Synopsis for April 30, 2004

The MMWR is embargoed until Thursday, 12 PM EDT.

1. Increases in Fluoroquinolone-Resistant Neisseria gonorrhoeae Among Men Who Have Sex with Men ― United States, 2003, and Revised Recommendations for Gonorrhea Treatment, 2004
2. Preliminary FoodNet Data on the Incidence of Infection with Pathogens Transmitted Commonly Through Food ― Selected Sites, United States, 2003
3. Progress Toward Poliomyelitis Eradication ― Nigeria, January 2003-March 2004
4. Recommended Childhood and Adolescent Immunization Schedule ― United States, July-December 2004

MMWR Surveillance Summary
Vol. 53/No. SS-1

Malaria Surveillance -- United States, 2002

Malaria can be a fatal disease for travelers but can be prevented by taking one of the recommended chemoprophylaxis regimens appropriate for the region of travel, and using personal protection measures to prevent mosquito bites.

Persons who are traveling to malaria-risk areas can almost always prevent this potentially deadly disease if they correctly take an effective antimalarial drug and follow measures to prevent mosquito bites. According to CDC’s Morbidity and Mortality Weekly Report, most of the 1,337 cases of malaria reported to the CDC in 2002 occurred in persons who had traveled to a malaria-endemic area. Eight deaths were attributed to malaria in 2002. Only 37.3% of U.S. civilians who acquired malaria abroad reported taking a chemoprophylatic drug recommended by CDC for the area to which they had traveled. Recommendations concerning malaria prevention can be obtained from CDC by calling the Malaria Hotline at 770-488-7788 or by accessing CDC’s Internet site at http://www.cdc.gov/travel.

CDC was created in 1946 to fight malaria in the United States. Nearly 60 years later, CDC participates actively in the worldwide battle against malaria abroad and at home, where reintroduction of the disease by travelers arriving or returning from malaria-endemic countries is a constant threat.

For a copy of the report, please contact:

Division of Media Relations
CDC, Office of Communications
(404) 639–3286

Synopsis for April 30, 2004

Increases in Drug-Resistant Gonorrhea Cases Prompt Change in CDC Treatment Recommendations for Men Who Have Sex with Men.

For the past decade, CDC has recommended fluoroquinolones – ciprofloxacin, ofloxacin and levofloxacin – for treatment of gonorrhea in the United States. However, the proportion of fluoroquinolone-resistant gonorrhea (QRNG) cases has recently more than doubled (from 0.4 percent in 2002 to 0.9 percent in 2003), according to a CDC study of men seen at sexually transmitted disease clinics in 23 U.S. cities. Occurrence of QRNG was highest among men who have sex with men (MSM), increasing nearly three-fold from 1.8 percent in 2002 to 4.9 percent in 2003. The nearly 5 percent rate among MSM was 12 times higher than QRNG prevalence among heterosexual men (0.4 percent in 2003). In response to these findings, CDC now recommends that fluoroquinolones no longer be used to treat gonorrhea among MSM. Recommended treatment options for MSM now include the injectable antibiotics ceftriaxone 125-mg IM and spectinomycin 2-g IM. Given the generally low prevalence of QRNG among heterosexual men and women, a change in national treatment recommendations is not warranted at this time.

Preliminary FoodNet Data on the Incidence of Infection with Pathogens Transmitted Commonly Through Food ― Selected Sites, United States, 2003

There has been a sustained and substantial decline in the incidence of infections caused by Yersinia, Campylobacter, and Salmonella in the past eight years, and a recent decline in E. coli O157. These declines indicate important progress towards achieving the national health objectives of reducing the incidence of several foodborne diseases by the end of the decade.

An estimated 76 million persons contract foodborne illnesses each year in the United States. In 2003, CDC's Emerging Infections Program Foodborne Diseases Active Surveillance Network (FoodNet) collected data about nine foodborne diseases in nine U.S. sites to quantify and monitor foodborne illnesses. This report describes preliminary surveillance data for 2003 and compares them with 1996B2002 data. The data show a decrease in foodborne illnesses caused by bacteria. This indicates progress toward meeting the US Department of Health and Human Services' Healthy People 2010 Objectives of reducing the incidence of foodborne diseases by 2010. However, some of these infections remain particularly common in children, indicating that increased efforts are needed to further reduce the incidence of foodborne illnesses.

For a copy of the HHS press release, E. COLI  0157 Incidence Posts Other Foodborne Illnesses Continue Downward Trend, please go to http://www.hhs.gov/news.

Progress Toward Poliomyelitis Eradication ― Nigeria, January 2003-March 2004

The suspension of polio immunization campaigns in key northern states in Nigeria has resulted in previously polio-free states in Nigeria and nine previously polio-free countries in Africa to be re-infected with the disease. If the goal of polio eradication is to be achieved, it is essential that Kano State, along with all other states in Nigeria, participate fully in polio immunization campaigns and vaccinate all target-aged children against polio.

After gains toward polio eradication during 1996-2002, Nigeria suffered a resurgence of wild polio virus transmission due to the suspension of vaccination campaigns in several northern states, particularly Kano, in fall 2003. This resurgence resulted in the reintroduction of wild polio virus into previously polio-free Nigerian states and the exportation of the virus to nine polio-free countries in West and Central Africa (Benin, Botswana, Burkina Faso, Cameroon, the Central African Republic, Chad, Ghana, Ivory Coast, and Togo). To address this outbreak, Nigeria and its polio partner agencies have endorsed a strategic plan that proposes conducting six supplementary polio immunization campaigns in all states with endemic disease by December 2004.

Recommended Childhood and Adolescent Immunization Schedule ― United States, July-December 2004

All children aged 6-23 months, as well as household and out-of-home caregivers for such children receive annual influenza vaccine.

CDC’s Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP) recommend that, beginning in fall 2004, all children aged 6-23 months, as well as household and out-of-home caregivers for such children receive annual influenza vaccine. This change is reflected in the revised childhood and adolescent immunization schedule for July-December 2004.

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