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MEDLIB-L  July 1994, Week 3

MEDLIB-L July 1994, Week 3

Subject:

Sudden Unexplained Death in Hmong Refug.

From:

"McGaughey, Sara" <[log in to unmask]>

Reply-To:

Medical Libraries Discussion List <[log in to unmask]>

Date:

Mon, 18 Jul 1994 11:18:00 EST

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (231 lines)

In response to the request for info. on Fatal Male Syndrome, attached are two
Morbidity and Mortality Weekly Report articles relating to Sudden Unexplained
Death Syndrome (SUDS) and fatal arsenic poisoning as a result of folk
remedies in Hmong refugees.
 
|||||||||||||||||||||||||||||||||||||||||||
||         Sara Thrift McGaughey         ||
|| Chief, Technical Information Activity ||
||         Division of HIV/AIDS          ||
||  Ctrs for Disease Ctrl & Prev (CDC)   ||
||        [log in to unmask]        ||
|||||||||||||||||||||||||||||||||||||||||||
 
 
 
MMWR TRANSFER FILE
TITLE:Update: Sudden Unexplained Death Syndrome Among Southeast Asian Re
fugees -- United States
SOURCE:37(37);568-570
SIZE:4277
DATE:Sep 23 1988
VOLUME:37
ISSUE:37
PAGE:568
SHORT:
CONTACT:
TEXT:
 Between October 1, 1986, and April 30, 1988, 10 cases of sudden
unexplained death syndrome (SUDS) in Southeast Asian (SEA) refugees
were reported to CDC. In addition, three earlier reports were confirmed
as SUDS based on additional information. These 13 reports bring the
total number of SUDS in SEA refugees to 117 since CDC surveillance for
SUDS began in 1981 (1,2). Since 1982, the number of SUDS cases has
continued to decline (Figure 1). Five deaths occurred in 1987 and two
in the first 4 months of 1988. The crude death rate in SEA males for
1987 was 1.1 per 100,000, the lowest since 1976.
 The 13 new cases occurred in nine states. California reported the most
cases (four), followed by Minnesota (two). North Carolina and Arizona,
which previously had not reported cases, had SUDS cases in January and
May 1987, respectively. Otherwise, the geographic distribution of cases
remains similar to that of previously reported cases (Table 1) (1). Age
at death ranged from 19 to 57 years (median: 33 years). All decedents
were men. Nine were Laotian (five Hmong, two lowland Lao, and two
unknown), and two each were Vietnamese and Kampuchean. Twelve of the
deaths occurred either at night or during sleep. One decedent, a
Laotian man, had a cardiac arrest at night during sleep. He was
resuscitated but was comatose when hospitalized; his condition
deteriorated, and he was pronounced brain dead 4 days later.
 Length of time in the United States was known for seven of the 13
decedents and ranged from 1 to 11 years (median: 4 years). The median
length of time in the United States for the 88 of the 117 decedents for
whom time in the United States was known was 17 months.
Reported by: Surveillance and Programs Br, Div of Environmental Hazards
and Health Effects, Center for Environmental Health and Injury Control,
CDC.
Editorial Note:   CDC continues to receive reports of sudden deaths in
SEA refugees in the United States, although the number of reported
cases and the crude death rate continue to decline. Approximately
850,000 SEA refugees live in the United States (3). The number of new
arrivals has declined since its peak of 151,000 in 1980 and was only
36,000 in 1987 (4,5). The decline in SUDS cases may be related to this
decline in newly arrived SEA refugees, since most deaths occur within
the first 2 years after arrival in the United States. The ceiling for
East Asian (including SEA) refugee admissions in fiscal year 1988
(October 1, 1987, to September 30, 1988) for the United States is
38,000 (5). Assuming the previous pattern continues, the number and
rate of SUDS deaths in 1988 will probably remain at 4-5 deaths and 1-2
deaths per 100,000 males, respectively. Although studies have suggested
that a structural abnormality of the cardiac conduction system (6) and
stress (7) may be risk factors for SUDS, the cause of the deaths
remains unknown.
 Please direct case reports and questions about sudden deaths in SEA
refugees directly to the Surveillance and Programs Branch, Division of
Environmental Hazards and Health Effects, Center for Environmental
Health and Injury Control, CDC, telephone: (404) 488-4780.
References
1.  CDC. Sudden unexplained death syndrome in Southeast Asian refugees:
a review of CDC surveillance. In: CDC surveillance summaries, Feb.
1987. MMWR 1987;36(no. 1SS): 43SS-53SS.
2. CDC. Sudden, unexpected, nocturnal deaths among Southeast Asian
refugees. MMWR 1981;30:581-4, 589.
3. Refugee Resettlement Program. Report to Congress. Washington, DC: US
Department of Health and Human Services, Social Security
Administration, 1988.
4. Refugee Program. Monthly summary, September 30, 1987. Washington,
DC: Department of State, Refugee Program, Sept. 1987.
5. Refugee Program. Monthly summary, December 31, 1987. Washington, DC:
Department of State, Refugee Program, Dec. 1987.
6. Kirschner RH, Eckner FAO, Baron RC. The cardiac pathology of sudden,
unexplained nocturnal death in Southeast Asian refugees. JAMA
1986;256:2700-5.
7. Baron RC, Thacker SB, Gorelkin L, Vernon AA, Taylor WR, Choi K.
Sudden death among Southeast Asian refugees. JAMA 1983;250:2947-51.
 
