Synopsis for October 31, 2003

The MMWR is embargoed until NOON ET, Thursdays.

1. Efficiency of Quarantine During an Epidemic of Severe Acute Respiratory Syndrome — Beijing, China, 2003
2. Prevalence of Selected Risk Factors for Chronic Disease — Jordan, 2002
3. Measles — Campania, Italy, 2002
4. Barium Toxicity Following Exposure to Contaminated Contrast Solution — Goias State, Brazil, 2003
5. Assessment of the Epidemiological Capacity in State and Territorial Health Departments — United States, 2001
6. Terrorism Preparedness in State Health Departments — United States, 2001–2003
7. West Nile Virus Activity — United States, October 16–22, 2003

Synopsis for October 31, 2003

Efficiency of Quarantine During an Epidemic of Severe Acute Respiratory Syndrome — Beijing, China, 2003

Quarantine for SARS can be limited to those people who have exposure to actively ill SARS patients.

Quarantine of approximately 30,000 persons to their homes or designated quarantined sites for an average of fourteen days each was one of several measures used to control the outbreak of SARS in Beijing, China. This study was done to identify ways to improve the efficiency of quarantine in future outbreaks. The results indicated that exposures (of household members, visitors, caregivers, etc.) to SARS patients during the days immediately before onset of fever led to little or no risk of developing SARS. Accordingly, the scope of quarantine could be limited by up to 66% by quarantining only persons exposed to actively ill SARS patients.

Prevalence of Selected Risk Factors for Chronic Disease — Jordan, 2002

Smoking, physical inactivity, and obesity contribute substantially to Jordan’s societal burden from chronic diseases; effective public health interventions are needed immediately.

The Jordanian population has significant risk factors for chronic disease as indicated by the 2002 Behavioral Risk Factor Survey. Nearly half of the male respondents were current smokers, compared with 8% of female respondents. 13 percent of the Jordan population would be considered obese by international standards and 32% would be considered overweight. Only 53% of all respondents reported any weekly physical activity. Jordan is the first Middle Eastern country to begin surveillance for behavioral risk factors for chronic disease. Using the results of repeated risk factor surveys in combination with mortality statistics, hospital discharge systems, and other periodic surveys, the Jordan Ministry of Health intends to develop effective control strategies for chronic diseases.

Measles — Campania, Italy, 2002

Measles can be severe and sometimes fatal, even in industrialized countries.

The interruption of measles transmission can be achieved only with coordinated and uniform actions, aimed to improve vaccination coverage. A large measles outbreak occurred in 2002 in Campania, a large region in southern Italy. The outbreak occurred as a result of low vaccination coverage and affected primarily unvaccinated school-aged children. Four measles-associated deaths, 15 encephalitis and 594 hospitalizations were detected. The epidemic, although limited initially to Campania, spread to other areas, affecting mainly others Italian southern regions.

Barium Toxicity Following Exposure to Contaminated Contrast Solution — Goias State, Brazil, 2003

Barium-containing solutions are used worldwide to provide contrast for radiologic studies of the upper and lower gastrointestinal tract (GIT), improving clinicians’ ability to diagnose cancer and other abnormalities.

Contrast solutions normally contain barium sulfate, a nontoxic, insoluble salt not absorbed by the GIT. This report describes an investigation in Brazil of severe toxicity due to exposure to one brand of contrast solution contaminated with barium carobonate, a highly toxic, soluble salt of barium. A national recall of the brand was announced, the manufacturer’s license was revoked and the production facility closed. Clinicians using contrast solutions should be alert for signs of barium toxicity, and quality control during production should assure that these solutions contain only the non-toxic sulfate salt of barium.

Assessment of the Epidemiological Capacity in State and Territorial Health Departments — United States, 2001

Epidemiology infrastructure building and training should be a priority for public health and resources need to be identified to support this effort.

The Council of State and Territorial Epidemiologists (CSTE) conducted a survey of the all the states and territories in 2001 to assess existing public health epidemiology capacity. Most states reported having an insufficient number of epidemiology staff and resources to carry out essential public health services. The survey also revealed that approximately 42% of all epidemiologists working in state and territorial health department have no formal training in that academic discipline. States reported that they are below optimal capacity in all epidemiology program areas (e.g. chronic disease, maternal child health, etc) except infectious disease. Increased resources to build epidemiology capacity in this country's public health system need to be identified.

Terrorism Preparedness in State Health Departments — United States, 2001–2003

The number of state health department epidemologists assigned to infectious disease and terrorism preparedness has increased by 132 percent.

The Iowa Department of Public Health's Center for Acute Disease Epidemiology (CADE) and the Iowa State University Department of Microbiology conducted two surveys of state public health epidemiologists during 2000–2003. This report summarizes the results of those surveys, which determined that although the number of state health department (SHD) employees in infectious disease epidemiology and terrorism preparedness increased by 131%, (from 366 in 2001 to 846 in 2003), concerns remained regarding the ability to hire qualified personnel, underscoring the need to develop more and diverse training venues for current and future infectious disease epidemiologists. Other areas of concern included difficulty allocating time for planning and setting up surveillance for infectious diseases.

West Nile Virus Activity — United States, October 16–22, 2003

No summary available.

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