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TABLE II. (Continued) Provisional cases of selected notifiable diseases, United States, weeks ending April 26, 2008, and April 28, 2007 (17th Week)*

West Nile virus disease
Varicella (chickenpox)

Neuroinvasive

Nonneuroinvasive Previous

Previous

Previous
Current 52 weeks Cum Cum Current 52 weeks Cum

Cum Current 52 weeks Cum Reporting area week Med Max 2008 2007

week Med Max 2008 2007 week Med Max 2008 United States 453 619 1,417 10,590 16,491

1 141

4

2 299 New England

12
31
186
289

2 Connecticut

0
1
1

1
Maine
0

0 Massachusetts 0

2 New Hampshire

18
91

129
Rhode Island
0

1 Vermont

21
95
159

0 Mid. Atlantic

61
145
838 2,175
3

3 New Jersey

N
N
1

0 New York (Upstate)

N
N
1

1 New York City

N
3

3
Pennsylvania
61 145 838 2,175

1

1 E.N. Central 147 157 358 2,398 4,738

18

12 Illinois

13
49 273
69
13

8
Indiana
0 222

4

2 Michigan

52 62

154
1,019 1,881
5

0 Ohio

82
61 208 1,089 2.282

4

3 Wisconsin

4
80
17
506
2.

2 W.N. Central

69
22
58 536 880

41

117 lowa

N
N
4

3
Kansas
36 219 346

3

7 Minnesota

9

12 Missouri 21 261 407 9

3 Nebraska

N

0
N
N

15 North Dakota

39
0
1
40
84
11

49 South Dakota

1
14
16
43
9

32
S. Atlantic
64 102 180 1,842 2,106

12 Delaware

1
4
9
14

1 District of Columbia

0
8

14 Florida

49 28

87
756 477

1 Georgia

N
N

8 Maryland

0

N
N
2

2 North Carolina

0
0
N
N
1

1 South Carolina

4
13
52 276 552

2

1 Virginia

5
25
81
497 551
1

1 West Virginia

6
17
66
290 512

0 E.S. Central

15
82
428
186

11 Alabama

15
82
421
184

2 Kentucky

0

N
N

1 Mississippi

7
2

7
3

12 Tennesseet

N
N

1

1 W.S. Central 133 172 842 3,606 4,764

34

18 Arkansas

11
42
233
287
5

2 Louisiana

1
8
27
60
5

3 Oklahoma

N
0
0
N
N
11

7
Texas
133 159 825 3,346 4,417

18

10 Mountain 35 38 120 744 1,333 36

143 Arizona 0

8

10 Colorado 31 261 17

65
Idaho
N

N
N
3

22 Montana

141
169
10

30 Nevada

N
N

1 New Mexico

94
216
8

6 Utah

247
410

8 Wyoming"

9
1
15

33 Pacific

4
12
20
18

23 Alaska

4
12

20 California

17

21
Hawaii
Oregon

3
Washington
American Samoa
C.N.M.I.
Guam

2
13
21

136 Puerto Rico

11
37
84

269 U.S. Virgin Islands

0

0

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C.N.M.I.: Commonwealth of Northern Mariana Islands.
U: Unavailable. - No reported cases. N: Not notifiable. Cum: Cumulative year-to-date counts. Med: Median. Max: Maximum.

Incidence data for reporting years 2007 and 2008 are provisional. +

Updated weekly from reports to the Division of Vector-Borne Infectious Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases (ArboNET Surveillancei for California serogroup, eastern equine, Powassan, St. Louis, and western equine diseases are available in Table I. Not notifiable in all states. Data from states where the condition is not notifiable are excluded from this table, except in 2007 for the domestic arboviral diseases and inves

associated pediatric mortality, and in 2003 for SARS-COV. Reporting exceptions are available at http://www.cdc.gov/epo/dphsi/phssinfdis.htm. Contains data reported through the National Electronic Disease Surveillance System (NEDSS).

