MMWR

Morbidity and Mortality Weekly Report

Multistate Measles Outbreak Associated with an International Youth Sporting Event — Pennsylvania, Michigan, and Texas, August–September, 2007

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

Measles is a highly infectious disease that can cause severe illness among people, including persons in the United States. The best protection against measles for individuals and the community is through routine, 2-dose immunization with the safe and effective MMR vaccine. Due to successful implementation of the measles vaccination program with high 2-dose coverage rates with the measles, mumps, and rubella (MMR) vaccine among children and adolescents, measles, a once common childhood disease, is no longer endemic in the United States. However, cases may still occur due to importations of measles from other countries. In August–September 2007, an outbreak of seven cases occurred in the United States as a result of measles imported from Japan. The first case occurred in an unvaccinated 12 year old boy who came to the U.S. to participate in a large international youth sporting event in Pennsylvania. Subsequently, there were six other cases identified: one in Pennsylvania, two in Michigan and three in Texas. Five of the seven cases occurred among U.S. residents, including an airplane passenger and an airport worker. An identical genotype (D5), concurrently circulating in Japan, was isolated from six cases from three generations in the outbreak. One person was hospitalized. During the outbreak, numerous state and local health departments worked together with the Centers for Disease Control and Prevention to implement control measures. Outbreak response efforts included identification and isolation of sick persons and vaccination of those without evidence of immunity. Ongoing circulation of measles virus outside the United States necessitates continued surveillance efforts, public health preparedness and outbreak response. To prevent measles infections, it is important to maintain high 2-dose MMR vaccination coverage in the U.S. population through routine immunization.

Emergence of Fluoroquinolone-Resistant Neisseria meningitidis — Minnesota and North Dakota, 2007-2008

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

Antimicrobial resistance is a growing problem and each new example stresses the importance of judicious use of antibiotics. The problem of ciprofloxacin-resistant N. meningitidis appears to be isolated to the North Dakota/Minnesota border region, and alternative medications are available. CDC is working to rapidly determine the extent of the problem. This report describes three cases of ciprofloxacin-resistant meningococcal disease that occurred among residents in selected counties of the border area of North Dakota and Minnesota during January 2007-January 2008. Until further notice, ciprofloxacin should not be used for prevention of disease in close contacts of those with meningococcal disease in those counties. Alternative medications are Ceftriaxone, rifampin, and azithromycin. Meningococcal disease causes substantial morbidity and mortality; approximately 10 percent of cases are fatal. Carrying N. meningitidis in the nose and throat is a precursor to developing the disease; however, most carriers do not develop the disease. Ciprofloxacin is one of several medications used to eliminate the carrying of N. meningitidis in close contacts. Although isolated cases of ciprofloxacin-resistant meningococcal disease have been described in other countries, until now, resistance to the medication had not been reported in North America.

Awareness of Heart Attack Warning Signs and Actions Taken — 14 States

PRESS CONTACT: CDC
National Center for Chronic Disease Prevention and Health Promotion
Office of Communications
(770) 488-5131

• Press Release

This study serves as an important indicator that more public education and communication campaigns are needed to increase awareness, particularly among high risk populations (men, blacks, Hispanics and undereducated) and in those areas where awareness is low. Significant disparities exist in multiple states among Americans failing to recognize heart attack warning signs and symptoms, according to a new CDC study conducted in 14 states. The study, “Disparities in Awareness of Heart Attack Warning Signs and Actions among U.S. Adults in 14 States, found that the awareness of heart attack warning signs and 9-1-1 calls to report heart attack or strokes were significantly low among men, blacks, Hispanics, and those with less than a high school education. Overall, only about 27 percent of all adult respondents recognized heart attack warning signs and would call 9-1-1 if they suspected that someone was having a heart attack or stroke. The study, based on data collected from the 2005 Behavioral Risk Factor Surveillance System, also found that the awareness of heart attack warning signs and 9-1-1 calls to report heart attack or strokes varied by states participating in study.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES