Synopsis for January 31, 2003

The MMWR is embargoed until 12 Noon ET, Thursdays.

1. Neurologic Impairment in Children Associated with Maternal Dietary Deficiency of Coibalamin -- Georgia, 2001
2. Pneumococcal Conjunctivitis at an Elementary School -- Maine, September 20-December 6, 2002
3. Rates of Lower Extremity Amputation Episodes Among Persons with Diabetes -- New Mexico, 2000

MMWR Recommendations and Reports
January 31, 2003/Vol.52/No. 2

Guidelines for Performing Single-Platform Absolute CD4+ T-Cell Determinations with CD45 Gating for Persons Infected with Human Immunodeficiency Virus

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Recommended Childhood and Adolescent Immunization Schedule -- United States, 2003
Each year, CDC's Advisory Committee on Immunization Practices (ACIP) reviews the recommended childhood and adolescent immunization schedule. This report presents the recommended childhood immunization for 2003.

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Synopsis for January 31, 2003

Neurologic Impairment in Children Associated with Maternal Dietary Deficiency of Coibalamin -- Georgia, 2001

Women who follow vegetarian diets must ensure adequate vitamin B12 intake, particularly pregnant women and those who breastfeed.

In 2001, neurologic impairment (including delays in speech, walking, and fine motor skills) and failure to thrive resulting from vitamin B12 deficiency was diagnosed in two children in Georgia. The children were breastfed by mothers who followed vegetarian diets. Vitamin B12 deficiency in young children is difficult to diagnose because of nonspecific symptoms. The only reliable, unfortified, sources of vitamin B12 are animal products. Vegetarians must ensure adequate vitamin B12 intake, particularly women during pregnancy and lactation. If it is not possible to consume the recommended dietary intake of vitamin B12 through food, a daily supplement should be taken that contains at least the recommended dietary intake from a reliable source. Health-care providers should be vigilant about the potential for vitamin B12 deficiency in breastfed children of vegetarian mothers.

Pneumococcal Conjunctivitis at an Elementary School -- Maine, September 20-December 6, 2002

Outbreaks of conjunctivitis among school children should be reported to state health departments and the CDC so that the cause can be determined and control strategies evaluated.

Conjunctivitis, or 'pink eye', is a common, mild infection of the eye. Several types of bacteria and viruses can cause conjunctivitis. This outbreak was caused by an uncommon strain of the bacterium Streptococcus pneumoniae, also referred to as the pneumococcus. This is the first time this strain of bacteria has caused an outbreak of conjunctivitis among young children; previously recognized outbreaks have occurred among college-aged adults. Although children were not seriously ill, the outbreak resulted in lost school days for ill children and costs to their parents for provider visits and missed work. State health departments should notify CDC of future outbreaks of conjunctivitis among young children so that prevention and control measures may be evaluated.

Rates of Lower Extremity Amputation Episodes Among Persons with Diabetes -- New Mexico, 2000

Regular comprehensive foot exams are important for persons with diabetes who undergo amputation.

Lower extremity amputation is one of the most devastating and disabling complications of diabetes, and approximately one-third of persons with diabetes are at high risk for amputation. Currently, surveillance of amputation is conducted using hospital discharge records. The article describes "episodes" of amputation that link hospital discharges to individuals. Episodes of amputation were twice as high among men as women, and the age-adjusted rate was approximately 3.5 times higher among American Indians compared with non-Hispanic whites.

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