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The MMWR is embargoed until Thursday, 12 PM EDT.
Synopsis for October 22, 2004
Self-Reported Frequent Mental Distress Among Adults — United States, 1993-2001
The prevalence of adult Americans’ frequent mental distress increased over the period 1993-2001 and differed substantially by race/ethnic group, sex, and household income—suggesting the need for improved access to mental health services, and educational programs that reduce stigma and encourage seeking treatment to reverse this trend and eliminate these disparities.
The purpose of this study was to examine population differences and factors contributing to poor mental health in a representative sample of more than 1 million U.S. adults from all 50 states during 1993-2001. Frequent Mental Distress, or FMD, was defined as 14 or more days in the past 30 days for which mental health (including stress, depression, or emotional problems) was not good. Between 1993 and 2001, the prevalence of FMD increased from 8.4 percent to 10.1 percent, mostly due to increases in the black and white non-Hispanic groups. FMD was most common among American Indians/Alaska Natives (14.4 percent) and other, non-Hispanics (12.9 percent), and least common among Asians/Pacific Islanders (6.2 percent). Respondents who were younger, female, separated, divorced, widowed, unemployed, or unable to work or who had less than a $15,000 annual household income, high school education, or no health insurance reported more FMD. Targeting socioeconomic risk factors, improving access to mental health services and social services (e.g., job training programs), and implementing educational programs that reduce stigma and encourage seeking mental health treatment could decrease FMD for U.S. adults.
Transmission of Primary and Secondary Syphilis by Oral Sex — Chicago, Illinois, 1998-2002
A new report by the Chicago Department of Public Health shows that about 14 percent of primary and secondary syphilis cases reported there between 2000 and 2002 were transmitted through oral sex.
Roughly 20 percent of MSM with syphilis indicated only oral sex exposure, and MSM were 3.8 and 3.4 times more likely than heterosexual men and women, respectively, to report only oral sex. Of all the MSM with syphilis, 51 percent were already HIV-positive, 34 percent were unaware of their status, and 14 percent were HIV-negative. While the risk of transmitting HIV through oral sex is much lower than through anal or vaginal sex, oral sex is a an efficient way of transmitting syphilis. Many people falsely believe that unprotected oral sex is a safe behavior and fail to use condoms during oral sex. Authors stress the importance of alerting people to the risk of syphilis transmission through oral sex, the role of syphilis in facilitating HIV transmission, and its possible role in HIV disease progression.
Postexposure Prophylaxis, Isolation, and Quarantine To Control an Import-Associated Measles Outbreak — Iowa, 2004
Isolation and quarantine may be necessary to prevent spread of infectious diseases.
In March 2004, an Iowa student while returning from India developed measles. He was unvaccinated, and was known to be exposed to other students with measles while in India. The public health effort used to prevent further spread of this disease, included isolation and quarantine. Recent changes in Iowa’s state law, because of concerns for bioterrorism and emerging diseases, allowed the state health department to use these tools to stop measles transmission. These tools, not normally used, were considered necessary since the student was a member of a particularly vulnerable community. As a result of using post exposure prophylaxis, isolation, and both voluntary and involuntary quarantine, only two additional people became ill.
West Nile Virus Activity — United States, October 13-19, 2004
No summary available.
Summary Surveillance for Waterborne-Disease Outbreaks Associated with Recreational Water — United States, 2001-2002
Remember that swimming means you’re sharing the water with your fellow swimmers. Don’t swim when you have diarrhea. Don’t swallow the pool water. Practice good hygiene before and during swimming activities. Many of these outbreaks could have been prevented by the public adopting these healthy swimming habits and pool operators being better trained and more vigilant in maintaining high water quality in their pools and spas.
The number of recreational waterborne illness outbreaks reported in 2001-2002 is the largest number of outbreaks recorded since data collection began in 1978. Over 2,500 people were affected in 65 outbreaks. Almost half (46.2%) were outbreaks of diarrheal illness, with Cryptosporidium accounting for half of outbreaks associated with disinfected swimming venues, likely due to its chlorine resistance. An increase in the number of skin infections associated with swimming over the period 1997 to 2002 was also documented. Although many of these recreational water illnesses were preventable, the increasing trend in reporting of recreational water-associated outbreaks underscores continuing problems with poor pool and spa maintenance, watershed contamination, and people ill with diarrhea who continue to swim despite their illness.
Summary Surveillance for Waterborne-Disease Outbreaks Associated with Drinking Water — United States, 2001-2002
Fewer drinking water outbreaks occurred during 2001-02 than during the previous reporting period, and is near the lowest numbers since reporting began. Drinking water regulations enacted by EPA are likely to be largely responsible for this decrease, and continued development of such regulations (including the pending Groundwater Rule) is warranted.
Provision of safe drinking water to the American public remains a priority. This summary of disease outbreaks related to drinking water during 2001-2002 demonstrates a decrease in the number of such outbreaks compared to the previous two-year period. Over the past 20 years, the number of outbreaks has declined dramatically. Because the steepest decrease has been of outbreaks associated with the types of water systems (“community” systems) governed most directly by EPA drinking water regulations, this decline is likely due in large part to these increasingly stringent regulations. Water systems using groundwater sources are associated with the largest proportion of outbreaks; this argues for the continued development of EPA’s Groundwater Rule, which calls for better regulation of groundwater systems. Individually operated groundwater systems (e.g., private wells, etc.) continue to account for a large proportion of outbreaks. Because these systems are not subject to regulation by EPA, there is a continued need for education of builders, owners and users of such wells.
This page last reviewed October 21, 2004
Disease Control and Prevention