HICNet Medical News Digest Wed, 26 Oct 1994 Volume 07 : Issue 54 Today's Topics: [MMWR] Drivers With Repeat Convictions for Driving-While-Impaired [MMWR] Update Human Plague - India, 1994 [MMWR] Availability of Inactivated Poliovirus Vaccine Medical BBS (Computer Bulletin Boards) List Legal Medicine Continuing Education Medical Course +------------------------------------------------+ ! ! ! Health Info-Com Network ! ! Medical Newsletter ! +------------------------------------------------+ Editor: David Dodell, D.M.D. 10250 North 92nd Street, Suite 210, Scottsdale, Arizona 85258-4599 USA Telephone +1 (602) 860-1121 FAX +1 (602) 451-1165 Internet: mednews@stat.com Bitnet: ATW1H@ASUACAD Mosaic WWW Asia/Pacific: http://biomed.nus.sg/MEDNEWS/welcome.html Americas: http://cancer.med.upenn.edu:3000/ Compilation Copyright 1994 by David Dodell, D.M.D. All rights Reserved. License is hereby granted to republish on electronic media for which no fees are charged, so long as the text of this copyright notice and license are attached intact to any and all republished portion or portions. The Health Info-Com Network Newsletter is distributed biweekly. Articles on a medical nature are welcomed. If you have an article, please contact the editor for information on how to submit it. If you are interested in joining the automated distribution system, please contact the editor. Associate Editors: E. Loren Buhle, Jr. Ph.D. Dept. of Radiation Oncology, Univ of Pennsylvania Tom Whalen, M.D., Robert Wood Johnson Medical School at Camden Douglas B. Hanson, Ph.D., Forsyth Dental Center, Boston, MA Lawrence Lee Miller, B.S. Biological Sciences, UCI Dr K C Lun, National University Hospital, Singapore W. Scott Erdley, MS, RN, SUNY@UB School of Nursing Jack E. Cross, B.S Health Care Admin, 882 Medical Trng Grp, USAF Albert Shar, Ph.D. CIO, Associate Prof, Univ of Penn School of Medicine Martin I. Herman, M.D., LeBonheur Children's Medical Center, Memphis TN Stephen Cristol, M.D. MPH, Dept of Ophthalmology, Emory Univ, Atlanta, GA Subscription Requests = mednews@stat.com anonymous ftp = vm1.nodak.edu; directory HICNEWS FAX Delivery = Contact Editor for information ---------------------------------------------------------------------- Date: Wed, 26 Oct 94 21:53:58 MST From: mednews@stat.com (HICNet Medical News) To: hicnews Subject: [MMWR] Drivers With Repeat Convictions for Driving-While- Impaired Message-ID: Drivers With Repeat Convictions or Arrests for Driving While Impaired -- United States In 1992 (the latest year for which data are available), more than 1.6 million persons in the United States (approximately 1% of licensed drivers) were arrested for driving while impaired (DWI) (1). Persons arrested for DWI are at substantially greater risk for future death in a motor-vehicle crash involving alcohol than those who have not been arrested for DWI, and this risk increases directly in relation to the number of DWI arrests (2). In addition, drivers convicted of DWI are at greater risk of being involved in a fatal crash, regardless of whether they are killed (3). This report summarizes data about convictions and arrests for DWI from state traffic safety officials analyzed by the National Highway Traffic Safety Administration (NHTSA) during 1994. During May-June 1994, NHTSA contacted the governor's traffic safety representative in each of the 50 states requesting all available data about the proportion of DWI arrests or convictions that involved a repeat DWI offender and the duration for which DWI convictions or arrests are retained in a driver's record. Of the 14 states for which data were available and complete, seven reported data by the number of drivers arrested or convicted for DWI, and seven reported data by the total proportion of DWI arrests or convictions. Only data reported by the number of drivers arrested or convicted for DWI are presented in this analysis. Five of the seven states reported data about drivers convicted for DWI; in these states, the estimated percentage of drivers with previous DWI convictions ranged from 21% (Iowa during 1992) to 48% (New Mexico during 1992) (Table 1). The other two states reported information about drivers arrested for DWI; the estimated percentages of drivers with previous DWI arrests were 26% (Colorado during 1989-91) and 46% (Minnesota during 1993) (Table 1). The percentage of drivers arrested or convicted for DWI with previous convictions or arrests did not vary substantially during the year(s) for which the data were reported. However, the