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Synopsis for May 10, 2002

The MMWR is embargoed until 12 NOON, ET, Thursdays.

  1. Nonoxynol-9 Spermicide Contraception Use — United States, 1999
  2. Assessment of Susceptibility Testing Practices for Streptococcus pneumoniae —United States, February 2000
  3. Pertussis in an Infant Adopted From Russia, May 2002

MMWR Recommendations and Reports
Vol. 51/No. RR-6/May 10, 2002

Sexually Transmitted Diseases Treatment Guidelines --- 2002
These guidelines for the treatment of patients who have sexually transmitted diseases (STDs) were developed by CDC after consultation with a group of professionals knowledgeable in the field of STDs who met in Atlanta on September 26--28, 2000. The information in this report updates the 1998 Guidelines for Treatment of Sexually Transmitted Diseases (MMWR 1998;47[No. RR-1]). Included in these updated guidelines are new alternative regimens for scabies, bacterial vaginosis, early syphilis, and granuloma inguinale; an expanded section on the diagnosis of genital herpes (including type-specific serologic tests); new recommendations for treatment of recurrent genital herpes among persons infected with human immunodeficiency virus (HIV); a revised approach to the management of victims of sexual assault; expanded regimens for the treatment of urethral meatal warts; and inclusion of hepatitis C as a sexually transmitted infection.

Contact: Office of Communications
CDC, National Center for HIV, STD and TB Prevention
(404) 639–8895

Telebriefing, May 9, 2002
WHO: Dr. Stuart Berman and Dr. Kimberly Workowski, CDC STD experts
WHAT: To discuss this week's MMWR report and recommendation on Sexually Transmitted Disease Guidelines 2002. Brief remarks followed by Q/A.
WHEN: Thursday, May 9, 2002; Noon–12:30 PM ET
WHERE: At your desk, by toll-free conference line: Dial 866-254-5942
Teleconference name: CDC
A full transcript of this teleconference will be available today following the teleconference on the CDC website at

This teleconference will also be audio webcast. Listen LIVE online at

Synopsis for May 10, 2002

Nonoxynol-9 Spermicide Contraception Use — United States, 1999

An assessment of contraceptive use among women attending Title X family planning clinics in 1999 indicated that some women were using Nonoxynol-9 (N-9) spermicide.

Office of Communication
CDC, National Center for Chronic Disease Prevention and Health Promotion
(770) 488-5131


Data were collected from the national family planning program, which serves predominantly low-income women. One percent to 5 percent of women attending these clinics said they used contraceptive products containing N-9, including vaginal films and inserts, gels, jellies and foams. This study measures N-9 usage prior to recommendations against the use of N-9 for STD and HIV prevention. However, the findings indicate that as of a few years ago, N-9 was being used as a contraceptive among some women in the U.S. Recently published studies conducted in commercial sex workers have shown that N-9 contraceptives do not protect against HIV, gonorrhea or chlamydia infection. Providers of family planning services should therefore ensure women at-risk for HIV/STDs are counseled that N-9 contraceptives do not protect against these infections.


Assessment of Susceptibility Testing Practices for Streptococcus pneumoniae —United States, February 2000

Antimicrobial resistance is rapidly changing for pneumococci, and recommendations for susceptibility testing probably will continue to change.

Ilin Chuang, MD
CDC, National Center for Infectious Diseases
(404) 639–2215

Most surveyed clinical laboratories were using appropriate methods for pneumococcal susceptibility testing; however, some inconsistencies with the National Committee for Clinical Laboratory Standards (NCCLS) guidelines were noted. For isolates from patients with potentially life-threatening infections, laboratories should bypass oxacillin disk screening; 53 percent of surveyed laboratories reported performing oxacillin disk screening. Laboratories should also test pneumococcal isolates for fluoroquinolones, an antibiotic increasingly used to treat for common pneumonia; only 40 percent of laboratories in this survey performed susceptibility testing against fluoroquinolones. Because treatment decisions may vary based on clinical syndrome and severity of illness, exact minimum inhibitory concentrations (MICs) in combination with interpretations can assist clinicians with therapeutic decisions.


Pertussis in an Infant Adopted From Russia, May 2002

Couples adopting children from Russia should be cautious of pertussis, have the child examined before bringing them to the United States to make sure they do not have the illness, and make sure they are examined and started on their childhood vaccination series soon after they arrive in the states.

Kristy Lillibridge, DMV
CDC, National Center for Infectious Diseases
(404) 498–1634

There was potential for exposure to other individuals during an infant's travel from Moscow to the United States, including the orphanage in Russia, the US embassy in Russia, and flights from Moscow to North Carolina via New York. CDC is working with the airlines to identify passengers who might have been exposed to the patient during the flight to the United States. Since pertussis illness can be mild in older children and adults and may go unrecognized, health officials are concerned about the risk of transmission to infants who are at higher risk for severe illness and death. Those who have been exposed should receive chemoprophylaxis with antibiotics to prevent transmission.


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