Synopsis for November 7, 2003

The MMWR is embargoed until NOON ET, Thursdays.

1. Prevalence of Self-Reported Heart Disease and Stroke Among Adults With and Without Diabetes — United States, 1999–2001
2. Receipt of Cardiac Rehabilitation Services Among Heart Attack Survivors — 19 States and the District of Columbia, 2001
3. Tobacco, Alcohol, and Other Drug Use Among American Indian High School Students — United States, 2001
4. Probable Transfusion-Transmitted Malaria — Houston, Texas, 2003
5. Progress Toward Poliomyelitis Eradication — Ethiopia, Somalia, and Sudan, January 2002–August 2003
6. West Nile Virus Activity — United States, October 30–November 5, 2003

Synopsis for November 7, 2003

Prevalence of Self-Reported Heart Disease and Stroke Among Adults With and Without Diabetes — United States, 1999–2001

The prevalence of self-reported heart disease and stroke is approximately two to four times greater in adults with diabetes than in adults without diabetes.

Among adults aged 35 years and older, the prevalence of self-reported heart disease and stroke is greater in the diabetic population than in the non-diabetic population. Relative to adults without diabetes, adults with diabetes were 3.7 times as likely to report a history of coronary heart disease, 3.6 times as likely to report a history of stroke, and 2.2 times as likely to report a history of another heart condition. Increased efforts are needed to improve the use of preventive care practices, such as antihypertensive treatment and aspirin use, in the U.S., particularly among adults with diabetes. In addition, efforts to prevent diabetes and to reduce the prevalence of cardiovascular disease risk factors, such as hypertension and high cholesterol, could substantially decrease the burden of heart diseases and stroke.

Receipt of Cardiac Rehabilitation Services Among Heart Attack Survivors — 19 States and the District of Columbia, 2001

Less than 1/3 of persons with heart disease have participated in cardiac rehabilitation even though the majority might have benefited.

Each year, over 650,000 persons have a first heart attack in the United States. Yet only 29.5% of these persons who have had a heart attack or coronary heart disease participated in cardiac rehabilitation even though cardiac rehabilitation is safe and beneficial when patients are properly evaluated and screened for these services. Benefits of cardiac rehabilitation include greater exercise tolerance, fewer cardiac symptoms, lower blood fat levels, cessation of smoking, improved psychosocial well-being, and less risk for illness and death. Public health efforts should focus on the development and implementation of policies that result in systems changes designed to increase insurance coverage, monitoring, tracking, feedback, education and counseling in order to facilitate access to the benefits of cardiac rehabilitation.

Tobacco, Alcohol, and Other Drug Use Among American Indian High School Students — United States, 2001

This study underscores the need for prevention education and intervention activities for American Indian students to begin before high school.

The Department of Interior's Bureau of Indian Affairs (BIA) is one of two federal school systems that serve approximately 50,000 students in grades K-12 attending 184 schools located on 63 Indian reservations residing in 23 states. The most important finding is that too many high school students in BIA-funded schools use tobacco, alcohol, and other drugs and these behaviors place them at risk for serious health, education, and social problems today and in the future. Fortunately, these behaviors are preventable. Schools and communities can successfully help youth avoid tobacco, alcohol, and other substance use through sustained and comprehensive efforts. The BIA has initiated a number of different prevention programs in BIA-funded schools in an effort to reduce the use of these substances among American Indian young people.

Probable Transfusion-Transmitted Malaria — Houston, Texas, 2003

Transfusion-transmitted malaria is rare but serious and the risk can be reduced by blood bank screeners carefully questioning blood donors at the time of blood donation.

Malaria is a parasitic infection typically transmitted by mosquitoes. People in the United States who get malaria most commonly get it from traveling to foreign countries where malaria is more common. Cases of malaria transmitted by blood transfusion are rare in the United States, occurring approximately once in every 3 million transfused blood units. During the 1990s, 12 cases of transfusion-transmitted malaria were identified; the last reported case was in January 1998. In 2003, a case of malaria occurred in Houston, Texas, that was likely acquired from a blood transfusion. Because there are no laboratory tests in the United States appropriate for screening donated blood for malaria, careful questioning of blood donors is critical to help prevent transfusion transmitted malaria.

Progress Toward Poliomyelitis Eradication — Ethiopia, Somalia, and Sudan, January 2002–August 2003

Ethiopia and Sudan have not reported wild poliovirus cases in over a year and Somalia is approaching 1 year without evidence of wild poliovirus transmission.

Since the World Health Assembly of the World Health Organization (WHO) resolved in 1988 to eradicate poliomyelitis worldwide, the estimated number of polio cases has declined >99%, and the number of countries from which reports of polio were received declined from 125 to seven. Ethiopia and Sudan have not reported wild poliovirus cases in over a year and Somalia is approaching 1 year without evidence of wild poliovirus transmission. This report provides an update of progress made in these countries during January 2002–August 2003 and describes remaining challenges to polio eradication. To maintain this progress, continued funding and improved access to children, particularly in the greater Mogadishu area in Somalia, are required.

West Nile Virus Activity — United States, October 30–November 5, 2003

No summary available.

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