MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'MMWR Morb Mortal Wkl...' source. Thu, 18 Mar 2010 16:09:38 +0100 http://www.medworm.com/index.php?rid=3359971&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20224541%26dopt%3DAbstract This report summarizes the results of that analysis, which found that among 427 IPD cases with known serotype in children aged <5 years, 274 (64%) were caused by serotypes contained in PCV13. In 2007, an estimated 4,600 cases of IPD occurred in children in this age group in the United States, including approximately 2,900 cases caused by serotypes covered in PCV13 (versus 70 cases caused by PCV7 serotypes). PCV13 use has the potential to further reduce IPD in the United States. Post-licensure monitoring will help characterize the effectiveness of PCV13 in different populations and track the potential changes in disease burden caused by non-PCV13 serotypes. PMID: 20224541 [PubMed - in process] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3359971 Fri, 12 Mar 2010 00:00:00 +0100 3359971 http://www.medworm.com/index.php?rid=3359970&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20224542%26dopt%3DAbstract This report summarizes recommendations approved by ACIP on February 24, 2010, for 1) routine vaccination of all children aged 2--59 months with PCV13, 2) vaccination with PCV13 of children aged 60--71 months with underlying medical conditions that increase their risk for pneumococcal disease or complications, and 3) PCV13 vaccination of children who previously received 1 or more doses of PCV7. CDC guidance for vaccination providers regarding transition from PCV7 to the PCV13 immunization program also is included. PMID: 20224542 [PubMed - in process] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3359970 Fri, 12 Mar 2010 00:00:00 +0100 3359970 http://www.medworm.com/index.php?rid=3359969&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20224543%26dopt%3DAbstract This report summarizes the results of those comparisons, which determined that health insurance coverage statewide increased by 5.5%, from 91.3% in the pre-law period to 96.3% in the post-law period, and that coverage increased 14.2% among Hispanics, from 77.9% to 89.0%. Despite the limitations inherent in this analysis, the increases in coverage likely are attributable to the new law. MDPH is using these results to target outreach more precisely to increase health insurance enrollment and health-care access among state residents. PMID: 20224543 [PubMed - in process] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3359969 Fri, 12 Mar 2010 00:00:00 +0100 3359969 http://www.medworm.com/index.php?rid=3359968&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20224544%26dopt%3DAbstract This report updates previous reports and describes polio eradication activities in Afghanistan and Pakistan during January--December 2009 and proposed activities in 2010 to address challenges. During 2009, both countries continued to conduct coordinated supplemental immunization activities (SIAs) and used multiple strategies to reach previously unreached children. These strategies included 1) use of short interval additional dose (SIAD) SIAs to administer a dose of oral poliovirus vaccine (OPV) within 1--2 weeks after a prior dose during negotiated periods of security; 2) systematic engagement of local leaders; 3) negotiations with conflict parties; and 4) increased engagement of nongovernmental organizations delivering basic health services. However, security problems continued to limit a... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3359968 Fri, 12 Mar 2010 00:00:00 +0100 3359968 http://www.medworm.com/index.php?rid=3359967&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20224545%26dopt%3DAbstract This report summarizes the approved indications for MenACWY-CRM and provides guidance from ACIP for its use. The following guidance for use of MenACWY-CRM is consistent with licensed indications and ACIP recommendations for meningococcal conjugate vaccines. PMID: 20224545 [PubMed - in process] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3359967 Fri, 12 Mar 2010 00:00:00 +0100 3359967 http://www.medworm.com/index.php?rid=3339878&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20203553%26dopt%3DAbstract This report summarizes the 11 cases and provides chemoprophylactic and additional preventive recommendations to minimize the risk for acquiring malaria for persons traveling to Haiti. PMID: 20203553 [PubMed - in process] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3339878 Fri, 05 Mar 2010 00:00:00 +0100 3339878 http://www.medworm.com/index.php?rid=3339877&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20203554%26dopt%3DAbstract Authors: Congenital hearing loss affects two to three infants per 1,000 live births. Undetected hearing loss can delay speech and language development. A total of 41 states, Guam, and the District of Columbia have statutes or regulatory guidance to identify infants with hearing loss. All states and U.S. territories also have established Early Hearing Detection and Intervention (EHDI) programs, which embody evidence-based public health policy for addressing infant hearing loss. EHDI programs help ensure that newborns and infants are screened and receive recommended follow-up through data collection and outreach to hospitals, providers, and families. To determine the status of efforts to identify newborns and infants with hearing loss, CDC analyzed EHDI surveillance data from 1999--200... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3339877 Fri, 05 Mar 2010 00:00:00 +0100 3339877 http://www.medworm.com/index.php?rid=3339876&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20203555%26dopt%3DAbstract This report summarizes the results for 2004--2008, when 17 SAEs in 15 adults and two children (aged 11 and 14 years) were reported. All patients had received INH therapy and had experienced severe liver injury. Five patients, including one child, underwent liver transplantation. Five adults died, including one liver transplant recipient. These findings underscore the risk for an idiosyncratic drug-induced reaction in patients of any age treated with INH, including those with or without a putative predictor for INH-associated liver injury. Patients receiving INH for LTBI therapy should be monitored according to American Thoracic Society (ATS)/CDC recommendations because of the risk for drug-induced hepatoxicity. Providers should counsel patients to terminate INH therapy promptly and seek me... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3339876 Fri, 05 Mar 2010 00:00:00 +0100 3339876 http://www.medworm.com/index.php?rid=3339875&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20203556%26dopt%3DAbstract Authors: Respiratory syncytial virus (RSV) is the most common cause of bronchiolitis and pneumonia in children aged <1 year worldwide. Each year in the United States, an estimated 75,000--125,000 infants are hospitalized with RSV. Among adults aged >65 years, an estimated 177,000 hospitalizations and 14,000 deaths a year have been attributed to RSV infections. In temperate climates, the RSV season generally begins during the fall and continues through the winter and spring, but the exact timing of RSV circulation varies by location and year. In the United States, data from the National Respiratory and Enteric Virus Surveillance System (NREVSS) are used to monitor the seasonal occurrence of RSV. During the 2008--09 season, onset occurred from mid-October to late December in the ... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3339875 Fri, 05 Mar 2010 00:00:00 +0100 3339875 http://www.medworm.com/index.php?rid=3315236&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20186117%26dopt%3DAbstract This report describes the clinical course and laboratory findings of an adolescent girl with encephalitis who had not had rabies vaccination and who had been exposed to bats 2 months before illness. Antibodies to rabies virus were detected in specimens of the girl's serum and cerebrospinal fluid (CSF) by indirect fluorescent antibody test (IFA). However, the presence of rabies VNA was not detected until after she had received single doses of rabies vaccine and human rabies immune globulin (HRIG). Although the patient required multiple hospitalizations and follow-up visits for recurrent neurologic symptoms, she survived without intensive care. No alternate etiology was determined, and abortive human rabies (defined in this report as recovery from rabies without intensive care) was diagnosed... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3315236 Fri, 26 Feb 2010 00:00:00 +0100 3315236 http://www.medworm.com/index.php?rid=3315235&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20186118%26dopt%3DAbstract This report summarizes the results of that investigation, which identified 135 cases in 25 states and the District of Columbia; 45% were in children aged </=5 years. Among 70 patients with primary infection, 37% reported turtle exposure, of which 81% was to small turtles most commonly purchased from street vendors. A matched case-control study showed a significant association between illness and exposure to turtles (matched odds ratio [mOR] = 16.5). Increasing enforcement of existing local, state, and federal regulations against the sale of small turtles, increasing penalties for illegal sales, and enacting more state and local laws regulating the sale of small turtles (e.g., requiring Salmonella awareness education at the point-of-sale), could augment federal prevention efforts. PM... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3315235 Fri, 26 Feb 2010 00:00:00 +0100 3315235 http://www.medworm.com/index.php?rid=3291116&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20168293%26dopt%3DAbstract Authors: Fatal and nonfatal overdoses from prescription pain medications have increased in recent years in Utah and throughout the nation. In 2008, the Utah Department of Health added 12 questions to the state's Behavioral Risk Factor Surveillance System (BRFSS) survey to better understand how state residents obtain and use prescription pain medication. Findings from the survey indicated that an estimated 20.8% of Utah adults aged >/=18 years had been prescribed an opioid pain medication during the preceding 12 months. Of those prescribed an opioid pain medication, 3.2% reported using their medication more frequently or in higher doses than had been directed by their doctor; 72.0% reported having leftover medication, and 71.0% of those with leftover medication reported that they h... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3291116 Fri, 19 Feb 2010 00:00:00 +0100 3291116 http://www.medworm.com/index.php?rid=3291115&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20168294%26dopt%3DAbstract This report summarizes the enhanced outbreak response, which identified a total of 106 cases of syphilis with onset from January 2007 to June 2009, including six congenital cases (two of them stillbirths). Initial communication gaps led to delays in response to this outbreak, but communication was improved through the formation of an outbreak response group that included members from county, state, and tribal health departments and IHS. For similar outbreaks in American Indian tribes, where various public health jurisdictions exist and often have concurrent responsibilities, formation of an outbreak response group can improve control efforts. PMID: 20168294 [PubMed - in process] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3291115 Fri, 19 Feb 2010 00:00:00 +0100 3291115 http://www.medworm.com/index.php?rid=3291114&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20168295%26dopt%3DAbstract This report summarizes the results of that investigation, which indicated that, of the 85 patients with FARI, 78 (92%) tested positive for pandemic H1N1 by rRT-PCR. The attack rate for confirmed pandemic H1N1 influenza was 22.0%. The most frequent symptoms, other than fever, were cough, headache, nasal congestion, and malaise. No complications or deaths occurred. Patients were treated according to World Health Organization (WHO) influenza treatment guidelines; six patients received antiviral medication because of preexisting comorbidities. A shipboard respiratory surveillance program, which had been implemented aboard the ship before its departure from Peru, permitted the early detection of the outbreak. Subsequent implementation of control measures might have slowed the outbreak. Laborato... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3291114 Fri, 19 Feb 2010 00:00:00 +0100 3291114 http://www.medworm.com/index.php?rid=3271400&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20150887%26dopt%3DAbstract Authors: State and local health departments, in collaboration with CDC, continue to investigate a mumps outbreak that began in New York in June 2009. The index case occurred in a boy aged 11 years who had returned on June 17 from a trip to the United Kingdom, where approximately 7,400 reports of laboratory-confirmed mumps were received by the Health Protection Agency in 2009. He then attended a New York summer camp for tradition-observant Jewish boys, where he became symptomatic on June 28. Subsequently, other camp attendees and a staff member were reported to have mumps, and transmission continued in multiple locations when the camp attendees returned home. As of January 29, 2010, a total of 1,521 cases had been reported, with onset dates from June 28, 2009, through January 29, 2010... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3271400 Fri, 12 Feb 2010 00:00:00 +0100 3271400 http://www.medworm.com/index.php?rid=3271399&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20150888%26dopt%3DAbstract This report summarizes the results of that investigation, which determined that the infant acquired yellow fever vaccine virus through breast-feeding. The mother reported 2 days of headache, malaise, and low fever occurring 5 days after receipt of yellow fever vaccine. The infant, who was exclusively breast-fed, was hospitalized at age 23 days with seizures requiring continuous infusion of intravenous anticonvulsants. The infant received antimicrobial and antiviral treatment for meningoencephalitis. The presence of 17DD yellow fever virus was detected by reverse transcription--polymerase chain reaction (RT-PCR) in the infant's cerebrospinal fluid (CSF); yellow fever--specific immunoglobulin M (IgM) antibodies also were present in serum and CSF. The infant recovered completely, was discharg... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3271399 Fri, 12 Feb 2010 00:00:00 +0100 3271399 http://www.medworm.com/index.php?rid=3271398&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20150889%26dopt%3DAbstract This report highlights results from the 2008 IISAR, which indicated that 75% of all U.S. children aged <6 years (approximately 18 million children) participated in an IIS in 2008, an increase from 65% in 2006. The majority of grantees (82%) reported that their IIS had the capacity to track vaccinations for persons of all ages, compared with 70% in 2006. Data-quality measures of timeliness and completeness indicated that in 2008, 67% of IIS data were received and processed within 30 days of vaccine administration, and data were reported for six of 17 core data elements in >/=90% of IIS records (both measures are similar to 2006 results). Increased provider use of electronic health record systems can benefit IISs and their users by producing immunization records that are more timely an... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3271398 Fri, 12 Feb 2010 00:00:00 +0100 3271398 http://www.medworm.com/index.php?rid=3248770&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20134398%26dopt%3DAbstract This report summarizes the results of those analyses, which indicated that, during 2004--2007, 85% of diagnoses of perinatal HIV infection were in blacks or African Americans (69%) or Hispanics or Latinos (16%). The average annual rate of diagnoses of perinatal HIV infection during 2004--2007 was 12.3 per 100,000 among blacks, 2.1 per 100,000 among Hispanics, and 0.5 per 100,000 among whites. However, from 2004 to 2007, the racial/ethnic disparity narrowed, as the annual rate of diagnoses of perinatal HIV infection for black children decreased from 14.8 to 10.2 per 100,000, and the rate for Hispanic children decreased from 2.9 to 1.7 per 100,000. To further reduce perinatal HIV transmission and racial/ethnic disparities, HIV-infected pregnant women, and particularly black and Hispanic wome... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3248770 Fri, 05 Feb 2010 00:00:00 +0100 3248770 http://www.medworm.com/index.php?rid=3248769&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20134399%26dopt%3DAbstract This report describes the poisoning incident, which resulted in six hospitalizations, and the subsequent multidisciplinary investigation. Health-care providers and public health officials should be aware that jimsonweed poisoning can occur among many age groups, including younger persons, who typically consume the plant material for recreational purposes, or persons of any age group who might unknowingly ingest the plant. A prompt diagnosis of jimsonweed poisoning is complicated by the difficulties in eliciting exposure histories in persons with altered mental status and the variable presentations of affected persons. Consultation with horticulturalists, poison control centers, and specialized laboratories might be necessary to investigate cases and outbreaks. PMID: 20134399 [PubMed - ... