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Update: Ebola Virus Disease Epidemic — West Africa, February 2015

February 26, 2015 Comments off

Update: Ebola Virus Disease Epidemic — West Africa, February 2015
Source: Morbidity and Mortality Weekly Report (CDC)

According to the latest World Health Organization update on February 18, 2015 (2), a total of 23,253 confirmed, probable, and suspected cases of Ebola and 9,380 Ebola-related deaths had been reported as of February 15 from the three West African countries (Guinea, Liberia, and Sierra Leone) where Ebola virus transmission has been widespread and intense. Total case counts include all suspected, probable, and confirmed cases, which are defined similarly by each country (3). Because of improvements in surveillance, the number of cases reported in recent weeks might overestimate the number of Ebola cases in some areas because nonconfirmed cases are included in the total case counts. Sierra Leone reported the highest number of laboratory-confirmed cases (8,212), followed by Liberia (3,149) and Guinea (2,727). During the week ending February 14, a daily average of 11 confirmed cases were reported from Sierra Leone, fewer than one from Liberia, and seven from Guinea. The areas with the highest numbers of confirmed cases reported during January 25–February 14 were the Western Area and Port Loko (Sierra Leone) and Forecariah (Guinea) (Figure). Guinea saw an increase in confirmed cases over the past 3 weeks. This might reflect improved surveillance and case reporting because of increased access to previously inaccessible communities.

Emergency Department Visits for Motor Vehicle Traffic Injuries: United States, 2010–2011

February 25, 2015 Comments off

Emergency Department Visits for Motor Vehicle Traffic Injuries: United States, 2010–2011
Source: National Center for Health Statistics

Key findings
Data from the National Hospital Ambulatory Medical Care Survey, 2010–2011

  • In 2010–2011, the emergency department (ED) visit rate for motor vehicle traffic injuries was highest among persons aged 16–24 years. The rates declined with age after 16–24, with rates for those aged 0–15 similar to those 65 and over.
  • The overall ED visit rate for motor vehicle traffic injuries was higher among non-Hispanic black persons compared with non-Hispanic white and Hispanic persons.
  • Imaging services were ordered or provided at 70.2% of ED visits for motor vehicle traffic injuries, which was higher than for other injury-related ED visits (55.9%).
  • About one-half of ED visits for motor vehicle traffic injuries had a primary diagnosis of sprains and strains of the neck and back, contusion with intact skin surface, or spinal disorders.

Notes from the Field: Prevalence of Risk Factors for Suicide Among Veterinarians — United States, 2014

February 24, 2015 Comments off

Notes from the Field: Prevalence of Risk Factors for Suicide Among Veterinarians — United States, 2014
Source: Morbidity and Mortality Weekly Report (CDC)

Veterinarians are believed to be at increased risk for suicide compared with the general population. Few data on the occurrence of suicidal behavior and suicide risk factors among U.S. veterinarians are available. Veterinarians participating in two wellness summits held during September 2013 concluded that more research is needed on veterinarians and their mental health.

During July 1–October 20, 2014, an anonymous, Web-based questionnaire was made available through the Veterinary Information Network (VIN), an online community for veterinarians; VIN News Service; JAVMA News; and monthly e-mail messages to veterinarians in 49 states (Maine was excluded) and Puerto Rico sent through the state’s veterinary medical association, agriculture or livestock department, or health department. The questionnaire asked respondents about their experiences with depression and suicidal behavior, and included standardized questions from the Kessler-6 psychological distress scale that assesses for the presence of serious mental illness. Respondents with nonresponses were included in the denominators when calculating prevalence estimates.

Responses were received from 10,254 currently employed veterinarians (10.3% of all employed U.S. veterinarians). The most commonly reported age category was 30–39 years (28.8%), and 31.3% were male. Thirty-four percent reported practicing veterinary medicine for <10 years, 24.6% for 10–19 years, 21.6% for 20–29 years, and 19.8% for ≥30 years. Most (68.6%) respondents practiced small animal medicine, and 37.8% were practice owners. In comparison, 44.4% of U.S. veterinarians are male, and 66.6% practice small animal medicine exclusively.

