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N. fowleri suggests it might be sensitive to global changes in surface temperature ( – 12). Analysis of recreational water exposures resulting in PAM could aid risk prediction, prevention, and public communication efforts. The US Centers for Disease Control and Prevention (CDC) maintains a database of reported PAM cases in the United States since 1962, cataloging information about dates, locations, and suspected exposures ( 2). In 1978, CDC established its Free-living Ameba Laboratory, which increased the national capacity for clinical testing and contributed to an increase in the number of...

Abstract Rwanda and Bhutan, 2 low- and middle-income countries, implemented primarily school-based national human papillomavirus (HPV) vaccination in 2011 (Rwanda) and 2010 (Bhutan). We estimated vaccination effectiveness through urine-based HPV prevalence surveys in schools in 2013–2014 and 2017. In Rwanda, 912 participants from baseline surveys and 1,087 from repeat surveys were included, and in Bhutan, 973 participants from baseline surveys and 909 from repeat surveys were included. The overall effectiveness against vaccine-targeted HPV types (i.e., HPV-6/11/16/18) was 78% (95% CI 51%–...