Issue
Number 489
November 1, 2004
CONTENTS OF THIS ISSUE
- New: CDC issues a supplement to the VIS for trivalent inactivated
influenza vaccine
- More than 4.2 million doses of influenza vaccine were shipped last
week to providers who serve high-priority groups
- New: Register now for CDC's Influenza Update Net Conference, scheduled
for November 19
- Updated: CDC adds new professional and patient information related to
the influenza vaccine shortage to its website
- DHHS announces that it has potentially identified more than 5 million
additional doses of influenza vaccine
- CDC issues an update on U.S. and worldwide influenza activity for
May-October 2004
- VIS translations: New hepatitis A vaccine VIS now available in eight
additional languages
- Reminder: November 19 is the deadline for abstracts for CDC's 2005
National Immunization Conference
- CDC issues notice about false-positive HBsAg tests
- CDC reports on laboratory surveillance for wild and vaccine-derived
polioviruses during January 2003-June 2004
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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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November 1, 2004
NEW: CDC ISSUES A SUPPLEMENT TO THE VIS FOR TRIVALENT INACTIVATED INFLUENZA
VACCINE
On October 29, CDC issued a supplement to the VIS for trivalent inactivated
influenza vaccine (TIV). Titled "Inactivated Influenza Vaccine: 2004-2005
Supplement--Vaccine Shortage," the one-page supplement lists the people who
should get influenza vaccine during the current vaccine shortage. The
supplement is intended to be used with the VIS for TIV, which is dated
5/24/04. The supplement is currently available in English only.
To access the supplement from the CDC website, go to:
http://www.cdc.gov/nip/publications/VIS/vis-flu-suplmt.pdf
To access the 5/24/04 VIS in English, go to:
http://www.cdc.gov/nip/publications/VIS/vis-flu.pdf
To access the 5/24/04 VIS in additional languages, go to:
http://www.immunize.org/vis/index.htm#influenza Click on the
language(s) you want.
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November 1, 2004
MORE THAN 4.2 MILLION DOSES OF INFLUENZA VACCINE WERE SHIPPED LAST WEEK TO
PROVIDERS WHO SERVE HIGH-PRIORITY GROUPS
On October 29, CDC issued a press release announcing that more than 4.2
million doses of influenza vaccine were shipped during the week of October
25-29. The press release is reprinted below in its entirety.
******************
For immediate release
October 29, 2004
OVER 4.2 MILLION INFLUENZA VACCINE DOSES SHIPPED THIS WEEK TO HEALTH
PROVIDERS SERVING HIGH-PRIORITY GROUPS
Over 4.2 million influenza vaccine doses were shipped this week to health
providers serving high-priority groups as part of the plan announced on
October 12 by the Centers for Disease Control and Prevention (CDC) and
Aventis Pasteur. Since October 11, 2004, more than 9 million doses of flu
vaccine have been shipped to the following groups:
- State public health departments
- Department of Veterans Administration
- Long-term care facilities/acute care
hospitals
- Vaccines for Children program
- Private physicians who care for young
children
- HMOs and private providers serving
high-priority groups
- Department of Defense
"We are and will continue to take all the
steps possible to get vaccine out in an equitable way to those who need it
most," said CDC Director Dr. Julie Gerberding. "The spirit of cooperation we
are seeing by Aventis Pasteur, state and local health officials, clinicians,
hospitals, and the public is extraordinary and is what will help deal with
this challenging situation."
Dr. Gerberding urged people to continue to be patient and persistent as
health officers work to fill vaccine coverage gaps in the coming weeks. The
approximately 16.5 million remaining doses of vaccine will be shipped to
public and private vaccine providers, at a rate of about 2.5-3 million doses
per week, primarily through early December. About 2.6 million doses of the
Aventis Pasteur vaccine will be available for shipment in early January
2005.
