Issue
Number 590
April 3, 2006
CONTENTS OF THIS ISSUE
- CDC reports on current mumps epidemic in Iowa
- CDC releases updated hepatitis A VIS
- New: Two more excellent thimerosal resources from Dr.
Paul Offit are now online
- Society of Adolescent Medicine's position paper on
adolescent immunization published in Journal of Adolescent Health
- IAC revises three hepatitis education pieces for
patients
- CDC updates its Influenza web section
- FDA approves the use of the antiviral drug Relenza for
preventing influenza, as well as treating it
- March 29 issue of Hep Express now available online
- May 18–19 are the dates for North Dakota's Vaccination
Expedition 2006
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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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April 3, 2006
CDC REPORTS ON CURRENT MUMPS EPIDEMIC IN IOWA
CDC published "Mumps Epidemic—Iowa, 2006" in the March 30 issue of MMWR
Dispatch. The article is reprinted below in its entirety, excluding
references.
***********************
In the United States, since 2001, an average of 265 mumps cases (range:
231–293 cases) have been reported each year, and in Iowa, an average of five
cases have been reported annually since 1996. However, in 2006, by March 28,
a total of 219 mumps cases had been reported in Iowa, and an additional 14
persons with clinically compatible symptoms were being investigated in three
neighboring states (11 in Illinois, two in Nebraska, and one in Minnesota)
in what has become the largest epidemic of mumps in the United States since
1988. This report summarizes and characterizes the ongoing mumps epidemic in
Iowa, the public health response, and recommendations for preventing further
transmission.
Mumps is an acute viral infection characterized by fever and nonsuppurative
swelling of the salivary glands; an estimated 20%–30% of cases are
asymptomatic. Complications can include inflammation of the testicles or
ovaries, meningitis/encephalitis, spontaneous abortion, and deafness. During
the prevaccine era, nearly everyone in the United States experienced mumps,
and 90% of cases occurred among children aged [younger than] 15 years. In
1977, Iowa law mandated 1 dose of measles, mumps, and rubella (MMR) vaccine
for entry to public schools; in 1991, the mandate became 2 doses. For the
2004–05 school year, 97% of children entering school in Iowa had received 2
doses of MMR vaccine.
The first reports to the Iowa Department of Public Health (IDPH) of
mumps-like illness occurred in December 2005 at a university in eastern
Iowa, where several students with glandular swelling were tested; two tested
positive for mumps-specific IgM antibodies. In mid-January 2006, an isolate
from an unrelated patient was cultured and identified as mumps virus at the
University Hygienic Laboratory (Iowa's state public health laboratory).
Viral isolates were sent to CDC, and the mumps strain was identified as
genotype G. By mid-February, active surveillance had been initiated in seven
geographic areas, including the campuses of the three largest universities
in Iowa.
Of the 219 cases reported in Iowa, the median patient age was 21 years
(range: 3–85 years), with 48% of patients aged 17–25 years; 30% (34 of 114)
were known to be college students. Of the 133 patients with investigated
vaccine history, 87 (65%) had documentation of receiving 2 doses, 19 (14%) 1
dose, and eight (6%) no doses; vaccine status could not be documented in 19
(14%) patients. Among the 114 patients for whom symptomatic information was
available, the most common symptoms were parotitis in 94 (83%) patients,
submaxillary/sublingual gland swelling in 46 (40%), fever in 41 (36%), and
sore throat in 36 (32%); average duration of illness was 5.1 days. Six (5%)
patients reported complications (e.g., orchitis); one suspected case of
encephalitis is being investigated. As of March 28, 2006, investigators had
determined that only 36 (16%) of the 219 cases were linked epidemiologically
(i.e., a source of infection was identified), suggesting frequent unapparent
transmission.
The source of the Iowa epidemic is unknown; however, the United Kingdom (UK)
experienced a recent mumps epidemic that peaked during 2005 with
approximately 56,000 cases and a high attack rate among young adults. The
mumps strain in the UK epidemic also was identified as genotype G, and the
UK epidemic has been linked to a 2005 mumps outbreak in the United States.
To educate healthcare professionals in Iowa regarding the epidemic and
mumps, information has been distributed via Iowa's Health Alert Network
(HAN), in weekly electronic newsletters, and via frequent conference calls.
The IDPH website has provided biweekly updates, county case counts, fact
sheets, and guidance to local health departments and healthcare facilities
on case investigations. IDPH recommendations include (1) requesting at least
5 days of isolation for all patients (quarantine is not being used), (2)
ensuring that students and staff members on all Iowa college campuses have
had 2 doses of MMR or are immune from mumps, (3) assessing vaccination
status of all healthcare professionals in Iowa and offering vaccination
where appropriate, and (4) sending all specimens collected from possible
cases to University Hygienic Laboratory for testing.
