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Hemorrhagic Fever Continued 12. Dournon E, Girard P, Moriniere B, Brion N. (Hemorrhagic fever with renal syndrome.

Epidemiologic data (Letter).) Presse Med 1985;14:1101. 13. Antoniadis A, Pyrpasopoulos M, Sion M, Daniel S, Peters CJ. Two cases of hemorrhagic

fever with renal syndrome in Northern Greece. J Infect Dis 1984;149:1011-3.

Perspectives in Disease Prevention and Health Promotion

Injuries and Amputations Resulting
From Work With Mechanical Power Presses

On May 22, 1987, the National Institute for Occupational Safety and Health, CDC, released Current Intelligence Bulletin #49: Injuries and Amputations Resulting from Work with Mechanical Power Presses. This publication is one of a series of bulletins providing new information or updating existing data on chemical substances, physical agents, or safety hazards found in the workplace. A summary of the document, which is now available to the public, * follows.

In 1980, there were an estimated 151,000 operators of mechanical power presses in the United States. The existing standard promulgated by the Occupational Safety and Health Administration (OSHA) for mechanical power presses provides requirements for press construction and operation (1). However, power press operators continue to be at risk of injury. Data from the U.S. Bureau of Labor Statistics indicate that about 20,000 amputations occur each year. Approximately 10% (1,600-2,000) of these amputations occur among power press operators (2). In addition, recent statistics compiled by OSHA indicate that approximately 49% of the injuries caused by mechanical power presses result in amputations (U.S. Department of Labor, Occupational Safety and Health Administration, unpublished data). Furthermore, an analysis of data on injury frequency and severity, operator hand speeds, payment of compensation, and the extent of worker exposure indicates that young male operators are at greater risk than other operators and that mechanical power presses are the metalworking machines most in need of research to improve safety. Current Intelligence Bulletin #49 provides recommendations for the safe use of mechanical power presses, specifically those operated by foot or dual palm-button controls. Adherence to these recommendations should reduce the risk of injury among mechanical power press operators. Reported by: Div of Standards Development and Technology Transfer, National Institute for Occupational Safety and Health, CDC. References 1. Office of the Federal Register. Code of federal regulations: labor. Washington, DC: Office of

the Federal Register, National Archives and Records Administration, 1986. (29 CFR 1910. 217). 2. Bureau of Labor Statistics. Work-related hand injuries and upper extremity amputations.

Washington, DC: US Department of Labor, Bureau of Labor Statistics, 1983. (Bulletin no. 2160).

*Copies of Current Intelligence Bulletin #49 can be obtained without charge from the Publications Dissemination Section, Division of Standards Development and Technology Transfer, National Institute for Occupational Safety and Health, 4676 Columbia Parkway, Cincinnati, Ohio 45226; telephone, (513) 841-4287.

Epidemiologic Notes and Reports

Influenza Update

United States

The following are indicators of influenza activity in the United States for the weeks ending January 23 and 30 and February 6 and 13. Figures are provisional and may change as additional reports are received for the given weeks.

Report Week Ending

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Influenza-associated morbidity levels reported
by state and territorial epidemiologists

Number of states reporting sporadic activity* 29 31 24
Number of states reporting regional activity 10

21 Number of states reporting widespread activity 2


5 Reports from sentinel physicians

Patients seen with influenza-like illness,

expressed as percentage of total patient visits 4.3 6.1 6.0 5.2
Sentinel physicians reporting outbreaks,
expressed as percentage of total number of
reports received for week


39 39 Pneumonia and influenza (P&I) mortality from 121 U.S. cities**

Percentage P&l deaths, upper limit of epidemic threshold

6.1 6.1 6.1 6.1 Percentage P&l deaths, observed value

5.8 5.8 6.0 5.9 Isolates reported by WHO Collaborating Laboratories and other laboratories Cumulative number of states reporting isolates of influenza A(H3N2)**

23 26

38 Cumulative number of states reporting isolates of influenza A(H1N1)

O 0


3 Cumulative number of states reporting isolates of influenza B


6 9 12 *Sporadically occurring cases, no known outbreaks. *Outbreaks in counties in which total population comprises less than 50% of total state population. *Outbreaks in counties in which total population comprises 50% or more of total state population. "Members of the American Academy of Family Physicians who submit weekly influenza surveillance reports based on their patient population. *All deaths for which pneumonia or influenza is listed as a primary or underlying cause on death certificates. The epidemic threshold was calculated as 1.645 standard deviations above projected values using a periodic regression model applied to observed P&l deaths for the preceding 5-year period, excluding observations during influenza outbreaks. **Additional states reporting isolates of influenza A(H3N2) to date: Alaska, Illinois, Indiana, Maryland, Nebraska, and Pennsylvania. SsStates reporting isolates of influenza A(H1N1) to date: Arkansas, New York, Texas. "States reporting isolates of influenza B to date: Arizona, California, Hawaii, Michigan, Montana, Nevada, New York, Ohio, Tennessee, Virginia, Washington, and Wisconsin.


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The Morbidity and Mortality Weekly Report is prepared by the Centers for Disease Control, Atlanta, Georgia, and available on a paid subscription basis from the Superintendent of Documents, U.S. Government Printing Office, Washington, D.C. 20402, (202) 783-3238.

The data in this report are provisional, based on weekly reports to CDC by state health departments. The reporting week concludes at close of business on Friday; compiled data on a national basis are officially released to the public on the succeeding Friday. The editor welcomes accounts of interesting cases, outbreaks, environmental hazards, or other public health problems of current interest to health officials. Such reports and any other matters pertaining to editorial or other textual considerations should be addressed to: Editor, Morbidity and Mortality Weekly Report, Centers for Disease Control, Atlanta, Georgia 30333. Director, Centers for Disease Control

Editor James O. Mason, M.D., Dr.P.H.

Michael B. Gregg, M.D. Director, Epidemiology Program Office

Managing Editor Carl W. Tyler, Jr., M.D.

Gwendolyn A. Ingraham

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