Page images
PDF
EPUB

Spinal Cord Injury - Continued

year (3). Lost earnings associated with SCI are estimated to be $3.4 billion (in 1987 dollars) annually (Department of Rehabilitation Medicine, University of Alabama/ Birmingham, unpublished data).

Surveillance is needed to better define the national incidence of acute traumatic SCI, to identify high-risk groups in order to target prevention strategies, and to determine etiologies so that prevention programs can be developed. The data presently collected by SCI registries may be useful in targeting high-risk groups and determining etiologies. However, case definitions, reporting sources, and level of information collected vary among registries.

CDC is working with CSTE and other interested groups to 1) review existing surveillance systems and registries for acute traumatic SCI, 2) determine the information needs of public health and clinical practice, 3) develop a workable case definition, 4) determine the information to be collected, and 5) identify reporting sources. SCI is one of the disabilities targeted for support by CDC's disabilities prevention program. This program will provide state and local agencies with funding to prevent primary and secondary disabilities such as those caused by acute traumatic SCIS.

The public health benefit of registries at the local level can be realized only if the information collected is useful to those planning intervention strategies. The implementation of these strategies may involve the participation of many agencies within the state or local government, along with private interest groups. Registries will be useful at the national level only if a standard case definition is used and if information is collected, analyzed, and interpreted consistently and systematically.

References

1. Kraus JF. Epidemiological aspects of acute spinal cord injury: a review of incidence, prevalence, causes, and outcome. In: Becker DP, Povlishock JT, eds. Central nervous system trauma status report-1985. Bethesda, Maryland: National Institute of Neurological and Communicative Disorders and Stroke, National Institutes of Health, 1985:313-22.

2. DeVivo MJ, Fine PR, Maetz HM, Stover SL. Prevalence of spinal cord injury: a reestimation employing life table techniques. Arch Neurol 1980;37:707-8.

3. Ergas Z. Spinal cord injury in the United States: a statistical update. Cent Nerv Syst Trauma 1985;2:31-2.

Update: Acquired Immunodeficiency Syndrome (AIDS)

Worldwide

As of March 21, 1988, 136 countries or territories throughout the world had reported a total of 84,256 cases of acquired immunodeficiency syndrome (AIDS) to the Global Programme on AIDS (GPA) (formerly the Special Programme on AIDS) of the World Health Organization (WHO) (Table 1).* Thirty-seven countries or territories had reported no AIDS cases. Reports are based on either the CDC/WHO surveillance definition (1,2), the WHO clinical definition (3), or a physician's diagnosis. From 1979 through March 21, 1988, the number of AIDS cases increased markedly in all geographic regions (Figure 1). The cumulative world total increased from 11,965 in 1984 to 25,150 in 1985 (a 110% increase) and to 48,413 in 1986 (a 92% increase). Because of reporting lags, the global total of AIDS cases reported for 1987 is not yet complete; however, as of March 21, 1988, 34,913 cases had been reported for 1987 *Because of varying reporting practices, AIDS case data are not available for all countries for the same time period.

[blocks in formation]

(a 72% increase). Data on the distribution of AIDS cases by region are presented below, followed by a discussion of the findings. Americas

Forty-two countries in the Americas have reported 73% of the world total of AIDS cases. As of March 21, 1988, the United States had reported a total of 54,233 cases. The case count in Brazil was 2,325; the number had increased from 801 at the end of June 1986 to 1,695 at the end of June 1987. Canada has reported a total of 1,517 cases. The following additional countries reported over 100 cases: Haiti (912), Mexico (713), Dominican Republic (352), Trinidad and Tobago (206), Bahamas (163), Colombia (153), Argentina (120), and Venezuela (101).

Europe

Twenty-eight countries in Europe have reported 13% of the world's total AIDS cases. Between December 1986 and December 1987, the number of cases reported from Europe to the WHO Collaborating Centre on AIDS (4) in Paris, France, increased by 124%. The greatest number of cases has been reported from France (3,073), the Federal Republic of Germany (1,669), Italy (1,411), the United Kingdom (1,227), TABLE 1. AIDS cases reported to the World Health Organization (WHO), by continent, 1979 - March 21, 1988

[blocks in formation]

FIGURE 1. Total AIDS cases reported to the World Health Organization, 1979 March 21, 1988

[blocks in formation]
[blocks in formation]

and Spain (789). The highest rates per population size are in France, Switzerland, and Denmark. Four countries with over 100 cases (Austria, France, Italy, and Spain) reported increases of more than 100% between December 1986 and December 1987. The lowest rates were reported from the Eastern European countries.

Ninety-two percent of patients reported from Europe were European; 4% were African; 1% were from the Caribbean; and 3% were from other countries (4). The relative percentage of patients who have been reported from Europe but whose country of origin is Africa has been decreasing over the past 2 years.

The age distribution of patients in Europe (Table 2, see page 293) is similar to that in the United States except that Europe has a higher percentage of patients under 19 years of age (3% compared with 2%). Europe has a lower percentage of adult patients in the homosexual and homosexual/intravenous-drug-user transmission categories *Such patients accounted for 12% of cases reported for Europe in June 1985, 6% in June 1986, and 4% in December 1987.

[blocks in formation]

TABLE II. Notifiable diseases of low frequency, United States

[blocks in formation]

*Because AIDS cases are not received weekly from all reporting areas, comparison of weekly figures may be misleading. 'One of the 142 reported cases for this week was imported from a foreign country or can be directly traceable to a known internationally imported case within two generations.

TABLE III. Cases of specified notifiable diseases, United States, weeks ending
May 7, 1988 and May 9, 1987 (18th Week)

[merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][ocr errors][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][ocr errors][subsumed][merged small][merged small][merged small][subsumed][merged small][merged small][merged small][subsumed][merged small][merged small][merged small][merged small][merged small][merged small][subsumed][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][subsumed][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][ocr errors][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][ocr errors][merged small][merged small][merged small][merged small][merged small][merged small][subsumed][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][ocr errors][merged small][merged small][subsumed][merged small][subsumed][merged small][merged small][subsumed][merged small][subsumed][merged small][subsumed][merged small][merged small][subsumed][merged small][merged small][subsumed][merged small][merged small][merged small][subsumed][merged small][merged small][merged small][merged small][subsumed][merged small][subsumed][merged small][subsumed][merged small][subsumed][merged small][merged small][subsumed][merged small][subsumed][merged small][merged small][subsumed][merged small][subsumed][merged small][subsumed][merged small][subsumed][merged small][merged small][merged small][subsumed][merged small][merged small][merged small][merged small][subsumed][merged small][merged small][subsumed][merged small][subsumed][merged small][subsumed][merged small][merged small][merged small][subsumed][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][ocr errors][subsumed][merged small][merged small][merged small][merged small][merged small][subsumed][merged small][merged small][merged small][merged small][merged small][merged small][subsumed][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][ocr errors][subsumed][subsumed][ocr errors][merged small][merged small][subsumed][merged small][merged small][subsumed][subsumed][subsumed][subsumed][subsumed][merged small][merged small][subsumed][merged small][subsumed][subsumed][merged small][merged small][subsumed][subsumed][merged small][subsumed][merged small][subsumed][subsumed][merged small][ocr errors][merged small][ocr errors][merged small][merged small][merged small][subsumed][merged small][subsumed][subsumed][subsumed][subsumed][merged small][merged small][merged small][merged small][merged small][subsumed][subsumed][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][ocr errors][merged small][merged small][subsumed][merged small][subsumed][merged small][subsumed][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][subsumed][merged small][merged small][merged small][ocr errors][merged small][merged small][subsumed][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][ocr errors][merged small][merged small][merged small][merged small][merged small][merged small][merged small]

TABLE III. (Cont'd.) Cases of specified notifiable diseases, United States, weeks ending May 7, 1988 and May 9, 1987 (18th Week)

[merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][ocr errors][merged small][merged small][subsumed][merged small][merged small][subsumed][subsumed][ocr errors][subsumed][merged small][merged small][subsumed][merged small][merged small][merged small][merged small][ocr errors][merged small][subsumed][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][ocr errors][subsumed][subsumed][subsumed][ocr errors][subsumed][subsumed][subsumed][merged small][subsumed][subsumed][subsumed][subsumed][merged small][subsumed][subsumed][subsumed][subsumed][merged small][subsumed][merged small][subsumed][subsumed][subsumed][merged small][merged small][merged small][subsumed][merged small][subsumed][merged small][ocr errors][merged small][merged small][subsumed][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][subsumed][subsumed][ocr errors][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][ocr errors][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][subsumed][subsumed][subsumed][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][subsumed][merged small][subsumed][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][ocr errors][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][ocr errors][merged small][subsumed][subsumed][merged small][merged small][subsumed][merged small][merged small][subsumed][ocr errors][ocr errors][ocr errors][merged small][merged small][merged small][merged small][merged small][ocr errors][ocr errors][subsumed][subsumed][subsumed][merged small][subsumed][subsumed][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][ocr errors][merged small][ocr errors][subsumed][merged small][subsumed][merged small][subsumed][merged small][subsumed][merged small][merged small][merged small][merged small][merged small][merged small][subsumed][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][subsumed][merged small][subsumed][merged small][merged small][merged small][subsumed][merged small][subsumed][merged small][subsumed][merged small][merged small][subsumed][merged small][merged small][merged small][merged small][merged small][subsumed][merged small][subsumed][merged small][subsumed][merged small][merged small][subsumed][merged small][subsumed][merged small][merged small][subsumed][merged small][subsumed][subsumed][merged small][subsumed][subsumed][merged small][merged small][subsumed][subsumed][subsumed][ocr errors][subsumed][merged small][merged small][subsumed][subsumed][merged small][merged small][subsumed][merged small][subsumed][merged small][subsumed][subsumed][merged small][merged small][merged small][merged small][subsumed][merged small][ocr errors][merged small][merged small][subsumed][subsumed][merged small][merged small][merged small][subsumed][subsumed][merged small][merged small][subsumed][subsumed][merged small][subsumed][subsumed][subsumed][subsumed][subsumed][subsumed][ocr errors][subsumed][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][subsumed][merged small][merged small][subsumed][merged small][subsumed][merged small][merged small][merged small][subsumed][merged small][merged small][subsumed][merged small][merged small][subsumed][merged small][merged small][subsumed][merged small][merged small][subsumed][merged small][merged small][subsumed][subsumed][merged small][merged small][subsumed][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small]

*For measles only, imported cases includes both out-of-state and international importations. N: Not notifiable U: Unavailable *International Out-of-state

« PreviousContinue »