Synopsis for May 25, 2001

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

1. Tobacco Use Among Adults — Arizona, 1996 and 1999
2. Outbreaks of Cryptosporidiosis Associated With Swimming Pool Use — Ohio and Nebraska, 2000
3. Prevalence of Parasites in Fecal Material from Chlorinated Swimming Pools — United States, 1999
4. Drowning — Louisiana, 1998

MMWR Reports & Recommendations
May 25, 2001/Vol. 50/No. RR-8

Contact: Charles Rupprecht, D.V.M.
CDC, National Center for Infectious Diseases
(404) 639–1050

Compendium of Animal Rabies Prevention and Control, 2001: National Association of State Public health Veterinarians, Inc.
The purpose of this compendium is to provide rabies information to veterinarians, public health officials, and others concerned with rabies prevention and control. These recommendations serve as the basis for animal rabies-control programs throughout the United States and facilitate standardization of procedures among jurisdictions, thereby contributing to an effective national rabies-control program. This document is reviewed annually and revised as necessary.

Synopsis for May 25, 2001

Tobacco Use Among Adults — Arizona, 1996 and 1999

Smoking prevalence among adults in Arizona dropped significantly from 1996 to 1999 following implementation of the Arizona Tobacco Education and Prevention Program.

In 1994, Arizona passed legislation increasing the tax on cigarettes from 18 cents to 58 cents, and allocated 23 percent of the resulting revenues for tobacco control activities. Following the implementation of Tobacco Education and Prevention Program (TEPP), smoking prevalence declined for women, men, whites, and Hispanics. A significant decrease in smoking prevalence among low income and low education groups also indicated a decrease in disparities in cigarette use. The study also showed an increase in the proportion of smokers who reported that a health professional had asked them about tobacco use and advised them to quit, which may have contributed to an increase in smoking cessation in the state. TEPP incorporates all nine components of a comprehensive tobacco control program as recommended by CDC's "Best Practices for Comprehensive Tobacco Control Programs".

Outbreaks of Cryptosporidiosis Associated With Swimming Pool Use — Ohio and Nebraska, 2000

Chlorine kills germs but it takes time and some pathogens, like Cryptosporidium, can survive for days in chlorinated pools.

Swimming is the second most popular exercise in the United States with approximately 360-400 million annual pool visits. The number of reported outbreaks of diarrheal illness spread through swimming pool use appears to have increased in recent years. This article summarizes an investigation of two pool-related outbreaks caused by Cryptosporidium, a chlorine-resistant parasite that has caused most of the recent pool-related outbreaks. Symptoms of Cryptosporidium infection include diarrhea, loss of appetite, abdominal cramps, and vomiting. Swimmers should refrain from swimming while ill with diarrhea, and should not swim for a 2-week period after diarrhea has ceased. These outbreaks, affecting almost 1000 people, lasted through the summer of 2000. Strategies to protect swimmers from the spread of recreational water illnesses should include swimmer and pool staff education and improved pool design and management.

Prevalence of Parasites in Fecal Material from Chlorinated Swimming Pools — United States, 1999

While you can get ill from swimming, there are ways to reduce your risk.

During the 1990s, reports of outbreaks of gastrointestinal disease associated with the use of disinfected recreational water (e.g., swimming pools) gradually increased. From 1989 to 1998, approximately 10,000 cases of diarrheal illness were associated with 32 recreational, waterborne disease outbreaks in the United States. Outbreaks of diarrheal illness are spread by swimming in chlorinated pools that have been contaminated by someone with infectious diarrhea. Swimmers should not swim when ill with diarrhea, swimmers should not swallow pool water, young children should be taken on regular bathroom breaks, and all swimmers should practice good hygiene (wash hands after using the restroom or diaper changing area, take showers before swimming, change diapers in a restroom instead of by the pool).

Drowning — Louisiana, 1998

Most drownings can be prevented by close supervision of children, by using personal flotation devices, and by avoiding alcohol during water recreation.

In 1998, in Louisiana, over 100 people drowned. Drowning in this state occurred most often in outdoor bodies of water, and in association with boating. The findings in this report also indicate that alcohol or illicit drugs were found in approximately 60% of case-patients 13 years of age and older. None of the case-patients in boating-related drownings were wearing personal flotation devices correctly. Most drownings can be prevented by taking the following precautions: 1)supervise children closely whenever they are in, or near, bodies of water such as swimming pools, ponds, and creek; 2) ensure that children are wearing a personal flotation device when they are playing in or around water; 3) all individuals should wear a personal flotation device when boating; and 4) avoid alcohol while participating in water recreational activities.

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