Synopsis for February 20, 2004

The MMWR is embargoed until Thursday, 12 PM EST.

1. Disparities in Premature Deaths from Heart Disease — 50 States and the District of Columbia, 2001
2. Heterosexual Transmission of HIV ― 29 States, 1999-2002
3. Using the Internet for Partner Notification of Sexually Transmitted Diseases ― Los Angeles County, California, 2003
4. Fatal Case of Unsuspected Pertussis Diagnosed from a Blood Culture — Minnesota, 2003

Synopsis for February 20, 2004

Disparities in Premature Deaths from Heart Disease — 50 States and the District of Columbia, 2001

Premature deaths from heart disease are unnecessary and can be avoided by preventing and/or modifying the risk factors, which include high blood pressure, elevated serum cholesterol levels, smoking, diabetes, physical inactivity, and obesity. Given the proportion of deaths in those younger than age 65, the high prevalence of the major risk factors in the general population calls for aggressive efforts in prevention strategies for heart disease in younger populations.

In 2001, one in six heart disease deaths in America occurred in persons younger than age 65. Some groups experienced higher proportions of early deaths. For example, one third of all heart disease deaths were premature for American Indians/Alaska Natives and African Americans, and nearly 1 in 4 were premature for Hispanics. Disparities in premature death can be explained by differences in demographics, risk factors for heart disease, and access to medical and emergency care. Premature heart disease deaths can be avoided by preventing and/or modifying the risk factors, which include high blood pressure, elevated serum cholesterol levels, smoking, diabetes, physical inactivity, and obesity. Given the proportion of deaths in those younger than age 65, the high prevalence of the major risk factors in the general population calls for aggressive efforts in prevention strategies for heart disease in younger populations.

Heterosexual Transmission of HIV ― 29 States, 1999-2002

Recent data from the 29 states that report HIV diagnoses indicate that more than a third (35%) of people diagnosed with HIV were infected through heterosexual contact. Hispanics and non-Hispanic blacks represent 84% of heterosexually acquired HIV diagnoses, but only 21% of the population in HIV-reporting states.

Analysis of previously reported HIV data from the 29 states with longstanding HIV reporting finds that from 1999 through 2002 more than one third (35 percent) of those diagnosed with HIV were infected through heterosexual contact. Of the 36,084 people who were exposed to HIV through heterosexual contact during those years, nearly two thirds (64 percent) were women. Hispanics and non-Hispanic blacks accounted for 84 percent of heterosexually acquired HIV, but represented only 21% of the population in those states. The authors state that these findings highlight the need for culturally sensitive HIV prevention and education programs that are designed to reach women and racial and ethnic minority populations.

Using the Internet for Partner Notification of Sexually Transmitted Diseases ― Los Angeles County, California, 2003

The Internet is a new vehicle for public health officials to use for partner notification, the practice of notifying individuals that they may have been exposed to an STD via a recent sexual partner.

Use of the Internet to meet sexual partners has resulted in a new vehicle for partner notification, a method used to inform the sexual partners of persons diagnosed with a sexually transmitted disease (STD) of possible exposure to infection. Two case studies from Los Angeles (LA) show that the Internet provides new opportunities for partner notification. In the first case, a man diagnosed with syphilis reported that he had met all of his recent sex partners online and had e-mail addresses as the sole contact information for a majority them. The LA Department of Health Services sent e-mails to the partners, successfully contacting over 25 percent of them. In the other case, a man diagnosed with syphilis sent e-mails to his past partners and successfully contacted 13.

Fatal Case of Unsuspected Pertussis Diagnosed from a Blood Culture — Minnesota, 2003

In adolescents or adults, pertussis should be considered as the cause of cough illness lasting >2 weeks, especially if accompanied by a "whoop", paroxyms of coughing, or vomiting.

A recent case of pertussis (whooping cough) in an elderly Minnesota woman who later died and identification of 3 additional cases in other adults in the community underline the importance of clinicians being aware that adults can get the highly contagious cough illness and they should request laboratory testing to confirm a diagnosis of pertussis. Increased reports of pertussis in teens and adults in the United States since the 1980s are a concern because infants who have not completed their pertussis vaccinations may be at increased risk of acquiring this disease. Pertussis should always be considered as a cause of cough illness lasting >2 weeks among adolescents and adults.

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