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Issue Number 101                       July 27, 1999

CONTENTS OF THIS ISSUE

  1. NVAC sponsors workshop on thimerosal in vaccines
  2. CDC publishes report on secondary cases of hepatitis A in Kansas
  3. Are your patients heading off to college? Check out these resources on meningococcal vaccine for college students
  4. CDC offers slide series on "Hepatitis A to E"

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(1)
July 23, 1999
NVAC SPONSORS WORKSHOP ON THIMEROSAL IN VACCINES

The Centers for Disease Control and Prevention (CDC) published the following announcement as a "Notice to Readers" in the July 23, 1999, issue of the MMWR:

NATIONAL VACCINE ADVISORY COMMITTEE WORKSHOP ON THIMEROSAL IN VACCINES
"The National Vaccine Advisory Committee will sponsor a workshop on thimerosal in vaccines on August 11-12, 1999. The workshop will be held at the Lister Hill Auditorium on the National Institutes of Health campus, Bethesda,  Maryland, and will review use of thimerosal in vaccines and its reduction and elimination from vaccines. Additional information is available from the National Vaccine Program Office, CDC, Mailstop A-11, 1600 Clifton Rd, N.E., Atlanta, GA 30333; telephone (404) 639-4450; or from the World-Wide Web, http://www.cdc.gov/od/nvpo/calendar.htm."

To obtain a text version of this MMWR article, click here: http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/mm4828a4.htm

For information on how to get a free electronic subscription to the MMWR, see the instructions that follow article two below.
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(2)
July 23, 1999
CDC PUBLISHES REPORT ON SECONDARY CASES OF HEPATITIS A IN KANSAS

The Centers for Disease Control and Prevention (CDC) published the article, "Ascertainment of Secondary Cases of Hepatitis A -- Kansas, 1996-1997," in the July 23, 1999, issue of the MMWR.

"Each year, 25,000-30,000 cases of hepatitis A are reported in the United States. The most common infection source (22%-26%) is household or sexual contact with a person already infected with hepatitis A virus (HAV) (i.e., the source-patient). In Kansas during 1992-1997, contact with a source-patient was reported by 39% of persons with hepatitis A. Cases reported in 1996 and 1997 were studied  retrospectively to determine the reasons for the apparently high proportion of secondary cases and to evaluate missed opportunities for prevention (i.e., postexposure prophylaxis with immune globulin [IG]). Results of this investigation  indicate that persons with hepatitis A often were classified incorrectly as secondary cases and that some correctly identified secondary cases represented missed opportunities for prevention."

The editorial note reads in part:

"...Accurate and understandable case definitions are needed to classify primary and secondary cases of hepatitis A; also, timely and complete case reporting and investigations are necessary to avoid missing opportunities for prevention.

"In Kansas, the high proportion of reported secondary cases occurred because some of these cases should have been classified as co-primary or unrelated cases..."

"The Advisory Committee on Immunization Practices recommends IG for persons who have been exposed to HAV and have not been vaccinated. IG should be given as quickly as possible after exposure, but no longer than 2 weeks after the last exposure. Situations in which IG is recommended include close personal contact with a person with hepatitis A, including household and sexual contacts; contact with HAV-infected persons in day-care centers, and sometimes following exposure to a foodhandler with hepatitis A. Hepatitis A vaccination is recommended for preexposure prophylaxis in certain populations and settings, but is not approved for postexposure prophylaxis.

"Approximately 25% of persons who had had household or sexual contact with a source-patient were identified too long after exposure to benefit from IG. Health departments should encourage rapid laboratory reporting of positive serologic test results and should educate health-care providers about the importance of complete and timely reporting. Local health department personnel also should be encouraged to conduct prompt and thorough case investigations to identify contacts for whom IG might be indicated.

"Another 30% of secondary cases occurred among persons who had no household or sexual contact with a person with hepatitis A but had reported other types of close personal contact that have been associated with transmission, such as contact with young children with unrecognized infection, and participating in the practices associated with illegal drug use. The risk for and the mode of transmission in these  circumstances have not been established and are difficult to assess. An evaluation of the characteristics of each contact should be conducted to identify exposed persons who are not household or sexual contacts. Persons who report other types of close personal contact with a hepatitis A patient should be considered candidates for IG..."

To obtain a text version of this MMWR article, click here: http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/mm4828a3.htm

HOW TO GET A FREE ELECTRONIC SUBSCRIPTION TO THE MMWR
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 to the MMWR website, click here: http://www2.cdc.gov/mmwr/
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(3)
July 27, 1999
ARE YOUR PATIENTS HEADING OFF TO COLLEGE? CHECK OUT THIS INFORMATION ABOUT THE USE OF MENINGOCOCCAL VACCINE FOR  COLLEGE STUDENTS

Your patients or their parents may be asking about meningococcal vaccine after reading about it in the popular press (e.g., "USA Today" ran two stories on June 1, 1999). Clinicians wishing to obtain more information about meningococcal vaccine for college students can visit the following websites:

American College Health Association: http://www.acha.org/special-prj/men.htm
American Academy of Pediatrics: http://www.aap.org/new/menvacc798.htm

The Journal of the American Medical Association published the article, "Risk of Meningococcal Infection in College Students," in its May 26, 1999, issue. To read the abstract of this article, click here: http://jama.ama-assn.org/issues/v281n20/abs/joc81788.html
You may also want to refer to "Control and Prevention of Meningococcal Disease and Control and Prevention of Serogroup C Meningococcal Disease: Evaluation and Management of Suspected Outbreaks" which was published by the Advisory Committee on Immunization Practices (ACIP) on February 14, 1997. These recommendations were published in the MMWR and are available on the Internet.

To obtain a camera-ready copy (PDF format) of the complete ACIP statement, click here: ftp://ftp.cdc.gov/pub/Publications/mmwr/RR/RR4605.pdf

This ACIP statement is also available in text format as two separate documents.

For "Control and Prevention of Meningococcal Disease," click here: http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/00046263.htm

For "Control and Prevention of Serogroup C Meningococcal Disease: Evaluation and Management of Suspected Outbreaks," click here:  http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/00046237.htm
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(4)
July 27, 1999
CDC OFFERS SLIDE SERIES ON "HEPATITIS A TO E"

Available on the website of the Hepatitis Branch of the Centers for Disease Control and Prevention (CDC) is a slide series entitled "Epidemiology and Prevention of Viral Hepatitis A to E: An Overview." The series includes 67 color  slides (2" x 2") which feature educational text, tables and graphics. A 21-page slide script is also provided. To view this training tool, please click here: http://www.cdc.gov/ncidod/diseases/hepatitis/slideset/httoc.htm

The technical notes accompanying the slides can be downloaded as an ASCII text file or as a WordPerfect document. The slides themselves can be downloaded in Microsoft Powerpoint format, WMF format, or GIF format. If you are unable to download these files from the Internet but would like to obtain the set, follow the instructions below. Cost for the complete series is $65, plus $5 for shipping and handling. For those ordering from outside the U.S., cost for the series is $75, plus $10 for shipping and handling.

To order the complete slide set, call the National Technical Information Service at: 800-553-6847 and reference order #: AVA19900-SS00INA. You can also fax your request to: 703-605-6900, or send an e-mail to orders@ntis.fedworld.gov

 

Immunization Action Coalition1573 Selby AvenueSt. Paul MN 55104
E-mail: admin@immunize.org Web: http://www.immunize.org/
Tel: (651) 647-9009Fax: (651) 647-9131

This page was updated on December 28, 2001