Issue
Number 451
March 22, 2004
CONTENTS OF THIS ISSUE
- AAP releases its latest immunization policy statement,
"Recommendations for Influenza Immunization of Children"
- Official CDC Health Advisory reports on a measles case
imported to the United States on March 12
- CDC reports on a school-associated outbreak of pertussis in
Arizona in 2002-03
- Free: Bulk copies of the latest issue of "NEEDLE TIPS"
(January 2004) are available--place your order now
- Read the March issue of CDC's "Immunization Works!" electronic
newsletter on the NIP website
- New: AAP makes four print resources available at no charge
- CDC releases "Dear Colleague" letter on recommended STD
prevention services for MSM
- HBF adds a National Library of Medicine tutorial to its
website
- CDC workbook on sharps injury prevention programs available
online
- AASLD practice guidelines published online
- Two new issues of "Viral Hepatitis" available on VHPB website
- WHO publishes injection safety documents
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ABBREVIATIONS: AAFP, American Academy of Family Physicians; 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; VPD, vaccine-preventable disease; WHO, World Health
Organization.
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March 22, 2004
AAP RELEASES ITS LATEST IMMUNIZATION POLICY STATEMENT, "RECOMMENDATIONS FOR
INFLUENZA IMMUNIZATION OF CHILDREN"
On March 10, AAP released "Recommendations for Influenza Immunization of
Children," its most recent immunization policy statement. The abstract is
reprinted below in its entirety.
*********************
ABSTRACT. Epidemiologic studies indicate that children of all ages with
certain chronic conditions and otherwise healthy children younger than 24
months of age are hospitalized for influenza infection and its complications
at high rates similar to those experienced by the elderly. Annual influenza
immunization is recommended for all children with high-risk conditions who
are 6 months of age and older. Young, healthy children are at high risk of
hospitalization for influenza infection; therefore, the American Academy of
Pediatrics recommends influenza immunization for healthy children between 6
and 24 months of age, for household contacts and out-of-home caregivers of
all children younger than 24 months of age, and for health care
professionals. To protect these children more fully against the
complications of influenza, increased efforts are needed to identify all
high-risk children and inform their parents when annual immunization is due.
The purposes of this statement are to update recommendations for routine use
of influenza vaccine in children and to review the indications for use of
trivalent inactivated influenza vaccine and live-attenuated influenza
vaccine.
*********************
To access a ready-to-copy (PDF) version of the complete statement from the
AAP website, go to:
http://www.aap.org/policy/influenzafinal.pdf
To access AAP immunization policy statements through links on the IAC
website, go to the web section titled "Immunization Policy Statements from
the American Academy of Pediatrics" at
http://www.immunize.org/aap
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March 22, 2004
OFFICIAL CDC HEALTH ADVISORY REPORTS ON A MEASLES CASE IMPORTED
TO THE UNITED STATES ON MARCH 12
On March 18, an official CDC Health Advisory, "Imported Case of
Measles Identified on Airline Flight into Detroit and Cedar
Rapids," was issued. It is reprinted below in its entirety.
*********************
This is an official CDC Health Advisory
Distributed via Health Alert Network
March 18, 2004, 12:46 EST
IMPORTED CASE OF MEASLES IDENTIFIED ON AIRLINE FLIGHT INTO
DETROIT AND CEDAR RAPIDS
On March 13, 2004, the Iowa Department of Health reported to CDC
a case of measles in the infectious stage in Cedar Rapids, Iowa.
The index case flew from New Delhi through the Detroit Metro
Airport to Cedar Rapids, Iowa, on March 12th. Flight numbers:
Northwest 039 from Amsterdam to Detroit, MI, and Northwest 3786
from Detroit to Cedar Rapids. The Iowa Department of Health and
the Michigan Department of Health have been contacting
passengers to alert them to the possible exposure. On March 15,
the Wayne County Health Department visited the Detroit Metro
Airport to vaccinate the Customs and Border Protection
personnel, airline personnel, and anyone else who was exposed.
CDC estimates that exposures to measles in a commercial aircraft
occur an average 10-12 times per year in the United States. Over
the past ten years, CDC has identified only three cases of
measles, which apparently resulted from exposure in a commercial
aircraft.
The case, which is now laboratory confirmed, occurred in a
19-year-old male who is a U.S. resident returning from travel to
India where measles is endemic. The student [had] not been
vaccinated against measles.
POST EXPOSURE PROPHYLAXIS
Persons who might have been exposed, or who are at high risk of
exposure to measles, should be evaluated to assure they are
immune to measles. Persons generally can be presumed immune to
measles if they have documentation of 2 doses of measles
vaccine, laboratory evidence of immunity to measles,
documentation of physician-diagnosed measles, or were born
before 1957. Persons who are not immune should be given MMR
vaccine or immune globulin according to ACIP recommendations.
SURVEILLANCE FOR POTENTIAL SECONDARY CASES
State public health departments should be alert to possible
cases of measles in persons who traveled on Northwest # 039 and
3786 or their contacts. Measles is an acute disease
characterized by fever, cough, coryza, an erythematous
maculopapular rash, and a pathognomonic enanthem (Koplik's
spots). Measles has an incubation period of 7-21 days and
infected people are considered contagious from 4 days before to
4 days after the appearance of rash. Serologic (Measles IgM)
testing is required to confirm the diagnosis. In addition to
serologic specimens, programs should collect throat swabs or
urine for viral isolation.
Further information on measles can be found at
http://www.cdc.gov/ncidod/diseases/submenus/sub_measles.htm
http://www.cdc.gov/nip/publications/acip-list.htm
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March 22, 2004
CDC REPORTS ON A SCHOOL-ASSOCIATED OUTBREAK OF PERTUSSIS IN
ARIZONA IN 2002-03
CDC published "School-Associated Pertussis Outbreak--Yavapai
County, Arizona, September 2002-February 2003" in the March 19
issue of MMWR. According to the article's opening paragraph, the
report " . . . summarizes the epidemiology of the outbreak and
the control measures used to contain it. Health care providers
should consider pertussis in persons of any age with acute cough
illnesses and consider obtaining nasopharyngeal (NP) specimens
for B. pertussis culture."
Portions of a summary made available to the press and of the
article's Editorial Note are reprinted below.
***********************
[From the press summary]
In adolescents or adults, pertussis should be considered as the
cause of cough illness lasting >=2 weeks, especially if the
coughing is accompanied by a "whoop" sound, or if the person
experiences spasms of coughing or vomiting after coughing.
Public health authorities in Arizona successfully implemented
measures to control an outbreak of pertussis, which began in a
middle school in Yavapai County and spread to others in the
community. Pertussis, or "whooping cough," is a serious
bacterial respiratory infection characterized by severe spasms
of cough that can last for a few weeks to several months.
Infants (aged <1 year) are at greatest risk from pertussis;
infants have the highest incidence of the disease and account
for the overwhelming majority of pertussis-related
hospitalizations, serious complications, and deaths. DTaP
vaccine prevents the complications of pertussis and is
recommended for all infants. However, vaccine protection against
pertussis wanes over time. Among older children and adults whose
protection has waned, pertussis can cause a range of symptoms
from mild to severe cough. Middle and high school-associated
pertussis outbreaks are increasingly recognized and reported.
Such outbreaks often result in a large number of cases among
adolescents and subsequent spread to the community with cases
among infants aged <1 year. This was the situation in the
Yavapai County outbreak, which began in a middle school in
September 2002 and resulted in 485 pertussis cases (113 cases in
students).
[From the article's Editorial Note]
Although infants with pertussis can become severely ill and die,
no pertussis-associated hospitalizations or deaths were reported
during this outbreak. In contrast to disease severity observed
commonly among infants, older persons with pertussis often have
a mild illness. As a result, older persons might not visit a
health-care provider until several weeks after cough onset, when
recovery of the fastidious B. pertussis bacterium is unlikely
and diagnosis might not be confirmed. Recognizing pertussis
outbreaks in schools is challenging for several reasons,
including (1) patients usually do not seek medical care early,
(2) a diagnosis of pertussis might be delayed or not considered,
and (3) the sensitivity and specificity of diagnostic tests will
be low if NP specimens are not obtained and transported to the
laboratory under optimal conditions. Health-care providers
should consider pertussis in persons of any age with an acute
cough illness and consider obtaining NP specimens for
B. pertussis culture. Early recognition, treatment, and
chemoprophylaxis can help prevent transmission to others;
because of its severity in young unvaccinated infants,
preventing pertussis in this population is of greatest
importance.
***********************
To access a web-text (HTML) version of the complete article, go
to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5310a4.htm
To access a ready-to-copy (PDF) version of this issue of MMWR,
go to: http://www.cdc.gov/mmwr/PDF/wk/mm5310.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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March 22, 2004
FREE: BULK COPIES OF THE LATEST ISSUE OF "NEEDLE TIPS"
(JANUARY 2004) ARE AVAILABLE--PLACE YOUR ORDER NOW
The Immunization Action Coalition (IAC) is giving away bulk
copies (up to 100 per request) of the January 2004 issue of
"NEEDLE TIPS."
If you have an immunization conference or an educational program
coming up for physicians, residents, or nurses who specialize in
pediatrics or family practice, this 24-page publication is an
excellent item to distribute. The January issue includes the
"Recommended Childhood and Adolescent Immunization Schedule--United States, January-June 2004," several practical pieces on
storing and administering vaccines, and hepatitis resources.
Because supplies are limited, it's best to make your request
right away. Free copies go quickly. Sorry, we can mail orders
only to addresses within the United States.
To request copies, fill out the online form on IAC's website:
http://www.immunize.org/freeoffer
You will be asked to supply the following information:
-
The number of copies you want (maximum 100)
-
A description of how you plan to use the copies
-
Your name and complete contact information, including mailing
address, telephone number, and email address
For further information, please contact Robin VanOss by email at
robin@immunize.org
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March 22, 2004
READ THE MARCH ISSUE OF CDC'S "IMMUNIZATION WORKS!" ELECTRONIC
NEWSLETTER ON THE NIP WEBSITE
The March issue of "Immunization Works!" a monthly email
newsletter published by CDC, is available on the NIP 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 March issue has already appeared
in previous issues of "IAC EXPRESS." Following is the text of
six articles we have not covered.
***********************
MEETINGS, CONFERENCES, AND RESOURCES
REQUEST FOR PROPOSAL (RFP) REGARDING VACCINE ADVERSE EVENTS:
The CDC, working with the Food and Drug Administration (FDA), is
seeking proposals to provide a single nationwide mechanism by
which vaccine adverse events (VAEs) occurring after receipt of
vaccines can be collected and analyzed. The project is required
by the National Childhood Vaccine Injury Act (NCVIA),
P.L. 99-660. The contractor will be responsible for all the
day-to-day aspects of the Vaccine Adverse Events Reporting
System (VAERS) operations, including (1) promoting reporting,
(2) data collection and entry into a database using standard
quality control and quality assurance measures, (3) follow-up of
serious and selected other reports, (4) data security,
integrity, authenticity, and confidentiality, (5) providing
support for CDC and FDA researchers in conducting epidemiologic
and other scientific studies of VAERS data, and (6) complete
detailed up-to-date documentation for all business processes and
IT systems. For more information, visit
http://www.eps.gov/spg/HHS/CDCP/PGOA/2004%2DN%2D01182/listing.html
***********************
REQUEST FOR PROPOSAL FOR IMMUNIZATION COALITION TECHNICAL
ASSISTANCE AND TRAINING: The CDC announces the availability of
fiscal year 2004 funds for a cooperative agreement program for
technical assistance and training for immunization coalitions
and immunization information dissemination. The purpose of the
program is to provide support for immunization coalitions and
for the dissemination of immunization information to enhance the
effectiveness of disease prevention programs that reduce the
annual burden of vaccine preventable diseases. The complete
program announcement was published in the Federal Register,
March 4, 2004, Volume 69, No. 43, Page 10,233. It can also be
accessed at
http://www.access.gpo.gov/su_docs/fedreg/frcont04.html Click on
Thursday, March 4, scroll down to CDC, and select TEXT or PDF
version. Application materials can be found on CDC's funding web
site at http://www.cdc.gov/od/pgo/funding/grantmain.htm The
application deadline is May 3.
***********************
SEVENTH ANNUAL CONFERENCE ON VACCINE RESEARCH: The 7th Annual
Conference on Vaccine Research will be held May 24-26, 2004, at
the Crystal Gateway Marriott in Arlington, Virginia. This
conference provides current reports of scientific progress
featured in both invited presentations and submitted abstracts.
International experts will lead seminars and panel discussions
on topical areas of basic immunology, product development,
clinical testing, regulation, and other aspects of vaccine
research. For more information, visit
http://www.nfid.org/conferences or e-mail
vaccine@nfid.org
***********************
NEW VACCINE ADVERSE EVENT REPORTING SYSTEM BROCHURE AVAILABLE:
A new Vaccine Adverse Event Reporting System (VAERS) brochure is
available for printing from the Web at
http://www.vaers.org/pdf/VAERS_brochure.pdf This colorful
brochure provides clear and concise information for providers
and the public on the VAERS system and vaccine adverse event
reporting.
***********************
FREE CME'S AVAILABLE RELATED TO THE VACCINE ADVERSE EVENT
REPORTING SYSTEM (VAERS): Health care providers may access the
"Vaccine Safety Post-Marketing Surveillance: The Vaccine Adverse
Event Reporting System" with free CMEs through September 19,
2004. To access the CME article, visit
http://www.cdc.gov/nip/vacsafe/VAERS/CME-post-mktg-surv.htm
Additional information related to VAERS is available at
www.vaers.org
***********************
JOB OPENINGS WITHIN THE NATIONAL IMMUNIZATION PROGRAM:
NIP is committed to recruiting and hiring qualified candidates
for a wide range of positions. Researchers, Medical Officers,
and Epidemiologists, as well as other specialties are often
needed to fill positions within NIP. We encourage all interested
parties to apply for these jobs. For a current listing of
positions available at NIP, please visit
www.usajobs.opm.gov
Once at the site, conduct a search for "National Immunization
Program."
***********************
To access the complete March issue from the NIP website, go to:
http://www.cdc.gov/nip/news/newsltrs/imwrks/2004/200403.htm
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March 22, 2004
NEW: AAP MAKES FOUR PRINT RESOURCES AVAILABLE AT NO CHARGE
AAP is making four print resources available free of charge on a
first-come first-served basis. If you are interested in
obtaining any of the following resources, contact Jill Ackermann
by email at jackermann@aap.org In your message, include your
complete mailing address and the number of copies you require of
each resource. The maximum number of copies you can order of any
resource is 50.
-
AAP Policy Statement: "Increasing Immunization Coverage"
(Committee on Community Health Services and Committee on
Practice and Ambulatory Medicine). "Pediatrics," October 2003,
Vol.112(4):993-996.
-
Special Article: "Standards for Child and Adolescent
Immunization Practices" (National Vaccine Advisory Committee).
"Pediatrics," October 2003, Vol. 112(4):958-963.
-
Commentary: "Child and Adolescent Immunizations: New
Recommendations, New Standards, New Opportunities" (Alan E.
Kohrt, MD, Department of Pediatrics, Children's Hospital of
Philadelphia). "Pediatrics," October 2003, Vol. 112 (4):978-981.
-
AAP Patient Education Brochure: "Immunizations: What You Need
to Know."
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March 22, 2004
CDC RELEASES "DEAR COLLEAGUE" LETTER ON RECOMMENDED STD
PREVENTION SERVICES FOR MSM
[The following is cross posted from IAC's "HEP EXPRESS"
electronic newsletter, 3/18/04.]
On March 8, 2004, CDC released a "Dear Colleague" letter
targeted to public health programs and private providers who
serve MSM [men who have sex with men]. The letter is intended to
encourage and facilitate efforts to deliver integrated and
appropriate services to populations at risk.
The letter recommends that clinicians routinely identify
sexually active MSM and provide
HIV counseling and testing at least annually;
Testing for syphilis, gonorrhea, and chlamydia
at least annually; and
Hepatitis A and hepatitis B vaccination.
The continued high rates of multiple STDs among MSM underscore
the importance and need for the delivery of comprehensive
STD-prevention services in both the public and private sectors.
Studies suggest that most (65%-85%) MSM receive primary health
care from private providers; fewer (2%-5%) receive primary
health care from public health clinics or community clinics.
The "Dear Colleague" letter was signed by the directors of CDC's
Division of Viral Hepatitis, Division of Sexually Transmitted
Diseases, Division of Immunization Services, and Division of
HIV/AIDS Prevention. The letter can be accessed at
http://www.immunize.org/msm/dearcolleague.pdf
The recommendations discussed in this letter can be studied in
more detail in CDC's 2002 "Sexually Transmitted Diseases
Treatment Guidelines" at
http://www.cdc.gov/mmwr/PDF/rr/rr5106.pdf
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March 22, 2004
HBF ADDS A NATIONAL LIBRARY OF MEDICINE TUTORIAL TO ITS WEBSITE
[The following is cross posted from IAC's "HEP EXPRESS"
electronic newsletter, 3/18/04.]
The Hepatitis B Foundation (HBF) announces the addition of a new
National Library of Medicine (NLM) tutorial to its website. The
tutorial teaches the viewer, through a step-by-step approach,
how to search the MEDLINE, MEDLINEplus, and Clinicaltrials.gov
databases. The tutorial was made possible through a grant from
NLM to expand hepatitis B information and education delivery on
the Internet.
To access this resource, go to:
http://www.hepb.org/nlmtutorial
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March 22, 2004
CDC WORKBOOK ON SHARPS INJURY PREVENTION PROGRAMS AVAILABLE
ONLINE
[The following is cross posted from IAC's "HEP EXPRESS"
electronic newsletter, 3/18/04.]
CDC has released a new resource on sharps injury prevention
programs, "Workbook for Designing, Implementing, and Evaluating
a Sharps Injury Prevention Program."
Occupational exposure to bloodborne pathogens from needlesticks
and other sharps injuries is a serious problem, but it is often
preventable. CDC estimates that each year 385,000 needlesticks
and other sharps-related injuries are sustained by hospital-based health care personnel. Similar injuries occur in other
health care settings, such as nursing homes, clinics, emergency
care services, and private homes. Sharps injuries are primarily
associated with occupational transmission of hepatitis B virus
(HBV), hepatitis C virus (HCV), and human immunodeficiency virus
(HIV), but they may be implicated in the transmission of more
than 20 other pathogens.
The workbook's goal is to help programs
Assess the facility's sharps injury prevention program;
Document the development and implementation of planning and
prevention activities; and
Evaluate the impact of prevention interventions.
The home page for the workbook can be accessed at
http://www.cdc.gov/sharpssafety
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March 22, 2004
AASLD PRACTICE GUIDELINES PUBLISHED ONLINE
[The following is cross posted from IAC's "HEP EXPRESS"
electronic newsletter, 3/18/04.]
Practice guidelines for the diagnosis, management, and treatment
of hepatitis B and hepatitis C are available on the American
Association for the Study of Liver Diseases (AASLD) website.
"Diagnosis Management and Treatment of Hepatitis C"
http://www.aasld.org/pdffiles/Prac._Guide_Hep_C.pdf
"Chronic Hepatitis B"
http://www.aasld.org/pdffiles/prac_guide__hep_B.pdf
"Chronic Hepatitis B: Update of Recommendations"
http://www.aasld.org/pdffiles/update_chronichep_B.pdf
AASLD represents more than 2,400 physicians, researchers, and
allied hepatology health professionals. To visit the AASLD
website, go to: http://www.aasld.org
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March 22, 2004
TWO NEW ISSUES OF "VIRAL HEPATITIS" AVAILABLE ON VHPB WEBSITE
[The following is cross posted from IAC's "HEP EXPRESS"
electronic newsletter, 3/18/04.]
The Viral Hepatitis Prevention Board (VHPB) website has been
updated and includes two new issues of the publication "Viral
Hepatitis."
"Viral Hepatitis," Volume 12, Number 1, is prepared from
material presented at the VHPB meeting on March 13-24, 2004, in
Geneva, Switzerland.
"Viral Hepatitis," Volume 12, Number 2, is a special edition
that includes the most recent updates of recommendations,
consensus statements, and meeting conclusions produced by, or in
collaboration with, VHPB during 1996-2003.
To access the ready-to-copy (PDF) versions of these issues, go
to: http://www.vhpb.org/Default.asp?navItem=newsletters
To access the home page of the VHPB website, go to:
http://www.vhpb.org
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March 22, 2004
WHO PUBLISHES INJECTION SAFETY DOCUMENTS
[The following is cross posted from IAC's "HEP EXPRESS"
electronic newsletter, 3/18/04.]
The World Health Organization (WHO) reports that in some
countries nearly 50% of the injections may be given with used,
contaminated injection equipment. WHO also estimates that
annually, unsafe injections account for 33% of new HBV
infections, 40% of new HCV infections, and 5% of new HIV
infections. This means that improvements in injection safety
could prevent 22 million people from acquiring HBV infections,
two million people from HCV infections, and 260,000 from HIV
infection each year.
WHO recently released the following documents related to
injection safety:
"A Guide for Supervising Injections" (Developed in
collaboration with the International Council of Nurses)
http://uqconnect.net/signfiles/Files/InjectionSupervisionGuideFinal.pdf
"Safety of Injections: Questions & Answers"
http://uqconnect.net/signfiles/Files/QuestionAndAnswersInjectionSafety.pdf
"Safety of Injections: A Glossary"
http://uqconnect.net/signfiles/Files/GlossaryInjectionSafety.pdf
"Safety of Injections: Global Facts & Figures"
http://uqconnect.net/signfiles/Files/FactAndFiguresInjectionSafety.pdf |
