Paralytic Poliomyelitis - Continued estimated 210 children who were 12-35 months of age as of May 1986. Results indicated that 26% to 28% of the children in that age group had received two doses of N-IPV as of May 1986. Reported by: Direction de l'Hygiène a la Promotion Sanitaire, Ministry of Health, Senegal. Association pour la Promotion de la Médicine Préventive, Paris, France. Task Force for Child Survival, Atlanta, Georgia. Div of Immunization, Center for Prevention Svcs; Div of Field Svcs, Epidemiology Program Office; International Health Program Office, CDC. Editorial Note: The results obtained during Phase II of this study based on certified cases of poliomyelitis in the Kolda Region indicate that two doses of N-IPV were approximately 89% effective in preventing paralytic poliomyelitis with residual paralysis. This estimate is compatible with previous serological reports. One dose of N-IPV did not confer effective protection. Although none of the cases in the Kolda Region were confirmed by viral isolation, all were most probably due to type 1 poliovirus, which was documented as the overall cause of the outbreak in both Senegal and The Gambia. The higher efficacy obtained during Phase II as compared with Phase I probably reflects the more specific case definition used, especially the requirement for certification of the diagnosis by experts. FIGURE 1. Certified cases of poliomyelitis with residual paralysis, by month of onset - Kolda Region, Senegal, April 1986-February 1987 TABLE 1. Vaccination status of patients and controls in a case-control study - Kolda Region, Senegal, 1986-1987 Paralytic Poliomyelitis - Continued The low level of polio vaccine coverage in the Kolda Region failed to prevent this outbreak of paralytic poliomyelitis. References 1. Salk J, Stoeckel P, van Wezel AL, Lapinleimu K, van Steenis G. Antigen content of inactivated poliovirus vaccine for use in a one- or two-dose regimen. Ann Clin Res 1982;14:204-12. 2. Stoeckel P, Schlumberger M, Parent G, et al. Use of killed poliovirus vaccine in a routine immunization program in West Africa. Rev Infect Dis 1984;6(suppl 2):S463-6. 3. Drucker J, Soula G, Diallo O, Fabre P. Evaluation of a new combined inactivated DPT-polio vaccine. Dev Biol Stand 1986;65:145-51. 4. Simoes EAF, Padmini B, Steinhoff MC, Jadhav M, John TJ. Antibody response of infants to two doses of inactivated poliovirus vaccine of enhanced potency. Am J Dis Child 1985; 139:977-80. 5. Centers for Disease Control. Preliminary report: paralytic poliomyelitis-Senegal, 1986. MMWR 1987;36:387-90. 6. Breslow NE, Day NE. Statistical methods in cancer research. Vol. 1. The analysis of case-control studies. Lyon, France: International Agency for Research on Cancer, 1980. (IARC scientific publication no. 32). 7. Orenstein WA, Bernier RH, Dondero TJ, et al. Field evaluation of vaccine efficacy. Bull WHO 1985;63:1055-68. 8. Henderson RH, Sundaresan T. Cluster sampling to assess immunization coverage: a review of experience with a simplified sampling method. Bull WHO 1982;60:253-60. FIGURE I. Reported measles cases United States, Weeks 12-15, 1988 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. 203 Perspectives in Disease Prevention and Health Promotion Understanding AIDS: An Information Brochure Approximately 107 million English-language versions of a brochure, "Understanding AIDS," will be distributed to every home and residential post office box by the U.S. Postal Service between May 26 and June 30, 1988. A Spanish-language version will be distributed in Puerto Rico and will also be available upon request after May 26, 1988. This national mailing marks the first time the federal government has attempted to contact virtually every resident, directly by mail, regarding a major public health problem. The brochure is reproduced in its entirety beginning on page 262. The brochure was prepared by CDC in consultation with the Surgeon General and a wide spectrum of public health officials, medical experts, advertising consultants, and members of the general public. Every effort was made to make the presentation simple, direct, and understandable to the widest possible audience. The purpose of the mailer is to provide understandable information and to encourage safe behaviors that can prevent HIV infection. The mailing has three objectives: To make it clear how AIDS is and is not transmitted. People can protect themselves without having unnecessary fears. • To make it clear that behaviors, not identification with "risk groups," put people at risk. As the brochure states, "who you are has nothing to do with whether you are in danger of being infected with the AIDS virus. What matters is what you do." • To stimulate informed discussions about AIDS within families, between sexual partners, and at all levels of society by presenting the facts and showing people how AIDS relates to their own lives. CDC has established a major effort to ensure that as many people as possible read and discuss this mailing. Major steps, including contacts with state health departments and manufacturers of AIDS testing kits, have been taken to handle the increased requests for information and testing that this brochure may genblate. CDC will add up to 1,000 operators to the National AIDS Information Line (hotline) (1-800-342-AIDS) to handle the 1.5 million new calls anticipated during the mailing period. At present, the hotline is handling 120,000 calls per month as a result of the "America Responds to AIDS" public information campcuments Center U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES/PUBLIC HEALTH SERVICE AIDS Continued Hotline callers wishing to talk with a counselor or requesting information about local counseling and testing will be referred to local hotline numbers or, if none exist, will be served by counselors who staff the National AIDS Information Line. More than 300 Spanish-speaking operators will be available to answer a toll-free hotline (1-800-344-SIDA) to take orders for Spanish-language copies of the brochure. Requests for copies of the brochure in English or Spanish will be filled by the CDC National AIDS Clearinghouse. To measure the impact of this brochure, CDC will use data gathered through the AIDS Knowledge and Attitudes supplement of the National Health Interview Survey (NHIS). This survey is conducted through interviews with a probability sample of American households by the Bureau of the Census for the National Center for Health Statistics. CDC will also monitor other indicators that may reflect public response to the brochure, such as calls to the national hotline and AIDS clearinghouse, requests for information to health-care providers, and media presentations of AIDS information. In spite of all these efforts, there are things the brochure will not do. It will not reach people who cannot read or who read only languages other than English or Spanish. It may not reach the homeless or drug abusers, who need intensive outreach efforts. CDC is working with state and local health departments to target ongoing educational efforts for the hard-to-reach. One million advance copies of the brochure are being sent to doctors, nurses, dentists, pharmacists, hospitals, and public health officials so that they can be prepared to answer questions from their patients and clients. T Understanding A Message From The Surgeon General his brochure has been sent to you by the Government of the I feel it is important that you have the best information now available for fighting the AIDS virus, a health problem that the Stopping AIDS is up to you, your family and your loved ones. Some of the issues involved in this brochure may not be things you are used to discussing openly. I can easily understand that. But now you must and community groups offer AIDS education activities. I encourage you to practice responsible behavior based on understanding and strong personal values. This is what you can do to stop AIDS. Cheery C. Everett Koop, M.D., Sc.D. Surgeon General |