INTRODUCTION: In the United States, children in Puerto Rico and non-Hispanic black children in the mainland US have a higher burden of asthma than non-Hispanic white children in the mainland US. We examined indoor environmental control (IEC) practices that reduce asthma triggers, by race/ethnicity among children in the mainland US and Puerto Rico. METHODS: We used 2013 and 2014 data from the Behavioral Risk Factor Surveillance System Asthma Call-back Survey Child Questionnaire from 14 states and Puerto Rico to measure the association between race/ethnicity and IEC practices, adjusting for sociodemographic covariates, among children identified as ever receiving an asthma diagnosis. Racial/ethnic groups were compared in 14 US states using aggregated data. Separate analyses compared IEC practices for children diagnosed with asthma in Puerto Rico with children of all races/ethnicities diagnosed with asthma in 14 states. RESULTS: Among households in 14 US states that had a child with asthma, non-Hispanic black children were more likely than non-Hispanic white children to use an air purifier (36.8% vs 25.2%; adjusted odds ratio [aOR] = 2.0; 95% confidence interval [CI], 1.3-3.2) and avoid pets in the bedroom (87.9% vs 58.3%; aOR = 4.5; 95% CI, 2.3-8.8). Children in Puerto Rico were more likely than children in 14 states to use dust mite-impermeable pillow covers (53.7% vs 36.4%; aOR = 3.6; 95% CI, 1.8-7.1) and mattress encasements (60.3% vs 30.3%; aOR = 2.4; 95% CI, 1.2-4.8). CONCLUSION: IEC practices such as using air purifiers, pillow covers, mattress encasements, and avoiding pets in the bedroom vary by race/ethnicity among children with asthma. These findings show that vulnerable populations are using IEC practices, but asthma prevention and control measures should continue to be assessed.

Background: Human adenoviruses (HAdVs) are known causes of respiratory illness outbreaks in congregate settings, but cases and clusters are less well described from community settings in the United States. During December 2016-February 2017, the New Jersey Department of Health received reports of HAdV infections from 3 sources in 3 adjacent counties. We investigated to characterize the epidemiologic, laboratory, and clinical features of this HAdV outbreak. Methods: A case was defined as a New Jersey resident with acute respiratory illness during December 1, 2016-March 31, 2017 with laboratory identification of HAdV genome type 7d (HAdV-7d). Human adenovirus was detected by real-time and conventional polymerase chain reaction and molecular typed by partial hexon capsid protein gene sequencing. The HAdV genome type was identified by whole genome sequencing analysis. Available medical, public health, and surveillance records were reviewed. Results: We identified 12 cases, including 3 treatment facility patients, 7 college students, and 2 cases at a tertiary-care hospital. Four cases died; all had underlying comorbidities. Nine HAdV-7d whole genome sequences obtained from all 3 sites were nearly identical. Conclusions: Transmission of HAdV-7d occurred in community and congregate settings across 3 counties and resulted in severe morbidity and mortality in some cases with underlying comorbidities. Clinicians and local and state health departments should consider HAdV in patients with severe respiratory infection.

On February 3, 2017, a local health department notified the New Jersey Department of Health (NJDOH) of a severe respiratory illness outbreak, including two hospitalizations and one death, at a substance abuse treatment facility. During December 2016–January 2017, NJDOH surveillance for noninfluenza respiratory viruses identified multiple human adenovirus (HAdV) cases in the surrounding community. HAdVs can cause severe respiratory illness, and outbreaks of HAdV type 4 (HAdV-4) and HAdV type 7 (HAdV-7) have been associated with communal living facilities, including military barracks (1). A combined HAdV-4 and HadV-7 live oral vaccine is available but is currently limited to military use (2). NJDOH and the local health department investigated the outbreak in consultation with CDC to describe outbreak scope and provide infection control recommendations in this communal facility.