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

1. CDC. CDC surveillance summaries. MMWR 1992;41(no. SS-3).

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