Synopsis for November 30, 2006

The MMWR is embargoed until Thursday, 12 PM EST.

1. Missed Opportunities for Earlier Diagnosis of HIV Infection – South Carolina 1997-2005
2. Injuries from Motor-Vehicle Collisions with Moose – Maine, 2000-2004
3. Racial/Ethnic Differences in Prevalence of Cigarette Use by Youths and Susceptibility to Start Smoking – United States, 2002-2004
4. Respiratory Syncytial Virus Activity – United States, 2005-2006

Missed Opportunities for Earlier Diagnosis of HIV Infection – South Carolina 1997-2005

A study of all HIV diagnoses reported in South Carolina between January 2001 and December 2005 found that 73 percent of individuals diagnosed late in the course of their infection had visited a health care facility at least once prior to their diagnosis, but had not been tested for HIV during those earlier visits. Researchers from the South Carolina Department of Health and Environmental Control, in collaboration with CDC, examined missed opportunities for testing among the 1,784 individuals who were diagnosed with AIDS within one year of their initial HIV diagnosis, defined as “late-testers.” These late-testers, who accounted for 41 percent of the 4,315 new HIV diagnoses reported during the 5-year period, made 7,988 visits to health-care facilities before they were tested for HIV. Nearly 80 percent (6,277) of these visits were for health problems unlikely to prompt an HIV test on the basis of risk criteria that have historically guided HIV testing practice. These findings underscore the potential benefits of routine HIV screening for all adults and adolescents attending health-care facilities in South Carolina, consistent with CDC’s 2006 recommendations. Such routine screening could lead to substantially earlier diagnosis of HIV infection, allowing infected individuals the opportunity to take full advantage of life-saving treatments and to take steps that would protect partners and loved ones from HIV infection.

Injuries from Motor-Vehicle Collisions with Moose – Maine, 2000-2004

Although collisions with moose occur less frequently than with other animals in Maine, there are more injuries and fatalities as a result of these types of collisions. Prevention strategies are necessary to reduce collisions with moose in Maine. Such strategies should focus on improving driver education programs, developing better engineering controls, and herd management.

Racial/Ethnic Differences in Prevalence of Cigarette Use by Youths and Susceptibility to Start Smoking – United States, 2002-2004

Targeted culturally appropriate interventions must be developed and evaluated to identify effective means of preventing youth from starting to smoke and reducing current cigarette smoking among specific populations. Analyses of National Survey on Drug Use and Health (NSDUH) data indicate that cigarette smoking varied widely among racial/ethnic subpopulations in addition to major populations of youth aged 12–17 years. Among this age group, American Indians/Alaska Natives had the greatest cigarette smoking prevalence (23.1 percent), followed by non-Hispanic whites (14.9 percent), Hispanics (9.3 percent), non-Hispanic blacks (6.5 percent), and Asians (4.3 percent). Among Asian subpopulations, smoking prevalence ranged from 2.2 percent for Vietnamese to 6.8 percent for Koreans; among Hispanic populations, prevalence ranged from 7.3 percent for Central and South Americans to 11.2 percent for Cubans. The study also suggests that approximately one in five nonsmokers aged 12–17 years is susceptible to start smoking.

Respiratory Syncytial Virus Activity – United States, 2005-2006

The 2006-2007 outbreak of RSV infections has begun. Healthcare providers should consider RSV infection in the differential diagnosis for persons of all ages presenting with lower respiratory tract infection, implement appropriate isolation precautions to prevent nosocomial spread of virus and provide appropriate immune prophylaxis to eligible children. Respiratory syncytial virus (RSV) causes annual outbreaks of lower respiratory tract infections among young children, the elderly, and people with compromised respiratory, cardiac, or immune systems. Data reported to the National Respiratory and Enteric Virus Surveillance System suggest the 2006-2007 outbreak of RSV infections has begun in Florida, the South and Northeast regions, and will likely begin in other regions soon. Healthcare providers should consider RSV infection in the differential diagnosis for people of all ages presenting with lower respiratory tract infection, implement appropriate isolation precautions to prevent nosocomial spread of virus, and provide monthly doses of humanized murine anti--RSV monoclonal antibody to eligible children, for example, some premature infants or infants and children with chronic lung and heart disease.

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