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MMWR – Morbidity and Mortality Weekly Report

News Summary for September 1, 2011

1. Antibiotic Prescribing for Persons Aged ≤14 Years — United States, 1993–1994 to 2007–2008

CDC Division of News and Electronic Media
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Inappropriate antibiotic use contributes to antibiotic resistance, which leads to increased health-care costs, treatment failures and deaths from infections. In this study, 58 percent of antibiotic prescriptions for office visits among children ≤14 years were for acute respiratory infections (ARIs), most episodes of which do not require antibiotic therapy.  Antibiotic prescribing for ARIs decreased 24 percent during 1993-2008, mostly due to decreased prescribing for patients with pharyngitis (26 percent decrease) and patients with nonspecific upper respiratory infections (URIs) or the common cold (19 percent decrease).  While this decrease is encouraging, antibiotics are still prescribed too frequently for children ≤14 years in the US. Interventions such as patient and health-care provider education, offered by CDC’s Get Smart: Know When Antibiotics Work campaign (www.cdc.gov/getsmart), are important steps towards further reducing rates of antibiotic use among children in the US.

2.National and State Vaccination Coverage Among Children Aged 19–35 Months — United States, 2010

CDC Division of News and Electronic Media
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Immunization of U.S. toddlers remains high, with coverage for most routine vaccines remaining at or over 90 percent, according to the 2010 National Immunization Survey (NIS). Vaccination coverage for many vaccine preventable diseases increased from the previous year, including coverage against measles, mumps and rubella, rotavirus, pneumococcal disease, hepatitis A, and Haemophilus influenza type B.  Vaccination coverage against poliovirus, varicella and the full series of hepatitis B remained stable above 90 percent. Vaccination coverage did not differ by racial or ethnic groups for most vaccines.  Rather, due to recent increases in coverage among minority children, vaccination levels for most vaccines among other racial/ethnic groups were similar to or higher than levels among white children.  The survey found less than 1 percent of toddlers had received no vaccines at all.  Maintaining high vaccination coverage levels is important to reduce the burden of vaccine-preventable diseases and prevent a resurgence of these diseases in the United States, particularly in undervaccinated populations.

3.Human Rabies — Wisconsin, 2010

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

Human rabies is a vaccine-preventable disease that is almost always fatal in unimmunized persons. Prompt and thorough wound cleaning and administration of post exposure prophylaxis as soon as possible after rabies virus exposure can eliminate the risk for rabies in nearly all cases. Clinical presentations of human rabies can vary and health-care providers should consider a diagnosis of rabies for any patient with unexplained progressive encephalitis. Obtaining information regarding exposure to animals in the United States and during foreign travel is a crucial component of the medical history. Continued public education regarding the risk for rabies after exposures to wildlife, particularly to bats, is needed. Health-care providers are reminded to use personal protective equipment when the possibility of exposure to infectious body fluids exists.

4.Trends in In–Hospital Newborn Male Circumcision — United States, 1999–2010

CDC Division of News and Electronic Media
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A CDC analysis of three independent data sources finds that incidence of in-hospital newborn male circumcision (NMC) has slightly declined over the last decade. CDC used data from the National Hospital Discharge Survey (NHDS) from the National Center for Health Statistics; the Nationwide Inpatient Sample (NIS) from the Agency for Healthcare Research and Quality; and the Charge Data Master (CDM) from SDIHealth (a private, non-governmental source) to estimate rates of NMC.  Incidence of NMC decreased from 62.5 percent in 1999 to 56.9 percent in 2008 in NHDS; from 63.5 percent in 1999 to 56.3 percent in 2008 in NIS; and from 58.4 percent in 2001 to 54.7 percent in 2010 in CDM.  The recent decreases were followed by an increase during the previous 10-year period (from 48.3 percent during 1988 – 1991 to 61.1 percent during 1997 – 2000).  Data in this report will inform healthcare providers, insurers, parents, public health officials and others regarding trends of NMC.

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