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MMWR – Morbidity and Mortality Weekly Report

1. Prepregnancy Contraceptive Use Among Teens with Unintended Pregnancies Resulting in Live Births — United States, 2004–2008

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The teen pregnancy rate in the United States remains the highest of any developed country. Teen pregnancy is a public health concern because teen mothers are more likely to experience negative social outcomes, and infants of teen mothers have higher risks for preterm birth, low birth weight, and related complications. Among teen females (15-19 years) who had a live birth from an unintended pregnancy, one half (50.1 percent) were not using any method of birth control when they got pregnant.  Of the teens not using contraception 31.4 percent believed they could not get pregnant at the time. Understanding the contraceptive use patterns of this particular group of teens, and their reasons for non-use of contraception, is critical to our understanding of how best to prevent teen pregnancy.  To decrease teen birth rates, efforts are needed to reduce or delay the onset of sexual activity, provide factual information about the conditions under which pregnancy can occur, increase teens’ negotiation skills for pregnancy prevention, improve access to contraceptives, and encourage use of more effective contraceptive methods.

2. Hospital-Associated Measles Outbreak — Pennsylvania, March–April 2009

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A 2009 hospital-associated measles outbreak in Pennsylvania highlights the potential of measles transmission in healthcare settings. The outbreak started when a child from India with fever and rash went to a hospital emergency department (ED) on March 10 and was diagnosed with viral exanthema but not tested for measles. On April 3, after an extensive public health investigation, the child was belatedly diagnosed with measles. Four other patients and one ED physician, who were in the ED on March 10, were diagnosed with measles. Healthcare providers should be aware of measles symptoms and should be vigilant about suspecting the disease and appropriately isolating patients, especially those with a history of international travel. Also, healthcare providers and employees should have documentation of measles immunity.

3. Mercury Exposure Among Household Users and Nonusers of Skin-Lightening Creams Produced in Mexico — California and Virginia, 2010

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Mercury-containing, skin-lightening creams can cause serious adverse health consequences for users of these cosmetics and members of their households, including children. Residents of California and Virginia who used skin-lightening creams produced in Mexico were exposed to mercury as were their household members who did not use these cosmetics. Prompted by results from a health study, health departments identified 15 persons in five households who had elevated urinary mercury concentrations, including nine cream users and six nonusers. Six users had nonspecific symptoms consistent with chronic exposure to mercury, including numbness, tingling, dizziness, forgetfulness, headaches, and depression. Mild-to-moderate symptoms of mercury toxicity typically resolve in 2-6 months without further therapy after exposure ends. Despite FDA restrictions, skin-lightening creams produced outside the United States that contain mercury are available to consumers. Consumers should avoid unlabeled products or those listing mercury, "mercurio," or "calomel" as ingredients.


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