On October 5, 2004, after Chiron Corporation announced that none of the
doses of influenza vaccine it had produced would be available this year, CDC
announced priority groups for vaccination for the 2004-2005 influenza
season:
- all children aged 6-23 months,
- adults aged 65 years and older,
- persons aged 2-64 years with underlying
chronic medical conditions,
- all women who will be pregnant during
influenza season,
- residents of nursing homes and long-term
care facilities,
- children 6 months-18 years of age on
chronic aspirin therapy,
- health care workers with direct patient
care, and
- out-of-home caregivers and household
contacts of children aged <6 months.
Influenza season is unpredictable. In most
years, the season peaks between December and March. It is too early to say
how severe the 2004-2005 season will be, but to date only sporadic cases
have been reported.
Vaccination is the best protection against influenza, but there are
alternatives. Antiviral drugs can be used before someone becomes ill to
prevent them from getting the flu or taken within 1-2 days of first flu
symptoms to reduce the severity of the illness.
The Department of Health and Human Services has purchased a stockpile of
antiviral drugs to treat more than 7 million people during the 2004-2005 flu
season. Other supplies of the antiviral drugs are available through private
health providers. It is estimated that about 40 million people could be
treated this flu season with the antiviral drugs available.
Finally, everyone can take practical steps to help prevent spread of flu:
- avoid close contact with people who
are sick,
- keep your distance from others if
you're sick,
- when possible, stay home from work,
school, and errands when you are sick, and don't send your children to
daycare or school if they are sick,
- cover your mouth and nose when
coughing or sneezing, and
- clean your hands often.
For more information about the flu, visit the
CDC website: http://www.cdc.gov/flu
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November 1, 2004
NEW: REGISTER NOW FOR CDC'S INFLUENZA UPDATE NET CONFERENCE, SCHEDULED FOR
NOVEMBER 19
Scheduled for November 19 from 12PM to 1PM (ET), the next Influenza Update
Net Conference will provide clinicians with the most up-to-date information
on influenza and will focus on antivirals. This is a limited-registration
event; registration closes November 18 at midnight (ET) or when the course
is full. Don't be disappointed, register NOW by going to
http://www2.cdc.gov/nip/isd/fluconference
More information on the program's content will be available soon. Stay
informed by going to
http://www.cdc.gov/flu/professionals/training/novnetconf.htm
The program will combine a telephone audio conference with simultaneous
online visual content. It will include a Q&A session, accessible by
telephone and Internet. Internet access and a separate phone line are needed
to participate. Graphics will be available to download as a PowerPoint file
after the presentations. For more information, see Instructions and System
Requirements at
http://www.cdc.gov/nip/ed/ciinc/instructions.htm
If you have questions, send them to Clinician Outreach and Communication
Activity at COCA@cdc.gov
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November 1, 2004
UPDATED: CDC ADDS NEW PROFESSIONAL AND PATIENT INFORMATION RELATED TO THE
INFLUENZA VACCINE SHORTAGE TO ITS WEBSITE
CDC recently posted several new documents related to the influenza vaccine
shortage to its website. Following are links to the new information.
PROFESSIONAL INFORMATION
(1) The two-page "Guidelines and Recommendations: Guidance for Prevention
and Control of Influenza in the Peri- and Postpartum Settings" details
infection control measures for hospitalized pregnant and recently delivered
women and their infants.
To access a ready-to-copy (PDF) version, go to:
http://www.cdc.gov/flu/professionals/infectioncontrol/pdf/peri-post-settings.pdf
To access a web-text (HTML) version, go to:
http://www.cdc.gov/flu/professionals/infectioncontrol/peri-post-settings.htm
(2) Three items have been added to the Q&A section on influenza vaccine
administration. To access them, go to:
http://www.cdc.gov/flu/about/qa/vaxadmin.htm
(3) One question has been added to the Q&A section on live attenuated
influenza vaccine. To access it, go to:
http://www.cdc.gov/flu/about/qa/nasalspray.htm
(4) The National Center for Infectious Diseases' web section on Personal
protective Equipment (PPE) in Health Care Settings offers a 12-minute video
on the topic, as well as a slide set and posters. To access the web section,
go to:
http://www.cdc.gov/ncidod/hip/ppe/default.htm
PATIENT INFORMATION
(5) The National Center for Infectious Diseases web section has added a
poster for health care settings: "Important Notice to All Patients: Please
tell staff immediately if you have flu symptoms." To access a ready-to-print
(PDF) version, go to:
http://www.cdc.gov/ncidod/hip/INFECT/RespiratoryPoster.pdf
(6) Patient information sheets and posters have recently been posted in the
following languages: Chinese, Vietnamese, Tagalog, and Russian. To access
them, go to:
http://www.cdc.gov/flu/languages.htm Click on the language(s) you
want.
