Issue
Number 439
January 27, 2004
CONTENTS OF THIS ISSUE
- CDC reports on human death associated with bat rabies
- CDC issues an update of U.S. influenza activity for January
11-17
- January 30 is the date for "Influenza and Beyond: Responding
to Vaccine-Preventable Diseases" satellite broadcast/webcast
- New: January issue of "NEEDLE TIPS" is in the mail and on the
Web
- New: January issue of CDC's "Immunization Works!" electronic
newsletter is posted on the IAC website
- February 19 is the first satellite broadcast of "Epidemiology
and Prevention of Vaccine-Preventable Diseases 2004"
- CDC reports on reduction in measles mortality in West Africa
- "Points Across: Strategies for Creating Health Messages that
Work" conference scheduled for March 25 in Columbia, MD
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ABBREVIATIONS: AAP, American Academy of Pediatrics; ACIP, Advisory Committee
on Immunization Practices; CDC, Centers for Disease Control and Prevention;
FDA, Food and Drug Administration; IAC, Immunization Action Coalition; MMWR
Morbidity and Mortality Weekly Report; NIP, National Immunization Program;
VIS, Vaccine Information Statement; WHO, World Health Organization.
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January 27, 2004
CDC REPORTS ON HUMAN DEATH ASSOCIATED WITH BAT RABIES
CDC published "Human Death Associated with Bat Rabies--California, 2003" in
the January 23 issue of MMWR. Portions of the article's opening paragraph
and of a summary made available to the press are reprinted below.
***********************
[From the article's opening paragraph]
Rabies is a rapidly progressive, incurable viral encephalitis that is, with
rare exceptions, transmitted by the bite of an infected mammal. On September
14, 2003, a previously healthy man aged 66 years who resided in Trinity
County, California, died from rabies approximately 6 weeks after being
bitten by a bat. This report summarizes the investigation by the Trinity and
Shasta County Health Departments and the California Department of Health
Services . . . .
[From the press summary]
The only documented [rabies] survivors have received rabies prophylaxis
BEFORE the onset of illness. . . . Medical professionals need to reemphasize
to the public that if direct contact with bats has occurred, exposed persons
should immediately 1) thoroughly disinfect and wash the wound, 2) capture
the animal safely for diagnostic submission, 3) contact the local Department
of Health, and 4) see a physician for evaluation about the need for
post-exposure prophylaxis.
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To access a web-text (HTML) version of the complete article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5302a4.htm
To access a ready-to-copy (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5302.pdf
To receive a FREE electronic subscription to MMWR (which includes new ACIP
statements), go to:
http://www.cdc.gov/mmwr/mmwrsubscribe.html
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January 27, 2004
CDC ISSUES AN UPDATE OF U.S. INFLUENZA ACTIVITY FOR JANUARY 11-17
CDC published "Update: Influenza Activity--United States, January 11-17,
2004" in the January 23 issue of MMWR. Portions of the article are reprinted
below.
***********************
The number of states reporting widespread influenza activity continued to
decrease during the reporting week of January 11-17, 2004. Health
departments in five states reported widespread influenza activity. A total
of 31 states and New York City reported regional activity, eight states
reported local activity, and sporadic activity was reported by six states,
the District of Columbia, Guam, and Puerto Rico. The percentage of
outpatient visits for influenza-like illness (ILI) continued to decrease in
all surveillance regions during the week ending January 17. For the first
time since the reporting week ending November 8, 2003, the national
percentage for ILI (2.0%) declined below the national baseline of 2.5%. The
percentage of specimens testing positive for influenza also decreased, but
the percentage of deaths attributed to pneumonia and influenza (P&I) was
unchanged. . . .
Antigenic Characterization
Of the 573 influenza viruses collected by U.S. laboratories since October 1,
2003, and characterized antigenically by CDC, 565 were influenza A (H3N2)
viruses, two were influenza A (H1) viruses, and six were influenza B
viruses. The hemagglutinin proteins of the influenza A (H1) viruses were
similar antigenically to the hemagglutinin of the vaccine strain A/New
Caledonia/20/99. Of the 565 influenza A(H3N2) isolates that have been
characterized, 106 (18.8%) were similar antigenically to the vaccine strain
A/Panama/2007/99 (H3N2), and 459 (81.2%) were similar to a drift variant, A/Fujian/411/2002
(H3N2). Five influenza B viruses characterized were similar antigenically to
B/Sichuan/379/99 and one was similar antigenically to B/Hong Kong/330/2001.
