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  Press Summaries

MMWR
April 30, 1999

MMWR articles are embargoed until 4 p.m. Eastern time on Thursday.


MMWR Synopsis
  1. Knowledge and Use of Folic Acid by Women of Childbearing Age -- United States, 1995 and 1998
  2. Outbreak of Poliomyelitis -- Angola, 1999
  3. Playground Safety -- United States, 1998-1999
  4. Childhood Work-Related Agricultural Fatalities -- Minnesota, 1994-1997
  5. Update: Outbreak of Nipah Virus -- Malaysia and Singapore, 1999
Notice to Readers: Prevention and Control of Influenza: Recommendations of the Advisory Committee on Immunization Practices (ACIP)
Press Release: CDC Urges Better Education Efforts From Health Care Providers and Others to Encourage Women to Take Folic Acid Every Day

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Synopsis April 30, 1999

Knowledge and Use of Folic Acid by Women of Childbearing Age -- United States, 1995 and 1998
Women need to take folic acid everyday before pregnancy to help prevent serious birth defects in children.

PRESS CONTACT:
Donald Mattison, M.D.
March of Dimes
(914) 428-7100
(Alternate: Katherine Lyon Daniel, Ph.D., CDC, 770-488-7160)
Most women still don't know that the B-vitamin folic acid can prevent some serious birth defects. Even fewer women know that folic acid must be taken before and during the first few weeks of pregnancy. Most women do not get any information about folic acid from their physician. It has been almost 8 years since the Public Health Service recommended that all women capable of becoming pregnant should consume 400 micrograms of folic acid everyday to prevent serious birth defects of the spine and brain, but little progress has been made toward preventing these birth defects. CDC, March of Dimes and the National Council on Folic Acid are launching an education outreach with public service announcement messages called -- "Before You Know It" -- to get this important message to women and their health care providers.

  Outbreak of Poliomyelitis -- Angola, 1999
The polio outbreak in Angola is the largest such epidemic ever recorded in Africa.
PRESS CONTACT:
Roland Sutter, M.D., M.P.H.&T.M.
CDC, National Immunization Program
(404) 639-8252
In March 1999, Angola reported 21 cases (3 deaths) of acute flaccid paralysis. By early April, there were 102 cases; by April 26th there were 562 cases. The Angola Ministry of Health (MOH) found that most of these cases were among children less than 5 years of age; 90% had received two or fewer doses of oral polio vaccine. The MOH soon began a vaccination campaign to control the epidemic. With war intensifying in the region at the end of 1998, large groups of displaced persons settled in crowed areas where sanitation is poor and water supplies inadequate -- an ideal environment for the spread of polio. Travelers to Angola are advised to review their polio vaccination history; ensuring that they have completed a primary series of three doses before beginning their travel.

  Playground Safety -- United States, 1998-1999
Playground safety includes supervision, age-appropriate equipment, resilient surfaces, and equipment maintenance.
PRESS CONTACT:
Donna Thompson, Ph.D.
National Program for Playground Safety
(800) 554-7529 (Central Standard Time)
Over 200,000 U.S. children receive emergency department care for playground injuries each year. As part of a national action plan to prevent such injuries, the National Program for Playground Safety conducted a survey of the nation's child care, elementary school, and park playgrounds. Results indicated that safety measures focusing on supervision, age-appropriate design of equipment, fall surfacing, and equipment maintenance should be implemented to reduce the number of playground injuries. Further information on the survey and safer playgrounds is available from the National Program for Playground Safety on the World-Wide Web at http://www.uni.edu/playground .

  Childhood Work-Related Agricultural Fatalities -- Minnesota, 1994-1997
Farm employers and parents can prevent work-related agricultural fatalities among youth by following established safe work procedures.
PRESS CONTACT:
Stephanie Pratt, M.A.
CDC, National Institute for Occupational Safety & Health
(304) 285-5916 (Cincinnati, Ohio)
(Alternate: Paul Moore, same phone number)
Investigations of six deaths on Minnesota farms between 1994-1997 show that younger agricultural workers are at-risk for injuries similar to those incurred by adult workers (e.g.; being struck by farm wagons, implements, or machine parts; tractor overturn; and suffocation in grain bins). Although youth under 16 years of age employed on farms are covered by provisions of the Fair Labor Standards Act, these protections do not apply to children working on their family's farm. Children working in agriculture are permitted to perform tasks prohibited in other industries. Exposure to agricultural machinery poses a particularly serious injury risk for young workers. CDC, National Institute for Occupational Safety & Health recommends that in assigning work tasks to youth, farm managers and parents evaluate the youth's training, experience, maturity, physical ability.

