MMWR. Morbidity and mortality weekly report
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MMWR Morb. Mortal. Wkly. Rep. · Jan 2012
Notes from the field : use of tetanus, diphtheria, and pertussis vaccine (Tdap) in an Emergency Department - Arizona, 2009-2010.
Because of an increasing incidence of reported pertussis cases attributed to waning immunity among adults and adolescents, the Advisory Committee on Immunization Practices (ACIP) in 2005 recommended administration of a new, combined tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap) for adolescents and adults aged 11-64 years. ACIP recommended that they receive a single dose of Tdap to replace tetanus and diphtheria toxoid vaccine (Td) for booster immunization against tetanus and diphtheria if they had not previously received Tdap. Adults aged ≥65 years were to receive Td according to ACIP recommendations. To learn whether these age-specific recommendations were being followed in an emergency department (ED), the charts of a sample of patients receiving tetanus vaccines at a large ED were reviewed.
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In November 2010, the Ministry of Health of the proposed nation of South Sudan requested CDC assistance in investigating a recent increase and geographic clustering of an illness resulting in head nodding and seizures. The outbreak was suspected to be nodding syndrome, an unexplained neurologic condition characterized by episodes of repetitive dropping forward of the head, often accompanied by other seizure-like activity, such as convulsions or staring spells. The condition predominantly affects children aged 5-15 years and has been reported in South Sudan from the states of Western and Central Equatoria and in Northern Uganda and southern Tanzania. ⋯ This difference was driven by the 25 pairs in Maridi (88.0% among case-patients, 44.0% among controls, mOR=9.3); among the 13 pairs in Witto, no significant association with onchocerciasis (known as river blindness) was observed. Although onchocerciasis was more prevalent among case-patients, whether infection preceded or followed nodding syndrome onset was unknown. Priorities for nodding syndrome investigations include improving surveillance to monitor the number of cases and their geographic distribution and continued work to determine the etiology of the syndrome.
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MMWR Morb. Mortal. Wkly. Rep. · Jan 2012
Prepregnancy contraceptive use among teens with unintended pregnancies resulting in live births - Pregnancy Risk Assessment Monitoring System (PRAMS), 2004-2008.
Approximately 400,000 teens aged 15-19 years give birth every year in the United States (1), and the teen birth rate remains the highest in the developed world. Teen childbearing is a public health concern because teen mothers are more likely to experience negative social outcomes, including school dropout. In addition, infants of teen mothers are more likely to be low birth weight and have lower academic achievement, and daughters of teen mothers are more likely to become teen mothers themselves. ⋯ This report describes estimated rates of self-reported prepregnancy contraceptive use among white, black, and Hispanic teen females aged 15-19 years with unintended pregnancies resulting in live births. Approximately one half (50.1%) of these teens were not using any method of birth control when they got pregnant, and of these, nearly one third (31.4%) believed they could not get pregnant at the time; 21.0% used a highly effective contraceptive method (although less than 1% used one of the most effective methods, such as an intrauterine device [IUD]); 24.2% used the moderately effective method of condoms; and 5.1% used the least effective methods, such as rhythm and withdrawal. To decrease teen birth rates, efforts are needed to reduce or delay the onset of sexual activity, provide factual information about the conditions under which pregnancy can occur, increase teens' motivation and negotiation skills for pregnancy prevention, improve access to contraceptives, and encourage use of more effective contraceptive methods.
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MMWR Morb. Mortal. Wkly. Rep. · Jan 2012
CDC grand rounds: prescription drug overdoses - a U.S. epidemic.
In 2007, approximately 27,000 unintentional drug overdose deaths occurred in the United States, one death every 19 minutes. Prescription drug abuse is the fastest growing drug problem in the United States. ⋯ In addition, for every unintentional overdose death related to an opioid analgesic, nine persons are admitted for substance abuse treatment, 35 visit emergency departments, 161 report drug abuse or dependence, and 461 report nonmedical uses of opioid analgesics. Implementing strategies that target those persons at greatest risk will require strong coordination and collaboration at the federal, state, local, and tribal levels, as well as engagement of parents, youth influencers, health-care professionals, and policy-makers.