Synopsis for October 28, 2005

The MMWR is embargoed until Thursday, 12 PM EDT.

1. Import-Associated Measles Outbreak – Indiana, May – June 2005
2. Progress Toward Global Eradication of Dracunculiasis, January 2004– June 2005
3. Estimated Adolescent Exposure to State-Funded Anti-Tobacco Television Advertisements – 37 States and the District of Columbia, 1999 – 2003
4. Prevalence of Epilepsy and Health-Related Quality of Life and Disability Among Adults with Epilepsy – South Carolina, 2003-2004
5. Update: West Nile Virus Activity ― United States, 2005

Import-Associated Measles Outbreak – Indiana, May – June 2005

Measles is a highly infectious and dangerous disease which is endemic in most of the world. Relatively small numbers of unvaccinated persons can produce outbreaks in the US when ACIP vaccination recommendations are not followed for vaccination of children, foreign travelers, and health care workers. The seriousness of the Indiana outbreak underscores the need for maintenance of high measles vaccination levels to prevent re-introduction of measles transmission in the US.

Over a four-week period in May-June 2005, a large measles outbreak occurred in Indiana. While measles transmission was eliminated from the United States in 2001 by high vaccination levels, globally measles causes 30 to 40 million cases and 530,000 deaths annually worldwide. The source of the Indiana outbreak was an unvaccinated teenager who had just returned from Romania where a large measles outbreak is currently occurring. Most of the 34 Indiana cases were children whose parents had declined to have them vaccinated. There were three hospitalizations, including one person who required mechanical ventilation in the intensive care unit. Strenuous containment efforts were required to prevent the outbreak from spreading further. The Advisory Committee on Immunization Practices (ACIP) has long-standing recommendations that children, foreign travelers, and health care workers should be vaccinated against measles. Had these recommendations been followed, the outbreak would not have occurred.

Progress Toward Global Eradication of Dracunculiasis, January 2004 – June 2005

Dracunculiasis eradication is nearly completed but public health leaders as well as national political leaders need to exhort and mobilize the remaining affected populations to help stop transmission of the parasite from occurring and use their oversight powers to ensure this is accomplished.

The objective is to update the public and scientific community about the current status of the Dracunculiasis (Guinea worm disease) Eradication Program (DEP). In 1986 there were 3.5 million cases of dracunculisis occurring annually in 20 endemic countries. Less than 10,000 cases of dracunculiasis have been reported during the January – July 2005 from 9 endemic countries. Over 90 percent of the cases were reported from Ghana and Sudan.

Estimated Adolescent Exposure to State-Funded
Anti-Tobacco Television Advertisements – 37 States and the District of Columbia, 1999 – 2003

Given the importance of counter-marketing in preventing tobacco use, states should make every effort to ensure that adolescents are frequently exposed to anti-tobacco television advertisements.

A study published in the October 28 issue of the Centers for Disease Control and Prevention (CDC) journal, Morbidity and Mortality Weekly Report, found that exposure to state anti-tobacco television advertisements among adolescents aged 12-17 increased from 1999 to 2002, but then declined in 2003. In the 37 states and the District of Columbia studied, the majority of adolescents were exposed to less than one state-sponsored anti-tobacco television advertisement per month. The 2003 reduction in ad exposure coincided with reduced funding for state tobacco prevention and control programs. Anti-tobacco television advertising plays an important role in tobacco prevention, and is recommended by CDC as a key component of a comprehensive state tobacco control program. Further efforts are warranted to ensure that adolescents are adequately exposed to effective paid anti-tobacco advertisements.

Prevalence of Epilepsy and Health-Related Quality of Life and Disability Among Adults with Epilepsy – South Carolina, 2003-2004

About 2 percent of adults in South Carolina have ever been told they have epilepsy, 1.1 percent had active epilepsy, and both groups reported substantially worse physical and mental health, and a much higher prevalence of disability than those who had never had epilepsy.

Data from the 2003 and 2004 South Carolina Behavioral Risk Factor Surveillance System, a random-digit dialed telephone survey of household adults, showed that 2.2 percent of adults in South Carolina have ever been told they have epilepsy and 1.1 percent had active epilepsy. Adults with active epilepsy had more than twice as many physically, mentally, and overall unhealthy days and activity limitation days than those without epilepsy, and more overall unhealthy days and activity limitation days than those with inactive epilepsy. Nearly half (46.7 percent) of those who have ever had epilepsy and 63.5 percent of those with active epilepsy reported some form of disability, compared with 17.9 percent of those without epilepsy. Health-care providers should screen their epilepsy patients for cognitive, emotional and physical health problems that might negatively affect health-related quality of life, and that limit educational or employment opportunities.

Update: West Nile Virus Activity ― United States, 2005

No Summary Available.

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