CDC MMWR News Synopsis for July 23, 2015

MMWR- Morbidity and Mortality Weekly Report                          

MMWR News Synopsis for July 23, 2015

Launch of a Nationwide Hepatitis C Elimination Program — Georgia, April 2015

Georgia has an estimated 6.7 percent prevalence of hepatitis C virus (HCV) infection among a population of 3.7 million people – one of the highest reported in the world. Georgia is scaling up capacity to meet the demand for HCV treatment, and collaborating with CDC and other partners on development of a comprehensive HCV elimination plan that includes specific goals and activities needed to achieve them. As more effective treatment for HCV became available in recent years, Georgia’s government began taking steps to develop a comprehensive prevention and control program aimed at elimination of HCV transmission and disease. The program was officially launched in April 2015. CDC has provided technical assistance to help identify priorities, launch a national population-based serosurvey to assess epidemiology, assess provider and laboratory capacity, and monitor the program’s progress. This report describes the activities undertaken to implement the initial phase of the program, focused on improving access to affordable diagnostics and free curative treatment for HCV-infected persons with severe liver disease, as well as early results of the treatment program. Through July 3, 2015, a total of 6,491 persons presented for treatment and 6,177 (95.2%) initiated diagnostic work-up.

Viral Hepatitis Surveillance — India, 2011–2013

The implementation of a viral hepatitis surveillance and monitoring system in India provides a snapshot of viral hepatitis throughout the country and identifies the potential factors contributing to reported outbreaks. India has a considerable burden of viral hepatitis, but national surveillance data to assess the breadth of the issue has been lacking. The National Integrated Disease Surveillance Program (IDSP) began collecting data across all Indian states for epidemic-prone diseases, including viral hepatitis, in 2009. This report summarizes findings from IDSP between 2011 and 2013 and provides the first comprehensive assessment of the burden of acute viral hepatitis in India. Between 2011 and 2013, a total of 804,782 viral hepatitis cases and 291 outbreaks were reported. Of the total cases, 740,611 (92%) were unspecified, while 44,663 (5.5%) and 19,508 (2.5%) were attributed to hepatitis A and hepatitis E, respectively. Contaminated drinking water was identified as the most common cause of hepatitis A and E outbreaks, highlighting the need for improved access to clean drink water, and sanitation. Viral hepatitis surveillance data can help identify local outbreaks, inform policy decisions, and assess the impact of prevention and control initiatives.

Severe Illness from Methyl Bromide Exposure at a Condominium Resort — U.S. Virgin Islands, March 2015

Methyl bromide is a highly toxic pesticide which is not permitted for use in residential settings in the United States and can result in serious illness or even death if used incorrectly. Nonpermitted use can also result in wide-ranging public health impact. In March 2015, a family of four became seriously ill as a result of being exposed to the highly toxic pesticide methyl bromide while vacationing at a condominium resort in the U.S. Virgin Islands. Methyl bromide, whose use in homes and other residential settings is banned in the United States, was inappropriately used in this situation. As a result of this use in March 2015 and on another occasion at the same resort in October 2014, 37 additional people were potentially exposed to the chemical. Six of these people experienced postexposure symptoms, including headache and fatigue.

Knowledge and Attitudes Regarding Antibiotic Use Among Adult Hispanic Consumers, All Adult Consumers, and Health Care Providers — United States, 2012–2013

Every year, more than two million people in the United States get infections that are resistant to antibiotics. Antibiotics should be used only when a health professional recommends them – and must be taken exactly as prescribed. Recent national survey results indicate that Hispanic adults are less aware of when antibiotics should be used and more likely to obtain antibiotics without a prescription compared to all adults surveyed. One out of two Hispanic adults in a recent national survey believed that antibiotics help them recover more quickly from a cold – which is a viral infection -- even though antibiotics are ineffective for treating illnesses caused by viruses. In comparison, only about one out of four of all adults surveyed thought antibiotics would help shorten this viral illness. These findings are concerning because unnecessary antibiotic use may put people at increased risk for antibiotic-resistant infections and avoidable adverse events, such as a serious allergic reaction or often-deadly Clostridium difficile diarrhea.

Notes from the Field: Death Following Ingestion of an Edible Marijuana Product ― Colorado, March 2014

The effects of edible marijuana have a delayed onset compared to smoking marijuana. Eating multiple servings within a short timeframe risks over-consumption, greater intoxication, and an increased risk of adverse psychological effects. In March 2014, the Colorado Department of Public Health and Environment (CDPHE) learned of the death of a man aged 19 years after consuming an edible marijuana product. CDPHE reviewed autopsy and police reports to assess factors associated with his death and to guide prevention efforts. The decedent’s friend, aged 23 years, had purchased marijuana cookies and provided one to the decedent. A police report indicated that initially the decedent ate only a single piece of his cookie, as directed by the sales clerk. Approximately 30–60 minutes later, not feeling any effects, he consumed the remainder of the cookie. During the next two hours, he reportedly exhibited erratic speech and hostile behaviors. Approximately 3.5 hours after initial ingestion, and 2.5 hours after consuming the remainder of the cookie, he jumped off a fourth floor balcony and died from trauma. The autopsy found marijuana intoxication to be a chief contributing factor. Quantitative toxicologic analyses confirmed only cannabinoids. This was the first reported death in Colorado linked to marijuana consumption without evidence of polysubstance use since the state approved recreational use of marijuana in 2012.

Notes from the Field:

Outbreak of Cryptosporidiosis Among Veterinary Medicine Students — Philadelphia, Pennsylvania, February 2015

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