Synopsis for November 2, 2001

The MMWR is NOT embargoed this week.

1. Update: Investigation of Bioterrorism-Related Anthrax and Interim Guidelines for Clinical Evaluation of Persons with Possible Anthrax
2. Prevalence of Major Cardiovascular Disease (CVD) During 1997–1999 and Major CVD Hospital Discharge Rates in 1997 Among Adult Women with Diabetes, United States
3. Hospital Discharge Rates for Nontraumatic Lower Extremity Amputation by Diabetes Status — United States, 1997
4. Weekly Update: West Nile Virus Activity — United States, October 24–30, 2001
   
   

Notices to Readers

Updated Recommendations for Antibiotic Prophylaxis Among Asymptomatic Pregnant Women After Exposure to Bacillus anthracis
The antibiotic of choice for initial prophylactic therapy among asymptomatic pregnant women exposed to Bacillus anthracis is ciprofloxacin. In instances where the specific B. anthracis strain has been shown to be penicillin-sensitive, prophylactic therapy with amoxicillin may be considered. Doxycycline should be used with caution in asymptomatic pregnant women, and only when there are contraindications to the use of other appropriate antibiotics.

Interim Recommendations for Protecting Workers From Exposure to Bacillus anthracis\t in Work Sites Where Mail is Handled or Processed
CDC has developed interim recommendations to assist personnel responsible for occupational health and safety in developing a comprehensive program to reduce potential cutaneous or inhalational exposures to Bacillus anthracis spores among workers in work sites where mail is handled or processed. Such work sites include post offices, mail distribution/handling centers, bulk mail centers, air mail facilities, priority mail processing centers, public and private mail rooms, and other settings in which workers are responsible for handling and processing mail. The recommendations are based on the limited information available on ways to avoid infection and the effectiveness of various prevention strategies, and will be updated as new information becomes available.

Contact: Division of Media Relations
CDC, Office of Communication
(404) 639–3286

Synopsis for November 2, 2001

Update: Investigation of Bioterrorism-Related Anthrax and Interim Guidelines for Clinical Evaluation of Persons with Possible Anthrax

Since October 3, 2001, CDC and state and local public health authorities have been investigating cases of bioterrorism-related anthrax.

 

PRESS CONTACT: Division of Media Relations CDC, Office of Communication (404) 639–3286

This report updates findings as of October 31, and includes interim guidelines for the clinical evaluation of persons with possible anthrax. A total of 21 cases (16 confirmed and five suspected) of bioterrorism-related anthrax have been reported among persons who worked in the District of Columbia, Florida, New Jersey, and New York City. Until the source of these intentional exposures is eliminated, clinicians and laboratorians should be alert for clinical evidence of Bacillus anthracis infection. Epidemiologic investigation of these cases and surveillance to detect new cases of bioterrorism-associated anthrax continues.

Prevalence of Major Cardiovascular Disease (CVD) During 1997–1999 and Major CVD Hospital Discharge Rates in 1997 Among Adult Women with Diabetes, United States

Compared to women without diabetes, major cardiovascular disease prevalence is twice as common and hospitalizations are nearly four times as common among women with diabetes.

 

PRESS CONTACT: Mike Engelgau, M.D., M.P.H. CDC, National Center for Chronic Disease Prevention & Health Promotion (770) 488–5024 (Alternate: Ed Tierney, M.P.H., same phone number)

Major CVD is the leading cause of mortality among women, and the risk of major CVD among women with diabetes mellitus is 2-4 times higher than that of women without diabetes. The 1997-1999 National Health Interview Survey provides evidence that approximately 72% of all women with diabetes report having some form of major CVD. The age-adjusted prevalence of CVD among women with diabetes was twice that of women without diabetes. In the 1997 Nationwide Inpatient Sample, 28% of all major CVD hospital discharges among women had an associated diabetes diagnosis. Effective treatments to prevent and control CVD currently exist and a concerted effort among health care workers, public health officials, patients and their families will be necessary to reduce the burden of major CVD among women with diabetes.

Hospital Discharge Rates for Nontraumatic Lower Extremity Amputation by Diabetes Status — United States, 19971

Lower extremity amputation (LEA) is a costly, disabling procedure that disproportionately affects persons with diabetes.

 

PRESS CONTACT: Mike Engelgau, M.D., M.P.H. CDC, National Center for Chronic Disease Prevention & Health Promotion (770) 488–5024 (Alternate: Ed Tierney, M.P.H., same phone number)

LEA is a costly, disabling procedure that disproportionately affects persons with diabetes. In 1997, the LEA hospital discharge rate for persons with diabetes was 28 times that for persons without diabetes, with men, non-Hispanic Blacks and the elderly having the highest rates. About 44-85% of LEA are preventable. Several efforts supported by CDC have been conducted to help further characterize the problem in order to reduce the burden of LEA among persons with diabetes.

Weekly Update: West Nile Virus Activity — United States, October 24–30, 2001

 

PRESS CONTACT: Division of Media Relations CDC, Office of Communication (404) 639–3286

The report summarizes surveillance data for West Nile Virus (WNV) activities in the United States. The report includes information on human cases and deaths, infected birds and other animals, and WNV-positive mosquito pools.

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