Approximately 6.8% (95% confidence interval [CI] = 5.9%–7.7%) of male and 10.9% (CI = 10.2%–11.6%) of female respondents were characterized as having serious psychological distress based on the Kessler-6 psychological distress scale, compared with 3.5% of male and 4.4% of female U.S. adults, respectively (5). Since graduating from veterinary school, 24.5% and 36.7% (CIs = 23.0%–26.0%, 35.6%–37.8%) of male and female respondents reported experiencing depressive episodes, respectively, 14.4% and 19.1% (CIs = 13.2%–15.7%, 18.2%–20.0%) suicidal ideation, and 1.1% and 1.4% (CIs = 0.7%–1.5%, 1.2%–1.7%) suicide attempts. In comparison, male and female U.S. adults had a lower lifetime prevalence of depressive episodes (15.1% and 22.9%, respectively) and suicidal ideation (5.1% and 7.1%) but a higher prevalence of suicide attempts (1.6% and 3.0%).

The findings in this report are subject to at least two limitations. First, the small number of veterinarians who responded compared with the number of those potentially eligible increases the likelihood of nonresponse bias. Second, the possibility exists for social desirability bias. Both of these factors could lead to overestimation or underestimation of the actual prevalence of risk factors for suicide among U.S. veterinarians. Nevertheless, these data suggest that nearly one in 10 U.S. veterinarians might suffer from serious psychological distress and more than one in six might have experienced suicidal ideation since graduation. Additional data, particularly data from representative samples, are needed to further characterize the underlying risk factors for suicidal behavior among veterinarians and identify effective prevention methods.

Prescription Cholesterol-lowering Medication Use in Adults Aged 40 and Over: United States, 2003–2012

February 23, 2015 Comments off

Prescription Cholesterol-lowering Medication Use in Adults Aged 40 and Over: United States, 2003–2012
Source: National Center for Health Statistics

Key findings

Data from the National Health and Nutrition Examination Survey

  • During 2003–2012, the percentage of adults aged 40 and over using a cholesterol-lowering medication in the past 30 days increased from 20% to 28%.
  • The use of statins increased from 18% to 26%. By 2011–2012, 93% of adults using a cholesterol-lowering medication used a statin.
  • Cholesterol-lowering medication use increased with age, from 17% of adults aged 40–59 to 48% of adults aged 75 and over.
  • About 71% of adults with cardiovascular disease and 54% of adults with hypercholesterolemia used a cholesterol-lowering medication.
  • Adults aged 40–64 with health insurance were more likely than those without health insurance to use a cholesterol-lowering medication.

Vital Signs: Disparities in Nonsmokers’ Exposure to Secondhand Smoke — United States, 1999–2012

February 6, 2015 Comments off

Vital Signs: Disparities in Nonsmokers’ Exposure to Secondhand Smoke — United States, 1999–2012
Source: Morbidity and Mortality Weekly Report (CDC)

Background:
Exposure to secondhand smoke (SHS) from burning tobacco causes disease and death in nonsmoking children and adults. No risk-free level of SHS exposure exists.

Methods:
National Health and Nutrition Examination Survey (NHANES) data from 1999–2012 were used to examine SHS exposure among the nonsmoking population aged ≥3 years. SHS exposure among nonsmokers was defined as a serum cotinine level (a metabolite of nicotine) of 0.05–10 ng/mL. SHS exposure was assessed overall and by age, sex, race/ethnicity, poverty level, education, and whether the respondent owned or rented their housing.

Results:
Prevalence of SHS exposure in nonsmokers declined from 52.5% during 1999–2000 to 25.3% during 2011–2012. During this period, declines were observed for all population subgroups, but disparities exist. During 2011–2012, SHS was highest among: children aged 3–11 years (40.6%), non-Hispanic blacks (46.8%), persons living below the poverty level (43.2%), and persons living in rental housing (36.8%). Among children aged 3–11 years, 67.9% of non-Hispanic blacks were exposed to SHS compared with 37.2% of non-Hispanic whites and 29.9% of Mexican Americans.

Conclusion:
Overall, SHS exposure in the United States has been reduced by half since 1999–2000. However, 58 million persons were still exposed to SHS during 2011–2012, and exposure remains higher among children, non-Hispanic blacks, those living in poverty, and those who rent their housing.

Implications for Public Health Practice:
Eliminating smoking in indoor spaces fully protects nonsmokers from SHS exposure; separating smokers from nonsmokers, cleaning the air and ventilating buildings cannot completely eliminate exposure. Continued efforts to promote implementation of comprehensive statewide laws prohibiting smoking in workplaces and public places, smoke-free policies in multiunit housing, and voluntary smoke-free home and vehicle rules are critical to protect nonsmokers from this preventable health hazard in the places they live, work, and gather.

Prevalence of Reduced Muscle Strength in Older U.S. Adults: United States, 2011–2012

January 30, 2015 Comments off

Prevalence of Reduced Muscle Strength in Older U.S. Adults: United States, 2011–2012
Source: National Center for Health Statistics

Key findings
Data from the National Health and Nutrition Examination Survey, 2011–2012

  • Five percent of adults aged 60 and over had weak muscle strength. Thirteen percent had intermediate muscle strength, while 82% had normal muscle strength.
  • The prevalence of reduced (weak and intermediate) muscle strength increased with age, while the prevalence of normal strength decreased with age.
  • Muscle strength status did not differ by sex, except among persons aged 80 and over, where women had a higher prevalence of weak muscle strength than men.
  • Non-Hispanic Asian and Hispanic persons had a higher prevalence of reduced muscle strength than non-Hispanic white persons.
  • Difficulty with rising from a chair increased as strength status decreased.

Assisted Reproductive Technology Surveillance — United States, 2011

January 27, 2015 Comments off

Assisted Reproductive Technology Surveillance — United States, 2011
Source: Morbidity and Mortality Weekly Report (CDC)

In 2011, a total of 151,923 ART procedures performed in 451 U.S. fertility clinics were reported to CDC. These procedures resulted in 47,818 live-birth deliveries and 61,610 infants. The largest numbers of ART procedures were performed among residents of six states: California (18,808), New York (excluding New York City) (14,576), Massachusetts (10,106), Illinois (9,886), Texas (9,576), and New Jersey (8,698). These six states also had the highest number of live-birth deliveries as a result of ART procedures and together accounted for 47.2% of all ART procedures performed, 45.3% of all infants born from ART, and 45.1% of all multiple live-birth deliveries, but only 34% of all infants born in the United States. Nationally, the average number of ART procedures performed per 1 million women of reproductive age (15–44 years), which is a proxy indicator of ART use, was 2,401. In 11 states (Connecticut, Delaware, Hawaii, Illinois, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Rhode Island, and Virginia), the District of Columbia, and New York City, this proxy measure was higher than the national rate, and of these, in three states (Massachusetts, New Jersey, and New York) and the District of Columbia, it exceeded twice the national rate. Nationally, among ART cycles with patients using fresh embryos from their own eggs in which at least one embryo was transferred, the average number of embryos transferred increased with increasing age (2.0 among women aged 40 years). Elective single-embryo transfer (eSET) rates decreased with increasing age (12.2% among women aged 40 years). Rates of eSET also varied substantially between states (range: 0.7% in Idaho to 53% in Delaware among women aged <35 years).

See also: Births Resulting From Assisted Reproductive Technology: Comparing Birth Certificate and National ART Surveillance System Data, 2011 (PDF; National Center for Health Statistics)

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