P&I Mortality Surveillance
During the week ending January 17, P&I accounted for 10.3% of all deaths
reported through the 122 Cities Mortality Reporting System. This percentage
is again above the epidemic threshold of 8.1% . . . .
Weekly updates on influenza activity will be published in MMWR during the
influenza season. Additional information about influenza activity is
available from CDC at
http://www.cdc.gov/flu
Influenza-Associated Deaths in Children Aged <18 Years
As of January 20, 2004, CDC had received reports of 111 influenza-associated
deaths in U.S. residents aged <18 years. This update is based on preliminary
data reported from 33 states. All patients had evidence of influenza virus
infection detected by rapid-antigen testing or other laboratory tests. Among
reported deaths, 56 (50.5%) were male. The median age was 4 years (range 1
month-17 years). Of the 64 children aged <5 years, 38 were aged 6 months-23
months. Twenty-one children had high-risk medical conditions that put them
at increased risk for complications from influenza. Of the children whose
influenza vaccination status was reported, three were vaccinated according
to recommendations, and 49 were not vaccinated.
***********************
To access a web-text (HTML) version of the complete article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5302a5.htm
To access a ready-to-copy (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5302.pdf
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January 27, 2004
JANUARY 30 IS THE DATE FOR "INFLUENZA AND BEYOND: RESPONDING TO
VACCINE-PREVENTABLE DISEASES" SATELLITE BROADCAST/WEBCAST
A national satellite broadcast and webcast, "Influenza and Beyond:
Responding to Vaccine-Preventable Disease," is scheduled from 2 pm to 3 pm
ET on January 30. The program will focus on identifying best practices for
improving adult immunization rates. Program sponsors are the School of
Public Health, University of North Carolina at Chapel Hill and CDC.
COURSE OVERVIEW, AUDIENCE, AND FACULTY
The course will cover the following: the effectiveness of current vaccines,
barriers to adult immunization, strategies to improve adult immunization
rates, and the Racial and Ethnic Disparities in Immunization Initiative (READII).
The course is intended for public health leaders and professionals from
local and state government agencies, hospitals, clinics, boards of health,
community based health organizations, academic institutions, federal
agencies, and others who seek to learn more about the public health response
to vaccine-preventable diseases.
The faculty includes William L. Roper, MD, MPH, Dean, School of Public
Health, University of North Carolina at Chapel Hill; Walter A. Orenstein,
MD, Assistant Surgeon General and Director, NIP, CDC; Kristin L. Nichol, MD,
MPH, MBA, Professor of Medicine, University of Minnesota, and Chief of
Medicine, Minneapolis Veterans Administration Medical Center; and Hugh H.
Tilson, MD, DrPH, Clinical Professor, Epidemiology and Health Policy, School
of Public Health, University of North Carolina at Chapel Hill.
To access a comprehensive course overview from the website of the Public
Health Grand Rounds, go to:
http://www.publichealthgrandrounds.unc.edu/flu/about.htm
For more information on course content, email
grand.rounds@sph.unc.edu
or call (919) 843-9261.
REGISTRATION AND CONTINUING EDUCATION CREDIT
To register online, go to:
http://www.publichealthgrandrounds.unc.edu/flu/partreg.htm Online
registration must be completed to receive continuing education credit.
For more information about registration, call (800) 418-7246 or email
ce@cdc.gov
HANDOUTS
Handouts will be posted on the Public Health Grand Rounds website on January
28; additional handouts may be added later. To access handouts, go to:
http://www.publichealthgrandrounds.unc.edu/flu/handouts.htm
POST-PROGRAM DISCUSSION
Content experts from CDC will facilitate an online discussion from January
30 through February 6. Course participants are invited to ask questions and
share their best practices. To participate in the discussion, go to:
http://www.publichealthgrandrounds.unc.edu/flu/after.htm beginning
January 30.
TECHNICAL INFORMATION
Webcast and satellite downlink information is available at
http://www.publichealthgrandrounds.unc.edu/flu/how.htm
Information about satellite coordinates is available at
http://www.publichealthgrandrounds.unc.edu/flu/satellite.htm
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January 27, 2004
NEW: JANUARY ISSUE OF "NEEDLE TIPS" IS IN THE MAIL AND ON THE WEB
The hard copy of the new "NEEDLE TIPS and the Hepatitis B Coalition News"
should be arriving soon in the mail boxes of 130,000 health professionals
and others who work in the field of immunization. If you haven't received
yours, you can access the entire issue or selected articles from the IAC
website. Immunization and hepatitis experts at CDC have reviewed each
article and education piece in the issue for accuracy (with the exception of
editorials).
Among the materials available for photocopying is the newly released
"Recommended Childhood and Adolescent Immunization Schedule--United States,
January-June 2004." The January issue has several practical pieces on
storing and administering vaccines, including "CDC's Guidelines for
Maintaining and Managing the Vaccine Cold Chain," "Vaccine Handling Tips,"
"Temperature Logs (Fahrenheit and Celsius) for Vaccines," and "Administering
Vaccines: Dose, Route, Site, and Needle Size." The issue also includes three
hepatitis resources: an editorial, "Prevent Viral Hepatitis: Vaccinate!"; an
updated patient-education piece, "Every Week Hundreds of Sexually Active
People Get Hepatitis B"; and a new professional-education piece, "Standing
Orders for Administering Hepatitis B Vaccine to Adolescents and Adults."
This is information you won't find anywhere else; we hope you'll peruse the
table of contents (given below) and read articles that interest you online.
HOW TO READ "NEEDLE TIPS" ON THE WEB
You can download the entire issue from the Web or view selected articles
from the table of contents below.
To view the table of contents with links to individual articles, go to:
http://www.immunize.org/nt
Please note: The PDF file of the entire January 2004 issue,
linked below, is large at 744,318 bytes. Some printers cannot
print such a large file. For tips on downloading and printing
PDF files, go to: http://www.immunize.org/nslt.d/tips.htm
To download the entire PDF version of the January 2004 issue, go
to: http://www.immunize.org/nslt.d/n29/n29.pdf
SUMMARIES OF INDIVIDUAL ARTICLES AND FEATURES
Summaries of "NEEDLE TIPS" articles and features are below,
followed by URLs.
-
"Ask the Experts"
CDC immunization expert William Atkinson, MD, MPH, and viral
hepatitis experts Linda Moyer, RN, and Eric Mast, MD, answer
readers' questions.
HTML: http://www.immunize.org/nslt.d/n29/expert29.htm
PDF: http://www.immunize.org/nslt.d/n29/expert29.pdf
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"Prevent Viral Hepatitis: Vaccinate!"
Citing the distressing statistic that nearly 80,000 persons in
the United States become infected with hepatitis B virus (HBV)
each year, this editorial urges health professionals to identify
and vaccinate adults with behavioral risk factors for HBV
infection.
PDF: http://www.immunize.org/nslt.d/n29/viralhepatitis.pdf
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"Vaccine Highlights"
A digest of recent recommendations and news about vaccines,
vaccine resources, and Vaccine Information Statements.
HTML: http://www.immunize.org/nslt.d/n29/vaccin29.htm
PDF: http://www.immunize.org/nslt.d/n29/vaccin29.pdf
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"Recommended Childhood and Adolescent Immunization Schedule--United States, January-June 2004"
Formatted for easy photocopying, this two-page resource includes
catch-up schedules for children and adolescents who start late
or are more than one month behind in getting vaccinated.
PDF: http://www.immunize.org/cdc/child-schedule.pdf
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"Administering Vaccines: Dose, Route, Site, and Needle Size"
This one-page professional-education sheet summarizes
information on administering 12 vaccines and four combination
vaccines commonly given to children, adolescents, and adults.
HTML: http://www.immunize.org/catg.d/p3085.htm
PDF: http://www.immunize.org/catg.d/p3085.pdf
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"What If You Don't Immunize Your Child?"
Updated in November 2003, this duo-fold patient brochure clearly
outlines the individual and social consequences of not
immunizing children.
HTML: http://www.immunize.org/catg.d/p4017.htm
PDF: http://www.immunize.org/catg.d/p4017.pdf
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"Every Week Hundreds of Sexually Active People Get Hepatitis B"
This recently revised duo-fold patient brochure succinctly
describes the facts associated with hepatitis B: what it is, who
gets it, how they get it, how to prevent it, and more.
HTML: http://www.immunize.org/catg.d/4112std.htm
PDF: http://www.immunize.org/catg.d/4112std.pdf
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"Standing Orders for Administering Hepatitis B Vaccine to
Adolescents and Adults"
This one-page sheet outlines the purpose, policy, and procedures
for using standing orders for hepatitis B vaccine administration
and presents information about contraindications, precautions,
and administration techniques.
PDF: http://www.immunize.org/nslt.d/n29/orders.pdf
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"CDC's Guidelines for Maintaining and Managing the Vaccine
Cold Chain"
Reprinted from the October 24, 2003 MMWR, this article presents
current information on recommended vaccine storage temperatures,
storage requirements, and temperature monitoring.
HTML: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5242a6.htm
PDF: http://www.immunize.org/nslt.d/n29/coldchain.pdf
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"Vaccine Handling Tips"
Updated in November 2003, this one-page sheet summarizes basic
information on vaccine storage.
PDF: http://www.immunize.org/catg.d/p3048.pdf
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"Temperature Logs (Fahrenheit and Celsius) for Vaccines"
This one-page sheet provides URLs for Fahrenheit and Celsius
temperature logs; each log has space for recording a month's
worth of temperatures.
One-page sheet with URLs for both temperature logs
PDF: http://www.immunize.org/nslt.d/n29/templogs.pdf
Fahrenheit temperature log
PDF: http://www.immunize.org/catg.d/p3039.pdf
Celsius temperature log
PDF: http://www.immunize.org/news.d/celsius.pdf
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"How's Your State Doing?"
This chart shows influenza immunization rates by state for
adults 50-64 years of age and those >=65 years, as well as
pneumococcal vaccination rates for those >=65 years. It also
shows which states mandate influenza and pneumococcal
vaccination in long-term care facilities and which authorize
pharmacists to vaccinate.
PDF: http://www.immunize.org/nslt.d/n29/state29.pdf
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"IAC's Catalog and Order Form"
Order materials for patients and clinic staff here.
HTML: http://www.immunize.org/nslt.d/n17/catalg1.htm
PDF: http://www.immunize.org/nslt.d/n29/catalog.pdf
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"Letter from the Executive Director: Your Yearly Contribution
Promotes Immunization!"
IAC's Executive Director, Deborah L. Wexler, MD, shows how much
good your money does when you contribute to IAC.
HTML: http://www.immunize.org/nslt.d/n29/back29.htm
PDF: http://www.immunize.org/nslt.d/n29/back29.pdf
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January 27, 2004
NEW: JANUARY ISSUE OF CDC'S "IMMUNIZATION WORKS!" ELECTRONIC
NEWSLETTER IS POSTED ON THE IAC WEBSITE
The January issue of "Immunization Works!" a monthly email
newsletter published by CDC, is available on the IAC website.
The newsletter offers members of the immunization community
non-proprietary information about current topics. CDC encourages
its wide dissemination.
Some of the information in the January issue has already
appeared in previous issues of "IAC EXPRESS." Following is the
text of three articles we have not covered.
**************************
OTHER IMMUNIZATION NEWS
MEASLES INITIATIVE CONTINUES: The American Red Cross, along with
CDC, United Nations Foundation, World Health Organization, and
United Nations Children's Fund continue to support the Measles
Initiative, a 5-year program to control measles death in Africa
by vaccinating 200 million children in 36 sub-Saharan countries
by 2005. While most Americans barely remember the disease,
measles kills nearly 800,000 children, a half million of those
in Africa alone. This fact makes measles the single leading
vaccine-preventable cause of death among children in Africa, yet
it can be easily prevented with a simple vaccination. At the
initiative's mid-way point, more than 106 million children have
been vaccinated in 24 countries, saving 194,000 young lives. For
more information about the Measles Initiative visit
www.measlesinitiative.org
**************************
MEETINGS, CONFERENCES, AND RESOURCES
ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES: The Advisory
Committee on Immunization Practices (ACIP) will hold its next
meeting February 24-25, 2004, at the Marriott Century Center in
Atlanta, Georgia. The meeting is open to the general public.
For more information on the meeting visit
www.cdc.gov/nip
**************************
NEW CDC PUBLICATIONS: CDC has several new publications available
on immunization related issues. All items are free of charge and
can be ordered by using the NIP online order form at
www.cdc.gov/nip/publications The new items include:
-
Vaccine Information Statements (Provider Set with all current
VISs)
-
2004 Adult Immunization Schedule (8.5 x 11 and pocket-size
laminated cards)
-
Guide to Contraindications
-
Standards for Adult Immunization Practices
-
Standards for Child and Adolescent Immunization Practices
**************************
To access a ready-to-copy (PDF) version of the entire January
issue of "Immunization Works!" go to:
http://www.immunize.org/news.d/news0104.pdf
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January 27, 2004
FEBRUARY 19 IS THE FIRST SATELLITE BROADCAST OF "EPIDEMIOLOGY
AND PREVENTION OF VACCINE-PREVENTABLE DISEASES 2004"
A live, four-part satellite broadcast by CDC, "Epidemiology and
Prevention of Vaccine Preventable Diseases," is scheduled from
noon to 3:30 pm ET on four consecutive Thursdays: February 19
and 26, and March 4 and 11. This live, interactive program will
provide the most current information available in the constantly
changing field of immunization. The broadcast will feature a Q&A
session in which participants nationwide can interact with the
course instructors by toll-free telephone lines.
