MMWR

Morbidity and Mortality Weekly Report

Influenza Testing and Antiviral Agent Prescribing Practices — Four States, 2006–07 Influenza Season

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Division of Media Relations
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In four states, influenza rapid antigen testing is used by the vast majority of primary care physicians (PCPs) as part of their clinical practice. Because these tests are more prone to produce false results, clinicians should continue to use proper clinical judgment and information as to when influenza is present in their communities to guide clinical decisions. Primary care physicians (PCPs*) from four states were surveyed about influenza testing and treatment practices during the 2006-07 influenza season. 54% of PCPs prescribed influenza antiviral medications to patients but approximately 20% of these PCPs prescribed amantadine or rimantadine, antiviral medications that CDC, in January 2006, ceased recommending because of influenza virus drug resistance. This survey also found that approximately 70% of PCPs reported testing patients with influenza-like illness for influenza. Of these, almost 90% used rapid antigen tests. Rapid antigen tests are an attractive diagnostic aid to PCPs, as testing can be performed in doctor’s offices and results can be available in as little as 30 minutes. Rapid antigen tests, however, are only moderately to reasonably accurate in diagnosing influenza, and, as such, PCPs need to use proper clinical judgment and know when influenza is circulating in their communities to guide clinical management decisions.

Knowledge and Practices of Obstetricians and Gynecologists Regarding Cytomegalovirus Infection During Pregnancy — United States, 2007

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Division of Media Relations
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Obstetricians and gynecologists can play a larger role in educating pregnant women about how to prevent congenital cytomegalovirus (CMV) infection, the leading infectious cause of birth defects and developmental disabilities. A recent U.S. survey of obstetricians and gynecologists found that less than half reported counseling their patients about preventing cytomegalovirus (CMV) infection, the leading infectious cause of birth defects and developmental disabilities. These results emphasize the need for additional training of OB/GYNs regarding CMV infection prevention and better understanding of why physician knowledge about CMV transmission does not necessarily result in patient counseling. The CDC and the American College of Obstetricians and Gynecologists recommend that pregnant women practice thorough handwashing when they come in contact with saliva or diapers from young children.

Multistate Outbreak of Salmonella Infections in Humans Associated with Exposure to Turtles —United States, 2007

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Division of Media Relations
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Pet turtles are sources of Salmonella infections, which can be very serious and occasionally fatal in young children. This report describes an outbreak of 103 Salmonella infections, many occurring in young children, associated with pet turtle exposure, in the United States between May and December, 2007. Salmonella infections in children may be severe and can result in hospitalization and occasionally in death. Recognition of a connection between exposure to turtles and Salmonella infection in children led to a prohibition of the sale and distribution of small turtles (i.e., those with a shell length <4 inches) in the United States in 1975. That prohibition led to a substantial decline in human Salmonella infections. However, human cases related to exposure to small turtles continue to occur and were documented in this report as part of this outbreak. This report also found that only one-fifth of patients exposed to turtles were aware of a link between reptile exposure and human illness from Salmonella. Although further efforts are needed to enforce the prohibition on the sale of small turtles, this prohibition remains the most effective public health action to prevent turtle-associated salmonellosis.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES