MMWR

Morbidity and Mortality Weekly Report

Imported Human Rabies – California, 2008

Press Contact: Christopher Cox, Health Communications Specialist, National Center for Zoonotic, Vectorborne, and Enteric Diseases
Phone: (404) 639-0045

Rabies cases are often not confined to the borders of any one country. As such, coordinated international efforts are necessary to investigate multi-national cases and re-enforce preventative messages domestically and internationally, especially in regards to human rabies prevention and animal rabies control along shared borders. Rabies is a highly fatal disease, but can be prevented by timely vaccination after an exposure. The risk of being exposed to rabies remains high in countries where dog rabies has not been controlled. Human cases of rabies in the United States among persons recently immigrating from abroad are a reminder of the global impact of rabies and complications, such as language barriers and cultural factors that can arise during contact investigations. The recent case of rabies reported from California in an immigrant from Mexico demonstrates the need for improved coordination among international entities to fully address these – and other – issues that affect the health status of persons crossing national boundaries.

Clinic-Based Testing for Rectal and Pharyngeal Neisseria gonorrhoeae and Chlamydia trachomatis Infections by Community-Based Organizations – Five Cities, United States, 2007

Press Contact: CDC, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention
Phone: (404) 639-8895

A CDC analysis of rectal and pharyngeal Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) testing data from six gay-focused community-based organizations found a large number of new NG and CT cases. Rectal NG and CT test positivity rates were higher at sites using nucleic acid amplification (NAA) tests (NG 5.4 percent CT 8.9 percent), and pharyngeal NG was detected in 5.3 percent of NAA tests. Using NAA tests, gay-focused CBOs may be able to detect thousands of NG and CT infections among men who have sex with men (MSM) that may not otherwise be diagnosed. NAA tests are not FDA cleared for the diagnosis of rectal or pharyngeal NG and CT infections, however individual laboratories such as Laboratory Corporation of America and Quest Diagnostics have met regulatory standards and now offer NAA tests for the diagnosis of rectal and pharyngeal NG and CT infections. According to the 2003−2005 National HIV Behavioral Surveillance study, only 36 percent of MSM reported being tested for gonorrhea in the previous year. CDC recommends at least yearly screening for rectal NG and CT infection for MSM who had receptive anal intercourse during the preceding year and for pharyngeal NG infection for MSM who have participated in receptive oral intercourse during the preceding year.

Progress Toward Poliomyelitis Eradication – India, January 2007-May 2009

Press Contact: CDC, Division of Media Relations
Phone: (404) 639-3286

Frequent mass campaigns with high vaccination coverage have reduced wild poliovirus circulation to few areas in two states. Eliminating all poliovirus transmission in India will require stopping WPV circulation in both states simultaneously, with the emphasis first on WPV1. Wild poliovirus (WPV) circulation in India has been restricted to small areas in two northern states, Bihar and Uttar Pradesh. These states have been the source of other cases in India since 2002, and sometimes the source for polio cases in other countries. With an accelerated effort to stop transmission of WPV type 1 (WPV1) before WPV type 3 (WPV3) with preferential use of a monovalent vaccine directed against WPV1 in campaigns, WPV1 is currently circulating in the smallest historical area in each state. Uttar Pradesh state, a densely populated area where the oral poliovirus vaccine appears to be less effective than elsewhere, had been free of WPV1 transmission for six months. However, an outbreak in Uttar Pradesh started in May 2008 because of WPV imported from Bihar; this outbreak is now waning. Bihar has had relatively few WPV1 cases in 2008-09 but because some areas are flood-prone, populations can be difficult to access. While new approaches are being explored to improve the effectiveness of vaccination, current levels of WPV circulation make polio elimination in India within reach.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES