Synopsis for September 7, 2006

The MMWR is embargoed until Thursday, 12 PM EST.

1. Evaluation of a Fruit and Vegetable Distribution Program – Mississippi, 2004-05 School Year
2. Delayed Onset Pseudomonas flourescens Bloodstream Infections after Exposure to Contaminated Heparin and Saline Flush – Michigan and South Dakota, 2005-06
3. Measles Outbreak and Response – Fiji, February-May 2006

Evaluation of a Fruit and Vegetable Distribution Program – Mississippi, 2004-05 School

The evaluation results suggest that the distribution of free fresh fruit at school to secondary students may be an effective component of a comprehensive approach to improving students’ dietary behaviors. During the 2004-2005 school year, the Mississippi Department of Education (MS DOE) Child Nutrition Programs initiated a pilot program to increase students’ access to an array of fresh fruit and vegetables, increase students’ degree of preference for and consumption of fruit and vegetables, and improve fruit and vegetable consumption. The pilot program’s evaluation involved students in grades 5, 8, and 10 from 5 of the 25 pilot program schools. The results suggest that the program increased the variety of fruit and vegetables ever tried by students from all three grades; that it increased the degree of preference (the degree to which students thought they would like particular fruit and vegetables) for fruit among 8th and 10th grade students; that it promoted positive attitudes toward eating fruit among 8th grade students; and that it increased consumption of fruit among 8th and 10th grade students.

Delayed Onset Pseudomonas flourescens Bloodstream Infections after Exposure to Contaminated Heparin and Saline Flush – Michigan and South Dakota, 2005-06

Health-care providers should be aware that patients with indwelling catheters who previously received contaminated injections are at risk for bloodstream infections even months after exposure, because of catheter biofilms. This week’s MMWR reports 28 cancer patients with indwelling central venous catheters, in Michigan and South Dakota, who were diagnosed with bloodstream infections with the bacteria, Pseudomonas fluorescens, between April 2005 through March 2006 – the same bacteria that was linked to a previous outbreak associated contaminated flush solution. An investigation revealed that all 28 patients received intravenous heparin flushes at clinics known to have used the contaminated heparin syringes, during the time before the product was recalled. Although these patients didn’t experience symptoms on initial exposure to the contaminated heparin flush, the bacteria formed and persisted in biofilms lining their catheters. When patients later had their catheters flushed with a new, uncontaminated product, the physical force of the flush disturbed the biofilms, releasing bacteria into patients’ bloodstreams, causing illness. Heath-care providers should conduct ongoing surveillance and be aware of possible bloodstream infection in patients with indwelling catheters who have received contaminated injections, even months after exposure. Also, they recommend catheter removal in such instances, because antibiotic therapy alone might not eliminate bacteria from catheter biofilms.

Measles Outbreak and Response – Fiji, February-May 2006

The measles outbreak in Fiju described in this report, like the 2003 outbreak in the Marshall Islands, underscores that absence of measles virus transmission should not creat a false sense of security and tht high population immunity is essential to preventing future outbreaks. This report describes the epidemiologic findings, public health response, and potential causes of a February – May 2006 measles outbreak that produced 132 cases in Fiji. In September 2005, the 37 countries and areas of the World Health Organization (WHO) Western Pacific Region (WPR) established a goal to eliminate measles in the region by 2012. The 2006 measles outbreak in Fiji, like the 2003 Marshall Islands outbreak in this region, underscores the importance of maintaining high population immunity in order to prevent future outbreaks caused by importation of measles disease.

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This page last reviewed November 9, 2006

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