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November 1, 2004
DHHS ANNOUNCES THAT IT HAS POTENTIALLY IDENTIFIED MORE THAN 5 MILLION
ADDITIONAL DOSES OF INFLUENZA VACCINE
On October 28, the Department of Health and Human Services (DHHS) issued a
press release announcing that it has potentially identified more than 5
million additional doses of influenza vaccine for the 2004-05 influenza
season. The press release also reports that DHHS is redirecting some
influenza vaccine initially earmarked for the military and federal employees
to high-risk populations nationwide and that a major vaccine manufacturer is
tripling its production of pneumococcal vaccine. Portions of the press
release are reprinted below.
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October 28, 2004
For immediate release
HHS IDENTIFIES MORE INFLUENZA VACCINE: Department Takes Steps To Acquire
Foreign Vaccine, Redirect Government Doses
HHS Secretary Tommy G. Thompson announced today significant progress
toward expanding the nation's supply of vaccines for flu season . . .
"We're continuing to build our arsenal of vaccines and medicines to
confront the coming flu season," Secretary Thompson said. "We are
encouraged about the potential for some 5 million doses of vaccine
from foreign manufacturers and we're sending our inspectors to those
facilities. . . ."
Secretary Thompson said FDA inspectors would be traveling to two
foreign manufacturing facilities--GlaxoSmithKline's facility in
Germany and IDBiomedical's facility in Canada--to inspect their
manufacturing plants and products. The inspection teams will confirm
the availability of the 5 million doses, assure that the vaccine can
be used safely, and then make arrangements to acquire them. . . .
Additionally, the department has recouped about 300,000 doses of
influenza vaccine that had been purchased by the federal government
for federal employees and the military this flu season. . . .
Secretary Thompson also announced that Merck & Co. is tripling its
production of pneumococcal vaccine used to prevent one of the major
complications of the flu, pneumonia. . . .
[Pneumococcal vaccine] is not a substitute for the influenza vaccine,
but can help shield people against flu complications . . . . Many
people who fall into the priority groups for the influenza vaccine
should also get the pneumonia vaccine, including seniors. . . .
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To read the complete press release, go to:
http://www.hhs.gov/news/press/2004pres/20041028a.html
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November 1, 2004
CDC ISSUES AN UPDATE ON U.S. AND WORLDWIDE INFLUENZA ACTIVITY FOR
MAY-OCTOBER 2004
CDC published "Update: Influenza Activity--United States and
Worldwide, May-October 2004" in the October 29 issue of MMWR. Portions
of the article and Editorial Note are reprinted below.
***********************
[From the article]
During May-October 2004, influenza A (H3N2) viruses circulated
worldwide and were associated with mild-to-moderate levels of disease
activity. Influenza A (H1N1) and B viruses were reported less
frequently. In North America, isolates of influenza A (H3N2), A
(H1N1), and B were identified sporadically. This report summarizes
influenza activity in the United States and worldwide during
May-October 2004. Influenza activity in North America typically peaks
during December-March.
United States
Until recently, in the United States, national influenza surveillance
was conducted by four systems that operated during October-May. . . .
For the 2004-05 influenza season, CDC has added two new surveillance
systems: one that tracks naturally reported pediatric deaths
associated with laboratory-confirmed influenza infections and another
that tracks hospitalizations associated with laboratory-confirmed
influenza infections in children aged <18 years. . . .
During May 23-October 2, the weekly percentage of patient visits to
sentinel providers for ILI [influenza-like illness] ranged from 0.4%
to 0.8%. WHO and NREVSS [National Respiratory and Enteric Virus
Surveillance System] collaborating laboratories tested 11,916
respiratory specimens; 54 (0.5%) were positive for influenza. Of the
positive results, 29 (54%) were influenza B viruses, 14 (26%) were
influenza A (H3N2) viruses, and 11 (20%) were influenza A viruses that
were not subtyped. Both influenza A and B viruses were reported during
late May-September 2004.
During October 3-16, influenza activity occurred at low levels in the
United States. Since October 3, WHO and NREVSS collaborating
laboratories in the United States have tested 1,414 respiratory
specimens; eight (0.6%) were positive. Of these, six were influenza A
viruses, and two were influenza B viruses. The proportion of patient
visits to sentinel providers for ILI and the proportion of deaths
attributed to pneumonia and influenza were below baseline levels.
During the week ending October 16, nine states and New York City
reported sporadic influenza activity, and 40 states and the District
of Columbia reported no influenza activity. . . .
[From the Editorial Note]
During May-October 2004, influenza A (H3N2) viruses were the most
frequently reported virus subtype worldwide; however, influenza A
(H1N1) and influenza B viruses also circulated. At this time, neither
the influenza virus subtype that will predominate in the United States
nor the severity and timing of the 2004-05 season can be predicted.
The ongoing widespread epizootic of highly pathogenic H5N1 [avian
influenza A] viruses in Asia remains a major concern. Since December
2003, nine Asian countries have reported H5N1 poultry outbreaks, with
human cases reported from two of these countries. No evidence of
sustained person-to-person transmission has been identified to date,
although a probable instance of limited person-to-person transmission
in a family cluster was identified recently in Thailand. CDC continues
to recommend enhanced surveillance for suspected H5N1 cases among
travelers with severe unexplained respiratory illness returning from
H5N1-affected countries. Additional information about avian influenza
is available at
http://www.phppo.cdc.gov/han/archivesys/viewmsgv.asp?alertnum=00209
Influenza surveillance reports for the United States are published
weekly during October-May and are available through CDC's voice
(telephone, [888] 232-3228) and fax (telephone, [888] 232-3299,
document number 361100) information systems and at
http://www.cdc.gov/flu/weekly/fluactivity.htm Additional
information about influenza viruses, influenza surveillance, and the
influenza vaccine is available at
http://www.cdc.gov/flu
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To access a web-text (HTML) version of the complete article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5342a5.htm
To access a ready-to-copy (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5342.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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November 1, 2004
VIS TRANSLATIONS: NEW HEPATITIS A VACCINE VIS NOW AVAILABLE IN EIGHT
ADDITIONAL LANGUAGES
Dated 8/4/04, the current version of the VIS for hepatitis A vaccine
is now available on the IAC website in eight additional languages:
Arabic, Armenian, Cambodian, Farsi, Haitian Creole, Hmong, Korean, and
Vietnamese. IAC gratefully acknowledges the Massachusetts Department
of Public Health for the Haitian Creole translation and the California
Department of Health Services for the remaining translations.
PLEASE NOTE: When hepatitis A vaccine is added to the Vaccine Injury
Compensation Program's injury table, presumably later in 2004, another
hepatitis A vaccine VIS will be issued. To avoid large printing
expenses, print off only as many of the 8/4/04 VISs as you anticipate
needing for the next several months.
