Issue
Number 414
September 29, 2003
CONTENTS OF THIS ISSUE
- CDC releases ACIP recommendations on using live, attenuated
influenza vaccine
- CDC reports on transmission of hepatitis B and C viruses in
U.S. outpatient settings during 2000-02
- Read it now: Washington Post article "Measles Cases Rebounding
in Affluent Society" accessible until October 5
- New: September 2003 issue of "VACCINATE WOMEN" now online
- September issue of CDC's "Immunization Works!" available
online
- CDC issues update on recent U.S. and global influenza activity
- American Lung Association encourages flu vaccine for people
with asthma and lung disease, as well as senior citizens
- CDC notifies readers about FDA approval of INFANRIX for fifth
consecutive DTaP vaccine dose
- Reminder: Register for CDC's "Epidemiology and Prevention of
Vaccine-Preventable Diseases" course in California
- CDC notifies readers about status of standards of excellence
for immunization registries
- CDC issues Health Advisory about a current multi-state
outbreak of foodborne hepatitis A
- CDC reports on laboratory surveillance for wild and
vaccine-derived polioviruses
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September 29, 2003
CDC RELEASES ACIP RECOMMENDATIONS ON USING LIVE, ATTENUATED INFLUENZA
VACCINE
The Centers for Disease Control and Prevention (CDC) published "Using Live,
Attenuated Influenza Vaccine for Prevention and Control of Influenza:
Supplemental Recommendations of the Advisory Committee on Immunization
Practices (ACIP)" in the September 26 issue of "MMWR Recommendations and
Reports" (MMWR). The summary is reprinted below.
***********************
This report summarizes recommendations by the Advisory Committee on
Immunization Practices (ACIP) for using intranasally administered,
trivalent, cold-adapted, live, attenuated influenza vaccine (LAIV), which
was approved for use in the United States on June 17, 2003, (FluMist,
produced by MedImmune, Inc., Gaithersburg, Maryland). LAIV is currently
approved for use among healthy persons (i.e., those not at high risk for
complications from influenza infection) aged 5-49 years. This report
includes information regarding 1) vaccine composition and mechanisms of
action; 2) comparison between LAIV and trivalent inactivated influenza
vaccine; 3) effectiveness and safety of LAIV; 4) transmission and stability
of LAIV viruses; 5) recommendations and contraindications for using LAIV;
and 6) dosage and administration of LAIV. This report supplements the 2003
ACIP recommendations regarding prevention and control of influenza (CDC.
Prevention and Control of Influenza: Recommendations of the Advisory
Committee on Immunization Practices [ACIP]. MMWR 2003;52[No. RR-8]:1-36.)
***********************
Links to the September 26, 2003, Supplemental ACIP Recommendation:
To obtain the complete text of the supplemental recommendations online, go
to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5213a1.htm
To obtain a camera-ready (PDF format) copy of the supplemental
recommendations, go to:
http://www.cdc.gov/mmwr/PDF/rr/rr5213.pdf
Links to the April 25, 2003, ACIP Recommendation titled "Prevention and
Control of Influenza: Recommendations of the Advisory Committee on
Immunization Practices (ACIP)": To obtain the complete text of the
recommendations online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5208a1.htm
To obtain a camera-ready (PDF format) copy of the recommendations, go to:
http://www.cdc.gov/mmwr/PDF/rr/rr5208.pdf
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 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 email.
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September 29, 2003
CDC REPORTS ON TRANSMISSION OF HEPATITIS B AND C VIRUSES IN U.S. OUTPATIENT
SETTINGS DURING 2000-02
The Centers for Disease Control and Prevention (CDC) published "Transmission
of Hepatitis B and C Viruses in Outpatient Settings--New York, Oklahoma, and
Nebraska, 2000-2002" in the September 26 issue of "Morbidity and Mortality
Weekly Report" (MMWR). Portions of the article and the complete contents of
a box of information about infection-control and safe injection practices
are reprinted below.
***********************
[The article's first paragraph]
Transmission of hepatitis B virus (HBV) and hepatitis C virus (HCV) can
occur in health-care settings from percutaneous or mucosal exposures to
blood or other body fluids from an infected patient or health-care worker.
This report summarizes the investigation of four outbreaks of HBV and HCV
infections that occurred in outpatient health-care settings. The
investigation of each outbreak suggested that unsafe injection practices,
primarily reuse of syringes and needles or contamination of multiple-dose
medication vials, led to patient-to-patient transmission. To prevent
transmission of bloodborne pathogens, all health-care workers should adhere
to recommended standard precautions and fundamental infection-control
principles, including safe injection practices and appropriate aseptic
techniques.
[The article's Editorial Note in its entirety, excluding references]
These four outbreaks are among the largest health-care-related viral
hepatitis outbreaks reported in the United States and share several common
characteristics. All occurred in outpatient settings and were reported to
public health authorities by clinicians who suspected these infections might
have been health-care-related. The investigations were resource-intensive
and involved notification, testing, and counseling of hundreds of patients.
Transmission probably occurred indirectly from patient to patient after
exposure to injection equipment that was contaminated with the blood of one
or more source patients. All of these outbreaks could have been prevented by
adherence to basic principles of aseptic technique for the preparation and
administration of parenteral medications.
Health-care-related exposures are a well-recognized but uncommon source of
viral hepatitis transmission in the United States. The majority of outbreaks
identified previously have been associated with unsafe injection practices,
primarily reuse of syringes and needles or contamination of multiple-dose
medication vials. However, because the majority of patients with acute HBV
or HCV infection are asymptomatic, clusters of patients infected in the
health-care setting might be unrecognized. Health-care-related transmission
should be suspected when cases are detected among persons without
traditional risk factors for infection. State and local health authorities
should consider strategies to improve case identification, such as targeting
intensive follow-up for persons who typically are at low risk for infection
(e.g., persons aged over 60 years).
In the outbreaks described in this report, health-care workers did not
adhere to fundamental principles related to safe injection practices,
suggesting that they failed to understand the potential of their actions to
lead to disease transmission. In addition, deficiencies related to oversight
of personnel and failures to follow up on reported breaches in
infection-control practices resulted in delays in correcting the implicated
practices. To prevent health-care-related transmission of bloodborne
viruses, certification and training programs need to reinforce
infection-control principles and practices, including aseptic techniques and
safe injection practices. These principles should be reviewed with frequent
in-service education for health-care staff, including those who work in
outpatient settings, and practices should be monitored as part of the
institutional oversight process. Finally, written policies and procedures to
prevent patient-to-patient transmission of bloodborne pathogens should be
established and implemented among all staff involved in direct patient care.
CDC is working with professional organizations, advisory groups, and state
and local health departments to address these issues.
[Contents of a box of information on infection-control and safe injection
practices]
BOX. Infection-control and safe injection practices to prevent
patient-to-patient transmission of bloodborne pathogens
Injection safety
- Use a sterile, single-use, disposable
needle and syringe for each injection and discard intact in an appropriate
sharps container after use.
- Use single-dose medication vials,
prefilled syringes, and ampules when possible. Do not administer
medications from single-dose vials to multiple patients or combine
left-over contents for use later.
- If multiple-dose vials are used, restrict
them to a centralized medication area or for single patient use. Never
re-enter a vial with a needle or syringe used on one patient if the vial
will be used to withdraw medication for another patient. Store vials in
accordance with manufacturer's recommendations and discard if sterility is
compromised.
- Do not use bags or bottles of intravenous
solution as a common source of supply for multiple patients.
- Use aseptic technique to avoid
contamination of sterile injection equipment and medications.
Patient-care equipment
- Handle patient-care equipment that might
be contaminated with blood in a way that prevents skin and mucous
membrane exposures, contamination of clothing, and transfer of
microorganisms to other patients and surfaces.
- Evaluate equipment and devices for
potential cross-contamination of blood. Establish procedures for safe
handling during and after use, including cleaning and disinfection or
sterilization as indicated.
Work environment
- Dispose of used syringes and needles
at the point of use in a sharps container that is puncture-resistant
and leak-proof and that can be sealed before completely full.
- Maintain physical separation between
clean and contaminated equipment and supplies.
- Prepare medications in areas
physically separated from those with potential blood contamination.
- Use barriers to protect surfaces from
blood contamination during blood sampling.
- Clean and disinfect blood-contaminated
equipment and surfaces in accordance with recommended guidelines.
Hand hygiene and gloves
- Perform hand hygiene (i.e., hand
washing with soap and water or use of an alcohol-based hand rub)
before preparing and administering an injection, before and after
donning gloves for performing blood sampling, after inadvertent
blood contamination, and between patients.
- Wear gloves for procedures that
might involve contact with blood and change gloves between patients.
***********************
To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5238a1.htm
To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5238.pdf
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September 29, 2003
READ IT NOW: WASHINGTON POST ARTICLE "MEASLES CASES REBOUNDING IN AFFLUENT
SOCIETY" ACCESSIBLE UNTIL OCTOBER 5
In the article "Measles Cases Rebounding in Affluent Society," Washington
Post staff writer David Brown uses the decreasing rate of MMR
(measles-mumps-rubella) vaccination in England, and the consequent increase
in measles incidence, as a point of departure in discussing the concept of
herd immunity. In conversational language, Brown explains herd immunity and
how near-universal vaccination of a population can break the chain of
person-to-person transmission of vaccine-preventable diseases. Health
professionals may find the article useful in addressing the concerns of some
vaccine-hesitant parents.
Published on September 22, the article can be accessed on the "Washington
Post" website for 14 days from the date it was posted. To access the article
until October 5, go to:
http://www.washingtonpost.com/wp-dyn/articles/A44227-2003Sep21.html
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September 29, 2003
NEW: SEPTEMBER 2003 ISSUE OF "VACCINATE WOMEN" NOW ONLINE
The September 2003 issue of "VACCINATE WOMEN" is now available on the
website of the Immunization Action Coalition (IAC). Hard copies were mailed
last week to all members of the American College of Obstetricians and
Gynecologists (ACOG). This publication was supported by a cooperative grant
by the Division of Viral Hepatitis at the Centers for Disease Control and
Prevention. It was distributed free of charge by ACOG.
The new issue is filled with reliable, practical information intended to
assist obstetricians/gynecologists in providing immunization services in
their health care settings.
Here are three ways to access "VACCINATE WOMEN" or its featured articles
online. (1) View each of the five main articles by clicking on the direct
links below. (2) Download any article from the publication's table of
contents toward the end of this article. (3) Download the entire issue from
the Web by clicking the link at the very end of this article.
Following are descriptions of and direct links to each of the main
"VACCINATE WOMEN" articles:
- "Ask the Experts"
CDC immunization expert William L. Atkinson, MD, MPH, answers
general immunization questions. Hepatitis specialists Eric Mast,
MD, and Linda A. Moyer, RN, answer hepatitis questions.
PDF: http://www.immunize.org/vw/expert3.pdf
- "States Report Hundreds of Medical
Errors in Perinatal Hepatitis B Prevention"
Written by IAC's epidemiologist consultant, Teresa Asper Anderson,
DDS, MPH, and executive director, Deborah L. Wexler, MD, this
article summarizes data collected from state and local hepatitis B
coordinators. Based on reports of more than 500 errors regarding
perinatal hepatitis B prevention, the article makes a compelling
case for giving the birth dose of hepatitis B vaccine to ALL
newborns before hospital discharge.
HTML: http://www.immunize.org/catg.d/p2062.htm
PDF:
http://www.immunize.org/catg.d/p2062.pdf
- "How to Administer IM and SC
Injections to Adults"
This invaluable one-page professional-education sheet presents
information and drawings that instruct professionals on which
vaccines are administered IM and which SC, where on the body each
is administered, which needle size is appropriate for each, and
proper needle insertion for each.
PDF (PDF file is in two-page format):
http://www.immunize.org/catg.d/p2020.pdf
- "Standing Orders for Administering
Hepatitis B Vaccine to Adults" and "Standing Orders for
Administering Influenza Vaccine to Adults"
Each of these one-page professional-education sheets covers the
purpose, policy, and procedure for using standing orders to
administer these vaccines, as well as information about medical
contraindications, precautions, and maintaining medical and
personal immunization records.
Standing Orders for Administering Hepatitis B Vaccine to Adults
PDF: http://www.immunize.org/vw/hepb3.pdf
Standing Orders for Administering Influenza Vaccine to Adults
PDF: http://www.immunize.org/vw/flu3.pdf
- "Seize the Day: Get Ready for
Influenza Vaccination Season NOW!"
In less than a page, Deborah L. Wexler, MD, IAC's executive
director, gives medical professionals five practical,
easy-to-implement suggestions for getting themselves and their
staff up to speed in time for influenza vaccination season.
PDF: http://www.immunize.org/vw/back3.pdf
To view a table of contents with links to the text version (HTML
format) of individual articles, go to:
http://www.immunize.org/vw
To download a camera-ready copy (PDF) format of the entire
September 2003 issue (289,311 bytes), go to:
http://www.immunize.org/vw/vw0903.pdf
WARNING: The PDF format of the entire publication is a very
large file, and some printers are unable to print a file of this
size. For some helpful tips on downloading and printing PDF
files, click here:
http://www.immunize.org/nslt.d/tips.htm
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September 29, 2003
SEPTEMBER ISSUE OF CDC'S "IMMUNIZATION WORKS!" NOW AVAILABLE
ONLINE
"Immunization Works!" a monthly email newsletter published by
the Centers for Disease Control and Prevention (CDC), offers
members of the immunization community information about current
topics. Some of the information in the September issue has
already appeared in previous issues of "IAC EXPRESS." Following
is the text of one article we have not covered.
**********************
Parents Guide to Childhood Immunization is Recognized: The CDC
produced booklet "Parents Guide to Childhood Immunization" has
been recognized with a Bronze Award by the 10th Annual National
Health Information Awards Program. This awards program, the most
comprehensive competition of its kind, is organized by the
Health Information Resource Center, a national clearinghouse for
consumer health information programs and materials. In 2003,
nearly 1,100 entries were submitted by a wide variety of leading
organizations in the consumer health field. The Parents Guide is
available in both English and Spanish can be found at
www.cdc.gov/nip/publications/Parents-Guide/default.htm#order
**********************
To access the entire September issue from the website of the
Immunization Action Coalition, go to:
http://www.immunize.org/news.d/news903.htm
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September 29, 2003
CDC ISSUES UPDATE ON RECENT U.S. AND GLOBAL INFLUENZA ACTIVITY
The Centers for Disease Control and Prevention (CDC) published
"Update: Influenza Activity--United States and Worldwide,
May-September, 2003" in the September 26 issue of "Morbidity and
Mortality Weekly Report" (MMWR). A summary made available to the
press is reprinted below.
*****************************
The best time to receive influenza vaccine is during October
or November.
During May–September 2003, influenza A(H3N2) viruses were the
most frequently reported influenza virus type/subtype
worldwide, but influenza A(H1) and B viruses also circulated.
The influenza virus type/subtype that will predominate and the
severity of influenza-related disease activity for the 2003–04
influenza season cannot be predicted. Influenza vaccine is
recommended for persons at high risk for developing influenza-related complications, health-care workers, and household
contacts of high risk persons. The optimal time for influenza
vaccination is during October–November. Influenza vaccine
supply should be adequate during October–November, therefore,
influenza vaccination can proceed for all high-risk and healthy
persons, individually and through mass campaigns, as soon as
vaccine is available.
*****************************
To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5238a4.htm
To obtain a camera-ready (PDF format) copy of this issue of
MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5238.pdf
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September 29, 2003
AMERICAN LUNG ASSOCIATION ENCOURAGES FLU VACCINE FOR PEOPLE WITH
ASTHMA AND LUNG DISEASE, AS WELL AS SENIOR CITIZENS
On September 19, the American Lung Association announced a
campaign that encourages people with asthma and lung disease, as
well as senior citizens, to be vaccinated against influenza. The
text of the announcement follows.
***************************
AMERICAN LUNG ASSOCIATION LAUNCHES FLU SHOT AWARENESS CAMPAIGN
TO TARGET PEOPLE WITH ASTHMA, LUNG DISEASE AND THE ELDERLY
September 19, 2003
Nearly 20.3 million Americans, 6.3 million of them under
the age of 18, have asthma. People with asthma are more
likely to develop serious complications and die from the flu
than those who do not have asthma, and hospitalization rates
for people with asthma increase two to three-fold during major
flu epidemics.
Until recently, experts were concerned that the flu vaccine may
worsen or exacerbate current asthma. But research indicates that
giving the flu vaccination to every child with asthma means more
than 100,000 kids would be spared a trip to the hospital, at a
savings of $398 million a year.
More than 36,000 Americans die each year from influenza and
related complications. Despite the risks, only 10 percent of
children and 39 percent of adults with asthma get vaccinated.
According to the American Lung Association, the flu shot is the
only approved form of vaccine for people in high-risk groups,
including those with asthma and lung disease as well as the
elderly. People are advised to "stick with the flu shot," as it
is literally their best shot at staying healthy this year.
