Monitoring and Characteristics of Mpox Contacts, Virginia, USA, May-November 2022.

During 2022, a global outbreak of mpox resulted primarily from human-to-human contact. The Virginia Department of Health (Richmond, VA, USA) implemented a contact tracing and symptom monitoring system for residents exposed to monkeypox virus, assessed their risk for infection, and offered interventions as needed. Among 991 contacts identified during May 1-November 1, 2022, import records were complete for 943 (95.2%), but 99 (10.0%) were not available for follow-up during symptom monitoring. Mpox developed in 28 (2.8%) persons; none were healthcare workers exposed at work (n = 275). Exposure risk category and likelihood of developing mpox were strongly associated. A total of 333 persons received >1 dose of JYENNOS (Bavarian Nordic, https://www.bavarian-nordic.com) vaccine, most (n = 295) administered after virus exposure. Median time from exposure to vaccination was 8 days. Those data tools provided crucial real-time information for public health responses and can be used as a framework for other emerging diseases.

Demographic and Clinical Characteristics of Mpox in Persons Who Had Previously Received 1 Dose of JYNNEOS Vaccine and in Unvaccinated Persons - 29 U.S. Jurisdictions, May 22-September 3, 2022.

As of November 14, 2022, monkeypox (mpox) cases had been reported from more than 110 countries, including 29,133 cases in the United States.* Among U.S. cases to date, 95% have occurred among males (1). After the first confirmed U.S. mpox case on May 17, 2022, limited supplies of JYNNEOS vaccine (Modified Vaccinia Ankara vaccine, Bavarian Nordic) were made available to jurisdictions for persons exposed to mpox. JYNNEOS vaccine was approved by the Food and Drug Administration (FDA) in 2019 as a 2-dose series (0.5 mL per dose, administered subcutaneously) to prevent smallpox and mpox disease.† On August 9, 2022, FDA issued an emergency use authorization to allow administration of JYNNEOS vaccine by intradermal injection (0.1 mL per dose) (2). A previous report on U.S. mpox cases during July 31-September 3, 2022, suggested that 1 dose of vaccine offers some protection against mpox (3). This report describes demographic and clinical characteristics of cases occurring ≥14 days after receipt of 1 dose of JYNNEOS vaccine and compares them with characteristics of cases among unvaccinated persons with mpox and with the vaccine-eligible vaccinated population in participating jurisdictions. During May 22-September 3, 2022, among 14,504 mpox cases reported from 29 participating U.S. jurisdictions,§ 6,605 (45.5%) had available vaccination information and were included in the analysis. Among included cases, 276 (4.2%) were among persons who had received 1 dose of vaccine ≥14 days before illness onset. Mpox cases that occurred in these vaccinated persons were associated with lower percentage of hospitalization (2.1% versus 7.5%), fever, headache, malaise, myalgia, and chills, compared with cases in unvaccinated persons. Although 1 dose of JYNNEOS vaccine offers some protection from disease, mpox infection can occur after receipt of 1 dose, and the duration of protection conferred by 1 dose is unknown. Providers and public health officials should therefore encourage persons at risk for acquiring mpox to complete the 2-dose vaccination series and provide guidance and education regarding nonvaccine-related prevention strategies (4).

Treatment Outcomes in Aspirin-Exacerbated Respiratory Disease Based on the 12-Item Short Form Survey.