Despite control efforts and a highly vaccinated population, this epidemic
has spread across Iowa and potentially to neighboring states. Ongoing
investigations will focus on identifying actual vaccine coverage on college
campuses, potential modes of mumps transmission, and the effectiveness of 1
or 2 doses of MMR.
***********************
To access a web-text (HTML) version of the complete article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm55d330a1.htm
To access a ready-to-print (PDF) version of this issue of MMWR Dispatch, go
to:
http://www.cdc.gov/mmwr/PDF/wk/mm55d330.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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April 3, 2006
CDC RELEASES UPDATED HEPATITIS A VIS
[The following is cross posted from IAC's Hep Express electronic newsletter,
3/29/06.]
On March 21, 2006, CDC posted an updated hepatitis A VIS that takes into
account the licensing of hepatitis A vaccines for children 12 months and
older and the ACIP recommendation for routine hepatitis A vaccination of all
children age one year. The previous hepatitis A VIS, dated 1/09/06, was an
interim version.
To obtain a ready-to-copy (PDF) version of the hepatitis A VIS, go to:
http://www.immunize.org/vis/v-hepa.pdf
Please note that the new VIS (dated 3/21/06) is currently available only in
English.
For information about the use of VISs, and for VISs in up to 33 languages,
visit IAC's VIS web section at
http://www.immunize.org/vis
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April 3, 2006
NEW: TWO MORE EXCELLENT THIMEROSAL RESOURCES FROM DR. PAUL OFFIT ARE NOW
ONLINE
If you are looking for authoritative information on the topic of thimerosal
and vaccine safety, the websites of the Vaccine Education Center (VEC) of
Children's Hospital of Philadelphia and of Every Child By Two (ECBT) may be
able to help you. Both resources are the work of Paul Offit, MD. An
immunization expert, Dr. Offit is chief, Division of Infectious Diseases,
Children's Hospital of Philadelphia, and professor of pediatrics and Maurice
R. Hilleman Professor of Vaccinology, University of Pennsylvania School of
Medicine.
FROM THE VEC WEBSITE
VEC recently posted a summary for parents of the evidence explaining that
thimerosal is not a cause of autism. To access it, go to:
http://www.chop.edu/consumer/jsp/division/generic.jsp?id=75751
FROM THE ECBT WEBSITE
ECBT recently posted the audio file and podcast of a conference call Dr.
Offit conducted with members of the media on March 15. The call begins with
his review of the scientific evidence disproving that the thimerosal in
vaccines is a cause of autism. The call concludes with his answers to
questions from the press.
To access the audio file, go to:
http://72.32.4.217/ecbt/vaccinesafety.htm Scroll down and click on the
link titled Dr. Paul Offit Discussing Vaccine Safety and Autism.
To access the podcast, open your PC software and copy the following URL to
the podcast location:
http://www.ecbt.org/OffitBroadcast.rss
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April 3, 2006
SOCIETY OF ADOLESCENT MEDICINE'S POSITION PAPER ON ADOLESCENT IMMUNIZATION
PUBLISHED IN JOURNAL OF ADOLESCENT HEALTH
"Adolescent immunizations: A position paper of the Society for Adolescent
Medicine" was published in the March issue of the Journal of Adolescent
Health. The abstract is reprinted below.
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ABSTRACT
New vaccines are being targeted to help protect the adolescent population
from disease. The Society for Adolescent Medicine strongly urges compliance
with adolescent vaccination recommendations provided by the Advisory
Committee on Immunization Practices. These vaccines will significantly
impact the health and well-being of the adolescent population. To enhance
vaccination compliance and access to prevention health care and promotion,
the Society supports linking vaccination to the three distinct comprehensive
preventive health care visits already recommended by multiple organizations
during early, middle, and late adolescence. In addition, multiple provider
strategies should be used to increase vaccination rates among adolescents.
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To access the entire paper, go to:
http://www.adolescenthealth.org/PositionPaper_Immunization.pdf
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April 3, 2006
IAC REVISES THREE HEPATITIS EDUCATION PIECES FOR PATIENTS
[The following is cross posted from IAC's Hep Express electronic newsletter,
3/29/06.]
IAC recently updated three hepatitis-related print pieces intended for
patients/clients. All three were revised to take into account the new ACIP
recommendations for hepatitis A vaccination and the change in hepatitis A
vaccine licensures.
