Synopsis for March 23, 2001

MMWR articles are embargoed until 4 p.m. E.S.T. Thursdays.

1. Tuberculosis Treatment Interruption — Ivanovo Oblast, Russia Federation, 1999
2. Evaluation of a Directly Observed Therapy Short Course Strategy for TB Disease — Orel Oblast, Russia, Russian Federation, 1999–2000
3. Influenza Activity — United States, 2000–01 Season

Tuberculosis Treatment Interruption — Ivanovo Oblast, Russia Federation, 1999
and
Evaluation of a Directly Observed Therapy Short Course Strategy for TB Disease — Orel Oblast, Russia, Russian Federation, 1999–2000

In the Russia Federation, the number of tuberculosis cases has nearly tripled, increasing from 45,000 cases in 1991 to 124,000 in 1999.

Multidrug resistant strains have also been shown to have increased dramatically in several regions. Russia has recently adopted the World Health Organization's (WHO) worldwide strategy of DOTS or Directly Observed Treatment, Short Course to control tuberculosis. The Centers for Disease Control and Prevention, WHO, and U.S. Agency for International Development are helping implement basic DOTS programs in the Orel and Vladimir oblasts (regions) and strengthen the DOTS program started in 1995 by WHO in Ivanovo oblast. CDC researchers evaluated the treatment outcomes of 310 civilian and 39 incarcerated TB patients in the first six months after introducing a DOTS program to the Orel Oblast. Treatment success – defined as a patient who completed treatment or who's cure can be documented using bacteriological tests – was achieved in 88% of the new civilian TB cases and 60% of the civilian patients being re-treated for the disease. Of the incarcerated patients, 97% completed treatment. As a whole, the treatment success rate was higher in Orel than in other parts of Russia, where the DOTS strategy has been effectively implemented. CDC suggests that this success may be due to the dedication of TB control staff to ensure patients complete treatment, lower rates of multi-drug resistant TB, and the possibility that patients are seeking treatment sooner rather than later. CDC scientists also reported on an evaluation of the Ivanovo TB control project, established five years ago. CDC found that 28% of highly infectious patients interrupted their six-month course of anti-TB drugs. Non-adherence to TB treatment may lead to the development of multi-drug resistant TB strains and to the spread of TB.

Influenza Activity — United States, 2000–01 Season

Influenza activity during the 2000-2001 season was moderate and peaked at the end of January.

Influenza activity peaked at the end of January when 24% of specimens tested at reporting laboratories were positive for influenza and 4.1% of visits to U.S. influenza sentinel physicians were due to influenza-like illness. During the previous three influenza seasons, the peak percentage of specimens testing positive for influenza ranged from 28% to 32% and the peak percentage of patient visits to sentinel physicians ranged from 4.9% to 5.6%. Pneumonia and influenza mortality as reported by the 122 Cities Mortality Reporting System remained below epidemic threshold during the 2000-2001 season. The predominant influenza strain circulating this season was influenza A (H1N1); however, the proportion of influenza B virus isolates is increasing.

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