BACKGROUND: Aspirin-exacerbated respiratory disease (AERD) is optimally managed by endoscopic sinus surgery (ESS) followed by aspirin therapy after desensitization (ATAD). Most AERD quality of life (QOL) studies use the 22-item Sinonasal Outcomes Test (SNOT-22), which focuses predominantly on sinonasal outcomes. OBJECTIVE: This study seeks to assess QOL outcomes in AERD patients after ESS and ATAD via the 12-item Short Form Survey (SF-12), a well-validated QOL measure for general health status of chronic conditions. METHODS: Retrospective review of 112 AERD patients who underwent ESS followed by ATAD at our institution between 2016 and 2019. SF-12 was collected preoperatively, postoperatively/pre-AD, and serially post-AD (1-3, 4-6, 7-12, and >12 months). Optum® PRO CoRE software was used to compare data to national norms. ANOVA was performed comparing physical component summary (PCS), mental component summary (MCS) and eight health domains (physical functioning, role physical, general health, bodily pain, vitality, social functioning, role emotional, and mental health). RESULTS: AERD patients showed improvement in PCS scores across all timepoints after ESS and ATAD (p = 0.004). When stratified by gender, women demonstrated an improvement in PCS scores (p = 0.004). Within the domains, there were significant improvements in social functioning (SF), role physical (RP), and bodily pain (BP) at all timepoints (SF: p = 0.006; RP: p = 0.005; BP: p < 0.001). CONCLUSIONS: AERD patients undergoing ESS and ATAD show improvement in physical QOL and 3 of the 8 health domains as measured by the SF-12. Future studies can use the SF-12 to study the impact of AERD treatment versus other chronic diseases and health demographics.

Acute contact with imidacloprid in soil affects the nesting and survival success of a solitary wild bee, Osmia lignaria (Hymenoptera: Megachilidae).

We assessed impacts of direct acute contact with imidacloprid-treated soil on nesting behavior and mortality of the blue orchard mason bee (Osmia lignaria Say), which is a native solitary cavity-nesting species that collects mud for nest partitions. Laboratory-reared O. lignaria females were exposed to three concentrations of imidacloprid (0, 50, 390 and 780 ppb), in wet (30% moisture) soil for 20 min and released in large flight cages, where impacts on nesting activity and nest cell production were evaluated. Mortality was tested in another experiment using exposure at the same concentrations with two differing soil moisture levels (20% and 40%). Nesting activity was reduced by 42% for females exposed at 390 ppb and by 66% for females exposed at 780 ppb. Females treated at 780 ppb produced 40% fewer nest cells per day. Sex ratios of F1 generation were skewed toward male in the 50 ppb treatment group with 50% fewer females. The number of cells and pre-pupae per nest, as well as the weight of pre-pupal cocoons did not vary among exposure levels. There were no mortality effects at 20% soil moisture for any level of imidacloprid, but at 40%, mortality of females was >50% at all levels of imidacloprid. These results suggest that acute exposure to imidacloprid residue in soil can have negative impacts on soil-interacting bees, and the effects may be relative to the degree of soil moisture.

Hemlock Woolly Adelgid (Hemiptera: Adelgidae) Management in Forest, Landscape, and Nursery Production.

Hemlock woolly adelgid, Adelges tsugae (Annand) (Hemiptera: Adelgidae), has caused significant damage to both eastern [Tsuga canadensis (L.) Carrière] and Carolina hemlock (Tsuga caroliniana Englemann) (Pinales: Pinaceae) since it was first reported in the eastern United States. This adelgid is particularly damaging to these hemlock species due to a lack of co-evolved plant defenses and natural enemies able to suppress hemlock woolly adelgid populations. Management of hemlock woolly adelgid relies heavily on insecticides to prevent death of vulnerable trees. Biological control programs have released natural enemies of hemlock woolly adelgid to aid in control at the landscape level. Quarantine restrictions on hemlock are in place in some regions of the United States and Canada. These quarantines impact sales and shipment of hemlock trees from nurseries as well as other hemlock products. A review of insect biology, description of life stages, damage, management options, and quarantine restrictions for hemlock woolly adelgid is presented.

Establishing access to technology: an evaluation and intervention model to increase the participation of children with cerebral palsy.

Children with a diagnosis of cerebral palsy often have significant physical limitations that prevent exploration and full participation in the environment. Assistive technology systems can provide opportunities for children with physical limitations to interact with their world, enabling play, communication, and daily living skills. Efficient access to and control of the technology is critical for successful use; however, establishing consistent access is often difficult because of the nature of the movement patterns exhibited by children with cerebral palsy. This article describes a 3-phase model of evaluation and intervention developed and used by Assistive Technology Services at the Aaron W. Perlman Center, Cincinnati Children's Hospital Medical Center, to establish successful access to technology systems in children with cerebral palsy.