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Immunization Action Coalition
IAC Express 2007
Issue number 681: August 27, 2007
 
Contents of this Issue
Select a title to jump to the article.
  1. Official CDC Health Advisory: Hepatitis A in a food handler who served persons from multiple states
  2. CDC releases revised interim meningococcal VIS
  3. New: Spanish-language version of the current recommended adult immunization schedule now online
  4. MMWR reports on respiratory illness mistakenly attributed to pertussis
  5. IAC updates "When Do Children and Teens Need Vaccinations?"
  6. August issue of CDC's Immunization Works electronic newsletter now available online
  7. MMWR features chart illustrating HPV infection prevalence
  8. Vaccine Education Center Newsletter includes important information for healthcare professionals
  9. North American Plan for Avian and Pandemic Influenza released
  10. WHO issues position paper on rotavirus vaccines
  11. Former CDC director writes about changes in public health from 1998-2002
 
Abbreviations
AAFP, American Academy of Family Physicians; AAP, American Academy of Pediatrics; ACIP, Advisory Committee on Immunization Practices; AMA, American Medical Association; CDC, Centers for Disease Control and Prevention; FDA, Food and Drug Administration; IAC, Immunization Action Coalition; MMWR, Morbidity and Mortality Weekly Report; NCIRD, National Center for Immunization and Respiratory Diseases; NIVS, National Influenza Vaccine Summit; VIS, Vaccine Information Statement; VPD, vaccine-preventable disease; WHO, World Health Organization.
  
Issue 681: August 27, 2007
1.  Official CDC Health Advisory: Hepatitis A in a food handler who served persons from multiple states

On August 26, CDC's Health Alert Network issued an official CDC Health Advisory titled "Hepatitis A in a Food Handler Who Served Persons from Multiple States." It is reprinted below in its entirety.


The Centers for Disease Control and Prevention (CDC) has recently been notified that an employee of a single Jamba Juice store in San Jose, California was recently diagnosed with hepatitis A. The food service worker also assisted with the preparation of fresh fruit smoothies for distribution at the booth of an exhibitor (JumpSport) at the 43rd Annual USA Gymnastics (USAG) National Congress and Trade Show held in conjunction with the 2007 Gymnastics National Championships, in San Jose, California. Attendees at the trade show and gymnastics competition were from a number of states and have since returned home.

Because it is likely the employee followed good hand hygiene and food safety practices, the risk of exposure is small. However, persons exposed in the last 14 days can reduce their risk. Persons who may have been exposed include:
  • Persons who ate or drank at the 1140 Lincoln Avenue San Jose, CA Jamba Juice on August 1-3, 6-9, 11, 13 and 15-16.
     
  • Persons who drank fruit smoothies distributed from the JumpSport booth at the USAG trade show on August 16 and 17.

People who have had a hepatitis A vaccine or have had the illness in the past, are protected from hepatitis A infection. CDC recommends that persons who are not protected and are within 14 days of exposure contact their medical provider or their state or local health department to receive a dose of single antigen hepatitis A vaccine or immune globulin (IG).

  • Healthy persons between the ages of 12 months and 40 years can receive single antigen hepatitis A vaccine or IG.
     
  • For persons over the age of 40 years, IG is preferred. Vaccine can be used if IG cannot be obtained.
     
  • IG should be used for children under the age of 12 months, immune compromised persons, persons who have been diagnosed with chronic liver disease, and persons for whom vaccine is contraindicated.

In persons exposed more than 14 days ago, vaccine or IG treatment will not prevent the illness. Those persons should watch for symptoms of hepatitis A and practice good hygiene, including frequent hand washing with soap and water.

Hepatitis A is a liver disease caused by the hepatitis A virus. Symptoms usually occur abruptly and include fatigue, abdominal pain, loss of appetite, nausea, jaundice (yellowing of the skin or eyes), and diarrhea. Symptoms usually last less than two months; but some people may be ill for as long as six months. The average time from exposure to symptoms is 28 days, but can range from 1550 days. Good personal hygiene, including frequent hand washing with soap and water is very important in preventing the spread of hepatitis A. If you experience symptoms, please contact your health care provider.

People seeking medical care related to possible exposure can contact Jamba Juice to learn about their reimbursement policy for related medical expenses and obtain a reimbursement form by calling (877) 217-4780.

More information about hepatitis A is available at http://www.cdc.gov/ncidod/diseases/hepatitis/ or by calling the CDC information line at (800) CDC-INFO ([800] 232-4636).

To access the health advisory, go to:
http://www2a.cdc.gov/HAN/ArchiveSys/ViewMsgV.asp?AlertNum=00266

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2 CDC releases revised interim meningococcal VIS

On August 16, CDC released a revised interim edition of the VIS for meningococcal vaccines. The interim meningococcal VIS has been updated slightly to make it consistent with ACIP's recent vote to recommend MCV4 for all children and adolescents 11-18 years of age, as published in an August 10, 2007, MMWR Notice to Readers. The change affects only the first two paragraphs of Section 3 of the VIS; providers may use up stocks of the previous version, but should be prepared to explain the updated indication to patients.

