Synopsis for March 30, 2001

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

1. Apparent Global Interruption of Wild Poliovirus Type 2 Transmission
2. Severe Malnutrition Among Young Children — Georgia, January 1997–June 1999
3. Outbreak of Community-Acquired Pneumonia Caused by Mycoplasma pneumoniae — Colorado, 2000

MMWR Surveillance Summary
March 30, 2001/Vol. 50/No. SS-1

Contact: Monica Parise, M.D.
CDC, National Center for Infectious Diseases
(770) 488–7760

"Malaria Surveillance — United States, 1996" and "Malaria Surveillance — United States, 1997"

In 1996, CDC received reports of 1,392 cases of malaria with onset of symptoms among persons in the United States or one of its territories. This number represents an increase of 19.3% from the 1,167 cases reported for 1995. P. vivax, P. falciparum, P. malariae, and P. ovale were identified in 47.4%, 37.4%, 5.4%, and 2.0% of cases, respectively. More than one species was present in four patients (0.3% of total). The infecting species was not determined in 104 (7.5%) cases. In 1997, CDC received reports of 1,544 cases of malaria with onset of symptoms among persons in the United States or one of its territories. This number represents an increase of 10.9% from the 1,392 cases reported for 1996. P. vivax, P. falciparum, P. malariae, and P. ovale were identified in 48.9%, 36.7%, 3.1%, and 2.0% of cases, respectively. More than one species was present in nine patients (0.6% of total). The infecting species was not determined in 134 (8.7%) cases.

Synopsis for March 30, 2001

Apparent Global Interruption of Wild Poliovirus Type 2 Transmission

There is accumulating evidence, obtained through AFP surveillance, that the transmission of wild poliovirus type 2 may have already been interrupted globally.

In 1988, the World Health Organization (WHO) resolved to eradicate poliomyelitis globally by 2000. The evidence is accumulating that the transmission of one of the three wild poliovirus types (i.e., type 2) may have already been interrupted. Since the last reported case of polio caused by wild poliovirus type 2 in India (late 1999), no further type 2 cases have been reported from any WHO region, despite improving surveillance for acute flaccid paralysis (AFP). AFP surveillance is supported by a global network of 148 accredited laboratories. During 2000, this network processed approximately 50,000 stool specimens identifying 434 wild poliovirus type 1 isolates, 233 wild polio virus type 3 isolates, and 7 mixed types 1 and 3 isolates. The apparent interruption of wild poliovirus type 2 transmission represents a historic milestone that will energize efforts toward the eradication of poliovirus types 1 and 3.

Severe Malnutrition Among Young Children — Georgia, January 1997–June 1999

Parents and physicians should routinely discuss the child's nutritional needs and dietary intake to ensure that dietary requirements are being met.

Rickets was reported in a child receiving an unfortified soy beverage and kwashiorkor (severe protein deficiency) was reported in a child receiving a rice beverage. In response, Georgia and CDC health officials initiated a review of Georgia hospital discharge data (Jan 1997-June 1999) to identify additional cases. The investigation revealed six children with vitamin-D deficient rickets and three children with protein energy malnutrition. While no additional cases were associated with the use of milk alternatives, officials noticed that all the children with rickets were African-American, and they were all breast-fed for more than 6 months without receiving routine vitamin-D supplementation. Parents and physicians should discuss the child's dietary intake to ensure that a child's nutritional needs are met.

Outbreak of Community-Acquired Pneumonia Caused by Mycoplasma pneumoniae — Colorado, 2000

Mycoplasma pneumoniae is a common cause of acute respiratory tract infections among school-aged children.

M. pneumoniae is a common cause of pharyngitis, bronchitis, pneumonia, and similar diseases among children. CDC is able to provide laboratory and epidemiologic assistance to local, state and territorial health departments in investigations of outbreaks of respiratory disease of unknown etiology. Community-wide outbreaks of acute respiratory illnesses of unknown etiology can be investigated by using a number of methods at CDC, including tissue culture, serological tests, and polymerase chain reaction (PCR) techniques. In the outbreak described in this report, these methods implicated M. pneumoniae as the etiologic agent of a large number of pneumonia cases in Moffat County, Colorado.

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