MMWR TRANSFER FILE
TITLE:Nonfatal Arsenic Poisoning in Three Hmong Patients -- Minnesota
SOURCE:33(24);347-9
SIZE:8069
DATE:Jun 22 1984
VOLUME:33
ISSUE:24
PAGE:347
SHORT:
CONTACT:
TEXT:
    Between December 1983 and April 1984, physicians at the Saint Paul
Ramsey Medical Center in Saint Paul, Minnesota, diagnosed arsenic
poisoning in three Hmong patients.  Hmong are recent immigrants to the
United States from the highland area of Northern Laos.  The source of
arsenic poisoning is suspected to be Hmong folk remedies, although two
of the three patients denied using them.  None of the three patients
had occupational exposures to arsenic-containing compounds or
pesticides.
    Patient 1:  A 68-year-old woman was admitted in December 1983 with
a 3-month history of abdominal pain, anorexia, sour taste and burning
sensation in the mouth, generalized pain, and paresthesias.  Six weeks
earlier, she had been admitted with similar complaints.  The diagnosis
at that time was goiter and hyperthyroidism, and she was treated with
radioiodine.  During this second admission, leukopenia
(3,200/mm((3))), anemia (hemoglobin 9.3 ug/dl, hematocrit 27.5%), and
a prolonged QT-interval on electrocardiogram (EKG) were observed.  She
had elevated levels of arsenic in 24-hour collections of urine on both
her first and sixth day of hospitalization (3,334 ug and 1,284 ug,
respectively; the normal level for this laboratory is less than 25 ug
per 24-hour urine collection).  Her serum arsenic level on the sixth
day of hospitalization was less than 0.01 ug/ml (normal for this
laboratory is less than 0.07 ug/ml).  She was treated with dimercaprol
(BAL) intramuscularly and with oral penicillamine.  Despite this
therapy, moderately severe peripheral neuropathy developed, persisting
for several months.  All other manifestations of arsenic poisoning
resolved.  The patient denied using Hmong folk remedies.
    Patient 2:  A 47-year-old woman was admitted in March 1984 with a
history of severe depression, anorexia, pain in the chest and arms,
and malaise.  She was found to have leukopenia (2,900/mm((3))),
hypocalcemia (7.6 mg/dl), hypomagnesemia (1.3 mg/dl), and hypokalemia
(2.7 meq/l).  A prolonged QT-interval was noted on EKG.  Her urine
arsenic level 11 days after admission was 327 ug per 24-hour
collection.  Her serum arsenic was less than 0.01 ug/ml.  She
recovered, and all hematologic and biochemical abnormalities resolved
without chelation therapy.  The patient denied using folk remedies to
overcome depression or any other illness.
    Patient 3:  A 39-year-old man suffered a "respiratory arrest" at
home in April 1984.  He had awakened in the middle of the night and
had taken a root-type Hmong folk remedy.  Ten minutes later, while
awake, he became unconscious, and his wife called for help.
Paramedics found his pulse to be 30 beats per minute, and his
respirations were shallow and feeble.  The man was resuscitated and
hospitalized.  His EKG showed sinus tachycardia with nonspecific ST
changes.  On monitoring, short runs of supraventricular tachycardia
were noted.  Pancytopenia and mild gastrointestinal bleeding developed
during the patient's hospitalization.  His 24-hour urine specimen
contained high levels of several metals, including arsenic (1,815 ug),
zinc (1,699 ug; normal is 300-600 ug), and iron (352 ug; normal is
100-300 ug).  On dermatologic examination, he had hyperkeratosis of
the palms and soles consistent with arsenic poisoning.  He was treated
with BAL and oral penicillamine and recovered.
Reported by N Holtan, MD, S Hall, MD, F Knight, MD, B Campion, MD, C
Drage, MD, Saint Paul Ramsey Medical Center; R Danila, MPH, Saint Paul
Div of Public Health; JN Kuritsky, MD, Medical Epidemiologist,
Minnesota Dept of Health; Special Studies Br, Chronic Diseases Div,
Center for Environmental Health, CDC.
Editorial Note: These appear to be the first three reported cases of
arsenic poisoning among the Hmong in the United States.  Although the
source of arsenic poisoning in these patients has not been identified,
it is possible that their clinical conditions resulted from ingestion
of arsenic-containing folk remedies.  There has been concern about
possible arsenic exposure in the Hmong, since arsenic (in addition to
lead and mercury) was found in some samples of Hmong folk remedies
(1).  Arsenic poisoning also has been reportedly associated with
herbal preparations used as medicine (2-4).  Although only one of the
three patients gave a history of using a folk remedy, that is still
the likeliest source of arsenic poisoning.  The use of folk remedies
should be suspected in all Hmong patients--not only those with
manifestations of acute or chronic illness, but also those who think
they may be ill.  Patients may go to great expense in seeking cures
with herbal and other folk remedies.  A reliable and accurate history
of folk remedy usage from Hmong patients is very difficult to obtain.
There have been incidents reported of Hmong admitting, and later
denying, that they used folk remedies, as well as conflicting reports
from within the same family about folk remedy use.
    These patients had no other known exposures to arsenic, such as
occupational exposures or use of arsenic-containing pesticides.
Arsenic exposure from dietary sources (such as from seafood) usually
does not result in acute toxicity as seen in these patients (5).
    The near-fatal case of the 39-year-old man is suggestive of the
sudden unexplained death syndrome (SUDS) among male Southeast Asian
refugees reported recently (6).  Although the epidemiologic
investigations of those deaths suggested that poisoning was an
unlikely cause of SUDS, toxicologic examinations did not include
assays for arsenic or other heavy metals.  While it is possible that
preparations of folk remedies may have been taken at bedtime and could
have resulted in effects shortly thereafter, family histories of such
practice among the patients were negative.  At present, there is
insufficient evidence to link arsenic ingestion or folk remedy use
with SUDS.
    The root-type Hmong folk remedy taken by the 39-year-old man is
being evaluated by health authorities and others to ascertain its
potential toxic effects and chemical composition.  Arsenic is toxic to
multiple organs and has neurologic (central and peripheral),
dermatologic, renal, hepatic, hematologic, and cardiac
manifestations.  The effects of arsenic on the heart include T-wave
abnormalities and a prolonged QT-interval (5).  Screening for arsenic,
mercury, and lead is indicated in Southeast Asian refugees who present
with symptoms consistent with heavy metal toxicity, especially those
who report recent use of folk remedies.  Testing for arsenic and
mercury is best performed on 24-hour urine specimens collected in
acid-rinsed containers; testing for lead poisoning should include
blood lead and erythrocyte protoporphyrin in whole blood (7).
Documented cases of heavy metal poisoning in the refugees should be
reported to local and state health departments and to CDC.
References
1.  CDC. Folk remedy-associated lead poisoning in Hmong
    children--Minnesota.  MMWR 1983;32:555-6.
2.  Tay C-H, Seah C-S. Arsenic poisoning from anti-asthmatic herbal
    preparations. Med J Aust 1975;2:424-8.
3.  Tay C-H. Cutaneous manifestations of arsenic poisoning due to
    certain Chinese herbal medicine.  Australas J Dermatol
    1974;15:121-31.
4.  Parsons JS. Contaminated herbal tea as a potential source of
    chronic arsenic poisoning.  NC Med J 1981;42:38-9.
5.  Perhsgen G. The epidemiology of human arsenic exposure.  In:
    Fowler BA, ed. Biological and environmental effects of arsenic.
    New York:  Elsevier Science Publishing Company, 1983.
6.  Baron RC, Thacker SB, Gorelkin L, et al.  Sudden death among
    Southeast Asian refugees.  An unexplained nocturnal phenomenon.
    JAMA 1983; 250:2947-51.
7.  CDC.  Preventing lead poisoning in young children: a statement by
    the Center for Disease Control.  Atlanta, Georgia:  Center for
    Disease Control, April 1978.
 

