Synopsis for December 19, 2003

The MMWR is embargoed until NOON ET, Thursdays.

1. Snowmobile Fatalities — Maine, New Hampshire, and Vermont, 2002–2003
2. Murine Typhus — Hawaii, 2002
3. Retention of Natural Teeth Among Older Adults — United States, 2002
4. The Internet and Early Syphilis Infection Among Men Who Have Sex with Men — San Francisco, California, 1999–2003
5. Update: Influenza Activity — United States, December 7–13, 2003

MMWR Reports & Recommendations
Vol. 52, No. RR-17, December 19, 2003

Guidelines for Infection Control in Dental Health-Care Settings — 2003
These guidelines, update and revise previous guidelines (1993, 1986) and consolidate recommendations from other relevant CDC guidelines.

Contact: William Kohl, DDS
CDC, National Center for Chronic Disease
Prevention & Health Promotion
(770) 488–6071

Synopsis for December 19, 2003

Snowmobile Fatalities — Maine, New Hampshire, and Vermont, 2002–2003

For safer snowmobiling, operators should take a safety course, maintain safe speeds, and stay attentive when using snowmobiles.

During 2002-2003 winter season, there were 28 snowmobile-related fatalities in Maine, New Hampshire and Vermont, the most reported annually by the three states during the preceding 12 winter seasons. The primary cause of these snowmobile fatalities were excessive speed, inattentive or careless operation, and inexperience. Efforts to reduce snowmobile fatalities should focus on improving safety measures, including establishing speed limits, strengthening enforcement of snowmobile operating rules, and promoting safety education.

Murine Typhus — Hawaii, 2002

People may become infected with murine typhus from close contact with rodents; rodent control is an important measure in decreasing the number of human infections.

Murine typhus, caused by Rickettsia typhi, is a potentially severe disease transmitted to humans by fleas that feed on infected rodents. Although not commonly reported in the United States, murine typhus is present in Hawaii, where 5 to 6 cases are expected annually. In 2002, 47 cases were reported in Hawaii, the largest number recorded there since 1947. Common symptoms in patients included fever, fatigue, headache, chills, nausea, vomiting, and skin rash. Although the disease is effectively treated with the antibiotic doxycycline, some cases of severe disease including kidney failure and meningitis were reported. Many patients reported close association with rodents, and increased rodent populations were observed locally during 2002. Rodent control measures and education, which were used by the Hawaii Department of Health to control this outbreak, are important to decrease transmission of murine typhus.

Retention of Natural Teeth Among Older Adults — United States, 2002

Over the past several decades the percentage of older adults who have their natural teeth has increased steadily.

A new CDC report, using data from the 2002 BRFSS, provides the first state-specific estimates of adults aged 65 years and older who report having most of their teeth (i.e., having lost no more than 5 teeth to disease). Although rates varied widely among states, in more than half the states, the majority of older adults had most of their natural teeth. In three states (California, Colorado, and Utah) 60% or more of older adults reported having most of their natural teeth. Retention of teeth was less common among adults with limited education and household income, non-Hispanic blacks, current smokers, people with diabetes, and those reporting fair or poor general health. Increased tooth retention results in improved oral function and quality of life. However, with increased tooth retention, older adults remain at risk (vulnerable) for the two most common oral diseases, tooth decay and gum disease, and could benefit from an array of preventive approaches.

The Internet and Early Syphilis Infection Among Men Who Have Sex with Men — San Francisco, California, 1999–2003

This report describes the increasing association between early syphilis infection and use of the Internet among men who have sex with men (MSM) to meet sex partners.

As the association between syphilis among MSM and the use of the Internet as a means for meeting sex partners grows, health departments must adopt new strategies for partner notification. In an analysis of MSM diagnosed with early syphilis in 2002, the San Francisco Department of Health (SFDPH) and the CDC found that Internet chat rooms and sex partner sites were the most common venues for meeting partners – more common than bars, bathhouses and sex clubs. Of those MSM interviewed for partner management, nearly 45% reported meeting partners online, and one-fifth of those men had no other locating information besides an e-mail address for online partners. Two successful cases studies are highlighted in this report, underscoring that Internet-based partner notification can be an effective tool for finding and treating syphilis infections. Concerns about protecting confidentiality and ensuring that messages are not discarded as junk e-mail, two common barriers to online partner notification, are addressed in interim guidance developed by SFDPH. Study authors also encourage health departments to collaborate with Internet service providers to implement additional online prevention activities.

Update: Influenza Activity — United States,
December 7–13, 2003

No summary available.

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