Issue Number
231 March 2, 2001
CONTENTS OF THIS ISSUE
- Revised! "Hepatitis A & B Vaccines: Give the Correct
Dose" is updated and available on IAC's website
- JAMA publishes article on 1999 rubella outbreak in
Nebraska
- CDC reports on influenza B virus outbreak on a European
cruise ship
- CDC reports on continued polio outbreak in the Dominican
Republic and Haiti
- CDC reports on polio eradication progress in Afghanistan
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(1)
March 2, 2001
REVISED! "HEPATITIS A & B VACCINES: GIVE THE CORRECT DOSE" IS UPDATED AND AVAILABLE ON IAC'S WEBSITE
Check the website of the Immunization Action Coalition (IAC) for the latest revision of a helpful dosage guide for
hepatitis A and B vaccines. This important educational piece has been updated to include licensing changes in
Merck & Co.'s hepatitis A vaccine, Vaqta.
The licensing change extended the age range for the pediatric formulation of
Vaqta an extra year--it is now approved for use from age 2 through age 18 instead of from
age 2 through age 17. It also extended the timing of the adult formulation booster dose of Vaqta from six months following
the initial dose to an interval of six to twelve months.
To obtain a copy of this resource, go to: http://www.immunize.org/catg.d/2081ab.htm
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(2)
March 2, 2001
JAMA PUBLISHES ARTICLE ON 1999 RUBELLA OUTBREAK IN NEBRASKA
The Journal of the American Medical Association (JAMA) published an article on December 6, 2000, titled "A Large
Rubella Outbreak with Spread from the Workplace to the Community." It reports on the largest U.S. rubella outbreak
in the past five years, which occurred in Nebraska during 1999. All 83 cases
were unvaccinated or of unknown vaccination status, and many of the cases involved adults
born in Latin America.
The findings suggest that crowded living and working conditions, not vaccine
failure or failures in U.S. childhood immunization strategies, contributed to the
outbreak.
To read the abstract of the article online, go to: http://jama.ama-assn.org/issues/v284n21/abs/joc01466.html
Editor's Note: Special attention should be given to administering MMR vaccine
to persons born in 1957 or later in countries where MMR vaccine has not been routinely
administered.
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(3)
March 2, 2001
CDC REPORTS ON INFLUENZA B VIRUS OUTBREAK ON A EUROPEAN CRUISE SHIP
The Centers for Disease Control and Prevention (CDC) published a report titled "Influenza B Virus Outbreak on a
Cruise Ship--Northern Europe, 2000," in the March 2, 2001, issue of Morbidity and Mortality Weekly Report
(MMWR). According to the article, an outbreak of influenza B occurred on a cruise ship June 23-July 5, 2000, during a 12-day Baltic cruise.
According to the Editorial Note: "Influenza A outbreaks have been reported on
cruise ships sailing in the Northern Hemisphere during the summer, but influenza B outbreaks have
not been documented. Early suspicion of a potential influenza outbreak among crew members and rapid
implementation of a respiratory illness control protocol probably limited the size of the
outbreak. Key elements of the protocol included 1) implementation of active and
passive surveillance using standard case definitions; 2) use of targeted rapid influenza diagnostic testing and viral
cultures to confirm cases of influenza virus infection; 3) isolation of all crew members meeting the ILI
[influenza-like illness] case definition or those with confirmed influenza; 4) use
of antiviral agents for treatment and, if indicated, for prophylaxis; and 5)
monitoring of intervention results."
The Note concludes: "Summertime influenza outbreaks among passengers and crew members on cruise ships suggest that
traveling in large groups can pose a risk for exposure to influenza viruses, even when the group is traveling
in regions where influenza is not in seasonal circulation. Travelers at high risk
for complications of influenza (e.g., persons aged 50 years and older, immunocompromised persons,
and persons with chronic disorders of the pulmonary or cardiovascular systems) who were not vaccinated with
influenza vaccine during the preceding fall or winter should consider receiving influenza
vaccine before travel 1) with large organized tourist groups at any time of year; 2) to
the tropics; or 3) to the Southern Hemisphere from April through September (the time of increased influenza activity
in that hemisphere). Cruise lines should attempt to achieve at least an 80% vaccination rate among
crew members on each ship each year."
For the complete text of this article, including tables, go to: http://www.cdc.gov/mmwr//preview/mmwrhtml/mm5008a1.htm
For information on how to obtain a free electronic subscription to the MMWR,
see the information following story five below.
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(4)
March 2, 2001
CDC REPORTS ON CONTINUED POLIO OUTBREAK IN THE DOMINICAN REPUBLIC AND HAITI
CDC published a Public Health Dispatch titled "Outbreak of Poliomyelitis--Dominican Republic and Haiti, 2000-2001," in
the March 2,2001, issue of MMWR.
According to CDC, 12 cases of polio have been confirmed in
the Dominican Republic and one case in Haiti among inadequately vaccinated or
unvaccinated patients. The date of paralysis onset of the last case was January 2, 2001.
The article warns: "Travelers to the Dominican Republic and Haiti who are not
vaccinated adequately are at risk for polio. All travelers should be vaccinated
against polio according to national vaccination policies."
For the complete text of this article, go to: http://www.cdc.gov/mmwr//preview/mmwrhtml/mm5008a4.htm
For information on how to obtain a free electronic subscription to the MMWR,
see the information following story five below.
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(5)
March 2, 2001
CDC REPORTS ON POLIO ERADICATION PROGRESS IN AFGHANISTAN
CDC published an article titled "Progress Toward Poliomyelitis Eradication--Afghanistan, 1999-2000" in the
March 2, 2001, issue of MMWR.
According to the Editorial Note, "Although polio remains endemic in Afghanistan, progress during 1999-2000
demonstrates that key strategies can be implemented successfully in countries experiencing internal strife." It
goes on to say that civil strife, returning refugees, nomadic populations, drought,
climate, and geographic barriers are some of the obstacles facing polio eradication
efforts in Afghanistan. Innovative measures and local peace initiatives will be important in creating opportunities for
reaching and vaccinating Afghanistan's isolated populations.
For the complete text of this article, go to: http://www.cdc.gov/mmwr//preview/mmwrhtml/mm5008a3.htm
HOW TO OBTAIN A FREE ELECTRONIC SUBSCRIPTION TO THE MMWR:
To obtain a free electronic subscription to the "Morbidity and Mortality Weekly Report" (MMWR), visit CDC's MMWR
website at: http://www.cdc.gov/mmwr
Select "Free MMWR Subscription" from the menu at the left of the screen. Once
you have submitted the required information, weekly issues of the MMWR and all new ACIP statements (published as MMWR's
"Recommendations and Reports") will arrive automatically by e-mail.
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