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1. Reducing Bloodstream Infections in an Outpatient Hemodialysis Center — New Jersey, 2008-2011

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Bloodstream infections are an important problem in hemodialysis patients but are preventable via the implementation of basic infection prevention interventions.In a 2010 Vital Signs report, CDC estimated that about 37,000 vascular access-related bloodstream infections (BSIs) occurred in outpatient hemodialysis patients with central lines. These infections are associated with substantial morbidity and, unlike BSIs in inpatient healthcare settings do not appear to be decreasing. CDC established the CDC Hemodialysis BSI Prevention Collaborative in 2009 in order to address this problem. The project took a collaborative approach in which interested facilities worked together to implement a package of prevention interventions with the goal of decreasing the incidence of these devastating infections. This report describes this prevention experience at one facility that combined this approach with a behavioral change process and demonstrated a large decrease in BSIs.

2. Tickborne Relapsing Fever in a Mother and Newborn Child — Colorado, 2011

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Tickborne relapsing fever (TBRF) is an uncommon disease spread by ticks in the western United States. Patients ill with TBRF often develop recurring fevers and body aches. Pregnant women are at higher risk of developing severe illness, and pregnancy complications including premature delivery or neonatal infection can occur. Physicians should be aware of TBRF as a cause of recurring febrile illness among patients residing in or traveling to areas in the western United States, particularly in mountainous areas at higher elevations. Because people often become ill after staying in tick-infested rustic dwellings, important prevention strategies include identification and pesticide treatment of dwellings as well as locating other persons who’ve resided in the same dwelling to facilitate their treatment for TBRF if needed. If you have recurrent flu-like symptoms including fever and body aches and reside in or have recently traveled to the mountainous western United States, ask your doctor if tickborne relapsing fever could be the cause of your illness.

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