Household Transmission of Mpox to Children and Adolescents, California, 2022.

BACKGROUND: In California, the 2022 mpox outbreak cumulated 5572 cases, 20% of US cases, as of November 28, 2022; 0.3% of cases were among children <16 years old. The secondary attack rate (SAR) for children sharing households with infected adults is unknown. METHODS: A line list of pediatric mpox household contacts aged <16 years reported through August 31, 2022 was created. It included demographic and clinical information on the contacts. Pediatric contact lists were crossmatched with the state vaccination database to identify those who received postexposure prophylaxis (PEP) with the JYNNEOS vaccine. RESULTS: We identified 129 pediatric household contacts with median age of 7 years (range, 0-15 years). Among 18 symptomatic contacts, 12 (66.7%) underwent mpox testing; 5 (41.2%) were confirmed cases, 6 (50%) were negative, and 1 (0.8%) had an indeterminate result. Six symptomatic children were not tested for mpox (33.3%). Overall, 6 infected contacts were identified, resulting in a SAR of 4.7% (6 of 129). The majority of pediatric household contacts and 4 of 6 infected children identified as Hispanic/Latino. Only 18 children (14%) reported receiving PEP. CONCLUSIONS: The SAR was overall low among pediatric household contacts; none had severe disease. This may be underestimated given low testing rates.

Multistate Outbreak of SARS-CoV-2 Infections, Including Vaccine Breakthrough Infections, Associated with Large Public Gatherings, United States.

During July 2021, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) B.1.617.2 variant infections, including vaccine breakthrough infections, occurred after large public gatherings in Provincetown, Massachusetts, USA, prompting a multistate investigation. Public health departments identified primary and secondary cases by using coronavirus disease surveillance data, case investigations, and contact tracing. A primary case was defined as SARS-CoV-2 detected <14 days after travel to or residence in Provincetown during July 3-17. A secondary case was defined as SARS-CoV-2 detected <14 days after close contact with a person who had a primary case but without travel to or residence in Provincetown during July 3-August 10. We identified 1,098 primary cases and 30 secondary cases associated with 26 primary cases among fully and non-fully vaccinated persons. Large gatherings can have widespread effects on SARS-CoV-2 transmission, and fully vaccinated persons should take precautions, such as masking, to prevent SARS-CoV-2 transmission, particularly during substantial or high transmission.

Effectiveness of Abbott BinaxNOW Rapid Antigen Test for Detection of SARS-CoV-2 Infections in Outbreak among Horse Racetrack Workers, California, USA.

The Abbott BinaxNOW rapid antigen test is cheaper and faster than real-time reverse transcription PCR (rRT-PCR) for detecting severe acute respiratory syndrome coronavirus 2. We compared BinaxNOW with rRT-PCR in 769 paired specimens from 342 persons during a coronavirus disease outbreak among horse racetrack workers in California, USA. We found positive percent agreement was 43.3% (95% CI 34.6%-52.4%), negative percent agreement 100% (95% CI 99.4%-100%), positive predictive value 100% (95% CI 93.5%-100%), and negative predictive value 89.9% (95% CI 87.5%-92.0%). Among 127 rRT-PCR-positive specimens, the 55 with paired BinaxNOW-positive results had a lower mean cycle threshold than the 72 with paired BinaxNOW-negative results (17.8 vs. 28.5; p<0.001). Of 100 specimens with cycle threshold <30, a total of 51 resulted in positive virus isolation; 45 (88.2%) of those were BinaxNOW-positive. Our comparison supports immediate isolation for BinaxNOW-positive persons and confirmatory testing for negative persons.

Cancer-related search for meaning increases willingness to participate in mindfulness-based stress reduction.

OBJECTIVE: A cancer diagnosis can prompt an examination and reevaluation of life's meaning, purpose, and priorities. There is evidence that mindfulness-based stress reduction (MBSR) may help facilitate the meaning-making process. This study examined the influence of meaning in life on willingness to participate (WTP) in MBSR and identified factors associated with the search for and/or presence of meaning. METHODS: A cross-sectional survey study of 300 patients undergoing radiation therapy was conducted. WTP in MBSR was dichotomized into yes/no by asking, "Would you participate in an MBSR program if it was offered at the cancer center?" The search for, and the presence of, meaning were assessed using the Meaning in Life Questionnaire. RESULTS: Eighty patients (27%) indicated WTP in MBSR. In a multivariate logistic regression model, search for meaning was the only significant predictor of WTP in MBSR (adjusted odds ratio [AOR] =1.04, P ≤ .001, 95% CI = 1.01-1.08). Identifying as non-white (adjusted ß = 4.62; 95% CI = 2.22-7.02; P < .001), and reporting subclinical (adjusted ß = 3.59; 95% CI = 0.84-6.34; P = .01) or clinical levels (adjusted ß = 5.52; 95% CI = 2.41-8.63; P = .001) of anxiety were the strongest predictors of search for meaning. CONCLUSION: Our study indicates that patients searching for meaning are receptive to MBSR. Nonwhite patients and those experiencing high levels of anxiety are most likely to endorse a search for meaning. Future research is needed to understand how best to support patients who are searching for meaning and remove barriers to evidence-based programs like MBSR.