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Publication of CDC Surveillance Summaries
Since 1983, CDC has published the CDC Surveillance Summaries
under separate cover as part of the MMWR series. Each report
published in the CDC Surveillance Summaries focuses on public
health surveillance; surveillance findings are reported for a broad
range of risk factors and health conditions.
Summaries for each of the reports published in the most recent
issue (dated May 29, 1992) of the CDC Surveillance Summaries (1)
are provided below. All subscribers to MMWR receive the CDC
Surveillance Summaries, as well as the MMWR Recommendations and
Reports, as part of their subscriptions.
HOMICIDE SURVEILLANCE -- UNITED STATES, 1979-1988
From 1979 through 1988, 217,578 homicides occurred in the
United States, an average of greater than 21,000 per year.
Homicide rates during this 10-year period were about 1.5 times
higher than the rates during the 1950s. The national homicide rate
of 10.7/100,000 in 1980 was the highest ever recorded. Homicide
occurs disproportionately among young adults. Among the 15- to
34-year age group, homicide is the fourth most common cause of
death among white females, the third most common cause among white
males, and the most common cause among both black females and black
males. In 1988, nearly two-thirds (61%) of homicide victims were
killed with a firearm, 75% of these with a handgun. More than half
(52%) of homicide victims were killed by a family member or
acquaintance, and about one-third (35%) of homicides stemmed from
a conflict not associated with another felony. The homicide
mortality rate among young black males 15-24 years of age has risen
54% since 1985. Ninety-nine percent of the increase was accounted
for by homicides in which the victim was killed with a firearm. The
surveillance data summarized in this report should assist public
health practitioners, researchers, and policymakers in addressing
this important public health problem.
Authors: Marcella Hammett, M.P.H., Kenneth E. Powell, M.D., M.P.H.,
Patrick W. O'Carroll, M.D., M.P.H., Sharon T. Clanton, Division of
Injury Control, National Center for Environmental Health and Injury
Control, CDC.
INFLUENZA -- UNITED STATES, 1989-90 AND 1990-91 SEASONS
During the 1989-90 influenza season, 98% of all influenza viruses
isolated in the United States and reported to CDC were influenza A.
Almost all those that were antigenically characterized were similar
to influenza A/Shanghai/11/87(H3N2), a component of the 1989-90
influenza vaccine. Regional and widespread influenza activity began
to be reported in late December 1989, peaked in mid-January 1990,
and declined rapidly through early April 1990. Most of the
outbreaks reported to CDC were among nursing-home residents.
Considerable influenza-associated mortality was reflected in the
percentage of deaths due to pneumonia and influenza (P&I) reported
through the CDC 121 Cities Surveillance System from early January
through early April. More than 80% of all reported P&I deaths were
among persons greater than or equal to 65 years of age. In contrast
to the predominance of influenza A during 1989-90, during the
1990-91 influenza season 86% of all influenza virus isolations
reported were influenza B. Widespread influenza activity was
reported from mid-January through April 1991, with regional
activity extending into May. Outbreaks were reported primarily
among schoolchildren, and no evidence of excess
influenza-associated mortality was found. Almost all the influenza
B isolates tested were related to influenza B/Yamagata/16/88, a
component of the 1990-91 influenza vaccine, but were antigenically
closer to B/Panama/45/90, a minor variant.
Authors: Louisa E. Chapman, M.D., M.S.P.H., Margaret A. Tipple,
M.D., Leone M. Schmeltz, Susan E. Good, B.S.R.N., Helen L. Regnery,
Ph.D., Alan P. Kendal, Ph.D., Howard E. Gary, Jr., Ph.D., Nancy J.
Cox, Ph.D., Lawrence B. Schonberger, M.D., M.P.H., Division of
Viral and Rickettsial Diseases, National Center for Infectious
Diseases, CDC.
LABORATORY-BASED SURVEILLANCE FOR ROTAVIRUS -- UNITED STATES,
JANUARY 1989-MAY 1991
Geographic and temporal trends of rotavirus detections in the
United States for the period January 1989-May 1991 were determined
by analyzing data reported monthly by 47 virology laboratories
participating in the North American Rotavirus Surveillance System.
Reports included complete information on the number of specimens
tested, the number of test results positive for rotavirus, and the
method used to detect rotavirus. Consistent trends in regional and
geographic area were identified, with distinctly different peaks of
rotavirus activity in the western and eastern states. Each year in
the western states, rotavirus activity began in November and peaked
in December-January, whereas in the eastern states activity began
in January and peaked in February-March. These differences do not
correlate with obvious trends in strain variation of rotavirus and
remain unexplained. Unexpected reporting of summer rotavirus
activity by some laboratories in 1989 was traced to the use of a
single diagnostic kit and to two questionable laboratory practices:
having more than six medical technologists perform the test and
failure to use controls with the test. Laboratory-based
surveillance of rotavirus activity has proven to be useful in
identifying and correcting problems in laboratory methods for
detecting rotavirus and will be a sensitive means for monitoring
coverage of the rotavirus vaccine now being developed.
Authors: Donna Ing, B.S.N., M.P.H., Roger I. Glass, M.D., Ph.D.,
Charles W. LeBaron, M.D., Judy F. Lew, M.D., Division of Viral and
Rickettsial Diseases, National Center for Infectious Diseases, CDC.
CHANCROID IN THE UNITED STATES, 1981-1990:
EVIDENCE FOR UNDERREPORTING OF CASES
Chancroid, a bacterial sexually transmitted disease (STD)
characterized by genital ulceration, has reemerged in the United
States during the last decade. From 1950 to 1980, cases were
infrequently reported. After an epidemic in California in 1981,
however, the numbers of cases increased, peaking in 1987 at 5035.
Despite a subsequent decline in numbers of reported cases to 4223
in 1990, new areas continue to report outbreaks. Interpreting
chancroid surveillance data is difficult because confirmatory
culture media are not commercially available. In addition, states
may not require that unconfirmed or even confirmed cases be
reported. To determine if chancroid is more widely distributed than
surveillance figures indicate, CDC contacted STD clinics in 115
health departments, located in 32 states, the District of Columbia,
and Puerto Rico -- areas chosen because they had reported five or
more cases of chancroid in any single year during 1986-1990 -- to
determine if cases might be occurring but not reported. Only 16 of
the 115 clinics had culture media available for Haemophilus
ducreyi, and only nine had laboratory facilities complete enough to
definitively diagnose chancroid, syphilis, or genital herpes, the
most common STDs characterized by genital ulcers. Five or more
clinically likely cases occurring in 1990 were identified in 24
states, seven more than surveillance figures indicated.
Surveillance can be improved if 1) states utilize the definitions
for chancroid cases adopted for use in 1990 and 2) microbiology
laboratories utilize enhanced diagnostic methods.
Authors: Joann M. Schulte, D.O., Frederick A. Martich, George P.
Schmid, M.D., Division of Sexually Transmitted Diseases and HIV
Prevention, National Center for Prevention Services, CDC.
Reference
CDC. CDC surveillance summaries. MMWR 1992;41(no. SS-3).
Disclaimer
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