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y, NY

en, NJ

ng. PA

48

LE III. Deaths in 122 U.S. cities,* week ending April 26, 2008 (17th Week)
All causes, by age (years)

All causes, by age (years)
All

P&It

All verting Area

P&It
Ages >65 45-64 25-44 1-24
Total Reporting Area Ages >65 45-64 25-44 1-24

Total England 496 359 87 24 13

44
S. Atlantic

1.245 793 282 88 En, MA

37 44 86
123 73 26
7 8 2 14

Atlanta, GA
122 69 28

10 2 13 4 1 eport, CT 27 16

1
1

1
Baltimore, MD

200 110 62 19 2 7 22 ridge, MA 16 16

Charlotte, NC

106
70 23

6 5 2 6 iver, MA 28 26

Jacksonville, FL
162 110 30

10

2 8 rd, CT

51 35
9

3
Miami, FL
103 64 21

9

4 13 I, MA

29 19
6

3
Norfolk, VA

46 34
10

2 2 MA

8
7
1

1
Richmond, VA
49 30 15

1
1

2 Bedford, MA

22 17
3

1
Savannah, GA

71 51

11
6 3

8 laven, CT

26 16

5

2
5 St. Petersburg, FL

64 48 11

2. 1 2 dence, RI 32 24 7

1

1
Tampa, FL

208
135
45
16

6 6 16 rville, MA

2
2

Washington, D.C.
98 60 24

7
3

4 3 yfield, MA

34 27

5
1

4
Wilmington, DE

16 12

2
2

2 bury, CT

36 31

4
1

3
ester, MA
62 50 10

E.S. Central 1

882 590 204 47 18 23 77 Birmingham, AL

169 101 45 12 3 8 Atlantic

15 2,323 1,628 489 129 48 28 144 Chattanooga, TN

109 74 27

4
1

3 12 47 35

8

1
2
1 2. Knoxville, TN

92 79

10
2 1

4 own, PA

33 27

5
1

1
Lexington, KY
73 54 15

3

1 10 : 0, NY 69 48 17

1
1 2 2. Memphis, TN

140 89 37 10 2 2. 13
29 20
6

2
Mobile, AL

119 64 29 11 9 6 5 eth, NJ

18 12

5
1

Montgomery, AL

34 23

9
1

1 PA

5 61 50 9

2

3
Nashville, TN
146 106 32

4 2 2 13 ✓ City, NJ

20 9

5

3 · Fork City, NY 1,054 725 238 64

W.S. Central
16
55

1,517
946 380 117 37

77 K, NJ 64 28 22

Austin, TX 9 3

97 63 3

23

6 5 son, NJ

26 13

9
3

Baton Rouge, LA

48 25 4

8

15 lelphia, PA

429
300 87 24 13 5 31

Corpus Christi, TX

55 32 19 urgh, PAS

32 20
5

Dallas, TX
4 2 1 1

194 118 44 16 8

11
32 22
7

El Paso, TX
2
1
3

131 93 26

4
8

3 ester, NY 133 110 19

Fort Worth, TX
2 2
16

130 79 35 10 3 3 7 jectady, NY

24 19

4
1

Houston, TX
3

382
218

109 38 3 14 21 ton, PA

25 18

5
2

Little Rock, AR
2

86

30
4

1 1 151 115 21

New Orleans, LA1

U 14

U

U
on, NJ
34 22 10

San Antonio, TX
157 112 29

7

6 NY

15 13
2

Shreveport, LA
96 68 22

3
1

2 10 rs, NY

27 22
5

Tulsa, OK

141 90 35 10 3 3 5 entral 2,147 1,459 471 134 50 33

Mountain 171

1,128 728

257 92

30 20 89 47 29 13

1
1

Albuquerque, NM
3 3
98 53 28 15 2

7 n, OH 43 30 13

Boise, ID

31 21

7
2. 1

2.
324
200 81 31

Colorado Springs, CO
7
25

61
12 7

2 nati, OH 110 72 24

Denver, CO
7
5
22

121 75 29

8

5 11 and, OH

238
168 51
12

Las Vegas, NV
4

305 196 84 21

1 29 ibus, OH 236 173 44 12 5

Ogden, UT 24

26 15

7
2 2.

1 135 97 24 12 2

Phoenix, AZ 14

165 100 36 14 8 6 11 t, MI

147
93 37 9 4

Pueblo, co

30 10

1
1

1 ville, IN 58 42 13

1
1

Salt Lake City, UT
3

121 78 23 11 5 4 11 layne, IN 82 53 13 12 3

Tucson, AZ 1

158

120 2

21

11 4 2 16 IN

17
8
9

Pacific

1,746 1,183 375 104 47 37 145 Rapids, MI

47 32

6
4
2 8
Berkeley, CA

17 13

2
1

1 1 apolis, IN 204 44 14

4 19
Fresno, CA

108

22

9 2. 4 11 ng, MI

40 34

4
2.

4
Glendale, CA

20 17

1
1
1

4 ukee, WI 107 61 34

4
4

11
Honolulu, HI
75 54 14

5 1

1 10
47 30 13
3

Long Beach, CA
59 38

7 2 1 ord, IL 51 40 6

2 3
2 Los Angeles, CA

244 173 45 10 11 5 38 Bend, IN

41 32

7
2

1
Pasadena, CA

23 16

4
1
1
1

2 ), OH 109 79 23

5 2

6
Portland, OR
145 103 29

7 2

4 14 istown, OH 64 50 12

1
2 Sacramento, CA

223 156 48 13 5 1 11 Central 650 434 145 26 28 17 59

San Diego, CA

163 96 46 10 3 8 10 loines, IA 45 33 12

San Francisco, CA
6

111
72

7 2. 2 8
28 23
3

San Jose, CA 2 4

201 145 41

9

3 8 s City, KS

15
9
5

Santa Cruz, CA
1

33 1

16 12

4

1 s City, MO

123
84 30
5 2 2

Seattle, WA

134

87 18

30

10 5 2 7. NE

49 36

7
2. 3

Spokane, WA

72 1

57

9 3

2 2. 2 9 apolis, MN 71 42 15 3 6

Tacoma, WA 5

118 4

69 33

8 7 1 7 a, NE 82 57 14 5 3 3 7

Total

12,134** 8,120 2,690 761 308 245 892 Jis, MO 81 42 31

2 5 1 5 Jl. MN

68
10 5 5

5 a, KS 88 61 18

4 4 1

6 available. -No reported cases. tality data in this table are voluntarily reported from 122 cities in the United States, most of which have populations of >100,000. A death is reported by the place of its urrence and by the week that the death certificate was filed. Fetal deaths are not included. umonia and influenza. ause of changes in reporting methods in this Pennsylvania city, these numbers are partial counts for the current week. Complete counts will be available in 4 to 6 weeks. ause of Hurricane Katrina, weekly reporting of deaths has been temporarily disrupted. - includes unknown ages.

use, NY

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, OH

40

go, IL

n, OH

42

136

71

I, IL

11

28

1, MN

47

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National Stroke Awareness

Month – May 2008 May is National Stroke Awareness Month. In 2008, i estimated 780,000 persons in the United States will five a stroke; of these, 150,000 will die from stroke, id 15%-30% of stroke survivors will be permanently sabled (1). Stroke ranks third among all causes of ath, behind heart disease and cancer. In 2008, the rect and indirect cost of stroke in the United States is pected to amount to approximately $65.5 billion (1). Preventing and controlling stroke risk factors (e.g., gh blood pressure, heart disease, atrial fibrillation,

gh blood cholesterol levels, diabetes, tobacco use, cohol use, physical inactivity, and obesity) are the ost important measures in reducing the incidence of roke (2). Recognizing stroke warning symptoms and imediately telephoning for emergency medical care e critical to preventing death and disability. CDC supports six state-based registries in the Paul overdell National Acute Stroke Registry, which has a ng-term goal of ensuring that all persons in the United ates receive the highest quality acute stroke care to duce deaths, prevent disability, and avoid recurrent rokes. Additional information about stroke programs, arning symptoms, prevention, and care is available at tp://www.cdc.gov/stroke, http://www.strokeassociation.org, tp://www.stroke.org, and http://www.ninds.nih.gov. eferences American Heart Association. Heart disease and stroke statistics: 2008 update. Dallas, TX: American Heart Association; 2008. Available at http://www.americanheart.org/downloadable/heart/ 1200078608862HS_Stats%202008.final.pdf. Goldstein LB, Adams R, Alberts MJ, et al. Primary prevention of ischemic stroke: a guideline from the American Heart Association/ American Stroke Association Stroke Council. Stroke 2006;37: 1583-633.

The MMWR series of publications is published by the Coordinating
Center for Health Information and Service, Centers for Disease
Control and Prevention (CDC), U.S. Department of Health and
Human Services, Atlanta, GA 30333.
Suggested Citation: Centers for Disease Control and Prevention.
[Article title). MMWR 2008;57:[inclusive page numbers).
Centers for Disease Control and Prevention
Julie L. Gerberding, MD, MPH

Director
Tanja Popovic, MD, PhD

Chief Science Officer
James W. Stephens, PhD
Associate Director for Science

Steven L. Solomon, MD
Director, Coordinating Center for Health Information and Service

Jay M. Bernhardt, PhD, MPH
Director, National Center for Health Marketing

Katherine L. Daniel, PhD
Deputy Director, National Center for Health Marketing
Editorial and Production Staff

Frederic E. Shaw, MD, JD
Editor, MMWR Series

Teresa F Rutledge
(Acting) Managing Editor, MMWR Series

Douglas W. Weatherwax
Lead Technical Writer-Editor
Donald G. Meadows, MA

Jude C. Rutledge

Writers-Editors

Peter M. Jenkins
(Acting) Lead Visual Information Specialist

Lynda G. Cupell

Malbea A. LaPete
Visual Information Specialists
Quang M. Doan, MBA

Erica R. Shaver
Information Technology Specialists

phone 9-1-1 was low; the percentage who met all the measures was 16.4%. In addition, disparities were obic by racelethnicity, sex, and education level. Public hea. agencies, clinicians, and educators should continue to the importance of learning to recognize stroke symptoms and the need to telephone 9-1-1 when someone appears : be having a stroke.

BRFSS is a state-based, random-digit-dialed telephuc survey of the U.S. civilian, noninstitutionalized popu. tion aged >18 years and is conducted in all 50 states, a Guam, Puerto Rico, and the U.S. Virgin Islands. Howeit in 2005, the optional heart attack and stroke module -included in the BRFSS surveys of 13 states* and DC. total of 71,994 respondents answered questions regards symptoms of stroke. An incorrect symptom was inclucas in another question (“Do you think sudden chest paio discomfort is a symptom of stroke?") to assess the posi. ity that respondents might answer “yes” to all of the quations in the series without actually considering the Respondents also were asked to select the one action in would do first, from the following list of actions, if th:thought that someone was having a heart attack or stroa take the person to the hospital, advise the person to cal: doctor, call 9-1-1, call a spouse or family member, or i: something else. Median response rate for the 13 states 12" DC, based on Council of American Survey and Rescara Organizations (CASRO) guidelines, was 54.5% (rang 45.1%–61.3%). Data were weighted to 2005 state popes lation estimates. Age-adjusted prevalence estimates 23 95% confidence intervals (CIS) were calculated; statis cally significant differences between characteristics we? determined by nonoverlapping Cis.

Respondent awareness of stroke warning symptoms 92.6% for sudden numbness or weakness of the face, a or leg, especially on one side; 86.5% for sudden confus... or trouble speaking; 83.4% for sudden trouble walking dizziness, or loss of balance; 68.8% for sudden trouble se ing in one or both eyes; and 60.4% for a severe headacto with no known cause. In addition, 85.9% of responders said they would call 9-1-1 if they thought someone wa having a heart attack or stroke. However, 39.5% of respot

Editorial Board William L. Roper, MD, MPH, Chapel Hill, NC, Chairman

Virginia A. Caine, MD, Indianapolis, IN

David W. Fleming, MD, Seattle, WA
William E. Halperin, MD, DrPH, MPH, Newark, NJ
Margaret A. Hamburg, MD, Washington, DC
King K. Holmes, MD, PhD, Seattle, WA
Deborah Holtzman, PhD, Atlanta, GA

John K. Iglehart, Bethesda, MD
Dennis G. Maki, MD, Madison, WI
Sue Mallonee, MPH, Oklahoma City, OK

Stanley A. Plotkin, MD, Doylestown, PA
Patricia Quinlisk, MD, MPH, Des Moines, IA
Patrick L. Remington, MD, MPH, Madison, WI

Barbara K. Rimer, DrPH, Chapel Hill, NC
John V. Rullan, MD, MPH, San Juan, PR

Anne Schuchat, MD, Atlanta, GA
Dixie E. Snider, MD, MPH, Atlanta, GA

John W. Ward, MD, Atlanta, GA

* Alabama, Florida, Iowa, Louisiana, Maine, Minnesota, Mississippi

, Maxis Montana, Oklahoma, Tennessee, Virginia, and West Virginia. + “Do you think sudden confusion or trouble speaking are symptoms of some “Do you think sudden numbness or weakness of face, arm, or leg, espeia one side, are symptoms of stroke?” “Do you think sudden trouble sering ? or both eyes is a symptom of stroke?” “Do you think sudden trouble was dizziness, or loss of balance are symptoms of stroke?” “Do you think a step headache with no known cause is a symptom of stroke?”

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