Date: Fri, 28 Apr 1995 11:05:11 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: Educational Material Additions, 4/27/95 CDC National AIDS Clearinghouse Educational Materials Database NEW MATERIALS The Clearinghouse's Educational Materials Databases contain bibliographic information about more than 14,000 brochures, videos, booklets, and other materials with education/prevention messages. Over the weekend, 52 newly catalogued materials were loaded to the UNPB Educational Materials Database. This brings the total number of materials on the Database to 15,744. These include the following: 14 Brochures 01 Coloring book 01 Comic book 04 Teaching guides Twelve of these materials are available in Spanish; and one each in Cambodian, Lao, Vietnamese, Korean, and French. The following materials attracted the attention of Educational Materials Staff: AN AD0016856. TI Please Read... Here Is Important Health Information for Korean Americans (translated title). FM 08 - Brochure. Print Material. AC 309 - Asians. AV Asian and Pacific Islander Coalition on HIV / AIDS 41 John St., 3rd Fl. New York, NY 10038-3701. (212) 349-3293. AB This brochure alerts Korean Americans to the issues they need to know about HIV infection and AIDS, and reminds them that being Korean American does not protect them from disease. It also reminds them that the United States government requires all potential immigrants to be tested for HIV. The brochure provides basic information: what is AIDS; how can HIV be transmitted; and how can this be prevented? It explains that HIV can not be spread through casual contact, such as hugging, shaking hands, or sharing living quarters. It assures the reader that the use of sterile tools can make acupuncture, ear piercing, and dentistry risk-free. The HIV antibody test is described, and early symptoms of infection are given. The brochure explains the concept of safer sex and describes a condom and how to use it. The brochure cautions about HIV transmission during pregnancy, and provides organization names to contact for further information. MJ AIDS 101. Safer sex. HIV prevention. Casual contact transmission. Attitudinal barriers. Antibody tests. Symptoms. AN AD0017285. TI AIDS Prevention (translated title). FT AIDS: Thaiv Kab Mob Phong Ngua. FM 08 - Brochure. Print Material. AC 309 - Asians. AV BIHA Women in Action 122 W. Franklin, #306 Minneapolis, MN 55404. (612) 870-1193. AB This brochure provides important information on HIV and AIDS for Asian American people, and reminds them that over 40 percent of Americans who have died of AIDS have been people of color. It explains what HIV and AIDS are; how the virus is transmitted, and how transmission can be prevented. It discusses symptoms that can indicate HIV infection, including loss of weight, fatigue, fevers, night sweats, diarrhea, and swollen lymph glands. The brochure tells the reader about the HIV-antibody test and the meaning of a positive result. The brochure dispels myths about casual contact transmission, informing the reader that HIV cannot be caught from toilet seats, hugging or embracing positive individuals, or sharing food or living quarters. MJ AIDS 101. HIV prevention. Casual contact transmission. Antibody tests. Symptoms. AN AD0017800. TI Human Rights of Individuals Living With HIV / AIDS (translated title). FT Derechos Humanos de las Personas que Viven con VIH / SIDA. FM 08 - Brochure. Print Material. AC 336 - Hispanics. AV Consejo Nacional de Prevencion y Control del SIDA Comercio y Administracion #35 Col. Copilco Universidad Mexico City, CP 04360, Mexico. 525 658 9251. ISBN: 968-805-809-2. A photocopy of this material is available from the CDC National AIDS Clearinghouse Document Delivery Service P.O. Box 6003 Rockville, MD 20849-6003. (800) 458-5231. Price: $5.45. AB This brochure contains a list of the fundamental human rights of individuals who have tested positive for HIV, or who have developed AIDS. These include the right to move about freely, to work, to marry, to engage in sexual relationships, to obtain an education, to join groups and associations, and to receive social support services, confidential medical care, and proper death and funeral services. Excerpts from articles of the Mexican Constitution provide support for these human rights, and list associations where individuals can report violations. MJ Discrimination. Civil or constitutional rights. Health care accessibility. Legal issues. Persons with AIDS. HIV positive persons. Patient rights. AN AD0018109. TI Teens With AIDS Speak Out. FM 32 - Monograph. Print Material. AC 306 - Adolescents. 445 - HIV Positive Persons. AV Simon and Schuster, Incorporated Prentice - Hall Rte. 9W Englewood Cliff, NJ 07632. (201) 592-2000. ISBN: 0-671-74543-3; Price: $8.95 per copy in 1991. AB This book is a compilation of the accounts of adolescents with HIV/AIDS. The teenagers explain how they become infected and what it is like to live with the disease, including the difficulties they experience at home, work, and school. The teens describe the medical treatments they undergo, the pain the disease has caused them, and the emotional and psychological problems that accompany facing mortality. The goal of this book is twofold: it encourages young people to assess their own risk of HIV infection and change their behavior accordingly, and it enlightens teenagers, encouraging them to treat those with HIV and AIDS with understanding, concern, and compassion. MJ Adolescents with HIV/AIDS. Sexual behavior. Sexually transmitted diseases (STDs). Sexual transmission. Sex education. STD prevention . Risk reduction. Risk factors. Health education needs. AN AD0018110. TI AIDS, A Pilgrimage to Healing. FM 32 - Monograph. Print Material. AC 100 - Health Professionals. 230 - Educators. 610 - Religious Organizations/Spiritual Leaders. 800 - Caregivers. AV Morehouse Publishing 78 Danbury Rd. Wilton, CT 06897. (203) 762-0721. ISBN: 0-85574-902-4. AB This monograph on the "psycho-spiritual dimensions of AIDS" explores ways that those affected by HIV or AIDS can surmount their fears and win serenity even in the face of pain, loss, and death. Written by a psychologist and therapist who has worked extensively with people who are living with AIDS, their families, and caregivers, the book utilizes the image of a pilgrimage to focus on the realization of the divine potential of being human. The author calls for an AIDS outreach, for models of compassionate community which will respect the locus of control in the individual and build loving awareness of others. The first section presents a perspective on psychosomatic medicine, psychoneuroimmunology, and their application to immune-deficiency conditions. The second section considers the applications of philosophical insights to contemporary conditions, along with accounts of therapies for promoting healing and serenity. Part three deals with AIDS and community growth, and the last section presents therapeutic exercises designed to be used by therapists, counselors, clergy, and group facilitators. MJ Alternative therapies. Psychotherapy. Psychological factors. Spirituality. Counseling. Pastoral counseling. Religion. AN AD0018118. TI Wonderfully, Fearfully Made: Letters on Living With Hope, Teaching Understanding, and Ministering With Love, From A Gay Catholic Priest With AIDS. FM 32 - Monograph. Print Material. AC 400 - Persons With AIDS. 610 - Religious Organizations/Spiritual Leaders. AV Harper Collins Publishers 1000 Keystone Industrial Park Scranton, PA 18512-4621. (717) 941-1500. ISBN: 0-06-060075-6; Price: $12.00 per copy in 1993. AB This is a collection of letters written by a gay priest who is living with AIDS. Through the priest's letters to family and friends, the reader learns of his emotional and physical struggle with the his homosexuality, his life as an HIV-positive person, and as a person with symptomatic AIDS. The author also shares the conflict and reaction he faced from society at large and from the Catholic Church once he went public with his sexuality and his disease. The letters provide insight into the priest's ministry to AIDS patients. The author transformed from the victim of a fatal disease to a fearless advocate for AIDS patients who he believes have previously been without sensitivity, compassion, and active support. MJ Church policies. Clergy education. Gay men. Religion. Religious organizations. Spirituality. Persons with AIDS. Outreach. Homosexuality. Family support. Pastoral counseling. AN AD0018133. TI Parish Resource Guide for AIDS Ministry. FT Guia de Recursos Para el Ministerio Parroquial de SIDA. FM 08 - Brochure. Print Material. AC 336 - Hispanics. 