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Issue Number 131            December 22, 1999

CONTENTS OF THIS ISSUE

  1. CDC publishes surveillance summary on public health indicators affecting older adults
  2. CDC publishes report on use of neuraminidase inhibitors for treatment of influenza A and B infections
  3. CDC publishes article about pyloric stenosis in infants following pertussis prophylaxis with erythromycin
  4. CDC publishes report on global measles control

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(1)
December 17, 1999
CDC PUBLISHES SURVEILLANCE SUMMARY ON PUBLIC HEALTH  INDICATORS AFFECTING OLDER ADULTS

The Centers for Disease Control and Prevention (CDC) published a surveillance summary titled "Surveillance for Selected Public Health Indicators Affecting Older Adults -- United States" in the December 17, 1999, issue of the MMWR. This 168-page report commemorates the United Nation's proclamation of the "International Year of Older Persons" (10/1/98 - 12/31/99), and addresses several factors of morbidity and mortality among adults aged greater than or equal to 65 years including findings related to influenza and pneumococcal vaccination rates.

A discussion of influenza and pneumococcal vaccination is included in the section titled "Surveillance for Use of Preventive Health-Care Services by Older Adults, 1995-1997." The report notes "in 1997, a total of 90% of U.S. deaths attributed to pneumonia and influenza occurred among persons aged greater than or equal to 65 years, making these illnesses the fifth leading cause of death for this age group. During influenza epidemics, persons aged greater than or equal to 65 years face increased risk for influenza-associated hospitalizations and deaths. Persons aged greater than or equal to 65 years are also at increased risk for invasive pneumococcal disease, including bacteremia and meningitis, with an estimated annual incidence of 50-83 cases/100,000 population compared with 15-30 cases/100,000 among  persons of all ages."

According to the summary report, a "Healthy People 2000" objective is to increase influenza and pneumococcal vaccination levels to greater than or equal to 60% among persons aged greater than or equal to 65 years. However, as the year 2000 nears, the report notes that national coverage levels for pneumococcal vaccination still fall short of this goal. "...during 1997, 65% of older adults reported receiving influenza vaccination in the past 12  months, and only 45% reported ever receiving pneumococcal vaccination."

In the section titled "Overview," the report asserts that "all adults aged greater than or equal to 65 years should receive influenza vaccinations annually; pneumococcal vaccination should be administered once, but can be repeated for certain groups at high risk after 5 years. Influenza and  pneumococcal vaccinations are cost-effective compared with other preventive measures and can be cost-saving; in addition, they have been reported to be effective in reducing serious complications and hospitalizations by approximately one half. Every effort should be made to increase vaccination coverage among older adults, particularly among those who suffer from chronic illnesses."

With the onset of the 21st century, the elderly are becoming a primary target for public health prevention strategies as "growth in the number of older adults  (persons aged greater than or equal to 65 years) in the United States will produce an unprecedented increase in the number of persons at risk for costly age-associated chronic diseases and other health conditions and injuries." 

To obtain a camera-ready copy (PDF format) of this surveillance summary, go to: ftp://ftp.cdc.gov/pub/Publications/mmwr/ss/ss4808.pdf

To obtain the full text version (HTML format) of this surveillance summary, go to: http://www2.cdc.gov/mmwr/mmwr_ss.html

For information on how to obtain a free electronic subscription to the MMWR, see the instructions that follow article four below.
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(2)
December 17, 1999
CDC PUBLISHES REPORT ON USE OF NEURAMINIDASE INHIBITORS FOR TREATMENT OF INFLUENZA A AND B INFECTIONS

The Centers for Disease Control and Prevention (CDC) published a report titled "Neuraminidase Inhibitors for Treatment of Influenza A and B Infections" in the December 17, 1999, issue of the MMWR.

The "Summary" statement reads: "Influenza epidemics are responsible for an average of approximately 20,000 deaths per year in the United States. The main method for preventing influenza and its severe complications is influenza vaccination. Influenza-specific antiviral drugs are an important adjunct to vaccine but are not a substitute for vaccine. In the United States, four antiviral agents are approved for preventing or treating influenza: amantadine, rimantadine, zanamivir, and oseltamivir. Amantadine has been available in the United States since 1976, and rimantadine has been available since 1993. This report provides information on two neuraminidase inhibitors, zanamivir and oseltamivir, which were approved in 1999. Neuraminidase inhibitors are a new class of antiviral drugs that inhibit influenza A and B viruses. Zanamivir is approved for treatment of uncomplicated acute illness caused by influenza virus in persons aged greater than or equal to 12 years who have been symptomatic for no more than 2 days. Oseltamivir is approved for treatment of
uncomplicated illness caused by influenza infection in adults aged greater than or equal to 18 years who have been symptomatic for no more than 2 days. Neither zanamivir nor oseltamivir is approved for influenza prophylaxis."

