Update: severe acute respiratory syndrome--United States,June 18, 2003

CDC continues to work with state and local health departments, the World Health Organization (WHO), and other partners to investigate cases of severe acute respiratory syndrome (SARS). This report updates reported SARS cases worldwide and in the United States and summarizes changes in travel recommendations for provinces in China with the exclusion of Beijing, where a travel advisory remains.     

Update: severe acute respiratory syndrome--United States,June 11, 2003

CDC continues to work with state and local health departments, the World Health Organization (WHO), and other partners to investigate cases of severe acute respiratory syndrome (SARS). This report updates SARS cases reported worldwide and in the United States, and describes the eighth probable U.S. SARS case with laboratory evidence of SARS-associated coronavirus (SARS-CoV) infection.     

Update: severe acute respiratory syndrome--United States,June 4, 2003

CDC continues to work with state and local health departments, the World Health Organization (WHO), and other partners to investigate cases of severe acute respiratory syndrome (SARS). This report updates SARS cases reported worldwide and in the United States and summarizes changes in CDC's recommendations for travel to Singapore and Hong Kong and the resulting modification to the interim U.S. case definition for SARS.     

Sentinel Chicken Surveillance Program in Australia, July 2003 to June 2004.

Detection of flavivirus seroconversions in sentinel chicken flocks located in four Australian states are used to provide an early warning of increased levels of Murray Valley encephalitis virus (MVEV) and Kunjin virus (KUNV) activity in the region. During the 2003-2004 season low levels of flavivirus activity were detected in northern Australia with both MVEV and KUNV virus activity detected in the Kimberley and Pilbara regions of Western Australia and in the Northern Territory. A single case of Murray Valley encephalitis was reported from Central Australia. MVEV activity was also detected at Minindee in western New South Wales for the first time since 2000-2001. No activity was detected in Victoria.     

Day care-related outbreaks of rhamnose-negative Shigella sonnei--six states, June 2001-March 2003

During June 2001--March 2003, outbreaks of Shigella sonnei infections were reported in Delaware, Maryland, New Jersey, North Carolina, South Carolina, and Virginia. Five- to fortyfold increases in statewide shigellosis rates were observed during this period. These increases were attributed primarily to outbreaks in multiple day care settings that became prolonged and community wide. S. sonnei isolates from these states, as well as from New York City and Philadelphia, were similar genetically by pulsed-field gel electrophoresis (PFGE). Many of these isolates lacked the capacity to ferment rhamnose, which is unusual for S. sonnei. This report summarizes these outbreaks and describes the laboratory characteristics that link them. The findings underscore the importance of rapid and coordinated public health responses to isolated outbreaks of shigellosis.     

Dietetic guidelines: diet in secondary prevention of cardiovascular disease (first update, June 2003)

AIM: To update dietetic guidelines summarizing the systematic review evidence on dietary advice to prevent further events in people with existing cardiovascular disease (CVD) (secondary prevention). METHODS: The Cochrane Library, MEDLINE and EMBASE were comprehensively searched to November 2002 for systematic reviews on aspects of diet and heart health. Reviews were included if they searched systematically for randomised controlled trials relating to diet and secondary prevention of CVD. Two members of the UK Heart Health and Thoracic Dietitians Group critically appraised each review. The quality and results of each review were discussed and summarized in a meeting of the whole group. RESULTS: Providing evidence-based dietary information (including increasing omega-3 fat intake) to all people who have had a myocardial infarction will save more lives than concentrating dietary advice on just those in need of weight loss or lipid lowering. The practice of prioritizing dietetic time in secondary prevention to those with raised lipids is out of date since the advent of statin therapy. However, effective dietary advice for those with angina, stroke, peripheral vascular disease or heart failure is less clear. CONCLUSION: There is good systematic review evidence that dietary advice to those with coronary heart disease can reduce mortality and morbidity as well as modify some risk factors. Dietary advice that does this most effectively should be prioritized.