MMWR – Morbidity and Mortality Weekly Report

1.Acute Kidney Injury Associated with Synthetic Cannabinoid Use — Multiple States, 2012

CDC
Division of News & Electronic Media
404-639-3286

Sixteen cases of synthetic cannabinoid-related acute kidney injury occurred in six states in 2012. Synthetic cannabinoids, which are sold in smoke shops and convenience stores under names like “synthetic marijuana,” “Spice,” “K2,” or “herbal incense,” are designer drugs dissolved in solvent, applied to plant material, and smoked. These psychoactive drugs can have a significant effect on mood or behavior, but also carry the risk of unpredictable toxicity. The growing use of synthetic cannabinoid products is an emerging public health concern. The sixteen cases reported in this study developed kidney damage after smoking synthetic cannabinoid products. In seven of the cases, analyses of the products or blood or urine samples found a unique cannabinoid called XLR-11. These products are often sold as incense and labeled “Not for Human Consumption.” Despite the labeling, individuals use the products as an alternative to marijuana use.  There is a risk that some cannabinoid compounds may be toxic and the health effects may not be easily predictable because of what is still unknown about the products. However, it is important that clinicians, scientists, public health officials, and law enforcement are alerted about the emerging adverse health effects from synthetic drug use.

2.Completeness of Reporting of Chronic Hepatitis B and C Virus Infection — Michigan, 1995–2008

National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
News Media Line – 404-639-8895
NCHHSTPMediaTeam@cdc.gov

An analysis of Michigan surveillance data for chronic Hepatitis B virus (HBV) and Hepatitis C virus (HCV) infections found that reporting of these cases to the state surveillance system, while increasing, remains incomplete.  In response to a recommendation from the Institute of Medicine, CDC conducted this study as a first step in better understanding the completeness of reporting of cases of these chronic infections to national surveillance systems.  In conjunction with partners at the Michigan Department of Community Health (MDCH) and an urban health care system in southeastern Michigan, CDC researchers compared confirmed cases of chronic HBV and HCV infection among individuals enrolled in a chronic hepatitis cohort study to cases reported to MDCH’s viral hepatitis disease registry.  Overall, 82 percent of the chronic HBV cases and 65 percent of the HCV cases were also reported to the state surveillance system.  Although basic demographic data were included for most reported cases, risk factor data were rarely reported.  Recently diagnosed cases were more likely to be reported than older cases, which researchers attribute to a new laboratory and provider-based electronic reporting system.  Despite this progress, additional and more efficient methods are still needed to improve reporting.  This research provides a model that can be used to evaluate completeness of viral hepatitis surveillance in other states.

CDC Grand Rounds: The Growing Threat of Multidrug-Resistant Gonorrhea

National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
News Media Line – 404-639-8895
NCHHSTPMediaTeam@cdc.gov

Gonorrhea infections can be cured with proper antibiotic treatment, but the treatment arsenal is shrinking. Action from public and private partners is urgently needed to prevent untreatable gonorrhea from becoming a reality in the United States. In 2011, 321,849 gonorrhea cases were reported to CDC, making it the second most commonly reported infectious disease in the nation. Antibiotics have long been used successfully to treat gonorrhea, but the bacteria that causes gonorrhea has eventually grown resistant to each drug used. In 2007, CDC revised its gonorrhea treatment guidelines to recommend only one class of antibiotics, cephalosporins, which includes the oral drug, cefixime, and the injectable drug, ceftriaxone. But, recent laboratory data show that cefixime is becoming less effective. Prompted by these data and the bacteria’s long resistance history, CDC changed its guidelines in 2012 to no longer recommend oral cefixime as a first-line treatment, leaving only injectable ceftriaxone to be used in combination with one of two oral antibiotics. Although the revised guidelines might help delay the emergence of cephalosporin-resistant gonorrhea, they do not permanently solve the problem. Research is needed to identify or develop new, effective drugs or drug combinations. Additionally, staying ahead of untreatable gonorrhea will require action in other fronts: healthcare providers should follow current treatment guidelines, health departments and labs should help monitor for emerging resistance, and individuals should protect themselves from infection. 

Notes from the Field

Salmonella Bredeney Infections Linked to a Brand of Peanut Butter — United States, 2012

Outbreak in an Acute-Care Hospital of Carbapenem-Resistant Klebsiella pneumoniae Producing New Delhi Metallo-Beta-Lactamase — Denver, Colorado, 2012

QuickStats

Motor Vehicle Traffic Death Rates Among Persons Aged 15-24 Years, by Sex and Age Group — United States, 1999-2011

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES