MMWR. Morbidity and mortality weekly report
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MMWR Morb. Mortal. Wkly. Rep. · Mar 2012
Comparative StudyVital signs: preventing Clostridium difficile infections.
Clostridium difficile infection (CDI) is a common and sometimes fatal health-care-associated infection; the incidence, deaths, and excess health-care costs resulting from CDIs in hospitalized patients are all at historic highs. Meanwhile, the contribution of nonhospital health-care exposures to the overall burden of CDI, and the ability of programs to prevent CDIs by implementing CDC recommendations across a range of hospitals, have not been demonstrated previously. ⋯ More needs to be done to prevent CDIs; major reductions will require antibiotic stewardship along with infection control applied to nursing homes and ambulatory-care settings as well as hospitals. State health departments and partner organizations have shown leadership in preventing CDIs in hospitals and can prevent more CDIs by extending their programs to cover other health-care settings.
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MMWR Morb. Mortal. Wkly. Rep. · Mar 2012
Case ReportsExposure to nitrogen dioxide in an indoor ice arena - New Hampshire, 2011.
In January 2011, the New Hampshire Department of Health and Human Services (NHDHHS) investigated acute respiratory symptoms in a group of ice hockey players. The symptoms, which included cough, shortness of breath, hemoptysis, and chest pain or tightness, were consistent with exposure to nitrogen dioxide gas (NO), a byproduct of combustion. Environmental and epidemiologic investigations were begun to determine the source of the exposure and identify potentially exposed persons. ⋯ The highest attack rate was among the hockey players (87.9%). After repair of the ventilation system, no additional cases were identified. To prevent similar episodes, ice arena operators should ensure ventilation systems and alarms are operating properly and that levels of NO and carbon monoxide (CO) are monitored continuously for early detection of increased gas levels.
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MMWR Morb. Mortal. Wkly. Rep. · Feb 2012
Community-based opioid overdose prevention programs providing naloxone - United States, 2010.
Drug overdose death rates have increased steadily in the United States since 1979. In 2008, a total of 36,450 drug overdose deaths (i.e., unintentional, intentional [suicide or homicide], or undetermined intent) were reported, with prescription opioid analgesics (e.g., oxycodone, hydrocodone, and methadone), cocaine, and heroin the drugs most commonly involved . Since the mid-1990s, community-based programs have offered opioid overdose prevention services to persons who use drugs, their families and friends, and service providers. ⋯ This report summarizes the findings for the 48 programs that completed the survey and the 188 local programs represented by the responses. Since the first opioid overdose prevention program began distributing naloxone in 1996, the respondent programs reported training and distributing naloxone to 53,032 persons and receiving reports of 10,171 overdose reversals. Providing opioid overdose education and naloxone to persons who use drugs and to persons who might be present at an opioid overdose can help reduce opioid overdose mortality, a rapidly growing public health concern.
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MMWR Morb. Mortal. Wkly. Rep. · Feb 2012
CDC grand rounds: dietary sodium reduction - time for choice.
Excess dietary sodium is a major contributor to hypertension (high blood pressure) and a critical public health issue in the United States. Nearly one in three U. S. adults, or 68 million persons, has hypertension, and half of those do not have their condition under control. ⋯ Reducing sodium intake to 2,300 mg/day potentially could prevent 11 million cases of hypertension and save billions of dollars in health-care expenditures; reducing sodium intake further would yield additional benefits. To achieve those reductions and help consumers make healthful choices, expanded educational efforts and monitoring of the sodium content of the food supply are needed. Increased availability of lower sodium products and reductions in the amount of sodium in foods served or sold in the marketplace also are needed.
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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.