Issue
Number 622
September 25, 2006
CONTENTS OF THIS ISSUE
- Recommendations for HIV testing in healthcare settings
published in MMWR Recommendations and Reports
- CDC publishes report on inadvertent misadministration of
meningococcal conjugate vaccine
- CDC releasing August 10 Immunization Update broadcast in
podcast format segments
- Heads up: November 1 is deadline for abstracts for the
2007 National Immunization Conference
- Updated: IAC revises two pieces for healthcare
professionals
- CDC issues update on U.S. and worldwide influenza
activity during May 21–September 9, 2006
- CDC reports on measles-control activities in Africa
- Earn continuing education credit online by participating
in interactive, case-based activities
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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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September 25, 2006
RECOMMENDATIONS FOR HIV TESTING IN HEALTHCARE SETTINGS PUBLISHED IN MMWR
RECOMMENDATIONS AND REPORTS
CDC published "Revised Recommendations for HIV Testing of Adults,
Adolescents, and Pregnant Women in Health-Care Settings" in the September 22
MMWR Recommendations and Reports. The summary is reprinted below in its
entirety, excluding references.
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These recommendations for human immunodeficiency virus (HIV) testing are
intended for all healthcare providers in the public and private sectors,
including those working in hospital emergency departments, urgent care
clinics, inpatient services, substance abuse treatment clinics, public
health clinics, community clinics, correctional healthcare facilities, and
primary care settings. The recommendations address HIV testing in healthcare
settings only. They do not modify existing guidelines concerning HIV
counseling, testing, and referral for persons at high risk for HIV who seek
or receive HIV testing in nonclinical settings (e.g., community-based
organizations, outreach settings, or mobile vans). The objectives of these
recommendations are to increase HIV screening of patients, including
pregnant women, in healthcare settings; foster earlier detection of HIV
infection; identify and counsel persons with unrecognized HIV infection and
link them to clinical and prevention services; and further reduce perinatal
transmission of HIV in the United States. These revised recommendations
update previous recommendations for HIV testing in healthcare settings and
for screening of pregnant women.
Major revisions from previously published guidelines are as follows:
For patients in all healthcare settings
-
HIV screening is recommended for patients in all healthcare settings after
the patient is notified that testing will be performed unless the patient
declines (opt-out screening).
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Persons at high risk for HIV infection should be screened for HIV at least
annually.
-
Separate written consent for HIV testing should not be required; general
consent for medical care should be considered sufficient to encompass
consent for HIV testing.
-
Prevention counseling should not be required with HIV diagnostic testing
or as part of HIV screening programs in healthcare settings.
For pregnant women
-
HIV screening should be included in the routine panel of prenatal
screening tests for all pregnant women.
-
HIV screening is recommended after the patient is notified that testing
will be performed unless the patient declines (opt-out screening).
-
Separate written consent for HIV testing should not be required; general
consent for medical care should be considered sufficient to encompass
consent for HIV testing.
-
Repeat screening in the third trimester is recommended in certain
jurisdictions with elevated rates of HIV infection among pregnant women.
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To access a web-text (HTML) version of the recommendations, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5514a1.htm
To access a ready-to-print (PDF) version, go to:
http://www.cdc.gov/mmwr/pdf/rr/rr5514.pdf
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September 25, 2006
CDC PUBLISHES REPORT ON INADVERTENT MISADMINISTRATION OF MENINGOCOCCAL
CONJUGATE VACCINE
CDC published "Inadvertent Misadministration of Meningococcal Conjugate
Vaccine—United States, June–August 2005" in the September 22 issue of
MMWR. The opening paragraph is reprinted below.
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During June–August 2005, CDC and the Food and Drug Administration (FDA)
were notified of seven clusters of inadvertent subcutaneous (SC)
misadministration of the new meningococcal conjugate vaccine (MCV4,
Menactra) (Sanofi Pasteur, Inc., Swiftwater, Pennsylvania), which is
licensed for intramuscular (IM) administration only. A total of 101
persons in seven states were reported to have received MCV4 by the SC
route. Of these, 100 were contacted by their healthcare providers and
advised of the administration error. CDC conducted an investigation to
determine whether SC administration of MCV4 resulted in a protective
immunologic response. This report describes the results of that
investigation, which indicated that, despite the misadministration,
persons vaccinated by the SC route were sufficiently protected and that
revaccination was not necessary.
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The Editorial Note is reprinted below, excluding footnotes.
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The most likely reason for the inadvertent misadministration of MCV4
described in this report was that the older meningococcal vaccine,
MPSV4, in use for nearly 30 years, is licensed for SC administration,
whereas MCV4 is licensed only for IM administration. This reason was
cited by healthcare providers participating in the investigation.
Although the overall serologic response for SC vaccinees was lower than
that of IM vaccinees as determined by GMTs [geometric mean titers],
nearly all persons vaccinated by the SC route developed rBSA [baby
rabbit complement] titers >=8, which was considered protective on the
basis of recent population-based studies of meningococcal C conjugate
vaccine efficacy in the United Kingdom. Therefore, CDC determined that
this particular group of persons vaccinated by the SC route was
sufficiently protected and that revaccination was not necessary.
CDC cautions healthcare providers to be aware that the licensed route of
vaccine administration can vary among similar vaccines and recommends
that providers carefully review and follow the route of administration
indicated on the vaccine label and package insert before administering
vaccines. This is especially important after introduction of a new
vaccine product.
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To access a web-text (HTML) version of the article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5537a2.htm
To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5537.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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September 25, 2006
CDC RELEASING AUGUST 10 IMMUNIZATION UPDATE BROADCAST IN PODCAST FORMAT
SEGMENTS
CDC's National Immunization Program is in the process of making the
August 10 Immunization Update broadcast available in segments as MP4
(audio and video) and MP3 (audio) files. These segments can be
downloaded to a computer or a portable music/video device (such as an
iPod) or viewed/listened to directly on the CDC podcast web page.
Currently, eight segments are available. Go to
http://www2a.cdc.gov/podcasts
and look under the following dates for the segments. To download either
an MP3 or MP4 file to your computer, right-click on the "download" link
for the file, then use the "save as" command to save the file.
September 8, 2006
"Vaccines: Guidelines for Healthcare Providers—Influenza Part 1"
"Vaccines: Guidelines for Healthcare Providers—Influenza Part 2"
"Vaccines: Guidelines for Healthcare Providers—Influenza Part 3"
"Vaccines: Guidelines for Healthcare Providers—Herpes Zoster (Shingles)"
September 15, 2006
"Vaccines: Guidelines for Healthcare Providers—HPV"
"Vaccines: Guidelines for Healthcare Providers—Varicella"
September 22, 2006
"Vaccines: Guidelines for Healthcare Providers—Rotavirus"
"Vaccines: Guidelines for Healthcare Providers—VIS"
Each segment is also available as a transcript in ready-to-print (PDF)
format.
Keep checking
http://www2a.cdc.gov/podcasts for newly released segments. Important
note: continuing education credit is not available for viewing/listening
to these segments.
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September 25, 2006
HEADS UP: NOVEMBER 1 IS DEADLINE FOR ABSTRACTS FOR THE 2007 NATIONAL
IMMUNIZATION CONFERENCE
November 1 is the deadline for submitting abstracts for CDC's 2007
National Immunization Conference, which will be held in Kansas City, MO,
on March 5-8, 2007. Abstracts must be submitted online. To access
submission guidelines, go to:
http://www.cdc.gov/nip/nic/#abstract
The deadline for early-bird registration ($200) is January 12. The
deadline for regular registration ($225) is February 16. Late and
on-site registration will be $250.
