Synopsis for January 26, 2006

The MMWR is embargoed until Thursday, 12 PM EST.

1. Human Orf – New York, California, Tennessee, and Illinois, 2004-2005
2. Rates of Cesarean Delivery Among Puerto Rican Women – Puerto Rico and the U.S. Mainland, 1992-2002
3. Surveillance for Early Detection of Disease Outbreaks at an Outdoor Mass Gathering – Virginia, 2005

Human Orf – New York, California, Tennessee, and Illinois, 2004-2005

Orf virus infection is largely preventable if sheep and goat handlers wear gloves and practice good hand hygiene to help protect against infection.

Orf virus, found worldwide, is a poxvirus that infects goats and sheep. Spread of this virus to people is a largely preventable work-related infection of sheep and goat handlers; family members of handlers and petting zoo attendees are also potentially at risk of infection. People who become infected normally develop skin ulcers, which can be confused with anthrax skin infection and clear without treatment. Serious infections can develop in people with poorly functioning immune systems. New laboratory tests can aid public health officials in diagnosing orf virus infection and guiding recommendations for affected people. The use of gloves and good hand hygiene may prevent the majority of infections in animal handlers.

Rates of Cesarean Delivery among Puerto Rican Women – Puerto Rico and the U.S. Mainland, 1992-2002

Nearly half of all live births in Puerto Rico in 2002 were by cesarean delivery. From 1992 to 2002 rates of cesarean delivery in Puerto Rico were consistently higher and increasing at a faster rate than those among Puerto Rican women delivering on the U.S. mainland.

Rates of cesarean delivery and primary cesarean delivery were 72 percent and 85 percent higher, respectively, among Puerto Rican women in Puerto Rico than among Puerto Rican women delivering on the U.S. mainland. From 1992 to 2002, the greatest increases in rates of cesarean delivery in Puerto Rico were among the youngest and least educated women; however, the highest rates remained among women aged greater than 40 years and those with the highest levels of education. During 2002, the rate of cesarean delivery among women at low risk giving birth for the first time in Puerto Rico was 45 percent, a rate 200 percent higher than the Healthy People 2010 target of 15 percent for women at low risk. Efforts to reduce the cesarean delivery rate in Puerto Rico should focus on lowering the rate of primary cesarean deliveries, especially among women with low-risk pregnancies.

Surveillance for Early Detection of Disease Outbreaks at an Outdoor Mass Gathering – Virginia, 2005

Public health surveillance at mass gatherings is crucial to enabling rapid detection of outbreaks and other health emergencies.

Implementing surveillance at mass gatherings might help detect outbreaks or possible acts of biologic terrorism and enable prompt public health intervention. In July 2005, a public health screening and surveillance system was implemented to monitor disease and injury among approximately 43,000 youths and adults attending a 10-day camping event. This report describes the public health surveillance and response during the event and presents recommendations for health surveillance at mass gatherings.

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This page last reviewed January 26, 2006
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