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August 2009, Week 1
July 2009, Week 5
July 2009, Week 4
July 2009, Week 3
July 2009, Week 2
July 2009, Week 1
June 2009, Week 5
June 2009, Week 4
June 2009, Week 3
June 2009, Week 2
June 2009, Week 1
May 2009, Week 5
May 2009, Week 4
May 2009, Week 3
May 2009, Week 2
May 2009, Week 1
April 2009, Week 5
April 2009, Week 4
April 2009, Week 3
April 2009, Week 2
April 2009, Week 1
March 2009, Week 5
March 2009, Week 4
March 2009, Week 3
March 2009, Week 2
March 2009, Week 1
February 2009, Week 4
February 2009, Week 3
February 2009, Week 2
February 2009, Week 1
January 2009, Week 5
January 2009, Week 4
January 2009, Week 3
January 2009, Week 2
January 2009, Week 1
December 2008, Week 5
December 2008, Week 4
December 2008, Week 3
December 2008, Week 2
December 2008, Week 1
November 2008, Week 5
November 2008, Week 4
November 2008, Week 3
November 2008, Week 2
November 2008, Week 1
October 2008, Week 5
October 2008, Week 4
October 2008, Week 3
October 2008, Week 2
October 2008, Week 1
September 2008, Week 5
September 2008, Week 4
September 2008, Week 3
September 2008, Week 2
September 2008, Week 1
August 2008, Week 5
August 2008, Week 4
August 2008, Week 3
August 2008, Week 2
August 2008, Week 1
July 2008, Week 5
July 2008, Week 4
July 2008, Week 3
July 2008, Week 2
July 2008, Week 1
June 2008, Week 5
June 2008, Week 4
June 2008, Week 3
June 2008, Week 2
June 2008, Week 1
May 2008, Week 5
May 2008, Week 4
May 2008, Week 3
May 2008, Week 2
May 2008, Week 1
April 2008, Week 5
April 2008, Week 4
April 2008, Week 3
April 2008, Week 2
April 2008, Week 1
March 2008, Week 5
March 2008, Week 4
March 2008, Week 3
March 2008, Week 2
March 2008, Week 1
February 2008, Week 5
February 2008, Week 4
February 2008, Week 3
February 2008, Week 2
February 2008, Week 1
January 2008, Week 5
January 2008, Week 4
January 2008, Week 3
January 2008, Week 2
January 2008, Week 1
December 2007, Week 5
December 2007, Week 4
December 2007, Week 3
December 2007, Week 2
December 2007, Week 1
November 2007, Week 5
November 2007, Week 4
November 2007, Week 3
November 2007, Week 2
November 2007, Week 1
October 2007, Week 5
October 2007, Week 4
October 2007, Week 3
October 2007, Week 2
October 2007, Week 1
September 2007, Week 5
September 2007, Week 4
September 2007, Week 3
September 2007, Week 2
September 2007, Week 1
August 2007, Week 5
August 2007, Week 4
August 2007, Week 3
August 2007, Week 2
August 2007, Week 1
July 2007, Week 5
July 2007, Week 4
July 2007, Week 3
July 2007, Week 2
July 2007, Week 1
June 2007, Week 5
June 2007, Week 4
June 2007, Week 3
June 2007, Week 2
June 2007, Week 1
May 2007, Week 5
May 2007, Week 4
May 2007, Week 3
May 2007, Week 2
May 2007, Week 1
April 2007, Week 4
April 2007, Week 3
April 2007, Week 2
April 2007, Week 1
March 2007, Week 5
March 2007, Week 4
March 2007, Week 3
March 2007, Week 2
March 2007, Week 1
February 2007, Week 4
February 2007, Week 3
February 2007, Week 2
February 2007, Week 1
January 2007, Week 5
January 2007, Week 4
January 2007, Week 3
January 2007, Week 2
January 2007, Week 1
December 2006, Week 5
December 2006, Week 4
December 2006, Week 3
December 2006, Week 2
December 2006, Week 1
November 2006, Week 5
November 2006, Week 4
November 2006, Week 3
November 2006, Week 2
November 2006, Week 1
October 2006, Week 5
October 2006, Week 4
October 2006, Week 3
October 2006, Week 2
October 2006, Week 1
September 2006, Week 5
September 2006, Week 4
September 2006, Week 3
September 2006, Week 2
September 2006, Week 1
August 2006, Week 5
August 2006, Week 4
August 2006, Week 3
August 2006, Week 2
August 2006, Week 1
July 2006, Week 5
July 2006, Week 4
July 2006, Week 3
July 2006, Week 2
July 2006, Week 1
June 2006, Week 5
June 2006, Week 4
June 2006, Week 3
June 2006, Week 2
June 2006, Week 1
May 2006, Week 5
May 2006, Week 4
May 2006, Week 3
May 2006, Week 2
May 2006, Week 1
April 2006, Week 4
April 2006, Week 3
April 2006, Week 2
April 2006, Week 1
March 2006, Week 5
March 2006, Week 4
March 2006, Week 3
March 2006, Week 2
March 2006, Week 1
February 2006, Week 4
February 2006, Week 3
February 2006, Week 2
February 2006, Week 1
January 2006, Week 5
January 2006, Week 4
January 2006, Week 3
January 2006, Week 2
January 2006, Week 1
December 2005, Week 5
December 2005, Week 4
December 2005, Week 3
December 2005, Week 2
December 2005, Week 1
November 2005, Week 5
November 2005, Week 4
November 2005, Week 3
November 2005, Week 2
November 2005, Week 1
October 2005, Week 5
October 2005, Week 4
October 2005, Week 3
October 2005, Week 2
October 2005, Week 1
September 2005, Week 5
September 2005, Week 4
September 2005, Week 3
September 2005, Week 2
September 2005, Week 1
August 2005, Week 5
August 2005, Week 4
August 2005, Week 3
August 2005, Week 2
August 2005, Week 1
July 2005, Week 5
July 2005, Week 4
July 2005, Week 3
July 2005, Week 2
July 2005, Week 1
June 2005, Week 5
June 2005, Week 4
June 2005, Week 3
June 2005, Week 2
June 2005, Week 1
May 2005, Week 5
May 2005, Week 4
May 2005, Week 3
May 2005, Week 2
May 2005, Week 1
April 2005, Week 5
April 2005, Week 4
April 2005, Week 3
April 2005, Week 2
April 2005, Week 1
March 2005, Week 5
March 2005, Week 4
March 2005, Week 3
March 2005, Week 2
March 2005, Week 1
February 2005, Week 4
February 2005, Week 3
February 2005, Week 2
February 2005, Week 1
January 2005, Week 5
January 2005, Week 4
January 2005, Week 3
January 2005, Week 2
January 2005, Week 1
December 2004, Week 5
December 2004, Week 4
December 2004, Week 3
December 2004, Week 2
December 2004, Week 1
November 2004, Week 5
November 2004, Week 4
November 2004, Week 3
November 2004, Week 2
November 2004, Week 1
October 2004, Week 5
October 2004, Week 4
October 2004, Week 3
October 2004, Week 2
October 2004, Week 1
September 2004, Week 5
September 2004, Week 4
September 2004, Week 3
September 2004, Week 2
September 2004, Week 1
August 2004, Week 5
August 2004, Week 4
August 2004, Week 3
August 2004, Week 2
August 2004, Week 1
July 2004, Week 5
July 2004, Week 4
July 2004, Week 3
July 2004, Week 2
July 2004, Week 1
June 2004, Week 5
June 2004, Week 4
June 2004, Week 3
June 2004, Week 2
June 2004, Week 1
May 2004, Week 4
May 2004, Week 3
May 2004, Week 2
May 2004, Week 1
April 2004, Week 5
April 2004, Week 4
April 2004, Week 3
April 2004, Week 2
April 2004, Week 1
March 2004, Week 5
March 2004, Week 4
March 2004, Week 3
March 2004, Week 2
March 2004, Week 1
February 2004, Week 5
February 2004, Week 4
February 2004, Week 3
February 2004, Week 2
February 2004, Week 1
January 2004, Week 5
January 2004, Week 4
January 2004, Week 3
January 2004, Week 2
January 2004, Week 1
December 2003, Week 5
December 2003, Week 4
December 2003, Week 3
December 2003, Week 2
December 2003, Week 1
November 2003, Week 5
November 2003, Week 4
November 2003, Week 3
November 2003, Week 2
November 2003, Week 1
October 2003, Week 5
October 2003, Week 4
October 2003, Week 3
October 2003, Week 2
October 2003, Week 1
September 2003, Week 5
September 2003, Week 4
September 2003, Week 3
September 2003, Week 2
September 2003, Week 1
August 2003, Week 5
August 2003, Week 4
August 2003, Week 3
August 2003, Week 2
August 2003, Week 1
July 2003, Week 5
July 2003, Week 4
July 2003, Week 3
July 2003, Week 2
July 2003, Week 1
June 2003, Week 5
June 2003, Week 4
June 2003, Week 3
June 2003, Week 2
June 2003, Week 1
May 2003, Week 5
May 2003, Week 4
May 2003, Week 3
May 2003, Week 2
May 2003, Week 1
April 2003, Week 5
April 2003, Week 4
April 2003, Week 3
April 2003, Week 2
April 2003, Week 1
March 2003, Week 5
March 2003, Week 4
March 2003, Week 3
March 2003, Week 2
March 2003, Week 1
February 2003, Week 4
February 2003, Week 3
February 2003, Week 2
February 2003, Week 1
January 2003, Week 5
January 2003, Week 4
January 2003, Week 3
January 2003, Week 2
January 2003, Week 1
December 2002, Week 5
December 2002, Week 4
December 2002, Week 3
December 2002, Week 2
December 2002, Week 1
November 2002, Week 5
November 2002, Week 4
November 2002, Week 3
November 2002, Week 2
November 2002, Week 1
October 2002, Week 5
October 2002, Week 4
October 2002, Week 3
October 2002, Week 2
October 2002, Week 1
September 2002, Week 5
September 2002, Week 4
September 2002, Week 3
September 2002, Week 2
September 2002, Week 1
August 2002, Week 5
August 2002, Week 4
August 2002, Week 3
August 2002, Week 2
August 2002, Week 1
July 2002, Week 5
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July 2002, Week 3
July 2002, Week 2
July 2002, Week 1
June 2002, Week 5
June 2002, Week 4
June 2002, Week 3
June 2002, Week 2
June 2002, Week 1
May 2002, Week 5
May 2002, Week 4
May 2002, Week 3
May 2002, Week 2
May 2002, Week 1
April 2002, Week 5
April 2002, Week 4
April 2002, Week 3
April 2002, Week 2
April 2002, Week 1
March 2002, Week 5
March 2002, Week 4
March 2002, Week 3
March 2002, Week 2
March 2002, Week 1
February 2002, Week 4
February 2002, Week 3
February 2002, Week 2
February 2002, Week 1
January 2002, Week 5
January 2002, Week 4
January 2002, Week 3
January 2002, Week 2
January 2002, Week 1
December 2001, Week 5
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December 2001, Week 3
December 2001, Week 2
December 2001, Week 1
November 2001, Week 5
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November 2001, Week 3
November 2001, Week 2
November 2001, Week 1
October 2001, Week 5
October 2001, Week 4
October 2001, Week 3
October 2001, Week 2
October 2001, Week 1
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August 2001, Week 4
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July 2001, Week 1
June 2001, Week 5
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June 2001, Week 1
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May 2001, Week 2
May 2001, Week 1
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April 2001, Week 3
April 2001, Week 2
April 2001, Week 1
March 2001, Week 5
March 2001, Week 4
March 2001, Week 3
March 2001, Week 2
March 2001, Week 1
February 2001, Week 4
February 2001, Week 3
February 2001, Week 2
February 2001, Week 1
January 2001, Week 5
January 2001, Week 4
January 2001, Week 3
January 2001, Week 2
January 2001, Week 1
December 2000, Week 5
December 2000, Week 4
December 2000, Week 3
December 2000, Week 2
December 2000, Week 1
November 2000, Week 5
November 2000, Week 4
November 2000, Week 3
November 2000, Week 2
November 2000, Week 1
October 2000, Week 5
October 2000, Week 4
October 2000, Week 3
October 2000, Week 2
October 2000, Week 1
September 2000, Week 5
September 2000, Week 4
September 2000, Week 3
September 2000, Week 2
September 2000, Week 1
August 2000, Week 5
August 2000, Week 4
August 2000, Week 3
August 2000, Week 2
August 2000, Week 1
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July 2000, Week 3
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July 2000, Week 1
June 2000, Week 5
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June 2000, Week 1
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May 2000, Week 2
May 2000, Week 1
April 2000, Week 5
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April 2000, Week 3
April 2000, Week 2
April 2000, Week 1
March 2000, Week 5
March 2000, Week 4
March 2000, Week 3
March 2000, Week 2
March 2000, Week 1
February 2000, Week 5
February 2000, Week 4
February 2000, Week 3
February 2000, Week 2
February 2000, Week 1
January 2000, Week 5
January 2000, Week 4
January 2000, Week 3
January 2000, Week 2
January 2000, Week 1
December 1999, Week 5
December 1999, Week 4
December 1999, Week 3
December 1999, Week 2
December 1999, Week 1
November 1999, Week 5
November 1999, Week 4
November 1999, Week 3
November 1999, Week 2
November 1999, Week 1
October 1999, Week 5
October 1999, Week 4
October 1999, Week 3
October 1999, Week 2
October 1999, Week 1
September 1999, Week 5
September 1999, Week 4
September 1999, Week 3
September 1999, Week 2
September 1999, Week 1
August 1999, Week 5
August 1999, Week 4
August 1999, Week 3
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July 1999, Week 3
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July 1999, Week 1
June 1999, Week 5
June 1999, Week 4
June 1999, Week 3
June 1999, Week 2
June 1999, Week 1
May 1999, Week 5
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May 1999, Week 3
May 1999, Week 2
May 1999, Week 1
April 1999, Week 5
April 1999, Week 4
April 1999, Week 3
April 1999, Week 2
April 1999, Week 1
March 1999, Week 5
March 1999, Week 4
March 1999, Week 3
March 1999, Week 2
March 1999, Week 1
February 1999, Week 4
February 1999, Week 3
February 1999, Week 2
February 1999, Week 1
January 1999, Week 5
January 1999, Week 4
January 1999, Week 3
January 1999, Week 2
January 1999, Week 1
December 1998, Week 5
December 1998, Week 4
December 1998, Week 3
December 1998, Week 2
December 1998, Week 1
November 1998, Week 5
November 1998, Week 4
November 1998, Week 3
November 1998, Week 2
November 1998, Week 1
October 1998, Week 5
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October 1998, Week 3
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October 1998, Week 1
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June 1998, Week 4
