Synopsis for July 2, 2004

The MMWR is embargoed until Thursday, 12 PM EDT.

1. Update: Influenza Activity ― United States and Worldwide, 2003-04 Season, and Composition of the 2004-05 Influenza Vaccine
2. Surveillance Data from Public Spa Inspections ― United States, May-September 2002
3. Racial Disparities in Tuberculosis ― Selected Southeastern States, 1991-2002
4. Progress Toward Sustainable Measles Mortality Reduction ― South-East Asia Region, 1999-2002
5. Injuries Associated with Homemade Fireworks ― Selected States, 1993-2004
6. West Nile Virus Activity ― United States, June 23-29, 2004

Synopsis for July 2, 2004

Update: Influenza Activity ― United States and Worldwide, 2003-04 Season, and Composition of the 2004-05 Influenza Vaccine

In the United States, the 2003-04 influenza season began and peaked earlier than usual, and was more severe than the previous three seasons. Beginning with the 2004-05 influenza season, all children aged 6-23 months and close contacts of children aged from birth to 23 months old are recommended to receive annual influenza vaccination.

In the United States, the 2003-04 influenza season began and peaked earlier than usual, and was more severe than the previous three seasons. Beginning with the 2004-05 influenza season, all children aged 6-23 months and close contacts of children aged from birth to 23 months old are recommended to receive annual influenza vaccination. In several Asian countries, widespread outbreaks of avian influenza A (H5N1) among poultry were reported. In Vietnam and Thailand, these poultry outbreaks were associated with 34 confirmed human infections with avian influenza A (H5N1) viruses, resulting in severe illnesses and 23 deaths. No evidence of efficient person-to-person spread of H5N1 has been found to date. CDC continues to recommend enhanced surveillance for suspected H5N1 cases among travelers with severe unexplained respiratory illness returning from H5N1-affected countries.

Surveillance Data from Public Spa Inspections ― United States, May-September 2002

Spa inspection data should be used more effectively for public health decision-making, and public health partnerships are needed to improve the level of training and vigilance by spa operators.

The therapeutic and recreational use of spas is a popular activity in the United States. Health departments protect the public’s health through public spa inspections but resources generally allow only a few annual inspections of each spa. We documented water quality, filtration system, and operations violations recognized during over 5000 spa inspections from multiple geographic sites during the summer of 2002. Over 56% of spa inspections had one or more violations; 11% of the spa inspections resulted in immediate spa closure pending correction of the serious violation item(s). This indicates that although some spas are well maintained, such an infrequent inspection process cannot ensure compliance with spa regulations. These findings underscore the need for increasing the level of training and vigilance by spa operators to ensure high-quality spa water and the utility of spa inspection data for public-health decision-making.

Racial Disparities in Tuberculosis ― Selected Southeastern States, 1991-2002

Rate of tuberculosis (TB) nearly five times higher for blacks than for whites in the Southeast.

The TB rate in seven southeastern states in 2002 was 4.7 times higher for blacks than for whites (11.3 vs. 2.4 cases per 100,000 population), according to a CDC analysis of surveillance data from 1991-2002. Over the full 12-year period, blacks represented 56 percent of all TB cases reported in those states, while whites represented 35 percent. Blacks with TB in the southeastern states were more likely than whites to report risk factors such as excessive drinking, drug use, and previous incarceration. Once diagnosed, however, a slightly higher percentage of blacks than whites received directly observed therapy – an important component of care that helps prevent multidrug-resistant TB – and completed their treatment on time. The seven states in the analysis – Alabama, Arkansas, Georgia, Louisiana, Mississippi, South Carolina, and Tennessee – have consistently had TB rates above the national average for all races. Nationwide, TB rates for blacks are eight times higher than for whites.

Progress Toward Sustainable Measles Mortality Reduction ― South-East Asia Region, 1999-2002

Although the South East Asian Region (SEAR) saw an increase in reported measles cases from 1999-2002, measures to improve control have been taken including the endorsement in 2003 by the SEAR Regional Technical Advisory Group on Immunization of a Regional Strategic Plan for Measles Mortality Reduction. The challenge is to develop the political and financial support to implement this strategic plan.

Measles remains the leading cause of vaccine-preventable deaths among children worldwide. This report summarizes progress in measles control in SEAR from 1999-2002 and outlines plans for future activities. During this time, reported measles cases increased, primarily due to increases in India, Indonesia and Thailand, and several nationwide outbreaks. This increase in reported measles incidence was primarily due to inadequate measles vaccination coverage as well as improvements in surveillance. From 1999-2002, four countries in SEAR introduced case-based measles surveillance and a regional measles laboratory network was established. Six countries conducted national or sub-national measles vaccination campaigns. In June 2003, the South East Asian Regional (SEAR) Technical Advisory Group on Immunization endorsed a Regional Strategic Plan for Measles Mortality Reduction (2003-2005) with the ultimate goal of achieving sustainable measles mortality reduction. Countries should prepare national action plans for measles control that are linked to their national Expanded Program on Immunization Plans.

Injuries Associated with Homemade Fireworks ― Selected States, 1993-2004

Homemade fireworks can pose a particular risk for injury because of the lack of knowledge and experience of persons preparing these materials.

Around the July 4 Independence Day holiday each year in the United States, injuries associated with fireworks are increasingly common. Some of these injuries are sustained from homemade fireworks. To describe injuries resulting from homemade fireworks explosions, the Agency for Toxic Substances and Disease Registry (ATSDR) researched data from its Hazardous Substances Emergency Events Surveillance (HSEES) system. This report summarizes four incidents involving homemade fireworks explosions that were identified by the surveillance system. To prevent injuries and deaths, no one should attempt to make their own fireworks.

West Nile Virus Activity ― United States, June 23-29, 2004

No summary available.

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