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Immunization Action Coalition

IAC Express 2011

Issue number 951: September 6, 2011

Please click here to subscribe to IAC Express as well as other FREE IAC periodicals.
Contents of this Issue
Select a title to jump to the article.
  1. CDC publishes MMWR Early Release about recent swine-origin influenza A (H3N2) virus infections in Indiana and Pennsylvania children
  2. CDC reports on vaccination coverage of children ages 19-35 months
  3. IAC updates its handout on influenza vaccine products available for the U.S. 2011-12 influenza season
  4. Bulk quantities of the 2011-12 Influenza Vaccine Pocket Guides and PPSV Pocket Guides are available--FREE!--from the National Influenza Vaccine Summit
  5. IAC's Video of the Week explores the pros and cons of physicians' refusing to see patients who decline vaccination
  6. Spotlight on immunize.org: IAC's Featured Resources
  7. AAP releases policy statement on recommendations for influenza immunization of children and makes influenza resources available on Red Book Online
  8. AAP releases an updated policy statement on recommendations for use of quadrivalent and monovalent varicella vaccines in children
  9. CDC's September 15 Net Conference to focus on influenza
  10. CDC publishes report on a measles outbreak in Indiana during June-July 2011
  11. CDC gives providers information for patients about febrile seizures related to simultaneous administration of PCV13 and TIV vaccines
  12. CDC updates information for clinicians on influenza vaccination, vaccine safety, and antiviral medications
  13. 2011-12 influenza vaccine VISs now available in Amharic and Thai
  14. CDC publishes report on a human rabies death in Wisconsin in 2010
  15. IAC's popular laminated versions of the 2011 U.S. immunization schedules are available. Order a supply for your workplace today!
  16. Award-winning DVD! "Immunization Techniques: Best Practices with Infants, Children, and Adults"--from the California Department of Public Health, Immunization Branch
  17. VICNetwork to host September 21 webinar on promoting influenza vaccination
  18. Minnesota immunization conference planned for October 20-21
 
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 951: September 6, 2011
1.  CDC publishes MMWR Early Release about recent swine-origin influenza A (H3N2) virus infections in Indiana and Pennsylvania children

On September 2, CDC published "Swine-Origin Influenza A (H3N2) Virus Infection in Two Children--Indiana and Pennsylvania, July-August 2011" as an electronic MMWR Early Release. Portions of the article and the Editorial Note are reprinted below.


Influenza A viruses are endemic in many animal species, including humans, swine, and wild birds, and sporadic cases of transmission of influenza A viruses between humans and animals do occur, including human infections with avian-origin influenza A viruses (i.e., H5N1 and H7N7) and swine-origin influenza A viruses (i.e., H1N1, H1N2, and H3N2). Genetic analysis can distinguish animal origin influenza viruses from the seasonal human influenza viruses that circulate widely and cause annual epidemics. This report describes two cases of febrile respiratory illness caused by swine-origin influenza A (H3N2) viruses identified on August 19 and August 26, 2011, and the current investigations. No epidemiologic link between the two cases has been identified, and although investigations are ongoing, no additional confirmed human infections with this virus have been detected. These viruses are similar to eight other swine-origin influenza A (H3N2) viruses identified from previous human infections over the past 2 years, but are unique in that one of the eight gene segments (matrix [M] gene) is from the 2009 influenza A (H1N1) virus. The acquisition of the M gene in these two swine-origin influenza A (H3N2) viruses indicates that they are "reassortants" because they contain genes of the swine-origin influenza A (H3N2) virus circulating in North American pigs since 1998 and the 2009 influenza A (H1N1) virus that might have been transmitted to pigs from humans during the 2009 H1N1 pandemic. However, reassortments of the 2009 influenza A (H1N1) virus with other swine influenza A viruses have been reported previously in swine. Clinicians who suspect influenza virus infection in humans with recent exposure to swine should obtain a nasopharyngeal swab from the patient for timely diagnosis at a state public health laboratory and consider empiric neuraminidase inhibitor antiviral treatment to quickly limit potential human transmission.

Case Reports

Patient A. On August 17, 2011, CDC was notified by the Indiana State Department of Health Laboratories of a suspected case of swine-origin influenza A (H3N2) infection in a boy aged <5 years. The boy, who had received influenza vaccine in September 2010, experienced onset of fever, cough, shortness of breath, diarrhea, and sore throat on July 23, 2011. He was brought to a local emergency department (ED) where a respiratory specimen later tested positive for influenza A (H3). The boy was discharged home, but was not treated with influenza antiviral medications. He has multiple chronic health conditions, returned to the ED on July 24, 2011, and was hospitalized for treatment of those health problems, which had worsened. The boy was discharged home on July 27, 2011, and has since recovered from this illness. As part of routine CDC-supported influenza surveillance, the respiratory specimen collected on July 24, 2011, was forwarded to the Indiana State Department of Health Laboratories, where polymerase chain reaction (PCR) testing identified a suspect swine-origin influenza A (H3N2) virus on August 17, 2011. The specimen was forwarded to CDC where the findings were confirmed through genome sequencing on August 19, 2011.

No direct exposure to swine was identified for this child; however, a caretaker reported direct contact with asymptomatic swine in the weeks before the boy's illness onset and provided care to the child 2 days before illness onset. No respiratory illness was identified in any of the child's family or close contacts, the boy's caretaker, or in the family or contacts of the caretaker.

Patient B. On August 24, 2011, CDC was notified by the Pennsylvania Department of Health of a suspected case of swine-origin influenza A (H3N2) virus infection in a girl aged <5 years. The girl, who had received influenza vaccine in September 2010, experienced acute onset of fever, nonproductive cough, and lethargy on August 20, 2011. She was brought to a local hospital ED where a nasopharyngeal swab tested positive for influenza A by rapid influenza diagnostic test. She was not treated with influenza antiviral medications and was discharged home the same day. The girl has completely recovered from this illness.

A nasopharyngeal swab and nasal wash specimen were obtained at the ED and forwarded to the Pennsylvania State Department of Health Bureau of Laboratories for additional testing as part of routine CDC-supported influenza surveillance. On August 23, 2011, the state public health laboratory identified a suspected swine-origin influenza A (H3N2) virus by PCR testing, and both specimens were forwarded to CDC. On August 26, 2011, genome sequencing confirmed the virus as swine-origin influenza A (H3N2). On August 16, 2011, the girl was reported to have visited an agricultural fair where she had direct exposure to swine and other animals. No additional illness in the girl's family or close contacts has been identified, but illness in other fair attendees continues to be investigated. No additional confirmed swine-origin influenza virus infections have been identified thus far. . . .

Editorial Note

The lack of known direct exposure to pigs in one of the two cases described in this report suggests the possibility that limited human-to-human transmission of this influenza virus occurred. Likely transmission of swine-origin influenza A (H3N2) virus from close contact with an infected person has been observed in past investigations of human infections with swine-origin influenza A virus, but has not resulted in sustained human-to-human transmission. Preliminary evidence from the investigation of the Indiana case shows no ongoing  transmission. No influenza illness has been identified, but if additional chains of transmission are identified, rapid intervention is warranted [to] try to prevent further spread of the virus. Clinicians should consider swine-origin influenza A virus infection as well as seasonal influenza virus infections in the differential diagnosis of patients with febrile respiratory illness who have been near pigs. Clinicians who suspect influenza virus infection in humans with recent exposure to swine, should obtain a nasopharyngeal swab from the patient, place the swab in a viral transport medium, contact their state or local health department to facilitate transport and timely diagnosis at a state public health laboratory, and consider empiric neuraminidase inhibitor antiviral treatment. CDC requests that state public health laboratories send all suspected swine-origin influenza A specimens to the CDC, Influenza Division, Virus Surveillance and Diagnostics Branch Laboratory.


To access the Early Release, go to: http://www.cdc.gov/mmwr/pdf/wk/mm60e0902.pdf
 
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2 CDC reports on vaccination coverage of children ages 19-35 months

CDC published "National and State Vaccination Coverage Among Children Aged 19-35 Months--United States, 2010" in the September 2 issue of MMWR. The first paragraph is reprinted below.


The National Immunization Survey (NIS) monitors vaccination coverage among children aged 19-35 months using a random-digit-dialed sample of telephone numbers of households to evaluate childhood immunization programs in the United States. This report describes the 2010 NIS coverage estimates for children born during January 2007-July 2009. Nationally, vaccination coverage increased in 2010 compared with 2009 for >=1 dose of measles, mumps, and rubella vaccine (MMR), from 90.0% to 91.5%; >=4 doses of pneumococcal conjugate vaccine (PCV), from 80.4% to 83.3%; the birth dose of hepatitis B vaccine (HepB), from 60.8% to 64.1%; >=2 doses of hepatitis A vaccine (HepA), from 46.6% to 49.7%; rotavirus vaccine, from 43.9% to 59.2%; and the full series of Haemophilus influenzae type b (Hib) vaccine, from 54.8% to 66.8%. Coverage for poliovirus vaccine (93.3%), MMR (91.5%), >=3 doses HepB (91.8%), and varicella vaccine (90.4%) continued to be at or above the national health objective targets of 90% for these vaccines. The percentage of children who had not received any vaccinations remained low (<1%). For most vaccines, no disparities by racial/ethnic group were observed, with coverage for other racial/ethnic groups in 2010 similar to or higher than coverage among white children. However, disparities by poverty status still exist. Maintaining high vaccination coverage levels is important to reduce the burden of vaccine-preventable diseases and prevent a resurgence of these diseases in the United States, particularly in undervaccinated populations.


To access the full article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6034a2.htm
 
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3 IAC updates its handout on influenza vaccine products available for the U.S. 2011-12 influenza season

IAC recently revised its professional-education handout "Influenza Vaccine Products for the 2011-12 Influenza Season." It now has two pages (it formerly had one), new Medicare codes, and information on administering intradermal influenza vaccine.

Go to: http://www.immunize.org/catg.d/p4072.pdf

IAC's Handouts for Patients and Staff web section offers healthcare professionals and the public approximately 250 FREE English-language handouts (many also available in translation), which we encourage website users to print out, copy, and distribute widely. To access all of IAC's free handouts, go to: http://www.immunize.org/handouts
 
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4 Bulk quantities of the 2011-12 Influenza Vaccine Pocket Guides and PPSV Pocket Guides are available--FREE!--from the National Influenza Vaccine Summit

To aid in efforts to vaccinate against influenza and pneumococcal disease, the Immunization Action Coalition is inviting IAC Express readers to place orders now for bulk quantities of the National Influenza Vaccine Summit's 2011-12 Influenza Vaccine Pocket Information Guide and Pneumococcal Polysaccharide Vaccination (PPSV) Pocket Guide. Both are free--you can order them in the hundreds or thousands!

These laminated, 3.75 x 6.75-inch, 2-color cards serve as a convenient reference for front-line healthcare professionals who vaccinate patients. Place a bulk order now, and your organization will be ready to educate healthcare professionals at upcoming immunization training sessions and conferences. Each staff person who administers influenza or PPSV vaccine needs these handy resources.

THE 2011-12 INFLUENZA POCKET GUIDE PROVIDES THE FOLLOWING INFORMATION:
  • Important points for healthcare providers
     
  • Indications, contraindications, and precautions for the injectable, intradermal, and intranasal influenza vaccines
     
  • Clear direction regarding which children ages 6 months through 8 years need 2 doses of influenza vaccine this year
     
  • Dosage, route of administration, and indicated age group for all the various influenza vaccine products
     
  • Talking points for discussing influenza vaccination with patients

See an image of the influenza vaccine pocket guide at http://www.immunize.org/pocketguides/pocketguide_flu.pdf

The influenza pocket guide also serves as a reminder to keep giving influenza vaccine throughout influenza season (through the spring months).

