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.     

Human rabies--Virginia, 1998

On December 31, 1998, a 29-year-old man in Richmond, Virginia, died from rabies encephalitis caused by a rabies virus variant associated with insectivorous bats. This report summarizes the clinical and epidemiologic investigations by the Virginia Department of Health and CDC.     

Update: influenza activity--United States, 1998-99 season

This report summarizes influenza activity in the United States from October 4, 1998, through February 27, 1999. It also presents results of an investigation of an influenza outbreak among staff and residents at one long-term-care facility (LTCF), and estimates the 1998-99 influenza vaccine effectiveness against the circulating influenza A(H3N2) viruses at that facility. Based on influenza surveillance data, influenza activity in the United States began to increase in mid-January 1999 and remained elevated in most regions of the country through the week ending February 27.     

Barriers to follow‐up of abnormal screening mammograms among low‐income minority women

Objective. To describe factors related to compliance diagnostic follow‐up among minority women of low socioeconomic status with abnormal screening mammograms.

Methods. A retrospective cross‐sectional survey using a structured telephone interview. Three cancer screening clinics at an urban inner‐city public hospital. All women with abnormal screening mammograms between September 1990 and January 1992 were eligible; women were interviewed in August 1992. Abnormal mammograms were those requiring specific, non‐routine clinical follow‐up; non‐compliance was defined as delayed follow‐up (four to six months after the date of the mammogram), or no follow‐up at the time of interview (more than 6 months after abnormal).

Results. Sixty‐two of 442 screened women had abnormal results; the overall rate of non‐compliance with follow‐up was 50%. Among the 42 (68%) women who agreed to be interviewed, non‐compliers were less likely to state that they had been told to receive follow‐up than compilers (65% versus 100%; p = 0.008). Non‐compliant women were less likely to have suspicious mammography interpretations (p = 0.05), and more likely to report barriers to follow‐up, such as cost of lost wages and medical care, system barriers, or fears, than compliant women (61.9% versus 9%, p = 0.01). There were no differences between the two groups for age, education, insurance, source of care, family history, knowledge or attitudes.

Conclusions. These preliminary results suggest that follow‐up of low income, minority women with abnormal screening mammograms could be enhanced by improved communication of results. Future studies should extend these findings with larger samples and in other settings and populations.     

HPLC测定克拉霉素及其制剂的含量

目的　采用HPLC法测定克拉霉素及其制剂的含量。方法　C1 8或C8色谱柱 (4 .6mm× 2 5 0mm ,5 μm) ,流动相分别为磷酸二氢钾溶液 (0 .0 6 7mol·L- 1 ) -甲醇 (4 0 0∶6 0 0 ) (pH 4 .0 )和磷酸二氢钾溶液 (0 .0 6 7mol·L- 1 ) -乙腈 (5 5∶4 5 ) ,检测波长 2 10nm ,均采用外标法。结果　 3种方法线性范围均为 0 .0 2 5～ 2 .0mg·ml- 1 (r=0 .9999) ,平均回收率为 10 0 .2 % ,RSD =0 .4 8% (n =6 )。结论　 3种方法的分离效果均较好 ,没有明显差异 ,其中方法b较为适宜。