MMWR

Morbidity and Mortality Weekly Report

Prevalence of Stroke – United States, 2005

PRESS CONTACT: CDC — Division of Media Relations
(404) 639-3286

• May 17, 2007: CDC Report Finds Significant Differences in Stroke Prevalence Among U.S. States and Territories

Strokes are common, debilitating and deadly. This study underscores the need for all states and U.S. territories, particularly those states experiencing the highest proportion of people impacted by stroke, to support programs and services designed to limit exposure to stroke risk factors, improve access to preventive services, provide education on the warning signs of stroke, and ensure timely access to emergency care when strokes occur. Prevalence data for stroke survivors is provided from all 50 U.S. states and territories, including the District of Columbia, Puerto Rico, and the U.S. Virgin Islands. The results indicate that the stroke prevalence in some states is double to almost triple that of other states, ranging from 1.5 percent in Connecticut to 4.3 percent in Mississippi. Several states within the "stroke belt" region were found to have significantly high stroke prevalence estimates. The study also identified gender, racial/ethnic, and educational level differences in stroke prevalence. American Indian/Alaska Natives (6 percent) had the highest stroke prevalence estimates, while Asians had the lowest (1.6 percent). Prevalence of stroke varied little between men (2.7 percent) and women (2.5 percent) and was more than twice as high in individuals with fewer than 12 years of education (4.4 percent) compared to college graduates (1.8 percent).

Pre-hospital and Hospital Delays after Stroke Onset–United States, 2005-2006

PRESS CONTACT: CDC — Division of Media Relations
(404) 639-3286

More extensive public education is needed about early symptom recognition and the urgency of calling 9-1-1 to access EMS transport. Concurrently, hospitals must work to improve the time it takes to evaluate possible stroke patients. Both efforts are needed to increase the proportion of patients with acute stroke who arrive within the time frame for prevention treatment and thereby decrease the chances of disability from stroke. For this report, data from the Paul Coverdell National Acute Stroke Registry (PCNASR) were collected and analyzed for four states (Georgia, Illinois, Massachusetts, and North Carolina) to provide information on stroke symptom treatment times. The results indicate a considerable difference in treatment times for those who arrived at an emergency department (ED) via EMS and those who arrived via other modes of transportation. Just over half of those suffering a stroke (53.7 percent) arrived at an ED via EMS, and less than half (48 percent) arrived at an ED for triage within 2 hours of stroke symptom onset. EMS transport was shown to improve stroke treatment times from symptom onset to hospital triage, onset to imaging, and hospital arriving to imaging.

Transmission of Vaccinia Virus in a Household Setting Associated with Contact with a Military Smallpox Vaccinee, Illinois and Indiana, 2007

PRESS CONTACT: CDC — National Center for Zoonotic, Vector-borne & Enteric Diseases
(404) 639-3286

Health-care providers and public health professionals should ask about any contact with recent smallpox vaccinees when evaluating patients with vesicular lesions compatible with vaccinia. Early identification of such an exposure allows for rapid and appropriate diagnostic testing, timely contact tracing and clinical intervention, as needed. In addition, correct, early diagnosis facilitates prompt patient counseling to prevent further transmission of the virus. Since February, 2007, the Centers for Disease Control and Prevention (CDC) and the U.S. Department of Defense have received five reports of vaccinia infection associated with military service members who had been recently vaccinated for smallpox, including two cases from Indiana and one case each from Alabama, Alaska, and New Mexico. This report describes the two cases from Indiana. The first, which occurred in a 28-month old child, involved a life-threatening complication of vaccinia virus infection, eczema vaccinatum (EV). The child initially became ill after coming into contact with his father, an active duty serviceman who had recently received a smallpox vaccination. After the child´s illness began, his mother also became ill, presumably having contracted vaccinia virus infection while caring for the child. The smallpox vaccine contains live vaccinia virus, which confers protection against infection from variola virus, the cause of smallpox. Vaccinia virus can be transmitted from the unhealed vaccination site of a vaccine recipient to other persons through direct (skin-to-skin) contact or through indirect contact by means of fomites (e.g. washclothes, towels).

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES