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MMWR – Morbidity and Mortality Weekly Report

1. Measles Among Returning Travelers — United States, 2001–2011

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

Measles is a highly contagious viral disease that is vaccine-preventable. Although measles was declared eliminated from the United States in 2000, it is still present in other regions of the world, including Western Europe, and imported cases continue to occur among U.S. residents returning from foreign travel and among foreign visitors to the United States. The risk of complications or death from measles is highest among young children. In the first two months of 2011, 7 cases of measles were reported among 6- through 23-month-old U.S. infants who traveled abroad, and 4 of these children were hospitalized due to severe measles-related complications. All 7 of these infections and the associated complications were potentially preventable through adherence to vaccination recommendations endorsed by the American Academy of Pediatrics and the Advisory Committee on Immunization Practices. International travelers of all ages should be up to date with their vaccinations. Considering the high risk of measles complications in children, infants aged 6–11 months should receive one dose of measles-mumps-rubella vaccine before traveling internationally, and children aged 12 months and older should receive two doses (separated by at least 28 days). Physicians should consider measles as a possible diagnosis of rash illness among patients with a recent history of international travel.

2. Outbreak of Invasive Listeriosis Associated with the Consumption of Hog Head Cheese — Louisiana, 2010

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

Ken Pastorick
Louisiana Department of Health and Hospitals
(225) 342-1881

An outbreak in Louisiana in 2010 was the first to link listeriosis with eating hog head cheese, a product made from pig heads and feet. Eight people became severely ill and two died. After the outbreak was traced to a processing establishment, it recalled 500,000 pounds of the product. Listeria contamination of other types of ready-to-eat meats has also caused outbreaks in the United States. Older adults, pregnant women, patients with impaired immune systems, and people with certain chronic conditions have a higher risk of listeriosis. The outbreak demonstrates that ready-to-eat meat is not always safe for these high-risk groups. Pregnant women, older adults, patients with impaired immune systems, and people with certain chronic medical conditions (such as cancer, diabetes, alcoholism, liver disease, and kidney disease) can reduce their risk of listeriosis by learning what foods to avoid and how to safely prepare and refrigerate food.

3. Assessment of ESSENCE Performance for Influenza-like Illness Surveillance After an Influenza Outbreak — U.S. Air Force Academy, Colorado, 2009

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

The Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE), version II, is an Internet-based syndromic disease surveillance system designed as an early warning system to detect and monitor an outbreak. After a 2009 pandemic influenza A (H1N1) outbreak at the U.S. Air Force Academy, CDC conducted an evaluation of the ESSENCE influenza-like illness (ILI) surveillance system and found strengths in data quality, flexibility, representativeness, and ability to monitor seasonal influenza. However, ESSENCE was not useful for detecting or monitoring the localized 2009 H1N1 outbreak due to a lack of timeliness (1–3 day delay), inadequate sensitivity (71.4 percent), and poor predictive value positive (31.8 percent). More frequent Internet data transmissions from the clinics to the ESSENCE server might improve timeliness. ESSENCE was found to be an effective surveillance system to monitor the normal seasonal variation of influenza-like illness on a military installation but may need more frequent data transmissions to enhance its usefulness for outbreak detection and monitoring.

4. Assessing Completeness of Perinatal Hepatitis B Virus Infection Reporting for Infants Born in 2005 — United States

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

Approximately 24,000 women with Hepatitis B give birth each year, and without vaccination, their infants are at risk of contracting the disease. Infants infected with hepatitis B have a 90 percent chance of developing a life-long infection and a 25 percent risk of premature death. To prevent mother-to-child transmission of hepatitis B, all pregnant women need to be tested for hepatitis B and all infections should be reported to local and state health departments. If infected, a woman should be referred for evaluation and treatment, and her infant should receive hepatitis B vaccine at the time of birth in order to prevent infection. All infants should receive the first shot in the Hepatitis B vaccine series before getting discharged from the hospital. Identifying pregnant women who are infected with hepatitis B and providing clinical care and monitoring of the women and their infants can prevent future cases of liver disease, liver cancer, and even death. This article describes how federally funded state and local immunization programs work to eliminate hepatitis B in the United States by monitoring hepatitis B infected pregnant women and their infants. Actively collected immunization program data on infant hepatitis B infections are more complete than passively collected surveillance data.



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