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MMWR – Morbidity and Mortality Weekly Report

1. Discordant Results from Reverse Sequence Syphilis Screening — Five Laboratories, United States, 2006-2010

National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
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(404) 639-8895

Although many laboratories conduct syphilis screening using a reverse sequence with initial treponemal testing, CDC continues to recommend the traditional screening algorithm of initial nontreponemal testing and confirmation by treponemal testing. The availability of automatable treponemal enzyme immunoassays (EIA) and chemiluminescence immunoassays (CIA) has led some laboratories to adopt a reverse sequence of syphilis screening in which a treponemal EIA or CIA is performed first, followed by testing of reactive sera with a nontreponemal test, such as the rapid plasma reagin test or Venereal Disease Research Laboratory test. For this report, researchers analyzed data from five laboratories to better understand the performance of treponemal EIA/CIA as screening tests. Researchers found that among patients with reactive EIA/CIA results, 57 percent had nonreactive nontreponemal test results; among these discordant sera 32 percent were nonreactive with a second, different treponemal test, suggesting that they were likely false-positive results. CDC continues to recommend screening with a nontreponemal test followed by testing of reactive sera with a treponemal test. However, for those laboratories that use reverse sequence screening, CDC recommends reflexively testing all sera with reactive EIA/CIA results with a quantitative nontreponemal test. Sera with discordant results should be reflexively tested with a confirmatory Treponemal pallidum particle agglutination test.

2. Decrease in Smoking Prevalence — Minnesota, 1999-2010

Mike Sheldon
ClearWay Minnesota
(952) 767-1425

From 1999 to 2010, Minnesota implemented a series of tobacco control efforts, including a comprehensive statewide smoke-free law, cigarette tax increases, mass media campaigns, and provision of statewide cessation services. As a result Minnesota has benefited from a sustained tobacco control program and has experienced decreasing trends in adult cigarette smoking and exposure to secondhand smoke. Adult cigarette smoking prevalence in Minnesota decreased from 22.1 percent in 1999 to 16.1 percent in 2010, a 27.1 percent decline compared to modest changes in the national cigarette smoking prevalence during this time. Per capita cigarette sales in Minnesota decreased 40 percent during the same period. In addition, more adults reported modifying home rules to restrict smoking in 2010 compared with 1999 (87.2 percent versus 64.5 percent) and adults were less likely to report exposure to secondhand smoke (45.5 percent versus 67.2 percent). Sustained investments in comprehensive state tobacco control programs are needed to further reduce cigarette smoking and exposure to secondhand smoke and have broad benefits for society.

3. Recommended Immunization Schedules for Persons Aged 0 Through 18 — United States, 2011

CDC Division of News and Electronic Media
(404) 639-3286

The purpose of the recommended immunization schedule is to prevent as much disease as possible by protecting infants and children early in life, before they are exposed to potentially life-threatening diseases. Today, we can protect children from 16 potentially serious diseases with vaccines. Every dose of a vaccine is important because they all protect against infectious diseases that are threats today. These diseases can be especially serious for infants and very young children. Parents may not have heard of some of today's vaccines or the serious diseases they prevent. For example, Haemophilus influenzae type b (Hib) vaccine prevents a serious bacterial infection that was a leading cause of mental retardation before the vaccine began to be used. Pneumococcal vaccine prevents today's leading cause of bacteria bacterial meningitis (infection of the fluid around the brain and spinal cord). The Centers for Disease Control and Prevention sets and annually publishes the U.S. childhood immunization schedule for children birth through 18 years of age based on recommendations from the Advisory Committee on Immunization Practices (ACIP)—a group of medical and public health experts. The schedule also is approved by the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP).

 

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