Synopsis for August 5, 2005

The MMWR is embargoed until Thursday, 12 PM EDT.

1. Multidrug-Resistant Tuberculosis in Hmong Refugees Resettling from Thailand into the United States, 2004-2005
2. Fatal Injuries Among Volunteer Workers ― United States, 1993-2002
3. Interim Guidance for Minimizing Risk for Human Lymphocytic Choriomeningitis Virus Infection Associated with Rodents
4. Tiered Use of Inactivated Influenza Vaccine in the Event of a Vaccine Shortage

Multidrug-Resistant Tuberculosis in Hmong Refugees Resettling from Thailand into the United States, 2004-2005

Results from a CDC investigation of tuberculosis (TB) cases among Hmong refugees found 37 cases of TB disease, including four culture-confirmed multidrug-resistant (MDR) cases, among a group of refugees resettled to the United States between June 2004 and January 2005.

Two-thirds of the resettled cases (24 of 37) were diagnosed in California, including 10 cases in children under 15 years of age. Among refugees in Thailand awaiting resettlement, 17 cases of MDR were also detected. In response to these cases, CDC coordinated several improvements to pre-migration screening requirements. Overseas screening was expanded to include chest radiograph for all children aged 6 months or older (previously only required for individuals aged 15 years or older). Tuberculin skin testing was also initiated for all children from 6 months to 10 years of age. In the United States, health departments intensified TB surveillance and provided diagnostic and treatment services for refugees, including latent TB treatment. Since these changes were implemented, no further TB cases have been diagnosed among the 3,500 additional refugees that have been resettled. Authors note that TB is a costly health threat that must be fought domestically as well as globally, with extensive national and international collaboration. Estimates of direct medical costs associated with TB and MDR TB range from $3,800 to $137,000 per case, depending on the complexity of the case.

Fatal Injuries Among Volunteer Workers ― United States, 1993-2002

Organizations and volunteers need to recognize that certain types of volunteer work can involve the risk of injury, and that practical precautions should be taken by organizations to keep volunteer workers safe while assisting in valuable activities.

An estimated 59 million people volunteer their time each year in the U.S. and from 1993 through 2002, 501 persons died while performing their volunteer duties. The majority of the deaths were to firefighters and to volunteers who were operating motor vehicles at the time of death. To reduce these fatalities, organizations that rely on volunteers need to provide adequate skills training based on written, communicated and enforced safety and health policies. Special attention to younger volunteers is warranted.

Interim Guidance for Minimizing Risk for Human Lymphocytic Choriomeningitis Virus Infection Associated with Rodents

No Summary Available.

Tiered Use of Inactivated Influenza Vaccine in the Event of a Vaccine Shortage

No Summary Available.

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