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MMWR – Morbidity and Mortality Weekly Report

1. Deaths Associated with Hurricane Sandy — October–November 2012

CDC Media Relations

On Oct. 29, 2012, Hurricane/Post-tropical Cyclone Sandy (Sandy) made landfall across the northeastern U.S. coastline. Flooding and winds from Sandy caused extensive damage to infrastructure and resulted in deaths in several states. The American Red Cross identified and followed up with 117 deaths related to Sandy. Drowning was the most common cause of death, and 45 percent of the drowning deaths occurred in flooded homes in New York City’s mandatory Evacuation Zone A. Drowning is one of the leading causes of hurricane-related deaths; however, drowning deaths in an evacuation zone are preventable. Hurricane plans should ensure individuals receive and comprehend evacuation messages and have the necessary resources to comply with them. Lessons learned from the Sandy-related drowning deaths identified by Red Cross can help communities and their emergency managers is to be more effective at planning and executing evacuations for future major storms.

2. Impact of a Shortage of First-Line Antituberculosis Medication on Tuberculosis Control in the United States — 2012–2013

National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention

A nationwide survey of TB programs conducted in January found that the majority of respondents reported difficulties obtaining isoniazid (INH), a key first-line anti-TB drug.  In November 2012, the  United States began to experience a severe interruption in the availability of INH due to supply and manufacturing difficulties.  To understand the extent of the shortage and how programs were dealing with it, the National TB Controllers Association conducted a nationwide survey of TB programs in January 2013.   The results indicated the shortage was significantly impacting TB control.  Of responding programs, 79 percent reported difficulties obtaining INH: 15 percent reported they no longer had it and 41 percent reported they would no longer have it within one month.  As a result, TB programs reported changing drug suppliers (69 percent), prioritizing high-risk patients for treatment of latent infection (72 percent) or delaying treatment (68 percent), and changing to alternative treatment regimens (88 percent).  All programs (100 percent) reported engaging in activities to address the shortage, such as modifying protocols, and 44 percent reported switching to more expensive regimens.  Although supplies of INH are now becoming more available, many health departments continue to report difficulties obtaining the drug and/or altering their practices as a result.  CDC is working with partners to find solutions to address the shortage and protect public health.

3. Assessing the Value of Pharmacy-Based Influenza Surveillance — Ontario, Canada, 2009

Public Health Agency of Canada Media Relations

As part of ongoing efforts to enhance disease surveillance, the Public Health Agency of Canada conducted a study based on sales of antiviral medications used to treat influenza during the 2009 H1N1 pandemic. The objective was to investigate whether the sales of antiviral medications could be used as an early indicator of influenza activity in the community, in comparison to traditional laboratory confirmed cases. Results from this investigation demonstrate that during the second wave of the H1N1 pandemic in 2009 in Ontario, sales of antivirals mirrored the onset of influenza A (H1N1) symptoms at the local level. The results of the study suggest that pharmacy-based surveillance can be used as a tool to monitor and detect influenza-like activity earlier than traditional surveillance. The results of the study suggest that pharmacy-based surveillance can be used as a tool to monitor and detect influenza-like activity earlier than traditional surveillance.

4. Progress Toward Elimination of Onchocerciasis in the Americas — 1993–2012

CDC Media Relations

By the end of 2012 transmission of onchocerciasis, or “river blindness,” an infectious parasitic eye disease spread by black flies, was interrupted or eliminated in four of the six countries in the Americas in regions where it has long been a public health problem and placed some 500,000 individuals at risk. Mass drug administration (MDA) to control transmission has been successful in 11 of the 13 geographical areas where the disease was targeted for elimination. Colombia requested WHO verification of onchocerciasis elimination in 2012 after completing MDA and monitoring its effectiveness, making it the first country in the world to do so. Transmission in the Americas now continues only among isolated, indigenous Yanomami communities living in the Amazonian forest between Brazil and Venezuela. Eliminating onchocerciasis (river blindness) is now likely in the Americas in the next few years due to sustained efforts from endemic countries and their global health partners. This success demonstrates the feasibility of elimination and provides lessons learned for affected countries in Africa to move from controlling the parasitic disease to eliminating it.

5. Building Laboratory Capacity to Support the Global Rotavirus Surveillance Network

CDC Media Relations

Rotavirus is a leading cause of severe diarrhea morbidity and mortality among young children worldwide. Two rotavirus vaccines are effective at preventing severe rotavirus diarrhea were licensed in 2006. Since 2009, the World Health Organization has recommended that all countries include rotavirus vaccination in national immunization programs. However, as of April 2013, only 47 countries have done so. Strong disease surveillance systems can monitor disease trends over time and provide timely data to inform decisions regarding vaccine introduction. The development of the Global Rotavirus Laboratory Network with a built-in quality assurance system has played a key role in generating timely and accurate rotavirus disease surveillance data that will help inform such decisions.  The Global Rotavirus Laboratory Network is an integral component of global rotavirus disease surveillance that provides quality rotavirus disease burden and strain prevalence data. Network expansion and continued data quality improvement measures have ensured that timely and accurate data are generated to help inform decisions regarding rotavirus vaccine introduction.



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