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Publication of CDC Surveillance Summaries

Since 1983, CDC has published the CDC Surveillance Summaries under separate cover as part of the MMWR series. Each report published in the CDC Surveillance Summaries focuses on public health surveillance; surveillance findings are reported for a broad range of risk factors and health conditions.

Summaries for each of the reports published in the most recent (June 4, 1993) issue of the CDC Surveillance Summaries (1) are provided below. All subscribers to MMWR receive the CDC Surveillance Summaries, as well as the MMWR Recommendations and Reports, as part of their subscriptions. SURVEILLANCE FOR DIABETES MELLITUS -- UNITED STATES, 1980-1989 Problem/Condition: In 1989, approximately 6.7 million persons reported that they had diabetes, and a similar number probably had this disabling chronic disease without being aware of it. Diabetes mellitus is the most important cause of lower extremity amputation and end-stage renal disease, the major cause of blindness among working-age adults, a major cause of disability, premature mortality, congenital malformations, perinatal mortality, and health-care costs, and an important risk factor for the development of many other acute and chronic conditions (e.g., diabetic ketoacidosis, ischemic heart disease, and stroke). Surveillance data describing diabetes and its complications are critical to increasing recognition of the public health burden of diabetes, formulating health-care policy, identifying high-risk groups, developing strategies to reduce the burden of this disease, and evaluating progress in disease prevention and control. Reporting Period Covered: This report summarizes data from CDC's diabetes surveillance system, evaluating trends in diabetes and its complications by age, sex, and race for the years 1980-1989 (end year depending on data source). Description of System: CDC has established an ongoing and evolving surveillance system to analyze and compile periodic, representative data on the disease burden of diabetes and its complications in the United States. Data sources currently include vital statistics, the National Health Interview Survey, the National Hospital Discharge Survey, and Medicare claims data for end-stage renal disease. Results and Interpretation: These surveillance data indicate that the disease burden of diabetes and its complications is likely to grow as the population ages, that effective intervention strategies are needed to prevent diabetes and its complications, that prevention efforts need to be intensified among groups at highest risk, including blacks, and that important gaps exist in periodic and representative data for describing the burden of diabetes and its complications. Actions Taken: CDC is currently exploring possible data sources to address the surveillance data gaps on blindness, adverse outcomes of pregnancy, and the public health burden of diabetes among minority groups. Authors: Linda S. Geiss, M.A., William H. Herman, M.D., Merilyn G. Goldschmid, M.D., Frank DeStefano, M.D., M.P.H., Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, CDC. Mark S. Eberhardt, Ph.D., Office of Analysis and Epidemiology, National Center for Health Statistics, CDC. Earl S. Ford, M.D., M.P.H., Robert R. German, M.P.H., Jeffrey M. Newman, M.D., M.P.H., David R. Olson, Ph.D., Stephen J. Sepe, M.P.H., John M. Stevenson, Ph.D., Frank Vinicor, M.D., M.P.H., Scott F. Wetterhall, M.D., M.P.H., Julie C. Will, Ph.D., Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, CDC.

LABORATORY-BASED SURVEILLANCE FOR MENINGOCOCCAL DISEASE IN SELECTED COUNTIES -- UNITED STATES, 1989-1991 Problem/Condition: Neisseria meningitidis is a leading cause of bacterial meningitis and septicemia in the United States. Accurate surveillance for meningococcal disease is required to detect trends in patient characteristics, antibiotic resistance, and serogroup-specific incidence of disease. Reporting Period Covered: January 1989 through December 1991. Description of System: A case of meningococcal disease was defined by the isolation of Neisseria meningitidis from a normally sterile site, such as blood or cerebrospinal fluid, in a resident of a surveillance area. Cases were reported by contacts in each hospital laboratory in the surveillance areas. The surveillance areas consisted of three counties in the San Francisco metropolitan area, eight counties in the Atlanta metropolitan area, four counties in Tennessee, and the entire state of Oklahoma. Results: Age- and race-adjusted projections of the U.S. population suggest that approximately 2600 cases of meningococcal disease occurred annually in the United States. The case-fatality rate was 12%. Incidence declined from 1.3 per 100,000 in 1989 to 0.9 per 100,000 in 1991. Seasonal variation occurred, with the highest attack rates in February and March and the lowest in September. The highest rates of disease were among infants, with 46% of cases in those less than or equal to 2 years of age. Males accounted for 55% of total cases, with an incidence among males of 1.2 per 100,000, compared with 1.0 per 100,000 among females (relative risk {RR}=1.3, 95% confidence interval {CI}=1.0-1.6). The incidence was significantly higher among blacks (1.5 per 100,000) than whites (1.1 per 100,000), with a relative risk of disease for blacks of 1.4 (95% CI=1.1-1.8). Serogroup B caused 46% of cases and serogroup C, 45%. Thirty-eight percent of isolates were reported to be resistant to sulfa; none were reported to be resistant to rifampin. Interpretation: The decline in incidence of meningococcal disease from 1989 to 1991 cannot be explained by any change in public health control measures; this trend should be monitored by continued surveillance. The age, sex, and race distribution and seasonality of cases are consistent with previous reports. The proportion of N. meningitidis isolates resistant to sulfa continues to be substantial. A relatively small proportion of cases is potentially preventable by the use of the currently available polysaccharide vaccine, which induces protection against serogroups A, C, Y, and W135 and is effective only for persons greater than 2 years of age. Actions Taken: Current recommendations against the use of sulfa drugs for treatment or prophylaxis of meningococcal disease unless the organism is known to be sulfa sensitive should be continued. Since resistance to rifampin is rarely reported, it continues to be the drug of choice for prophylaxis. The development of vaccines effective for infants and vaccines inducing protection against serogroup B would be expected to have a substantial impact on disease. Authors: Lisa A. Jackson, M.D., Jay D. Wenger, M.D., Meningitis and Special Pathogens Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, CDC. The Meningococcal Disease Study Group.

Reference

  1. CDC. CDC surveillance summaries (June 4). MMWR 1993;42(no. SS- 2).



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