MMWR

Morbidity and Mortality Weekly Report

1. Surveillance for Pediatric Deaths Associated with 2009 Pandemic Influenza A (H1N1) Virus Infection — United States, 2009

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

Any child, even previously healthy children and especially those with chronic medical conditions, can have a severe illness or even death from 2009 Pandemic influenza A (H1N1).  All children aged 6 months and older should receive 2009 pandemic influenza A (H1N1) vaccine when it becomes available, and children with high-risk medical conditions should immediately consult with a health care provider if they develop an illness consistent with influenza.  As of August 8, 2009, 477 deaths have been associated with 2009 pandemic influenza A (H1N1) virus infection in the United States, including 36 children younger than 18 years.  Based on studies from previous influenza outbreaks, children aged younger than 5 years or with certain chronic medical conditions are at increased risk for complications and death from influenza.  Sixty-seven percent of children who died had at least one chronic high-risk medical condition.  Neurodevelopmental conditions, such as developmental delay, epilepsy, and cerebral palsy, were the most frequently noted chronic medical conditions, reported in over 90 percent of children with a chronic medical condition.  A number of children also had bacterial infections, including most children who were older than 5 years and did not have high-risk medical conditions.  This finding suggests that bacteria, in combination with H1N1 influenza, can cause severe disease in children who may be otherwise healthy.

2. Inadvertent Marijuana Ingestion – Los Angeles, California, 2009

Press Contact: Los Angeles County Department of Public Health
Office of External Relations and Communications     
Phone: (213) 240-8144

It is beneficial for local health departments to establish good working relationships with law enforcement.  In April, 2009, the Los Angeles Police Department and the Los Angeles County Department of Public Health launched a collaborative investigation concerning a group of preschool teachers with neurological and gastrointestinal symptoms after eating brownies purchased from a sidewalk vendor. This report summarizes the results of that investigation, which detected cannabinoids in a recovered sample of the brownies. Two patients sought medical treatment, and one patient’s urine and serum tested positive for marijuana metabolites. The findings demonstrate the utility of a collaborative investigation by public health and law enforcement and the importance of timely testing of clinical specimens after symptom onset. It also underscores the need to consider marijuana as a potential contaminant during foodborne illness investigations.

3. Laboratory Surveillance for Wild and Vaccine-Derived Polioviruses—Worldwide, January 2008–June 2009

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

The work of the Global Polio Laboratory Network is essential to provide timely information on the global status of wild poliovirus circulation, to assure the program can respond quickly to importations or outbreaks by adjusting vaccination tactics.  The Global Polio Laboratory Network is comprised of 144 laboratories in 97 countries coordinated by the World Health Organization.  Data from the network are used to guide the Global Polio Eradication Initiative by confirming polio cases, detecting and determining the origin of importations, identifying vaccine-derived polioviruses, and documenting the circulation of wild polioviruses. The network tested 247,794 fecal samples sent to the laboratories from investigations of acute flaccid paralysis cases, from which 14,279 polioviruses and 46,462 nonpolio enterovirus isolates were detected during January 2008–June 2009. Despite this increasing workload, the laboratory network has improved the efficiency of poliovirus testing and reduced reporting times by 50 percent since 2007.  These virus testing improvements enable more rapid implementation of responsive supplementary immunization activities targeted at areas of confirmed wild poliovirus circulation.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES