Issue Number 43            January 8, 1999

CONTENTS OF THIS ISSUE

1. CDC releases ACIP recommendations on human rabies prevention
2. MMWR publishes article on transmission of measles among a highly vaccinated school population

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(1)
January 8, 1999
CDC RELEASES ACIP RECOMMENDATIONS ON HUMAN RABIES PREVENTION

Today, January 8, 1999, CDC released "Human Rabies Prevention United States, 1999," the Advisory Committee on Immunization Practice (ACIP) recommendations on the prevention of human rabies.

Published in MMWR, Recommendations and Reports, Vol 48, No RR-1, these recommendations update the previous recommendations on rabies prevention which were published in 1991 (MMWR 1991; 40[No.RR-3]). The 1999 rabies recommendations reflect the current status of rabies and antirabies biologics in the United States.

According to the 1999 rabies recommendations, rabies among humans is rare in the United States but every year approximately 16,000- 39,000 persons receive postexposure prophylaxis. The report is intended to guide clinical practice and policy development related to appropriate management of persons at risk for rabies.

The 1999 rabies recommendations contains new information on the following topics:

1. a human rabies vaccine approved for U.S. use in 1997 2. recommendations regarding exposure to bats 3. recommendations regarding an observation period for domestic ferrets 4. changes in the local administration of rabies immune globulin

NOTE: Continuing education credits (CMEs, CEUs, CNEs) sponsored by CDC are available for reading the 1999 ACIP recommendations on human rabies prevention and completing the test which is printed at the end of the document.

To access the complete document in text format, click here: http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/00056176.htm

For the camera-ready (pdf format) copy of the document, click here: ftp://ftp.cdc.gov/pub/Publications/mmwr/rr/rr4801.pdf -----------------------------------------------------------------

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(2)
January 8, 1999
MMWR PUBLISHES ARTICLE ON TRANSMISSION OF MEASLES AMONG A HIGHLY VACCINATED SCHOOL POPULATION

An article entitled, "Transmission of Measles Among a Highly Vaccinated School Population - Anchorage, Alaska, 1998," was published in the MMWR on January 8, 1999. The article states that 33 confirmed measles cases were reported to the Anchorage Department of Health and Human Services and the Alaska Department of Health and Social Services (ADHSS) from August 10, 1998, through November 23, 1998. This was the largest outbreak of measles in the United States since 1996.

The article which summarizes the results of the epidemiologic investigation also underscores the importance of second-dose requirements for measles vaccine.

According to the article, 17 of the cases occurred at a high school where, based on school records, only one of 2,186 students had not received any doses of measles-containing vaccine (MCV) before the outbreak; 1,057 (49%) had received one dose of MCV; and 1,112 (51%) had received two or more doses.

An emergency order was issued by the ADHSS requiring that all Anchorage schoolchildren have two doses of MCV by November 16, 1998. Subsequently, the order was expanded to require all students in the state to have two doses of MCV by January 4, 1999.

By November 17, 1998, 98.6% of 49,346 Anchorage School District students had provided documentation of two doses of MCV to their schools.

The "Editorial Note" emphasizes the importance of school requirements for a second dose of MCV and also notes the efficacy of MCV: "MCV is highly effective; <5% of children who receive one dose fail to develop immunity. However, most children respond to a second dose, and >99% of persons >12 months of age receiving two or more doses at least 28 days apart develop immunity.

To access the complete article in text format, click here: http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/00056144.htm

TO GET A FREE ELECTRONIC SUBSCRIPTION TO THE MMWR (delivered weekly), go to the MMWR website and sign up. When you sign up, you will also receive all new ACIP statements which are published as MMWR's "Recommendations and Reports." To get to the MMWR website, click here: http://www.cdc.gov/epo/mmwr/mmwr.html