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TABLE II. (Continued) Provisional cases of selected notifiable diseases, United States, weeks ending May 31, 2008, and June 2, 2007
(22nd Week)*

West Nile virus diseaset
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 462 648 1,676 14,843 22,762

1 141

8

1 New England

5
22
78 242
1.343
0 2

2. Connecticut

12
58
781
2

1 Maine

1
26

183 Massachusetts

2 New Hampshire

18
110

180
Rhode Island
0

1 Vermont

3

19

132 199 Mid. Atlantic

51
58 147 1,226 2,795

3 New Jersey

N
0
0
N
N
1

0
New York (Upstate)
N

N
N
1

1 New York City

N

3 Pennsylvania

51
58 147 1,226 2,795

1

1 E.N. Central 89 157 359 3,484 6,170

18

12 Illinois

8
5
62 532
88

13
Indiana
0 222

4

2 Michigan

35
63 154 1,471 2,447

5 Ohio

46
57 128 1,388 2,964

4

3 Wisconsin

6
80
93
671
2

2 W.N. Central

23
144 680 1,074

41

117 lowa

N
N
4

3 Kansas

6
36
233
443

7
Minnesota
0

12 Missouri

47

382 573 Nebraska

N
5

15
North Dakota
140

11

49 South Dakota

1

17
58
9

32 S. Atlantic

73
99
157 2,459 2,833

0

12 Delaware

1
18

1 District of Columbia

15

20 Florida

31
87 980 653

1 Georgia

8 Maryland

2 North Carolina

1

1 South Carolina

32
14
63
451
652

1 Virginia

23

635
839
1

1
West Virginia
10 15

364

651 E.S. Central

15
83 684
297
11

14 Alabama

15
15
83
676
296
2

1 Kentucky

N
N
1

0 Mississippi

8
1

7
4

12 Tennessee

0
N
N

1
1

2
W.S. Central
193 170 927 4,900 6,567

34

18 Arkansas

14
42
318 385

5
1

2 Louisiana

1
7
27
84
5

3 Oklahoma

0
0
N
N
11

7
Texas
193 159 894 4,555 6,098

18

10 Mountain 30 42 105 1,147 1,661

36

143 Arizona

0

0

8 Colorado 43 531 625

65 Idaho

N
N
3

22 Montana

40
159
249
10

30 Nevada

0
N
N
1

3 New Mexico

22
115
259
8

6 Utah

13
8
55
337
512
8

8 Wyoming

0
9
5
16
4

33 Pacific

1

21
22
18

23 Alaska

1
4
21

22 California

17

21
Hawaii
Oregon

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

2
17
50

159 Puerto Rico

11
37
230

361 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.
1 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 Surveillancel. 22
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 it Jata
associated pediatric mortality, and in 2003 for SARS-COV. Reporting exceptions are available at http://www.cdc.gov/epo/dphsi/phs/infdis.htm.
Contains data reported through the National Electronic Disease Surveillance System (NEDSS).

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BLE III. Deaths in 122 U.S. cities,* week ending May 31, 2008 (22nd Week)
All causes, by age (years)

All causes, by age (years)
All

P&It

All porting Area

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

Total

Reporting Area Ages >65 45-64 25-44 1-24 31 Total N England 507 365 98 21 12 11 38 S. Atlantic

1,039

645 256 83 32 23 73 ston, MA 163 111 30 11

3
8 11
Atlanta, GA
116 64 34 12 4

2 geport, CT

28 21

6

1
6 Baltimore, MD

148 79 43 16 6 4 16 nbridge, MA

13 11
2
2. Charlotte, NC

110 76 20

8 2 4 I River, MA

26 21
5

1
Jacksonville, FL

90 34

6 1 2 6 tford, CT

40 28

6
2.

2
Miami, FL
88 62 18

5 3

24 vell, MA

31 23

7
1
5 Norfolk, VA

39 24

8
5 1

1 12 10

1
1

Richmond, VA
53 34 15 3

1 2 N Bedford, MA 13 12 1

Savannah, GA
39 26 9 2 1

4 Haven, CT 36 19 14

1

1
St. Petersburg, FL
41 29 6

3 2 1 vidence, RI 33 23 6

2

4
Tampa, FL

158 97 43 11 5 2 7 nerville, MA

4
3
1

Washington, D.C.

