Synopsis for December 2, 2005

The MMWR is embargoed until Thursday, 12 PM EST.

1. Severe Clostridium difficile – Associated Disease in Previously Low-Risk Populations – New Hampshire, New Jersey, Ohio, and Pennsylvania, 2005
2. Early Onset and Late Onset Neonatal Group B Streptococcal Disease – United States, 1996-2004
3. Trends in Recommended Lifestyle Physical Activity and Inactivity – United States, 2001 and 2003

Severe Clostridium difficile – Associated Disease in Previously Low-Risk Populations – New Hampshire, New Jersey, Ohio, and Pennsylvania, 2005

The findings underscore the importance of judicious antimicrobial use, the need for community clinicians to maintain a higher index of suspicion for CDAD and the need for surveillance to better understand the changing epidemiology of CDAD.

Recently both the frequency and severity of healthcare-associated Clostridium difficile-associated disease (CDAD) has increased. This report summarizes the results of an investigation that indicates the presence of severe CDAD in healthy persons living in the community and peripartum women, both of whom are populations previously thought to be at low risk. Certain features of CDAD that have been uncommon in the past, such as close-contact transmission, high recurrence rate, young patient age, bloody diarrhea, and lack of antimicrobial exposure, might be changing.

Early Onset and Late Onset Neonatal Group B Streptococcal Disease – United States, 1996-2004

Screening all pregnant women for group B streptococcus (GBS) and giving antibiotics to GBS carriers during labor helps to prevent GBS disease in newborns.

Screening all pregnant women for group B streptococcus (GBS) and giving antibiotics to GBS carriers during labor helps to prevent GBS disease in newborns during the first week of life. The rate of GBS disease in infants less than one week old declined after guidelines recommending universal screening were introduced in 2002. Improved implementation of the screening strategy may result in additional health gains.

Trends in Recommended Lifestyle Physical Activity and Inactivity – United States, 2001 and 2003

More than half of US adults (54.1 percent) are not active enough to gain health benefits.

This report found that more than half of adults (18 years and over) in US states and territories are not active at the minimum level that is beneficial to health; although during 2001- 2003 there was slight improvement in such activity level. This is the first national report on the trend of recommended lifestyle physical activity which includes activities during household work, transportation and discretionary/ leisure time. This report also found that more than 15 percent of US adults are inactive during their lifestyle activities. Public health efforts at local, state and federal level should be concerted and continuous to improve the participation of US adults in physical activity.

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