Synopsis for February 2, 2001

MMWR articles are embargoed until 4 p.m. E.S.T. Thursdays.

1. Hypothermia-Related Deaths — Suffolk County, New York, January 1999–March 2000, and United States, 1979–1998
2. Underdiagnosed of Dengue — Laredo, Texas, 1999
3. Injection Practices Among Nurses and Hepatitis B Virus Transmission — Vâlcea, Romania, 1998

Hypothermia-Related Deaths — Suffolk County, New York, January 1999–March 2000, and United States, 1979–1998

Hypothermia-related deaths are preventable.

Hypothermia, or lowering of core body temperature, is an under-reported life-threatening condition in the United States. On average, nearly 700 people die each year due to hypothermia. Of all U.S. hypothermia-related deaths, half occur among persons 65 years of age or older. People with underlying disease, mental impairment, drug or alcohol use, lack of adequate housing, and both young children and older persons are at higher risk for hypothermia death. Preventive measures include wearing several layers of clothing; eating well-balanced meals; drinking warm, nonalcoholic beverages; avoiding exertion in cold and windy climates; and keeping extra clothing and blankets in the car when traveling. Further measures to prevent hypothermia-related deaths include education efforts to assist the public and health-care providers in identifying people at risk for hypothermia.

Underdiagnosed of Dengue — Laredo, Texas, 1999

Dengue is an arboviral illness transmitted by Aedes aegypti mosquitos.

During July 23-August 20 1999, a review of medical records in five Laredo medical facilities revealed that 50% of suspected dengue fever case-patients had undiagnosed recent dengue fever (DF). DF patients may visit their healthcare provided because of an undifferentiated febrile illness and, unless there is a high index of suspicion among physicians, this diagnosis is likely to be missed in areas of infrequent transmission. Heightened awareness (surveillance), improved diagnosis, and increased communication and prompt reporting of dengue fever cases are needed for early recognition of the disease in a community. The latter strategies are not only beneficial for individual patient management, but are needed for implementing effective outbreak prevention and control activities.

Injection Practices Among Nurses and Hepatitis B Virus Transmission — Vâlcea, Romania, 1998

Overuse of injections and unsafe injection practices may lead to large-scale transmission of bloodborne pathogens.

Almost all Romanian adults are aware of the risk for HIV infection associated with the reuse of syringes and needles. Patients either provide their own equipment or insist on observing the opening of the package containing and new needle and syringe before receiving an injection. However, injections prepared in areas potentially contaminated with blood, multidose vial mishandling, and inadequate supplies were reported by nurses and validated by observation. In the United States, similar practices have been associated with hepatitis B virus (HBV) transmission in hemodialysis settings. Most of the nurses interviewed in this study were unaware that HBV persists in the environment for at least 1 week. They also did not realize that transmitting HBV through injections can be up to 100 times greater than the risk for transmitting HIV.

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