610 - Religious Organizations/Spiritual Leaders. AV Episcopal Diocese of Northwest Texas Diocesan AIDS Task Force P.O. Box 2949 Big Spring, TX 79720. (915) 267-8201. AB This booklet (with English and Spanish sections) is a reference resource to aid parish ministers in their ministry to persons living with HIV/AIDS, their families, and their friends; and outlines different ways in which people can minister to persons living with HIV/AIDS. It begins with basic medical facts about AIDS, its progression, transmission, and treatment. The volunteer opportunities within the Diocese of Dallas, Texas are outlined. These include a supper club comprised of individuals who prepare meals for AIDS patients and an interfaith network care team. The booklet also lists the agencies in the Dallas, Texas area that can provide services to people living with ARC, AIDS, and HIV. The booklet concludes with a discussion of pastoral care, healing through liturgy, and an example of a memorial service. MJ Religion. Religious organizations. Religious programs. Spirituality. Persons with AIDS. Patient support. Pastoral counseling. Outreach. Volunteer education. Volunteer organizations. Clergy education. Church policies. AN AD0018134. TI International AIDS Grantmaking: A Guide for Corporations, Foundations, and Other Donors. FM 32 - Monograph. Print Material. AC 670 - Organizations. 700 - Businesses/Corporations. AV Funders Concerned About AIDS 310 Madison Ave., Ste. 1630 New York, NY 10017. (212) 573-5533. Free of charge. AB This manual provides summary information about the current course and potential consequences of the AIDS pandemic in the developing world, then defines the need and outlines the opportunities for philanthropic involvement. To assist donors that intend to continue their work overseas and to guide those that will be awarding international grants for the first time, four categories of funding opportunities are presented: HIV/AIDS Prevention; Social Services/Health Care; Economic Impact Studies/Social and Behavioral Research; and Human Rights Advocacy. A selected summary of grants awarded by several organizations illustrates various approaches to the grantmaking process and demonstrates how concern about various aspects of the pandemic can be translated into philanthropic action. MJ Funding sources. Fundraising. Financial issues. Developing nations . Advocacy. International health programs. AN AD0018138. TI People Living With AIDS... A Closer Look. FM 08 - Brochure. Print Material. AC 610 - Religious Organizations/Spiritual Leaders. 300 - General Public, Consumers. 325 - Families of AIDS Patients. 400 - Persons With AIDS. 327 - Friends. 800 - Caregivers. AV Catholic AIDS Ministry 910 Marion Street Seattle, WA 98104. (206) 382-4885. AB This booklet contains stories drawn from actual experiences of persons living with AIDS. The profiles include persons with AIDS and members of their families, as well as individuals working in Catholic AIDS ministries. The accounts deal with death and dying, reconciliation, acceptance, denial, and faith. The editor indicates that the format allows each story to be easily copied, and they can be used as bulletin inserts or as the basis for classroom discussions. MJ HIV positive persons. Persons with AIDS. Death or dying. Families of Persons with HIV/AIDS. Pastoral counseling. Church roles. Religious programs. Support groups. Spirituality. AN AD0018167. TI Extending A Hand, Soothing A Soul. FT Extendiendo Una Mano, Aliviando Un Alma. FM 08 - Brochure. Print Material. AC 300 - General Public, Consumers. 336 - Hispanics. 610 - Religious Organizations/Spiritual Leaders. AV Catholic AIDS Ministry 910 Marion Street Seattle, WA 98104. (206) 382-4885. AB In this brochure, the AIDS Ministry Office of the Archdiocese of Seattle explains HIV infection and urges a pastoral response by the Christian community to AIDS. It describes AIDS-related anxiety, HIV transmission, and fears of exposure by infected church members. The pastoral response involves acceptance and support on the community, church, and individual levels. The brochure stresses confidentiality and that disclosure of HIV status is an individual decision, since there is no risk of casual transmission. In addition, the brochure explains that AIDS can be fought by promoting Catholic teachings on sexual issues along with accurate information on transmission. MJ Church roles. Clergy education. HIV transmission. Confidentiality. Religion. Anxiety. AN AD0018189. TI South Arkansas Fights AIDS; Red Ribbon Patrol Says. FM 12 - Coloring Book. Print Material. AC 314 - Children. AV South Arkansas Fights AIDS 1616 W. Block El Dorado, AR 71730. (501) 862-0977. A photocopy of this material is available from the CDC National AIDS Clearinghouse Document Delivery Service P.O. Box 6003 Rockville, MD 20849-6003. (800) 458-5231. Price: $5.25. AB Young children can learn facts about HIV transmission from this coloring book. It warns children not to touch anyone else's blood such as from a nosebleed or a used syringe. In addition, the text reassures that AIDS cannot be casually transmitted by playing with or sitting next to a person with AIDS. A true or false quiz reviews HIV transmision routes. MJ Adolescents. Preschool children. Casual contact transmission. HIV transmission. AN AD0018207. TI Important News for Pregnant Women. FT Informacion Importante Para Mujeres Embarazadas (Spanish title). Nouvelles Importantes Pour les Femmes Enceintes (French title). FM 52 - Other Printed Material. Print Material. AC 390 - Women. 490 - Women With HIV/AIDS. AV New York Department of Health Office of Public Health AIDS Institute 5 Penn Plaza. New York, NY 10001. (212) 613-2600. AB This pink and blue brochure, designed as a little bunny, provides important information on HIV and AIDS for women who are considering pregnancy. It explains the chances that the baby will be HIV-positive if the mother is, and also how the mother-to-be can protect the baby by not breastfeeding. It describes what the HIV-antibody test is, that the results are confidential, and urges women to seek medical care for either pregnancy or HIV infection. MJ Breastfeeding. Childbirth. Perinatal transmission. Pregnancy. Antibody tests. Medical treatment. From root@aspensys.com Fri May 5 06:57:03 1995 Received: from casti.com (vector.casti.com [204.91.98.64]) by qrd.rdrop.com (8. 6.9/8.6.9) with ESMTP id GAA27301 for ; Fri, 5 May 1995 06:57:00 - 0700 Received: from aspensys by casti.com (8.6.9/NX3.0M) id KAA13465; Fri, 5 May 1995 10:09:22 -0400 Received: by aspensys (5.0/SMI-SVR4) id AA07040; Fri, 5 May 1995 10:08:12 +0500 Date: Fri, 5 May 1995 10:08:12 +0500 Message-Id: <9505051328.tf@aspensys> Errors-To: martha_vander_kolk@smtpinet.aspensys.com Reply-To: aidsnews@aspensys.com Originator: aidsnews@cdcnac.aspensys.com Sender: aidsnews@aspensys.com Precedence: bulk From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com To: qrd@vector.casti.com Subject: MMWR 05/05/95 X-Listprocessor-Version: 6.0c -- ListProcessor by Anastasios Kotsikonas X-Comment: CDC National AIDS Clearinghouse content-length: 14364 MORBIDITY AND MORTALITY WEEKLY REPORT Centers for Disease Control and Prevention May 5, 1995 Vol. 44, No. 17 Reptile-Associated Salmonellosis -- Selected States, 1994-1995 During 1994-1995, health departments in 13 states reported to CDC persons infected with unusual Salmonella serotypes in which the patients had direct or indirect contact with reptiles (i.e., lizards, snakes, or turtles). In many of those cases, the same serotype of Salmonella was isolated from patients and from reptiles with which they had had contact or a common contact. For some cases, infection resulted in invasive illness, such as sepsis and meningitis. This report summarizes clinical and epidemiologic information for six of these cases. Connecticut. During January 1995, a 40-year-old man was hospitalized because of an acute illness characterized by constipation, lower back pain, chills, and fever. He reported having taken ranitidine and an antacid for symptoms of heartburn before onset of mild diarrhea 3 days before hospitalization. A blood culture yielded Salmonella serotype Wassenaar. A magnetic resonance image scan of the right sacrum suggested osteomyelitis. Ciprofloxacin therapy was initiated for presumed Salmonella osteomyelitis, and he was discharged after 14 days. All household contacts were asymptomatic. The family had purchased two iguanas (Iguana iguana) in October 1994; although the patient denied directly handling the iguanas, he reported having recently cleaned their aquarium. Stool samples obtained from both iguanas yielded Salmonella Wassenaar. New Jersey. During September 1994, a 5-month-old girl was hospitalized because of an acute illness including vomiting, lethargy, and fever; on admission, she had a bulging fontanelle and stiff neck. Blood cultures and cerebrospinal fluid yielded Salmonella serotype Rubislaw. She was treated with intravenous ceftazidime for Salmonella sepsis and meningitis and discharged from the hospital after 10 days. Other members of the family were asymptomatic. The infant routinely was fed infant formula. Although the family did not own a reptile, the infant frequently stayed at a babysitter's house where an iguana was kept. Culture of a stool sample from the iguana yielded Salmonella Rubislaw. The infant was reported to have not touched the iguana; however, the iguana frequently was handled by the babysitter and other members of the babysitter's family. All members of the babysitter's family were asymptomatic, but stool cultures from two members, including a child who had frequently played with and fed the infant, yielded Salmonella Rubislaw. New York. In December 1994, a 45-year-old man infected with human immunodeficiency virus was hospitalized because of weakness, nausea, vomiting, and diarrhea. His CD4+ T-lymphocyte count was less than 50 cells/uL. Cultures from blood and sputum samples yielded Salmonella serotype IIIa 41:z subscript 4 z subscript 23:- (S. subspecies Arizonae). He owned corn snakes and, until shortly before onset of illness, had worked at a pet store where he handled reptiles frequently. Salmonella sepsis was diagnosed, and he was treated with oral ciprofloxacin. North Carolina. During December 1994, a 2-day-old boy born 8 weeks prematurely developed respiratory difficulties, had pneumothorax diagnosed, and was transferred to a referral hospital. Blood obtained at birth for culture had been negative, but a culture of blood obtained 9 days later because of an elevated white blood cell count yielded Salmonella serotype Kintambo. He was treated with intravenous ampicillin for Salmonella sepsis and was discharged from the hospital after 30 days. Eleven days after the positive culture was collected, Salmonella Kintambo was cultured from a blood sample obtained from a 12-day-old acutely ill boy who was born at 28 weeks' gestation and had shared a room at the referral hospital with the first infant. The second infant was treated with intravenous cefotaxime for Salmonella sepsis and was discharged after 44 days. Both infants had been in the hospital continuously from birth until onset of illness. The mother of the first infant reported having had a diarrheal illness 4 days before the birth of the infant; she frequently handled a savanna monitor lizard (Varanus exanthemapicus) that the family had purchased in September 1994 and kept in a cage in the kitchen. Culture of a stool sample from the lizard yielded Salmonella Kintambo. The second family did not own a reptile. Ohio. During January 1994, a 6-week-old boy was hospitalized because of diarrhea, stiff neck, and fever; culture of samples of blood and cerebrospinal fluid yielded Salmonella serotype Stanley. The infant was treated with intravenous cefotaxime for Salmonella sepsis and meningitis and discharged from the hospital after 56 days. He had been fed only formula and had not attended a child-care facility; household contacts were asymptomatic. The family had purchased a 4-inch water turtle in April 1993. A culture of stool from the turtle yielded Salmonella Stanley. Although the infant had not had contact with the turtle, other family members had had direct contact, and the turtle's food and water bowls were washed in the kitchen sink. Pennsylvania. During October 1994, a 21-day-old girl was hospitalized because of an illness including vomiting, bloody diarrhea, and fever. She received empirical treatment with intravenous ampicillin. A culture of stool yielded Salmonella serotype Poona; she was discharged from the hospital after 11 days. Other members of the family were asymptomatic. The infant had been fed infant formula and had not attended a child-care center. The family owned an iguana, and culture of a stool sample from the iguana yielded Salmonella Poona. Although the infant did not have contact with the iguana, the iguana was handled frequently by her mother and other members of the family. Additional investigations. In addition to the six states in this report, seven other states (California, Colorado, Florida, Illinois, Minnesota, Oregon, and Utah) have reported recent isolation of the same Salmonella serotype from samples obtained from patients and reptiles with which they had been in contact or associated. Several of these states issued press releases about the risk for acquiring salmonellosis from reptiles. In addition, some states have issued health alerts to pet stores to warn owners and prospective owners about the risks for salmonellosis associated with contact with reptiles and to provide instructions about proper handling of reptiles; store owners have been asked to post the alert and provide copies to all persons purchasing a reptile. Reported by: JW Weinstein, MD, EG Seltzer, MD, Yale Univ School of Medicine, New Haven; RS Nelson, DVM, JL Hadler, MD, State Epidemiologist, Connecticut Dept of Public Health and Addiction Svcs. SM Paul, MD, FE Sorhage, VMD, Div of Epidemiology, Environmental and Occupational Health Svcs; K Pilot, S Matluck, Public Health and Environmental Laboratories; K Spitalny, MD, State Epidemiologist, New Jersey State Dept of Health. M Gupta, MD, J Misage, G Balzano, T Root, G Birkhead, MD, DL Morse, MD, State Epidemiologist, New York State Dept of Health. A Kopelman, MD, S Engelke, MD, L Jones, Pitt County Memorial Hospital, Greenville; L Latour, PhD, P Perry, Wilson County Health Dept, Wilson; B Jenkins, State Laboratory of Public Health, J-M Maillard, MD, JN MacCormack, MD, State Epidemiologist, North Carolina Dept of Environment, Health, and Natural Resources. C Richards, P Fruth, Defiance County Health Dept, Defiance; S Hufford, MD, B Dick, MPH, Toledo Hospital; M Bundesen, Bur of Public Health Laboratories, EP Salehi, MPH, Infectious Disease Epidemiology Unit, TJ Halpin, MD, State Epidemiologist, Ohio Dept of Health. P Lurie, MD, M Deasy, K Mihelcic, JT Rankin, Jr, DVM, State Epidemiologist, Pennsylvania Dept of Health. Foodborne and Diarrheal Diseases Br, Div of Bacterial and Mycotic Diseases, National Center for Infectious Diseases; Div of Field Epidemiology, Epidemiology Program Office, CDC. Editorial Note: For most of the cases described in this report, the identification of rare Salmonella serotypes in persons who had no other apparent exposures was linked to direct or indirect contact with a pet reptile from which the same serotype was isolated. In addition, these cases are consistent with previous reports indicating that direct contact with a reptile is not necessary for transmission of Salmonella (1,2). This report also illustrates the severe complications of Salmonella infection that can occur in young children, immunocompromised persons, and infants during the peripartum period. Reptiles are popular as pets in the United States: an estimated 7.3 million pet reptiles are owned by approximately 3% of households (G. Mitchell, Pet Industry Joint Advisory Council, personal communication, 1995). Because the most popular reptiles species will not breed if closely confined, most reptiles are captured in the wild and imported. The number of reptiles imported into the United States has increased dramatically since 1986 and primarily reflects importation of iguanas (27,806 in 1986 to 798,405 in 1993) (M. Albert, Fish and Wildlife Service, U.S. Department of the Interior, personal communication, June, 1994). A high proportion of reptiles are asymptomatic carriers of Salmonella. Fecal carriage rates can be more than 90% (3); attempts to eliminate Salmonella carriage in reptiles with antibiotics have been unsuccessful and have led to increased antibiotic resistance (1,4). A wide variety of Salmonella serotypes has been isolated from reptiles, including many that rarely are isolated from other animals (reptile-associated serotypes). Reptiles can become infected through transovarial transmission or direct contact with other infected reptiles or contaminated reptile feces. High rates of fecal carriage of Salmonella can be related to the eating of feces by