Synopsis for June 15, 2001

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

1. Progress Toward Poliomyelitis Eradication — West and Central Africa, 1999–2000
2. Exposure to Patients with Meningococcal Disease on Aircrafts — United States
3. University Outbreak of Calicivirus Infection Mistakenly Attributed to Shiga Toxin-Producing Escherichia coli O157:H7 — Virginia, 2000
4. Kernicterus in Full-Term Infants — United States, 1994–1998

Synopsis for June 15, 2001

Progress Toward Poliomyelitis Eradication — West and Central Africa, 1999–2000

Remarkable progress in the polio eradication initiative has been achieved during the last two years in West and Central Africa.

Strong political support for the polio eradication program has permitted millions of children — previously unvaccinated in remote and inaccessible areas — to be reached by mass national immunization campaigns. These efforts have occurred simultaneously in 16 countries of West and Central Africa involving cross-border vaccination activities. In order to achieve certification of polio eradication, high quality mass vaccination campaigns should continue and surveillance should be maintained. Polio vaccination campaigns have been implemented in countries in conflict and across borders. The reduction of the number of polio cases among children from West and Central Africa will be the best indicator of the quality of the synchronized campaigns in West Africa.

Exposure to Patients with Meningococcal Disease on Aircrafts — United States

Most cases of meningitis among air passengers are not detected until after the flight has landed and the passengers have dispersed.

CDC and the Council of State and Territorial Epidemiologists (CSTE) have developed new guidelines for the management of meningococcal disease on aircraft. Meningococcus is the bacteria responsible for many cases of meningitis, as well at other communicable, potentially fatal diseases. A passenger sick with meningococcal disease has the potential to spread the infection to others on the plane. Because surveillance in incomplete, the actual number of cases may be much higher. The new guidelines establish a standard procedure for notifying exposed passengers. The guidelines also call for airlines to improve their record keeping, to assist public health officials in identifying potentially exposed passengers and crew.

University Outbreak of Calicivirus Infection Mistakenly Attributed to Shiga Toxin-Producing Escherichia coli O157:H7 — Virginia, 2000

Follow-up specimens testing positive for pathogens of public health interest by non-culture rapid assay should be submitted to the state laboratory for confirmation and sub-typing.

As many clinical laboratories turn to non-culture rapid assay methods to detect bacterial pathogens, such as E. coli O157:H7 and other Shiga toxin-producing strains, in patient specimens, it is essential that follow-up cultures are performed when these tests are positive. Cultures are necessary to confirm the presence of pathogenic bacteria and obtain isolates for subtyping by pulse-field gel electrophoresis at state public health laboratories. This allows public health agencies identify common source outbreaks and respond appropriately. Routine submission of these isolates is also imperative for the performance of enhanced surveillance for illness caused by pathogens of public health importance.

Kernicterus in Full-Term Infants — United States, 1994–1998

Jaundice needs to be recognized and treated in otherwise healthy full-term infants to prevent brain damage and permanent disability from kernicterus.

Mild jaundice or hyperbilirubinemia is common in healthy full-term newborns. If severe jaundice is not recognized or treated, kernicterus may develop. This report summarizes case histories of four full-term, healthy infants who developed kernicterus. Kernicterus is a type of brain damage that can cause cerebral palsy and hearing loss. Kernicterus is a preventable disability. Early detection and treatment is critical to prevent cases of kernicterus. Some healthcare providers rely on visual assessment to detect the disease; however, this method is unreliable. Hyperbilirubinemia can be reduced by healthcare providers recognizing risk factors for the disease.

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