A brief bout of moderate intensity exercise may provide some short-term relief from alcohol urges during exercise. Further studies are required to replicate the present findings and to confirm whether any moderating effect of exercise on alcohol urges is sustained following exercise.

A brief bout of aerobic exercise (e.g. stationary bicycle) has been shown to result in an acute reduction in tobacco withdrawal symptoms and cravings in abstinent smokers. However, aerobic exercise is often not practical and it is of interest to examine whether non-aerobic exercise has a similar effect. We investigated whether isometric exercise (involving muscular contractions against resistance without movement, e.g. placing the palms of the hands together and pushing) reduces desire to smoke and tobacco withdrawal symptoms. Following overnight abstinence smokers were randomized to 5-min of: isometric exercises (n = 20), body scanning (focusing attention on sensations in different areas of the body, n = 20, control), or sitting passively (n = 20, control). Desire to smoke and tobacco withdrawal symptoms ('irritable', 'depressed', 'stressed', 'tense', 'restless' and 'poor concentration') were rated at baseline, immediately post-intervention, and 5-, 10-, 15- and 20-min post-intervention. Isometric exercise produced a significantly greater reduction in desire to smoke versus passive control at immediate post-intervention and 5-min post-intervention, relative to baseline (p < 0.05). Most withdrawal symptoms were significantly moderated by exercise versus controls at some point between 5- to 20-min post-intervention, relative to baseline (p < 0.05). Brief isometric exercise has potential for offering immediate relief from a desire to smoke.

ObjectiveEvaluating the effectiveness of a surveillance system, and how it improves over time has significant implications for disease control and prevention. In the Democratic Republic of Congo (DRC), the Integrated Disease Surveillance and Response (IDSR) was implemented to estimate the burden of disease, monitor changes in disease occurrence, and inform resource allocation. For this effort we utilized national passive surveillance data from DRC’s IDSR to explore reporting trends of human monkeypox (MPX) from 2001 to 2013.MethodsWe obtained surveillance data on MPX cases occurring between January 2001 and December 2013 from the DRC Ministry of Health (MoH). Phases of the surveillance system, yearly trends in reporting and estimated incidence for MPX were analyzed using SAS v9.2 and Health Mapper.ResultsBetween 2001 and 2013, three discrete surveillance phases were identified that described the evolution of the surveillance system. Overall, an increase in suspected MPX cases was reported, beyond what would be expected from simply an improved reporting system. When restricting the analysis to the “stable phase,” national estimated incidence increased from 2.13 per 100,000 in 2008 to 2.84 per 100,000 in 2013.ConclusionsThe reported increase in MPX, based on an evolving surveillance system, is likely to be a true increase in disease occurrence rather than simply improvements to the surveillance system. Further analyses should provide critical information for improved prevention and control strategies and highlight areas of improvement for future data collection efforts.

From 2006 to 2007, an active surveillance program for human monkeypox (MPX) in the Democratic Republic of the Congo identified 151 cases of coinfection with monkeypox virus and varicella zoster virus from 1158 suspected cases of human MPX (13%). Using clinical and socio-demographic data collected with standardized instruments by trained, local nurse supervisors, we examined a variety of hypotheses to explain the unexpectedly high proportion of coinfections among the sample, including the hypothesis that the two viruses occur independently. The probabilities of disease incidence and selection necessary to yield the observed sample proportion of coinfections under an assumption of independence are plausible given what is known and assumed about human MPX incidence. Cases of human MPX are expected to be underreported, and more coinfections are expected with improved surveillance.

Monkeypox, caused by a zoonotic orthopoxvirus, is endemic in Central and West Africa. Monkeypox has been sporadically reported in the Republic of the Congo. During March 22–April 5, 2017, we investigated 43 suspected human monkeypox cases. We interviewed suspected case-patients and collected dried blood strips and vesicular and crust specimens (active lesions), which we tested for orthopoxvirus antibodies by ELISA and monkeypox virus and varicella zoster virus DNA by PCR. An ecologic investigation was conducted around Manfouété, and specimens from 105 small mammals were tested for anti-orthopoxvirus antibodies or DNA. Among the suspected human cases, 22 met the confirmed, probable, and possible case definitions. Only 18 patients had available dried blood strips; 100% were IgG positive, and 88.9% (16/18) were IgM positive. Among animals, only specimens from Cricetomys giant pouched rats showed presence of orthopoxvirus antibodies, adding evidence to this species’ involvement in the transmission and maintenance of monkeypox virus in nature.

Duration of immunity against Ebola virus among survivors remains unclear. We assessed serological immune profiles and retention of Ebola virus neutralizing antibodies in 14 survivors of the 1976 Yambuku outbreak 40 years postinfection, providing the longest documentation of such measures reported.

On June 29, 2020, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr). Transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), by asymptomatic and presymptomatic persons poses important challenges to controlling spread of the disease, particularly in congregate settings such as correctional and detention facilities (1). On March 29, 2020, a staff member in a correctional and detention facility in Louisiana developed symptoms † and later had a positive test result for SARS-CoV-2. During April 2-May 7, two additional cases were detected among staff members, and 36 cases were detected among incarcerated and detained persons at the facility; these persons were removed from dormitories and isolated, and the five dormitories that they had resided in before diagnosis were quarantined. On May 7, CDC and the Louisiana Department of Health initiated an investigation to assess the prevalence of SARS-CoV-2 infection among incarcerated and detained persons residing in quarantined dormitories. Goals of this investigation included evaluating COVID-19 symptoms in this setting and assessing the effectiveness of serial testing to identify additional persons with SARS-CoV-2 infection as part of efforts to mitigate transmission. During May 7-21, testing of 98 incarcerated and detained persons residing in the five quarantined dormitories (A-E) identified an additional 71 cases of SARS-CoV-2 infection; 32 (45%) were among persons who reported no symptoms at the time of testing, including three who were presymptomatic. Eighteen cases (25%) were identified in persons who had received negative test results during previous testing rounds. Serial testing of contacts from shared living quarters identified persons with SARS-CoV-2 infection who would not have been detected by symptom screening alone or by testing at a single time point. Prompt identification and isolation of infected persons is important to reduce further transmission in congregate settings such as correctional and detention facilities and the communities to which persons return when released. * These two authors contributed equally. † COVID-19-related signs and symptoms include subjective fever, cough, shortness of breath, chills, muscle aches, headache, sore throat, loss of taste, or loss of smell. https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/ symptoms.html. * During the 2 months preceding the date of data collection. † During the 2 months preceding testing and during the 14-day testing period. The person who was asymptomatic and had a positive test result on day 14 had not developed symptoms at follow-up 1 week later. § Persons who reported onset of symptoms after the date of specimen collection, which resulted in a positive test.

C orrectional and detention facilities face unique challenges for controlling severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease (COVID-19). These challenges include an inability for incarcerated or detained persons to socially distance and an ongoing risk for virus introduction caused by staff movement outside and within the facilities (1,2). These inherent difficulties underpin increased rates of SARS-CoV-2 infections and deaths among incarcerated and detained persons compared with the general population; 146,472 cases and 1,122 deaths in this population were reported in the United States as of October 20, 2020 (3,4). The Centers for Disease Control and Prevention (CDC) released interim guidance for management of COVID-19 in correctional and detention facilities; however, some facilities reported limitations to fully implementing the guidance (5-7). In addition, the potential for asymptomatic and presymptomatic transmission limits the effectiveness of symptom screening to identify cases and halt transmission (8-10). In other congregate settings, serial testing and physically separating persons based on their SARS-CoV-2 test results have been used to interrupt transmission (11,12). We investigated a COVID-19 outbreak in a detention center in Louisiana, USA (facility X) and used a serial testing strategy to identify infections and interrupt transmission in affected dormitories. All residents of affected dormitories underwent SARS-CoV-2 testing to assess the extent of transmission within the dormitory, to cohort detained persons based on their test result to prevent transmission, and to evaluate the utility of serial testing in this setting. We report the findings of this investigation; initial results were previously reported (13).