Twenty cases of measles reported in Minnesota children

Minnesota's Hennepin County is currently experiencing an outbreak of measles cases. All of the cases are confirmed to be Somali-American children age 0 through 5 years of age. Sixteen of the cases are confirmed to be unvaccinated; vaccination status of the remaining cases has not yet been determined. The local Somali community has been targeted for years with misinformation about a connection between vaccination and autism, including a 2011 visit from Andrew Wakefield, the controversial physician whose license to practice medicine was revoked by Britain's General Medical Council as a result of ethical and financial misconduct.

Related Links

• Minnesota Department of Health: Measles Outbreak Information
• Minnesota Department of Health: Measles Outbreak Vaccination Guidance
• Star Tribune: Two new measles cases confirmed by Minnesota health officials (4/20/17)
• Star Tribune: In measles outbreak, a misconception about vaccines still plagues Somali community (4/22/17)
• Star Tribune: Anti-vaccine doctor meets with Somalis (3/24/11)

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CDC reports on a varicella death on a cargo ship in Puerto Rico

CDC published Notes from the Field: Varicella Fatality on a Cargo Vessel—Puerto Rico, 2015 in the April 21 issue of MMWR (page 410). Sections of the report are reprinted below.

The U.S. Code of Federal Regulations (42 §71.21) requires that the master of a ship destined to a U.S. port of entry report certain illnesses, as well as any death on board to the nearest CDC Quarantine Station. On December 30, 2015, the U.S. Coast Guard notified CDC of the death of a crew member of a foreign cargo vessel off the coast of Puerto Rico. ... Lung tissue and skin lesion specimens collected at autopsy were positive for varicella-zoster virus DNA by polymerase chain reaction at CDC. The cause of death was reported as varicella pneumonia. No other medical conditions were reported....

Per CDC recommendations, all 24 shipmates were considered contacts of the index patient; the master of the ship instituted daily temperature and rash surveillance for 21 days (i.e., one incubation period) after the death.... 

This investigation highlights the importance of early notification of illness or death to CDC by ships arriving to U.S. ports of entry, and the use of CDC’s varicella management guidance to prevent further transmission, including surveillance for febrile rash illness, isolation of cases, screening for varicella immunity, and vaccination of nonimmune persons. Collaboration with the U.S. Coast Guard was critical for expediting communication with the master of the ship. Assistance from the Puerto Rico Department of Health and the Puerto Rico Forensic Sciences Institute was instrumental in ensuring a thorough and timely investigation and public health response. Keeping a stock of acyclovir onboard was added to the CDC maritime varicella management guidance.

Related Links

• MMWR main page provides access to MMWR Weekly, MMWR Recommendations and Reports, MMWR Surveillance Summaries, and MMWR Supplements
• Free MMWR electronic subscription

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World Meningitis Day celebrated on April 24

World Meningitis Day is celebrated every year on April 24, with organization by the Confederation of Meningitis Organisations (CoMO). CoMO is an international member organization that works to reduce the incidence and impact of meningitis worldwide. CoMO brings together patient groups, health professionals and organizations, meningitis survivors and families from more than 25 countries to help prevent meningitis.

The theme of the 2017 campaign is "24 Hours—Trust your instincts." The key messages of the 2017 campaign are: 

• Meningitis is a potentially deadly disease that affects more than 1 million people worldwide each year
• Meningitis can affect people of all ages and cause death within 24 hours
• Some forms of meningitis are vaccine preventable
• Don’t wait until it threatens the life of someone you care about, learn what to look for and trust your instincts

Visit the Confederation of Meningitis Organisations website for more information on World Meningitis Day 2017, including resources to help spread awareness of meningococcal disease.

Related Links

• Meningitis Angels
• Meningitis Foundation of America
• Meningitis Vaccine Project
• National Meningitis Association
• The Kimberley Coffey Foundation
• CDC's Meningococcal Vaccination web page
• WHO's Meningitis disease web page
• IAC's Meningococcal ACWY Disease web page on immunize.org
• IAC's Meningococcal B Disease web page on immunize.org
• IAC's Meningococcal ACWY Handouts web page for healthcare professionals, patients, and parents
• IAC's Meningococcal B Handouts web page for healthcare professionals, patients, and parents
• Vaccine Education Center's Meningococcus: What you should know; also in Spanish

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IAC Spotlight! Archived webinar of Dr. William L. Atkinson presenting “Adolescent Immunization: Where We Are Now and How We Can Do Better” can be viewed on IAC website; slide set and speaker notes also available

In July 2016, Dr. William L. Atkinson, MD, MPH, IAC’s associate director for immunization education, presented a webinar titled “Adolescent Immunization: Where We Are Now and How We Can Do Better.” Dr. Atkinson reviewed the recommendations for each adolescent vaccine, provided strategies to improve coverage rates in this population, and listed available resources to assist immunization providers in their efforts to improve coverage rates.

This presentation is available on the home page of IAC’s main website at www.immunize.org. To view it, scroll down to the middle of the page to Dr. Atkinson’s photo and click on the link.

In addition, the slide presentation and speakers notes are available on IAC’s PowerPoint Slide Set web page. At this link, you can request the full PowerPoint slide set and speaker's notes to create your own adolescent immunization presentation.

Related Links

• Adolescent Immunization Initiative white paper: Rationale for an Immunization Platform at 16 Years of Age 
• Technically Speaking: New “16-year-old Vaccination Platform” Highlighted in 2017 U.S. Child/Teen Immunization Schedule 
• Position Statement, Society of Adolescent Health and Medicine: Establishing an Immunization Platform for 16-Year-Olds in the United States 
• IAC's Give2MCV4 website
• National Foundation for Infectious Diseases: Call to Action: Addressing New and Ongoing Adolescent Vaccination Challenges 

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IAC HANDOUTS

IAC posts Spanish translations of four updated HPV handouts for parents, teens, or adults 

Earlier this year, IAC revised four fact sheets for parents and teens about human papillomavirus (HPV) infection and vaccination. Changes included new data on cervical cancer and the number of doses in the schedule, since it can be either two or three. The Spanish-language versions of these resources have now been updated to match the English-language versions.

1. HPV is a serious disease...Make sure your child is protected!  (Spanish-language version)
2. Protect yourself from HPV...Get vaccinated!  (Spanish-language version)
3. Human Papillomavirus (HPV): A Parent's Guide to Preteen and Teen HPV Vaccination (Spanish-language version)
4. HPV Vaccine: A Guide for Young Adults  (Spanish-language version)

Related Links

• Access all IAC's print resources related to HPV vaccination
• Access all IAC's handouts for parents

IAC's Handouts for Patients & Staff web section offers healthcare professionals and the public more than 250 FREE English-language handouts (many also available in translation), which we encourage website users to print out, copy, and distribute widely.

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IAC corrects a small error on its "Screening Checklist for Contraindications to Vaccines for Adults"

IAC recently corrected a small error on page 2 of its Screening Checklist for Contraindications to Vaccines for Adults. The abbreviation "IIV" was changed to "IPV" in the item #9 question on the second page ("For women: Are you pregnant or is there a chance you could become pregnant during the next month? [HPV, IPV, MMR, LAIV, VAR, ZOS]").

Page 2 is where explanations are provided for healthcare professionals as to why the screening questions are asked and what should be considered. This change does not in any way affect page 1, which is the checklist given to patients to fill out.

Related Link

• IAC's Screening Questionnaires web section

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OFFICIAL RELEASES AND ANNOUNCEMENTS

CDC publishes community mitigation guidelines to prevent pandemic influenza

CDC published Community Mitigation Guidelines to Prevent Pandemic Influenza—United States, 2017 as a MMWR Recommendations and Reports on April 21. The "Summary" section is reprinted below.
 
When a novel influenza A virus with pandemic potential emerges, nonpharmaceutical interventions (NPIs) often are the most readily available interventions to help slow transmission of the virus in communities, which is especially important before a pandemic vaccine becomes widely available. NPIs, also known as community mitigation measures, are actions that persons and communities can take to help slow the spread of respiratory virus infections, including seasonal and pandemic influenza viruses.

These guidelines replace the 2007 Interim Pre-pandemic Planning Guidance: Community Strategy for Pandemic Influenza Mitigation in the United States—Early, Targeted, Layered Use of Nonpharmaceutical Interventions. Several elements remain unchanged from the 2007 guidance, which described recommended NPIs and the supporting rationale and key concepts for the use of these interventions during influenza pandemics. NPIs can be phased in, or layered, on the basis of pandemic severity and local transmission patterns over time. Categories of NPIs include personal protective measures for everyday use (e.g., voluntary home isolation of ill persons, respiratory etiquette, and hand hygiene); personal protective measures reserved for influenza pandemics (e.g., voluntary home quarantine of exposed household members and use of face masks in community settings when ill); community measures aimed at increasing social distancing (e.g., school closures and dismissals, social distancing in workplaces, and postponing or cancelling mass gatherings); and environmental measures (e.g., routine cleaning of frequently touched surfaces).

Several new elements have been incorporated into the 2017 guidelines. First, to support updated recommendations on the use of NPIs, the latest scientific evidence available since the influenza A (H1N1)pdm09 pandemic has been added. Second, a summary of lessons learned from the 2009 H1N1 pandemic response is presented to underscore the importance of broad and flexible prepandemic planning. Third, a new section on community engagement has been included to highlight that the timely and effective use of NPIs depends on community acceptance and active participation. Fourth, to provide new or updated pandemic assessment and planning tools, the novel influenza virus pandemic intervals tool, the Influenza Risk Assessment Tool, the Pandemic Severity Assessment Framework, and a set of prepandemic planning scenarios are described. Finally, to facilitate implementation of the updated guidelines and to assist states and localities with prepandemic planning and decision-making, this report links to six supplemental prepandemic NPI planning guides for different community settings that are available online (https://www.cdc.gov/nonpharmaceutical-interventions).

Related Link

• CDC's Pandemic Influenza web section

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WORLD NEWS

Immunization campaign protects 5 million children from polio and measles in Yemen

The World Health Organization (WHO), UNICEF, and the World Bank are sponsoring a campaign to vaccinate children against polio in war-torn Yemen. A 2-year conflict has all but destroyed the country's health system, including the immunization program. A section of an April 8 joint press release from these organization is reprinted below.

In an effort to keep Yemen polio-free, nearly 5 million children under the age of five have been vaccinated in a nationwide campaign covering all governorates in the country. The campaign was supported by a partnership between the World Bank, UNICEF, and WHO launched in February 2017.
 
Despite intensifying violence in Sa'ada governorate, more than 369,000 children between the ages of 6 months and 15 years were immunized against measles—a highly contagious and potentially fatal disease—and over 155,000 children under the age of 5 were vaccinated against polio. 

Read the complete press release: Nationwide immunization campaign protects 5 million children against polio in war-torn Yemen.

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WHO publishes global strategy on eliminating yellow fever epidemics

The World Health Organization (WHO) published Eliminate Yellow fever Epidemics (EYE): a global strategy, 2017–2026 in the April 21 issue of its Weekly Epidemiological Record. The goal of the EYE strategy is to eliminate yellow fever epidemics globally by 2026. The "Strategic objectives" are reprinted below:

With a view towards achieving the goal of the EYE strategy, 3 objectives have been defined

1. To protect at-risk populations.
2. To prevent international spread of the disease.
3. To contain outbreaks rapidly.

The revised strategy is both global—extending beyond the established endemic areas in Africa and the Americas, and comprehensive—covering activities beyond vaccination. It emphasizes surveillance and laboratory capacity strengthening, the application of the International Health Regulations (2005) (IHR), and the involvement of the private sector, especially the mining, forestry, and agro-industries.

Related Link

• Current issue and archives of the Weekly Epidemiological Record

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World Malaria Day was commemorated on April 25

CDC published Announcement: World Malaria Day—April 25, 2017 in the April 21 issue of MMWR (page 412). The first paragraph is reprinted below.

World Malaria Day is commemorated each year on April 25, the date in 2000 when leaders of 44 African nations met in Abuja, Nigeria, and committed their countries to reducing the number of malaria-related deaths. Approximately 90% of all malaria deaths occur in Africa. During the last 15 years, donors have collectively supported the procurement and distribution of billions of insecticide-treated bed nets and courses of artemisinin-based combination therapy globally. These improvements in malaria control are estimated to have saved an estimated 6.8 million lives, mostly among children aged <5 years. From 2010 to 2015, the World Health Organization (WHO) reported that the estimated number of malaria deaths worldwide declined by approximately 60%, including a 69% decline among children aged <5 years. This year, as in 2016, the theme of World Malaria Day is “End Malaria for Good,” reflecting the increased interest in and commitment to eliminating malaria.

Related Link

• CDC's Malaria web section

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