107 58 26 11 7 5 ingfield, MA

35 24
7
2 Wilmington, DE

7
6

1 terbury, CT

25 22
3

3
rcester, MA
48 37 10

E.S. Central
1
1

689 440 170 46 18 15 61 Birmingham, AL

145 91

37
9 4

4 5 1. Atlantic 1,844 1,274 393 96 44 37

108 Chattanooga, TN

61 48 11

1

1 42 31

4
2 5 5 Knoxville, TN

80 48 18

8 4 2 5 intown, PA

16 10

3
3

1
Lexington, KY
35 19 9

4

3 1 falo, NY 59 39 12 4 3

Memphis, TN

124 84 26 10 2 2 12 nden, NJ 37 21 12

Mobile, AL
58 37 15

5 1

7 abeth, NJ

10
8
1
1
Montgomery, AL
58 38 14

4 2

8 41 25 10

3
Nashville, TN

128 75 40 5 5 3 15 sey City, NJ

14 10
4

3
York City, NY
943 673 206

W.S. Central 36 17 11 39

1,218 771 302 83 32 29 71 vark, NJ 47 17 13 9 1 7

Austin, TX

102 4.

57 33

8 2 2 10 erson, NJ

20 12
3

Baton Rouge, LA
1 2 2

56 1

23 25

3 5 adelphia, PA 255 153 70 16 11 5

Corpus Christi, TX

34

43
15

7
1

1 sburgh, PAS

24 15

7
2.

Dallas, TX
1

154 99 35 12 iding, PA

33 25
5

El Paso, TX
1

77 54
3

18
3

1 chester, NY 146 116 20 9

Fort Worth, TX

101 11

73 21

6

1 4 enectady, NY

10
7
3

Houston, TX

251 2

144 68 19 7 12 17 anton, PA

22 19

2
1

Little Rock, AR

77 1

53 19

1
1

3 1 acuse, NY 75 55 10

New Orleans, LAT 4

U U
4

U
U

U U nton, NJ

19

2
2.

San Antonio, TX

211 138 44 17 8 4 13
14
8
5
1

Shreveport, LA
72 47 16 7 1

1 7 kers, NY

17
16
1

Tulsa, OK
74 49 16

6 1

2 4 . Central

1,744
1,128 417 124 42 32

Mountain
126

829 549 196 43 26 14 52 on, OH 52 23 18 6 3

Albuquerque, NM 2 1

74 48 16

6
3

1 iton, OH 29 16 10

Boise, ID
3
2

16 11

4

1 ago, IL 229 133 69 18

5

27
Colorado Springs, CO 60 43 10

4 3

2 cinnati, OH 86 55 22

5 4

17
Denver, CO
71 40 23 2

1 7 Ieland, OH

207
146 38 13

Las Vegas, NV
6
4

208 150 51

5

2 13 umbus, OH 116 34 17 3 3 11

Ogden, UT

19 5

1
1

1 ton, OH 121 75 37 7

Phoenix, AZ
1
1 7

104 56 31

5 4 7 11 roit, MI 119 62 35 14 3

Pueblo, CO 5

31 22

6 1

2 1

4 nsville, IN 50 38 5 3 2

Salt Lake City, UT 2

114 71 24 1

13 4 2 8 Wayne, IN 72 54 12 3 1 2

Tucson, AZ 3

125 89 26

4 5 1 14 8 4 1 1

Pacific

1,321

284 61 33 20 119 nd Rapids, MI 44 30 7

4
1
2 5
Berkeley, CA

10
9
1

2 anapolis, IN 160 98 45 10 5

13
Fresno, CA
87 69 14

4
44 29 9 4 1 1

Glendale, CA
22 17 3

2
aukee, WI
84 57 18

7
1
1 5
Honolulu, HI
58 42 13

2

2 ria, IL 43 29 13

1

4
Long Beach, CA

53

13
4

3 8 kford, IL

61 45

8
4
2 2
Los Angeles, CA

200 127

42

9 17 5 21 th Bend, IN

42 34

4
2
1
1 1
Pasadena, CA

16
4

1 do, OH 62 39 19

2
1
1 8
Portland, OR
28 22

2

1 ngstown, OH

41 10

1
Sacramento, CA
175 120 46

7 1

1 16 Central 584 377 151 27 20

San Diego, CA 41

112 81 24

5 2

11 Moines, IA 105 79 24

San Francisco, CA
1
1
8

108 64 32 7 3 2 13 ith, MN

28 18
9

San Jose, CA
1
1

144 110 23

6 1

4 10 sas City, KS

14
7
4
3

Santa Cruz, CA

26
1

21
3
2

1 sas City, MO 85 59 17 5 2

Seattle, WA 2 8

114 73 28

4 4 5 6 oln, NE

33 18
10

56
4

Spokane, WA 1

46 1

9 1

4 neapolis, MN 50 26 17

1
4 2
Tacoma, WA

106
4

73 25 6

7 tha, NE 88 58 24

2 1 8
Total
9,775** 6,472 2,267

584

259 190 689 ouis, MO 94 53 28

5 2 5 aul, MN 39 27 11

1 2
hita, KS
48 32 7

4
4

1 3 navailable. -:No reported cases. ortality 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 currence and by the week that the death certificate was filed. Fetal deaths are not included. eumonia and influenza. cause 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.

cause of Hurricane Katrina, weekly reporting of deaths has been temporarily disrupted. e-tal includes unknown ages.

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The Morbidity and Mortality Weekly Report (MMWR) Series is prepared by the Centers for Disease Control and Prevention (CDC) and is available free of charg in electronic format. To receive an electronic copy each week, send an e-mail message to listserv@listserv.cdc.gov. The body content should read SUBscribe ripaus toc. Electronic copy also is available from CDC's Internet server at http://www.cdc.gov/mmwr or from CDC's file transfer protocol server at ftp://ftp.cdc.goviputa publications/mmwr. Paper copy subscriptions are available through the Superintendent of Documents, U.S. Government Printing Office, Washing 20402; telephone 202-512-1800. Data in the weekly MMWR are provisional, based on weekly reports to CDC by state health departments. The reporting week concludes at close of bus Friday; compiled data on a national basis are officially released to the public on the following Friday. Data are compiled in the National Center for Public Informatics, Division of Integrated Surveillance Systems and Services. Address all inquiries about the MMWR Series, including material to be consid publication, to Editor, MMWR Series, Mailstop E-90, CDC, 1600 Clifton Rd., N.E., Atlanta, GA 30333 or to mmwrg@cdc.gov. All material in the MMWR Series is in the public domain and may be used and reprinted without permission; citation as to source, however, is appreci Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.S. Department of Health and Human References to non-CDC sites on the Internet are provided as a service to MMWR readers and do not constitute or imply endorsement of these organiza) their programs by CDC or the U.S. Department of Health and Human Services. CDC is not responsible for the content of these sites. URL addresses! MMWR were current as of the date of publication.

ויויויויוייוייהו-חוויון-יוייוויו...ויויו-יו.

HU.S. Government Printing Office: 2008-723-026/41100 Region IV ISSN: 0149-2195

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ATLANTA, GA 30333
CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC)
DEPARTMENT OF HEALTH AND HUMAN SERVICES

Permit No. G-284

PHS/CDC
POSTAGE & FEES PAID

FIRST-CLASS MAIL

[merged small][merged small][graphic][subsumed][merged small][subsumed][subsumed][subsumed][subsumed][subsumed][merged small][merged small][merged small]

eastfeeding-Related Maternity Practices at Hospitals and Birth Centers

- United States, 2007 stfeeding provides optimal nutrition for infants and is birth centers in all states, the District of Columbia, and three ted with decreased risk for infant and maternal mor- U.S. territories. The survey was mailed to 3,143 hospitals and and mortality (1); however, only four states (Alaska, 138 birth centers with registered maternity beds, with the ina, Oregon, and Washington) have met all five (2) request that the survey be completed by the person most y People 2010 targets for breastfeeding (3).* Maternity knowledgeable of the facility's infant feeding and maternity es in hospitals and birth centers throughout the intra- practices. o period, such as ensuring mother-newborn skin-to-skin Questions regarding maternity practices were grouped into t, keeping mother and newborn together, and not giv- seven categories that served as subscales in the analyses: 1) -plemental feedings to breastfed newborns unless medi- labor and delivery, 2) breastfeeding assistance, 3) mother-newndicated, can influence breastfeeding behaviors during born contact, 4) newborn feeding practices, 5) breastfeeding d critical to successful establishment of lactation (4-9). support after discharge, 6) nurse/birth attendant breastfeeding 07, to characterize maternity practices related to training and education, and 7) structural and organizational eeding, CDC conducted the first national Maternity factors related to breastfeeding. The subscales were derived es in Infant Nutrition and Care (mPINC) Survey. This summarizes results of that survey, which indicated that $Labor and delivery = mother-newborn skin-to-skin contact and early bstantial proportion of facilities used maternity prac

breastfeeding initiation. Breastfeeding assistance = assessment, recording, and

instruction provided on infant feeding; not giving pacifiers to breastfed iat are not evidence-based and are known to interfere

newborns. Mother-newborn contact = avoidance of separation during postpartum reastfeeding and 2) states in the southern United States facility stay. Newborn feeding practices = what and how breastfed infants are fed ly had lower mPINC scores, including certain states

during facility stay. Breastfeeding support after discharge = types of support

provided after mothers and babies are discharged. Nurselbirth attendant usly determined to have the lowest 6-month

breastfeeding training and education = quantity of training and education that eeding rates. These results highlight the need for U.S. nurses and birth attendants receive. Structural and organizational factors related als and birth centers to implement changes in

to breastfeeding = 1) facility breastfeeding policies and how they are

communicated to staff, 2) support for breastfeeding employees, 3) facility not ity practices that support breastfeeding.

