Synopsis for January 21, 2005

The MMWR is embargoed until Thursday, 12 PM EDT.

1. Increase in Poisoning Deaths Caused by Non-Illicit Drugs ― Utah, 1991-2003
2. Unintentional Non-Fire-Related Carbon Monoxide Exposures ― United States, 2001-2003
3. Escherichia Coli 0157:H7 Infectious Associated with Ground Beef from U.S. Military Installation ― Okinawa, Japan, February 2004
4. Elevated Blood Lead Levels in Refugee Children ― New Hampshire, 2003-2004

Increase in Poisoning Deaths Caused by Non-Illicit Drugs ― Utah, 1991-2003

Prescription narcotics can benefit many people, but these data indicate that they are also dangerous. Providers and patients should assure that these medications are used appropriately and safely.

Deaths due to drug poisoning have been increasing in Utah for more than a decade, but the pattern of increase has changed. During the period 1993 to 1999, deaths due to illicit drugs increased to more than 100 a year. From 1999 to 2003, an even larger increase occurred due to drugs that can be legally prescribed (non-illicit drugs). In 2003, the typical drug overdose death in Utah was an overweight adult, aged 25-54 years who died from the effects of non-illicit drugs. In contrast to deaths due to illicit drugs, this newer problem has affected urban and non-urban areas and both men and women similarly. Prescription narcotic drugs contributed to the most deaths.

Unintentional Non-Fire-Related Carbon Monoxide Exposures ― United States, 2001-2003

Primary prevention of CO exposures in the home can be accomplished through improved maintenance of home heating sources and gas burning appliances, avoiding the indoor use of unvented gas burning appliances, unvented gas or wood burning stoves, and unvented fireplaces.

Approximately 480 U.S. residents died annually from non-fire-related CO poisoning during 2001-2002. In addition, during 2001-2003, an estimated 15,200 persons with confirmed or possible non-fire-related CO exposure/poisoning were treated annually in U.S. hospital emergency departments. The primary source of CO was home appliances. CO exposures/poisonings occurred more often during the fall and winter months when people are more likely to be using gas furnaces and heaters.

Fact Sheet: Study: Unintentional Non-Fire-Related Carbon Monoxide Exposures — United States, 2001–2003

Escherichia Coli 0157:H7 Infectious Associated with Ground Beef from U.S. Military Installation ― Okinawa, Japan, February 2004

The use of standardized molecular subtyping methods internationally, like the PulseNet USA protocol used in this investigation, can facilitate detection and prevention of foodborne diseases worldwide.

This report summarizes a collaborative investigation of Escherichia coli O157:H7 infection in a Japanese family associated with eating ground beef purchased from a U.S. military base. Public health officials from multiple agencies in Japan and the United States were involved. The investigation resulted in a voluntary recall of approximately 90,000 pounds of frozen ground beef in the United States and at U.S. military bases. Use of the PulseNet USA protocol for molecular subtyping facilitated the investigation. The results of this investigation demonstrate the potential for multinational foodborne outbreaks and the benefits of international public health communication and use of standardized methods of molecular subtyping for detection and prevention of foodborne diseases.

Elevated Blood Lead Levels in Refugee Children ― New Hampshire, 2003-2004

Refugee children should be tested for lead poisoning upon arrival and several months after initial screening to assess exposure after resettlement.

Although blood lead levels (BLLs) in children aged 1 to 5 years are decreasing in the United States, the risk for elevated BLLs remains high for certain populations, such as refugees. This investigation found that of the 92 refugee children resettled in New Hampshire that were tested upon arriving in the United States and again 3 to 6 months after permanent placement, 37 had elevated BLLs that were greater than 10 micrograms per deciliter (mcg/dL) -- the level targeted for elimination in U.S. children by the end of the decade. Refugee children should be tested for lead poisoning upon arrival and several months after initial screening to assess exposure after resettlement and provided a pediatric multivitamin with iron upon arrival in the United States.

Fact Sheet: CDC Report Finds Refugee Children at High Risk for Lead Exposure

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