Synopsis for October 8, 2004

The MMWR is embargoed until Thursday, 12 PM EDT.

1. Smoking During Pregnancy ― United States, 1990- 2002
2. State Estimates of Neonatal Health-Care Costs Associated with Maternal Smoking― United States, 1999
3. State-Specific Trends in Chronic Kidney Failure ― New Jersey, 1990-2001
4. Carbon Monoxide Releases and Poisonings Attributed to Underground Utility Cables Fires ― New York, January, 2000- June, 2004
5. West Nile Virus Activity ― United States, September 29- October 5, 2004
6. Interim Influenza Vaccination Recommendations, 2004-05 Influenza Season

Synopsis for October 8, 2004

Smoking During Pregnancy ― United States, 1990-2002

Although fewer pregnant women in the US smoke while pregnant than in the past, some continue to put themselves and their children at risk. Efforts must continue to ensure that women receive support and encouragement to not smoke especially while they are pregnant.

In 2002, women were far less likely to smoke while pregnant than a decade ago. Rates of smoking during pregnancy in the United States have consistently declined since 1990. All States that have collected these data since 1990 had significantly lower rates in 2002, several over 50 percent lower. Teenage mothers 15 to 19 years of age continue to have high smoking rates. In fact, over this same time period, rates of smoking during pregnancy for teenagers increased in a few States. Intensive public health campaigns to prevent smoking during pregnancy have been partially successful but additional interventions will be needed to lower these rates further and thus reduce poor birth outcomes and their associated social and financial costs.

State Estimates of Neonatal Health-Care Costs Associated with Maternal Smoking― United States, 1999

States should consider these costs when they make decisions about funding for smoking cessation interventions and adoption of other policies, such as increases in excise taxes that reduce smoking prevalence among pregnant women.

For the first time, CDC has released estimates for each state on direct neonatal health care costs associated with a mother’s smoking status while she was pregnant, by demographic characteristics and insurance status. The estimates are generated using the Maternal and Child Health Smoking-Attributable Mortality, Morbidity and Economic Costs (MCH SAMMEC) software. Driven largely by smoking rates and numbers of birth, significant variation in costs exists across states. Relatively more of the states’ smoking-attributable neonatal health care costs accrue to the public sector than to private insurers.

State-Specific Trends in Chronic Kidney Failure ― New Jersey, 1990-2001

There are key steps that adults can take to prevent chronic kidney disease. These include the control of diabetes and high blood pressure and the monitoring of kidney function for those at increases risk for the disease.

Kidney disease is the ninth leading cause of death in the United States and approximately 19 million US adults have chronic kidney disease. Between 1990 and 2001 the prevalence of chronic kidney failure increased 104 percent with the increases in all 50 states. Causes for these increases include: an increase in the prevalence of risk factors, primarily hypertension and diabetes; the aging of the US population; and a higher survival rate among persons with chronic kidney failure. Treating and controlling risk factors and screening persons at high risk for chronic kidney failure are key steps that health care providers and public health practitioners can take to reverse the upward trend in this disease.

Carbon Monoxide Releases and Poisonings Attributed to Underground Utility Cables Fires ―New York, January, 2000 ― June, 2004

The general public should be aware that emissions from underground utility fires might contain Carbon monoxide (CO), which can migrate into living and working spaces. Common symptoms of CO poisoning include headache, dizziness, weakness, nausea, vomiting, loss of muscle control, shortness of breath, chest tightness and pain, visual changes, sleepiness, fluttering of the heart, and confusion. At higher CO levels, loss of consciousness and death can occur. The findings underscore the need for preventive actions such as CO detectors.

CO, a potentially deadly gas that is odorless, colorless, and tasteless, is typically generated from sources such as furnaces, generators, and non-electric space heaters. While CO exposure from indoor sources has long been recognized, another less commonly mentioned source is from underground utility cable fires. Using the Agency for Toxic Substances and Disease Registry’s Hazardous Substances Emergency Events Surveillance system, the New York State Department of Health has documented 234 CO events during January 2000–June 2004 resulting from underground utility cable fires. This report describes and summarizes these events and discusses associated injuries.

West Nile Virus Activity ― United States, September 29 - October, 5 2004

No summary available.

Interim Influenza Vaccination Recommendations, 2004-05 Influenza Season

No summary available.

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