MMWR. Morbidity and mortality weekly report
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MMWR Morb. Mortal. Wkly. Rep. · Feb 2008
Progress toward introduction of Haemophilus influenzae type b vaccine in low-income countries--worldwide, 2004-2007.
Haemophilus influenzae type b (Hib) disease is estimated to cause 3 million cases of meningitis and severe pneumonia and approximately 386,000 deaths worldwide per year in children aged <5 years. Safe and effective Hib conjugate vaccines have been widely used in industrialized countries for nearly 20 years. However, primarily because of financial constraints and lack of awareness among both public health officials and the public regarding Hib disease burden and benefits of the vaccine, use of these vaccines has been low in developing countries, where most Hib disease and deaths occur. ⋯ Despite this support, before 2005, adoption of Hib vaccine by these countries remained low. In response, in June 2005, the GAVI Alliance established the Hib Initiative to accelerate evidence-informed decision making regarding use of Hib vaccine in GAVI-eligible countries. During 2004-2007, the number of GAVI-eligible countries using Hib vaccine or approved to use the vaccine increased from 13 (18%) to 47 (65%).
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MMWR Morb. Mortal. Wkly. Rep. · Jan 2008
Influenza-testing and antiviral-agent prescribing practices--Connecticut, Minnesota, New Mexico, and New York, 2006-07 influenza season.
Influenza is a major cause of morbidity and mortality in the United States, with an average of 36,000 deaths attributed to the disease annually. Patients with influenza-like illness (ILI) often are evaluated by their primary-care physicians (PCPs). Antiviral therapy initiated within 48 hours of ILI symptom onset can shorten the course of influenza illness; antiviral therapy also is used as chemoprophylaxis for influenza, particularly in institutions and communities. ⋯ To assess influenza-testing and antiviral-agent prescribing practices during the 2006-07 influenza season, personnel at four of 10 Emerging Infections Program (EIP) sites with influenza hospitalization surveillance surveyed PCPs. This report describes the results of that survey, which indicated that 69.0% of the PCPs administered influenza tests to patients who had ILI during the influenza season and 53.8% prescribed antiviral agents, including two (i.e., amantadine and rimantadine) no longer recommended by CDC. Health agencies, medical societies, and continuing medical education organizations should advance programs for physicians that increase awareness of recommendations regarding appropriate influenza testing and use of antiviral agents.
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MMWR Morb. Mortal. Wkly. Rep. · Oct 2007
Case ReportsAcute respiratory distress syndrome in persons with tickborne relapsing fever--three states, 2004-2005.
Tickborne relapsing fever (TBRF) is a bacterial illness caused by certain species of Borrelia and transmitted through brief and painless bites from Ornithodoros ticks. Illness usually is characterized by intermittent periods of fever, fatigue, and muscle aches. In April 2005, CDC received reports of two cases of severe TBRF associated with acute respiratory distress syndrome (ARDS) in residents of California and Nevada. ⋯ This report summarizes these three cases and the results of the subsequent epidemiologic investigations. The findings indicate that ARDS might occur more frequently in patients with TBRF than previously recognized. Optimal management of TBRF requires both prompt diagnosis and careful observation during the initial phases of treatment.
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MMWR Morb. Mortal. Wkly. Rep. · Sep 2007
State-specific prevalence of cigarette smoking among adults and quitting among persons aged 18-35 years--United States, 2006.
Each year, cigarette smoking in the United States causes approximately 438,000 deaths and results in an estimated $167 billion in health-care costs plus lost productivity attributed to premature deaths. Although smoking cessation has major and immediate health benefits for persons of all ages, the benefit is greater the earlier in life a person quits. Persons who quit before the age of 35 years have a life expectancy similar to that of those who never smoked. ⋯ Virgin Islands (USVI) (range: 9.1%-28.6%). The majority of current smokers aged 18-35 years reported that they had attempted to quit smoking during the past year (median: 58.6%; range: 48.0% [Nevada] to 69.2% [New Mexico]), and the median proportion of ever smokers aged 18-35 years who had quit smoking was 34.0% (range: 27.0% [Louisiana] to 47.9% [Utah]). Effective, comprehensive tobacco-use prevention and control programs should be continued and expanded to further reduce smoking initiation by young persons and to encourage cessation as early in life as possible.
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In 2000, countries represented by the World Health Organization (WHO) Regional Office for Africa established a goal to reduce, by the end of 2005, measles mortality to 50% of the 506,000 deaths from measles estimated in 1999. Strategies adopted included strengthening routine vaccination, providing a second opportunity for measles vaccination through supplemental immunization activities (SIAs), monitoring disease trends, and improving measles case management. ⋯ A follow-up SIA, initially scheduled for July 2005, was postponed to 2006 to include concurrent distribution of long-lasting insecticide-treated bednets (LLINs). This report documents progress made in reducing measles morbidity and mortality in Kenya and describes the consequences of a large measles outbreak, beginning in September 2005, on the integrated measles follow-up SIA.