MMWR

Morbidity and Mortality Weekly Report

Racial Disparities in Total Knee Replacements Among Medicare Enrollees a€“ United States, 2000-2006

PRESS CONTACT: CDC
Division of Media Relations
(404) 639-3286

This study suggests that racial disparities in total knee replacements are unchanged. Blacks with disabling knee osteoarthritis continue to lag in use of an important intervention for reducing pain and disability. This disparity may be reduced by disseminating culturally sensitive information about total knee replacements (TKR) in a variety of public settings, encouraging health care providers to initiate discussions about knee pain symptoms and loss of physical function with all older adult patients, and equipping health care providers with resources that enable them to have discussions that are thorough and tailored to the needs and concerns of their patients. A substantial increase in TKR occurred from 2000 to 2006, with a large disparity in knee replacements seen among black and white Medicare enrollees 65 years and older. Overall, total knee replacements increased by 58 percent between 2000 and 2006, with rates increasing 61 percent among whites and 56 percent among blacks. However, the rate for total knee replacement among blacks was 39 percent lower than for whites in 2006. The rate of total knee replacements varied widely in states among blacks and whites with the lowest differences occurring in D.C., Massachusetts and Delaware and the widest gaps occurring in Illinois and Pennsylvania. Despite the increase total knee replacement, historically whites have been more likely to undergo this procedure than blacks

Clostridium perfringens Food Poisoning Among Inmates in a County Jail a€“ Wisconsin, August 2008

PRESS CONTACT: CDC
Division of Media Relations
(404) 639-3286

To prevent foodborne illness in institutional settings prepared foods should not include reused meats or other food items that are cooked or served with meats from previous meals unless stringent food hygiene, preparation, and storage procedures are followed. On August 8, 2008 a Wisconsin county jail nurse informed local health department staff reported over 100 inmates reported experiencing nausea, vomiting and diarrhea over night. This report summarizes findings of the ensuing foodborne outbreak investigation conducted by the Wisconsin Division of Public Health and local health department staff. The illnesses were caused by eating casserole served during the evening meal on August 7, and made in part with foods from previous meals that contained macaroni, ground beef, and ground turkey (RR = 25.1). Clostridium perfringens was isolated from a leftover sample of casserole; enterotoxin was detected in stool samples obtained on August 8 from 6 ill inmates. An environmental investigation determined the casserole was made with food items that were prepared and stored improperly.