MMWR. Morbidity and mortality weekly report
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MMWR Morb. Mortal. Wkly. Rep. · Jan 2011
Practice GuidelineUpdated recommendations for use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccine from the Advisory Committee on Immunization Practices, 2010.
Despite sustained high coverage for childhood pertussis vaccination, pertussis remains poorly controlled in the United States. A total of 16,858 pertussis cases and 12 infant deaths were reported in 2009. ⋯ In October 2010, ACIP recommended expanded use of Tdap. This report provides the updated recommendations, summarizes the safety and effectiveness data considered by ACIP, and provides guidance for implementing the recommendations.
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MMWR Morb. Mortal. Wkly. Rep. · Jan 2011
Vital signs: nonfatal, motor vehicle--occupant injuries (2009) and seat belt use (2008) among adults --- United States.
Motor vehicle crashes are the leading cause of death in the United States among persons aged 5-34 years. Seat belts have been shown to be the most effective method for reducing injuries among adults in the event of a crash. ⋯ Seat belt use is a proven method to reduce motor vehicle--occupant injuries, and the results of this analysis demonstrate that states with primary enforcement laws have higher prevalence of self-reported seat belt use. To help reduce the number of motor vehicle--occupant injuries, 19 states without primary enforcement laws should consider enacting them.
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MMWR Morb. Mortal. Wkly. Rep. · Jan 2011
Post-earthquake injuries treated at a field hospital --- Haiti, 2010.
On January 12, 2010, a 7.0-magnitude earthquake struck Haiti, resulting in an estimated 222,570 deaths and 300,000 persons with injuries. The University of Miami Global Institute/Project Medishare (UMGI/PM) established the first field hospital in Port-au-Prince, Haiti, after the earthquake. To characterize injuries and surgical procedures performed by UMGI/PM and assess specialized medical, surgical, and rehabilitation needs, UMGI/PM and CDC conducted a retrospective medical record review of all available inpatient records for the period January 13-May 28, 2010. ⋯ The most common injury-related surgical procedures were wound debridement/skin grafting, treatment for orthopedic trauma, and surgical amputation. Among patient records with documented injury-related mechanisms, 162 (28%) indicated earthquake-related injuries. Earthquake preparedness planning for densely populated areas in resource-limited settings such as Haiti should account for injury-related medical, surgical, and rehabilitation needs that must be met immediately after the event and during the recovery phase, when altered physical and social environments can contribute to a continued elevated need for inpatient management of injuries.
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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.