Synopsis for December 23, 2005

The MMWR is embargoed until Thursday, 12 PM EST.

1. Outbreaks of Escherichia coli 0157:H7 Associated with Petting Zoos– North Carolina, Florida, and Arizona, 2004-2005
2. Mycobacterioum tuberculosis Transmission in a Newborn Nursery and Maternity Ward – New York City, 2003
3. Pertussis – United States, 2001-2003
4. Update: Public Health Notification Regarding Ralsonia Associated with Vapotherm Respiratory Gas Administration Devices – United States, 2005
5. Supplemental Testing for Confirmation of Reactive Oral Fluid Rapid HIV Antibody Tests

Outbreaks of Escherichia coli 0157:H7 Associated with Petting Zoos – North Carolina, Florida, and Arizona, 2004-2005

Children and their parents may find petting zoos appealing, but they should recognize that contact with animals or animal manure can pose serious health risks, especially for young children who may be more prone to put objects in their mouths. It's important that parents and petting zoo operators closely supervise children and encourage proper hand washing after leaving the petting areas.

Three petting zoo associated outbreaks of E. coli O157:H7 illnesses occurred in 2004 and 2005. Eighty-two of the 108 people in North Carolina who became ill said they visited a petting zoo at the 2004 State Fair in Raleigh. Investigators linked illnesses with contact with animal manure, hand-to-mouth activities such as thumb sucking or pacifier use, and falling or sitting on the ground in the petting zoo that likely held contaminated animal bedding. In March, 2005, Florida investigators found 63 persons who became ill after visiting petting zoos at fairs or festivals. Investigators linked touching or feeding petting zoo animals to illness, as well as touching sawdust and shavings in the petting zoos there. Two children were hospitalized after visiting a petting zoo in Arizona in July, 2005. These outbreaks suggest parents exercise caution if they take young children into petting zoos.

Mycobacterioum tuberculosis Transmission in a Newborn Nursery and Maternity Ward – New York City, 2003

CDC findings released today underscore the need for effective testing and treatment for latent tuberculosis (TB) infection among healthcare workers – especially those born or trained overseas.

A December 2003 investigation of active TB in a foreign-born nurse working in the newborn nursery and maternity ward of a New York City hospital found that she had been diagnosed with latent TB 11 years earlier but declined treatment. The nurse attributed her positive test, in part, to prior BCG vaccination and reported that most adults from her home country, the Philippines, test positive for latent TB infection but do not take treatment. In this case, limited transmission of TB was found, but four infants (who had not been vaccinated for BCG) had a positive test for latent TB -- a sentinel indicator of recent transmission of M. tuberculosis in children. Authors note that foreign-born health care workers are less likely to accept latent TB treatment or recommend it to their families and recent BCG-vaccinated immigrants. As the proportion of foreign-born health care workers in the United States increases, health care settings should ensure appropriate latent TB screening and treatment adherence.

Pertussis – United States, 2001-2003

The burden of pertussis among adolescents in the United States is significant and providing pertussis protection to all adolescents aged 11-18 years by vaccination with Tdap, as newly recommended by ACIP, will greatly reduce this burden.

Pertussis is a highly contagious, vaccine-preventable bacterial illness characterized by fits of cough, posttussive vomiting, and inspiratory whoop. Most hospitalizations and almost all deaths from pertussis are reported in infants aged <6 months, but substantial morbidity does occur in other age groups. Reported pertussis cases have increased from a historic low of 1,010 in 1976 to 11,647 cases in 2003. A large increase in reported cases has occurred among adolescents; adolescents become susceptible to pertussis approximately 6-10 years after childhood vaccination. Recently, booster vaccines for adolescents and adults combining pertussis antigens with tetanus and diphtheria toxoids (Tdap) were approved by the Food and Drug Administration (FDA) and recommended by the Advisory Committee on Immunization Practices for all adolescents aged 11-18 years. This report summarizes national surveillance data on pertussis reported to CDC during 2001–2003 and focuses on pertussis reported among adolescents before implementation of national recommendations for adolescent pertussis vaccination.

Update: Public Health Notification Regarding Ralsonia Associated with Vapotherm Respiratory Gas Administration Devices – United States, 2005

NO SUMMARY AVAILABLE

Supplemental Testing for Confirmation of Reactive Oral Fluid Rapid HIV Antibody Tests

NO SUMMARY AVAILABLE

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