MMWR. Morbidity and mortality weekly report
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MMWR Morb. Mortal. Wkly. Rep. · Jul 2008
Nonpharmaceutical fentanyl-related deaths--multiple states, April 2005-March 2007.
On April 21, 2006, increases in overdoses were reported among illicit drug users in Camden, New Jersey, via the CDC Epidemic Information Exchange (Epi-X). This alert elicited reports of similar increases in overdoses in other parts of New Jersey, and in Maryland; Chicago, Illinois; Detroit, Michigan; and Philadelphia, Pennsylvania. The increases in Chicago and Detroit had been recognized several months earlier but attributed to heroin overdoses until fentanyl was detected in the blood or urine of some decedents. ⋯ This report summarizes the results of that effort, which identified 1,013 NPF-related deaths that occurred during April 4, 2005-March 28, 2007. As a result, on April 23, 2007, DEA began regulating access to N-phenethyl-4-piperidone, a chemical used to make illicit NPF. Increased public health efforts are needed to improve epidemiologic data collection on drug overdoses, enable early detection of increases in drug overdoses, educate illicit drug users regarding the risks for overdose, and help users obtain treatment for their addictions.
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MMWR Morb. Mortal. Wkly. Rep. · May 2008
Case ReportsPrimary amebic meningoencephalitis--Arizona, Florida, and Texas, 2007.
Primary amebic meningoencephalitis (PAM) is a rare but nearly always fatal disease caused by infection with Naegleria fowleri, a thermophilic, free-living ameba found in freshwater environments. Infection results from water containing N. fowleri entering the nose, followed by migration of the amebae to the brain via the olfactory nerve. ⋯ This report summarizes the investigations of the cases, which occurred in three southern tier states (Arizona, Florida, and Texas) during June-September and presents preliminary results from a review of PAM cases during 1937-2007. Because deaths from PAM often prompt heightened concern about the disease among the public, an updated and consistent approach to N. fowleri risk reduction messages, diagnosis and treatment, case reporting, and environmental sampling is needed.
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MMWR Morb. Mortal. Wkly. Rep. · May 2008
Acute hepatitis C virus infections attributed to unsafe injection practices at an endoscopy clinic--Nevada, 2007.
On January 2, 2008, the Nevada State Health Division (NSHD) contacted CDC concerning surveillance reports received by the Southern Nevada Health District (SNHD) regarding two persons recently diagnosed with acute hepatitis C. A third person with acute hepatitis C was reported the following day. This raised concerns about an outbreak because SNHD typically confirms four or fewer cases of acute hepatitis C per year. ⋯ Health officials advised clinic A to stop unsafe injection practices immediately, and approximately 40,000 patients of the clinic were notified about their potential risk for exposure to HCV and other bloodborne pathogens. This report focuses on the six cases of acute hepatitis C identified during the initial investigation, which is ongoing; additional cases of acute hepatitis C associated with exposures at clinic A might be identified. Comprehensive measures involving viral hepatitis surveillance, health-care provider education, public awareness, professional oversight, licensing, and improvements in medical devices can help detect and prevent transmission of HCV and other bloodborne pathogens in health-care settings.
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In 2007, a total of 13,293 tuberculosis (TB) cases were reported in the United States; the TB rate declined 4.2% from 2006 to 4.4 cases per 100,000 population. This report summarizes provisional 2007 data from the National TB Surveillance System and describes trends since 1993. The TB incidence rate in 2007 was the lowest recorded since national reporting began in 1953. ⋯ The slowing decline in TB incidence and persistent disparities between U. S.-born and foreign-born persons and between whites and minorities threaten progress toward TB elimination in the United States. The strategic plan for the elimination of TB issued in 1989 by CDC and the Advisory Committee for the Elimination of Tuberculosis set a goal of TB elimination (i.e., less than one case per 1 million population) by 2010 and an interim target case rate of 3.5 per 100,000 population by 2000.
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MMWR Morb. Mortal. Wkly. Rep. · Mar 2008
Use of colorectal cancer tests--United States, 2002, 2004, and 2006.
Colorectal cancer is the second-leading cause of cancer-related deaths in the United States among cancers that affect both men and women. The U. S. ⋯ To estimate rates of use of colorectal cancer tests and to evaluate changes in test use, CDC compared data from the 2002, 2004, and 2006 Behavioral Risk Factor Surveillance System (BRFSS) surveys. This report describes the results of that comparison, which indicated that the proportion of respondents aged > or =50 years reporting use of FOBT and/or sigmoidoscopy or colonoscopy increased overall from 2002 to 2006; however, certain populations, such as racial/ethnic minorities and those who reported no health insurance coverage, had lower prevalence of testing. Specific measures to increase colorectal cancer screening and address disparities in screening are needed.