percentages were greater in most of the states that retained driving records for longer periods of time. Reported by: JC Fell, MS, Office of Alcohol and State Programs, National Highway Traffic Safety Administration. Div of Unintentional Injury Prevention, National Center for Injury Prevention and Control, CDC. Editorial Note: Motor-vehicle crashes are the leading cause of death in the United States for persons in all age groups from ages 1 through 34 years (4). Approximately 44% of the 40,115 traffic fatalities in 1993 were alcohol-related (5). In 1990, alcohol- related crashes cost $46.1 billion, including $5.1 billion in medical expenses (6). Although state laws have been effective in reducing drinking and driving and deaths associated with alcohol-related crashes (6), the findings in this report indicate that, in those states that provided data, approximately one third of drivers who were arrested or convicted for DWI had previous offenses for alcohol-impaired driving. Although this finding is consistent with previous unpublished reports of state data, it probably underestimates the prevalence of such drivers because convictions or arrests for DWI that occur out-of-state may not be included in a driver's record. Because of the limited number of states with available data, the findings in this report may not be representative of all drivers with previous convictions or arrests for DWI. The need for such information underscores the importance for states and localities to develop systems to track DWI offenders (e.g., systems that combine criminal justice records with driver history data). The risk for repeat arrests for DWI is higher among males and young persons (7); this risk is also higher among persons with histories of numerous traffic violations, a high alcohol concentration at arrest, and histories of alcohol problems (7). For example, of 461 drivers convicted of DWI in New York City during 1983-84, approximately 73% had histories of serious alcohol problems (8). In addition to the influence of the risk factors, the percentage of drivers with previous convictions or arrests for DWI may reflect the aggressiveness with which states enforce laws against alcohol-impaired driving. Although the annual arrest rate for DWI nationally in 1992 was nine per 1000 licensed drivers (1), the rate varied by state and ranged from three to 22 per 1000 licensed drivers (1). In addition, most repeat arrests for DWI occur within 5 years of the previous arrest date (R. Peck, California Department of Motor Vehicles, unpublished data, 1994). Effective strategies implemented by states and localities to prevent drinking and driving have included prompt license suspension for persons who drive while intoxicated; enactment of legislation lowering permissible blood alcohol content to 0.08 g/dL for adults and to 0.02 g/dL for drivers aged less than 21 years; and initiation of public education, community awareness, and media campaigns about the dangers of alcohol-impaired driving (6). Specific measures implemented to prevent repeat convictions and arrests for DWI include mandatory substance-abuse assessment and treatment, incarceration, and both; house arrest with electronic monitoring; ignition interlocks on vehicles; license plate tags that identify drivers with licenses suspended for DWI; vehicle impoundment or confiscation; fines; and increases in automobile insurance rates (9). The effectiveness of these specific measures must be evaluated further; however, the findings in this report suggest that, to prevent injuries and deaths in alcohol-related crashes, additional and stronger state legislation (e.g., mandatory substance-abuse assessment and treatment) should be directed toward persons arrested for or convicted of DWI. References 1. Federal Bureau of Investigation, US Department of Justice. Uniform crime reports: crime in the United States, 1992. Washington, DC: US Department of Justice, Federal Bureau of Investigation, 1993. 2. Brewer RD, Morris PD, Cole T, Watkins S, Patetta MJ, Popkin C. The risk of dying in alcohol-related automobile crashes among habitual drunk drivers. N Engl J Med 1994;331:513-7. 3. Fell JC. Repeat DWI offenders: their involvement in fatal crashes. In: Utzelmann H-D, Berghaus G, Kroj G, eds. Proceedings of the 12th International Conference on Alcohol, Drugs, and Traffic Safety. Cologne, Germany: Verlag TUV Rheinland, 1993. 4. NCHS. Health, United States, 1993. Hyattsville, Maryland: US Department of Health and Human Services, Public Health Service, CDC, 1994; DHHS publication no. (PHS)94-1232. 