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US data on invasive pneumococcal disease incidence among pregnant and postpartum women are limited. We estimated incidence in those groups using population-based surveillance. Compared with nonpregnant women of childbearing age, incidence was similar for pregnant women but 3.5 times higher for postpartum women. Our findings could inform pneumococcal vaccine recommendations.

Abstract Background Older age and chronic conditions are associated with severe influenza outcomes; however, data are only comprehensively available for adults ≥65 years old. Using data from the Influenza Hospitalization Surveillance Network (FluSurv-NET), we identified characteristics associated with severe outcomes in adults 18–49 years old hospitalized with influenza. Methods We included FluSurv-NET data from nonpregnant adults 18–49 years old hospitalized with laboratory-confirmed influenza during the 2011–2012 through 2018–2019 seasons. We used bivariate and multivariable logistic regression to determine associations between select characteristics and severe outcomes including intensive care unit (ICU) admission, invasive mechanical ventilation (IMV), and in-hospital death. Results A total of 16 140 patients aged 18–49 years and hospitalized with influenza were included in the analysis; the median age was 39 years, and 26% received current-season influenza vaccine before hospitalization. Obesity, asthma, and diabetes mellitus were the most common chronic conditions. Conditions associated with a significantly increased risk of severe outcomes included age group 30–39 or 40–49 years (IMV, age group 30–39 years: adjusted odds ratio [aOR], 1.25; IMV, age group 40–49 years: aOR, 1.36; death, age group 30–39 years: aOR, 1.28; death, age group 40–49 years: aOR, 1.69), being unvaccinated (ICU: aOR, 1.18; IMV: aOR, 1.25; death: aOR, 1.48), and having chronic conditions including extreme obesity and chronic lung, cardiovascular, metabolic, neurologic, or liver diseases (ICU: range aOR, 1.22–1.56; IMV: range aOR, 1.17–1.54; death: range aOR, 1.43–2.36). Conclusions To reduce the morbidity and mortality associated with influenza among adults aged 18–49 years, health care providers should strongly encourage receipt of annual influenza vaccine and lifestyle/behavioral modifications, particularly among those with chronic medical conditions.

Haemophilus influenzae (Hi) can cause meningitis and other serious invasive disease. Encapsulated Hi is classified into six serotypes (a-f) based on chemical composition of the polysaccharide capsule; unencapsulated strains are termed nontypeable Hi (NTHi). Hi serotype b (Hib) was the most common cause of bacterial meningitis in children in the pre-Hib vaccine era, and secondary transmission of Hi among children (e.g., to household contacts and in child care facilities) (1,2) led to the Advisory Committee on Immunization Practices (ACIP) recommendation for antibiotic chemoprophylaxis to prevent Hib disease in certain circumstances.* High Hib vaccination coverage since the 1990s has substantially reduced Hib disease, and other serotypes now account for most Hi-associated invasive disease in the United States (3). Nevertheless, CDC does not currently recommend chemoprophylaxis for contacts of persons with invasive disease caused by serotypes other than Hib and by NTHi (non-b Hi). Given this changing epidemiology, U.S. surveillance data were reviewed to investigate secondary cases of invasive disease caused by Hi. The estimated prevalence of secondary transmission was 0.32% among persons with encapsulated Hi disease (≤60 days of one another) and 0.12% among persons with NTHi disease (≤14 days of one another). Isolates from all Hi case pairs were genetically closely related, and all patients with potential secondary infection had underlying medical conditions. These results strongly suggest that secondary transmission of non-b Hi occurs. Expansion of Hi chemoprophylaxis recommendations might be warranted to control invasive Hi disease in certain populations in the United States, but further analysis is needed to evaluate the potential benefits against the risks, such as increased antibiotic use.

Pregnant women might be at increased risk for severe coronavirus disease 2019 (COVID-19) (1,2). The COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) (3) collects data on hospitalized pregnant women with laboratory-confirmed SARS-CoV-2, the virus that causes COVID-19; to date, such data have been limited. During March 1-August 22, 2020, approximately one in four hospitalized women aged 15-49 years with COVID-19 was pregnant. Among 598 hospitalized pregnant women with COVID-19, 54.5% were asymptomatic at admission. Among 272 pregnant women with COVID-19 who were symptomatic at hospital admission, 16.2% were admitted to an intensive care unit (ICU), and 8.5% required invasive mechanical ventilation. During COVID-19-associated hospitalizations, 448 of 458 (97.8%) completed pregnancies resulted in a live birth and 10 (2.2%) resulted in a pregnancy loss. Testing policies based on the presence of symptoms might miss COVID-19 infections during pregnancy. Surveillance of pregnant women with COVID-19, including those with asymptomatic infections, is important to understand the short- and long-term consequences of COVID-19 for mothers and newborns. Identifying COVID-19 in women during birth hospitalizations is important to guide preventive measures to protect pregnant women, parents, newborns, other patients, and hospital personnel. Pregnant women and health care providers should be made aware of the potential risks for severe COVID-19 illness, adverse pregnancy outcomes, and ways to prevent infection.

Health care personnel (HCP) can be exposed to SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), both within and outside the workplace, increasing their risk for infection. Among 6,760 adults hospitalized during March 1-May 31, 2020, for whom HCP status was determined by the COVID-19-Associated Hospitalization Surveillance Network (COVID-NET), 5.9% were HCP. Nursing-related occupations (36.3%) represented the largest proportion of HCP hospitalized with COVID-19. Median age of hospitalized HCP was 49 years, and 89.8% had at least one underlying medical condition, of which obesity was most commonly reported (72.5%). A substantial proportion of HCP with COVID-19 had indicators of severe disease: 27.5% were admitted to an intensive care unit (ICU), 15.8% required invasive mechanical ventilation, and 4.2% died during hospitalization. HCP can have severe COVID-19-associated illness, highlighting the need for continued infection prevention and control in health care settings as well as community mitigation efforts to reduce transmission.

Rising employment, a strong economy and a red-hot stock market have combined to vastly boost confidence about Americans' personal finances, according to Phoenix Home Life Mutual Insurance Co., a New York-based concern that does an annual \"fiscal fitness\" survey. Asked about their biggest financial concern over the next five years, 22 percent of Americans responded \"none.\" Nearly nine out of 10 people surveyed were optimistic about their financial futures, while four in 10 call themselves \"very optimistic.\" All those responses were significantly rosier than they were a year ago - and far more optimistic than they were in 1996. \"I can understand why people are feeling flush - the money they have in their 401(k) plans has grown rapidly, probably much more rapidly than they ever were told it would. So they're thinking, `Hey, I'm ahead of schedule. I can afford to tap some of this money,' \" says Paul Yakobowski, an analyst at the Employee Benefit Research Institute in Washington, D.C. \"But this could be false confidence.\"

A: The answer hinges on why you feel you \"can't take\" further losses. If you realize that your stock market money is needed for expenses in the next six months to one year, you should sell, said Ken Kamen, president of Mercadien Asset Management in Princeton, N.J. That's because that money should never have been in stocks in the first place. Q: Everybody says \"hang tight,\" but I remember that in 2000, after the market's initial jolt, the slide continued for two years. Wouldn't it have been smarter to sell out before all the bloodletting? Wouldn't that have saved the long-term value of my portfolio? Secondly, consider rebalancing your portfolio, [Brent Kessel] said. That would likely prompt you to sell some bonds, which have probably increased in value as interest rates have fallen, and buy some stocks. That's precisely the opposite of what feels comfortable, but it's age-old wisdom: \"buy low, sell high.\"

The Bellevue, Wash.-based company, which took in about $2.1 billion in coins last year, estimated that Americans have $10 billion in coins accumulating in ashtrays and jars. The average household has $99 worth of change lying around, [Alex Camara] added. Those who want credit at iTunes, Amazon.com, Starbucks, Borders, Hollywood Video, Eddie Bauer or Pier 1 Imports can get the full value of their coins, said Alex Camara, senior vice president of Coinstar Inc. In these instances, Coinstar collects its toll from the retailer, not the consumer. Newsday Photos/J. Conrad Williams Jr. - 1) At a Commerce Bank branch, manager Kathleen Petronis helps customer Diana Tadler of Manhasset with the Penny Arcade, a machine that counts change and gives a receipt that can be cashed in with a teller. 2) At left, customer Barbara Tracey of Garden City dumps coins into the Penny Arcade. More banks are making it easier for customers to cash in loose change. 3) Turning pennies into dollars

Teachers unions across the country -- including statewide teacher associations in Pennsylvania, Michigan and Oregon -- have struck their own endorsement deals. Unions in Dallas, Miami, Phoenix, Seattle and Atlanta, among others, refer members to products approved by the NEA and typically receive a share of endorsement revenue in return. Many teachers say they presume an endorsement means their union has used its clout to get the best price, as unions do on products varying from eyeglasses to automobiles. But when it comes to retirement accounts, union backing is often a sign that the product will cost more. \"This is a national problem,\" said Dan Otter, a former Maryland teacher and founder of 403bwise.com, a Web site that offers tips on finding low-cost 403(b) plans. \"It's a rare school district that gives teachers access to quality choices,\" Otter said. \"And it's the rare union that's advocating for better 403(b) investments for its members. In many cases, the 403(b) is a source of profit for unions.\" The broker who showed up at [Crystal Mendez]'s school two years ago was from Zahorik Investments of Pasadena, another preferred provider. Two years later, she discovered that her money was in a fixed-rate ING annuity. To take her money out, she would have to forfeit 10 percent of her savings -- $1,000. She did so, reluctantly. \"I could have stayed in for the 10 years and not paid the surrender fee,\" she said. \"But we figured it would cost me more than that in lost investment returns if I did.\"

A: Many itemized deductions would be eliminated, including deductions for property taxes, state income taxes, un-reimbursed business expenses and professional dues. But limited write-offs for charitable contributions and some mortgage expenses would be available for everyone -- even people who don't itemize. A: Today's cacophony of tax-favored retirement accounts and college savings accounts would be replaced by a series of new accounts that would not offer up-front deductions, but would promise future tax-free income. A: The AMT would be eliminated. This parallel tax system was established in the 1970s to ensure that high-income filers paid at least some tax. But because of factors including rising income and home prices, more and more middle-income filers have been drawn into the AMT system in recent years -- drawing protests from people who say the AMT was never intended for middle-class Americans. *