THE PPSV POCKET GUIDE PROVIDES THE FOLLOWING INFORMATION:

  • Indications for vaccination with PPSV, contraindications, and precautions
     
  • Indications for vaccination with 2 doses of PPSV and intervals between doses
     
  • Dosage and routes of administration

See an image of the PPSV pocket guide at http://www.immunize.org/pocketguides/pocketguide_ppsv.pdf

The 2011-12 influenza pocket guide and PPSV pocket guide are designed to be used by healthcare professionals only; THEY ARE NOT PATIENT HANDOUTS.

HOW TO ORDER
Place your order at http://www.preventinfluenza.org/pocketguides There is no cost for the pocket guides, shipping, or handling within the U.S. They're going fast, so to avoid disappointment, place your order ASAP!

If you have questions, email admininfo@immunize.org

BACKGROUND
For background information on the pocket guides, see http://www.immunize.org/express/issue949.asp#n3

Thanks for your dedication to immunization, and don't forget to keep vaccinating against influenza through the spring months!

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5 IAC's Video of the Week explores the pros and cons of physicians' refusing to see patients who decline vaccination

IAC encourages IAC Express readers to watch a 5-minute video segment from The Today Show titled "Should Doctors Ban Kids Who Aren't Vaccinated?" In the segment, NBC's chief medical correspondent, Dr. Nancy Snyderman, and pediatrician Dr. Lisa Thornton discuss the growing number of doctors who, in an attempt to keep their offices safe from the spread of disease, refuse to see parents/patients who choose not to vaccinate.

The video will be available on the home page of IAC's website through September 11. To access it, go to: http://www.immunize.org and click on the image under the words Video of the Week.

Remember to bookmark IAC's home page to view a new video every Monday.

To access the archives of IAC's Videos of the Week, go to: http://www.immunize.org/votw
 
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6 Spotlight on immunize.org: IAC's Featured Resources

Looking for noteworthy immunization resources for patients and healthcare staff? Look no further. IAC's Featured Resources section is a frequently updated listing of links to timely, practical, and cool resources from our immunization partners.

To access Featured Resources, visit http://www.immunize.org/news/featured-resources.asp
 
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7 AAP releases policy statement on recommendations for influenza immunization of children and makes influenza resources available on Red Book Online

On September 2, the American Academy of Pediatrics (AAP) published a policy statement online (ahead of print) made by AAP's Committee on Infectious Diseases. Titled "Recommendations for Prevention and Control of Influenza in Children, 2011-2012," this statement updates the current recommendations for routine use of trivalent seasonal influenza vaccine and antiviral medications for the prevention and treatment of influenza in children.

The full text and abstract of the statement are available at no charge. To access the full text, go here.

To access the abstract, go here.

INFLUENZA RESOURCES ON RED BOOK ONLINE
AAP's Committee on Infectious Diseases has compiled a comprehensive list of influenza resources to serve as a centralized point of reference for vaccine guidance, prevention, treatment, payment, policies, news, and other information pertaining to influenza for infants, children, adolescents, and young adults.

To access the resources, go to the Influenza Resource Page of AAP's Red Book Online at http://aapredbook.aappublications.org/flu Some links may require member or subscriber log-in. The resources are updated frequently; be sure to check back often.
 
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8 AAP releases an updated policy statement on recommendations for use of quadrivalent and monovalent varicella vaccines in children

On August 28, the American Academy of Pediatrics (AAP) published an online version of "Policy Statement--Prevention of Varicella: Update of Recommendations for Use of Quadrivalent and Monovalent Varicella Vaccines in Children." A portion of the policy statement is reprinted below.


POLICY OR RECOMMENDATION
The routinely recommended ages for measles, mumps, rubella, and varicella vaccination continue to be 12 through 15 months for dose 1 and 4 through 6 years for dose 2. The American Academy of Pediatrics recommends for the first dose at ages 12 through 47 months that either MMR and varicella vaccines [be] administered separately or MMRV can be used. Use of separate MMR and varicella vaccines averts the slight increase in risk of fever and febrile seizures after MMRV administration but at the cost of the pain associated with an extra injection and the risk of an infant falling behind schedule if all vaccines indicated at that visit are not given. Providers who are considering administering MMRV should discuss the benefits and risks of both vaccination options with the parents or caregivers. Because parents need to be fully aware of the slight increase in risk of febrile seizures with the combination MMRV compared with separate MMR and varicella injections at the same visit, providers who face barriers to clearly communicating these benefits and risks for any reason (e.g., language barriers) should administer MMR and varicella vaccines separately.

