Influenza surveillance -- United States, 1992-93 and 1993-94; Surveillance for silicosis, 1993 -- Illinois, Michigan, New Jersey, North Carolina, Ohio, Texas, and Wisconsin
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Influenza surveillance -- United States, 1992-93 and 1993-94; Surveillance for silicosis, 1993 -- Illinois, Michigan, New Jersey, North Carolina, Ohio, Texas, and Wisconsin

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    Influenza surveillance -- United States, 1992-93 and 1993-94;Surveillance for silicosis, 1993 -- Illinois, Michigan, New Jersey, North Carolina, Ohio, Texas, and Wisconsin;Silicosis surveillance -- Illinois, Michigan, New Jersey, North Carolina, Ohio, Texas, and Wisconsin, 1993;
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    Influenza surveillance -- United States, 1992-93 and 1993-94: "PROBLEM/CONDITION: CDC conducts active surveillance annually from October through May on the emergence and spread of influenza virus variants and the impact of influenza-related morbidity and mortality. Influenza activity is also monitored throughout the year by passive surveillance. REPORTING PERIOD COVERED: This report summarizes U.S. influenza surveillance from October 1992 through May 1994. DESCRIPTION OF SYSTEM: Influenza surveillance comprises four components, three of which provide weekly data from October through May: a) state and territorial epidemiologists provide estimates of local influenza activity; b) approximately 140 sentinel physicians report their total number of patient visits and the number of cases of influenza-like illness; and c) approximately 70 collaborating laboratories of the World Health Organization (WHO) report weekly influenza virus isolations and submit selected influenza isolates to CDC for antigenic analysis. Throughout the year, vital statistics offices of 121 cities report deaths related to pneumonia and influenza (P&I), providing an index of the impact of influenza on mortality. RESULTS: Influenza B viruses predominated during the 1992-93 influenza season, but influenza A(H3N2) isolates increased and were associated with outbreaks in nursing homes at the end of the season. The increase in influenza A(H3N2) activity was associated with a rise in P&I-related mortality. Preseason outbreaks of influenza A(H3N2) virus were reported during August and September 1993 in Louisiana. In the past, preseason outbreaks of influenza have been associated with earlier than usual epidemic-level activity. During the 1993-94 influenza season, activity rose during November and December and peaked earlier than usual, during the last week of December and the first week of January; influenza A(H3N2) viruses predominated. INTERPRETATION: The change in predominance from influenza B to influenza A in the spring of 1993 emphasizes the importance of annual influenza surveillance. Although influenza vaccine is effective against both influenza A and B, the antiviral drugs amantadine and rimantadine are effective only against influenza A. Outbreaks during the summer of 1993 emphasize that influenza should be considered a possible cause of respiratory infections during summer and early autumn. ACTIONS TAKEN: Surveillance data were provided weekly throughout the influenza season to public health officials, WHO, and health-care providers" - p. 1

    Surveillance for silicosis, 1993 -- Illinois, Michigan, New Jersey, North Carolina, Ohio, Texas, and Wisconsin "PROBLEM/CONDITION: Silicosis is an occupational respiratory disease caused by the inhalation of respirable dust containing crystalline silica. Public health surveillance programs to identify workers at risk for silicosis and target workplace-specific and other prevention efforts are currently being field-tested in seven U.S. states. REPORTING PERIOD COVERED: Confirmed cases ascertained by state health departments during the period January 1, 1993, through December 31, 1993; the cases and associated workplaces were followed through December 1994. DESCRIPTION OF SYSTEMS: As part of the Sentinel Event Notification System for Occupational Risks (SENSOR) program initiated by CDC's National Institute for Occupational Safety and Health (NIOSH), development of state-based surveillance and intervention programs for silicosis was initiated in 1987 in Michigan, New Jersey, Ohio, and Wisconsin and in 1992 in Illinois, North Carolina, and Texas. RESULTS: From January 1, 1993, through December 2, 1994, the SENSOR silicosis programs in Illinois, Michigan, New Jersey, North Carolina, Ohio, Texas, and Wisconsin confirmed 256 cases of silicosis that were initially ascertained in 1993. Overall, 185 (72%) were initially identified through review of hospital discharge data or through hospital reports of silicosis diagnoses; 188 (73%) were associated with silica exposure in manufacturing industries (e.g., foundries; stone, clay, glass, and concrete manufacturers; and industrial and commercial machinery manufacture). Overall, 42 (16%) cases were associated with silica exposure from sandblasting operations. Among the 193 confirmed cases for which information was available about duration of employment in jobs with potential exposure to silica, 37 (19%) were employed < or = 10 years in such jobs and 156 (81%) were employed > or = 11 years. A total of 192 primary workplaces associated with potentially hazardous silica exposures were identified for the 256 confirmed silicosis cases. Of these, nine (5%) workplaces were inspected by state health department (SHD) industrial hygienists, 19 (10%) were referred to the Occupational Safety and Health Administration (OSHA) for follow-up, and seven (4%) were routinely monitored by the Mine Safety and Health Administration. Of the 157 (82%) remaining workplaces, follow-up activities determined that 82 were no longer in operation, eight were no longer using silica, 18 were assigned a lower priority for follow-up, six were associated with building trades and could not be inspected because of the transient nature of work in the construction industry, and 43 workplaces were not inspected for other reasons. Fourteen (7%) of the 192 workplaces were inspected. At 10 of the 14 workplaces, airborne levels of crystalline silica were measured; in nine, silica levels exceeded the NIOSH-recommended exposure level of 0.05 mg/m, and in six, airborne silica levels also exceeded federal permissible exposure limits. ACTIONS TAKEN: Employee-specific and other preventive interventions have been initiated in response to reported cases. In addition, special silicosis prevention projects have been initiated in Michigan, New Jersey, North Carolina, Ohio, Texas, and Wisconsin. To facilitate the implementation of silicosis surveillance by other states, efforts are ongoing to identify and standardize core data needed by surveillance programs to describe cases and the workplaces where exposure occurred. These core variables will be incorporated into a user-friendly software system that states can use for data collection and reporting." - p. 13

    Includes bibliographical references (p. 11-12 and p. 27-28).

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