BACKGROUND: In October 2022, the Uganda Ministry of Health (MoH) confirmed the first case of a Sudan Virus Disease (SVD) outbreak in the Kampala Metropolitan area (KMA). A multicomponent infection prevention and control (IPC) strategy was implemented to control the spread of Orthoebolavirus sudanense (SUDV) in KMA. We describe the deployment of this strategy, its effect on IPC capacities, and the successful control of the SVD outbreak in KMA during the 2022 outbreak. METHODOLOGY: The multicomponent IPC strategy included (1) IPC pillar coordination: an IPC task force convened by government and health partner representatives and designated focal persons at the district level (2) Ring IPC: intense and targeted IPC support was developed to provide support to healthcare facilities (HCFs) and communities around each confirmed case, (3) IPC in HCFs: HCFs were assessed using a modified WHO SVD IPC scorecard rapid assessment tool that measured 15 IPC capacity domains, mentorship and IPC supplies were provided to HCFs with low scores on the rapid assessment. RESULTS: A KMA task force was established, and 13 IPC Rings were activated; 790 HCFs were assessed for IPC readiness, and 2,235 healthcare workers (HCWs) were trained. The mean (± standard-deviation) IPC score was 59.2% (± 18.6%) at baseline and increased to 65.5% (± 14.7%) at follow-up after 2 weeks (p < 0.001) of support. The mean IPC scores at baseline were lowest for primary HCFs (57%) and private-for-profit HCFs (47.1%). Similar gaps were revealed across all HCFs, with eight out of 15 (53.3%) IPC capacity areas assessed, resulting in scores < 50% at baseline. At follow-up, only four out of 15 (26.7%) capacity areas (26.7%) were below this threshold. CONCLUSION: The IPC strategy enhanced the IPC capacities at HCFs and could be adopted for future outbreaks. Leadership commitment and resource allocation to IPC during non-outbreak periods are critical for preparedness, rapid response, and access to safe care.

OBJECTIVE: This report highlights state and local practices for optimizing the pediatric COVID-19 vaccination program for children ages 6 months through 11 years. METHODS: State and local practices designed to optimize pediatric COVID-19 vaccine uptake were identified from a range of sources, including immunization program, CDC, and partner staff; and media stories or program descriptions identified via online searches. RESULTS: A range of practices were identified across different categories: provider-focused practices, school-based practices, jurisdiction or health department-based activities, community-focused practices involving partners, use of vaccination incentives, and Medicaid-related practices. CONCLUSIONS: Immunization programs and stakeholders implemented a variety of practices to meet the challenge of the pediatric COVID-19 vaccination program. The key findings may serve to inform not only the current pediatric COVID-19 vaccination program, but also future outbreak response work and routine immunization activities.

The coronavirus disease pandemic has highlighted the need to establish and maintain strong infection prevention and control (IPC) practices, not only to prevent healthcare-associated transmission of SARS-CoV-2 to healthcare workers and patients but also to prevent disruptions of essential healthcare services. In East Africa, where basic IPC capacity in healthcare facilities is limited, the US Centers for Disease Control and Prevention (CDC) supported rapid IPC capacity building in healthcare facilities in 4 target countries: Tanzania, Ethiopia, Kenya, and Uganda. CDC supported IPC capacity-building initiatives at the healthcare facility and national levels according to each country's specific needs, priorities, available resources, and existing IPC capacity and systems. In addition, CDC established a multicountry learning network to strengthen hospital level IPC, with an emphasis on peer-to-peer learning. We present an overview of the key strategies used to strengthen IPC in these countries and lessons learned from implementation.

In the United States, the public health response to control COVID-19 required rapid expansion of the contact tracing workforce from approximately 2200 personnel prepandemic to more than 100 000 during the pandemic. We describe the development and implementation of a free nationwide training course for COVID-19 contact tracers that launched April 28, 2020, and summarize participant characteristics and evaluation findings through December 31, 2020. Uptake of the online asynchronous training was substantial: 90 643 registrants completed the course during the first 8 months. In an analysis of a subset of course participants (n = 13 697), 7724 (56.4%) reported having no prepandemic public health experience and 7178 (52.4%) reported currently serving as case investigators, contact tracers, or both. Most participants who completed a course evaluation reported satisfaction with course utility (94.8%; 59 497 of 62 753) and improved understanding of contact tracing practice (93.0%; 66 107 of 71 048). These findings suggest that the course successfully reached the intended audience of new public health practitioners. Lessons learned from this implementation indicate that an introductory course level is appropriate for a national knowledge-based training that aims to complement jurisdiction-specific training. In addition, offering a range of implementation options can promote course uptake among public health agency staff. This course supported the emerging needs of the public health practice community by training a workforce to fill an important gap during the COVID-19 pandemic and could serve as a feasible model for enhancing workforce knowledge for future and ongoing public health threats.

INTRODUCTION: The 2019 coronavirus (COVID-19) pandemic has been an unprecedented global health challenge. Traditional modes of knowledge dissemination have not been feasible. A rapid solution was needed to share guidance and implementation examples among the global Infection Prevention and Control (IPC) community. We designed the IPC Global Webinar Series to bring together subject matter experts and IPC professionals in the fight against COVID-19. METHODS: The Extension for Community Healthcare Outcomes (ECHO) model was adapted to create an interactive global knowledge network. Speakers and panelists provided presentations and answers to questions from participants. The webinars were simultaneously interpreted to five languages and recorded for later access. RESULTS: Thirteen webinar sessions were completed from May 14 through August 6, 2020. On average, 634 participants attended each session (range: 393 - 1,181). Each session was represented by participants from an average of over 100 countries; sessions 1-3 had participation from approximate 120 countries, and sessions 6 and 12 had participation from approximately 80 countries. DISCUSSION: The IPC Global Webinar Series shared critical information and promoted peer-to-peer learning during the COVID-19 pandemic response. The webinar sessions reached a broader audience than many in-person events. The webinar series was rapidly scaled and can be rapidly re-activated as needed. Our lessons learned in designing and implementing the series can inform design of other global health virtual knowledge networks. The continued and expanded use of adapted virtual communities of practice and other learning networks for the IPC community can serve as a valuable tool for addressing COVID-19 and other infectious disease threats.

National data show an increasing trend of reduced azithromycin susceptibility (AZM-RS) among Neisseria gonorrhoeae (Ng) isolates, especially in the Midwest.1 Sentinel surveillance data from the Gonococcal Isolate Surveillance Project, which examines isolates from men with urethritis from 27 sites across the United States, indicates that the proportion of AZM-RS Ng isolates (minimum inhibitory concentration [MIC] ≥2 μg/mL) increased 4-fold between 2013 (0.6%) and 2014 (2.5%).1 Most AZM-RS Ng infections occur in men who have sex with men.1,2

Background.: Neisseria meningitidis (Nm) is a Gram-negative diplococcus that normally colonizes the nasopharynx and rarely infects the urogenital tract. On Gram stain of urethral exudates, Nm can be misidentified as the more common sexually transmitted pathogen Neisseria gonorrhoeae. Methods.: In response to a large increase in cases of Nm urethritis identified among men presenting for screening at a sexually transmitted disease clinic in Columbus, Ohio, we investigated the epidemiologic characteristics of men with Nm urethritis and the molecular and phylogenetic characteristics of their Nm isolates. The study was conducted between 1 January and 18 November 2015. Results.: Seventy-five Nm urethritis cases were confirmed by biochemical and polymerase chain reaction testing. Men with Nm urethritis were a median age of 31 years (interquartile range [IQR] = 24-38) and had a median of 2 sex partners in the last 3 months (IQR = 1-3). Nm cases were predominantly black (81%) and heterosexual (99%). Most had urethral discharge (91%), reported oral sex with a female in the last 12 months (96%), and were treated with a ceftriaxone-based regimen (95%). A minority (15%) also had urethral chlamydia coinfection. All urethral Nm isolates were nongroupable, ST-11 clonal complex (cc11), ET-15, and clustered together phylogenetically. Urethral Nm isolates were similar by fine typing (PorA P1.5-1,10-8, PorB 2-2, FetA F3-6), except 1, which had a different PorB type (2-78). Conclusions.: Between January and November 2015, 75 urethritis cases due to a distinct Nm clade occurred among primarily black, heterosexual men in Columbus, Ohio. Future urogenital Nm infection studies should focus on pathogenesis and modes of sexual transmission.

Neisseria meningitidis (Nm) urogenital infections, although less common than infections caused by Neisseria gonorrhoeae (Ng), have been associated with urethritis, cervicitis, proctitis, and pelvic inflammatory disease. Nm can appear similar to Ng on Gram stain analysis (gram-negative intracellular diplococci). Because Nm colonizes the nasopharynx, men who receive oral sex (fellatio) can acquire urethral Nm infections. This report describes an increase in Nm-associated urethritis in men attending sexual health clinics in Columbus, Ohio, and Oakland County, Michigan.

Gene-lifestyle interactions have been suggested to contribute to the development of type 2 diabetes. Glucose levels 2 h after a standard 75-g glucose challenge are used to diagnose diabetes and are associated with both genetic and lifestyle factors. However, whether these factors interact to determine 2-h glucose levels is unknown. We meta-analyzed single nucleotide polymorphism (SNP) x BMI and SNP x physical activity (PA) interaction regression models for five SNPs previously associated with 2-h glucose levels from up to 22 studies comprising 54,884 individuals without diabetes. PA levels were dichotomized, with individuals below the first quintile classified as inactive (20%) and the remainder as active (80%). BMI was considered a continuous trait. Inactive individuals had higher 2-h glucose levels than active individuals (beta = 0.22 mmol/L [95% CI 0.13-0.31], P = 1.63 x 10(-6)). All SNPs were associated with 2-h glucose (beta = 0.06-0.12 mmol/allele, P ≤ 1.53 x 10(-7)), but no significant interactions were found with PA (P > 0.18) or BMI (P ≥ 0.04). In this large study of gene-lifestyle interaction, we observed no interactions between genetic and lifestyle factors, both of which were associated with 2-h glucose. It is perhaps unlikely that top loci from genome-wide association studies will exhibit strong subgroup-specific effects, and may not, therefore, make the best candidates for the study of interactions.