The risk of febrile seizures is not increased in older children who receive the second dose of MMRV. Therefore, when the first dose of measles, mumps, rubella, and varicella vaccines is administered at ages 48 months and older, and for dose 2 at any age (15 months through 12 years), use of the MMRV generally is preferred over separate injections of its equivalent component vaccines (i.e., MMR and varicella vaccines) because of the decreased number of injections required with the MMRV.

A personal or family (such as sibling or parent) history of seizures is now a precaution for MMRV vaccination. Children with a personal or family history of seizures generally should be vaccinated with MMR and varicella vaccines, because the risks of using the MMRV in this group of children generally outweigh the benefits. . . .


The full text of the updated policy statement is available at no cost, as is the abstract. To access the full text, go here.

To access the abstract, go here.
 
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9 CDC's September 15 Net Conference to focus on influenza

The next "Current Issues in Immunization" Net Conference will be held on September 15 from noon to 1 PM Eastern Time. Carolyn Bridges, MD, and others from CDC will make presentations on influenza. Andrew Kroger, MD, MPH, will moderate the discussion.

Registration is limited and will close on September 13 or when the course is full. To register, go to: http://www2.cdc.gov/vaccines/ed/ciinc
 
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10.  CDC publishes report on a measles outbreak in Indiana during June-July 2011

CDC published "Notes from the Field: Measles Outbreak--Indiana, June-July 2011" in the September 2 issue of MMWR. Portions of the article are reprinted below.


On June 20, 2011, an emergency department (ED) physician reported five epidemiologically linked measles cases to the Indiana State Department of Health. The subsequent investigation identified a total of 14 confirmed cases in northeast Indiana. Of these, 10 were laboratory-confirmed, and four were among household contacts of persons with laboratory-confirmed measles. Of the 14 patients, 13 were unvaccinated persons in the same extended family. The nonfamily member was a child aged 23 months who had received 1 dose of measles, mumps, and rubella vaccine 4 months before illness onset. Four of the 14 patients were males; median age was 11.5 years (range: 15 months-27 years). One patient was a woman in week 32 of pregnancy who was hospitalized for acute pneumonitis.

The index patient was an unvaccinated U.S. resident aged 24 years who noted a rash on June 3 during a return flight from Indonesia, where measles is endemic. The patient was admitted to an Indiana hospital during June 7-9 and treated for presumed dengue fever. Measles was not considered, and the patient was not isolated. The outbreak was unrecognized until June 20, when five family members visited an ED after experiencing onset of measles symptoms at various times over the previous few days. Subsequently, measles genotype D9, a strain endemic in Indonesia, was isolated from nasopharyngeal swabs from two of these patients.

A contact investigation involving approximately 780 persons included follow-up of exposures at a church (approximately 150 persons), a factory (approximately 300 persons), and in a bus ridden by school-aged children who had traveled out of state. . . .

As of August 26, 198 cases and 15 outbreaks of measles had been confirmed in the United States, the highest number since 1996 (CDC, unpublished data, 2011). Of the 198 cases, 179 (90%) were associated with U.S. residents traveling internationally. Of the 15 outbreaks, the outbreak in Indiana is the second largest. With ongoing importation and suboptimal vaccination rates among specific populations, measles outbreaks might continue to occur. In addition to providing accurate information on the risks and benefits of vaccines and making vaccination accessible, state and local health departments should continue to investigate contacts of suspected measles patients to institute control measures to prevent measles transmission in the community. Parents should be reminded, as children return to school, to check their children's vaccination status for measles, mumps, and rubella vaccine and all other recommended vaccines.


To access the full article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6034a5.htm
 
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11.  CDC gives providers information for patients about febrile seizures related to simultaneous administration of PCV13 and TIV vaccines

CDC recently posted a brief note about a sentence that appears in the 2011-12 VIS for trivalent inactivated influenza vaccine (TIV; injectable). The sentence mentions that an increased risk of febrile seizures exists when TIV and pneumococcal conjugate vaccine (PCV13) are given to young children simultaneously. The brief note, which is reprinted below, gives providers information they can share with patients about this issue. A more detailed explanation will be published on CDC's website at a future date.


The 2011-2012 inactivated influenza vaccine VIS states that "young children who get inactivated flu vaccine and pneumococcal vaccine (PCV13) at the same time appear to be at increased risk for seizures caused by fever."

ACIP chose to include this statement on the VIS to inform parents of this potential risk. However, additional information has not yet been published to help providers respond to parents' questions.

Increased rates of febrile seizures have been reported among children, especially those 12 through 23 months of age, who received simultaneous vaccination with TIV and PCV13, compared with children who received these vaccines separately. However, because there are risks associated with delaying either of these vaccines, ACIP does not recommend administering them at separate visits or deviating from the recommended vaccine schedule in any way.

Febrile seizures are not uncommon, occurring in 2% to 5% of all children; and they are generally benign. Healthcare providers should be prepared to discuss parents' questions about this issue, including questions about fever and febrile seizures.

More detailed information will soon be available on CDC's website, and will be updated as additional data become available.


To access the note, which is titled "Febrile Seizures Associated with TIV & PCV13," go to: http://www.cdc.gov/vaccines/pubs/vis/tiv-pcv-note.htm

 
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12.  CDC updates information for clinicians on influenza vaccination, vaccine safety, and antiviral medications

CDC recently updated the following three web pages of influenza information for clinicians.

(1) "Influenza Vaccination: A Summary for Clinicians"
http://www.cdc.gov/flu/professionals/vaccination/vax-summary.htm

(2) "Seasonal Influenza Vaccine Safety: A Summary for Clinicians"
http://www.cdc.gov/flu/professionals/vaccination/vaccine_safety.htm

(3) "2011-2012 Influenza Antiviral Medications: A Summary for Clinicians"
http://www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm

To access CDC's continually updated influenza information for professionals and patients/parents, go to: http://www.cdc.gov/flu/whatsnew.htm

 
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13.  2011-12 influenza vaccine VISs now available in Amharic and Thai

The 2011-12 VIS for inactivated influenza (TIV) vaccine and the 2011-12 VIS for live, intranasal influenza (LAIV) vaccine are now available in Amharic (spoken in Ethiopia) and Thai. IAC gratefully acknowledges the Minnesota Department of Health and the DSMA Ethiopian Orthodox Tewahedo Church Parish Nursing Program, Minneapolis, MN, for the Amharic translations, and Asian Pacific Health Care Venture, Inc., for the Thai translations.

To access the new translations of the VIS for TIV, as well as the English version, go to: http://www.immunize.org/vis/vis_flu_inactive.asp

To access the new translations of the VIS for LAIV, as well as the English version, go to: http://www.immunize.org/vis/vis_flu_live.asp

For information about the use of VISs, and for VISs in more than 35 languages, visit IAC's VIS web section at http://www.immunize.org/vis
 
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14.  CDC publishes report on a human rabies death in Wisconsin in 2010

CDC published "Human Rabies--Wisconsin, 2010" in the September 2 issue of MMWR. The first paragraph is reprinted below.