5. National Highway Traffic Safety Administration, US Department of Transportation. Traffic safety facts, 1993: alcohol. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration, 1994. 6. CDC. Reduction in alcohol-related traffic fatalities--United States, 1990-1992. MMWR 1993; 42:905-9. 7. Arstein-Kerslake GW, Peck RC. A typological analysis of California DUI offenders and DUI recidivism correlates. Sacramento, California: California Department of Motor Vehicles, Research and Development Office, 1985. 8. Miller BA, Whitney R, Washousky R. Alcoholism diagnoses for convicted drinking drivers referred for alcoholism evaluation. Alcohol Clin Exp Res 1986;10:651-6. 9. Popkin CL, Wells-Parker E. A research agenda for the specific deterrence of DWI. Journal of Traffic Medicine 1994;22:1-14. ------------------------------ Date: Wed, 26 Oct 94 21:54:48 MST From: mednews@stat.com (HICNet Medical News) To: hicnews Subject: [MMWR] Update Human Plague - India, 1994 Message-ID: <2T9Tuc4w165w@stat.com> Update: Human Plague -- India, 1994 From August 26 through October 18, 1994, a total of 693 suspected bubonic or pneumonic plague cases with positive test results for antibodies to Yersinia pestis were reported by India to the World Health Organization (WHO). Cases were reported from five states (Maharashtra [488 cases], Gujarat [77 cases], Karnataka [46 cases], Uttar Pradesh [10 cases], and Madhya Pradesh [4 cases]) and from the federal district of New Delhi (68 cases). Nationwide, 56 fatal plague cases have been reported; no deaths have been reported since October 11. As of October 19, WHO considered the outbreak to be under control because few new suspected cases had been reported. In addition, WHO continues to recommend no restrictions for travelers visiting India. However, travelers to the city of Surat, Gujarat, or the Beed district, Maharashtra--areas where plague transmission may be ongoing--are advised to seek medical attention for any illness that begins within 6 days of departure. As of October 19, no imported plague cases had been detected in persons in other countries. No plague cases had been reported in U.S. residents in India. Reported by: World Health Organization, Geneva. Div of Quarantine, National Center for Prevention Svcs; Bacterial Zoonoses Br, Div of Vector-Borne Infectious Diseases, National Center for Infectious Diseases, CDC. Editorial Note: The reliability of reported data about the plague outbreaks in India is unknown, and criteria for clinical and laboratory confirmation of cases have not been described. However, the most recent data suggest that transmission has been more geographically limited than previously reported (1,2). Studies have been initiated to accurately assess the extent of the outbreaks, their relation to persistent foci of transmission, and the clinical spectrum and epidemiologic features of the illness, including the incidence of person-to-person transmission. Travelers to India and other plague-endemic countries continue to be at low risk for infection with Y. pestis. As of October 19, health officials had identified and evaluated 12 airline passengers who had arrived from India with febrile or other illnesses and who disembarked in the United States. Using similar surveillance protocols, health officials have evaluated 40 travelers in Canada (B. Gushulak, Laboratory Center for Disease Control, Ottawa, personal communication, October 18, 1994) and 27 in the United Kingdom (J. Watson, Public Health Laboratory Service Communicable Disease Surveillance Center, London, personal communication, October 18, 1994); none have been diagnosed with plague. Suspected human plague cases in international travelers should be reported through state and local health departments to CDC's Division of Quarantine, National Center for Prevention Services, telephone (404) 639-8107 or (404) 639-2888 (nights, Sundays, and holidays). References 1. CDC. Human plague--India, 1994. MMWR 1994;43:689-91. 2. CDC. Update: human plague--India, 1994. MMWR 1994;43:722-3. ------------------------------ Date: Wed, 26 Oct 94 21:57:03 MST From: mednews@stat.com (HICNet Medical News) To: hicnews Subject: [MMWR] Availability of Inactivated Poliovirus Vaccine Message-ID: Update: Availability of Inactivated Poliovirus Vaccine -- United States The shortage of inactivated poliovirus vaccine (IPV) in the United States earlier this year (1) has been resolved. On September 28, 1994, the Food and Drug Administration announced the release of IPV lots manufactured by Pasteur Merieux Serums & Vaccines, S.A.