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MMWR – Morbidity and Mortality Weekly Report

1. Sodium Azide Poisoning at a Restaurant — Dallas County, Texas, 2010

Chief of Toxicology, North Texas Poison Center/UT Southwestern Medical Center
Kurt Kleinschmidt, MD
214-590-2537

This MMWR article is the first detailed report of sodium azide poisonings at a public venue.  Although all 5 of the patients recovered quickly, the incident provides a reminder that chemical poisoning should be considered as a cause of any rapid-onset foodborne illness.  Unusual chemicals can be difficult to detect in food, drink, and biologic specimens with commonly available screening tests.  A multi-disciplinary investigation involving the health department, forensic toxicologists, and medical toxicologists can lead to successful identification of the contaminated food vehicle and the etiologic chemical agent.  The potential for recurrences of similar events in the future reinforces the need to continue promoting awareness about the possibility of such events.

2. Human Exposures to Marine Brucella Isolated from a Harbor Porpoise — Maine, 2012

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

Marine mammals can be infected with organisms which can cause diseases in humans; therefore, precautions should be taken when handling sick or dead animals to avoid exposure to potential pathogens. Four persons, a university faculty member, two students, and a community volunteer, participated in the necropsy of a harbor porpoise that was subsequently found to be infected with a Brucella species. Because they did not wear respiratory protection, they were advised to take antimicrobial prophylaxis and be monitored for brucellosis for 24 weeks. None of the four became ill. Persons who handle marine mammals should be educated on the potential for infection associated with their activities and the precautions necessary to avoid being exposed to infectious agents. Failure to use primary protection to avoid exposure necessitates using more costly and time-consuming secondary strategies, such as prophylactic antimicrobials and clinical and laboratory monitoring.

3. Progress in Immunization Information Systems — United States, 2010

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

Immunization information systems (IIS), computerized systems that consolidate vaccination data, are a proven tool to increase vaccination rates.  An annual survey of immunization programs shows 82 percent of U.S. children less than 6 years of age participate in IIS, up from 78 percent in 2009.  Vaccination provider sites enroll in IIS to share vaccination data and to use IIS functions and features that support vaccine delivery. Provider participation in IIS is essential to ensure providers have access to complete immunization histories for the children they serve. To encourage provider site participation, almost three-quarters of U.S. immunization programs are planning to interface their IIS with VTrckS, CDC’s new national vaccine ordering and inventory management system for publicly purchased vaccine.

4. Updated Recommendations for Use of Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis (Tdap) Vaccine in Adults 65 Years and Older — Advisory Committee on Immunization Practices (ACIP), 2012

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

The best way for adolescents and adults to protect themselves and others against pertussis (whooping cough) is to get vaccinated with Tdap. In 2011, more than 15,000 pertussis cases were reported in the United States.  Pertussis is highly contagious and can cause serious or prolonged illness.  To boost their immunity to pertussis, everyone 11 years and older is recommended to receive a one-time dose of the pertussis booster shot, Tdap.  Tdap should be administered regardless of when the previous Td dose was given. Getting vaccinated with Tdap at least two weeks before coming into close contact with an infant is especially important for families with and caregivers of new infants.  After receipt of Tdap, persons should continue to receive Td for routine booster immunization against tetanus and diphtheria.

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