Issue Number 73
May 4, 1999
CONTENTS OF THIS ISSUE
- CDC releases annual ACIP statement,
"Prevention and Control of Influenza"
- CPT coding inadvertently causing
serious delays in tests that diagnose acute hepatitis
- MMWR publishes article on outbreak of
poliomyelitis in Angola
- MMWR publishes article on progress
toward poliomyelitis eradication in Nigeria
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(1)
April 30, 1999
CDC RELEASES ANNUAL ACIP STATEMENT, "PREVENTION AND CONTROL OF INFLUENZA"
On April 30, 1999, the Advisory Committee on Immunization Practices released its updated
statement, "Prevention and Control of Influenza," for the 1999-2000 influenza
season.
This report updates the 1998 recommendations by the Advisory Committee on Immunization
Practices on the use of influenza vaccine and antiviral agents (MMWR
1998;47{No.RR-6}:1-26). The principal changes include a) information on the
influenza virus strains included in the 1999-2000 trivalent vaccine; b) discussion of the
potential expanded use of influenza vaccine; c) new background information on
live-attenuated influenza vaccines, neuraminidase-inhibitor drugs, and rapid
diagnostic tests; d) new information on the epidemiology of influenza among travelers; and
e) the addition of referenced citations.
In addition, this annually revised ACIP statement reviews recommendations for the use of
influenza vaccine such as which children and adults should be given influenza vaccine,
when it should be administered, who needs more than one dose, vaccine side effects,
antiviral treatment for influenza, and more.
NOTE: Continuing education credits (CMEs, CEUs, CNEs) sponsored by CDC are available for
reading this statement and completing the test which is printed at the end of the
document.
To access the complete document in text format, click here:
http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/00057028.htm
For the camera-ready copy (pdf format) of the document, click here: ftp://ftp.cdc.gov/pub/Publications/mmwr/rr/rr4804.pdf
TO GET A FREE ELECTRONIC SUBSCRIPTION TO THE MMWR (delivered weekly), go to the MMWR
website and sign up. When you sign up, you will also automatically begin to receive all
new ACIP statements which are published as MMWR's "Recommendations and Reports."
To get the MMWR website, click here: http://www.cdc.gov/epo/mmwr/mmwr.html
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(2)
April 30, 1999
CPT CODING INADVERTENTLY CAUSING SERIOUS DELAYS IN TESTS THAT DIAGNOSE ACUTE HEPATITIS
An article entitled "Changes in CPT Code for Hepatitis Panel Causing Delayed Reports
of Acute Hepatitis" was reported in the April 30, 1999, issue of MMWR as a
"Notice to Readers." CDC reports that these CPT (Current Procedural Terminology)
changes are causing repercussions which include physicians not having sufficient time to
provide postexposure prophylaxis to prevent transmission of HAV or HBV to susceptible
contacts of the case-patient.
The entire notice reads as follows:
NOTICE TO READERS: CHANGES IN CPT CODE FOR HEPATITIS PANEL CAUSING DELAYED REPORTS OF
ACUTE HEPATITIS
Current Procedural Terminology (CPT) codes are standardized codes developed and maintained
by the CPT Board of the American Medical Association for reporting medical services. The
Health Care Financing Administration requires use of these codes in the Common Procedure
Coding System when services are reported to Medicare and Medicaid for reimbursement.
Effective January 1, 1998, the CPT Board changed the hepatitis serology panel (CPT#80059)
to exclude the tests for IgM antibody to hepatitis A virus (IgM anti-HAV) and IgM antibody
to hepatitis B core antigen (IgM anti-HBc). These two tests specifically identify recent
infection with HAV and HBV, respectively. Many providers may be unaware that these tests
are not part of the standard hepatitis panel, and diagnoses of cases of acute viral
hepatitis are likely to be delayed by the need to perform additional testing. As a result,
reporting of cases to health departments may be delayed, and CDC has received reports of
instances of insufficient time to provide postexposure prophylaxis to prevent
transmission of HAV or HBV to susceptible contacts of the case-patient.
The CPT Board has revised the hepatitis serology panel to include both IgM tests that were
deleted. However, these modifications will not be implemented until the next CPT code
manual is issued on January 1, 2000. Until this change takes effect, health departments
should notify health-care practitioners and/or laboratories of the need to order
individual tests for IgM anti-HAV (CPT#86709) and IgM anti-HBc (CPT#86705) for accurate
determination of the cause of illness in patients with signs and/or symptoms of acute
viral hepatitis and for timely prophylaxis of contacts.
If you would like to access a copy of this article directly from the MMWR's website, click
here: http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/00057022.htm
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(3)
April 30, 1999
MMWR PUBLISHES ARTICLE ON OUTBREAK OF POLIOMYELITIS IN ANGOLA
An article entitled "Outbreak of Poliomyelitis - Angola, 1999" was published in
the April 30, 1999, issue of the MMWR. This article describes one of the largest epidemics
of poliovirus type 3 in the vaccine era.
On March 23, 1999, the Pediatric Hospital in Luanda, Angola, reported 21 cases (three
deaths) of acute flaccid paralysis (AFP). By April 25, 1999, 634 AFP cases and 39 deaths
had been reported. Preliminary data suggest that the outbreak primarily resulted from
failure to vaccinate, with approximately 90% of the cases being unvaccinated or partially
vaccinated. The civil war in Angola helped create conditions for the spread of poliovirus,
with many displaced persons living in crowded and unsanitary conditions.
To read the complete MMWR article, which also includes advice to travelers, please click
here:
http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/00056989.htm
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(4)
April 23, 1999
MMWR PUBLISHES ARTICLE ON PROGRESS TOWARD POLIOMYELITIS ERADICATION IN NIGERIA
An article entitled "Progress Toward Poliomyelitis Eradication - Nigeria,
1996-1998" was published in the April 23, 1999, issue of the MMWR. The article
describes how, despite much effort, NID (National Immunization Day) coverage has not been
high enough to eradicate the wild poliovirus, which remains widespread in Nigeria.
The "Editorial Note" concludes that "Nigeria and West Africa are among the
few remaining reservoirs of wild poliovirus transmission in the world. Interruption of
wild poliovirus transmission will require 1) successful mopping-up in 15 states during
April and May 1999; 2) high quality mopping-up in additional states guided by surveillance
before the start of NIDs in November 1999; 3) house-to-house vaccination during the next
two NIDs to assure high coverage; 4) statewide house-to-house mopping-up in any state with
wild poliovirus transmission during 2000; and 5) maintenance and further strengthening of
AFP surveillance. Nigeria's polio eradication efforts are supported by WHO, United Nations
Children's Fund (UNICEF), Rotary International, U.S. Agency for International Development,
and CDC.
To access the complete MMWR article, please click here:
http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/00056970.htm |
