Synopsis for November 18, 2005

The MMWR is embargoed until Thursday, 12 PM EST.

1. Cruise-Ship Associated Legionnaires Disease – November 2003-May 2004
2. Trends in HIV/AIDS Diagnoses – 33 States, 2001-2004
3. Immunization Information System Progress – United States, 2004
4. Lower Extremity Disease Among Persons Aged greater than 40 Years With and Without Diabetes – United States 1999-2002
5. Congenital Rubella Syndrome – New Hampshire, 2005

Cruise-Ship Associated Legionnaires Disease –
November 2003-May 2004

Travel-associated Legionnaires disease is preventable, but requires the cooperation of clinicians and local, national, and international public health agencies to foster diagnosis and prevention.

Legionnaires disease, a potentially severe pneumonia caused by the water-borne bacterium Legionella, can occur among susceptible travelers, including cruise ship passengers. However, outbreaks of Legionnaires disease that occur among cruise passengers are difficult to detect because passengers often return home before symptoms start. Healthcare providers need to consider Legionnaires disease as a cause of pneumonia in returning cruise ship passengers and they need to obtain appropriate specimens for diagnostic testing. Timely reporting of cases must occur to allow local, national, and international public health agencies to determine the source of the outbreak.

Trends in HIV/AIDS Diagnoses – 33 States, 2001-2004

A CDC analysis of data from 33 U.S. states indicates that while the rate of new HIV/AIDS diagnoses (all new HIV diagnoses with our without a concurrent AIDS diagnosis) among blacks dropped roughly five percent each year between 2001 and 2004, the magnitude of the epidemic among African-Americans remains severe.

In 2004, the rate of diagnosis among blacks was 8.4 times higher than among whites (76 diagnoses per 100,000 vs. 9), and blacks represented more than half of all diagnoses during the four-year period. These data also emphasize the continued impact of HIV among men who have sex with men who accounted for 44 percent of diagnoses during the period. By comparison, high-risk heterosexual contact accounted for 34 percent of new diagnoses, followed by injection drug use (IDU) at 17 percent. From 2001 to 2004, the overall number of HIV/AIDS diagnoses in these states decreased slightly, largely as a result of a 9 percent annual decline in diagnoses among injection drug users and a somewhat smaller 4 percent decline among heterosexuals, which researchers attribute in part to declines in New York State. The authors point to the need for intensified prevention and HIV testing efforts to reduce the impact of HIV among African-Americans and gay and bisexual men of all races.

MMWR Fact Sheet

Immunization Information System Progress –
United States, 2004

Immunization Information Systems have made progress enrolling children and health-care providers in their systems.

This report summarizes data from CDC's 2004 Immunization Information System (IIS) Annual Report. The findings indicate that approximately 48percent of U.S. children aged less than 6 years participated in an IIS. Moreover, 76 percent of public vaccination provider sites and 39 percent of private vaccination provider sites submitted immunization data to an IIS. Overcoming grantee challenges and barriers to increasing the number of provider sites and the percentage of children aged less than 6 years participating in an IIS is critical. CDC has developed a plan of action to address those challenges to meet the national health objective. Major components of the plan include, but are not limited to, a multi-year IIS business plan for each grantee and enhanced technical assistance to grantees with unresolved challenges.

Lower Extremity Disease Among Persons Aged greater than 40 Years With and Without Diabetes – United States 1999-2002

NO SUMMARY AVAILABLE

Congenital Rubella Syndrome – New Hampshire, 2005

Maintenance of a high index of suspicion for CRS in infants with compatible clinical signs, along with rubella vaccination of susceptible persons, will prevent the transmission of rubella.

Rubella was declared to be no longer endemic in the United States by an independent panel convened by the CDC in 2004. This article describes a public health investigation around an imported case of congenital rubella syndrome (CRS) in an infant born in New Hampshire to refugee parents. Rubella remains endemic in other parts of the world. Therefore, CRS should be considered in infants with compatible clinical signs, particularly in those born to mothers who resided in countries without rubella elimination programs or with recently implemented programs. Since rubella virus can be shed by an infant with CRS up to one year after birth, prompt diagnosis of CRS, along with rubella vaccination of susceptible persons, will prevent the transmission of rubella.

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