To access a ready-to-print (PDF) version of "Hepatitis A is a serious liver
disease," go to:
http://www.immunize.org/catg.d/p4080.pdf
To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/p4080a.htm
To access a ready-to-print (PDF) version of "Should You Be Vaccinated
Against Hepatitis A? A screening questionnaire for adults," go to:
http://www.immunize.org/catg.d/2190hepa.pdf
To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/2190hepa.htm
To access a ready-to-print (PDF) version of "Hepatitis A, B, and C: Learn
the differences," go to:
http://www.immunize.org/catg.d/p4075abc.pdf
To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/p4075abc.htm
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April 3, 2006
CDC UPDATES ITS INFLUENZA WEB SECTION
CDC recently updated eight pages of its Influenza web section. Six pages
were updated on March 31 as a result of the FDA approving the antiviral
medication zanamivir for treatment of influenza (see article #7 below); two
pages were updated to reflect the spread of avian influenza to animals in
Jordan.
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Antiviral agents for influenza: Background information for clinicians
(posted 3/31/06)
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Antiviral drugs and influenza (posted 3/31/06)
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Avian influenza infection in humans (posted 3/31/06)
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Antiviral agents for influenza: Dosage (posted 3/31/06)
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Recommendations for using antiviral agents for influenza (posted 3/31/06)
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Antiviral agents for influenza: Indications for use (posted 3/31/06)
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Embargo of birds from specified countries [Jordan added to embargo]
(posted 3/29/06)
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Avian influenza: Current situation [Jordan added to list of countries
reporting animal cases] (posted 3/27/06)
To access these materials, go to:
http://www.cdc.gov/flu/whatsnew.htm#updated and click on the pertinent
links.
To access a broad range of continually updated information on seasonal
influenza, avian influenza, and pandemic influenza, go to:
http://www.cdc.gov/flu
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April 3, 2006
FDA APPROVES THE USE OF THE ANTIVIRAL DRUG RELENZA FOR PREVENTING
INFLUENZA, AS WELL AS TREATING IT
On March 29, FDA issued a press release announcing that it has approved
the use of Relenza for preventing influenza. Previously, the drug was
licensed only for influenza treatment. The opening paragraph of the press
release is reprinted below.
*****************
For immediate release
March 29, 2006
FDA APPROVES A SECOND DRUG FOR THE PREVENTION OF INFLUENZA A AND B IN
ADULTS AND CHILDREN
The Food and Drug Administration (FDA) today approved the use of Relenza (zanamivir
for inhalation) for prevention (prophylaxis) of influenza (flu) in adults
and children 5 years of age and older. Relenza, an antiviral medication,
was previously approved for the treatment of influenza A and B virus
infections in adults and children. Tamiflu (oseltamivir phosphate)
previously was approved for both prevention and treatment of flu; today's
approval of Relenza for prevention provides Americans with another option
for the prevention of influenza A and B infections. . . .
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To access the complete press release, go to:
http://www.fda.gov/bbs/topics/news/2006/new01341.html
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April 3, 2006
MARCH 29 ISSUE OF HEP EXPRESS NOW AVAILABLE ONLINE
The March 29 issue of Hep Express, an electronic newsletter published by
IAC, is now available online. It is intended for health and social service
professionals involved in the prevention and treatment of viral hepatitis.
IAC Express has already covered some of the information presented in the
March 29 issue; titles of articles we have not yet covered follow.
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LOLA sponsors second Hepatitis C March in New York City on May 18
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International HBV Meeting scheduled for September 17–20 in Vancouver,
Canada
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SIGN 2005 meeting report now online
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National Task Force on Hepatitis B: Focus on Asian and Pacific Islander
Americans works to reduce hepatitis B-related mortality and morbidity
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Dr. Raymond Schinazi receives HBF scientific award for 2005
To access the March 29 issue, go to:
http://www.hepprograms.org/hepexpress/issue42.asp
To sign up for a free subscription to Hep Express, go to:
http://www.hepprograms.org/hepexpress/signup.asp
To access previous issues of Hep Express, go to:
http://www.hepprograms.org/hepexpress
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April 3, 2006
MAY 18–19 ARE THE DATES FOR NORTH DAKOTA'S VACCINATION EXPEDITION 2006
Vaccination Expedition 2006: A North Dakota Adventure will feature
presentations by two nationally recognized immunization experts, William
Atkinson, MD, MPH, from CDC's National Immunization Program, and Paul
Offit, MD, from the Vaccine Education Center at Children's Hospital of
Philadelphia.
Sponsored by Grand Forks Public Health, the conference will be held in
the Alerus Center in Grand Forks on May 18–19. For registration and
program information email Kathy Dunn at
kdunn@grandforksgov.com or
call (701) 787-8100. |
