Data on human papillomavirus (HPV) type distribution in invasive and pre-invasive cervical cancer is essential to predict the future impact of HPV16/18 vaccines and HPV-based screening tests. A meta-analyses of HPV type distribution in invasive cervical cancer (ICC) and high-grade squamous intraepithelial lesions (HSIL) identified a total of 14,595 and 7,094 cases, respectively. In ICC, HPV16 was the most common, and HPV18 the second most common, type in all continents. Combined HPV16/18 prevalence among ICC cases was slightly higher in Europe, North America and Australia (74-77%) than in Africa, Asia and South/Central America (65-70%). The next most common HPV types were the same in each continent, namely HPV31, 33, 35, 45, 52 and 58, although their relative importance differed somewhat by region. HPV18 was significantly more prevalent in adeno/adenosquamous carcinoma than in squamous cell carcinoma, with the reverse being true for HPV16, 31, 33, 52 and 58. Among HSIL cases, HPV16/18 prevalence was 52%. However, HPV 16, 18 and 45 were significantly under-represented, and other highrisk HPV types significantly over-represented in HSIL compared to ICC, suggesting differences in type-specific risks for progression. Data on HPV-typed ICC and HSIL cases were particularly scarce from large regions of Africa and Central Asia. ' 2007 Wiley-Liss, Inc.Key words: human papillomavirus; genotype; cervical cancer; highgrade squamous intraepithelial lesions; meta-analysis; epidemiology Data on human papillomavirus (HPV) type distribution in women with invasive cervical cancer (ICC) and its precursor lesions are essential to predict the potential worldwide impact of new prophylactic vaccines against HPV16/18, 1,2 as well as to determine priorities for the inclusion of HPV types in future HPV vaccines and HPV-based screening tests.A standardised pooled analysis of 3,607 ICC cases 3 and a wider meta-analysis of 10,058 ICC cases 4 both confirmed that a majority of worldwide ICC cases are associated with HPV16/18. They also suggested some geographical variation in the importance of specific HPV types, 3,4 although data were limited or missing from many regions in Africa and Asia.A further meta-analysis in 4,338 high-grade squamous intraepithelial lesions (HSIL) showed that the most common HPV types in HSIL were broadly similar, but not identical, to those in ICC. 5 The purpose of the present publication is to update previous meta-analyses of HPV type distribution in ICC and HSIL with studies published between January 2002 and January 2006, including many from previously under-studied regions, and to identify remaining worldwide epidemiological data gaps prior to HPV vaccine implementation. Material and methodsThe detailed methods used for this meta-analysis of type-specific HPV prevalence have been reported previously, and are similar for both ICC and HSIL. 4,5 In brief, Medline was employed to search for citations published from January 2002 to January 2006 using the following MeSH terms: ''cervical cancer'', ''cervical intraepit...

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In February 2020, CDC issued guidance advising persons and health care providers in areas affected by the coronavirus disease 2019 pandemic to adopt social distancing practices, specifically recommending that health care facilities and providers offer clinical services through virtual means such as telehealth.* Telehealth is the use of two-way telecommunications technologies to provide clinical health care through a variety of remote methods. † To examine changes in the frequency of use of telehealth services during the early pandemic period, CDC analyzed deidentified encounter (i.e., visit) data from four of the largest U.S. telehealth providers that offer services in all states. § Trends in telehealth encounters during January-March 2020 (surveillance weeks 1-13) were compared with encounters occurring during the same weeks in 2019. During the first quarter of 2020, the number of telehealth visits increased by 50%, compared with the same period in 2019, with a 154% increase in visits noted in surveillance week 13 in 2020, compared with the same period in 2019. During January-March 2020, most encounters were from patients seeking care for conditions other than COVID-19. However, the proportion of COVID-19-related encounters significantly increased (from 5.5% to 16.2%; p<0.05) during the last 3 weeks of March 2020 (surveillance weeks 11-13). This marked shift in practice patterns has implications for immediate response efforts and longer-term population health. Continuing telehealth policy changes and regulatory waivers might provide increased access to acute, chronic, primary, and specialty care during and after the pandemic.Data for this analysis were provided to CDC from four large national telehealth providers as part of partner engagement to monitor and improve outcomes during the COVID-19 pandemic. Datasets included the date of the telehealth encounter, patient sex, age, county and state of residence, and, for 2020 visits, disposition after the visit (e.g., home or location the provider recommended that the patient seek additional care, if needed, such as in an emergency department [ED] or with a primary care provider), "reason for visit" (text field), and diagnosis defined by one or more International Classification of

IMPORTANCEThe coronavirus disease 2019 (COVID-19) pandemic, associated mitigation measures, and social and economic impacts may affect mental health, suicidal behavior, substance use, and violence.OBJECTIVE To examine changes in US emergency department (ED) visits for mental health conditions (MHCs), suicide attempts (SAs), overdose (OD), and violence outcomes during the COVID-19 pandemic. DESIGN, SETTING, AND PARTICIPANTSThis cross-sectional study used data from the Centers for Disease Control and Prevention's National Syndromic Surveillance Program to examine national changes in ED visits for MHCs, SAs, ODs, and violence from December 30, 2018, to October 10, 2020 (before and during the COVID-19 pandemic). The National Syndromic Surveillance Program captures approximately 70% of US ED visits from more than 3500 EDs that cover 48 states and Washington, DC.MAIN OUTCOMES AND MEASURES Outcome measures were MHCs, SAs, all drug ODs, opioid ODs, intimate partner violence (IPV), and suspected child abuse and neglect (SCAN) ED visit counts and rates. Weekly ED visit counts and rates were computed overall and stratified by sex.