MMWR. Morbidity and mortality weekly report
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MMWR Morb. Mortal. Wkly. Rep. · Dec 2009
Agranulocytosis associated with cocaine use - four States, March 2008-November 2009.
In April 2008, a clinical reference laboratory in New Mexico notified the New Mexico Department of Health (NMDOH) of a cluster of unexplained agranulocytosis cases confirmed by bone marrow histopathology during the preceding 2 months. NMDOH began an investigation, which identified cocaine use as a common exposure in 11 cases of otherwise unexplained agranulocytosis during April 2008-November 2009. In the midst of the NMDOH investigation, in November 2008, public health officials in British Columbia and Alberta, Canada, reported detecting levamisole (an antihelminthic drug used mainly in veterinary medicine and a known cause of agranulocytosis) from clinical specimens and drug paraphernalia of cocaine users with agranulocytosis. ⋯ According to the Drug Enforcement Administration (DEA), as of July 2009, 69% of seized cocaine lots coming into the United States contained levamisole as an added agent. This report summarizes the investigations in New Mexico and Washington, which suggested that levamisole in cocaine was the likely cause of the agranulocytosis. Health-care providers should consider these findings in the differential diagnosis of agranulocytosis, and public health officials should be aware of cases of agranulocytosis associated with cocaine use.
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MMWR Morb. Mortal. Wkly. Rep. · Dec 2009
Safety of influenza A (H1N1) 2009 monovalent vaccines - United States, October 1-November 24, 2009.
The Food and Drug Administration (FDA) licensed the first 2009 influenza A (H1N1) monovalent vaccines ("H1N1 vaccines") on September 15, 2009. The H1N1 vaccines are available as a live, attenuated monovalent vaccine (LAMV) for intranasal administration and as monovalent, inactivated, split-virus or subunit vaccines for injection (MIV). The licensure and manufacturing processes for the monovalent H1N1 vaccines were the same as those used for seasonal trivalent inactivated (TIV) or trivalent live, attenuated influenza vaccine (LAIV); none of these vaccines contains an adjuvant. ⋯ No increase in any adverse events under surveillance has been seen in VSD data. Many agencies are using multiple systems to monitor H1N1 vaccine safety. Health-care providers and the public are encouraged to report adverse health events that occur after vaccination.
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MMWR Morb. Mortal. Wkly. Rep. · Nov 2009
State-specific secondhand smoke exposure and current cigarette smoking among adults - United States, 2008.
Secondhand smoke (SHS) causes immediate and long-term adverse health effects in nonsmoking adults and children, including heart disease and lung cancer, and SHS exposure occurs primarily in homes and workplaces. Smoke-free policies, including not allowing smoking anywhere inside the home (i.e., having a smoke-free home rule), are the best way to provide protection from exposure to SHS. To assess SHS exposure in homes and indoor workplaces and the prevalence of smoke-free home rules, CDC analyzed 2008 Behavioral Risk Factor Surveillance System (BRFSS) data from 11 states and the U. ⋯ As in previous years, the results showed substantial variation in self-reported cigarette smoking prevalence (range: 6.5%--27.4%; median for 50 states and DC = 18.4%). Additional legislation is needed to increase the number of smoke-free workplaces and other public places. Health-care providers should continue to encourage persons to make their homes completely smoke-free.
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MMWR Morb. Mortal. Wkly. Rep. · Oct 2009
Overdose deaths involving prescription opioids among Medicaid enrollees - Washington, 2004-2007.
During 1999-2006, the number of poisoning deaths in the United States nearly doubled, from approximately 20,000 to 37,000, largely because of overdose deaths involving prescription opioid painkillers. This increase coincided with a nearly fourfold increase in the use of prescription opioids nationally. In Washington, in 2006, the rate of poisoning involving opioid painkillers was significantly higher than the national rate. ⋯ Methadone, oxycodone, and hydrocodone were involved in 64.0%, 22.9%, and 13.9% of deaths, respectively. These findings highlight the prominence of methadone in prescription opioid--related overdose deaths and indicate that the Medicaid population is at high risk. Efforts to minimize this risk should focus on assessing the patterns of opioid prescribing to Medicaid enrollees and intervening with Medicaid enrollees who appear to be misusing these drugs.
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MMWR Morb. Mortal. Wkly. Rep. · Oct 2009
Prevalence of Duchenne/Becker muscular dystrophy among males aged 5-24 years - four states, 2007.
Muscular dystrophies are a group of genetic diseases characterized by progressive skeletal muscle weakness and muscle cell death with replacement of muscle cells by fibrosis and fat. The most common muscular dystrophy in children is Duchenne muscular dystrophy (DMD), which predominantly affects males. Historically, DMD has resulted in loss of ambulation between ages 7 and 13 years and death in the teens or 20s. ⋯ This report summarizes those findings, which indicated overall state-specific prevalences on January 1, 2007, of 1.3-1.8 per 10,000 males aged 5--24 years. Among MD STARnet subjects, more than 90% of males with DBMD aged >or=15 years used wheelchairs. Nearly 60%percnt; of males with DBMD born during 1983-1987 had survived through 2007, emphasizing the need to develop and implement programs that address lifelong needs of males with DBMD.