For general information on the 41st National Immunization Conference,
including conference goals, objectives, and registration, go to:
http://www.cdc.gov/nip/nic
Those without Internet access can contact the conference planning team
at (404) 639-8225 or nipnic@cdc.gov
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September 25, 2006
UPDATED: IAC REVISES TWO PIECES FOR HEALTHCARE PROFESSIONALS
IAC recently revised two pieces for healthcare professionals.
"First do no harm: Protect patients by making sure all staff receive
yearly influenza vaccine!" encourages healthcare employers to protect
patients by increasing staff influenza vaccination rates. The revised
piece is based on the CDC publication, "Influenza Vaccination of
Health-Care Personnel," published February 2006. "First do no harm" also
includes information on the Joint Commission of Accreditation of
Healthcare Organization's infection control standard requiring
accredited organizations to offer influenza vaccination to staff,
volunteers, and independent practitioners who have close patient
contact.
The updated piece also features a list of practical resources, including
links to standing order protocols, screening questionnaires, and
declination of influenza vaccination forms.
To access a ready-to-print (PDF) version, go to:
http://www.immunize.org/catg.d/p2014.pdf
To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/p2014.htm
IAC's "Vaccine Administration Record for Adults" was revised to include
space to record HPV and zoster vaccines.
To access a ready-to-print (PDF) version, go to:
http://www.immunize.org/catg.d/p2023b.pdf
To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/p2023b.htm
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September 25, 2006
CDC ISSUES UPDATE ON U.S. AND WORLDWIDE INFLUENZA ACTIVITY DURING MAY
21–SEPTEMBER 9, 2006
CDC published "Update: Influenza Activity—United States and Worldwide,
May 21–September 9, 2006" in the September 22 issue of MMWR. The opening
paragraph is reprinted below.
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During May 21–September 9, 2006, influenza A(H3), influenza A(H1), and
influenza B viruses cocirculated worldwide and were identified
sporadically in North America. This report summarizes influenza activity
in the United States and worldwide since the last MMWR update.
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To access a web-text (HTML) version of the article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5537a4.htm
To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5537.pdf
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September 25, 2006
CDC REPORTS ON MEASLES-CONTROL ACTIVITIES IN AFRICA
CDC published "Effects of Measles-Control Activities—African Region,
1999–2005" in the September 22 issue of MMWR. A summary made available
to the press is reprinted below in its entirety.
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This study demonstrates that the strategies used in the accelerated
measles control program in the WHO African Region, when implemented
effectively, can result in a sharp drop in measles cases. Reported
measles cases in 32 African countries were reduced by 93 percent—from
nearly 203,000 in 1999 to just over 14,000 in 2005—as a result of
large-scale vaccination campaigns, improvements in routine immunization
services, case management, and surveillance activities. The remaining
children in Africa not yet vaccinated against measles will be targeted
for vaccination campaigns by the end of 2006. Successful control of
measles in these countries is important to reducing child mortality and
reaching global goals of measles mortality reduction. Measles is the
leading vaccine-preventable cause of death worldwide, causing nearly
half a million deaths annually.
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To access a web-text (HTML) version of the complete article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5537a3.htm
To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5537.pdf
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September 25, 2006
EARN CONTINUING EDUCATION CREDIT ONLINE BY PARTICIPATING IN INTERACTIVE,
CASE-BASED ACTIVITIES
The University of Pennsylvania School of Medicine and SCIOS Continuing
Education are jointly sponsoring a series of interactive, online
case-based learning opportunities designed to improve childhood
immunization rates. Titled "Medical Detectives," the series has been
designed for family practice physicians, pediatricians, nurse
practitioners, physician assistants, and other healthcare professionals
interested in learning about overcoming barriers to optimal pediatric
vaccine use.
The activities have been approved for credit for physicians; the program
is pending approval by the National Association of Pediatric Nurse
Practitioners. Faculty includes Jay M. Lieberman, MD; Sharon G. Humiston,
MD, MPH, FAAP; and S. Michael Marcy, MD.
For more information, or to register, go to:
http://www.pedsvaccinescme.com |
