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MMWR – Morbidity and Mortality Weekly Report

1. Update: Cholera Outbreak — Haiti, 2010

CDC Division of News and Electronic Media
(404) 639-3286

In October 2010, an outbreak of cholera was reported from Haiti. This report describes the laboratory investigation of the initial cases, the ongoing outbreak of cholera in Haiti, and initial control measures. A 2-day train-the-trainer program was launched in Port-au-Prince to educate health-care providers on cholera treatment and management techniques. Recommendations for reducing the risk for cholera include drinking and using safe water, cooking food thoroughly, peeling fruits and vegetables, washing hands often with soap and water, using latrines or burying feces, and cleaning oneself away from drinking water sources.

2. Occupational Transmission of Neisseria meningitidis — California, 2009

California Department of Public Health
Office of Public Affairs
(916) 440-7259

This report details the transmission of Neisseria meningitidis to a police officer and a respiratory therapist involved in an emergency response to an infected patient. Infection with N. meningitides can result in severe disability and death. The police officer had minimal patient contact while the respiratory therapist assisted in the patient's endotracheal intubation; neither secondary case had worn an N95 respirator or surgical mask. Lapses in the use of personal protective equipment, and delays in notification of the local health authority and in worker post-exposure follow-up and prophylaxis contributed to the occurrence of secondary cases. Other groups have reported transmission to healthcare workers after unprotected exposure to an infected patient during endotracheal intubation, airway suctioning, and oxygen administration. Healthcare facilities should review infection control and occupational health recommendations as well as disease reporting requirements. Clinicians should carefully evaluate workers exposures to determine whether postexposure prophylaxis is indicated.

3. Smoking Restrictions in Large-Hub Airports — United States, 2002 and 2010

CDC Office on Smoking & Health
(770) 488-5493

Air travelers and workers are exposed to secondhand smoke at some of the nation's busiest airports. As an alternative to adopting smoke-free policies, several U.S. airports have installed enclosed, ventilated smoking rooms. The Surgeon General concluded in 2006 that separating smokers from non-smokers, cleaning the air, and ventilating buildings cannot completely eliminate exposure to secondhand smoke. CDC supports comprehensive smoke-free policies that completely eliminate smoking in all public places and workplaces. Only 100 percent smoke-free policies will fully protect the thousands of airport workers and millions of travelers from the risk of secondhand smoke exposure at airports. An analysis of smoke-free policies among large-hub U.S. airports in 2002 and 2010 found that 1 in 4 of the airports still allows smoking indoors, putting millions of air travelers and workers at risk of being exposed to secondhand smoke. Smoking is still allowed inside seven of the nation's largest airports, including three of the five busiest: Hartsfield-Jackson Atlanta International Airport, Dallas Fort Worth International Airport, and Denver International Airport. Other airports that still allow smoking indoors include: Las Vegas McCarran International Airport, Charlotte Douglas International Airport, Washington Dulles International Airport, and Salt Lake City International Airport. According to the report, 22 percent of U.S. passenger boardings take place at these airports. Research shows that there is no safe level of exposure to secondhand smoke, which causes serious disease and death, including 46,000 heart disease deaths and 3,400 lung cancer deaths each year.

4. Syringe Exchange Program — United States, 2008

National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
News Media Line
(404) 639-8895

A national survey reveals that the number of syringe exchange programs (SEPs) and the number of syringes exchanged in 2008 remained similar to recent years, in contrast to a period of rapid growth in the 1990s and early 2000s. In a survey of 123 SEPs, researchers with the Beth Israel Medical Center found that these SEPs operated in 93 cities and exchanged 29.1 million syringes in 2008. Budgets for SEPs increased steadily from 1994 through 2008, with the majority of funds (79 percent) coming from public sources. While previous studies have concluded that SEPs can reduce needle sharing among injection drug users (IDUs)—which may also reduce the transmission of blood borne pathogens like HIV, hepatitis B and hepatitis C—authors note that SEPs also offer a point of access for a high-risk population to other disease prevention services, clinical care and substance abuse treatment referral services. In addition to providing clean syringes, SEPs surveyed offered a range of services for IDUs: nearly all provided services such as HIV/STD (96 percent) and hepatitis (97 percent) prevention education; HIV counseling and testing services (87 percent); and substance abuse treatment referrals (89 percent).



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