  Update: Outbreak of Nipah Virus -- Malaysia and Singapore, 1999
CDC continues its investigation of the new paramyxovirus -- Nipah virus.
PRESS CONTACT:
Division of Media Relations
CDC, Office of Communication
(404) 639-3286
As of April 24, 1999 there have been 257 reported cases and 100 deaths related to the new Nipah virus. Pigs are considered to be the most probable source of infection. All cases have been reported from Malaysia and Singapore. However, there have been no new cases reported from Singapore since abattoirs were closed, and the decrease in cases in Malaysia coincides with measures to limit human contact with pigs. Human-to-human transmission of the new virus has not been documented. Field and laboratory studies conducted by CDC, Australian researchers, and the Ministries of Health of Malaysia and Singapore are ongoing.

  MMWR Reports & Recommendations
Notice to Readers:

April 30, 1999/Vol 48/No. RR-4
"Prevention and Control of Influenza: Recommendations of the Advisory Committee on Immunization Practices (ACIP)"

This is an annual report. Principal changes include: 1) flu strains for the 1999-2000 vaccine are A/Beijing (H1N1)-like, A/Sydney (H3N2)-like, and B/Yamanashi; 2) potential expanded use of flu vaccine; 3) new information on live-attenuated flu vaccines; and 4) new information on flu among travelers.

The full report can be accessed on-line at www.cdc.gov/flu/

Contact: Division of Media Relations
CDC, Office of Communication
(404) 639-3286


  Releases

CDC Urges Better Education Efforts From Health Care Providers and Others to Encourage Women to Take Folic Acid Every Day

April 30, 1999
CDC, Division of Media Relations
(404) 639-3286

The Centers for Disease Control and Prevention (CDC) published a report today showing that most women of childbearing age still do not know that taking 400 mcg (.4 mg)* of the B-vitamin folic acid every day throughout their childbearing years will prevent neural tube birth defects in their children.

The report, authored by staff of the March of Dimes (MOD), and CDC's Division of Birth Defects and Pediatric Genetics Division, was published in CDC's Morbidity and Mortality Weekly Report. It shows that of the women studied, only 13% knew that folic acid helps prevent birth defects, and only 7% knew that it should be taken before pregnancy to prevent the birth defects. Of those who knew that folic acid prevents neural tube birth defects, 31% received their information from print media, 23% from radio or television, and only 19% received the information from their health care providers. "Women need to know about the lifesaving potential of folic acid but not enough are hearing about it from their health care providers," said Jennifer L. Howse, Ph.D., President, March of Dimes Birth Defects Foundation.

"Recent focus group research conducted by CDC revealed that most health care providers don't talk to their female patients about birth defect prevention before they get pregnant," said Katherine Lyon Daniel, Ph.D., Behavioral Scientist, CDC, Birth Defects and Pediatric Genetics Division. In addition, CDC identified the need for more educational materials to assist health care providers to inform women about taking folic acid before and during pregnancy to prevent neural tube defects.

CDC, MOD, and the National Council on Folic Acid will kick-off an educational campaign entitled, "Before You Know It" on Mother's Day which will include a series of public service announcements and other outreach activities to both health care providers and women. The key message is to urge women in their childbearing years to take 400 micrograms of folic acid every day before and during pregnancy to reduce their risk of having a baby born with neural tube birth defects.

"Women of childbearing years should be getting 400 micrograms daily," said J. David Erickson, DDS, Ph.D., Acting Director, CDC, Birth Defects and Pediatric Genetics Division.

CDC and the National Council on Folic Acid estimate that if folic acid were taken by all women of childbearing years every day prior to conception and throughout the early stages of pregnancy, the incidence of neural tube birth defects could be reduced by 50% to 70%.

Neural tube birth defects affect an estimated 4,000 pregnancies each year. The most common of these defects is spina bifida, the leading cause of childhood paralysis. Another is anencephaly, which affects the brain and results in miscarriage, stillbirth, or babies who live only a few days.

To prevent these birth defects, women must have sufficient folic acid in the body when they become pregnant. "The critical time when folic acid is needed is in the very first days of pregnancy, usually before a woman knows that she is pregnant," said Dr. Erickson, "and this is well before her first prenatal visit."

Experts advise that women consume foods fortified with folic acid like breakfast cereals, enriched breads and pastas, in addition to a balanced diet including foods rich in folate, such as leafy green vegetables, orange juice, and beans.

Although it is possible to get enough folic acid from fortified foods, it is not easy. Most experts caution that it may be difficult to maintain the daily requirement without taking a folic acid pill or multivitamin.

For more information, check out the web site: http://www.cdc.gov/nceh/folicacid.htm

* mcg = micrograms; mg = milligrams


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