Abstract

Cigarette smoking is the leading preventable cause of death in the United States. Environmental and policy interventions, particularly tobacco-control laws and regulations, are an important means to prevent and reduce tobacco use. For this study, preemptive legislation was defined as legislation that prevents any local jurisdiction from enacting restrictions that are more stringent than the state law or restrictions that may vary from the state law. One of the national health objectives for 2000 is to reduce to zero the number of states with preemptive smokefree indoor air laws (objective 3.25); a proposed objective for 2010 is to reduce the number of states with any preemptive tobacco-control laws to zero. To document trends in preemptive tobacco-control legislation at the state level, CDC identified state preemptive provisions and their effective dates from June 1982 (the oldest provision currently in effect) to September 1998. This report summarizes the results of this analysis, which indicate an increase in the number of preemptive provisions from 1982 to 1996; no preemptive provisions in tobacco-control laws have been enacted since 1996.

Highlights

  • DURING AUGUST 10-NOVEMBER 23, 1998, 33 confirmed* measles cases were reported to the Anchorage Department of Health and Human Services and the Alaska Department of Health and Social Services (ADHSS)

  • Antibody test, and seven met the clinical case definition. This was the largest outbreak of measles in the United States since 1996.1,2 This report summarizes results of the epidemiologic investigation conducted by ADHSS and underscores the importance of second-dose requirements for measles vaccine

  • The child was hospitalized for 1 day, and measles was diagnosed by positive rubeola IgM enzyme-linked immunosorbent assay

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Summary

Transmission of Measles Among a Highly Vaccinated

26 cases were confirmed by positive rubeola IgM antibody test, and seven met the clinical case definition This was the largest outbreak of measles in the United States since 1996.1,2 This report summarizes results of the epidemiologic investigation conducted by ADHSS and underscores the importance of second-dose requirements for measles vaccine. On September 5, 26 days after onset of the imported case, a 16-yearold high school student developed measles, confirmed by IgM testing. 15 other students and one teacher at the same high school developed measles during September 14October 4; 12 cases were laboratory confirmed. CDC Editorial Note: The occurrence of this outbreak primarily in one school, despite the extremely high one-dose measles vaccine coverage, demonstrates the importance of school requirements for a second dose of MCV. Most children respond to a second dose, and .99% of persons aged $12 months receiving two or more doses at least 28 days apart develop immunity

The Advisory Committee on Immunization Practices and the American
Preemptive State
Findings
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