MMWR. Surveillance summaries : Morbidity and mortality weekly report. Surveillance summaries
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Each year, approximately 795,000 persons in the United States experience a new or recurrent stroke. Data from the prototype phase (2001-2004) of the Paul Coverdell National Acute Stroke Registry (PCNASR) suggested that numerous acute stroke patients did not receive treatment according to established guidelines. ⋯ Results from PCNASR indicate the need for additional public health measures to inform the public of the need for timely activation of EMS services for signs and symptoms of stroke. In addition, low rates of adherence to certain measures of stroke care underscore the need for continuing coordinated programs to improve stroke quality of care. Additional analyses are needed to assess improvements in adherence to guidelines over time.
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This report presents data for 2002-2007 concerning the sexual and reproductive health of persons aged 10-24 years in the United States. Data were compiled from the National Vital Statistics System and multiple surveys and surveillance systems that monitor sexual and reproductive health outcomes into a single reference report that makes this information more easily accessible to policy makers, researchers, and program providers who are working to improve the reproductive health of young persons in the United States. The report addresses three primary topics: 1) current levels of risk behavior and health outcomes; 2) disparities by sex, age, race/ethnicity, and geographic residence; and 3) trends over time. ⋯ For example, birth rates among adolescents aged 15-19 years decreased annually during 1991-2005 but increased during 2005-2007, from 40.5 live births per 1,000 females in 2005 to 42.5 in 2007 (preliminary data). The annual rate of AIDS diagnoses reported among males aged 15-19 years has nearly doubled in the past 10 years, from 1.3 cases per 100,000 population in 1997 to 2.5 cases in 2006. Similarly, after decreasing for >20 years, gonorrhea infection rates among adolescents and young adults have leveled off or had modest fluctuations (e.g., rates among males aged 15-19 years ranged from 285.7 cases per 100,000 population in 2002 to 250.2 cases per 100,000 population in 2004 and then increased to 275.4 cases per 100,000 population in 2006), and rates for syphilis have been increasing (e.g., rates among females aged 15-19 years increased from 1.5 cases per 100,000 population in 2004 to 2.2 cases per 100,000 population in 2006) after a significant decrease during 1997-2005.
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Smoking among nonpregnant women contributes to reduced fertility, and smoking during pregnancy is associated with delivery of preterm infants, low infant birthweight, and increased infant mortality. After delivery, exposure to secondhand smoke can increase an infant's risk for respiratory tract infections and for dying of sudden infant death syndrome. During 2000-2004, an estimated 174,000 women in the United States died annually from smoking-attributable causes, and an estimated 776 infants died annually from causes attributed to maternal smoking during pregnancy. ⋯ The data provided in this report are important for developing, monitoring, and evaluating state tobacco-control policies and programs to reduce smoking among female and pregnant smokers. States can reduce smoking before, during, and after pregnancy through sustained and comprehensive tobacco-control efforts (e.g., smoke-free policies and tobacco excise taxes). Health-care providers should increase efforts to assess the smoking status of their patients and offer effective smoking-cessation interventions to every female or pregnant smoker to whom they provide health-care services.
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In the United States, acute viral hepatitis most frequently is caused by infection with any of three distinct viruses: hepatitis A virus (HAV), hepatitis B virus (HBV), or hepatitis C virus (HCV). These unrelated viruses are transmitted through different routes and have different epidemiologic profiles. Safe and effective vaccines have been available for hepatitis B since 1981 and for hepatitis A since 1995. No vaccine exists against hepatitis C. HBV and HCV can persist as chronic infections and represent a leading cause of chronic liver disease and hepatocellular carcinoma in the United States. ⋯ The expansion in 2006 of recommendations for routine hepatitis A vaccination to include all children in the United States aged 12-23 months is expected to reduce hepatitis A rates further. Ongoing hepatitis B vaccination programs ultimately will eliminate domestic HBV transmission, and increased vaccination of adults with risk factors will accelerate progress toward elimination. Further prevention of hepatitis B and hepatitis C relies on identifying and preventing transmission of HBV or HCV in hospital and nonhospital health-care associated settings. In addition, prevention of hepatitis C relies on identifying and counseling uninfected persons at risk for hepatitis C (e.g., injection-drug users) regarding ways they can protect themselves from infection. Public health management of persons with chronic HBV or HCV infection will help to interrupt the transmission to susceptible persons, and their medical management will help to reduce the development of the sequelae from chronic liver disease.
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An estimated 50,000 persons die annually in the United States as a result of violence-related injuries. This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) regarding violent deaths from 16 U.S. states for 2006. Results are reported by sex, age group, race/ethnicity, marital status, location of injury, method of injury, circumstances of injury, and other selected characteristics. ⋯ For the occurrence of violent deaths in the United States to be better understood and ultimately prevented, accurate, timely, and comprehensive surveillance data are necessary. NVDRS data can be used to track the occurrence of violence-related fatal injuries and assist public health authorities in the development, implementation, and evaluation of programs and policies to reduce and prevent violent deaths at the national, state, and local levels. The continued development and expansion of NVDRS is essential to CDC's efforts to reduce the personal, familial, and societal costs of violence. Further efforts are needed to increase the number of states participating in NVDRS, with an ultimate goal of full national representation.