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MMWR – Morbidity and Mortality Weekly Report


1. Measles — United States, 2011

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Measles is a highly contagious viral disease that can cause serious complications and death. In the United States, measles elimination (i.e. absence of year round transmission) was declared in 2000. However, measles continues to be imported into the United States from countries where measles is still common. During 2011, 222 measles cases and 17 measles outbreaks were reported to CDC, an increase compared with cases and outbreaks during 2001-2010. Of the 222 cases, 200 (90 percent) were associated with importations and 112 (50 percent) were associated with outbreaks. Measles, mumps and rubella (MMR) vaccine is highly effective in preventing measles.Among U.S. residents, 85 percent were unvaccinated or had unknown vaccination status and were eligible for MMR vaccination. People need to be up-to-date on MMR and other vaccinations, including when they are preparing to travel internationally to any destination. Unvaccinated people place themselves and others in their communities at risk for measles and its complications.

2. Human Papillomavirus–Associated Cancers — United States, 2004–2008

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During 2004-2008, there were an average of 33,369 HPV-associated cancers diagnosed annually; 12,080 among males and 21,290 among females.  CDC researchers used data from CDC’s National Program of Cancer Registries and NCI’s Surveillance, Epidemiology and End Results program covering 100 percent of the US population. The analysis included cancers in sites and cell types where HPV DNA is most frequently found, including cervix, vulva, vagina, penis, anus and oropharynx. Cervical cancer was the most common of these cancers, with an average of 11,967 cases annually; oropharyngeal cancer was the second most common, with an average of 11,726 cases annually (2,370 among females and 9,356 among males). More than 33,000 cancers occur in sites associated with HPV annually in the US, over 21,000 among females and over 12,000 among males. Of these, CDC estimates nearly 26,000 can be attributed to the virus and many of these may be preventable through use of the HPV vaccine.  Two vaccines are available to protect against HPV 16 and 18, the types that cause most cervical and other anogenital cancers as well as some oropharyngeal cancers. The Advisory Committee on Immunization Practice recommends routine vaccination of females aged 11 or 12 years with 3 doses of either vaccine and routine vaccination of males aged 11 or 12 years with 3 doses of quadrivalent vaccine.

3. Pseudomonas aeruginosa Respiratory Tract Infections in Cardiovascular Surgery Patients Associated with Contaminated Ultrasound Gel Used for Transesophageal Echocardiography — Michigan, December 2011–January 2012

Paul Chittick
Associate Corporate Epidemiologist
Beaumont Health System

From December 9, 2011 to January 20, 2012, a cluster of 16 cases of Pseudmonas aeruginosa respiratory tract infections in cardiovascular surgery patients occurred at Beaumont Health System.  An investigation found that contaminated ultrasound transmission gel, other-Sonic (Pharmaceutical Innovations, Inc., Newark, NJ) was the likely source of the outbreak, and that the contamination likely occurred during the time of manufacture, packaging, or shipping.  An FDA investigation is ongoing.  Sterile ultrasound gel should be used for invasive procedures as well as procedures involving contact with non-intact skin or mucous membranes.

4. Tracking Progress Toward Global Polio Eradication, 2010–2011

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To achieve polio eradication, surveillance for acute flaccid paralysis (AFP) is used to identify areas with poliovirus (PV) transmission and those with low reporting where cases might go undetected.  During 2010–2011, AFP surveillance was suboptimal in some key countries and unimproved overall. Only 62 percent of countries with circulating wild PV (WPV) met national AFP surveillance performance targets. All three countries with reestablished WPV transmission and 16 of 19 countries with WPV outbreaks had >20 percent of their respective populations living in areas with underperforming surveillance. Genetic characterization of WPV isolates provided evidence that several chains of transmission were missed by surveillance deficiencies. The search for poliovirus circulation requires improvement in some key countries and regions; given the current elevated status of polio eradication as a “programmatic emergency for global public health,” efforts must be taken to improve AFP surveillance quality at all levels within a country to track potential polio transmission and provide timely outbreak response.


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