***************************
To access the announcement and a video of an interview with
Michael S. Niederman, MD, Chairman, Department of Medicine,
Winthrop University Hospital, go to:
http://www.prnewswire.com/broadcast/11293/11293_consumer.html
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September 29, 2003
CDC NOTIFIES READERS ABOUT FDA APPROVAL OF INFANRIX FOR FIFTH
CONSECUTIVE DTaP VACCINE DOSE
The Centers for Disease Control and Prevention (CDC) published
"Notice to Readers: FDA Approval of Diphtheria and Tetanus
Toxoids and Acellular Pertussis Vaccine Adsorbed, (INFANRIX) for
Fifth Consecutive DTaP Vaccine Dose" in the September 26 issue
of "Morbidity and Mortality Weekly Report" (MMWR). The notice is
reprinted below in its entirety, excluding references.
*****************************
On July 8, 2003, the U.S. Food and Drug Administration (FDA)
approved the use of Diphtheria and Tetanus Toxoids and Acellular
Pertussis Vaccine Adsorbed (DTaP) (INFANRIX, SmithKline Beecham
Biologicals, Rixensart, Belgium) as a fifth dose for children
aged 4-6 years after 4 previous doses of INFANRIX. INFANRIX had
been previously approved for the first 4 doses in the DTaP
vaccination series. Sufficient data are now available to
establish the frequency of adverse events after a fifth dose of
INFANRIX at age 4-6 years in children who have received
4 previous doses of INFANRIX.
The frequency of local injection site reactions (erythema and
swelling) increases with successive doses of INFANRIX. In two
German studies, 93 and 390 children, respectively, received a
fifth dose of INFANRIX at age 4-6 years after 4 previous doses
of INFANRIX. Among solicited adverse events, swelling of 5 cm
(2 inches) or more in the injected limb within the 3 days after
vaccination was reported in 15% and 20% of the vaccinees,
respectively. Extensive swelling of the injected limb was
reported spontaneously by parents of nine (9.7%) and 25 (6.4%)
vaccinees, respectively, in these two studies.
The Advisory Committee on Immunization Practices (ACIP), the
American Academy of Pediatrics, and the American Academy of
Family Physicians recommend that children routinely receive a
series of 5 doses of vaccine against diphtheria, tetanus, and
pertussis before age 7 years. ACIP recommends that the first
4 doses be administered at ages 2, 4, 6, and 15-18 months and
the fifth dose at age 4-6 years.
Data are limited on the safety, immunogenicity, and efficacy of
using DTaP vaccines from different manufacturers for successive
doses of the DTaP series. ACIP recommends that, whenever
feasible, the same brand of DTaP should be used for all doses of
the series but that vaccination should not be deferred because
the type of DTaP used for previous doses is not available or is
unknown. In such situations, any of the available licensed DTaP
vaccines can be used to continue or complete the series.
*****************************
To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5238a9.htm
To obtain a camera-ready (PDF format) copy of this issue of
MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5238.pdf
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September 29, 2003
REMINDER: REGISTER FOR CDC'S "EPIDEMIOLOGY AND PREVENTION OF
VACCINE-PREVENTABLE DISEASES" COURSE IN CALIFORNIA
The Centers for Disease Control and Prevention (CDC) course
"Epidemiology and Prevention of Vaccine-Preventable Diseases"
will be offered this fall in two locations in California. The
two-day courses will be held in Torrance (Los Angeles area) on
November 17-18 and in Sacramento on November 20-21. Space is
available in Torrance; only limited space is available in
Sacramento. The registration deadline is November 1.
This course provides the latest information for providers on
immunizations and the diseases they can prevent. Information
includes the following: updates on schedules, contraindications,
standard immunization practices, vaccine-preventable diseases,
and vaccine management and safety. Participants will receive the
course textbook, "Epidemiology and Prevention of Vaccine-Preventable Diseases" (the Pink Book), as well as other
immunization materials.
Continuing education credits will be offered for various
professions based on 15 hours of instruction.
To access a course flyer and registration form, go to:
http://www.cdc.gov/nip/ed/CAFlier2003.pdf
For information, contact Melissa Dahlke at
mdahlke@dhs.ca.gov or
(510) 540-2379.
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September 29, 2003
CDC NOTIFIES READERS ABOUT STATUS OF STANDARDS OF EXCELLENCE
FOR IMMUNIZATION REGISTRIES
The Centers for Disease Control and Prevention (CDC) published
"Notice to Readers: Immunization Registry Standards of
Excellence in Support of Core Immunization Program Strategies"
in the September 26 issue of "Morbidity and Mortality Weekly
Report" (MMWR). The notice is reprinted below in its entirety,
excluding references.
*****************************
Progress continues to be made in achieving the national health
objective for 2010 of increasing to 95% the proportion of
children aged less than 6 years in a fully operational
population-based immunization registry. Approximately 44% of
children are registry participants. Much of the developmental
focus of these confidential tracking systems has been on
identifying and achieving minimum technical capabilities, such
as ensuring data security and confidentiality, timely data
access, and standardized data exchange.
In 2001, to ensure that immunization registries can support
required core immunization program activity areas, CDC, the
American Immunization Registry Association, and the Association
of Immunization Managers formed the Programmatic Registry
Operations Workgroup (PROW). Standards of excellence were
written to specify how registries can support vaccine
management, provider quality assurance, service delivery,
consumer information, vaccine-preventable disease surveillance,
and vaccination coverage assessment. In February 2003, the
National Vaccine Advisory Committee endorsed these efforts.
Additional information about these standards of excellence is
available at
http://www.immregistries.org/pdf/PROWstandardscomp1.pdf
*****************************
To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5238a10.htm
To obtain a camera-ready (PDF format) copy of this issue of
MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5238.pdf
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September 29, 2003
CDC ISSUES HEALTH ADVISORY ABOUT A CURRENT MULTI-STATE OUTBREAK
OF FOODBORNE HEPATITIS A
On September 26, the Centers for Disease Control and Prevention
(CDC) issued a Health Advisory, "Multi-state, Foodborne
Hepatitis A Outbreak--Tennessee, Georgia, September 2003."
According to CDC, a Health Advisory "provides important
information for a specific incident or situation; [it] may not
require immediate action." The advisory is reprinted below in
its entirety.
************************
This is an official CDC Health Advisory
September 26, 2003
MULTI-STATE, FOODBORNE HEPATITIS A OUTBREAK--TENNESSEE, GEORGIA,
SEPTEMBER 2003
On September 18, the Knox County (Tennessee) Health Department
(KCHD) alerted EpiX that four cases of hepatitis A had occurred
in food handlers employed at the O'Charley's Restaurant. At this
time there are at least 57 cases of hepatitis A associated with
O'Charley's Restaurants in Tennessee, and several others
associated with O'Charley's Restaurants in Georgia and
potentially in at least one additional state. Most cases
identified to date have onset dates clustered around early to
mid-September. An investigation to determine the source of the
outbreak is underway. Cases of hepatitis A should be interviewed
regarding exposure to O'Charley's Restaurants. O'Charley's is a
regional chain with restaurants located in Alabama, Arkansas,
Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana,
Mississippi, Missouri, North Carolina, Ohio, South Carolina,
Tennessee, Virginia, and West Virginia. Cases of hepatitis A
associated with this outbreak should be reported to CDC directly
and to state or local health departments; available serum should
be frozen and saved for molecular testing at CDC. Please call
Dr. Joe Amon at CDC (404) 371-5461 to report cases and arrange
shipment of serum.
************************
To access the Health Advisory, go to:
http://www.phppo.cdc.gov/HAN/Documents/AlertDocs/156.asp
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September 29, 2003
CDC REPORTS ON LABORATORY SURVEILLANCE FOR WILD AND VACCINE-DERIVED POLIOVIRUSES
The Centers for Disease Control and Prevention (CDC) published
"Laboratory Surveillance for Wild and Vaccine-Derived
Polioviruses, January 2002-June 2003" in the September 26 issue
of "Morbidity and Mortality Weekly Report" (MMWR). A summary
made available to the press is reprinted below.
*****************************
During the final stages of polio eradication, the laboratory
network provides critical molecular evidence to track down the
remaining strains of polioviruses.
After the 1988 World Health Assembly resolution to eradicate
poliomyelitis, the Global Laboratory Network for Poliomyelitis
Eradication was established by the World Health Organization
(WHO). During January 2002-June 2003, the global laboratory
network for polioviruses has continued to provide critical input
and meet the challenges of the polio eradication initiative. It
played a key role in providing substantial evidence for the
eradication of wild type 2 poliovirus and interruption of wild
poliovirus transmission in the Western Pacific Region. In the
seven remaining polio endemic countries, the network has
provided timely virologic evidence of where poliovirus is
circulating, which is critical for guiding activities aimed at
interrupting transmission. To ensure the achievement and
maintenance of polio eradication globally, the continued support
for the laboratory network by national governments and WHO
partner agencies is essential.
*****************************
To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5238a5.htm
To obtain a camera-ready (PDF format) copy of this issue of
MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5238.pdf |