To obtain a ready-to-copy (PDF) version of the VIS for hepatitis A
vaccine in ARABIC, go to:
http://www.immunize.org/vis/ab_hpa04.pdf
To obtain it in ARMENIAN, go to:
http://www.immunize.org/vis/ar_hpa04.pdf
To obtain it in CAMBODIAN, go to:
http://www.immunize.org/vis/ca_hpa04.pdf
To obtain it in FARSI, go to:
http://www.immunize.org/vis/fa_hpa04.pdf
To obtain it in HAITIAN CREOLE, go to:
http://www.immunize.org/vis/ha_hpa04.pdf
To obtain it in HMONG, go to:
http://www.immunize.org/vis/hm_hpa04.pdf
To obtain it in KOREAN, go to:
http://www.immunize.org/vis/ko_hpa04.pdf
To obtain it in VIETNAMESE, go to:
http://www.immunize.org/vis/vn_hpa04.pdf
To obtain it in ENGLISH, go to:
http://www.immunize.org/vis/v-hepa.pdf
For information about the use of VISs, and for VISs in a total of 32
languages, visit IAC's VIS web section at
http://www.immunize.org/vis
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November 1, 2004
REMINDER: NOVEMBER 19 IS THE DEADLINE FOR ABSTRACTS FOR CDC'S
2005 NATIONAL IMMUNIZATION CONFERENCE
November 19 is the deadline for submitting abstracts for CDC's
2005 National Immunization Conference, which will be held in
Washington, DC, on March 21-24, 2005. The deadline for early-bird registration ($150) is January 28. The deadline for regular
registration ($175) is March 4.
Abstracts must be submitted online. To access submission
guidelines, go to: http://www.cdc.gov/nip/nic/#abstract
For general conference information, including conference goals,
objectives, and registration, go to:
http://www.cdc.gov/nip/nic
For additional information, contact the conference planning team
at (404) 639-8225 or nipnic@cdc.gov
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November 1, 2004
CDC ISSUES NOTICE ABOUT FALSE-POSITIVE HBsAg TESTS
CDC recently posted the following notice on the Viral Hepatitis
section of the National Center for Infectious Diseases' (NCID)
website.
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FALSE-POSITIVE HBsAg TESTS NOTED
BD and Abbott Diagnostics have initiated an investigation
concerning the increased rate of initial and/or repeat reactive
results for the AUSZYME Monoclonal test when using BD Vacutainer
SST Plus tubes. As described in the AUSZYME package insert,
reactive specimens should be repeated in duplicate. If either of
the repeats is positive, the sample should then be tested with a
licensed neutralizing confirmatory test, such as the HBsAg
Confirmatory Assay. Only those specimens in which the HBsAg can
be neutralized by the confirmatory test procedure may be
designated as positive for HBsAg. All highly sensitive
immunoassay systems have a potential for nonspecific reactions.
The specificity of a repeatedly reactive specimen can be
confirmed by neutralization tests.
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To access the notice, go to:
http://www.cdc.gov/ncidod/diseases/hepatitis/new.htm#top Click
on the link titled "False positive HBsAg tests noted."
For additional technical or product-related information, read
the BD technical bulletin at
http://www.bd.com/vacutainer/pdfs/techbulletins/Abbott_Diagnostics_17september2004.pdf
If you have identified a cluster of infants born to false-positive HBsAg mothers, who because of the false-positive
results, have been monitored as if they were born to
HBsAg-positive mothers, please call Susan A. Wang, MD, MPH,
at NCID at (404) 371-5953.
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November 1, 2004
CDC REPORTS ON LABORATORY SURVEILLANCE FOR WILD AND VACCINE
DERIVED POLIOVIRUSES DURING JANUARY 2003-JUNE 2004
CDC published "Laboratory Surveillance for Wild and Vaccine-Derived Polioviruses, January 2003-June 2004" in the October 29
issue of MMWR. Portions of a summary made available to the press
are reprinted below.
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In 1988, the World Health Organization (WHO) established a
global laboratory network to ensure that specimens from acute
flaccid paralysis cases undergo appropriate processing and
testing to detect the presence of poliovirus. The network
currently includes 123 national laboratories, 15 regional
reference laboratories, and 7 global specialized laboratories.
Between January 2003 and June 2004, the network tested 104,946
specimens. The network analyzes the genetic data from all wild
poliovirus isolates to determine their relatedness and infer
common sources and chains of transmission. Six wild poliovirus
genotypes were detected between January 2003 and June 2004. The
network has also played a role in detecting the circulation of
vaccine-derived poliovirus, which has the potential to cause
outbreaks of poliomyelitis. The network is playing a key role in
the global eradication of polio.
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To access a web-text (HTML) version of the complete article, go
to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5342a4.htm
To access a ready-to-copy (PDF) version of this issue of MMWR,
go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5342.pdf |