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June 1998, Week 1
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May 1998, Week 1
April 1998, Week 5
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April 1998, Week 3
April 1998, Week 2
April 1998, Week 1
March 1998, Week 5
March 1998, Week 4
March 1998, Week 3
March 1998, Week 2
March 1998, Week 1
February 1998, Week 4
February 1998, Week 3
February 1998, Week 2
February 1998, Week 1
January 1998, Week 5
January 1998, Week 4
January 1998, Week 3
January 1998, Week 2
January 1998, Week 1
December 1997, Week 5
December 1997, Week 4
December 1997, Week 3
December 1997, Week 2
December 1997, Week 1
November 1997, Week 5
November 1997, Week 4
November 1997, Week 3
November 1997, Week 2
November 1997, Week 1
October 1997, Week 5
October 1997, Week 4
October 1997, Week 3
October 1997, Week 2
October 1997, Week 1
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September 1997, Week 1
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May 1997, Week 3
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May 1997, Week 1
April 1997, Week 5
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April 1997, Week 1
March 1997, Week 5
March 1997, Week 4
March 1997, Week 3
March 1997, Week 2
March 1997, Week 1
February 1997, Week 4
February 1997, Week 3
February 1997, Week 2
February 1997, Week 1
January 1997, Week 5
January 1997, Week 4
January 1997, Week 3
January 1997, Week 2
January 1997, Week 1
December 1996, Week 5
December 1996, Week 4
December 1996, Week 3
December 1996, Week 2
December 1996, Week 1
November 1996, Week 5
November 1996, Week 4
November 1996, Week 3
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November 1996, Week 1
October 1996, Week 5
October 1996, Week 4
October 1996, Week 3
October 1996, Week 2
October 1996, Week 1
September 1996, Week 5
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September 1996, Week 1
August 1996, Week 5
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April 1996, Week 5
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April 1996, Week 3
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April 1996, Week 1
March 1996, Week 5
March 1996, Week 4
March 1996, Week 3
March 1996, Week 2
March 1996, Week 1
February 1996, Week 5
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February 1996, Week 1
January 1996, Week 5
January 1996, Week 4
January 1996, Week 3
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January 1996, Week 1
December 1995, Week 5
December 1995, Week 4
December 1995, Week 3
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October 1995, Week 3
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July 1995, Week 2
July 1995, Week 1
June 1995, Week 5
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May 1995, Week 1
April 1995, Week 5
April 1995, Week 4
April 1995, Week 3
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April 1995, Week 1
March 1995, Week 5
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March 1995, Week 3
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March 1995, Week 1
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February 1995, Week 1
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December 1994, Week 5
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