Synopsis for May 7, 2004

The MMWR is embargoed until Thursday, 12 PM EDT.

1. Awareness of Stroke Warning Signs -- 17 States and the U.S. Virgin Islands, 2001
2. Spina Bifida and Anencephaly Before and After Folic Acid Mandate -- United States, 1995-1996 and 1999-2000
3. Lyme Disease -- United States, 2001-2002
4. Impact of Heat Waves on Mortality -- Rome, Italy, June-August 2003

Synopsis for May 7, 2004

Awareness of Stroke Warning Signs -- 17 States and the U.S. Virgin Islands, 2001

Be a hero. Learn the 5 major warning signs of a stroke and be willing to take action to dial 911 for a potential stroke patient.

In 2001, only 17 percent of adults were able to recognize all five major signs of a stroke and also knew that calling 911 for medical assistance was the first action that should be taken for someone who might be having a stroke. The five major warning signs of a stroke are 1) sudden confusion and trouble speaking or understanding; 2) sudden numbness or weakness of the face, arm, or leg, especially on one side of the body; 3) sudden trouble seeing in one or both eyes; 4) sudden trouble walking, dizziness, or loss of balance or coordination; and 5) sudden, severe headache with no known cause. Immediate emergency transport to the hospital and timely, appropriate care can reduce disability and death associated with stroke. The public, particularly bystanders, should be aware of the major warning signs of stroke and be willing to dial 911 for a potential stroke patient.

Spina Bifida and Anencephaly Before and After Folic Acid Mandate -- United States, 1995-1996 and 1999-2000

Two serious birth defects in the U.S., anencephaly and spina bifida are on the decline since fortification of enriched cereal grain products with folic acid. However, at least another 1,000 babies could be born free of these birth defects if all women of childbearing age consume 400 micrograms of folic acid daily from supplements and fortified foods (especially breakfast cereals with 100% Daily Value of folic acid per serving) in addition to eating a healthful diet.

The number of pregnancies affected by anencephaly and spina bifida, serious birth defects of the brain and spine. Between 50 percent and 70 percent of all these defects might be prevented if all women of childbearing age consume 400 micrograms (mcg) of folic acid daily. In 1998, the United States fortified enriched cereal grain products with folic acid to help prevent the occurrence of these devastating birth defects. Since that time, the estimated number of pregnancies affected with these birth defects has declined from 4,000 per year prior to fortification to 3,000 per year after fortification. This decline in affected pregnancies is a partial success story. The U.S. Public Health Service estimates that at least an additional 1,000 pregnancies affected with spina bifida or anencephaly could be averted, creating the opportunity for the birth of babies who would not have these serious birth defects. To attain this goal, all women of childbearing age need to consume 400 mcg (0.4mg) of folic acid every day. This can be accomplished from supplements (vitamins containing 400 mcg of folic acid), fortified foods (especially breakfast cereals with 100 percent Daily Value of folic acid per serving), or both, in addition to a healthful diet.

Lyme Disease -- United States, 2001-2002

People can reduce their risk of LD by using preventive measures such as daily tick checks, repellent use, and changes in landscaping practices like removing leaf debris and placing wood chip barriers on the edge of their lawns. In addition, novel interventions such as bait-boxes will soon be available to potentially help reduce a person’s risk of LD.

Lyme Disease (LD) is a persistent and growing public health concern in the United States. In 2002, 23,763 cases of LD were reported to the CDC representing a 40% increase from 2001. Possible reasons for this increase include growing populations of deer that support the tick vector, increased residential development into wooded areas, dispersal of infected ticks to new areas, improved disease recognition, and enhanced reporting. LD is most common during the spring and summer months in northeastern, Mid-Atlantic, and north central states among persons aged 5-14 years and 50-59 years.

Impact of Heat Waves on Mortality -- Rome, Italy,
June-August 2003

No summary available.

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