Concept: Humid subtropical climate
After 2 decades of progress toward tuberculosis (TB) elimination with annual decreases of ≥0.2 cases per 100,000 persons (1), TB incidence in the United States remained approximately 3.0 cases per 100,000 persons during 2013-2015. Preliminary data reported to the National Tuberculosis Surveillance System indicate that TB incidence among foreign-born persons in the United States (15.1 cases per 100,000) has remained approximately 13 times the incidence among U.S.-born persons (1.2 cases per 100,000). Resuming progress toward TB elimination in the United States will require intensification of efforts both in the United States and globally, including increasing U.S. efforts to detect and treat latent TB infection, strengthening systems to interrupt TB transmission in the United States and globally, accelerating reductions in TB globally, particularly in the countries of origin for most U.S.
Influenza activity in the United States began to increase in early November 2017 and rose sharply from December through February 3, 2018; elevated influenza activity is expected to continue for several more weeks. Influenza A viruses have been most commonly identified, with influenza A(H3N2) viruses predominating, but influenza A(H1N1)pdm09 and influenza B viruses were also reported. This report summarizes U.S. influenza activity* during October 1, 2017-February 3, 2018,†and updates the previous summary (1).
This report summarizes U.S. influenza activity* during October 2, 2016-February 4, 2017,(†) and updates the previous summary (1). Influenza activity in the United States began to increase in mid-December, remained elevated through February 4, 2017, and is expected to continue for several more weeks. To date, influenza A (H3N2) viruses have predominated overall, but influenza A (H1N1)pdm09 and influenza B viruses have also been identified.
Palliative care is expanding rapidly in the United States.
Newcastle disease is caused by virulent strains of Newcastle disease virus (NDV), which causes substantial morbidity and mortality events worldwide in poultry. The virus strains can be differentiated as lentogenic, mesogenic, or velogenic based on a mean death time in chicken embryos. Currently, velogenic strains of NDV are not endemic in United States domestic poultry; however, these strains are present in other countries and are occasionally detected in wild birds in the U.S. A viral introduction into domestic poultry could have severe economic consequences due to the loss of production from sick and dying birds, the cost of control measures such as depopulation and disinfection measures, and the trade restrictions that would likely be imposed as a result of an outbreak. Due to the disease-free status of the U.S. and the high cost of a potential viral incursion to the poultry industry, a qualitative risk analysis was performed to evaluate the vulnerabilities of the U.S. against the introduction of virulent strains of NDV. The most likely routes of virus introduction are explored and data gathered by several federal agencies is provided. Recommendations are ultimately provided for data that would be useful to further understand NDV on the landscape and to utilize all existing sampling opportunities to begin to comprehend viral movement and further characterize the risk of NDV introduction into the U.S.
Overprescribing of opioids is considered a major driving force behind the opioid epidemic in the United States. Marijuana is one of the potential nonopioid alternatives that can relieve pain at a relatively lower risk of addiction and virtually no risk of overdose. Marijuana liberalization, including medical and adult-use marijuana laws, has made marijuana available to more Americans.
Despite numerous studies of geographic variation in healthcare cost and utilization at the local, regional, and state levels across the U.S., a comprehensive characterization of geographic variation in outcomes has not been published. Our objective was to quantify variation in US health outcomes in an all-payer population before and after risk-adjustment.
The disquieting patterns of end-of-life care in the United States have been well documented. In the last month of life, one in two Medicare beneficiaries visits an emergency department, one in three is admitted to an intensive care unit, and one in five has inpatient surgery. But one of the most sobering facts is that no current policy or practice designed to improve care for millions of dying Americans is backed by a fraction of the evidence that the Food and Drug Administration would require to approve even a relatively innocuous drug. For example, more than two thirds of U.S. . . .
In 2016, a total of 9,287 new tuberculosis (TB) cases were reported in the United States; this provisional* count represents the lowest number of U.S. TB cases on record and a 2.7% decrease from 2015 (1). The 2016 TB incidence of 2.9 cases per 100,000 persons represents a slight decrease compared with 2015 (-3.4%) (Figure). However, epidemiologic modeling demonstrates that if similar slow rates of decline continue, the goal of U.S. TB elimination will not be reached during this century (2). Although current programs to identify and treat active TB disease must be maintained and strengthened, increased measures to identify and treat latent TB infection (LTBI) among populations at high risk are also needed to accelerate progress toward TB elimination.
To examine changes over 40 years (1970-2010) in life expectancy, life expectancy with disability, and disability-free life expectancy for American men and women of all ages.