Synopsis for May 14, 2004

There is no embargo for this MMWR issue.

1. Prevalence of Doctor-Diagnoses Arthritis and Possible Arthritis ― 30 States, 2002
2. Update: Direct and Indirect Costs of Arthritis and Other Rheumatic Conditions ― United States, 1997
3. Outbreak of Varicella Among Vaccinated Children ― Michigan, 2003
4. Creutzfeldt-Jakob Disease Not Related to a Common Venue ― New Jersey, 1995-2004
   On May 7, this report was posted as an MMWR Early Release on the MMWR website (http://www.cdc.gov/mmwr/).
   

Synopsis for May 14, 2004

Prevalence of Doctor-Diagnoses Arthritis and Possible Arthritis ― 30 States, 2002

Doctor-diagnosed arthritis is a large public health problem affecting about 1 in 4 adults in 30 states. The problem is likely to grow as the population ages.

This report provides the first state-specific estimates of doctor-diagnosed arthritis. Doctor-diagnosed arthritis is a large problem that affects about 1 in 4 adults in 30 states and occurs more frequently among women and older adults. The prevalence of arthritis is likely to increase because the U.S. population is aging. The estimated prevalence of doctor-diagnosed arthritis among adults in the states ranged from 17.8% to 35.8% (median 27.6%). For adults 65 and older the median prevalence was 55.6% and ranged among the 30 states from 48.1%-64.2%. Increased intervention efforts, including early diagnosis and appropriate clinical and self-management (e.g., physical activity, education, and maintaining appropriate weight), are needed to reduce the impact of arthritis.

Update: Direct and Indirect Costs of Arthritis and Other Rheumatic Conditions ― United States, 1997

Costs for arthritis are high (at 1 percent of the U.S. gross domestic product) and underscore the need for better interventions to reduce the impact of this disabling and costly condition.

In 1997, arthritis and other rheumatic conditions (AORC) cost the United States $86.2 billion ($51.1 billion in medical care expenditures and $35.1 billion in lost earnings). Total costs attributable to AORC ranged from $121 million in Wyoming to $8.3 billion in California. These estimates are based on better quality data on people’s health expenditures; account for their personal characteristics and whether people had health insurance or other expensive diseases. These cost estimates use enhanced statistical methods to update those we presented in November 2003.

These state-specific cost estimates provide a measure of the economic and societal burden of arthritis for each of the 50 states. Costs among persons with AORC may be reduced, and quality of life increased, with more widespread public health programs to increase physical activity, maintain a healthy weight, and expand the use of self-management education.

Facts about Prevalence of Arthritis—U.S., 2004

Outbreak of Varicella Among Vaccinated Children ― Michigan, 2003

Varicella vaccine was 85% effective at preventing disease during a large school-based outbreak: even when vaccination failed, significantly milder disease resulted as compared with disease seen in unvaccinated students.

A large varicella (chicken pox) outbreak occurred at a kindergarten-third grade elementary school in Oakland County, Michigan in November 2003. Public health investigators found that varicella vaccine effectiveness was in the expected range (85%); vaccinated cases had significantly milder disease (<50 lesions) as compared with unvaccinated cases; and transmission of varicella was sustained at the school for nearly a month despite high vaccination coverage. In order to prevent disease spread in school settings, health care providers, school administrators, and parents must learn to recognize students with mild symptoms of varicella and exclude them from school until all lesions crust or fade away. Varicella is a highly infectious disease that, in the prevaccine era, resulted in approximately 4 million illnesses, 11,000 hospitalizations, and 100 deaths annually in the United States. Vaccination must remain the cornerstone of our varicella control efforts.

Creutzfeldt-Jakob Disease Not Related to a Common Venue ― New Jersey, 1995-2004

No evidence has indicated that any of the racetrack-associated reported deaths resulted from variant Creutzfeldt-Jakob disease and no evidence supports the hypothesis that the racetrack-associated deaths were causally linked with consumption of BSE-contaminated meat.

Concerns were raised that a suspected cluster of deaths caused by Creutzfeldt-Jakob disease (CJD) might have resulted from consumption of meat contaminated with the agent causing bovine spongiform encephalopathy (BSE, commonly called “mad cow disease”) served at restaurants in the Garden State Racetrack, Cherry Hill, New Jersey. Consumption of BSE-contaminated cattle products has been linked to variant CJD (vCJD) in humans but not the classic form of CJD. The investigation reported in the MMWR article determined no support that any of the deaths resulted from vCJD or for the hypothesis that the racetrack-associated deaths were causally linked with a common source of infection. Because neuropathologic evaluation is the most definitive method to diagnose human prion diseases and monitor for vCJD or the emergence of new prion disease in the United States, physicians should arrange for brain autopsies of all patients with clinically suspected or diagnosed CJD and utilize the services provided by the National Prion Disease Pathology Surveillance Center.

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