MMWR – Morbidity and Mortality Weekly Report

1. National HIV Testing Day — June 27, 2010 (Box)

CDC National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, News Media Line
Phone: (404) 639-8895

No summary available.

2. HIV Testing and Linkage to Care — District of Columbia, 2004–2008

Michael Kharfen, D.C. Department of Health
Phone: (202) 671-4809
E-mail: Michael.Kharfen@dc.gov

A study of HIV testing and AIDS surveillance data in D.C. from 2004-2008 indicates success of expanded testing efforts, with more HIV-positive residents being tested earlier, entering into care faster and progressing to AIDS more slowly in recent years. Researchers from the D.C. Department of Health worked with CDC to review D.C. HIV testing and AIDS case surveillance data from 2004-2008 and found, following an expansion of local testing efforts in 2006, the overall proportion of persons tested for HIV in the previous 12 months increased from 15 percent in 2005 to 19 percent in 2007. In addition, from 2004-2008, the proportion of persons entering HIV care within 3 months of diagnosis increased slightly (from 62 percent in 2004 to 64 percent in 2008), and authors note that local efforts are ongoing to continue improving community and clinical linkages to HIV care. Finally, the rate of newly reported AIDS cases decreased (from 164 cases/100,000 in 2004 to 107 cases/100,000 in 2008), pointing to slower progression of disease following HIV infection. Despite these overall successes, racial/ethnic disparities persist, as African Americans were diagnosed with more advanced disease and had lower rates of entry into care. Authors conclude the findings suggest measurable improvements in the delivery of HIV testing and linkage to care services in D.C., but persistent racial/ethnic disparities point to a need for increased efforts.

3. Routine Jail-Based HIV Testing, Rhode Island, 2000–2007

Jessica Grimes, The Miriam Hospital
Phone: (401) 793-7484
E-mail: jgrimes2@lifespan.org

A review of Rhode Island Department of Corrections (RIDOC) HIV testing records from 2000-2007 shows that offering voluntary, opt-out testing upon inmate intake can lead to a substantial number of new diagnoses among an otherwise hard-to-reach population. Researchers in the RIDOC, in collaboration with CDC, reviewed data on HIV testing records from 2000-2007 and found, during this period, 169 persons were newly diagnosed with HIV, of whom 80 (48 percent) did not disclose HIV risk behaviors prior to testing. These 169 new diagnoses represented 15.3 percent of all new HIV diagnoses in Rhode Island over the same time period. All HIV testing was completed within 24 hours of incarceration. However, had testing occurred beyond 7 days, 72 HIV-infected persons (43 percent) who were released within 7 days of incarceration would not have been identified, which points to the value of HIV testing early in the incarceration as part of the first clinical evaluation, and of routinely providing voluntary HIV testing to all detainees regardless of reported risk factors. Researchers conclude that expansion of HIV testing within jails has the potential to increase diagnoses of HIV infection and help stem continued transmission, as it is estimated that people unaware of their infection are approximately three times more likely to transmit HIV than those aware of their infection.

4. Sodium Consumption Among Adults — United States, 2005−2006

CDC Division of News and Electronic Media
Phone: (404) 639-3286

Less than 10 percent of American adults limit their daily sodium intake to recommended levels, according to a new report. Sodium has become so pervasive in our food supply that it’s difficult for the vast majority of Americans to consume sodium within recommended limits. Overconsumption of sodium may have negative health effects, including increasing average levels of blood pressure. High blood pressure is a major risk factor for heart disease and stroke. About 70 percent of adults are recommended to limit intake to 1,500 mg and only 5.5 percent are successful in limiting intake to that level. This report also finds that most sodium in the American diet comes from grains and meats, foods that may not necessarily taste salty. Strategies should be implemented at every level: local, state, federal as well as food manufacturing to lower sodium intake and improve blood pressure.

5. Detection of Enterobacteriaceae Isolates Carrying Metallo-Beta-Lactamase — United States, 2010

CDC Division of News and Electronic Media
Phone: (404) 639-3286

Antimicrobial resistance in Gram-negative bacteria is a well-recognized problem, and a new resistance mechanism found in three U.S. Enterobacteriaceae could compound this challenge. This new mechanism, New Delhi Metalol-beta-lactamase (NDM-1), is linked to receipt of medical care in India or Pakistan, where it is common among enteric bacteria. NDM-1 is an enzyme that destroys many commonly used antibiotics, rendering them ineffective. It is carried on a mobile element that can readily spread to other bacteria. In order to prevent transmission of bacteria possessing NDM-1 in the U.S., CDC is alerting clinicians to be aware of NDM-1 in patients who have recently received medical care in India or Pakistan and requesting that carbapenem-resistant enteric bacteria from these patients be sent to CDC for further investigation. Also, CDC is reiterating the importance of implementing CDC recommendations to prevent the spread of these highly resistant organisms.

 

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES