MMWR

Morbidity and Mortality Weekly Report

1. Assessment of Epidemiology Capacity in State Health Departments – United States, 2009

Press Contact: Council of State and Territorial Epidemiologists (CSTE)
Lauren Rosenberg, Associate Research Analyst
(770) 458-3811

The epidemiology capacity needed to produce the scientific data that underlies public health is less than adequate and eroding. A national vision is needed for what public health epidemiology and related technological capacity should be and a strategy for achieving it.  Epidemiology provides the scientific foundation for public health. The 2009 Epidemiology Capacity Assessment conducted by the Council of State and Territorial Epidemiologists (CSTE) found that state-level epidemiology capacity to conduct surveillance, investigation and evaluate public health programs has eroded from an already inadequate level since 2006 in association with a decrease in bioterrorism/emergency response funding and a 10% decrease in the state-level public health epidemiology workforce. CSTE interprets the state of national epidemiology capacity and trends as constituting a national preparedness and public health vulnerability, and recommends that state, federal and local agencies work together to address the downward trends and major gaps, and develop a common vision for what public health epidemiology and related technological capacity should be and a strategy for achieving it. 

2. Imported Case of Marburg Hemorrhagic Fever – Colorado, 2008

Press Contact: CDC
Division of Media Relations 
(404) 636-3286

Marburg hemorrhagic fever (MHF) is a severe, often fatal disease that occurs in tropical areas of Africa, and is associated with exposure to caves or mines inhabited by fruit bats. Health care providers should advise travelers to MHF-endemic areas to avoid entering caves or mines inhabited by bats, and should rapidly report, isolate and test suspected cases.  An imported case of Marburg hemorrhagic fever (MHF) was diagnosed in a Colorado resident who returned from Uganda in January, 2008.  She had visited the Python Cave in Uganda, which harbors numerous Egyptian fruit bats (Rousettus aegyptiacus), the presumed reservoir of Marburg virus. She survived after a severe illness; no evidence of secondary transmission was found, nor evidence of infection among her tour companions who visited the cave.  Because initial signs and symptoms of MHF may be nonspecific, health care providers should consider MHF in severely ill patients exposed to cave-dwelling fruit bats in tropical areas of Africa.  Health care providers should rapidly report, isolate, and test suspected cases.  Travelers to tropical areas of Africa should be advised to avoid entering caves or mines inhabited by bats.

3. Agranulocytosis Associated with Cocaine Use – Four States, March 2008-July 2009

Press Contacts:
New Mexico Department of Health
Deborah Busemeyer, Communications Director
(505) 827-2619

Washington State Department of Health
Tim Church, Communications Director
(360) 236-4077

Donn Moyer, Media Relations Manager
(360) 236-4076

Agranulocytosis is a life-threatening condition therefore people who use cocaine should seek medical attention if they experience persistent sore throat, persistent or recurrent fever, swollen glands, painful sores, skin infections or other unusual infections. Healthcare providers should consider agranulocytosis or neutropenia in patients who use cocaine and present with these symptoms.  The New Mexico Department of Health and Washington State Department of Health have identified 21 cases of agranulocytosis, a life-threatening condition that compromises the immune system, among persons using cocaine. The condition is believed to be caused by inadvertent exposure to levamisole via cocaine use. Levamisole is a pharmaceutical drug commonly added to cocaine for reasons unknown. The U.S. Drug Enforcement Administration estimated that the proportion of cocaine coming into the United States containing levamisole has dramatically increased over the last few years from less than 10% in July of 2007 to 69% in July of 2009. National surveillance is being conducted to further examine this public health issue.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES