A Health Equity Approach for Implementation of JYNNEOS Vaccination at Large, Community-Based LGBTQIA+ Events - Georgia, August 27-September 5, 2022.

Gay, bisexual, and other men who have sex with men (MSM) have been disproportionately affected during the 2022 U.S. monkeypox outbreak, with Black or African American (Black) MSM being the most affected demographic group (1). As of September 28, 2022, Georgia had reported 1,784 monkeypox cases; 98% of which occurred in males and 77% among Black persons (2). As of September 13, 2022, 60% of reported cases were among persons with HIV infection, and 50% of persons with monkeypox had a sexually transmitted infection within the past year (3). Because of racial disparities in the incidence of monkeypox cases and a large proportion of cases among MSM in Georgia, early vaccination beginning in July focused on improving equitable access by establishing new and leveraging existing partnerships with community-based organizations that serve affected populations, including persons with HIV infection. Despite these efforts, disparities persisted because of high demand and limited vaccine supply. The Georgia Department of Public Health (DPH) requested CDC support for a vaccine pilot and received an additional allocation of 5,500 doses of JYNNEOS vaccine for administration at events leading up to and throughout a Black gay Pride festival in Atlanta, a multiday event held Labor Day weekend (September 2-5, 2022). The event celebrates lesbian, gay, bisexual, transgender, queer or questioning, intersex, asexual, and other (LGBTQIA+) communities of color and hosts more than 125,000 attendees each year. Before the festival (as of August 24), 17,546 persons had been vaccinated in Georgia, of whom 96% were male, 34% aged 25-36 years, 44% Black, and 8% Hispanic or Latino (Hispanic) (4).

Pilot survey of mosquitoes (Diptera: Culicidae) from southeastern Georgia, USA for Wolbachia and Rickettsia felis (Rickettsiales: Rickettsiaceae).

BACKGROUND & OBJECTIVES: Mosquito surveillance is one of the critical functions of local health departments, particularly in the context of outbreaks of severe mosquito-borne viral infections. Unfortunately, some viral and parasitic infections transmitted by mosquitoes, manifests non-specific clinical symptoms which may actually be of rickettsial etiology, including Rickettsia felis infections. This study tested the hypothesis that mosquitoes from southeastern Georgia, USA may be infected with Rickettsia felis and Wolbachia, an endosymbiotic bacterium of the order Rickettsiales. METHODS: Specimens of the five most common mosquito species occurring in the region were collected using gravid and light-traps and identified using morphological keys. Mosquitoes were then pooled by species, sex, trap and collection site and their DNA was extracted. Molecular methods were used to confirm mosquito identification, and presence of Wolbachia and R. felis. RESULTS: Wolbachia DNA was detected in 90.8% of the mosquito pools tested, which included 98% pools of Cx. quinquefasciatus Say (Diptera: Culicidae), 95% pools of Ae. albopictus Skuse (Diptera: Culicidae), and 66.7% of pools of Cx. pipiens complex. Samples of An. punctipennis Say (Diptera: Culicidae) and An. crucians Wiedemann (Diptera: Culicidae) were tested negative for Wolbachia DNA. Three genotypes of Wolbachia sp. belonging to Group A (1 type) and Group B (2 types) were identified. DNA of R. felis was not found in any pool of mosquitoes tested. INTERPRETATION & CONCLUSIONS: This study provides a pilot data on the high presence of Wolbachia in Cx. quinque-fasciatus and Ae. albopictus mosquitoes prevalent in the study region. Whether the high prevalence of Wolbachia and its genetic diversity in mosquitoes affects the mosquitoes' susceptibility to R. felis infection in Georgia will need further evaluation.

A Multicomponent, Multi-Trigger Intervention to Enhance Asthma Control in High-Risk African American Children.

INTRODUCTION: We evaluated the effectiveness and feasibility of implementation of a multicomponent, multi-trigger (MCMT) intervention through a public health department in a high risk population of African American children. METHODS: This was a pragmatic quasi-experimental pretest-posttest study. The population consisted of African American children enrolled in Medicaid and Children's Medical Services who had poorly controlled asthma. The MCMT intervention included 4 educational sessions and home asthma trigger reduction. Parents reported outcomes at baseline and at 1 to 3 months, 6 months, and 12 months after the MCMT intervention. Analysis used the McNemar χ2 test and Student t test for paired observations. Data were collected during 2014 through 2016 in Augusta, Georgia. RESULTS: The number of children with asthma that was assessed as well controlled increased from 4 to 17 out of 20 (P < .001). Compared with baseline, at 12 months parents reported fewer days of school missed (6.4 vs 4.2, P = .01), fewer emergency department visits (1.7 vs 0.6, P = .02) and fewer hospitalizations (0.59 vs 0.18, P = .05). The most common environmental interventions were dust mitigation, getting a mattress or pillow protector, and cockroach mitigation. CONCLUSION: An MCMT intervention in high risk African American children with poorly controlled asthma administered through the health department was associated with significant improvements in asthma control, days of school missed, and emergency department visits. Broader implementation of these strategies is warranted.

A Multiagency Approach to Reducing West Nile Virus Risk in Richmond County, Georgia, in 2015.

The Richmond County Mosquito Control program's mission statement is to incorporate strategies of integrated mosquito control management that are effective, practical, and environmentally safe and protect the health of Richmond County residents, as well as promote public education, in order to prevent large mosquito populations and the diseases that they transmit. To this end, the program coordinates efforts with other county agencies in order to provide better service. This is a small program with limited resources, so in an effort to provide better integrated mosquito management, the mosquito control program and the Phinizy Center for Water Sciences joined efforts to trap mosquitoes at sites across the county, identify the species, and send the mosquitoes off for viral testing. These data help determine locations of disease-carrying mosquitoes so the county can more efficiently control the mosquito populations and reduce the risk of West Nile virus transmission.