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Morbidity and Mortality Weekly Report

1. Severe 2009 Pandemic Influenza A (H1N1) in Pregnant Women – New York City, 2009

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Physicians should educate pregnant and postpartum women regarding the risks posed by influenza infection, highlight the safety and effectiveness of influenza vaccination and initiate prompt antiviral treatment in pregnant or postpartum patients with possible 2009 H1N1 influenza. This report describes clinical characteristics of 16 pregnant women and one postpartum woman with 2009 H1N1 influenza infection who were admitted to intensive care units in New York City during 2009. Pandemic 2009 H1N1 Influenza illness in these women resulted in two maternal deaths, one infant death, and a stillbirth. Two illustrative case reports show the rapid clinical deterioration that can occur in 2009 H1N1-infected pregnant women. Delays in care-seeking, diagnosis, and treatment of influenza might have increased the potential for rapid clinical decline in some of these patients. Physicians should educate pregnant and postpartum women regarding the risks posed by influenza infection, highlight the safety and effectiveness of influenza vaccination and initiate prompt antiviral treatment in pregnant or postpartum patients with possible 2009 H1N1 influenza.

2. Racial/Ethnic Disparities in Breastfeeding Among U.S. Children Born During 2003–2006, by State — National Immunization Survey, United States, 2004–2008

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Breastfeeding provides a wide range of benefits to the mother, the child, and the community. However, many children, particularly those who are black, are not receiving these benefits. CDC analyzed data from the National Immunization Survey for children born in 2003-2006 to assess the prevalence of breastfeeding initiation and duration among blacks, whites, and Hispanics for each state. Overall, 74 percent of women are initiating breastfeeding; however rates of breastfeeding duration are below target levels. Substantial disparities exist, as breastfeeding initiation and duration rates are lower among blacks than whites and Hispanics in most states. Thirteen states, predominantly in the southeast, had a prevalence of breastfeeding initiation that was more than 20 percentage points lower for blacks than whites. A better understanding of and strategies to address barriers to breastfeeding among black women are needed.

3. Tick-Borne Encephalitis Among Five U.S. Travelers — Europe and Asia, 2000–2009

CDC
Division of News and Electronic Media
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Travelers to certain countries in Europe and Asia are at risk for tick borne encephalitis (TBE), which can cause infection of the brain (encephalitis) or lining of the brain (meningitis).TBE has rarely been reported among North American travelers to Europe. This report describes five cases of TBE among U.S. travelers, 2000-2009. Four cases were among travelers to Europe who all made nearly complete recoveries. The fifth patient, who represents the first reported case of TBE in a U.S. traveler to China, had a more severe illness and ongoing neurologic impairment. Health-care providers should be aware of TBE, counsel travelers about measures to reduce exposure to tick bites, and consider the diagnosis of TBE in travelers returning from TBE-endemic countries in Europe and Asia with meningitis or encephalitis. Vaccines to protect against TBE are licensed and available in Europe and Canada.

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

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