To access the interim VIS for meningococcal vaccines from the CDC website, go to:
http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-mening.pdf

To access it from the IAC website, go to:
http://www.immunize.org/vis/menin06.pdf

For information about the use of VISs, and for VISs in more than 30 languages, visit IAC's VIS web section at http://www.immunize.org/vis

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3 New: Spanish-language version of the current recommended adult immunization schedule now online

The October 2006-September 2007, Recommended Adult Immunization Schedule is now available in Spanish and can be printed from the CDC website. The Recommended Adult Immunization Schedule--which was released in English in October 2006--has been approved by the Advisory Committee on Immunization Practices (ACIP), the American Academy of Family Physicians (AAFP), the American College of Physicians (ACP), and the American College of Obstetricians and Gynecologists (ACOG).

To access the Spanish-language schedule directly, go to:
http://www.cdc.gov/vaccines/recs/schedules/downloads/adult/06-07/adult-schedule-sp.pdf

To view, download, or print the adult schedule in various formats, visit http://www.cdc.gov/vaccines/recs/schedules/adult-schedule.htm

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4 MMWR reports on respiratory illness mistakenly attributed to pertussis

CDC published "Outbreaks of Respiratory Illness Mistakenly Attributed to Pertussis--New Hampshire, Massachusetts, and Tennessee, 2004-2006" in the August 24 issue of MMWR. The introduction and last paragraph of the Editorial Note are reprinted below, excluding footnotes and one figure.


Pertussis, or whooping cough, is a highly infectious, nationally notifiable respiratory disease associated with prolonged cough illness and paroxysms of coughing, inspiratory "whoop," or posttussive vomiting. Reported pertussis cases have tripled in the United States since 2001, with 25,616 probable or confirmed cases reported in 2005. This increase has been attributed to increased circulation of Bordetella pertussis, waning vaccine-induced immunity among adults and adolescents, heightened awareness of pertussis among healthcare providers, increased public health reporting, and increased use of polymerase chain reaction (PCR) testing for diagnosis. To minimize the spread of pertussis, control measures must be implemented early in the course of illness when the risk for transmission is highest. However, diagnosis of pertussis is complicated by nonspecific signs and symptoms, particularly in the early catarrhal stage of disease. In addition, the lack of rapid, sensitive, and specific laboratory tests makes early and accurate identification of pertussis challenging. This report describes two hospital outbreaks and one community outbreak of respiratory illness during 2004-2006 in New Hampshire, Massachusetts, and Tennessee that were attributed initially to pertussis. However, subsequent investigations revealed negative or equivocal laboratory results and epidemiologic and clinical features atypical of pertussis, suggesting that pertussis was not the cause of these outbreaks. The findings in this report underscore the need for thorough epidemiologic and laboratory investigation of suspected pertussis outbreaks when considering extensive control measures . . . .


Considering the challenges of diagnosing pertussis and controlling outbreaks, prevention of pertussis outbreaks through widespread vaccination is an important strategy. The Advisory Committee on Immunization Practices recommends vaccination of persons aged 11-64 years with the newly licensed Tdap vaccines, which have been estimated 85%-92% effective. Achieving high coverage is expected to prevent disease and decrease the likelihood of future pertussis outbreaks. Although the effectiveness of vaccination with Tdap in interrupting transmission of pertussis during an outbreak has not been established, persons previously vaccinated with Tdap should have a lower risk for acquiring and transmitting pertussis, thereby preventing the outbreak from expanding. Investigation of suspected pertussis outbreaks should include timely consideration of clinical, laboratory, and epidemiologic data, including vaccination status of the population affected, to help health officials implement appropriate control measures.


To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5633a1.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5633.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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5 IAC updates "When Do Children and Teens Need Vaccinations?"

IAC recently revised "When Do Children and Teens Need Vaccinations?" to include updated information on hepatitis A, influenza, Tdap, HPV, and meningococcal vaccination.

To access the newly revised piece, go to:
http://www.immunize.org/catg.d/p4050.pdf

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6 August issue of CDC's Immunization Works electronic newsletter now available online

The August issue of Immunization Works, a monthly email newsletter published by CDC, is available on the website of the National Center for Immunization and Respiratory Diseases (NCIRD). The newsletter offers members of the immunization community non-proprietary information about current topics. CDC encourages its wide dissemination.

All of the information in the August issue has already appeared in previous issues of IAC Express. The titles of the articles appear below.

FRONT PAGE NEWS
CDC Launches Pre-Teen Vaccine Campaign

OTHER NEWS & SUMMARIES
Influenza Update
Revised MCV4 Recommendations
Hepatitis A Vaccination Coverage, Children 24-35 Months
Progress toward Global Polio Eradication

MEETINGS, CONFERENCES & RESOURCES
HPV--Gardasil and GBS Fact Sheet
Save the Date, Immunization & Health Coalitions Conference
Updated VIS Statements
Updated "Guidelines for Vaccinating Pregnant Women"
Upcoming Broadcasts, Webcasts and Netconferences
Vaccine Safety Article

Issues of Immunization Works are posted on CDC's Vaccines & Immunizations website a few days after publication. To access the August issue, go to: http://www.cdc.gov/vaccines/news/newsltrs/imwrks Click on the link titled "Aug" under the banner titled "2007 Newsletters Available Online."

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7 MMWR features chart illustrating HPV infection prevalence

In the August 24 issue of MMWR, CDC published a chart titled "QuickStats: Prevalence of HPV Infection Among Sexually Active Females Aged 14-59 Years, by Age Group--National Health and Nutrition Examination Survey, United States, 2003-2004."

To access a web-text (HTML) version of the chart, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5633a5.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5633.pdf

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8 Vaccine Education Center Newsletter includes important information for healthcare professionals

On August 14, the Vaccine Education Center (VEC) at the Children's Hospital of Philadelphia (CHOP) published an issue of its electronic newsletter for healthcare providers. It includes the following items.

(1) Information about the Vaccine Education Center Symposium scheduled for September 15 at CHOP.
This one-day symposium for health professionals will focus on concerns and questions related to vaccine financing, science, and exemptions. The registration deadline is August 31. To access a ready-to-print (PDF) version of the symposium brochure, go to: http://www.chop.edu/cme/2007/vaccine/pdf/vaccine_std.pdf To register, go to CHOP's Continuing Medical Education Department at http://www.chop.edu/cme or call (215) 590-5263.

(2) Ordering information for updated VEC educational materials.
VEC has revised "Meningococcus: What You Should Know" and "Influenza: What You Should Know." These materials come in tear pads of 50 sheets and are available in English and Spanish. Healthcare professionals can order two pads of each title in each language free of charge by contacting VEC by phone ([215] 590-9990), email (vaccines@email.chop.edu), fax ([215] 590-2025), or online at http://vaccine.chop.edu (select "order educational materials").

(3) Description of new materials promoting adolescent and teen vaccination.
VEC has developed a new set of materials to help educate families about adolescent and teen vaccines, including a parent bookmark, adolescent and teen bookmarks, and a laminated 'tips' card for healthcare offices. The bookmarks are available in English and Spanish, and the teen bookmarks come in a choice of four styles. To learn more or order materials, visit http://vaccine.chop.edu

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9 North American Plan for Avian and Pandemic Influenza released

On August 21, the Presidents of the United States and Mexico and the Prime Minister of Canada announced the release of the North American Plan for Avian and Pandemic Influenza. The plan was developed as part of the Security and Prosperity Partnership of North American, an effort to increase security and enhance prosperity in Canada, Mexico, and the United States through greater cooperation and information sharing.

The plan outlines how the three countries will work together to prepare for and manage outbreaks of highly pathogenic avian influenza and pandemic influenza. The North American Plan provides a framework to accomplish the following:

  • Detect, contain, and control an avian influenza outbreak and prevent transmission to humans;
  • Prevent or slow the entry of a new strain of human influenza into North America;
  • Minimize illness and deaths; and
  • Sustain infrastructure and mitigate the impact to the economy and the functioning of society.

To read or download the North American Plan for Avian and Pandemic Influenza, go to:
http://www.state.gov/g/avianflu/91242.htm

To read a related fact sheet, "Combatting Avian Flu in North American: The North American Plan for Avian and Pandemic Influenza," go to:
http://www.state.gov/documents/organization/91387.pdf

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10.  WHO issues position paper on rotavirus vaccines

The August 10 issue of the WHO periodical "Weekly Epidemiological Record" covered the latest WHO position paper on rotavirus vaccines. To access it, go to:
http://www.who.int/wer/2007/wer8232.pdf

A collection of WHO position papers on vaccines is available in alphabetical order at
http://www.who.int/immunization/documents/positionpapers

They are available in chronological order on the IAC website at
http://www.immunize.org/who

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11.  Former CDC director writes about changes in public health from 1998-2002

CDC published "Director's Perspective--Jeffrey P. Koplan, MD, MPH, 1998-2002" in the August 24 issue of MMWR. In commemoration of CDC's 60th anniversary, MMWR has been publishing a series of commentaries by CDC directors. This is the sixth of these personal perspectives.

To access a web-text (HTML) version of this article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5633a3.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5633.pdf

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Immunization Action Coalition  •  Saint Paul, MN
tel 651-647-9009  •  fax 651-647-9131
 
This website is supported in part by a cooperative agreement from the National Center for Immunization and Respiratory Diseases (Grant No. 5U38IP000290) at the Centers for Disease Control and Prevention (CDC) in Atlanta, GA. The website content is the sole responsibility of IAC and does not necessarily represent the official views of CDC.