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MMWR
Synopsis for December 7, 2001

The MMWR is NOT embargoed this week.

  1. Update: Investigation of Bioterrorism-Related Anthrax — Connecticut, 2001
  2. Update: Unexplained Deaths Following Knee Surgery — Minnesota, 2001
  3. Septic Arthritis Following Anterior Cruciate Ligament Reconstruction Using Tendon Allografts — Florida and Louisiana, 2000
  4. Influenza Activity — United States, 2001–02 Season

Notices to Readers

Use of Onsite Technologies for Rapidly Assessing Environmental Bacillus anthracis Contamination on Surfaces in Buildings
Recently, rapid-assay devices that can provide quick results have been used for onsite detection of environmental contamination. Some of the devices are PCR-based and others are immune-based assays for B. anthracis. CDC has not obtained validation data for these devices.

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


Reports and Recommendations
December 7, 2001/Vol. 50/ No. RR-22

School Health Guidelines to Prevent Unintentional Injuries and Violence
This report summarizes school health recommendations for preventing unintentional injury, violence, and suicide among young persons. These guidelines were developed by CDC in collaboration with specialists from universities and from national, federal, state, local, and voluntary agencies and organizations.

Contact: Katie Baer
CDC, National Center for Chronic Disease Prevention and Health Promotion
(770) 488–5131


Synopsis for December 7, 2001

Update: Investigation of Bioterrorism-Related Anthrax — Connecticut, 2001

As of December 5, a total of 11 inhalational anthrax cases have been identified in the United States.

 

PRESS CONTACT:
Division of Media Relations

CDC, Office of Communication
(404) 639–3286

 

The source of exposure to Bacillus anthracis for the inhalational anthrax cases in Connecticut and New York City remain under investigation by public health and law enforcement officials. No direct exposure to B. anthracis-containing envelopes has been identified for these cases. In the absence of definitive evidence indicating how transmission occurred, infection from a cross-contaminated envelope is one hypothesis being considered by investigators. Cross-contamination could also explain how B. anthracis spores were spread to some postal facilities that did not process the envelopes addressed to the U.S. senators.

 

Update: Unexplained Deaths Following Knee Surgery — Minnesota, 2001

This report is an update on the investigation involving the Minnesota patients who died unexpectedly following elective knee surgery.

 
PRESS CONTACT:
Division of Media Relations

CDC, Office of Communication
(404) 639–3286
 

The Minnesota Department of Health (MDOH) with the assistance of CDC has been conducting this investigation. The epidemiologic investigation showed no common causes of death for the three victims. However, lab testing has shown the presence of microorganism Clostridium sordelli in the blood of one of the patients. Test conducted on the other two patients for an infectious cause of death were negative. The investigation is now focused on the possible contamination of the allograft tissue received by the patient diagnosed with the bacterial infection. Clinicians are encouraged to report infections involving allograft tissue to the Food and Drug Administration’s MedWatch system. Also, clinicians should contact their State health department and CDC’s Division of Healthcare Quality Promotion.

 

Septic Arthritis Following Anterior Cruciate Ligament Reconstruction Using Tendon Allografts — Florida and Louisiana, 2000

This report describes four cases of knee infection in patients who had reconstructive knee surgery using human donor tissues (allografts).

 
PRESS CONTACT:
Division of Media Relations

CDC, Office of Communication
(404) 639–3286
 

This investigation showed no detectible lapses in infection control procedures, but found that contaminated allografts were the most likely source of the infections. Some types of allografts are not sterilized using conventional sterilization methods in order to preserve their functional and mechanical properties. Effective sterilization methods, that do not adversely affect the function of grafted musculoskeletal tissue, are needed to prevent allograft-related bacterial infections. Current regulations have focused on screening donors to prevent transmission of such viruses as HIV and hepatitis. Standardized practices for screening, disinfecting, or discarding potentially contaminated allografts, and mechanisms to ensure adherence to quality control standards are needed.

 

Influenza Activity — United States, 2001–02 Season

From September 30 – November 24, influenza activity in the U.S. was at low levels.

 
PRESS CONTACT:
Alicia Postema, M.P.H.

CDC, National Immunization Program
(404) 639–3747
 

During this time period, 16 states have reported influenza isolates but the weekly percent of respiratory specimens testing positive for influenza is low, ranging from 0.4% to 1.7% (compared to 24%-33% testing positive at the peak of the previous 3 seasons). So far this season, the weekly percent of patient visits to sentinel physicians for influenza-like illness has not exceeded baseline and the percentage of deaths due to pneumonia and influenza as reported by the 122 Cities Mortality Reporting System has not exceeded the epidemic threshold. The majority of influenza viruses isolated were influenza A (H3N2) and were well matched by the influenza A (H3N2) vaccine strain. Vaccine supplies are now plentiful and are available for immediate shipment from the three U.S. licensed manufacturers (Aventis Pasteur, Wyeth-Lederle, and Henry Schein/GIV for Evans Vaccines).

 


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