The second fifty years: A history of the American College Health Association.

Objective: On the occasion of the American College Health Association's (ACHA) 100th anniversary, this article seeks to explore the second fifty years of its organizational history, as well as many of the key historical moments in the field of American college health. Materials and methods: This article examines ACHA's second fifty years, decade-by-decade, in key thematic areas that have driven focus, innovation and change at both ACHA and the field of college health and well-being, including: Changes in ACHA Governance, Leadership and Organizational Structure; Clinical Care, Immunizations, Emergency Preparedness and Outbreak Response; Health Promotion: Moving from Health to Wellness to WellBeing; Mental Health: Stigma, Suicide and Access to Care; Nursing Practice and Nurse Certification; Using Education, Research, Data and Publications to Drive Change and Innovation; Advocacy for the Health of College Students and Our College Communities; Growth and Development of the American College Health Foundation; and Recognizing Quality of Care, Excellence and Outstanding Contributions to ACHA. Results: ACHA's second fifty years have provided an enormous volume of high-quality programs and services, used to further improve the health and well-being of college students. The narrative shows that the organization has indeed met its mission over the past fifty years. The article concludes with predictions of changes and advances at ACHA in the next decade. Conclusions: Since 1920, ACHA has served as the voice for college student health and well-being in the United States. ACHA's second fifty years is a remarkable story of hard work, vision and achievement by a large number of talented and committed college health professionals, students and colleagues across college campuses and in sister professional organizations.

Norovirus outbreaks on college and university campuses.

Objective: To describe norovirus outbreaks at colleges and universities. Participants: None. Conducted September 2016 to March 2018. Methods: College and university norovirus outbreaks reported to the US National Outbreak Reporting System (NORS, 2009-2016) or published and indexed by EMBASE, PubMed, and Web of Science (1985-2017) were analyzed. Results: Seventy-seven norovirus outbreaks were reported to NORS and 23 were identified in the systematic literature review. Outbreaks occurred more frequently during the beginning of the school year (September-February). NORS outbreaks were more often spread by person-to-person transmission (61%) and, in published outbreaks, by food (57%). The reported exposures of published outbreaks were campus dining (n = 8) and ill food service workers (n = 7). Higher attack rates were associated with smaller on-campus population size, social networks or residences, and specific food exposures. Common control measures were communal area disinfection and health/hygiene education. Conclusions: Recommendations summarized to prevent and control norovirus outbreaks at colleges or universities.

Viewpoint: Why you should provide HIV pre-exposure prophylaxis (PrEP) at your college health center.

By providing HIV pre-exposure prophylaxis, or PrEP (a single daily oral pill), in a primary care college health setting, clinical providers can make a dramatic contribution to the current and long-term health and well-being of the students they see. This viewpoint article describes the approach taken to instituting primary care PrEP services at two college health programs. It delineates which students might benefit from PrEP and how to prescribe/monitor PrEP over time. Additionally, common barriers to PrEP are reviewed, including concerns about affordability, and the concerns that the use of PrEP will encourage risky sexual activity. Implementation strategies are discussed, including identifying a clinic champion, partnering with knowledgeable colleagues, and developing an educational campaign.

Residual hormone levels in used contraceptive rings as a measurement of adherence to vaginal ring use.

OBJECTIVE: This study sought to measure residual contraceptive hormone levels in vaginal rings as an adherence marker for monitoring product use in clinical trials. STUDY DESIGN: Residual etonogestrel and ethinyl estradiol levels from used NuvaRings® of 26 self-reported adherent women enrolled in a clinical trial of vaginal ring acceptability were compared to those from 16 women who used NuvaRing® as their contraceptive choice. RESULTS: Twenty-one (81%) clinical trial rings had contraceptive hormone levels within the range of those used as a contraceptive choice. Five returned rings had unused or discordant levels of residual contraceptive hormones. CONCLUSION: Residual vaginal ring drug levels could help assess adherence in clinical trials.

Hepatitis B vaccination coverage and documented seroprotection among matriculating healthcare students at an academic institution in the United States.

We evaluated hepatitis B vaccination coverage and documentation of antibody to hepatitis B surface antigen (anti-HBs) concentration among a cohort of healthcare students. Of 4,075 students, 59.8% had documentation of vaccination and 83.8% had anti-HBs concentration greater than or equal to 10 mIU/mL. Documenting hepatitis B vaccination and anti-HBs concentration among healthcare students is needed to prevent transmission in healthcare settings.

Pseudoepidemic of Q fever at an animal research facility.

Serum samples from people exposed to sheep at a research facility were evaluated by a commercial laboratory and resulted in an overall Coxiella burnetii seroprevalence of 75%. We interviewed individuals to determine exposure history and compatible illness, and retested their sera. Analysis indicated that the commercial laboratory was misinterpreting its results; when corrected, the seroprevalence dropped to 27%. Test kits of the brand used by the commercial laboratory gave equivalent results to the in-house CDC assay when tested in parallel at CDC. Upon final analysis, only the attending veterinarian was confirmed as a Q fever case. This event resulted in increased risk reduction protocols at the research facility and improved public health communication among health authorities. This pseudoepidemic resulted from a lapse in laboratory quality control for testing. Similar errors can be avoided through standardization and improved review of laboratory procedures.