Synopsis for February 18, 2005

The MMWR is embargoed until Thursday, 12 PM EDT.

1. Hepatitis A Vaccination Coverage Among Children Aged 24-35 Months ― United States, 2003
2. Nonfatal Motor-Vehicle-Related Backover Injuries Among Children ― United States, 2001-2003
3. Measuring Exposure to an Elemental Mercury Spill ― Dakota County, Minnesota, 2004
4. Tuberculosis Transmission in a Homeless Shelter Population ― New York, 200-2003

Hepatitis A Vaccination Coverage Among Children Aged 24-35 Months ― United States, 2003

Hepatitis A vaccination programs are reaching many children but need to reach more.

In 1999, routine hepatitis A vaccination of children was recommended in regions of the country where hepatitis A was more common. Results from the first national hepatitis A vaccination survey show that 50 percent of 24- to 35-month-old children in the 11 states where routine vaccination is recommended have received at least 1 dose, compared to 25 percent in the six states where consideration of routine vaccination was recommended. Vaccination rates were highest among populations that have had the highest rates of hepatitis A in the past, such as Hispanic, American Indian, and Alaskan Native children. However, increasing the number of children who are vaccinated against hepatitis A is needed to ensure continued declines in the number of hepatitis A cases in the United States.

Nonfatal Motor-Vehicle-Related Backover Injuries Among Children ― United States, 2001-2003

Motor vehicle backover-related injuries pose a serious risk to children and youth, especially those between the ages of one and four years.

Alerting parents to this risk makes it possible for them to take simple steps to protect children from backover-related injuries. Motor vehicle backover-related injuries pose a serious risk to children and youth with an estimated 7,475 children from ages one to 14 years treated in U.S. emergency departments between 2001 and 2003 for nonfatal backover-related injuries. CDC researchers found that half of the children injured were ages one to four years old. Most backover-related injuries took place at home or on public property with 40 percent of incidents reported in driveways or parking lots. While the majority (78 percent) of cases were treated and released from the emergency departments, motor vehicles backing over children and youth pose a substantial risk for severe injury and death. Alerting parents and caretakers to this risk makes it possible for them to take simple steps to protect children from backover-related injuries. Additionally, prevention measures ranging from environmental modifications, like fencing off driveways, to changes in vehicle design, like extra mirrors or sensing devices, may reduce the risk of backover-related injuries to children and youth and should be evaluated.

MMWR Article

Measuring Exposure to an Elemental Mercury Spill ― Dakota County, Minnesota, 2004

No Summary Available.

Tuberculosis Transmission in a Homeless Shelter Population ― New York, 200-2003

Compared to the general population, homeless persons continue to be at a greater risk of latent TB infection and progression to active TB disease. Preventing and controlling TB among homeless persons requires coordinated surveillance, multifaceted interventions and intensive outreach. Ongoing coordination across multiple health and social service agencies is critical in identifying and controlling outbreaks in these settings.

This report describes an outbreak of tuberculosis (TB) among homeless persons in a large shelter in New York State, with cases diagnosed and reported in three different local health jurisdictions. The outbreak was recognized through enhanced surveillance, coordinated across several public health jurisdictions, and real time genotyping of TB strains which suggested that multiple chains of transmission were occurring simultaneously. Because standard screening and contact investigation efforts had not been effective in preventing transmission, an intensive onsite active case finding effort involving multiple agencies was undertaken. Four persons with active TB were identified as a result of this intensive case identification, and a program of directly observed treatment for TB-infected individuals was initiated at the shelter.

During the subsequent year, five additional active cases have been identified (one culture-negative case and four with the shelter-associated strain), likely linked to transmission in the shelter before the intensive case-finding effort. Only two of these cases were resident at the shelter at the time of diagnosis.

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