COURSE OVERVIEW, AUDIENCE, AND FACULTY
Intended to improve U.S. immunization practices, the course will
cover principles of vaccination, general recommendations on
immunization, strategies to improve immunization coverage
levels, and specific information about vaccine-preventable
diseases and the vaccines that prevent them.
The course is intended for physicians, nurses, nurse
practitioners, physician assistants, DoD paraprofessionals,
pharmacists, and others who either give immunizations or set
policy for their offices, clinics, or communicable
disease/infection control programs.
The faculty is drawn from NIP. It includes William Atkinson, MD,
MPH; Donna Weaver, MN, RN; Sharon Roy, MD, MPH; and Andrew
Kroger, MD, MPH.
To access a comprehensive course overview from the website of
the Public Health Training Network, go to:
http://www.phppo.cdc.gov/PHTN//epv04
For more information on course content, email
nipinfo@cdc.gov
REGISTRATION AND CONTINUING EDUCATION CREDIT
Individual registration began January 22. To register online,
visit the Training and Continuing Education Online System at
http://www.phppo.cdc.gov/phtnonline Participants must use the
online system to receive continuing education credit.
For more information about registration, call (800) 418-7246 or
email ce@cdc.gov
COURSE MATERIALS
Participants are strongly encouraged to buy a copy of the
primary course text, "Epidemiology and Prevention of Vaccine-Preventable Disease" (the "Pink Book," 8th edition, 2004). It is
available from the Public Health Foundation for $29. To order,
call (877) 252-1200 or go to:
http://bookstore.phf.org/prod171.htm
TECHNICAL INFORMATION
Webcast information and viewing options are available at
http://www.phppo.cdc.gov/phtn/webcast/epv04
Technical support for the webcast is available at
http://www.phppo.cdc.gov/phtn/webcast/techsupport.asp
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January 27, 2004
CDC REPORTS ON REDUCTION IN MEASLES MORTALITY IN WEST AFRICA
CDC published "Measles Mortality Reduction—-West Africa,
1996-2002" in the January 23 issue of MMWR. The article's
opening paragraph is reprinted below.
***********************
The World Health Organization (WHO) estimates that, during 2000,
measles accounted for approximately 777,000 deaths worldwide, of
which 452,000 (58%) occurred in Africa. In response, in 2000,
WHO's African Regional Office (AFRO) adopted a plan to reduce
measles mortality >50% by 2005. The plan recommended
1) increasing measles vaccination by strengthening routine
health services; 2) providing a second opportunity for measles
vaccination for all children, primarily through wide-age-range
supplemental immunization activities (SIAs); 3) enhancing
measles surveillance; and 4) improving management of measles
cases. The initial wide-age-range SIA targets all children aged
9 months-14 years, regardless of history of measles disease or
vaccination. Follow-up SIAs are needed 3-5 years after the
initial SIA to provide a second opportunity for vaccination to
children born since the previous SIA (i.e., those aged
9 months-4 years). During the 1990s, the countries of the
Americas and seven countries in southern Africa used this
strategy to reduce the number of measles deaths to near zero.
This report describes the recent implementation of this strategy
in three West African countries, where reported measles cases
declined 83%-97% during the first year after SIAs. Successful
implementation of this strategy by other African countries
should result in achieving the goal of >50% reduction in measles
mortality by 2005.
***********************
To access a web-text (HTML) version of the complete article, go
to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5302a2.htm
To access a ready-to-copy (PDF) version of this issue of MMWR,
go to: http://www.cdc.gov/mmwr/PDF/wk/mm5302.pdf
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January 27, 2004
"POINTS ACROSS: STRATEGIES FOR CREATING HEALTH MESSAGES THAT
WORK" CONFERENCE SCHEDULED FOR MARCH 25 IN COLUMBIA, MD
A social marketing and health literacy conference, "Points
Across: Strategies for Creating Health Messages that Work," will
be held March 25 in Columbia, MD. The deadline for "early bird"
registration is February 6.
Intended for health educators, outreach workers, nurses, public
health administrators, government officials, and community
leaders, the conference is sponsored by the Maryland Partnership
for Prevention, Inc., Maryland's immunization coalition.
To access conference and registration information, go to:
http://www.edcp.org/pdf/MPP_Points_Across_Conference_Brochure.pdf
For additional information, call (410) 902-4677.
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