Frequency of Children Diagnosed with Perinatal Hepatitis C, United States, 2018-2020.

We describe hepatitis C testing of 47 (2%) of 2,266 children diagnosed with perinatal hepatitis C who were exposed during 2018-2020 in 7 jurisdictions in the United States. Expected frequency of perinatal transmission is 5.8%, indicating only one third of the cases in this cohort were reported to public health authorities.

Clinical Characteristics and Outcomes of SARS-CoV-2 Positive Neonates Born to Persons With SARS-CoV-2 Infection in Pregnancy in Los Angeles County, California, May 22, 2020-February 22, 2021.

BACKGROUND: It is well established that pregnant persons with SARS-CoV-2 are at an increased risk for preterm birth, however, less is known about perinatal outcomes for neonates with intrauterine exposure to SARS-CoV-2. METHODS: Characteristics of 50 SARS-CoV-2 positive neonates born to SARS-CoV-2 pregnant persons positive between May 22, 2020, and February 22, 2021, in Los Angeles County, CA, were assessed. Pattern of neonate SARS-CoV-2 test results and time to positive test was analyzed. Objective clinical severity criteria were applied to assess neonatal disease severity. RESULTS: Median gestational age was 39 weeks with 8 (16%) neonates born preterm. Most (74%) were asymptomatic, while 13 (26%) were symptomatic from any cause. Four (8%) symptomatic neonates met criteria for severe disease, of which 2 (4%) were likely secondary to COVID-19. The other 2 with severe disease had more likely alternate diagnoses, and 1 of these neonates subsequently died at 7 months of life. Among 12 (24%) that were positive within 24 hours after birth, one was persistently positive and represented likely intrauterine transmission. Sixteen (32%) were admitted to the neonatal intensive care unit. CONCLUSION: In this case series of 50 SARS-CoV-2 positive mother-neonate pairs, we found that most neonates were asymptomatic regardless of when they tested positive during the 14 days after birth, that there was relatively low risk of COVID-19 associated severe disease, and that intrauterine transmission can occur in rare cases. Although short-term outcomes are mostly promising, more research is needed to study long-term consequences of SARS-CoV-2 infection in neonates born to positive pregnant persons.

Zika-Associated Birth Defects Reported in Pregnancies with Laboratory Evidence of Confirmed or Possible Zika Virus Infection - U.S. Zika Pregnancy and Infant Registry, December 1, 2015-March 31, 2018.

Zika virus infection during pregnancy can cause serious birth defects of the brain and eyes, including intracranial calcifications, cerebral or cortical atrophy, chorioretinal abnormalities, and optic nerve abnormalities (1,2). The frequency of these Zika-associated brain and eye defects, based on data from the U.S. Zika Pregnancy and Infant Registry (USZPIR), has been previously reported in aggregate (3,4). This report describes the frequency of individual Zika-associated brain and eye defects among infants from pregnancies with laboratory evidence of confirmed or possible Zika virus infection. Among 6,799 live-born infants in USZPIR born during December 1, 2015-March 31, 2018, 4.6% had any Zika-associated birth defect; in a subgroup of pregnancies with a positive nucleic acid amplification test (NAAT) for Zika virus infection, the percentage was 6.1% of live-born infants. The brain and eye defects most frequently reported included microcephaly, corpus callosum abnormalities, intracranial calcification, abnormal cortical gyral patterns, ventriculomegaly, cerebral or cortical atrophy, chorioretinal abnormalities, and optic nerve abnormalities. Among infants with any Zika-associated birth defect, one third had more than one defect reported. Certain brain and eye defects in an infant might prompt suspicion of prenatal Zika virus infection. These findings can help target surveillance efforts to the most common brain and eye defects associated with Zika virus infection during pregnancy should a Zika virus outbreak reemerge, and might provide a signal to the reemergence of Zika virus, particularly in geographic regions without ongoing comprehensive Zika virus surveillance.

Driving Distractions Among Public Health Center Clients: A Look at Local Patterns During the Infancy of Distracted Driving Laws in California.

Objective: To provide a baseline of various driving behaviors and to identify opportunities for prevention of distracted driving during the infancy of state laws that prohibited cellphone use while operating a motor vehicle, the 2010-2011 Distracted Driving Survey collected information on multiple distracted driving behaviors from lower-income clients of three designated, multi-purpose public health centers in Los Angeles County. Methods: Descriptive and multivariable negative binomial regression analyses were performed to examine patterns of driving distractions using the Distracted Driving Survey dataset (n = 1,051). Results: The most common distractions included talking to other passengers (n = 912, 86.8%); adjusting the radio, MP3, or cassette player (n = 873, 83.1%); and adjusting other car controls (n = 838, 79.7%). The median number of distinct distractions per survey participant was 11 (range: 0-32). Factors predicting the number of distinct distractions included being male [incidence rate ratio (IRR): 1.14; 95% confidence interval (CI): 1.06, 1.23], having a lower education (IRR: 0.73; 95% CI: 0.62, 0.84), and having more years of driving experience (IRR: 1.67; 95% CI: 1.33, 2.11). A variety of distractions, including cellphone use and texting, were predictive of increased motor vehicle crashes in the prior 12 months (p < 0.05). Conclusions: Distracted driving beyond cellphone use and texting were common in the survey sample, suggesting a need for additional public education and more inclusive distracted driving laws that cover these other activity types.

Burden of Bites by Dogs and Other Animals in Los Angeles County, California, 2009-2011.

OBJECTIVES: The objective of this study was to analyze all animal-to-human bite reports during a 3-year period from a regional surveillance database. Results helped to inform local efforts to reduce and prevent animal-to-human bites. METHODS: We reviewed all cases of animal-to-human bites occurring from 2009 through 2011 that were reported to the Los Angeles County Department of Public Health's Animal Bites Database. We collected data on the bite victim's date of birth, age, and address; bite circumstances (ie, date, time, location, how bite occurred); anatomic site and treatment of bite; type of reporting facility; and breed and management of biting animal. RESULTS: From 2009 through 2011, 26   169 animal-to-human bites were reported, of which 23   103 (88%) were dog bites. Most animal-to-human bites (n = 7673, 29%) occurred between 4 pm and 8 pm and peaked during the month of July (n = 2663, 10%). Most animal-to-human bites occurred outdoors (n = 8772, 34%) and while victims engaged in recreational activities (n = 4353, 17%). The hands were the most common injury site (n = 9130, 35%), and only 1% of animal bites (n = 267) resulted in hospitalization. A total of 4115 bite victims (16%) received tetanus vaccinations. Of all animal-to-human bite cases, medical organizations reported 13   451 (51%), and animal control agencies reported 10   682 (41%). CONCLUSIONS: Animal-to-human bites can often lead to medical complications. Surveillance is essential in helping to identify, manage, and reduce these highly preventable injuries and direct public health actions and policies on animal bite risk and prevention.