hatchlings--a typical behavior for iguanas and other lizards--which can establish normal intestinal flora for hindgut fermentation (5). During the early 1970s, small pet turtles were an important source of Salmonella infection in the United States; an estimated 4% of families owned turtles, and 14% of salmonellosis cases were attributed to exposure to turtles (6). In 1975, the Food and Drug Administration prohibited the distribution and sale of turtles with a carapace less than 4 inches; many states prohibited the sale of such turtles. These measures resulted in the prevention of an estimated 100,000 cases of salmonellosis annually (6). However, since 1986, the popularity of iguanas and other reptiles that can transmit infection to humans has been paralleled by an increased incidence of Salmonella infections caused by reptile-associated serotypes (7). Because young children are at increased risk for reptile-associated salmonellosis and severe complications (e.g., septicemia and meningitis) (7-9), reducing exposure of infants or children aged less than 5 years to reptiles is particularly important. The risks for transmission of Salmonella from reptiles to humans can be reduced by avoiding direct and indirect contact with reptiles (see box). (BOX) Recommendations for Preventing Transmission of Salmonella From Reptiles to Humans o Persons at increased risk for infection or serious complications of salmonellosis (e.g., pregnant women, children aged less than 5 years, and immunocompromised persons such as persons with AIDS) should avoid contact with reptiles. o Reptiles should not be kept in child-care centers and may not be appropriate pets in households in which persons at increased risk for infection reside. o Veterinarians and pet store owners should provide information to potential purchasers and owners of reptiles about the increased risk of acquiring salmonellosis from reptiles. o Veterinarians and operators of pet stores should advise reptile owners always to wash their hands after handling reptiles and reptile cages. o To prevent contamination of food-preparation areas (e.g., kitchens) and other selected sites, reptiles should be kept out of these areas in particular, kitchen sinks should not be used to bathe reptiles or to wash reptile dishes, cages, or aquariums. References 1. CDC. Iguana-associated salmonellosis--Indiana, 1990. MMWR 1992;41:38-9. 2. CDC. Lizard-associated salmonellosis--Utah. MMWR 1992;41:610-1. 3. Chiodini RJ, Sundberg JP. Salmonellosis in reptiles: a review. Am J Epidemiol 1981;113:494-9. 4. Shane SM, Gilbert R, Harrington KS. Salmonella colonization in commercial pet turtles (Pseudemys scripta elegans). Epidemiol Infect 1990;105:307-16. 5. Troyer K. Transfer of fermentative microbes between generations in herbivorous lizard. Science 1982;216:540-2. 6. Cohen ML, Potter M, Pollard R, Feldman RA. Turtle-associated salmonellosis in the United States: effect of public health action, 1970 to 1976. JAMA 1980;243:1247-9. 7. Cieslak PR, Angulo FJ, Dueger EL, Maloney EK, Swerdlow DL. Leapin' lizards: a jump in the incidence of reptile-associated salmonellosis [Abstract]. In: Program and abstracts of the 34th Interscience Conference on Antimicrobial Agents and Chemotherapy. Washington, DC: American Society for Microbiology, 1994. 8. Ackman D, Drabkin P, Birkhead B, Cieslak P. Reptile-associated salmonellosis: a case-control study [Abstract]. In: Program and abstracts of the 34th Interscience Conference on Antimicrobial Agents and Chemotherapy. Washington, DC: American Society for Microbiology, 1994. 9. Dalton C, Hoffman R, Pape J. Iguana-associated salmonellosis in children. Pediatr Infect Dis J 1995;14:319-20. Monthly Immunization Table To track progress toward achieving the goals of the Childhood Immunization Initiative (CII), CDC publishes monthly a tabular summary of the number of cases of all diseases preventable by routine childhood vaccination reported during the previous month and year-to-date (provisional data). In addition, the table compares provisional data with final data for the previous year and highlights the number of reported cases among children aged less than 5 years, who are the primary focus of CII. Data in the table are derived from CDC's National Notifiable Diseases Surveillance System.