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MMWR – Morbidity and Mortality Weekly Report

1. Recovery of a Patient from Clinical Rabies — California, 2011

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After contact with free-roaming cats, an 8 year-old girl was hospitalized and ultimately diagnosed with rabies. To help make recovery possible, a process was initiated that suppresses brain activity in order to help the immune system fight the rabies virus. The girl survived and was discharged after a 52-day hospitalization. This is the third reported case of recovery from rabies in a patient who was unvaccinated before illness onset. Despite these instances, rabies is usually fatal. It can, however, be prevented through vaccination of domestic animals (such as dogs and cats) and avoidance of wild or unfamiliar animals. When an exposure has occurred, a preventive vaccine known as PEP can prevent infection. In addition, clinicians caring for patients with acute progressive encephalitis should consider rabies in the differential diagnosis and pursue laboratory diagnostic testing when indicated.

2. Adult Vaccination Coverage — United States, 2010

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Approximately 45,000 adults die annually from vaccine-preventable diseases.  Between 2008 and 2010, U.S. coverage with routinely recommended vaccinations to protect adults aged ≥19 years remained low.  Compared with 2009 estimates, vaccination increased for only three vaccines in 2010:  tetanus, diphtheria, and acellular pertussis (Tdap) vaccination increased 1.6 percentage points to 8.2 percent, herpes zoster vaccination for non-Hispanic whites and non-Hispanic Asians aged ≥60 years increased more than 5 percentage points to 16.6 percent and 12.7 percent, respectively, and women aged 19–26 years reporting receipt of ≥1 dose of HPV vaccine increased 3.6 percentage points to 20.7 percent.  Wider use of practices shown to improve adult vaccination is needed, including implementing reminder-recall systems, using standing order programs for vaccination, and assessing practice-level vaccination rates with feedback to staff members.

3. Progress in Global Measles Control, 2000–2010

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In 2010, the World Health Assembly (WHA) endorsed the following measles objectives for 2015: 1) raise routine coverage with the first dose of MCV (MCV1) for children aged 1 year to ≥90 percent nationally and ≥80 percent in every district or equivalent administrative unit, 2) reduce and maintain annual measles incidence at <5 cases per million, and 3) reduce measles mortality by ≥95 percent from the 2000 estimate. During 2000–2010, global MCV1 coverage increased from 72 percent to 85 percent with approximately 1 billion children vaccinated during measles SIAs. Reported measles cases decreased from 2000 to 2008, remained stable in 2009, and increased in 2010. By the end of 2010, 40 percent of countries still had not met the incidence target of <5 cases per million. While substantial progress has been made, challenges must be overcome to meet the 2015 WHA measles objectives.

4. Notes from the Field: Outbreak of Salmonellosis Associated with Pet Turtle Exposures — United States, 2011

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Turtles are not appropriate pets in households with young children or other high risk individuals (pregnant women, older persons, people with weak immune systems). This report describes an outbreak of 132 human Salmonella infections in the United States between August 2010 and September 2011, associated with exposure to small turtles. Many of the infections occurred in young children. Salmonella infections in children may be severe and can result in hospitalization. A 1975 federal prohibition against the sale of small turtles (ie. those with shell lengths < 4 inches) led to a substantial decline in human Salmonella infections. However, these infections continue to occur. Increasing enforcement of existing regulations against the sale of small turtles, increasing penalties for illegal sales, and enacting more state and local laws regulating the sale of small turtles can assist in decreasing infections from these reptiles. 


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