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Volume 30, Number 4—April 2024
CME ACTIVITY - Synopsis

Concurrent Outbreaks of Hepatitis A, Invasive Meningococcal Disease, and Mpox, Florida, USA, 2021–2022

Timothy J. DoyleComments to Author , Megan Gumke, Danielle Stanek, Joshua Moore, Brian Buck, Timothy Locksmith, Kelly Tomson, Sarah Schmedes, George Churchwell, Shan Justin Hubsmith, Baskar Krishnamoorthy, Karalee Poschman, Brandi Danforth, Daniel Chacreton, and the outbreak investigation team1
Author affiliations: Florida Department of Health, Tallahassee, Florida, USA (T.J. Doyle, M. Gumke, D. Stanek, J. Moore, B. Buck, T. Locksmith, K. Thomson, S. Schmedes, G. Churchwell, S.J. Hubsmith, B. Krishnamoorthy, K. Poschman, B. Danforth, D. Chacreton); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (T.J. Doyle, K. Poschman)

Main Article

Table 1

Case definitions used in the investigation of concurrent outbreaks of hepatitis A, invasive meningococcal disease, and mpox, Florida, USA, 2021–2022*

Disease Definition
Hepatitis A
Inclusion criteria Florida residents meeting the surveillance case definition for hepatitis A† with symptom onset during November 1, 2021–November 30, 2022
Confirmed case A hepatitis A case with laboratory evidence of infection with HAV genotype IA, A17 cluster 21, or epidemiologically linked to a case with HAV A17 cluster 21 infection
Probable case A hepatitis A case who identified as transgender or MSM or had sexual contact with MSM, irrespective of other risk factors for hepatitis A
Suspected case A male hepatitis A case with unknown sexual history, and absence of other risk factors for hepatitis A (e.g., foreign travel, drug use, homelessness, incarceration)
Epidemiologically linked Household or sexual contact during the 15–50 d before symptom onset
Exclusions
 Cases with sequencing results indicating infection with HAV other than genotype IA, A17 cluster 21
Invasive meningococcal disease
Inclusion criteria Florida residents meeting the surveillance case definition for invasive meningococcal disease† with symptom onset during November 1, 2021–November 30, 2022
Confirmed case An invasive meningococcal disease case who identifies as MSM or had sexual contact with MSM and evidence of serogroup C infection; or laboratory evidence of infection with ST11 CC11 serogroup C, with <100 SNPs difference to the outbreak strain, irrespective of sexual history
Probable case An invasive meningococcal disease case who identifies as MSM or had sexual contact with MSM and for whom no additional serogroup, ST, or CC typing is available; or who had evidence of serogroup C infection regardless of sexual history
Exclusions
 Cases with sequencing results indicating infection with Neisseria meningitides other than ST11 CC11 serogroup C or with >100 SNP differences to the outbreak strain
Mpox
Inclusion criteria Florida residents meeting the surveillance case definition for confirmed or probable mpox‡ with symptom onset during May 1­–November 30, 2022

*CC, clonal complex; HAV, hepatitis A virus; MSM, men who have sex with men; SNP, single-nucleotide polymorphism; ST, sequence type; STI, sexually transmitted infection. †Per Florida Department of Health definition (15). ‡Per Centers for Disease Control and Prevention definition (16).

Main Article

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Main Article

1Members of the team are listed at the end of the article.

Page created: February 06, 2024
Page updated: March 18, 2024
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