 from these 7 STD clinics in the same 7 jurisdictions were examined for monthly utilization trends by overall visits, patient characteristics, and TH visits. RESULTS: Survey results indicated 7 clinics prioritized patients for in-person visits and 4 jurisdictions reported urgent care centers were the most common referral location. In April 2020 (relative to April 2019) clinic visits and unique patients decreased by 68.0% and 75.8%, respectively. Telehealth were documented in 4 clinics, beginning in March 2020, peaking in December 2020, and tapering until December 2021. We observed the number of clinic visits (-12.2%) and unique patients presenting for care (-27.2%) in December 2021 had yet to return to levels to that seen in December 2019. CONCLUSIONS: Sexually transmitted disease clinics showed fragility and resiliency in their adjustment to the pandemic; allowing for the continuation of services. Overall patient census has been slow to return to prepandemic levels, and many patients may still not be seeking timely care. This could result in missed opportunities to screen and treat STIs and increasing the possibility of harmful sequelae.

Evaluation of Sexually Transmitted Disease Surveillance System Electronic Laboratory Processing in Florida: Automating Case Creation, Reporting, and Closure of Chlamydia and Gonorrhea Cases.

BACKGROUND: Each year, Florida Department of Health staff process hundreds of thousands of electronically received laboratory results for chlamydia (CT) and gonorrhea (GC). These processing steps are currently performed manually in Florida's surveillance system and divert from other sexually transmitted disease prevention efforts. We developed processes that would automate these procedures and evaluated the impact on potential programmatic time savings. METHODS: We evaluated 575,952 electronic CT/GC laboratory results from January 2019 to December 2021. Laboratory results were processed through the newly automated procedures and algorithms. Expected time savings were projected using conservative estimates of 1 minute saved every time an automated process replaced a current manual procedure: profile matching, profile creation, event record creation, case review, and case reporting. Exceptions to automatic case reporting applied to certain higher-priority populations needing intervention. RESULTS: During this period, 297,348 electronic CT/GC laboratory results were received for people with no previous recorded history of sexually transmitted diseases and required profile creation. In total, 386,763 new surveillance infection records were created for reporting. Of reported cases, 127,345 were from higher-priority groups. The proposed automations would have saved an estimated 33,121 hours of staff time, about 11,040 hours or the work of 5.3 full-time staff annually. CONCLUSIONS: Automating current CT/GC laboratory processing would save thousands of personnel hours that could be redirected to higher-priority activities. Flexibility in prioritization criteria for automated case reporting allows programs to adjust automation to disease prevention priorities and resources. Similar automation procedures could be developed by other jurisdictions or health programs.