Synopsis for January 24, 2003

The MMWR is embargoed until 12 Noon ET, Thursdays.

1. Norovirus Activity -- United States, 2002
2. Deaths Among Drivers of Off-Road Vehicles After Collisions with Trail Gates -- New Hampshire, 1997-2002
3. Human Rabies -- Iowa, 2002

MMWR Recommendations and Reports
January 24, 2003/Vol.52/No. 1

Prevention and Control of Infections with Hepatitis Viruses in Correctional Settings
This report consolidates previous recommendations and adds new ones for the prevention and control of infections with hepatitis viruses in correctional settings. These recommendations provide guidelines for juvenile and adult correctional systems regarding 1) identification and investigation of acute viral hepatitis; 2) preexposure and postexposure immunization for hepatitis A and hepatitis B; 3) prevention of hepatitis C virus infection and its consequences; 4) health education; and 5) release planning. Implementation of these recommendations can reduce transmission of infections with hepatitis viruses among adults at risk in both correctional facilities and the outside community. This report can serve as a resource for correctional health, corrections and public health professionals involved in planning and implementing health care programs for incarcerated persons.

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MMWR Surveillance Summaries
January 24, 2003/Vol.52/No. 1

Surveillance for Safety After Immunization: Vaccine Adverse Event Reporting System (VAERS) -- United States, 1991?001
VAERS was established in 1990 under the joint administration of CDC and the Food and rug Administration (FDA) to accept reports of suspected adverse events after administration of any vaccine licensed in the United States. VAERS is a passive surveillance system: reports of events are voluntarily submitted by those who experience them, their caregivers, or others. During 1991?001, VAERS received 128,717 reports, whereas >1.9 billion net doses of human vaccines were distributed. Overall, the most commonly reported adverse event was fever, which appeared in 25.8% of all reports, followed by injection-site hypersensitivity (15.8 percent), rash (unspecified) (11.0 percent ), injection-site edema (10.8 percent), and vasodilatation (10.8 percent). A total of 14.2% of all reports described serious adverse events, which by regulatory definition include death, life- threatening illness, hospitalization or prolongation of hospitalization, or permanent disability.

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Synopsis for January 24, 2003

Norovirus Activity -- United States, 2002

CDC laboratory data indicate the possible emergence of a predominant, circulating norovirus (Norwalk-like) strain.

Noroviruses are the most common cause of gastroenteritis in the United States. Although many reports have focused on foodborne transmission, recent outbreaks on cruise ships and in institutional settings indicate the potential for large norovirus outbreaks not associated with foods. This report describes recent norovirus activity in two states and New York City. The cause of the increase in norovirus activity is unclear. Methods for preventing the spread of noroviruses include basic food and water hygiene methods, proper disposal of waste, and disinfection of potentially contaminated surfaces.

Deaths Among Drivers of Off-Road Vehicles After Collisions with Trail Gates -- New Hampshire, 1997-2002

Off-highway recreational vehicle users and those who maintain trails need to be aware of the hazards of trail gates.

During 1997-2002, the New Hampshire Department of Health five deaths (including four children) on New Hampshire trails when drivers of off-highway recreational vehicles (OHRV) collided with trail gates (horizontal steel pipes on posts 3 feet high) designed to keep cars off trails. Fatalities involving trail gates occurred most frequently in males who were < 17 years of age or intoxicated. A high proportion of the collisions at night occurred on OHRVs that did not have operating headlights. One death occurred on an all-terrain vehicle (ATV), two on motorbikes, and two on snowmobiles. The New Hampshire Fish and Game Department and the New Hampshire Department of Revenue and Economic Development抯 Bureau of Trails are working to increase trail safety and the visibility of trail gates. The state also offers a safety course on use of OHRVs.

Human Rabies -- Iowa, 2002

Nonbite-associated cases of rabies -- cases with no evidence or history of an animal bite -- constitute the largest category of human rabies cases in the United States.

In September 2002, a 20-year-old man, residing in Iowa, died from rabies. This is the first human case of rabies in that state since 1951. The source of the patient抯 infection remains unclear. Because the patient was a musician who had traveled to recording studios in several cities in Iowa and Illinois during the infectious stage of his illness, family member抯 permitted the public release of his name to the media. A total of 53 family members or associates of the patient were given rabies post-exposure prophylaxis (PEP). Additionally, 71 hospital staff members were also give PEP. This case represents the third report of human rabies during 2002.

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