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3248769 Fri, 05 Feb 2010 00:00:00 +0100 3248769 http://www.medworm.com/index.php?rid=3248768&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20134400%26dopt%3DAbstract This report updates the previous analysis and summarizes changes that occurred from December 31, 2004, to December 31, 2009, in state laws that preempt local smoke-free laws for the same three settings. During that period, the number of states preempting local smoking restrictions in at least one of these three settings decreased from 19 to 12. In contrast with the 2005 findings, this decrease indicates progress toward achieving the goal of eliminating state laws preempting local smoking restrictions. Further progress could result in additional reductions in secondhand smoke exposure. PMID: 20134400 [PubMed - in process] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3248768 Fri, 05 Feb 2010 00:00:00 +0100 3248768 http://www.medworm.com/index.php?rid=3236505&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20110933%26dopt%3DAbstract This report summarizes the investigations of these five cases, which determined that the New York cases were associated with one anesthesiologist and the Ohio cases were associated with a second anesthesiologist. In Ohio, the anesthesiologist did not wear a mask; wearing a mask might have prevented the infections. The findings underscore the need to follow established infection-control recommendations during spinal procedures, including the use of a mask and adherence to aseptic technique. PMID: 20110933 [PubMed - indexed for MEDLINE] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3236505 Fri, 29 Jan 2010 00:00:00 +0100 3236505 http://www.medworm.com/index.php?rid=3236504&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20110934%26dopt%3DAbstract This report summarizes the results of that analysis, which indicated that DOE school milk purchases per student per year increased 1.3% in fiscal year 2009 compared with 2004 purchases. By removing whole milk and switching from low-fat to fat-free chocolate milk, NYC public school milk-drinking students were served an estimated 5,960 fewer calories and 619 fewer grams of fat in 2009 than they were in 2004. Other school systems can use these results to guide changes to their own school food policies. PMID: 20110934 [PubMed - indexed for MEDLINE] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3236504 Fri, 29 Jan 2010 00:00:00 +0100 3236504 http://www.medworm.com/index.php?rid=3236503&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20110935%26dopt%3DAbstract This report summarizes the three outbreaks, which involved facilities primarily housing older patients. These outbreaks illustrate that, despite the lower risk for infection with 2009 H1N1 among persons aged >or=65 years compared with seasonal influenza, 2009 H1N1 outbreaks still can occur in LTCFs. These outbreaks also underscore the importance of respiratory illness surveillance and recommended infection-control procedures in LTCFs. All health-care personnel should be vaccinated against seasonal influenza and 2009 H1N1. LTCF residents should receive seasonal influenza vaccination, and should be vaccinated against 2009 H1N1 after assessment of vaccine availability at the local level indicates that demand for vaccine among younger age groups is being met. PMID: 20110935 [PubMed - in... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3236503 Fri, 29 Jan 2010 00:00:00 +0100 3236503 http://www.medworm.com/index.php?rid=3223787&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20110933%26dopt%3DAbstract This report summarizes the investigations of these five cases, which determined that the New York cases were associated with one anesthesiologist and the Ohio cases were associated with a second anesthesiologist. In Ohio, the anesthesiologist did not wear a mask; wearing a mask might have prevented the infections. The findings underscore the need to follow established infection-control recommendations during spinal procedures, including the use of a mask and adherence to aseptic technique. PMID: 20110933 [PubMed - in process] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3223787 Fri, 29 Jan 2010 00:00:00 +0100 3223787 http://www.medworm.com/index.php?rid=3223786&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20110934%26dopt%3DAbstract This report summarizes the results of that analysis, which indicated that DOE school milk purchases per student per year increased 1.3% in fiscal year 2009 compared with 2004 purchases. By removing whole milk and switching from low-fat to fat-free chocolate milk, NYC public school milk-drinking students were served an estimated 5,960 fewer calories and 619 fewer grams of fat in 2009 than they were in 2004. Other school systems can use these results to guide changes to their own school food policies. PMID: 20110934 [PubMed - in process] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3223786 Fri, 29 Jan 2010 00:00:00 +0100 3223786 http://www.medworm.com/index.php?rid=3223785&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20110935%26dopt%3DAbstract This report summarizes the three outbreaks, which involved facilities primarily housing older patients. These outbreaks illustrate that, despite the lower risk for infection with 2009 H1N1 among persons aged >/=65 years compared with seasonal influenza, 2009 H1N1 outbreaks still can occur in LTCFs. These outbreaks also underscore the importance of respiratory illness surveillance and recommended infection-control procedures in LTCFs. All health-care personnel should be vaccinated against seasonal influenza and 2009 H1N1. LTCF residents should receive seasonal influenza vaccination, and should be vaccinated against 2009 H1N1 after assessment of vaccine availability at the local level indicates that demand for vaccine among younger age groups is being met. PMID: 20110935 [PubMed - in ... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3223785 Fri, 29 Jan 2010 00:00:00 +0100 3223785 http://www.medworm.com/index.php?rid=3209935&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20094025%26dopt%3DAbstract This report summarizes the subsequent investigation by the hospital and CDC to identify lapses in donor deferral and to determine whether transfusion-related transmission of YF vaccine virus occurred. The investigation found that a recent change in the timing of trainee vaccination had occurred and that vaccinees had not reported recent YF vaccination status at time of donation. Despite a prompt recall, six units of blood products were transfused into five patients. No clinical evidence or laboratory abnormalities consistent with a serious adverse reaction were identified in four recipients within the first month after transfusion; the fifth patient, who had prostate cancer and end-stage, transfusion-dependent, B-cell lymphoma, died while in hospice care. Three of the four surviving patien... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3209935 Fri, 22 Jan 2010 00:00:00 +0100 3209935 http://www.medworm.com/index.php?rid=3200818&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20094024%26dopt%3DAbstract This report describes the results of that analysis, which found that the prevalence of abnormal lipid levels among youths aged 12-19 years was 20.3%. This prevalence varied by BMI; 14.2% of normal weight youths, 22.3% of overweight and 42.9% of obese had at least one abnormal lipid level. Among all youths, 32% had a high BMI and therefore would be candidates for lipid screening under AAP recommendations. Given the high prevalence of abnormal lipid levels among youths who are overweight and obese in this study, clinicians should be aware of lipid screening guidelines, especially recommendations for screening youths who are overweight or obese. PMID: 20094024 [PubMed - in process] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3200818 Fri, 22 Jan 2010 00:00:00 +0100 3200818 http://www.medworm.com/index.php?rid=3200817&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20094025%26dopt%3DAbstract This report summarizes the subsequent investigation by the hospital and CDC to identify lapses in donor deferral and to determine whether transfusion-related transmission of YF vaccine virus occurred. The investigation found that a recent change in the timing of trainee vaccination had occurred and that vaccinees had not reported recent YF vaccination status at time of donation. Despite a prompt recall, six units of blood products were transfused into five patients. No clinical evidence or laboratory abnormalities consistent with a serious adverse reaction were identified in four recipients within the first month after transfusion; the fifth patient, who had prostate cancer and end-stage, transfusion-dependent, B-cell lymphoma, died while in hospice care. Three of the four surviving patien... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3200817 Fri, 22 Jan 2010 00:00:00 +0100 3200817 http://www.medworm.com/index.php?rid=3200816&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20094026%26dopt%3DAbstract This report summarizes U.S. influenza activity from August 30, 2009, through January 9, 2010. PMID: 20094026 [PubMed - in process] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3200816 Fri, 22 Jan 2010 00:00:00 +0100 3200816 http://www.medworm.com/index.php?rid=3200815&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20094027%26dopt%3DAbstract Authors: In July 2009, the Advisory Committee on Immunization Practices (ACIP) issued recommendations for use of the influenza A (H1N1) 2009 monovalent vaccine. Recognizing that the vaccine supply would not be ample immediately but would grow over time, ACIP identified 1) initial target groups, consisting of approximately 160 million persons, and 2) a limited vaccine subset of the target groups, initially estimated at 42 million persons (and more recently estimated at 62 million persons), to receive first priority while the 2009 H1N1 vaccine supply was limited. ACIP recommended expanding vaccination to the rest of the population as vaccine supplies increased. To estimate 2009 H1N1 vaccination coverage to date for the 2009--10 influenza season, CDC analyzed results from the National 2... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3200815 Fri, 22 Jan 2010 00:00:00 +0100 3200815 http://www.medworm.com/index.php?rid=3180593&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20075837%26dopt%3DAbstract This report describes the results of that survey, which indicated that 36.2% of 8th-grade respondents had heard of the choking game, 30.4% had heard of someone participating, and 5.7% had participated themselves. Youths in rural areas were significantly more likely (6.7%) to have participated than youths in urban areas (4.9%). Choking game participation was higher among 8th graders who reported mental health risk factors (4.0%), substance use (7.9%), or both (15.8%), compared with those who reported neither (1.7%). Public health surveillance of these strangulation activities among youths should be expanded to better quantify the risks and understand the motives and circumstances surrounding participation. Parents, educators, counselors, and others who work with youths should be aware of st... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3180593 Fri, 15 Jan 2010 00:00:00 +0100 3180593 http://www.medworm.com/index.php?rid=3180592&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20075838%26dopt%3DAbstract This report summarizes the results of that investigation, which found that the outbreak was caused by adenovirus 14 (Ad14), an emerging adenovirus serotype in the United States that is associated with a higher rate of severe illness compared with other adenoviruses. Among the 46 cases identified in the outbreak from September 1 through October 27, 2008, the most frequently observed characteristics included the following: male (70%), Alaska Native (61%), underlying pulmonary disease (44%), aged > or = 65 years (26%), and current smoker (48%). Patients aged > or = 65 years had a fivefold increased risk for hospitalization. The most commonly reported symptoms were cough (100%), shortness of breath (87%), and fever (74%). Of the 11 hospitalized patients, three required intensive care, an... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3180592 Fri, 15 Jan 2010 00:00:00 +0100 3180592 http://www.medworm.com/index.php?rid=3157737&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20057349%26dopt%3DAbstract This report summarizes the results of this ongoing investigation, which, as of December 30, had identified 85 S. Typhimurium human isolates with the outbreak strain from 31 states. In a multistate case-control study, exposure to frogs was found to be significantly associated with illness (63% of cases versus 3% of controls; matched odds ratio [mOR] = 24.4). Among 14 case-patients who knew the type of frog, all had exposure to an exclusively aquatic frog species, the African dwarf frog. Environmental samples from aquariums containing aquatic frogs in four homes of case-patients yielded S. Typhimurium isolates matching the outbreak strain. Preliminary traceback information has indicated these frogs likely came from the same breeder in California. Reptiles (e.g., turtles) and amphibians (e.g.... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3157737 Fri, 08 Jan 2010 00:00:00 +0100 3157737 http://www.medworm.com/index.php?rid=3157736&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20057350%26dopt%3DAbstract This report summarizes the findings of this analysis. Approximately 60% of admitted patients were aged <;18 years. The most commonly documented underlying condition was asthma, observed among 50% of patients aged <18 years and 46% of adult patients. Multiple underlying conditions were observed in 17% of patients (12% of children, 24% of adults). Patients treated with oseltamivir within 2 days of symptom onset had shorter median hospitalizations than those who did not (2 days versus 3 days [p = 0.03]). The findings of this assessment were used to inform immediate outbreak response measures in New York City. During such outbreaks, public education campaigns should encourage patients at high risk of severe illness to seek treatment promptly after symptom onset and should emphasize the i... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3157736 Fri, 08 Jan 2010 00:00:00 +0100 3157736 http://www.medworm.com/index.php?rid=3157735&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20057351%26dopt%3DAbstract This report summarizes the results of the investigation, which detected an outbreak of pandemic H1N1 cases at the school over the ensuing 3 weeks. A total of 16 cases were identified; all patients recovered with no hospitalizations or deaths. HDOH, the school, and the Hawaii Department of Education (HDOE) instituted an education campaign asking students and employees to stay home if ill. After consulting with HDOH, school officials decided not to close the school; the outbreak ended after 19 days. This outbreak represented the first documented community transmission of pandemic H1N1 virus in Hawaii. The investigation contributed to the early understanding of the epidemiology of H1N1 influenza in Hawaii (e.g., that risk factors for infection would not be restricted to mainland or foreign tr... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3157735 Fri, 08 Jan 2010 00:00:00 +0100 3157735 http://www.medworm.com/index.php?rid=3134264&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20032923%26dopt%3DAbstract This report summarizes the results of that assessment, which determined that 64% of adults reported intent to receive H1N1 vaccine. In addition, 65% of parents reported intent to have all their children (aged 6 months to <18 years) vaccinated with H1N1 vaccine, and 51% said they would have all their children vaccinated with both H1N1 and seasonal influenza vaccines. The most commonly reported reasons for not intending to receive H1N1 vaccine were belief in a low likelihood of infection (18%) and concern over vaccine side effects (14%); 85% of participants said they received their H1N1 information from television. To increase coverage with H1N1 and seasonal influenza vaccines, public health departments should use television to focus public health messages on the risks for infection and s... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3134264 Fri, 25 Dec 2009 00:00:00 +0100 3134264 http://www.medworm.com/index.php?rid=3134263&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20032924%26dopt%3DAbstract This report summarizes the results of that survey, which indicated that 97.0% of respondents agreed with the decision to close schools. In 29.1% of households, an adult had to miss work to provide child care, and in 15.7% of households, at least one adult lost pay because of missed work. Although the schools closed because of high absenteeism affecting school operations and funding, this was not fully communicated to families; 64.4% of respondents believed the closures would "keep people from getting ill," and 90.8% thought it was "extremely or very important" to disinfect schools while closed to reduce community spread of influenza. School districts and health departments should provide families with specific information about the reason for school closings and provide recommendations for... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3134263 Fri, 25 Dec 2009 00:00:00 +0100 3134263 http://www.medworm.com/index.php?rid=3134262&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20032925%26dopt%3DAbstract This report summarizes the five cases, including the clinical findings and likely means of transmission of a hantavirus. Thrombocytopenia, elevated white blood cell (WBC) count, and pulmonary infiltrates were observed in all five children; elevated hematocrit was observed in three. One child died, and three of the four children who recovered required mechanical ventilation during hospitalization. Clinicians should consider HPS in the differential diagnosis for children with unexplained acute respiratory distress, especially if recent rodent exposure is noted. Public health agencies should promote preventive measures, including rodent control in housing and play areas, and children should be advised to avoid contact with rodents and areas of infestation. PMID: 20032925 [PubMed - indexed... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3134262 Fri, 25 Dec 2009 00:00:00 +0100 3134262 http://www.medworm.com/index.php?rid=3134261&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20032926%26dopt%3DAbstract This report describes the results of that analysis, which indicate that during 1968-2006, a total of 22,625 YPLL were attributed to CWP (mean per decedent: 5.7). Annual YPLL attributed to CWP decreased 91.2%, from an average of 1,484 YPLL per year during 1968-1972 to 154 per year during 2002-2006. However, annual YPLL from CWP have been increasing since 2002, from 135 in that year to 169 YPLL in 2006, suggesting a need for strengthening CWP prevention measures. CDC intends to maintain surveillance of CWP deaths to determine future trends and promote safer work environments. PMID: 20032926 [PubMed - indexed for MEDLINE] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3134261 Fri, 25 Dec 2009 00:00:00 +0100 3134261 http://www.medworm.com/index.php?rid=3122445&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20032923%26dopt%3DAbstract This report summarizes the results of that assessment, which determined that 64% of adults reported intent to receive H1N1 vaccine. In addition, 65% of parents reported intent to have all their children (aged 6 months to <18 years) vaccinated with H1N1 vaccine, and 51% said they would have all their children vaccinated with both H1N1 and seasonal influenza vaccines. The most commonly reported reasons for not intending to receive H1N1 vaccine were belief in a low likelihood of infection (18%) and concern over vaccine side effects (14%); 85% of participants said they received their H1N1 information from television. To increase coverage with H1N1 and seasonal influenza vaccines, public health departments should use television to focus public health messages on the risks for infection and s... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3122445 Fri, 25 Dec 2009 00:00:00 +0100 3122445 http://www.medworm.com/index.php?rid=3122444&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20032924%26dopt%3DAbstract This report summarizes the results of that survey, which indicated that 97.0% of respondents agreed with the decision to close schools. In 29.1% of households, an adult had to miss work to provide child care, and in 15.7% of households, at least one adult lost pay because of missed work. Although the schools closed because of high absenteeism affecting school operations and funding, this was not fully communicated to families; 64.4% of respondents believed the closures would "keep people from getting ill," and 90.8% thought it was "extremely or very important" to disinfect schools while closed to reduce community spread of influenza. School districts and health departments should provide families with specific information about the reason for school closings and provide recommendations for... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3122444 Fri, 25 Dec 2009 00:00:00 +0100 3122444 http://www.medworm.com/index.php?rid=3122443&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20032925%26dopt%3DAbstract This report summarizes the five cases, including the clinical findings and likely means of transmission of a hantavirus. Thrombocytopenia, elevated white blood cell (WBC) count, and pulmonary infiltrates were observed in all five children; elevated hematocrit was observed in three. One child died, and three of the four children who recovered required mechanical ventilation during hospitalization. Clinicians should consider HPS in the differential diagnosis for children with unexplained acute respiratory distress, especially if recent rodent exposure is noted. Public health agencies should promote preventive measures, including rodent control in housing and play areas, and children should be advised to avoid contact with rodents and areas of infestation. PMID: 20032925 [PubMed - in proc... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3122443 Fri, 25 Dec 2009 00:00:00 +0100 3122443 http://www.medworm.com/index.php?rid=3122442&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20032926%26dopt%3DAbstract This report describes the results of that analysis, which indicate that during 1968--2006, a total of 22,625 YPLL were attributed to CWP (mean per decedent: 5.7). Annual YPLL attributed to CWP decreased 91.2%, from an average of 1,484 YPLL per year during 1968--1972 to 154 per year during 2002--2006. However, annual YPLL from CWP have been increasing since 2002, from 135 in that year to 169 YPLL in 2006, suggesting a need for strengthening CWP prevention measures. CDC intends to maintain surveillance of CWP deaths to determine future trends and promote safer work environments. PMID: 20032926 [PubMed - in process] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3122442 Fri, 25 Dec 2009 00:00:00 +0100 3122442 http://www.medworm.com/index.php?rid=3103009&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20019653%26dopt%3DAbstract This report summarizes the results of the assessment, which determined that in 2009, 10% fewer epidemiologists were working in state health departments than in 2006. Compared with 2006, the percentage of state health departments with substantial-to-full (>50%) epidemiology capacity decreased in three ESPH, including 1) capacities to monitor and detect health problems, 2) investigate them, and 3) evaluate the effectiveness of population-based services. The percentage of departments with substantial-to-full epidemiology capacity for bioterrorism/emergency response decreased slightly, from 76% in 2006 to 73% in 2009. More than 30% of states reported minimal-to-no (<25%) capacity to evaluate and conduct research and for five of nine epidemiology program areas, including environmental hea... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3103009 Fri, 18 Dec 2009 00:00:00 +0100 3103009 http://www.medworm.com/index.php?rid=3103008&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20019654%26dopt%3DAbstract Authors: Marburg hemorrhagic fever (MHF) is a rare, viral hemorrhagic fever (VHF); the causative agent is an RNA virus in the family Filoviridae, and growing evidence demonstrates that fruit bats are the natural reservoir of Marburg virus (MARV). On January 9, 2008, an infectious disease physician notified the Colorado Department of Public Health and Environment (CDPHE) of a case of unexplained febrile illness requiring hospitalization in a woman who had returned from travel in Uganda. Testing of early convalescent serum demonstrated no evidence of infection with agents that cause tropical febrile illnesses, including VHF. Six months later, in July 2008, the patient requested repeat testing after she learned of the death from MHF of a Dutch tourist who had visited the same bat-roosti... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3103008 Fri, 18 Dec 2009 00:00:00 +0100 3103008 http://www.medworm.com/index.php?rid=3103007&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20019655%26dopt%3DAbstract This report summarizes the investigations in New Mexico and Washington, which suggested that levamisole in cocaine was the likely cause of the agranulocytosis. Health-care providers should consider these findings in the differential diagnosis of agranulocytosis, and public health officials should be aware of cases of agranulocytosis associated with cocaine use. PMID: 20019655 [PubMed - in process] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3103007 Fri, 18 Dec 2009 00:00:00 +0100 3103007 http://www.medworm.com/index.php?rid=3097151&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19959984%26dopt%3DAbstract This report describes the results of that investigation. A total of nine cases of IGM were confirmed during 2006-2008 in Indianapolis, for an annual prevalence of IGM of 2.4 per 100,000 women aged 20-40 years. The prevalence was 12 times higher among Hispanic women. Among IGM patients at the hospital, a median of 5 months elapsed between symptom onset and diagnostic biopsy. Histopathologic evaluations confirmed IGM. In a case-control study of all seven cases and 21 controls from the hospital, case-patients were significantly more likely than controls to have less than a sixth-grade education (odds ratio [OR] = 12.7), a positive tuberculin skin test (OR = undefined), or a medication allergy (OR = 15.0). No other risk factors were significantly associated with case status. Barriers to access... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3097151 Fri, 04 Dec 2009 00:00:00 +0100 3097151 http://www.medworm.com/index.php?rid=3097150&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19959985%26dopt%3DAbstract This report updates a previously published report, provides details on activities implemented during 2008, assesses progress toward the 2010 goal, and evaluates the potential effects of decreased financial support. During 2000--2008, global measles mortality declined by 78%, from an estimated 733,000 deaths in 2000 to 164,000 in 2008, but the reduction in measles mortality has been leveling off since 2007. To reach the 2010 goal, India should fully implement the recommended strategies, and financial support for sustaining measles control in the other 46 priority countries should be secured. PMID: 19959985 [PubMed - indexed for MEDLINE] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3097150 Fri, 04 Dec 2009 00:00:00 +0100 3097150 http://www.medworm.com/index.php?rid=3060670&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19959984%26dopt%3DAbstract This report describes the results of that investigation. A total of nine cases of IGM were confirmed during 2006--2008 in Indianapolis, for an annual prevalence of IGM of 2.4 per 100,000 women aged 20--40 years. The prevalence was 12 times higher among Hispanic women. Among IGM patients at the hospital, a median of 5 months elapsed between symptom onset and diagnostic biopsy. Histopathologic evaluations confirmed IGM. In a case-control study of all seven cases and 21 controls from the hospital, case-patients were significantly more likely than controls to have less than a sixth-grade education (odds ratio [OR] = 12.7), a positive tuberculin skin test (OR = undefined), or a medication allergy (OR = 15.0). No other risk factors were significantly associated with case status. Barriers to acce... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3060670 Fri, 04 Dec 2009 00:00:00 +0100 3060670 http://www.medworm.com/index.php?rid=3060669&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19959985%26dopt%3DAbstract This report updates a previously published report, provides details on activities implemented during 2008, assesses progress toward the 2010 goal, and evaluates the potential effects of decreased financial support. During 2000--2008, global measles mortality declined by 78%, from an estimated 733,000 deaths in 2000 to 164,000 in 2008, but the reduction in measles mortality has been leveling off since 2007. To reach the 2010 goal, India should fully implement the recommended strategies, and financial support for sustaining measles control in the other 46 priority countries should be secured. PMID: 19959985 [PubMed - in process] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3060669 Fri, 04 Dec 2009 00:00:00 +0100 3060669 http://www.medworm.com/index.php?rid=3036279&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19940834%26dopt%3DAbstract Authors: Injection-drug users (IDUs) acquire human immunodeficiency virus (HIV) infection by sharing drug equipment with HIV-infected persons and by engaging in risky sexual behavior. In 2007, injection-drug use was the third most frequently reported risk factor for HIV infection in the United States, after male-to-male sexual contact and high-risk heterosexual contact. To characterize HIV-infected IDUs aged >/=13 years in the United States, CDC analyzed data from the national notifiable disease reporting system for 2004--2007 from the 34 states that had conducted confidential, name-based HIV surveillance since at least 2003. The results of that analysis indicated that, during 2004--2007, 62.2% of IDUs with a new diagnosis of HIV infection were males, 57.5% were blacks or African ... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3036279 Fri, 27 Nov 2009 00:00:00 +0100 3036279 http://www.medworm.com/index.php?rid=3036278&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19940835%26dopt%3DAbstract Authors: Acute human immunodeficiency virus (HIV) infection (AHI) is a highly infectious phase of disease that lasts approximately 2 months and is characterized by nonspecific clinical symptoms. AHI contributes disproportionately to HIV transmission because it is associated with a high level of viremia, despite negative or indeterminate antibody (Ab) tests. Diagnosis of AHI with individual or pooled nucleic acid amplification tests (p-NAAT) can enable infected persons to adopt behaviors that reduce HIV transmission, facilitate partner referral for counseling and testing, and identify social networks of persons with elevated rates of HIV transmission. The national HIV surveillance case definition does not distinguish AHI from other stages of HIV infection, and the frequency of AHI amo... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3036278 Fri, 27 Nov 2009 00:00:00 +0100 3036278 http://www.medworm.com/index.php?rid=3036277&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19940836%26dopt%3DAbstract This report summarizes the ensuing health hazard evaluation conducted by CDC to determine the source of antimony exposure. In February 2009, CDC administered questionnaires to and collected urine samples from two groups of firefighters: 20 firefighters from fire department A who did not wear pants made from antimony-containing fabric, and 42 firefighters from fire department B (also located in Florida) who did. All 20 firefighters from fire department A and 41 (98%) from fire department B had urine antimony concentrations below or within the laboratory reference range. CDC concluded that wearing pants made from antimony-containing fabric was not associated with elevated levels of urinary antimony. Only validated methods (e.g., urine testing) should be used for the determination of antimony... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3036277 Fri, 27 Nov 2009 00:00:00 +0100 3036277 http://www.medworm.com/index.php?rid=3036283&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19940830%26dopt%3DAbstract This report provides an overview of the methodology used and a descriptive analysis of the resulting estimates. The results indicated distinct geographic patterns in diabetes and obesity prevalence in the United States, including high prevalence rates for diabetes (>/=10.6%) and obesity (>/=30.9%) in West Virginia, the Appalachian counties of Tennessee and Kentucky, much of the Mississippi Delta, and a southern belt extending across Louisiana, Mississippi, middle Alabama, south Georgia, and the coastal regions of the Carolinas. Isolated counties, including tribal lands in the western United States, also had high prevalence of diabetes and obesity. This report demonstrates how model-based estimates can identify areas with populations at high risk, providing local public health officia... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3036283 Fri, 20 Nov 2009 00:00:00 +0100 3036283 http://www.medworm.com/index.php?rid=3036282&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19940831%26dopt%3DAbstract Authors: Three years after the introduction and spread of West Nile virus (WNV) in the United States, transmission through blood transfusion and solid organ transplantation was documented in 2002. Within a year, these findings led to nationwide screening of blood donors for WNV. Although screening is extremely sensitive, current methods still do not detect all WNV-infected blood donations, and organ donors are not screened routinely. In October 2008, the Louisiana Department of Health (LDH) was notified of a heart transplant recipient with suspected West Nile neuroinvasive disease (WNND). LDH launched an investigation to confirm the diagnosis and determine whether the organ recipient's infection was derived from the organ donor or blood products the donor received before organ donati... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3036282 Fri, 20 Nov 2009 00:00:00 +0100 3036282 http://www.medworm.com/index.php?rid=3036281&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19940832%26dopt%3DAbstract This report summarizes the clinical and environmental findings of that investigation. Thirty-three confirmed cases involved illness comparable to that associated with previous outbreaks of murine typhus. Illness ranged from mild to severe, with 73% of patients requiring hospitalization. Delayed diagnosis and administration of no or inappropriate antibiotics might have contributed to illness severity. Environmental investigation suggested that opossums and domestic animals likely played a role in the maintenance and spread of R. typhi; however, their precise role in the outbreak has not been determined. These findings underscore the need to increase awareness of murine typhus and communicate appropriate treatment and prevention measures through the distribution of typhus alerts before and t... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3036281 Fri, 20 Nov 2009 00:00:00 +0100 3036281 http://www.medworm.com/index.php?rid=3036280&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19940833%26dopt%3DAbstract Authors: Mumps is a vaccine-preventable viral infection characterized by fever and inflammation of the salivary glands and whose complications include orchitis, deafness, and meningo-encephalitis. In August 2009, CDC was notified of the onset of an outbreak of mumps in a summer camp in Sullivan County, New York. The outbreak has spread and gradually increased in size and is now the largest U.S. mumps outbreak since 2006, when the United States experienced a resurgence of mumps with 6,584 reported cases. On August 18, public health departments in Sullivan County, New York state, and CDC began an investigation into the mumps outbreak, later joined by departments in New York City and other locales. As of October 30, a total of 179 confirmed or probable cases had been identified from mul... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3036280 Fri, 20 Nov 2009 00:00:00 +0100 3036280 http://www.medworm.com/index.php?rid=3000315&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19910909%26dopt%3DAbstract This report summarizes the results of that analysis, which indicated that during 1998-2008, the proportion of U.S. adults who were current cigarette smokers declined 3.5% (from 24.1% to 20.6%). However, the proportion did not change significantly from 2007 (19.8%) to 2008 (20.6%). In 2008, adults aged >or=25 years with low educational attainment had the highest prevalence of smoking (41.3% among persons with a General Educational Development certificate [GED] and 27.5% among persons with less than a high school diploma, compared with 5.7% among those with a graduate degree). Adults with education levels at or below the equivalent of a high school diploma, who comprise approximately half of current smokers, had the lowest quit ratios (2008 range: 39.9% to 48.8%). Evidence-based programs ... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3000315 Fri, 13 Nov 2009 00:00:00 +0100 3000315 http://www.medworm.com/index.php?rid=3000314&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19910910%26dopt%3DAbstract This report summarizes the results, which showed wide variation among states in exposure to SHS in homes (from 3.2% [Arizona] to 10.6% [West Virginia]) and indoor workplaces (from 6.0% [Tennessee] to 17.3% [USVI]). The majority of persons surveyed in the 11 states and USVI reported having smoke-free home rules (from 68.8% [West Virginia] to 85.7% [USVI]). This report also provides the 2008 results for CDC's annual BRFSS-based state-specific estimates of current smoking in 50 states, the District of Columbia (DC), and three territories (Guam, Puerto Rico, and USVI). As in previous years, the results showed substantial variation in self-reported cigarette smoking prevalence (range: 6.5%--27.4%; median for 50 states and DC = 18.4%). Additional legislation is needed to increase the number of s... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3000314 Fri, 13 Nov 2009 00:00:00 +0100 3000314 http://www.medworm.com/index.php?rid=3000313&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19910911%26dopt%3DAbstract This report summarizes U.S. influenza activity from August 30, 2009, defined as the beginning of the 2009-10 influenza season, through October 31, 2009. PMID: 19910911 [PubMed - indexed for MEDLINE] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3000313 Fri, 13 Nov 2009 00:00:00 +0100 3000313 http://www.medworm.com/index.php?rid=3000312&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19910912%26dopt%3DAbstract Authors: Since first reports in April 2009, the 2009 pandemic influenza A (H1N1) virus has spread around the world. The pandemic virus is antigenically distinct from seasonal influenza A (H1N1) viruses targeted by seasonal influenza vaccines. Results from recent serologic studies have suggested that seasonal influenza vaccines are unlikely to provide substantial cross-protection against infection with the pandemic H1N1 virus. However, how serologic results correlate with the complex immune responses that confer clinical protection remains uncertain. To complement the serologic studies and evaluate the effectiveness of 2008-09 trivalent seasonal influenza vaccine against laboratory-confirmed pandemic influenza A (H1N1) illness, CDC used available data to conduct a case-cohort analysis... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=3000312 Fri, 13 Nov 2009 00:00:00 +0100 3000312 http://www.medworm.com/index.php?rid=2972117&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19893479%26dopt%3DAbstract This report summarizes the results of that survey, which found that 43 (84%) programs offered coverage for some form of tobacco-dependence treatment to Medicaid enrollees in traditional fee-for-service (FFS) Medicaid, with four Medicaid programs adding coverage since 2006 and 20 programs adding coverage in the past decade. Only two states (New Mexico and New Jersey) reported access to tobacco-dependence treatments without any limitations or restrictions. Of the 25 states covering pharmacotherapy for Medicaid enrollees in both FFS and managed-care organizations (MCOs), only 13 covered the same tobacco-dependence treatments for enrollees in both populations. Research demonstrates that providing access to comprehensive tobacco-dependence treatments increases quit rates. Providing Medicaid cov... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2972117 Fri, 06 Nov 2009 00:00:00 +0100 2972117 http://www.medworm.com/index.php?rid=2972116&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19893480%26dopt%3DAbstract This report describes this case, which was the second case of human vaccinia infection related to the ORV program. Public health agencies should educate the public, and particularly pet owners, regarding potential hazards associated with handling wildlife rabies vaccine baits and should provide guidance for persons exposed to this vaccine. PMID: 19893480 [PubMed - in process] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2972116 Fri, 06 Nov 2009 00:00:00 +0100 2972116 http://www.medworm.com/index.php?rid=2972115&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19893481%26dopt%3DAbstract This report summarizes the patient's treatment and clinical course. The report highlights the importance of raising public awareness of rabies, particularly the risk for rabies after bat and other wildlife exposures. Health-care providers should maintain a high clinical suspicion for rabies in patients with a recent animal bite history and unexplained encephalitis. PMID: 19893481 [PubMed - in process] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2972115 Fri, 06 Nov 2009 00:00:00 +0100 2972115 http://www.medworm.com/index.php?rid=2947691&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19875978%26dopt%3DAbstract This report describes the results of that analysis, which found that 1,668 persons died from prescription opioid-related overdoses during the period (6.4 deaths per 100,000 per year); 58.9% of decedents were male, the highest percentage of deaths (34.4%) was among persons aged 45-54 years, and 45.4% of deaths were among persons enrolled in Medicaid. The age-adjusted rate of death was 30.8 per 100,000 in the Medicaid-enrolled population, compared with 4.0 per 100,000 in the non-Medicaid population, an age-adjusted relative risk of 5.7. Methadone, oxycodone, and hydrocodone were involved in 64.0%, 22.9%, and 13.9% of deaths, respectively. These findings highlight the prominence of methadone in prescription opioid--related overdose deaths and indicate that the Medicaid population is at high r... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2947691 Fri, 30 Oct 2009 00:00:00 +0100 2947691 http://www.medworm.com/index.php?rid=2947690&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19875979%26dopt%3DAbstract This report summarizes the results, which showed that among 403,981 respondents, 30.7% reported no days of insufficient rest or sleep and 11.1% reported insufficient rest or sleep every day during the preceding 30 days. Females (12.4%) were more likely than males (9.9%) and non-Hispanic blacks (13.3%) were more likely than other racial/ethnic groups to report insufficient rest or sleep. State estimates of 30 days of insufficient rest or sleep ranged from 7.4% in North Dakota to 19.3% in West Virginia. Health-care providers should consider adding an assessment of chronic rest or sleep insufficiency to routine office visits so they can make needed interventions or referrals to sleep specialists. PMID: 19875979 [PubMed - in process] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2947690 Fri, 30 Oct 2009 00:00:00 +0100 2947690 http://www.medworm.com/index.php?rid=2947689&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19875980%26dopt%3DAbstract This report describes isolation of Cronobacter spp. in two nonhospitalized, unrelated infants (one male and one female) in New Mexico in 2008; one infant developed severe brain injury and hydrocephalus, and the other infant died. An investigation by the New Mexico Department of Health (NMDOH) determined that PIF consumption was the only known risk factor in the two cases, although the sources of the Cronobacter spp. could not be determined. Cronobacter spp. were not isolated from sealed canisters of formula associated with the two infants, and clinical isolates from the infants differed by pulsed-field gel electrophoresis (PFGE). However, a Cronobacter organism was isolated from an opened canister of formula consumed by the male infant and was indistinguishable from an isolate from his pos... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2947689 Fri, 30 Oct 2009 00:00:00 +0100 2947689 http://www.medworm.com/index.php?rid=2940938&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19847148%26dopt%3DAbstract This report describes the four introductions and the accompanying analysis. The overall rate of secondary household transmission of laboratory-confirmed pandemic H1N1 was 26% (range: 7%-33%), which is comparable to secondary household attack rates reported for laboratory-confirmed seasonal influenza virus infection. However, additional and more rigorous studies are needed to better understand the secondary attack rates associated with the current pandemic. PMID: 19847148 [PubMed - indexed for MEDLINE] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2940938 Fri, 23 Oct 2009 00:00:00 +0100 2940938 http://www.medworm.com/index.php?rid=2940937&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19847149%26dopt%3DAbstract Authors: Worldwide, rotavirus is the leading cause of severe acute diarrhea in children aged <5 years. In the United States, before introduction of a live, oral pentavalent rotavirus vaccine (RV5) in 2006, rotavirus caused an estimated 20 to 60 deaths, 55,000 to 70,000 hospitalizations, 205,000 to 272,000 emergency department visits, and 410,000 outpatient visits annually. Before 2000, rotavirus had a predictable winter-spring seasonality and geographic pattern in the United States, with activity beginning in the West census region during December-January, extending across the country, and ending in the Northeast region during May-June. A similar but less pronounced trend was observed during 2000-2006. To characterize trends and compare the 2007-08 and 2008-09 rotavirus seasons wi... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2940937 Fri, 23 Oct 2009 00:00:00 +0100 2940937 http://www.medworm.com/index.php?rid=2940936&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19847150%26dopt%3DAbstract This report provides an update on progress toward polio eradication in Nigeria during 2008-2009 and activities planned to interrupt transmission. During 2008-2009, Nigeria was the source for WPV1 transmission to 11 countries and WPV type 3 (WPV3) transmission to four countries. In addition, transmission of circulating type 2 vaccine-derived poliovirus (cVDPV2) has been ongoing since 2005. WPV1 cases decreased 87%, from 574 during January-July 2008 to 73 for the same period in 2009. However, WPV3 cases rose approximately six-fold, from 51 during January-July 2008 to 303 during the same period in 2009, partly because of the increased emphasis on controlling WPV1. The decline in the proportion of children who have never received oral poliovirus vaccine (OPV) in the highest- incidence northern... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2940936 Fri, 23 Oct 2009 00:00:00 +0100 2940936 http://www.medworm.com/index.php?rid=2923842&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19847148%26dopt%3DAbstract This report describes the four introductions and the accompanying analysis. The overall rate of secondary household transmission of laboratory-confirmed pandemic H1N1 was 26% (range: 7%--33%), which is comparable to secondary household attack rates reported for laboratory-confirmed seasonal influenza virus infection. However, additional and more rigorous studies are needed to better understand the secondary attack rates associated with the current pandemic. PMID: 19847148 [PubMed - in process] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2923842 Fri, 23 Oct 2009 00:00:00 +0100 2923842 http://www.medworm.com/index.php?rid=2923841&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19847149%26dopt%3DAbstract Authors: Worldwide, rotavirus is the leading cause of severe acute diarrhea in children aged <5 years. In the United States, before introduction of a live, oral pentavalent rotavirus vaccine (RV5) in 2006, rotavirus caused an estimated 20 to 60 deaths, 55,000 to 70,000 hospitalizations, 205,000 to 272,000 emergency department visits, and 410,000 outpatient visits annually. Before 2000, rotavirus had a predictable winter-spring seasonality and geographic pattern in the United States, with activity beginning in the West census region during December--January, extending across the country, and ending in the Northeast region during May--June. A similar but less pronounced trend was observed during 2000--2006. To characterize trends and compare the 2007--08 and 2008--09 rotavirus seaso... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2923841 Fri, 23 Oct 2009 00:00:00 +0100 2923841 http://www.medworm.com/index.php?rid=2923840&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19847150%26dopt%3DAbstract This report provides an update on progress toward polio eradication in Nigeria during 2008--2009 and activities planned to interrupt transmission. During 2008--2009, Nigeria was the source for WPV1 transmission to 11 countries and WPV type 3 (WPV3) transmission to four countries. In addition, transmission of circulating type 2 vaccine-derived poliovirus (cVDPV2) has been ongoing since 2005. WPV1 cases decreased 87%, from 574 during January--July 2008 to 73 for the same period in 2009. However, WPV3 cases rose approximately six-fold, from 51 during January--July 2008 to 303 during the same period in 2009, partly because of the increased emphasis on controlling WPV1. The decline in the proportion of children who have never received oral poliovirus vaccine (OPV) in the highest- incidence nort... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2923840 Fri, 23 Oct 2009 00:00:00 +0100 2923840 http://www.medworm.com/index.php?rid=2916859&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19834452%26dopt%3DAbstract This report summarizes those findings, which indicated overall state-specific prevalences on January 1, 2007, of 1.3-1.8 per 10,000 males aged 5--24 years. Among MD STARnet subjects, more than 90% of males with DBMD aged >or=15 years used wheelchairs. Nearly 60%percnt; of males with DBMD born during 1983-1987 had survived through 2007, emphasizing the need to develop and implement programs that address lifelong needs of males with DBMD. PMID: 19834452 [PubMed - indexed for MEDLINE] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2916859 Thu, 15 Oct 2009 23:00:00 +0100 2916859 http://www.medworm.com/index.php?rid=2916858&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19834453%26dopt%3DAbstract This report updates continued progress toward global eradication of dracunculiasis since January 2008. At the end of December 2008, dracunculiasis was endemic in six countries (Ethiopia, Ghana, Mali, Niger, Nigeria, and Sudan). The number of indigenous cases of dracunculiasis had decreased 52%, from 9,585 in 2007 to 4,619 in 2008. Of the 1,446 cases that occurred during January-June 2009, 1,413 (98%) were reported from Sudan and Ghana. Currently, insecurity (e.g., sporadic violence or civil unrest) in areas of Sudan and Mali where dracunculiasis is endemic poses the greatest threat to the success of the global dracunculiasis eradication program. PMID: 19834453 [PubMed - indexed for MEDLINE] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2916858 Thu, 15 Oct 2009 23:00:00 +0100 2916858 http://www.medworm.com/index.php?rid=2901881&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19834452%26dopt%3DAbstract This report summarizes those findings, which indicated overall state-specific prevalences on January 1, 2007, of 1.3--1.8 per 10,000 males aged 5--24 years. Among MD STARnet subjects, more than 90% of males with DBMD aged >/=15 years used wheelchairs. Nearly 60%percnt; of males with DBMD born during 1983--1987 had survived through 2007, emphasizing the need to develop and implement programs that address lifelong needs of males with DBMD. PMID: 19834452 [PubMed - in process] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2901881 Thu, 15 Oct 2009 23:00:00 +0100 2901881 http://www.medworm.com/index.php?rid=2901880&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19834453%26dopt%3DAbstract This report updates continued progress toward global eradication of dracunculiasis since January 2008. At the end of December 2008, dracunculiasis was endemic in six countries (Ethiopia, Ghana, Mali, Niger, Nigeria, and Sudan). The number of indigenous cases of dracunculiasis had decreased 52%, from 9,585 in 2007 to 4,619 in 2008. Of the 1,446 cases that occurred during January--June 2009, 1,413 (98%) were reported from Sudan and Ghana. Currently, insecurity (e.g., sporadic violence or civil unrest) in areas of Sudan and Mali where dracunculiasis is endemic poses the greatest threat to the success of the global dracunculiasis eradication program. PMID: 19834453 [PubMed - in process] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2901880 Thu, 15 Oct 2009 23:00:00 +0100 2901880 http://www.medworm.com/index.php?rid=2894993&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19816396%26dopt%3DAbstract This report summarizes the results of the analysis, which indicated that reported influenza vaccination coverage of >or=1 doses was 40.9% for ages 6-23 months, 32.0% for 2-4 years, and 20.8% for 5-17 years. Among adults, reported coverage was 32.1% for persons aged 18--49 years with high-risk conditions, 42.3% for persons 50--64 years, and 67.2% for persons >or=65 years. These results are consistent with previous studies that have found no significant increases in vaccination coverage for any of these age groups over previous seasons. These 2008--09 season estimates provide a baseline for assessing implementation of the 2008 recommendation for school-aged children. Attaining higher coverage rates likely will require additional vaccination programs in schools and expanded vaccination ... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2894993 Thu, 08 Oct 2009 23:00:00 +0100 2894993 http://www.medworm.com/index.php?rid=2894992&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19816397%26dopt%3DAbstract This report summarizes the investigations of these outbreaks, which resulted in a total of approximately 1,000 cases of reported illness, including at least 10 hospitalizations, and prompted closure of one of the three campuses. Median duration of the three outbreaks was 19 days (range: 16-20 days), and the attack rates ranged from 1.5% to 12.9%. Because of the potential for widespread infection and rapid transmission on college campuses, efforts to prevent and control norovirus outbreaks in these settings should focus on promoting hand hygiene, environmental disinfection, and exclusion of ill food workers. PMID: 19816397 [PubMed - indexed for MEDLINE] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2894992 Thu, 08 Oct 2009 23:00:00 +0100 2894992 http://www.medworm.com/index.php?rid=2894991&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19816399%26dopt%3DAbstract This report summarizes the results of those analyses, which indicated that, during 2002-2008, the percentage of schools in which students could not purchase candy or salty snacks not low in fat increased in 37 of 40 states. From 2006 to 2008, the percentage of schools in which students could not purchase soda pop or fruit drinks that were not 100% juice increased in all 34 participating states. Despite these improvements, in 2008, the percentage of schools among states in which students could not purchase sports drinks ranged from 22.7% to 84.8% (state median: 43.7%), and the percentage in which students could not purchase soda pop ranged from 25.6% to 92.8% (state median: 62.9%). The percentage of schools in which students could not purchase candy or salty snacks also varied widely among ... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2894991 Thu, 08 Oct 2009 23:00:00 +0100 2894991 http://www.medworm.com/index.php?rid=2881419&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19816396%26dopt%3DAbstract This report summarizes the results of the analysis, which indicated that reported influenza vaccination coverage of >/=1 doses was 40.9% for ages 6--23 months, 32.0% for 2--4 years, and 20.8% for 5--17 years. Among adults, reported coverage was 32.1% for persons aged 18--49 years with high-risk conditions, 42.3% for persons 50--64 years, and 67.2% for persons >/=65 years. These results are consistent with previous studies that have found no significant increases in vaccination coverage for any of these age groups over previous seasons. These 2008--09 season estimates provide a baseline for assessing implementation of the 2008 recommendation for school-aged children. Attaining higher coverage rates likely will require additional vaccination programs in schools and expanded vaccination... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2881419 Thu, 08 Oct 2009 23:00:00 +0100 2881419 http://www.medworm.com/index.php?rid=2881418&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19816397%26dopt%3DAbstract This report summarizes the investigations of these outbreaks, which resulted in a total of approximately 1,000 cases of reported illness, including at least 10 hospitalizations, and prompted closure of one of the three campuses. Median duration of the three outbreaks was 19 days (range: 16--20 days), and the attack rates ranged from 1.5% to 12.9%. Because of the potential for widespread infection and rapid transmission on college campuses, efforts to prevent and control norovirus outbreaks in these settings should focus on promoting hand hygiene, environmental disinfection, and exclusion of ill food workers. PMID: 19816397 [PubMed - in process] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2881418 Thu, 08 Oct 2009 23:00:00 +0100 2881418 http://www.medworm.com/index.php?rid=2881417&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19816398%26dopt%3DAbstract Authors: On September 15, 2009, four influenza vaccine manufacturers received approval from the Food and Drug Administration for use of influenza A (H1N1) 2009 monovalent influenza vaccines in the prevention of influenza caused by the 2009 pandemic influenza A (H1N1) virus. Both live, attenuated and inactivated influenza A (H1N1) 2009 monovalent vaccine formulations are available; each contains the strain A/California/7/2009(H1N1)pdm. None of the approved influenza A 2009 (H1N1) monovalent vaccines or seasonal influenza vaccines contains adjuvants. CDC's Advisory Committee on Immunization Practices has made recommendations previously for which persons should be the initial targets for immunization with influenza A (H1N1) 2009 monovalent vaccines and has issued guidelines on decisions... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2881417 Thu, 08 Oct 2009 23:00:00 +0100 2881417 http://www.medworm.com/index.php?rid=2881416&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19816399%26dopt%3DAbstract This report summarizes the results of those analyses, which indicated that, during 2002--2008, the percentage of schools in which students could not purchase candy or salty snacks not low in fat increased in 37 of 40 states. From 2006 to 2008, the percentage of schools in which students could not purchase soda pop or fruit drinks that were not 100% juice increased in all 34 participating states. Despite these improvements, in 2008, the percentage of schools among states in which students could not purchase sports drinks ranged from 22.7% to 84.8% (state median: 43.7%), and the percentage in which students could not purchase soda pop ranged from 25.6% to 92.8% (state median: 62.9%). The percentage of schools in which students could not purchase candy or salty snacks also varied widely among... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2881416 Thu, 08 Oct 2009 23:00:00 +0100 2881416 http://www.medworm.com/index.php?rid=2858047&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19798018%26dopt%3DAbstract Authors: Vaccination is the most effective way to prevent influenza-related morbidity and mortality. Annual influenza vaccination was first recommended for children aged 6-23 months in 2004 and for children aged 24-59 months in 2006. In August 2008, the Advisory Committee on Immunization Practices (ACIP) expanded its recommendations to include all children aged 5-18 years, beginning with the 2008-09 influenza season. Among children aged 6 months--8 years, previously unvaccinated children and children who received only 1 vaccine dose for the first time in the preceding influenza season are recommended to receive 2 influenza vaccine doses. Children aged 9-18 years are recommended to receive 1 vaccine dose. To update previous estimates by assessing influenza vaccination coverage among c... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2858047 Thu, 01 Oct 2009 23:00:00 +0100 2858047 http://www.medworm.com/index.php?rid=2858046&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19798019%26dopt%3DAbstract Authors: Infants and children aged <2 years often require medical care for influenza and have higher rates of influenza-related hospitalization than any other age group except persons aged >or=65 years. Since 2004, the Advisory Committee on Immunization Practices (ACIP) has recommended seasonal influenza vaccination for all children aged 6-23 months. Full vaccination for these children requires receipt of 2 doses in the current influenza season if they have not been vaccinated previously or received a single dose during the preceding season. To assess influenza vaccination coverage among children aged 6-23 months during September-December of the 2007-08 influenza season, CDC analyzed data from the 2008 National Immunization Survey (NIS). The results of those analyses indicated ... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2858046 Thu, 01 Oct 2009 23:00:00 +0100 2858046 http://www.medworm.com/index.php?rid=2858045&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19798020%26dopt%3DAbstract This report describes the assessment, which found that services to residents were disrupted longer and more extensively than anticipated, and that the greatest need among surveyed households was for assistance obtaining food (26.8%). The results suggest the need to prepare communities at risk for hurricanes for longer than the commonly anticipated 3-5 day recovery period. These findings also highlight the importance of rapid assessments of health and basic needs in such areas, even when communities sustain little structural loss and few injuries. Responders should prepare to support such areas that might experience health-related effects exacerbated by protracted recovery periods. PMID: 19798020 [PubMed - in process] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2858045 Thu, 01 Oct 2009 23:00:00 +0100 2858045 http://www.medworm.com/index.php?rid=2858044&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19798021%26dopt%3DAbstract This report summarizes the demographic and clinical findings from these cases and the laboratory evaluation of the specimens. Evidence of concurrent bacterial infection was found in specimens from 22 (29%) of the 77 patients, including 10 caused by Streptococcus pneumoniae (pneumococcus). Duration of illness was available for 17 of the 22 patients; median duration was 6 days (range: 1-25 days). Fourteen of 18 patients for whom information was available sought medical care while ill, and eight (44%) were hospitalized. These findings confirm that bacterial lung infections are occurring among patients with fatal cases of 2009 pandemic influenza A (H1N1) and underscore both the importance of pneumococcal vaccination for persons at increased risk for pneumococcal pneumonia and the need for earl... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2858044 Thu, 01 Oct 2009 23:00:00 +0100 2858044 http://www.medworm.com/index.php?rid=2834773&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19779397%26dopt%3DAbstract This report summarizes the findings from this performance assessment, which indicated that, compared with rRT-PCR, the sensitivity of the RIDT for detecting infection in patients with 2009 pandemic influenza A (H1N1) was 47%, and the specificity was 86%. Sensitivity and specificity did not vary substantially by the presence or absence of CDC-defined influenza-like illness (ILI) or by time from symptom onset to specimen acquisition. In this group of patients, although positive RIDT results performed well in predicting confirmed infection with pandemic H1N1 virus (positive predictive value: 92%), negative tests did not accurately predict the absence of infection (negative predictive value: 32%). These results affirm recent CDC recommendations against using negative RIDT results for managemen... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2834773 Thu, 24 Sep 2009 23:00:00 +0100 2834773 http://www.medworm.com/index.php?rid=2834772&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19779398%26dopt%3DAbstract This report describes the results of that analysis, which indicated that Ixodes scapularis (the tick vector for Anaplasma phagocytophilum) was broadly distributed in Maine, whereas Amblyomma americanum (the tick vector for Erhlichia chaffeenisis) was scarce. Moreover, 95% of physician-reported ehrlichiosis cases lacked a concurrent serologic assessment to exclude anaplasmosis, suggesting that antibody cross-reactivity might have resulted in misclassification. In 2008, Maine modified case classification to enhance specificity; ehrlichiosis cases that lack a concurrent test for anaplasmosis are now classified as suspect rather than probable and therefore are not included in national surveillance summaries. The accuracy of case classification and surveillance can be improved by educating heal... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2834772 Thu, 24 Sep 2009 23:00:00 +0100 2834772 http://www.medworm.com/index.php?rid=2834771&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19779399%26dopt%3DAbstract This report summarizes the progress made during 2001- -2008 toward improving measles control in AFR. During 2001- -2008 estimated MCV1 coverage increased from 57% to 73%, SIAs vaccinated approximately 398 million children, and reported measles cases decreased by 93%, from 492,116 in 2001 to 32,278 in 2008. By 2005, global measles deaths had decreased by 60%, and the AFR goal had been achieved; AFR adopted a new goal to reduce deaths by 90%, compared with 2000, and that goal was achieved in 2006. However, inaccuracies in reported vaccination coverage exist, surveillance is suboptimal, and measles outbreaks continue to occur in AFR countries. Further progress in measles control will require full implementation of recommended strategies, including validation of vaccination coverage. PMID:... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2834771 Thu, 24 Sep 2009 23:00:00 +0100 2834771 http://www.medworm.com/index.php?rid=2834770&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19779400%26dopt%3DAbstract This report provides the rationale for the new recommendation and updates and replaces previous recommendations for revaccination with MCV4. PMID: 19779400 [PubMed - in process] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2834770 Thu, 24 Sep 2009 23:00:00 +0100 2834770 http://www.medworm.com/index.php?rid=2809981&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19763074%26dopt%3DAbstract This report summarizes the results, which indicated that adults aged =65 years made an estimated 51,700 initial visits to EDs for nonfatal scald burns during 2001-2006, for an average of 8,620 visits per year and an estimated average annual rate of 23.8 visits per 100,000 population. Two thirds of visits were made by women. Most (76%) of the nonfatal scald injuries occurred at home; 42% were associated with hot food and 30% with hot water or steam. The findings in this report highlight the need for effective scald-prevention programs targeted to older persons. PMID: 19763074 [PubMed - indexed for MEDLINE] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2809981 Thu, 17 Sep 2009 23:00:00 +0100 2809981 http://www.medworm.com/index.php?rid=2809980&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19763075%26dopt%3DAbstract This report summarizes results from the 2008 NIS-Teen and, for the first time, includes estimates for each of the 50 states and selected local areas. Nationally, vaccination coverage for the three most recently recommended adolescent vaccinations and one childhood vaccination increased from 2007 to 2008: MCV4 (from 32.4% to 41.8%), Tdap (from 30.4% to 40.8%), >/=1 dose of HPV4 (from 25.1% to 37.2%), and >/=2 doses of VAR among those without disease history (from 18.8% to 34.1%). However, substantial variability in vaccination coverage was observed in 2008 among state and local areas and by race/ethnicity and poverty status. For the first time, the Healthy People 2010 target of 90% coverage among adolescents aged 13-15 years was met for MMR and HepB. Public health agencies should cont... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2809980 Thu, 17 Sep 2009 23:00:00 +0100 2809980 http://www.medworm.com/index.php?rid=2809979&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19763076%26dopt%3DAbstract This report updates previous summaries and describes VDPVs detected worldwide during January 2008-June 2009. During this period, 1) two new outbreaks of circulating VDPVs (cVDPVs) (accounting for 4-20 cases) were identified in the Democratic Republic of Congo and Ethiopia; 2) a previously identified outbreak in Nigeria ultimately resulted in a cumulative total of 292 cases; 3) two newly identified paralyzed immunodeficient persons in Argentina and the United States were found to excrete VDPVs; and 4) isolated VDPVs were found among persons and environmental samples in 11 countries. All countries need to maintain 1) high rates of poliovirus vaccination coverage to prevent VDPV spread and 2) sensitive poliovirus surveillance to detect VDPVs. PMID: 19763076 [PubMed - indexed for MEDLINE] ... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2809979 Thu, 17 Sep 2009 23:00:00 +0100 2809979 http://www.medworm.com/index.php?rid=2809978&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19763077%26dopt%3DAbstract This report introduces the new recommendation and outlines the underlying epidemiologic and programmatic rationale. PMID: 19763077 [PubMed - indexed for MEDLINE] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2809978 Thu, 17 Sep 2009 23:00:00 +0100 2809978 http://www.medworm.com/index.php?rid=2809977&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19763078%26dopt%3DAbstract This report summarizes the indications for Hiberix use and provides guidance on Hib booster dose administration based on increasing vaccine supplies. Vaccination recommendations in this report update the previous advisory on Hib booster administration (June 26, 2009), which advised that children with deferred booster doses receive it at the next regularly scheduled visit. Vaccination providers are now recommended to begin recall of children in need of the booster dose when feasible and monovalent Hib vaccine supply in the office is adequate. PMID: 19763078 [PubMed - indexed for MEDLINE] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2809977 Thu, 17 Sep 2009 23:00:00 +0100 2809977 http://www.medworm.com/index.php?rid=2809976&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19763079%26dopt%3DAbstract This report provides an overview of influenza activity during April-August 2009 and recommendations for the upcoming 2009-10 influenza season. Pandemic H1N1 influenza activity peaked in the United States during May and June and declined during July and early August. However, levels of influenza activity remained above normal for summer months, and focal outbreaks were reported throughout the summer. During the last 2 weeks of August, pandemic H1N1 influenza activity increased in certain areas of the United States. Clinicians and public health officials should be aware that these recent increases might signal an early start to the 2009-10 influenza season, with pandemic H1N1 influenza viruses predominating at least initially. PMID: 19763079 [PubMed - indexed for MEDLINE] (Source: MMWR M... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2809976 Thu, 17 Sep 2009 23:00:00 +0100 2809976 http://www.medworm.com/index.php?rid=2786779&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19745803%26dopt%3DAbstract Authors: Initial testing of the 2009 pandemic influenza A (H1N1) virus found it susceptible to neuraminidase inhibitors (oseltamivir and zanamivir) and resistant to adamantanes (amantadine and rimantadine). Neuraminidase inhibitors have been used widely for treatment and chemoprophylaxis of 2009 pandemic influenza A (H1N1); however, sporadic cases of oseltamivir-resistant 2009 pandemic influenza A (H1N1) virus infection have been reported worldwide, including nine U.S. cases identified as of September 4. On July 14, CDC was contacted by a physician at a summer camp in North Carolina regarding two cases of influenza-like illness (ILI) in adolescent girls receiving oseltamivir chemoprophylaxis during an ILI outbreak that had begun June 18. The two girls stayed in the same cabin, and bo... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2786779 Thu, 10 Sep 2009 23:00:00 +0100 2786779 http://www.medworm.com/index.php?rid=2786778&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19745804%26dopt%3DAbstract This report summarizes the results, which showed that in Georgia, the prevalence of influenza vaccination during the woman's most recent pregnancy increased from 10.4% in 2004 to 15.5% in 2006. In Rhode Island, vaccination prevalence increased from 21.9% in 2004 to 33.4% in 2007. During 2006 in Georgia, the most common reasons for not receiving vaccination were, "I don't normally get the flu vaccination" (69.4%), and "my physician did not mention anything about a flu vaccine during my pregnancy" (44.5%). Increased efforts are needed to assess vaccine coverage during pregnancy and to educate providers and pregnant women about ACIP and ACOG recommendations on providing intramuscular, inactivated influenza vaccine during any trimester of pregnancy. PMID: 19745804 [PubMed - in process] (So... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2786778 Thu, 10 Sep 2009 23:00:00 +0100 2786778 http://www.medworm.com/index.php?rid=2786777&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19745805%26dopt%3DAbstract This report describes completion of Phase I containment activities by WPR countries, and updates a previous report on Phase I completion in the European Region and global progress. PMID: 19745805 [PubMed - in process] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2786777 Thu, 10 Sep 2009 23:00:00 +0100 2786777 http://www.medworm.com/index.php?rid=2770380&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19730406%26dopt%3DAbstract Authors: Children aged <5 years or with certain chronic medical conditions are at increased risk for complications and death from influenza. Because of this increased risk, the Advisory Committee on Immunization Practices (ACIP) has prioritized influenza prevention and treatment for children aged <5 years and for those with certain chronic medical and immunosuppressive conditions. CDC monitors child influenza deaths through its influenza-associated pediatric mortality reporting system. As of August 8, 2009, CDC had received reports of 477 deaths associated with 2009 pandemic influenza A (H1N1) in the United States, including 36 deaths among children aged <18 years. To characterize these cases, CDC analyzed data from April to August 2009. The results of that analysis indicate... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2770380 Thu, 03 Sep 2009 23:00:00 +0100 2770380 http://www.medworm.com/index.php?rid=2770379&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19730407%26dopt%3DAbstract This report summarizes the results of that investigation, which detected cannabinoids in a recovered sample of the brownies. Two patients sought medical attention, and one patient's urine and serum tested positive for 11-nor-9-carboxy-delta 9-tetrahydrocannabinol (THC-COOH), a marijuana metabolite. The findings in this report demonstrate the utility of a collaborative investigation by public health and law enforcement.The findings also underscore the need to consider marijuana as a potential contaminant during foodborne illness investigations and the importance of identifying drug metabolites by testing of clinical specimens soon after symptom onset. PMID: 19730407 [PubMed - in process] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2770379 Thu, 03 Sep 2009 23:00:00 +0100 2770379 http://www.medworm.com/index.php?rid=2770378&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19730408%26dopt%3DAbstract This report updates previous reports and summarizes GPLN activities and detection of WPVs and VDPVs during January 2008-June 2009. During this period, GPLN tested 247,794 fecal samples from 127,566 acute flaccid paralysis cases, from which 14,279 (5.8%) poliovirus isolates (vaccine-related and WPV) were detected, including 4,280 (1.7%) WPVs from 22 countries. GPLN laboratory capacity and capabilities remain an integral part of surveillance for polioviruses and efforts to eliminate polio from the remaining areas of circulation. PMID: 19730408 [PubMed - in process] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2770378 Thu, 03 Sep 2009 23:00:00 +0100 2770378 http://www.medworm.com/index.php?rid=2745667&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19713879%26dopt%3DAbstract This report summarizes laboratory-confirmed cases identified during April 24-July 25 and provides clinical and epidemiologic data for a subset of those cases. By July 25, a total of 1,557 laboratory-confirmed cases had been reported to CDPH. The overall attack rate was highest among children aged 5-14 years (147 per 100,000 population), which was 14 times higher than for adults aged >or=60 years. A total of 205 (13%) patients were hospitalized, with the highest rate observed among children aged 0-4 years (25 per 100,000), followed by children aged 5-14 years (11 per 100,000). These findings affirm prevention strategies that target children and young adults, who are at a disproportionate risk for infection and hospitalization. The Advisory Committee on Immunization Practices (ACIP) recom... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2745667 Thu, 27 Aug 2009 23:00:00 +0100 2745667 http://www.medworm.com/index.php?rid=2745666&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19713880%26dopt%3DAbstract This report describes the results of those analyses, which determined that the number of viruses identified as 2009 pandemic influenza A (H1N1) rapidly overtook the number identified as seasonal influenza, and the peak weekly consultation rate for ILI was three times the peak rate in New Zealand during the same period in 2008. These findings demonstrate the value of using integrated epidemiologic and virologic surveillance in New Zealand to monitor the scope of an influenza epidemic, identify circulating strains, assist public health control measures, and guide effective use of influenza vaccines and antivirals. PMID: 19713880 [PubMed - in process] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2745666 Thu, 27 Aug 2009 23:00:00 +0100 2745666 http://www.medworm.com/index.php?rid=2745665&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19713881%26dopt%3DAbstract This report describes the 2008 NIS coverage estimates for this series and individual vaccines, 7-valent pneumococcal conjugate vaccine (PCV7), >or=2 doses of hepatitis A vaccine (HepA), and hepatitis B vaccination received in the first 3 days of life (HepB birth dose) among children born during January 2005-June 2007. In 2008, 4:3:1:3:3:1 series coverage was 76.1%, compared with 77.4% in 2007; >or=90% coverage was maintained for all recommended series vaccines, except >or=4 doses of diphtheria, tetanus, and acellular pertussis (DTaP) vaccine. Coverage with >or=3 doses of Haemophilus influenzae type b vaccine (Hib) decreased from 2007, likely because of the shortage of Hib vaccine and the recommendation to defer the routine Hib vaccine booster dose administered at age 12-15 mont... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2745665 Thu, 27 Aug 2009 23:00:00 +0100 2745665 http://www.medworm.com/index.php?rid=2741831&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19696717%26dopt%3DAbstract This report summarizes the results of that survey, which indicated that 38% of Georgia high school students reported current alcohol use, and 19% reported binge drinking in the past 30 days. Among students who reported current alcohol use, 44% reported that the usual type of alcohol they consumed was liquor (e.g., bourbon, rum, scotch, vodka, or whiskey), 58% reported that their usual location of alcohol consumption was at another person's home, and 37% reported that their usual source of alcohol was someone giving it to them. These results underscore the need for further research in Georgia and other states on underage drinking behavior, motives, and access to alcohol, which could facilitate development of additional effective intervention strategies. Evidence-based interventions should b... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2741831 Thu, 20 Aug 2009 23:00:00 +0100 2741831 http://www.medworm.com/index.php?rid=2741830&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19696718%26dopt%3DAbstract Authors: Persons employed in high-risk lead-related occupations can transport lead dust home from a worksite through clothing, shoes, tools, or vehicles. During 2008, the Maine Childhood Lead Poisoning Prevention Program (MCLPPP) identified 55 new cases of elevated (>or=15 microg/dL) venous blood lead levels (BLLs) among children aged <6 years through mandated routine screening. Although 90% of childhood lead poisoning cases in Maine during 2003-2007 had been linked to lead hazards in the child's home, no lead-based paint or dust or water with elevated lead levels were found inside the homes associated with six of the 2008 cases (i.e., five families, including one family with two affected siblings). An expanded environmental investigation determined that these six children were... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2741830 Thu, 20 Aug 2009 23:00:00 +0100 2741830 http://www.medworm.com/index.php?rid=2741829&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19696719%26dopt%3DAbstract This report summarizes the case histories and resulting investigations and highlights the importance of 1) close monitoring for antiviral drug resistance among immunosuppressed patients receiving treatment for novel influenza A (H1N1) virus infection and 2) the implications for infection control. PMID: 19696719 [PubMed - indexed for MEDLINE] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2741829 Thu, 20 Aug 2009 23:00:00 +0100 2741829 http://www.medworm.com/index.php?rid=2723443&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19696717%26dopt%3DAbstract This report summarizes the results of that survey, which indicated that 38% of Georgia high school students reported current alcohol use, and 19% reported binge drinking in the past 30 days. Among students who reported current alcohol use, 44% reported that the usual type of alcohol they consumed was liquor (e.g., bourbon, rum, scotch, vodka, or whiskey), 58% reported that their usual location of alcohol consumption was at another person's home, and 37% reported that their usual source of alcohol was someone giving it to them. These results underscore the need for further research in Georgia and other states on underage drinking behavior, motives, and access to alcohol, which could facilitate development of additional effective intervention strategies. Evidence-based interventions should b... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2723443 Thu, 20 Aug 2009 23:00:00 +0100 2723443 http://www.medworm.com/index.php?rid=2723442&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19696718%26dopt%3DAbstract Authors: Persons employed in high-risk lead-related occupations can transport lead dust home from a worksite through clothing, shoes, tools, or vehicles. During 2008, the Maine Childhood Lead Poisoning Prevention Program (MCLPPP) identified 55 new cases of elevated (>/=15 mug/dL) venous blood lead levels (BLLs) among children aged <6 years through mandated routine screening. Although 90% of childhood lead poisoning cases in Maine during 2003--2007 had been linked to lead hazards in the child's home, no lead-based paint or dust or water with elevated lead levels were found inside the homes associated with six of the 2008 cases (i.e., five families, including one family with two affected siblings). An expanded environmental investigation determined that these six children were ex... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2723442 Thu, 20 Aug 2009 23:00:00 +0100 2723442 http://www.medworm.com/index.php?rid=2723441&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19696719%26dopt%3DAbstract This report summarizes the case histories and resulting investigations and highlights the importance of 1) close monitoring for antiviral drug resistance among immunosuppressed patients receiving treatment for novel influenza A (H1N1) virus infection and 2) the implications for infection control. PMID: 19696719 [PubMed - in process] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2723441 Thu, 20 Aug 2009 23:00:00 +0100 2723441 http://www.medworm.com/index.php?rid=2702785&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19680219%26dopt%3DAbstract This report describes the results of that analysis, which indicated that one data source, Texas poison centers, received reports of 54 persons with storm-related CO exposures during the surveillance period. Another data source, the Undersea and Hyperbaric Medical Society (UHMS) hyperbaric oxygen treatment database, reported that 15 persons received hyperbaric oxygen treatment for storm-related CO poisoning. Medical examiners, public health officials, and hospitals in Texas reported that seven persons died from storm-related CO poisoning. Among the data sources, the percentage of reported storm-related CO exposures caused by improper generator use ranged from 82% to 87%. These findings underscore the need for effective prevention messages during storm preparation, warnings, and response per... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2702785 Thu, 13 Aug 2009 23:00:00 +0100 2702785 http://www.medworm.com/index.php?rid=2702784&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19680220%26dopt%3DAbstract This report summarizes the results of that investigation, which determined that the patients did not have LD and that nonsterile ice used to cool saline-filled syringes for bronchoalveolar lavage was the likely source of Legionella contamination of these clinical specimens. Ice was supplied by two ice machines, which became contaminated by heavy Legionella colonization within the center's potable water supply during a 6-month period (February--July 2008). Findings from the investigation underscore the importance of adherence to recommended infection control practices and surveillance for LD in health-care settings. Clinicians and endoscopy technicians should ensure that nonsterile items are not introduced during bronchoscopy procedures. PMID: 19680220 [PubMed - in process] (Source: MMW... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2702784 Thu, 13 Aug 2009 23:00:00 +0100 2702784 http://www.medworm.com/index.php?rid=2702783&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19680221%26dopt%3DAbstract Authors: Artemisinins are a class of compounds that include artesunate, artemether, and artemisinin and have potent antimalarial activity. In combination with other drugs (artemisinin combination therapy), these compounds are the first-line treatment recommended by the World Health Organization for Plasmodium falciparum infections. Artemisinins have been available in the United States without a prescription as herbal supplements for at least 10 years; these supplements are marketed for general health maintenance and for treatment of parasitic infections and cancers. On August 27, 2008, CDC was notified of a patient who developed hepatitis after a 1-week course of an herbal supplement containing artemisinin. The patient had abdominal pain, dark urine, and laboratory results consistent... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2702783 Thu, 13 Aug 2009 23:00:00 +0100 2702783 http://www.medworm.com/index.php?rid=2682168&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19661855%26dopt%3DAbstract This report summarizes those results, which indicated that 88.0% of postpartum women reported current use of at least one contraceptive method; 61.7% reported using a method defined as highly effective, 20.0% used a method defined as moderately effective, and 6.4% used less effective methods. Rates of using highly effective contraceptive methods postpartum were lowest among Asian/Pacific Islanders (35.3%), women who had wanted to get pregnant sooner (49.9%), women aged >or=35 years (53.0%), and women who had no prenatal care (54.5%). State policy makers and health-care providers can use these results to promote use of highly effective contraception among postpartum women and target interventions for those with particularly low rates of usage, including women with no prenatal care. P... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2682168 Thu, 06 Aug 2009 23:00:00 +0100 2682168 http://www.medworm.com/index.php?rid=2682167&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19661856%26dopt%3DAbstract Authors: The recent appearance and worldwide spread of novel influenza A (H1N1) virus has highlighted the need to evaluate commercially available, widely used, rapid influenza diagnostic tests (RIDTs) for their ability to detect these viral antigens in respiratory clinical specimens. As an initial assessment, CDC conducted an evaluation of multiple RIDTs. Sixty-five clinical respiratory specimens collected during April-May 2009 that had previously tested positive either for novel influenza A (H1N1) or for seasonal influenza A (H1N1) or A (H3N2) viruses by real-time reverse transcription--polymerase chain reaction (rRT-PCR) assay were used in the evaluation. The results showed that, although the RIDTs were capable of detecting novel A (H1N1) virus from respiratory specimens containing... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2682167 Thu, 06 Aug 2009 23:00:00 +0100 2682167 http://www.medworm.com/index.php?rid=2682166&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19661857%26dopt%3DAbstract This report updates Advisory Committee on Immunization Practices (ACIP) recommendations for routine poliovirus vaccination. These updates aim to 1) emphasize the importance of the booster dose at age >/=4 years, 2) extend the minimum interval from dose 3 to dose 4 from 4 weeks to 6 months, 3) add a precaution for the use of minimum intervals in the first 6 months of life, and 4) clarify the poliovirus vaccination schedule when specific combination vaccines are used. PMID: 19661857 [PubMed - in process] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2682166 Thu, 06 Aug 2009 23:00:00 +0100 2682166 http://www.medworm.com/index.php?rid=2662835&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19644439%26dopt%3DAbstract This report describes the subsequent investigations conducted by the Virginia Department of Health and CDC to identify the source of infection and any cases of contact transmission. Of the patient's 102 possible contacts, seven had underlying risk factors for developing serious vaccinia infection. Investigators found no evidence of contact transmission and, based on the results of molecular typing, further concluded that the patient had been exposed to a VACV strain that had contaminated the seed stock from the laboratory where the patient worked. This case underscores the importance of adherence to ACIP vaccination recommendations for laboratory workers and use of safety precautions when working with nonhighly attenuated VACV. PMID: 19644439 [PubMed - in process] (Source: MMWR Morb Mo... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2662835 Thu, 30 Jul 2009 23:00:00 +0100 2662835 http://www.medworm.com/index.php?rid=2662834&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19644440%26dopt%3DAbstract This report summarizes that investigation, which identified 21 cattle-related deaths. These deaths occurred throughout the year, and decedents tended to be older (aged =60 years) (67%) and male (95%). Except in one case, the cause of death was blunt force trauma to the head or chest. Circumstances associated with these deaths included working with cattle in enclosed areas (33%), moving or herding cattle (24%), loading (14%), and feeding (14%). One third of the deaths were caused by animals that had previously exhibited aggressive behavior. To reduce the risk for death from cattle-caused injuries, farmers and ranchers should be aware of and follow recommended practices for safe livestock-handling facilities and proper precautions for working with cattle, especially cattle that have exhibite... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2662834 Thu, 30 Jul 2009 23:00:00 +0100 2662834 http://www.medworm.com/index.php?rid=2662833&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19644441%26dopt%3DAbstract This report presents the results of that assessment, which indicated that, in 2007, state electronic disease surveillance systems varied widely and were in various stages of implementation. Each state had either custom-built systems or purchased systems that were customizable, with associated disease modules to meet its own surveillance needs. As interoperability becomes the standard for electronic data sharing, more states will face customization costs and the need to hire more technical specialists who can manage health information and exchange. Further collaboration and support from surveillance and health-care IT stakeholders with public health will be needed to improve the efficacy and quality of electronic disease surveillance systems. PMID: 19644441 [PubMed - in process] (Source... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2662833 Thu, 30 Jul 2009 23:00:00 +0100 2662833 http://www.medworm.com/index.php?rid=2639811&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19629026%26dopt%3DAbstract Authors: Childhood obesity continues to be a leading public health concern that disproportionately affects low-income and minority children. Children who are obese in their preschool years are more likely to be obese in adolescence and adulthood and to develop diabetes, hypertension, hyperlipidemia, asthma, and sleep apnea. One of the Healthy People 2010 objectives (19-3) is to reduce to 5% the proportion of children and adolescents who are obese. CDC's Pediatric Nutrition Surveillance System (PedNSS) is the only source of nationally compiled obesity surveillance data obtained at the state and local level for low-income, preschool-aged children participating in federally funded health and nutrition programs. To describe progress in reducing childhood obesity, CDC examined trends and ... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2639811 Thu, 23 Jul 2009 23:00:00 +0100 2639811 http://www.medworm.com/index.php?rid=2639810&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19629027%26dopt%3DAbstract This report summarizes the clinical characteristics of those four cases. Patients were aged 7-17 years and were admitted with signs of influenza-like illness (ILI) and seizures or altered mental status. Three of the four patients had abnormal electroencephalograms (EEGs). In all four patients, novel influenza A (H1N1) viral RNA was detected in nasopharyngeal specimens but not in cerebrospinal fluid (CSF). Antiviral therapy included oseltamivir (four patients) and rimantadine (three patients). All four patients recovered fully and had no neurologic sequelae at discharge. These findings indicate that, as with seasonal influenza, neurologic complications can occur after respiratory tract infection with novel influenza A (H1N1) virus. For children who have ILI accompanied by unexplained seizur... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2639810 Thu, 23 Jul 2009 23:00:00 +0100 2639810 http://www.medworm.com/index.php?rid=2639809&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19629028%26dopt%3DAbstract Authors: Plague is a life-threatening fleaborne disease caused by the bacterium Yersinia pestis. The most common clinical form is bubonic plague, which is characterized by high fever and regional lymphadenitis. Without treatment, infection can spread from lymph nodes to the lungs, resulting in pneumonic plague and the potential for person-to-person transmission through respiratory droplets. In November 2006, the Uganda Ministry of Health received reports of an increase in bubonic plague cases and a possible outbreak of pneumonic plague among residents in the Arua and Nebbi districts. In response, the Uganda Ministry of Health and CDC conducted a joint investigation in the two districts during November 28-December 30, 2006. Overall, 127 clinical plague cases were identified, along wit... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2639809 Thu, 23 Jul 2009 23:00:00 +0100 2639809 http://www.medworm.com/index.php?rid=2614540&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19609246%26dopt%3DAbstract This report describes the three previously unpublished cases. All were Asian immigrants or family members who traveled to Asia to live or to visit friends or relatives and had not been vaccinated for JE. The three patients experienced fever with mental status changes, but JE was recognized early in the clinical course of only one patient. All recovered, but two patients had residual neurologic deficits. Travelers to Asia might be at increased risk for JE because of rural itineraries and lack of perceived risk. To protect against JE, travelers should seek medical advice on protective measures, including possible JE vaccination, well in advance of departure for Asia. While in Asia, travelers should use personal protective measures to reduce the risk for mosquito bites. Health-care providers ... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2614540 Thu, 16 Jul 2009 23:00:00 +0100 2614540 http://www.medworm.com/index.php?rid=2614539&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19609247%26dopt%3DAbstract Authors: Obesity is associated with increased health-care costs, reduced quality of life, and increased risk for premature death. Common morbidities associated with obesity include coronary heart disease, hypertension and stroke, type 2 diabetes, and certain types of cancer. As of 2007, no state had met the Healthy People 2010 objective to reduce to 15% the prevalence of obesity among U.S. adults. An overarching goal of Healthy People 2010 is to eliminate health disparities among racial/ethnic populations. To assess differences in prevalence of obesity among non-Hispanic blacks, non-Hispanic whites, and Hispanics, CDC analyzed data from Behavioral Risk Factor Surveillance System (BRFSS) surveys conducted during 2006--2008. Overall, for the 3-year period, 25.6% of non-Hispanic blacks,... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2614539 Thu, 16 Jul 2009 23:00:00 +0100 2614539 http://www.medworm.com/index.php?rid=2614538&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19609248%26dopt%3DAbstract This report describes the results of that analysis, which identified 190 cases (87 confirmed and 103 probable), for an average annual incidence of 0.4 cases per 100,000 population statewide. Most cases occurred during the summer months (78%) and among males (66%). Analysis of 121 clinical charts revealed that children were more likely than adults to be diagnosed with glandular tularemia, whereas adults were more likely to be diagnosed with pneumonic tularemia. Sixty-three (52%) patients were hospitalized; one patient died. Among 78 cases with a documented exposure source, 72% were associated with tick bite. In 33 (85%) of 39 culture-confirmed cases, the laboratory received specimens without any indication of suspicion of a tularemia diagnosis. Clinicians should 1) be aware of the range of ... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2614538 Thu, 16 Jul 2009 23:00:00 +0100 2614538 http://www.medworm.com/index.php?rid=2614537&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19609249%26dopt%3DAbstract This report summarizes the clinical characteristics of a series of 10 patients with novel influenza A (H1N1) virus infection and ARDS at a tertiary-care ICU in Michigan. Of the 10 patients, nine were obese (body mass index [BMI] >or=30), including seven who were extremely obese (BMI =40); five had pulmonary emboli; and nine had multiorgan dysfunction syndrome (MODS). Three patients died. Clinicians should be aware of the potential for severe complications of novel influenza A (H1N1) virus infection, particularly in extremely obese patients. PMID: 19609249 [PubMed - in process] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2614537 Thu, 16 Jul 2009 23:00:00 +0100 2614537 http://www.medworm.com/index.php?rid=2591984&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19590490%26dopt%3DAbstract This report summarizes the epidemiologic investigation and the ensuing public health response. A total of 20 persons, mostly household contacts, received postexposure prophylaxis (PEP) because of potential exposure to rabies virus from the patient. The findings underscore the difficulties encountered in the diagnosis and epidemiologic investigations of imported human rabies cases and the importance of a coordinated public health response across multiple international jurisdictions. PMID: 19590490 [PubMed - in process] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2591984 Thu, 09 Jul 2009 23:00:00 +0100 2591984 http://www.medworm.com/index.php?rid=2591983&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19590491%26dopt%3DAbstract This report summarizes the results of the study, which found that three organizations collected samples for NAA testing and three for culture. In total, approximately 30,000 tests were performed; 5.4% of rectal gonorrhea, 8.9% of rectal chlamydia, 5.3% of pharyngeal gonorrhea, and 1.6% of pharyngeal chlamydia tests were positive. These results demonstrate that gay-focused community-based organizations can detect large numbers of gonorrhea and chlamydia cases and might reach MSM not being tested elsewhere. Public health officials could consider providing support to certain community-based organizations to facilitate testing and treatment of gonorrhea and chlamydia. PMID: 19590491 [PubMed - in process] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2591983 Thu, 09 Jul 2009 23:00:00 +0100 2591983 http://www.medworm.com/index.php?rid=2591982&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19590492%26dopt%3DAbstract This report updates previous reports and summarizes India's progress toward polio eradication since January 2007, as of May 29, 2009. In 2005, the government of India introduced the use of monovalent oral polio vaccine type 1 (mOPV1), which has higher efficacy against WPV1 than does trivalent oral polio vaccine (tOPV), in supplementary immunization activities. After a multistate WPV1 outbreak in 2006, preferential use of mOPV1 was accelerated and WPV1 cases decreased from 83 in 2007 to 18 during January-May 2009. A resurgence of WPV3 cases in Uttar Pradesh in 2007 led to an outbreak in Bihar. SIAs using monovalent type 3 OPV (mOPV3) were expanded in 2007, and the number of WPV3 cases declined from 794 in 2007 to 41 during January-May 2009. Simultaneously interrupting transmission in high-r... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2591982 Thu, 09 Jul 2009 23:00:00 +0100 2591982 http://www.medworm.com/index.php?rid=2577543&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19574951%26dopt%3DAbstract This report updates previous findings regarding hepatitis A vaccination coverage, providing estimates based on National Immunization Survey (NIS) data for 2006 and 2007. From 2006 to 2007, estimated national hepatitis A vaccination coverage levels among children aged 24-35 months who received at least 1 dose increased from 26.3% to 47.4%. The increase in hepatitis A vaccination coverage likely is the result of the expanded 2006 ACIP recommendations; adherence to these recommendations should lead to further declines in hepatitis A incidence in the United States. PMID: 19574951 [PubMed - indexed for MEDLINE] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2577543 Thu, 02 Jul 2009 23:00:00 +0100 2577543 http://www.medworm.com/index.php?rid=2577542&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19574952%26dopt%3DAbstract This report summarizes findings of the outbreak investigation and laboratory testing. The overall attack rate for the most recent outbreak was approximately 14% among patients and 7% among employees. The outbreak was unusual in that it lasted 63 days, versus 24-27 days for the two previous outbreaks in 2007. Person-to-person transmission was suggested by a prolonged and dispersed epidemic curve and lack of illness in some wards, although all wards were served by one central kitchen. Barriers to conducting adequate hygiene (e.g., lack of handwashing stations) and multiple lapses in infection control (e.g., noncompliance with staff wellness policies) were identified. Timely and sustained implementation of comprehensive and effective infection control measures are needed to prevent and contai... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2577542 Thu, 02 Jul 2009 23:00:00 +0100 2577542 http://www.medworm.com/index.php?rid=2544547&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19553901%26dopt%3DAbstract Authors: Without effective antiretroviral therapy, most persons infected with human immunodeficiency virus (HIV) will progress to acquired immunodeficiency syndrome (AIDS) in approximately 10 years (1). Testing, diagnosis, and medical care soon after HIV infection and before developing AIDS can prevent unnecessary morbidity and mortality and reduce further HIV transmission. Persons who receive an AIDS diagnosis concurrently or soon after receiving their initial HIV diagnosis (e.g., <or=3 years) represent missed opportunities for prevention and treatment (2). A Healthy People 2010 developmental objective is to increase the proportion of new HIV infections diagnosed before progression to AIDS. To characterize late HIV testing, CDC examined data from 1996-2005 from 34 states with con... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2544547 Thu, 25 Jun 2009 23:00:00 +0100 2544547 http://www.medworm.com/index.php?rid=2544546&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19553902%26dopt%3DAbstract Authors: In the United States, an estimated 1.1 million persons were living with human immunodeficiency virus (HIV) infection in 2006, of whom an estimated 232,700 were undiagnosed and unaware they were HIV infected. Adolescents and young adults aged 13-24 years represented 4.4% of the total but disproportionately comprised an estimated 9.9% of the undiagnosed cases. Early diagnosis of HIV infection facilitates medical interventions and enables infected persons to reduce high-risk behavior and the likelihood of further HIV transmission. To determine the extent to which adolescents are being tested for HIV, data from the 2007 Youth Risk Behavior Survey (YRBS) (the most recent data available) were analyzed. The results indicated that nationwide, 12.9% of all high school students had ev... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2544546 Thu, 25 Jun 2009 23:00:00 +0100 2544546 http://www.medworm.com/index.php?rid=2544545&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19553903%26dopt%3DAbstract This report describes progress toward measles elimination in the WPR through 2008. Measles likely has been eliminated or nearly eliminated in 24 of the 37 countries and areas in the WPR (referred to in this report as countries). However, large numbers of measles cases continue to be reported from several countries. During 2008, a total of 131,441 confirmed measles cases (98.4 per million population) were reported from China and 11,015 cases (86.1 per million population) from Japan, two countries that account for 82% of the region's population and >97% of its confirmed measles cases. Intensified efforts by WPR countries, particularly China and Japan, will be required to achieve the 2012 goal. PMID: 19553903 [PubMed - indexed for MEDLINE] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2544545 Thu, 25 Jun 2009 23:00:00 +0100 2544545 http://www.medworm.com/index.php?rid=2544544&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19553904%26dopt%3DAbstract Authors: On December 13, 2007, certain lots of Haemophilus influenzae type b (Hib) vaccine marketed as PedvaxHIB (monovalent Hib vaccine) and Comvax (Hib-HepB vaccine), and manufactured by Merck & Co., Inc., were recalled voluntarily, and the company temporarily suspended production of these vaccines. To conserve the limited supply of Hib-containing vaccines, CDC, in consultation with the Advisory Committee on Immunization Practices (ACIP), the American Academy of Family Physicians (AAFP), and the American Academy of Pediatrics (AAP), on December 18, 2007, recommended that vaccination providers temporarily defer the routine Hib vaccine booster dose administered to most healthy children at age 12-15 months. PMID: 19553904 [PubMed - indexed for MEDLINE] (Source: MMWR Morb Morta... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2544544 Thu, 25 Jun 2009 23:00:00 +0100 2544544 http://www.medworm.com/index.php?rid=2544549&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19543198%26dopt%3DAbstract This report summarizes the results of that analysis, which indicated that the overall prevalence of alcohol intoxication (i.e., blood alcohol concentration [BAC] at or above the legal limit of 0.08 g/dL) was nearly 24% among suicide decedents tested for alcohol, with the highest percentage occurring among American Indian/Alaska Natives (AI/ANs) (37%), followed by Hispanics (29%) and persons aged 20-49 years (28%). These results indicate that many populations can benefit from comprehensive and culturally appropriate suicide-prevention strategies that include efforts to reduce alcohol consumption, especially programs that focus on persons aged <50 years. PMID: 19543198 [PubMed - indexed for MEDLINE] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2544549 Thu, 18 Jun 2009 23:00:00 +0100 2544549 http://www.medworm.com/index.php?rid=2544548&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19543199%26dopt%3DAbstract Authors: Soon after identification of novel influenza A (H1N1) virus infections in the United States in mid-April 2009, CDC provided interim recommendations to reduce the risk for transmission in health-care settings. These included recommendations on use of personal protective equipment (PPE), management of health-care personnel (HCP) after unprotected exposures, and instruction of ill HCP not to report to work. To better understand the risk for acquiring infection with the virus among HCP and the impact of infection-control recommendations, CDC solicited reports of infected HCP from state health departments. As of May 13, CDC had received 48 reports of confirmed or probable infections with novel influenza A (H1N1) virus; of these, 26 reports included detailed case reports with info... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2544548 Thu, 18 Jun 2009 23:00:00 +0100 2544548 http://www.medworm.com/index.php?rid=2544552&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19521332%26dopt%3DAbstract This report summarizes epidemiologic data on FBDOs reported during 2006 (the most recent year for which data have been analyzed). A total of 1,270 FBDOs were reported, resulting in 27,634 cases and 11 deaths. Among the 624 FBDOs with a confirmed etiology, norovirus was the most common cause, accounting for 54% of outbreaks and 11,879 cases, followed by Salmonella (18% of outbreaks and 3,252 cases). Among the 11 reported deaths, 10 were attributed to bacterial etiologies (six Escherichia coli O157:H7, two Listeria monocytogenes, one Salmonella serotype Enteritidis, and one Clostridium botulinum), and one was attributed to a chemical (mushroom toxin). Among outbreaks caused by a single food vehicle, the most common food commodities to which outbreak-related cases were attributed were poultry... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2544552 Thu, 11 Jun 2009 23:00:00 +0100 2544552 http://www.medworm.com/index.php?rid=2544551&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19521333%26dopt%3DAbstract This report summarizes the investigation of the outbreak and highlights the importance of splash park design, operation, access to hygiene facilities, and public education in prevention of waterborne cryptosporidiosis and other infectious agents. Educational efforts and enactment of regulations requiring enhanced disinfection technology, exclusion of persons with diarrhea, adequate hygiene facilities, and preconstruction consultation with health departments might decrease the risk for recreational water illness at splash parks. PMID: 19521333 [PubMed - indexed for MEDLINE] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2544551 Thu, 11 Jun 2009 23:00:00 +0100 2544551 http://www.medworm.com/index.php?rid=2544550&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19521334%26dopt%3DAbstract Authors: Historically, brucellosis from Brucella suis infection occurred among workers in swine slaughterhouses. In 1972, the U.S. Department of Agriculture National Brucellosis Eradication Program was expanded to cover swine herds. Subsequent elimination of brucellosis in commercial swine resulted in a decrease in B. suis-associated illness in humans. Currently, swine-associated brucellosis in humans in the United States is predominantly associated with exposure to infected feral swine (i.e., wild boar or wild hogs). In May and July 2008, CDC was contacted by the state health departments in South Carolina and Pennsylvania regarding two cases of brucellosis possibly linked to feral swine hunts. Both state health departments contacted the state health department in Florida, where the ... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2544550 Thu, 11 Jun 2009 23:00:00 +0100 2544550 http://www.medworm.com/index.php?rid=2544556&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19498335%26dopt%3DAbstract This report presents the first estimate of national prevalence of diagnosed TS among a national sample of U.S. children and adolescents aged 6-17 years. Based on data from the 2007 National Survey of Children's Health (NSCH), the estimated prevalence of a lifetime diagnosis of TS by parent report was 3.0 per 1,000. A diagnosis of TS was almost three times as likely for boys as girls, twice as likely for persons aged 12-17 years than for those aged 6-11 years, and twice as likely for non-Hispanic white persons than for Hispanic and non-Hispanic black persons. Among persons ever diagnosed with TS, 79% also had been diagnosed with at least one co-occurring mental health or neurodevelopmental condition. CDC sponsors efforts by the Tourette Syndrome Association to educate health-care providers ... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2544556 Thu, 04 Jun 2009 23:00:00 +0100 2544556 http://www.medworm.com/index.php?rid=2544555&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19498336%26dopt%3DAbstract This report updates a previous report on the outbreak in Mexico and summarizes public health actions taken to date by Mexico to monitor and control the outbreak. During March 1-May 29, national surveillance identified 41,998 persons with acute respiratory illness; specimens from 25,127 (59.8%) patients were tested, of which 5,337 (21.2%) were positive for novel influenza A (H1N1) virus infection by real-time reverse transcription--polymerase chain reaction (rRT-PCR). As of May 29, 97 patients with laboratory-confirmed infection had died. Epidemiologic evidence to date suggests that the outbreak likely peaked nationally in late April, although localized cases continue to be identified. PMID: 19498336 [PubMed - indexed for MEDLINE] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2544555 Thu, 04 Jun 2009 23:00:00 +0100 2544555 http://www.medworm.com/index.php?rid=2544554&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19498337%26dopt%3DAbstract Authors: In 2006, 33 U.S. states and five territories had confidential, name-based, human immunodeficiency virus (HIV) infection reporting; among territories, Puerto Rico had the second highest rate of HIV infection. To characterize the HIV epidemic in Puerto Rico in 2006 (the year with the most recent available data), the Puerto Rico Department of Health and CDC analyzed data on diagnoses of HIV infection (including infections that occurred in 2006 and in previous years) and used a stratified extrapolation approach developed by CDC to generate HIV incidence estimates (the number of persons newly infected with HIV in 2006). The results indicated that, in 2006, an estimated 1,440 persons aged >or=13 years were newly infected with HIV in Puerto Rico, resulting in an estimated incide... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2544554 Thu, 04 Jun 2009 23:00:00 +0100 2544554 http://www.medworm.com/index.php?rid=2544553&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19498338%26dopt%3DAbstract This report describes the results of that analysis, which indicated that use of the new standards would have increased the prevalence of global acute malnutrition on average by 14% and would have increased the prevalence of severe acute malnutrition on average by 100%. Admissions to feeding programs would have increased by 56% for moderately malnourished children and by 260% for severely malnourished children. For programs in Darfur, this would have resulted in approximately 23,200 more children eligible for therapeutic feeding programs. For the immediate future, the prevalence of acute malnutrition in children should be reported using both the old WHO/CDC/NCHS reference and the new WHO standards. More research is needed to better ascertain the validity of the admission criteria based on t... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2544553 Thu, 04 Jun 2009 23:00:00 +0100 2544553 http://www.medworm.com/index.php?rid=2544558&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19478724%26dopt%3DAbstract This report describes the incident and public health response, and highlights the importance of unified risk communication. After a potential large-scale exposure to rabies virus, guidance from clinicians should be consistent with ACIP recommendations to ensure appropriate use of rabies PEP. PMID: 19478724 [PubMed - indexed for MEDLINE] (Source: MMWR Morb Mortal Wkl...) MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2544558 Thu, 28 May 2009 23:00:00 +0100 2544558 http://www.medworm.com/index.php?rid=2544557&cid=s_28386_54_f&fid=28386&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19478725%26dopt%3DAbstract Authors: Despite substantial reductions in U.S. infant mortality during the past several decades, black-white disparities in infant mortality persist. Among 40 states with sufficient numbers of black infant deaths to generate reliable rates for the years 2002-2004, Wisconsin had the highest black infant mortality rate (IMR) at 17.6 deaths per 1,000 live births, approximately three times the state rate for whites. However, in contrast to trends in Wisconsin and the other 39 states, the black IMR in Dane County, Wisconsin, has declined substantially, achieving parity with whites and meeting Healthy People 2010 objective 16-1 for reducing fetal and infant deaths. The county rate declined 67%, from 19.4 per 1,000 live births for the period 1990-2001 to 6.4 for the period 2002-2007. To ga... MMWR Morb Mortal Wkl... journals http://www.medworm.com/rss/comments.php?id=2544557 Thu, 28 May 2009 23:00:00 +0100 2544557