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MMWR – Morbidity and Mortality Weekly Report

1. Tetanus Surveillance — United States, 2001–2008

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

Tetanus is a rare but life-threatening disease in the United States and it is caused by the toxin of Clostridium tetani, which is found in soil and animal excrement. Reported tetanus cases have declined >95 percent and deaths from tetanus have declined >99 percent in the United States since 1947. CDC analyzed tetanus cases reported to the National Notifiable Diseases Surveillance System (NNDSS) during 2001–2008. The results show that 233 cases were reported during 2001–2008. The case-fatality rate was 13.2 percent among the 197 cases with known outcomes. Case fatality was higher among persons >65 years, diabetics, and among unvaccinated persons or those not up-to-date with vaccination. Tetanus is a vaccine preventable disease. Health-care providers should ensure up-to-date TT vaccination of all their patients, especially persons aged ≥65 years, and diabetics. Children should receive a complete series of vaccine at ages 2, 4, 6, 18 months and then 4-6 years of age. A booster dose should be administered at age 11-12 years and then every ten years after.

2. CDC Grand Rounds: Chlamydia Prevention: Challenges and Strategies for Reducing Disease Burden and Sequelae

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

CDC recommends annual chlamydia testing for young women, yet far too many women remain untested. Chlamydia, a sexually transmitted infection, often has no symptoms but can cause severe reproductive complications, including infertility in women. This report details the burden of chlamydia and its complications and discusses challenges and strategies for increasing chlamydia awareness and prevention. An estimated 2.8 million chlamydia infections occur each year, with most infections occurring among sexually active adolescents and young adults. Chlamydia can be easily diagnosed and treated, but if left untreated can lead to pelvic inflammatory disease, infertility, and ectopic pregnancy in women. To prevent these complications, health officials recommend that all sexually active women under the age of 25 get tested for chlamydia every year, yet data show that about half of all sexually active women seeking healthcare were not tested for chlamydia in the past year. Report authors emphasize the importance of expanding chlamydia testing and treatment among sexually active young women, providing effective services to promptly treat male sex partners of infected women, and re-testing men and women infected with chlamydia three months after treatment.

3. Measles Outbreaks and Progress Toward the Measles Preelimination Goal — Africa, 2009–2010

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

During 2001–2008, African countries made remarkable progress in reducing measles mortality and morbidity by increasing measles vaccination. However, since reaching an historic low of 32,278 reported cases in 2008, a resurgence of measles has led to multiple large outbreaks during 2009–2010. The 2009–2010 outbreaks highlight the need for full implementation of regional measles immunization efforts with an emphasis on improving vaccination coverage through routine immunization services and supplemental immunization activities ensuring that all eligible children receive two doses of measles vaccine. Renewed dedication by donors and governments is needed to ensure that national multiyear plans, budgetary line-items, and financial commitments exist for adequately supporting routine measles immunization and control activities.



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