Synopsis for October 29, 1999

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

1. Diabetes Preventive-Care Practices in Managed-Care Organizations — Rhode Island, 1995-1996
2. Influenza and Pneumococcal Vaccination Rates Among Persons with Diabetes Mellitus — United States, 1997
3. Progress Toward Poliomyelitis Eradication — Myanmar, 1996-1999
4. Public Health Response to a Potentially Rabid Bear Cub — Iowa, 1999

Synopsis for October 29, 1999

Diabetes Preventive-Care Practices in Managed-Care Organizations — Rhode Island, 1995-1996

Increased eye exams reflect improved prevention efforts for diabetes, but continued efforts are needed to enhance other preventive care services.

 

PRESS CONTACT: Edward Gregg, Ph.D. CDC, National Center for Chronic Disease Prevention & Health Promotion (770) 488-1273

Eye exams, foot exams, and glycosylated hemoglobin (GHb) assessment help prevent debilitating complications of diabetes, including vision loss, kidney disease, amputation, and disability. The high levels of eye exams (87%) reported among patients with diabetes in this Rhode Island study may reflect recent statewide initiatives to enhance eye exam rates. However, 42% of individuals with diabetes did not receive GHb assessments, a blood test of overall glucose control, which is important to the prevention of diabetic eye and kidney disease and nerve damage. Similarly, 42% had not received semi-annual foot exams which are important to help identify sores and infections and provide therapy to prevent further infection and amputation. This report is consistent with previous reports showing that large proportions of people with diabetes don't receive recommended preventive services.

Influenza and Pneumococcal Vaccination Rates Among Persons with Diabetes Mellitus — United States, 1997

Immunization is important for reducing illness and deaths from influenza and pneumonia among persons with diabetes.

 

PRESS CONTACT: Stephanie Benjamin, Ph.D., M.P.H. CDC, National Center for Chronic Disease Prevention & Health Promotion (770) 488-1263

A national health objective for the year 2000 is to increase influenza and pneumococcal vaccination rates to 60% among persons at high risk for complications, including persons with diabetes. In 1997, among adults with diabetes, 52.1% reported receiving an influenza vaccination during the past 12 months and 33.2% reported ever receiving a pneumococcal vaccination. When vaccination rates were examined by state, only 12 states met the national objective of 60% for influenza vaccination and none of the states reached the national objective of 60% for the pneumococcal vaccination. Increased efforts are necessary to improve influenza and pneumococcal vaccination rates among persons with diabetes.

Progress Toward Poliomyelitis Eradication — Myanmar, 1996-1999

Myanmar is successfully implementing the polio eradication strategies recommended by the World Health Organization.

 

PRESS CONTACT: Roland Sutter, M.D., M.P.H. & T.M. CDC, National Immunization Program (404) 639-8252

In 1988, the World Health Assembly adopted the goal of global eradication of polio to be achieved by the year 2000. Substantial progress toward this goal has been reported from virtually every polio-endemic country in the world. Myanmar has conducted National Immunization Days since 1996, vaccinating >95% of target children <5 years in each of two annual rounds. During the same period surveillance for acute flaccid paralysis (AFP) has been improving rapidly and the non-polio AFP rate, a measure for the completeness of polio surveillance increased to 0.91 in 1998. However, wild poliovirus was isolated from four patients with paralytic disease along the border with Bangladesh. The apparent decline in surveillance for 1999 and the leveling-off of routine vaccination coverage levels, along the Bangladesh border, will need attention and appropriate action to remedy.

Public Health Response to a Potentially Rabid Bear Cub — Iowa, 1999

A false-positive test result for rabies in a bear affords an opportunity to review testing procedures and protocols for rabies.

 

PRESS CONTACT: Robert Gibbons, M.D. CDC, National Center for Infectious Diseases (404) 639-1075

On August 27, 1999, a black bear cub in an Iowa petting zoo died after several hours of acute central nervous system symptoms. Preliminary tests, conducted in Iowa, indicated rabies. The Iowa Department of Public Health initiated an appropriate campaign to identify and inform persons potentially exposed to the bear's saliva. On August 31, brain tissues were submitted to CDC to identify the wildlife species associated with the virus. However, subsequent testing conducted by CDC (and a second Iowa laboratory) found no evidence of rabies virus in the brain or spinal cord tissues of the bear. Symptomatic rabies is 100% fatal, while the risk for receiving vaccine is minimal. National and international reference laboratories (including the WHO Collaborating Centre for Reference and Research for Rabies at CDC) are available to clarify and interpret rabies test results.

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