MMWR. Morbidity and mortality weekly report
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On October 19, 2010, the Haitian Ministry of Public Health and Population (MSPP) was notified of unusually high numbers of patients from Artibonite and Centre departments who had acute watery diarrhea and dehydration, in some cases leading to death. Within 4 days, the National Public Health Laboratory (LNSP) in Haiti isolated Vibrio cholerae serogroup O1, serotype Ogawa, from stool specimens obtained from patients in the affected areas by an investigation team from MSPP and CDC Haiti. ⋯ As of November 13, MSPP had reported 16,111 persons hospitalized with acute watery diarrhea and 992 cholera deaths, 620 of which occurred among hospitalized patients. Prevention and control measures implemented by MSPP with assistance from governmental and nongovernmental partners include 1) providing better access to treated drinking water; 2) providing education on improvement of sanitation, hygiene, and food preparation practices; 3) advising ill persons to begin using oral rehydration solution immediately and seek health care at the onset of watery diarrhea; 4) enhancing cholera treatment capacity at existing health-care institutions; and 5) establishing cholera treatment centers.
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An outbreak of cholera is ongoing in Haiti. On October 21, 2010, toxigenic Vibrio cholerae O1, serotype Ogawa, biotype El Tor was identified by the National Laboratory of Public Health of the Ministry of Public Health and Population in Haiti. Identification of the isolate was confirmed by CDC. Antimicrobial susceptibility testing of selected V. cholerae O1 isolates conducted at the National Laboratory of Public Health and at CDC demonstrated susceptibility to tetracycline (susceptibility to this drug predicts doxycycline susceptibility), ciprofloxacin, and kanamycin; and resistance to trimethoprim-sulfamethoxazole, furazolidone, nalidixic acid, sulfisoxazole, and streptomycin.
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MMWR Morb. Mortal. Wkly. Rep. · Nov 2010
State-specific prevalence of cigarette smoking and smokeless tobacco use among adults --- United States, 2009.
The health consequences of cigarette smoking and smokeless tobacco use both have been well documented, including increased risk for lung, throat, oral, and other types of cancers. To assess state-specific current cigarette smoking and smokeless tobacco use among adults, CDC analyzed data from the 2009 Behavioral Risk Factor Surveillance System (BRFSS). This report summarizes the results of that analysis, which indicated wide variation in self-reported cigarette smoking prevalence (range: 6.4% [U. ⋯ From 0.9% (Puerto Rico) to 13.7% (Wyoming) of current smokers reported also using smokeless tobacco. Clinicians should identify all tobacco use in their patients and advise those who use any tobacco product to quit. The World Health Organization (WHO) recommends implementing this approach in combination with other measures, including raising excise taxes on tobacco and strengthening smoke-free policies to prevent tobacco-related deaths.