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MMWR
Synopsis for April 20, 2001

MMWR articles are embargoed until 4 p.m. E.S.T. Thursdays.

  1. Mortality During a Famine — Gode District, Ethiopia, July 2000
  2. Fatal and Severe Hepatitis Associated With Rifampin and Pyrazinamide for the Treatment of Latent Tuberculosis Infection — New York and Georgia, 2000
  3. A Cluster of Tuberculosis Cases Among Exotic Dancers and Their Close Contacts — Kansas, 1994–2000
  4. Outbreaks of Escherichia coli O157:H7 Infections Among Children Associated with Farm Visits — Pennsylvania and Washington, 2000

MMWR Recommendations & Reports
Vol.50/RR–4/April 20, 2001

Contact: Carolyn Bridges, M.D.
CDC, National Center for Infectious Diseases
(404) 639–3747

Prevention and Control of Influenza: Recommendations of the Advisory Committee on Immunization Practices (ACIP)

This report updates the 2000 recommendations by the Advisory Committee on Immunization Practices (ACIP) on the use of influenza vaccine and antiviral agents. The 2001 recommendations include new or updated information regarding a) the cost-effectiveness of influenza vaccination; b) the influenza vaccine supply; c) neuraminidase-inhibitor antiviral drugs; d) the 2001--2002 trivalent vaccine virus strains, which are A/Moscow/10/99 (H3N2)-like, A/New Caledonia/20/99 (H1N1)-like, and B/Sichuan/379/99-like strains; and e) extension of the optimal time period for vaccination through November. A link to this report and other information regarding influenza can be accessed at http://www.cdc.gov/flu/


Synopsis for April 20, 2001

Mortality During a Famine — Gode District, Ethiopia, July 2000

During famine and humanitarian emergencies, measles vaccination campaigns should be rapidly implemented for children 6 months–14 years of age.

 

PRESS CONTACT:
Peter Salama, M.D., M.P.H.

CDC, National Center for Chronic Disease & Health Promotion
(770) 488–4466
 


This study conducted in July 2000 by CDC, Save the Children Fund-US, and UNICEF demonstrated the importance of understanding trends in mortality, and causes of death during famine. Approximately 6000 excess deaths occurred in an 8-month period in Gode district (Somali region of Ethiopia), and more than 70% of deaths occurred before any humanitarian intervention commenced. As expected, malnutrition was a major cause of death, however, so were common and preventable infectious diseases such as diarrhea and measles. In refugee camps, mass measles immunization has become an early priority for humanitarian interventions. While such campaigns are more difficult to implement in situations where populations are widely dispersed, these cost-effective interventions should be an early priority, and should include all children from 6 months to 14 years of age, where feasible.

 

Fatal and Severe Hepatitis Associated With Rifampin and Pyrazinamide for the Treatment of Latent Tuberculosis Infection — New York and Georgia, 2000

This article reports the first known death associated with a new 2-month drug regimen of rifampin and pyrazinamide for the treatment of latent tuberculosis infection.

 

PRESS CONTACT:
Office of Communications

CDC, National Center for HIV, STD and TB Prevention
(404) 639–8895
 


This regimen was recommended by American Thoracic Society (ATS) and CDC in April 2000 as an alternative to isoniazid. In September 2000, a 53-year-old man in New York died from hepatitis after five weeks on this course of therapy. In December 2000, another severe case of hepatitis was reported, when a 59-year-old woman in Georgia was admitted to the hospital after taking the drug combination for seven weeks. Because both regimens recommended for treating latent TB infection have been associated with hepatitis previously, CDC continues to recommend health care providers educate their patients about the rare, but potentially severe, adverse effects of treatment and monitor their patients closely. Most importantly, patients should be reminded during each visit to their provider or at least monthly to stop taking their medication and contact their provider if symptoms, such as gastrointestinal pains, develop.

 

A Cluster of Tuberculosis Cases Among Exotic Dancers and Their Close Contacts — Kansas, 1994–2000

In January 2001, CDC EIS Officers were asked to assist in the investigation of an outbreak of tuberculosis (TB) among women who worked as exotic dancers in Wichita, Kansas

 

PRESS CONTACT:
Office of Communication

CDC, National Center for HIV, STD and TB Prevention
(404) 639–8895
 


Within a 4-month period, CDC, working with Wichita-Sedgwick County Department of Community Health and Kansas Department of Health and Environment, had linked 18 patients with active TB disease and 76 with latent infection to this outbreak. Patients with active disease included seven women who were exotic dancers, along with seven men, one woman, and three children who had been exposed to these individuals. The first patient was diagnosed in 1994, and the last five were diagnosed in 2000. This outbreak, which evolved over a 6-year period, demonstrates the importance of maintaining local TB control systems capable of quickly identifying, containing, and curing TB even in low incidence areas. Kansas routinely has a low incidence of TB (provisionally reporting only 77 active cases of TB in 2000). All states need outbreak response plans for outbreaks and during other times of increased demand.

 

Outbreaks of Escherichia coli O157:H7 Infections Among Children Associated with Farm Visits — Pennsylvania and Washington, 2000

Outbreaks of E. coli O157 infections among children associated with farms visits occurred in Pennsylvania and Washington in 2000.

 

PRESS CONTACT:
John Crump

CDC, National Center for Infectious Diseases
(404) 639–2206
 


These outbreaks resulted in 56 illnesses and 19 hospitalizations. Children became infected through direct contact with animals or the animals’ environment. E. coli O157 causes an estimated 60 deaths and 73,000 illness annually in the United States and although most reported outbreaks are due to contaminated food or water, direct transmission from animals to people is a growing concern. Some people (e.g., children under 5 years old) are at greater risk of serious infection. CDC has issued strategies to reduce transmission of such infections (e.g., E. coli O157, Campylobacter, Salmonella, Cryptosporidium) at venues that allow public access to farm animals, including improved handwashing facilities; and separation of food preparation, serving, and consumption from animal areas. Also, animal contact should occur only in a defined, supervised, interaction areas.

 


 

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