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MMWR – Morbidity and Mortality Weekly Report

Note: In observance of the July 4th holiday on Thursday, CDC is issuing an embargoed copy of this week’s MMWR on Wednesday, July 3, 2013.

1. Botulism Associated with Home-Fermented Tofu in Two Chinese Immigrants — New York City, March–April 2012

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In March 2012, the New York City Department of Health and Mental Hygiene received two reports of recent immigrants from China admitted to the same hospital 23 days apart for suspected foodborne botulism. The first patient had a laboratory-confirmed case of foodborne botulism associated with home-fermented tofu. The second patient had a probable case of foodborne botulism associated with home-fermented tofu. Both patients had purchased fresh tofu from the same Chinese grocery in January 2012 and had prepared home-fermented tofu using similar recipes. Similar fermentation practices at the two homes might have facilitated toxin production. Testing confirmed botulinum toxin type B in home-fermented tofu consumed by the first patient. Public health responders and clinicians should be aware of the association between botulism and fermented tofu.

2. Suicide and Suicidal Ideation Among Bhutanese Refugees — United States, 2009–2012

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During the period February 2009–February 2012, the Office of Refugee Resettlement of the U.S. Department of Health and Human Services reported 16 suicides among the approximately 57,000 Bhutanese refugees who had resettled in the United States since 2008. In collaboration with the Massachusetts Department of Public Health’s Refugee Health Technical Assistance Center, CDC conducted a survey of randomly selected Bhutanese refugees in four U.S. states with large populations of resettled refugees to identify risk factors that might be associated with suicidal ideation among Bhutanese refugees. The survey findings suggest that Bhutanese refugees who have resettled in the United States could have a high burden of undiagnosed mental illness. Mental health services should be considered one of the priorities in the service package for refugees arriving in the United States. Current programs to address post-arrival challenges such as job and language training should consider adding social support and mental health components. Refugee communities and service providers might benefit from additional suicide awareness training to identify those at highest risk and greatest need for early intervention.

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