receiving free infant formula, 4) prenatal breastfeeding education, and 5) 007, in collaboration with Battelle Centers for Public coordination of lactation care. Research and Evaluation, CDC conducted the mPINC

INSIDE to characterize intrapartum practices in hospitals and

625 Escherichia coli 0157:H7 Infections in Children Associated

with Raw Milk and Raw Colostrum From Cows — eding objectives are increases in the proportions of mothers who :d their babies to meet the following targets: 75% in the early postpartum

California, 2006 16-19a), 50% at 6 months (16-19b), 25% at 1 year (16-190), 40% 628 Cutaneous Anthrax Associated with Drum Making lusively breastfeed for 3 months (16-19d), and 17% who exclusively

Using Goat Hides from West Africa — Connecticut, 2007 d for 6 months (16-19e). Objectives 16-190 and 16-19e were revised

631 Electronic Record Linkage to Identify Deaths Among : midcourse review. Additional information is available at ftp://ftp.cdc. /health_statistics/nchs/datasets/data2010/focusarea16/01619d.pdf and

Persons with AIDS — District of Columbia, 2000-2005 .cdc.gov/pub/health_statistics/nchs/datasets/data2010/focusarea 16/ 634 Notice to Readers pdf.

635 QuickStats • at http://www.cdc.gov/breastfeeding/data/nis_data/data_2004.htm.

DEPARTMENT OF HEALTH AND HUMAN SERVICES
CENTERS FOR DISEASE CONTROL AND PREVENTION

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

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Director, National Center for Health Marketing

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Deputy Director, National Center for Health Marketing
Editorial and Production Staff

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Editor, MMWR Series

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(Acting) Managing Editor, MMWR Series

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Writers-Editors

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Visual Information Specialists
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Information Technology Specialists

from literature reviews and consultation with breastfe experts. Researchers assigned scores to facility responses 0–100 scale, with 100 representing a practice most favor toward breastfeeding. Mean scores were calculated for a subscale, generally excluding questions that were unansws or answered “not sure” or “not applicable.” Mean subso and mean total scores for each state were calculared as average of scores from all facilities in the state; mean to scores were rounded to the nearest whole number. U.S.com were calculated as the mean scores for all participating faci ties. A subscale score was not calculated if more than hart response data were missing, and mean total scores were calculated if more than half the subscale scores were mise

Responses were received from 2,690 (82%) facilities: het ever, data from three respondent facilities in Guam and U.S. Virgin Islands were excluded from this analysis beurt of disclosure concerns, resulting in a sample size of 26 facilities (2,546 hospitals and 121 birth centers) in the states, the District of Columbia, and Puerto Rico." I response rate among birth centers (88%) was higher than among hospitals (82%).

Among states, mean total scores ranged from 48 in Arka sas to 81 in New Hampshire and Vermont (Table 1, 2 regional variation was evident (Figure). Mean total scores ge erally were higher in the western and northeastern regions the United States and lower in the southern region. Men total scores among facilities did not differ by annual numb of births, but were higher among birth centers (86 out of 10 compared with hospitals (62) (Table 2).

Among the seven subscales, the highest mean score di was for breastfeeding assistance (i.e., assessment, recording and instruction provided on infant feeding). Within d subscale, 99% of facilities had documented the feeding del sions of the majority of mothers in facility records, and of facilities had taught the majority of mothers techniek related to breastfeeding. However, 65% of facilities acii women to limit the duration of suckling at each breastfeedin and 45% reported giving pacifiers to more than half st healthy, full-term breastfed infants, practices that are supportive of breastfeeding (7).

The lowest score (40) was for breastfeeding support discharge. For this subscale, 70% of facilities report providing discharge packs containing infant formula suma to breastfeeding mothers, a practice not supportive breastfeeding (8). Although 95% of facilities reported

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

Additional information regarding survey questions and scoring is avail

http://www.cdc.gov/mpinc. ** In describing the results of this study, the District of Columbia and

Rico are referred to as states.

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