In late December 2010, a male resident of Wisconsin, aged 70 years, sought treatment for progressive right shoulder pain, tremors, abnormal behavior, and dysphagia at an emergency department (ED). He was admitted for observation and treated with benzodiazepines and haloperidol, a neuroleptic, for presumed alcohol withdrawal syndrome. The next day, he had rhabdomyolysis, fever, and rigidity, and neuroleptic malignant syndrome was diagnosed. The neuroleptic was discontinued, but the patient's clinical status worsened, with encephalopathy, respiratory failure, acute renal failure requiring hemodialysis, and episodes of cardiac arrest. With continued clinical deterioration, additional causes were considered, including rabies. On hospital day 12, rabies virus antigens and nucleic acid were detected in the nuchal skin biopsy and rabies virus nucleic acid in saliva specimens sent to CDC. A rabies virus variant associated with silver-haired bats (Lasionycteris noctivagans) was identified. The patient died on hospital day 13. His spouse reported that they had been selling firewood, and bats had been present in the woodpile; however, the man had not reported a bat bite. Two relatives and five healthcare workers potentially exposed to the man's saliva received postexposure prophylaxis. This case highlights the variable presentations of rabies and the ease with which a diagnosis of rabies can be missed in a clinically challenging patient with comorbidities. Clinicians should consider rabies in the differential diagnosis for patients with progressive encephalitis or neurologic illness of unknown etiology, and caregivers should take precautions to avoid exposure to body fluids. Continued public education regarding risks for rabies virus exposure during interactions with wildlife, particularly bats, is important.


To access the full article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6034a3.htm
 
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15.  IAC's popular laminated versions of the 2011 U.S. immunization schedules are available. Order a supply for your workplace today!

IAC's laminated versions of the 2011 U.S. child/teen and adult immunization schedules are covered with a tough, washable coating that lets them stand up to a year's worth of use in every area of your workplace where immunizations are given. Each has six pages (i.e., three double-sided pages) and is folded to measure 8.5" by 11".

Laminated schedules are printed in color for easy reading, come complete with essential tables and footnotes, and include contraindications and precautions--a feature that will help you make an on-the-spot determination about the safety of vaccinating patients of any age.

PRICING
1-4 copies: $7.50 each
5-19 copies: $5.50 each
20-99 copies: $4.50 each

To view images of the laminated schedules, or to order online or download an order form, go to: http://www.immunize.org/shop/laminated-schedules.asp

For quotes on customizing or placing orders in excess of 999 schedules, call (651) 647-9009 or email admininfo@immunize.org

To learn about other essential immunization resources available for purchase from IAC, go to: http://www.immunize.org/shop
 
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16.  Award-winning DVD! "Immunization Techniques: Best Practices with Infants, Children, and Adults"--from the California Department of Public Health, Immunization Branch

The California Department of Public Health (CDPH), Immunization Branch, has updated its award-winning training video, "Immunization Techniques: Best Practices with Infants, Children, and Adults." The 25-minute program can be used to train new employees and to refresh the skills of experienced staff. The video demonstrates the skills and techniques needed to administer vaccines to patients of all ages.

Prices start at $17 each for 1-9 copies and are greatly reduced for large orders, dropping to $3 each for 1,000-1,499 copies.

To learn more about the DVD, and find out how to order it, go to: http://www.immunize.org/dvd

For quotes on larger quantities, call (651) 647-9009 or email admininfo@immunize.org

The Immunization Action Coalition is the only nationwide vendor of the DVD.

Note for healthcare settings located in California: Contact your local health department immunization program for a free copy.
 
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17.  VICNetwork to host September 21 webinar on promoting influenza vaccination

The Virtual Immunization Communication Network (VICNetwork) is hosting "What's New with the Flu? Info and Strategies for Healthcare Personnel and Health Communicators" on September 21 at 11 AM Pacific time/2 PM Eastern time. The presenter is Litjen (L.J.) Tan, MS, PhD, director, Medicine and Public Health, American Medical Association, and co-chair, National Influenza Vaccine Summit.

For additional information, and to register for the webinar, go to: http://vicnetwork.org

VICNetwork is a project of the National Public Health Information Coalition in collaboration with the California Immunization Coalition.
 
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18.  Minnesota immunization conference planned for October 20-21

The Minnesota Department of Health's "Got Your Shots?" immunization conference will be held in Brooklyn Park, MN, on October 20-21. The conference focuses on helping parents make informed decisions about immunization. Continuing education credit is available to participants.

For comprehensive conference information, go to: http://www.health.state.mn.us/divs/idepc/immunize/conference/index.html
 
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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.