MMWR

Morbidity and Mortality Weekly Report

(Box) National Stroke Awareness Month — May 2008

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No summary available

Disparities in Adult Awareness of Stroke Warning Signs and Symptoms — 14 States, 2005

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Early recognition of the signs and symptoms of stroke and the need for victims or bystanders to immediately call 911 at the onset of symptoms is a matter of life and death. The five signs and symptoms of stroke include: 1) Sudden numbness or weakness of the face, arms, or legs; 2) Sudden confusion or trouble speaking or understanding others; 3) Sudden trouble seeing in one or both eyes; 4) Sudden trouble walking, dizziness, or loss of balance or coordination; and 5) Sudden severe headache with no known cause. Although the number of deaths from stroke have declined since the 1960s, more than half (54 percent) of U.S. stroke deaths occur outside a hospital. A new CDC study revealed that less than half (44 percent) of people when asked about their awareness of the signs and symptoms of a stroke knew all five symptoms of a stroke, and only 38 percent of respondents knew to call 911 if they thought someone was having a stroke. This study, Disparities in Adult Awareness of Stroke Warning Signs and Symptoms, analyzed 2005 Behavior Risk Factor Surveillance Study data from 13 states and the District of Columbia found there was no improvement in the publics′ awareness of stroke symptoms since a similar study conducted in 2001. Significant disparities exist in the awareness of stroke warning symptoms by race/ethnicity, sex, education level and by state. Blacks, Hispanics and people with lower education levels were less aware of all five stroke symptoms and the need to call 911 at the onset of symptoms than were whites, women and those with higher education levels.

Arthritis as a Potential Barrier to Physical Activity Among Adults with Diabetes — United States, 2005 and 2007

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Division of Media Relations
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• Press Release

Adults with diabetes and arthritis have additional barriers for physical activity, such as concerns about pain, or aggravating and worsening arthritis condition, thereby limiting the ability to manage both conditions. Engaging in joint friendly activities, such as walking, swimming, biking and participating in available arthritis-specific exercise programs may help people with both conditions to be more physically active. For more information on joint friendly exercise programs, visit CDC′s Arthritis Web site at http://www.cdc.gov/arthritis/intervention. A new CDC study shows that arthritis may be an unrecognized barrier for adults with diabetes seeking to manage their condition through physical activity. The study, “Arthritis as a Potential Barrier to Physical Activity among Adults with Diabetes: United States, 2005 and 2007”, found that more than half (52 percent) of adults with diabetes also have arthritis. The study also found that the prevalence of physically inactivity is significantly higher for adults with both diagnosed diabetes and arthritis (29.8 percent) compared to adults with only diabetes (21 percent). Among people with diabetes and arthritis, the high frequency of arthritis appears to be a barrier to increasing physical activity. Physical activity is an important health strategy for managing diabetes as well as for reducing pain, improving function and delaying disability attributed to arthritis.

Progress Toward Interruption of Wild Poliovirus Transmission — Worldwide, January 2007–April 2008

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Division of Media Relations
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With concerted effort by global polio eradication partners to selectively eliminate type 1 wild poliovirus, there is great promise that this objective will be reached in India by the end of 2008. The global polio eradication initiative began 20 years ago (1988), when the global incidence of poliomyelitis associated with wild polioviruses (WPVs) was an estimated 350,000 cases occurring in approximately 125 countries. With eradication initiative strategies, this was reduced to 1,997 reported cases in 2006. The number of countries that have never succeeded in interrupting WPV transmission is reduced to four (Afghanistan, India, Nigeria, and Pakistan); each of these has unique challenges to interrupting WPV transmission which have slowed the progress made from earlier years in the initiative. This article summarized progress toward polio eradication in 2007. An accelerated effort during 2007–2008 toward elimination of WPV transmission has expanded use of type 1 monovalent oral poliovirus vaccine (OPV) (mOPV1) in immunization campaigns to preferentially eliminate type 1 WPV (WPV1) transmission before type 3 WPV (WPV3); WPV1 is more likely to cause paralytic disease and have a wide geographic spread than WPV3. Type 2 WPV (WPV2) circulation was last observed in October 1999. In 2007, the overall number of WPV cases declined to 1,308 in 2007. The number of WPV1 cases has been reduced 81 percent to 321 in 2007; this in large part is because of substantial progress toward the interruption of WPV1 circulation in India, which is anticipated in 2008. Progress in other countries with poliovirus circulation has been made, but with ongoing limitations in reaching all children in vaccination efforts; WPV1 elimination will continue to be preferentially targeted in those countries as well.

(Early Release from May 1) Measles — United States, January 1–April 25, 2008

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Division of Media Relations
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The 2008 upsurge in U.S. measles cases serves as a reminder that measles can still occur in this country from imported cases. These cases and outbreaks result primarily from failure to vaccinate, many because of personal or religious belief exemption. Unvaccinated persons are at risk for acquiring measles themselves and also of transmitting to others, including children too young to be vaccinated. Measles, a highly contagious acute viral disease, can result in serious complications and death. Due to a successful measles vaccination program, measles elimination (interruption of endemic measles transmission) was declared in the United States in 2000. However, every year, more than 20 million measles cases occur worldwide and importations of measles into the U.S will continue. From January 1 through April 25, 2008, the Centers for Disease Control and Prevention received 64 reports of confirmed measles cases—the highest number reported for the same time period since 2001. Ten cases were acquired overseas, 9 from the European WHO region where large measles outbreaks are occurring in Switzerland and in Israel. The remaining 54 cases are considered to be linked to importations. Only one of the 64 cases had documentation of prior vaccination. Many of the measles cases among U.S. children in 2008 occurred in children whose parents claimed exemption from vaccination due to religious or personal beliefs or in children too young to be vaccinated. Increases in the proportion of persons declining vaccination for themselves or their children could result in large-scale outbreaks in the U.S., as has occurred in other countries, such as the United Kingdom and the Netherlands.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES