MMWR. Morbidity and mortality weekly report
-
MMWR Morb. Mortal. Wkly. Rep. · Feb 2010
Adult use of prescription opioid pain medications - Utah, 2008.
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 >or=18 years had been prescribed an opioid pain medication during the preceding 12 months. ⋯ Approximately 1.8% of all adults reported using prescription opioids that had not been prescribed to them. In 2009, the Utah Department of Health published a set of guidelines to reduce morbidity, mortality, and disability associated with misuse or abuse of prescription drugs, especially narcotics. The guidelines include recommendations that providers 1) counsel patients to dispose of unused medication properly once the pain has resolved and 2) prescribe no more than the number of doses needed based on the usual duration of pain severe enough to require opioids for that condition.
-
MMWR Morb. Mortal. Wkly. Rep. · Feb 2010
Case ReportsTransmission of yellow fever vaccine virus through breast-feeding - Brazil, 2009.
In April, 2009, the state health department of Rio Grande do Sul, Brazil, was notified by the Cachoeira do Sul municipal health department of a case of meningoencephalitis requiring hospitalization in an infant whose mother recently had received yellow fever vaccine during a postpartum visit. The Field Epidemiology Training Program of the Secretariat of Surveillance in Health of the Brazilian Ministry of Health assisted state and municipal health departments with an investigation. This report summarizes the results of that investigation, which determined that the infant acquired yellow fever vaccine virus through breast-feeding. ⋯ The infant recovered completely, was discharged after 24 days of hospitalization, and has had normal neurodevelopment and growth through age 6 months. The findings in this report provide documentation that yellow fever vaccine virus can be transmitted via breast-feeding. Administration of yellow fever vaccine to breast-feeding women should be avoided except in situations where exposure to yellow fever viruses cannot be avoided or postponed.
-
MMWR Morb. Mortal. Wkly. Rep. · Jan 2010
Case ReportsBacterial meningitis after intrapartum spinal anesthesia - New York and Ohio, 2008-2009.
In June 2007, the Healthcare Infection Control Practices Advisory Committee (HICPAC) recommended for the first time that surgical masks be worn by spinal procedure operators to prevent infections associated with these procedures. HICPAC made the recommendation in response to several reports of meningitis following myelography procedures. In September 2008, three bacterial meningitis cases in postpartum women were reported to the New York State Department of Health (NYSDOH); in May 2009, two similar cases were reported to the Ohio Department of Health. ⋯ 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.
-
MMWR Morb. Mortal. Wkly. Rep. · Jan 2010
"Choking game" awareness and participation among 8th graders--Oregon, 2008.
The "choking game" is an activity in which persons strangulate themselves to achieve euphoria through brief hypoxia. It is differentiated from autoerotic asphyxiation. The activity can cause long-term disability and death among youths. ⋯ 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 strangulation activities and their serious health effects; they should watch for signs of participation in strangulation activities, especially among youths with suspected substance use or mental health risk factors.
-
MMWR Morb. Mortal. Wkly. Rep. · Jan 2010
Patients hospitalized with 2009 pandemic influenza A (H1N1) - New York City, May 2009.
The first cases of 2009 pandemic influenza A (H1N1) in New York City occurred in April 2009, raising many questions about how best to contain the epidemic. To rapidly assess the severity of influenza illness and identify persons at highest risk for severe infection, the New York City (NYC) Department of Health and Mental Hygiene (DOHMH) reviewed the medical charts of the first 99 patients with laboratory confirmed H1N1 admitted to any NYC hospital. The purpose of the review was to characterize the demographics of the first hospitalized patients, identify associated underlying medical conditions, describe the course and severity of disease, and examine the use of antiviral medications. ⋯ 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 importance of early antiviral therapy for patients with underlying risk conditions.