Tuberculosis outbreaks in prison housing units for HIV-infected inmates--California, 1995-1996

During 1995-1996, staff from the California departments of corrections and health services and local health departments investigated two outbreaks of drug-susceptible tuberculosis (TB). The outbreaks occurred in two state correctional institutions with dedicated HIV housing units. In each outbreak, all cases were linked by IS6110-based DNA fingerprinting of Mycobacterium tuberculosis isolates. This report describes the investigations of both outbreaks; the findings indicated that M. tuberculosis can spread rapidly among HIV-infected inmates and be transmitted to their visitors and prison employees, with secondary spread to the community.     

National Child Passenger Safety Week--February 14-20, 1999

In 1997, 1791 U.S. children aged <15 years were killed and 282,000 were injured while riding in motor vehicles. National Child Passenger Safety Week, February 14-20, 1999, will highlight safety recommendations for children aged >4 years and weighing >40 lbs who have outgrown their child safety seats.     

Total tooth loss among persons aged > or =65 years--selected states, 1995-1997

Loss of all natural permanent teeth (edentulism) substantially reduces quality of life, self-image, and daily functioning. Although loss of teeth results from oral diseases such as dental caries and periodontitis, it also reflects patient and dentist attitudes, availability and accessibility of dental care, and the prevailing standard of care. One of the national health objectives for 2000 is to reduce to no more than 20% the proportion of persons aged > or =65 years who have lost all their natural teeth (objective 13.4). Edentulism has been declining in the United States since the 1950s, but few state-specific data are available on adult tooth loss. To estimate the prevalence of edentulism among persons aged > or =65 years, CDC analyzed data from the 46 states that participated in the oral health module of the 1995-1997 Behavioral Risk Factor Surveillance System (BRFSS). This report summarizes the findings from this analysis, which indicate a large state-specific variation in edentulism and that many states have not yet achieved the national health objective for preventing total tooth loss.     

Availability of immune globulin intravenous for treatment of immune deficient patients--United States, 1997-1998

Immune globulin intravenous (IGIV) is a lifesaving treatment for patients with primary immunodeficiency. Since November 1997, a shortage of IGIV has existed in the United States. In 1998, the Food and Drug Administration (FDA) required pharmaceutical companies to increase the frequency of reporting on IGIV distribution from biannually to monthly; in addition, FDA facilitated IGIV distribution and informed clinicians about the ongoing shortage. To assess the impact of the IGIV shortage on patient care, in 1998 the Immune Deficiency Foundation (IDF) surveyed physicians caring for immunodeficient patients about whether they have had difficulty obtaining IGIV, measures they have taken because of the shortage, and the effect of the shortage on their patients. This report summarizes data reported to FDA and data obtained from the IDF survey and provides recommendations for IGIV use during the shortage.     

Decline in cigarette consumption following implementation of a comprehensive tobacco prevention and education program--Oregon, 1996-1998

In November 1996, residents of Oregon approved a ballot measure increasing the cigarette tax by 30 cents (to 68 cents per pack). The measure stipulated that 10% of the additional tax revenue be allocated to the Oregon Health Division (OHD) to develop and implement a tobacco-use prevention program. In 1997, OHD created Oregon's Tobacco Prevention and Education Program (TPEP), a comprehensive, community-based program modeled on the successful tobacco-use prevention programs in California and Massachusetts. To assess the effects of the tax increase and TPEP in Oregon, OHD evaluated data on the number of packs of cigarettes taxed before (1993-1996) and after (1997-1998) the ballot initiative and implementation of the program. Oregon's results also were compared with national data. This report summarizes the results of the analysis, which indicate that consumption of cigarettes in Oregon declined substantially after implementation of the excise tax and TPEP and exceeded the national rate of decline.     

Outbreak of poliomyelitis--Iraq, 1999

Since May 1999, 86 cases of acute flaccid paralysis (AFP) have been reported in Iraq. Sixteen cases with onset during May-July have been confirmed as paralytic poliomyelitis by isolation of wild poliovirus type 1; the remaining cases are either negative, pending virus isolation (n=10), or positive for type 1 poliovirus with intratypic differentiation pending (n=nine). The first confirmed case occurred in a person residing in Ninevah governorate in the northern part of the country; subsequently, confirmed cases were reported from nine of the 18 governorates in Iraq, suggesting widespread transmission of poliovirus. Before this outbreak, the last confirmed cases of wild polioviruses occurred in Iraq during April-May 1997.     

World's population to reach six billion

The United Nations (UN) estimates that the world's population will reach six billion on October 12, 1999. The world's population reached one billion in 1804; subsequently, one billion increases came at intervals of 123, 33, 14, 13, and 12 years. Population growth rates increased over time because of high fertility rates and declines in mortality rates, especially since the early to mid-1900s. The UN projects that it will take 14 years for the world's population to reach 7 billion and another 15 years to reach 8 billion.     

Cigarette smoking among adults--United States, 1997

In the United States, cigarette smoking is the leading cause of preventable morbidity and mortality and results in approximately 430,000 deaths each year (1). One of the national health objectives for 2000 is to reduce the prevalence of cigarette smoking among adults to no more than 15% (objective 3.4) (2). To assess progress toward meeting this objective, CDC analyzed self-reported data about cigarette smoking among U.S. adults from the 1997 National Health Interview Survey (NHIS) Sample Adult Core Questionnaire. This report summarizes the findings of this analysis, which indicate that, in 1997, 24.7% of adults were current smokers and that the overall prevalence of current smoking in 1997 was unchanged from the overall prevalence of current smoking from the 1995 NHIS.     

Frequency of vaccine-related and therapeutic injections--Romania, 1998

In Romania and other countries, therapeutic injections have been associated with transmission of hepatitis B and C viruses, human immunodeficiency virus type 1 (HIV-1), and other bloodborne pathogens. During 1997-1998, acute hepatitis B was associated with recent injections in Romanian children aged <5 years. Injection-associated bloodborne pathogen transmission occurs when infection-control practices are inadequate, and overuse of injections to administer medications might increase opportunities for transmission. To estimate the frequency of therapeutic injections and to describe the attitudes and practices of adults about injections to administer medications, local health departments in Romania surveyed the general population of four districts (Hunedoara, Iasi, Mures, and Prahova [1997 combined population: 2.8 million]) in June 1998. This report summarizes results from these surveys, which indicate that injections are used frequently to administer medications in Romania.     

Progress toward poliomyelitis eradication--Nigeria, 1996-1998

In 1988, the World Health Assembly resolved to eradicate poliomyelitis globally by 2000. In the African Region of the World Health Organization (WHO), eradication efforts were accelerated following supporting resolutions by WHO's Regional Committee for Africa in 1995 and the Organization of African Unity in 1996. Nigeria, the most populous country in Africa and part of a densely populated West African area extending from Nigeria to Cote D'Ivoire, is critically important to the global polio eradication initiative. This report summarizes 1) the success of National Immunization Days (NIDs); 2) the establishment of acute flaccid paralysis (AFP) surveillance; and 3) accelerated efforts to meet the 2000 target, including mopping-up planned for later in 1999.