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This article presents news from the U.S. Centers for Disease Control and Prevention (CDC). In this study, the CDC looked at outbreaks of respiratory illness in New Hampshire, Massachusetts and Tennessee during 2004-2006 that were mistakenly thought to be cases of pertussis or whooping cough. Cases of the disease have been increasing in the U.S. due to the circulation of Bordetella pertussis and waning vaccination in communities. There are not fast, sensitive tests for pertussis which can make definitive diagnosis difficult. The cases in the three states are examined. Vaccination efforts need to be increased to prevent the disease.

On November 26, 2013, the CDC poxvirus laboratory was notified by the Boston Public Health Commission (BPHC) of an inadvertent inoculation of a recently vaccinated (ACAM2000 smallpox vaccine) laboratory worker with wild type vaccinia virus (VACV) Western Reserve. A joint investigation by CDC and BPHC confirmed orthopoxvirus infection in the worker, who had reported a needle stick in his thumb while inoculating a mouse with VACV. He experienced a non-tender, red rash on his arm, diagnosed at a local emergency department as cellulitis. He subsequently developed a necrotic lesion on his thumb, diagnosed as VACV infection. Three weeks after the injury, the thumb lesion was surgically debrided and at 2 months post-injury, the skin lesion had resolved. The investigation confirmed that the infection was the first reported VACV infection in the United States in a laboratory worker vaccinated according to the Advisory Committee on Immunization Practices (ACIP) recommendations. The incident prompted the academic institution to outline biosafety measures for working with biologic agents, such as biosafety training of laboratory personnel, vaccination (if appropriate), and steps in incident reporting. Though vaccination has been shown to be an effective measure in protecting personnel in the laboratory setting, this case report underscores the importance of proper safety measures and incident reporting.

Following an outbreak of hepatitis B (HBV) in a municipal house of correction, HBV markers were detected in 173/406 (43 percent) inmates and 10/129 (8 percent) staff. Of the 173 HBV-infected inmates, 14 (8 percent) had hepatitis D (HDV) markers compared to 0/10 staff members. Intravenous drugs use (IVDU) was most strongly associated with HBV marker presence. Increasing duration of imprisonment, history of hepatitis B and especially IVDU were associated with the prevalence of HDV markers.