* (Lyon, France). In addition, IPV (human diploid cell) lots manufactured by Connaught Laboratories, Limited (Willowdale, Ontario, Canada), were released on October 5, 1994. The release of vaccine lots from both manufacturers, distributed by Connaught Laboratories, Inc. (Swiftwater, Pennsylvania), should quickly restore normal supplies. Reference 1. CDC. Limited supplies of inactivated poliovirus vaccine--United States. MMWR 1994;43:595-6. *Use of trade names and commercial sources is for information only and does not imply endorsement by the Public Health Service or the U.S. Department of Health and Human Services. ------------------------------ Date: Wed, 26 Oct 94 21:58:06 MST From: mednews@stat.com (HICNet Medical News) To: hicnews Subject: Medical BBS (Computer Bulletin Boards) List Message-ID: The Black Bag Medical BBS List ============================== Edward Del Grosso M.D. <*> Copyright 1985-1994 All Rights Reserved Current as of October 1, 1994 The following list is a list of medical, fire/EMS, science, recovery, AIDS and disABILITY related bulletin board systems. All have been checked within the last thirty days. You are granted the right to distribute the list in electronic form as long as it remains UNALTERED. Please remember how much time and effort goes into this and abide by this simple yet unenforceable request. For more info or to add your system please see the comments at the end of the list. 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(286/926) 417-782-6909 V32b EMSPILOT + WILDCAT 09/03/94 ***** MONTANA ***** Virtual Medical Center 406-994-2564 V32b WILDCAT 09/11/94 ****** NEBRASKA ***** Emergency Wildcat 402-372-3158 V32b FIRE WILDCAT 09/11/94 **** NEW HAMPSHIRE *** Easy Does It (132/131) 603-228-0705 VFC RECOVERY MAXIMUS 09/02/94 EMS Cooperative (132/260) 603-529-1948 V32b EMS + REMOTE 09/03/94 Gate City Striders (132/239)603-888-5477 V32b FITNESS + FIRST 09/03/94 ***** NEW JERSEY ***** DEN 201-342-3273 V32b DISABLE TBBS 09/22/94 Laboratory (2604/303) 201-342-5659 V32b SCIENCE RBBS 09/22/94 The Biomedical Engineering 201-596-5679 V32b BIOMED SEARCH GONE The Right Place (2604/539) 201-947-8231 VFC RECOVERY RYBBS 09/03/94 Sugar Free BBS (2604/304) 201-996-9397 V32b DIABETES REMOTE 09/22/94 Maple Shade (266/12) 609-482-8604 VFC PSYCH MAXIMUS 09/10/94 Self Help (107/955) 908-289-3981 V32b SELFHELP REMOTE 09/22/94 The Diner 908-418-4354 V32b RECOVERY PCBOARD 09/22/94 ***** NEW MEXICO ***** NASW (305/101) 505-646-2868 HST SOCIAL OPUS 09/11/94 ***** NEW YORK STATE ***** Guide Dog Foundation 516-366-4462 2400 BLIND + MAXIMUS 09/03/94 Medical Help Line 516-423-0472 V32b + MAJOR 09/03/94 The Metro Fire/Rescue BBS 516-488-4325 V32b FIRE MAJOR 09/29/94 New York State Fireli -- |Fidonet: Edward DelGrosso 1:2614/706 |Internet: ed@blackbag.com ------------------------------ Date: Wed, 26 Oct 94 21:59:22 MST From: mednews@stat.com (HICNet Medical News) To: hicnews Subject: Legal Medicine Continuing Education Medical Course Message-ID: LEGAL MEDICINE CME Correspondence Course (published Annually) SPONSORS: Armed Forces Institute of Pathology, and the American Registry of Pathology. GENERAL INFORMATION: AFIP/ARP Legal Medicine Dept.,14th & Alaska Ave, N.W., Washington, DC 20306-6000 USA; Toll free 1-800-8 MED CME (US only) or (301) 427-5373; FAX (301) 427-5098; INTERNET: LOWTHER@email.afip.osd.mil CONTENT: This publication is designed to provide medicolegal education for health care providers. Completion and return of an attached quiz will earn physicans 5 hours of Category 1 Continuing Medical Education (CME) credits in the area of risk management. Questions regarding this publication can be directed to the Department of Legal Medicine. COURSE DIRECTOR: Frank T. Flannery, Col, MC, USA, MD, JD. Stephen V. Mawn, CDR, MC, USN, MD, JD TUITION: Free to all active duty military, DoD civilians, full- time permanent Department of Veterans Affairs employees (not residents or fellows), and commissioned officers of the Public Health Service with authorized approval. Non-federal civilian physicians may also participate and obtain a yearly total of 5 CME credit hours in risk management by entering an annual subscription (two issues) to this publication for $20. ------------------------------ End of HICNet Medical News Digest V07 Issue #54 *********************************************** --- Editor, HICNet Medical Newsletter Internet: david@stat.com FAX: +1 (602) 451-1165 Bitnet : ATW1H@ASUACAD