To obtain the text version (HTML format) of this document, go to: http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/rr4814a1.htm

A short erratum to this report can be read at: http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/mm4849a6.htm

Other influenza reports, including recommendations of the Advisory Committee on Immunization Practices (ACIP) on influenza prevention and control, can be found at: http://www.cdc.gov/ncidod/diseases/flu/fluvirus.htm

For information on how to obtain a free electronic subscription to the MMWR, see the instructions that follow article four below.
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(3)
December 17, 1999
CDC PUBLISHES ARTICLE ABOUT PYLORIC STENOSIS IN INFANTS FOLLOWING PERTUSSIS PROPHYLAXIS WITH ERYTHROMYCIN

The Centers for Disease Control and Prevention (CDC) published an article titled "Hypertrophic Pyloric Stenosis in Infants Following Pertussis Prophylaxis with Erythromycin -- Knoxville, Tennessee, 1999" in the December 17, 1999,  issue of the MMWR.

The article's introduction reads: "In February 1999, pertussis was diagnosed in six neonates born at hospital A in Knoxville, Tennessee. Because a health-care worker at hospital A was most likely the source of exposure, the local health department recommended on February 25, 1999, that erythromycin be prescribed as postexposure prophylaxis for the approximately 200 infants born at hospital A during February 1-24, 1999. In March 1999, local pediatric surgeons noticed an increased number of cases of infantile hypertrophic pyloric stenosis (IHPS) in the area, with seven cases occurring during a 2-week period. All seven IHPS cases were in infants born in hospital A during February who were given erythromycin orally for prophylaxis following possible exposure to pertussis, although none had pertussis diagnosed. The Tennessee Department of Health and CDC investigated the cluster of IHPS cases and its possible association with use of erythromycin. This report summarizes the results of the investigation, which suggest a causal role of erythromycin in this cluster of IHPS cases."

The "Editorial Note" states in part: "The prevention of pertussis in infants is important; most hospitalizations for and deaths from pertussis occur in children aged less than 1 year. Although no data exist to confirm a safe and  effective alternative to erythromycin for prophylaxis of neonates exposed to pertussis, these findings indicate a need for further examination of recommendations for erythromycin prophylaxis."

"The first case reports of a possible association between IHPS and erythromycin in five neonates were published in 1976, but the association was considered improbable and had remained unconfirmed. The only subsequent report of this association was a single case report of IHPS in a breastfed infant whose mother had taken erythromycin. The findings in this report provide further evidence that erythromycin has a causal role in the etiology of IHPS and raise concerns about the use of erythromycin in neonates."

To obtain the text version (HTML format) of this MMWR article, go to: http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/mm4849a1.htm

For information on how to obtain a free electronic subscription to the MMWR, see the instructions that follow article four below.
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(4)
December 17, 1999
CDC PUBLISHES REPORT ON GLOBAL MEASLES CONTROL

The Centers for Disease Control and Prevention (CDC) published an article titled "Global Measles Control and Regional Elimination, 1998-1999" in the December 17, 1999, issue of the MMWR. According to the article, "data for 1998 suggest that routine measles vaccination coverage has declined in some regions, the number of countries reporting cases and coverage to the World Health Organization (WHO) has decreased, and measles continues to be an important cause of morbidity and mortality."

"Global reported coverage with one dose of measles vaccine declined from 79% in 1997 to 72% in 1998. In 1998, 14 countries reported measles coverage below 50%." In addition, "for 1998, WHO estimated that approximately 30 million measles cases and 888,000 measles-related deaths occurred worldwide; an estimated 85% of the measles-related deaths  occurred in the African Region (AFR) and the South-East Asia Region (SEAR)."

The "Editorial Note" states in part: "With approximately 1 million deaths attributed to measles in 1998, measles remains an important cause of vaccine-preventable illness and death. Failure to deliver at least one dose of measles vaccine to all infants remains the primary reason, despite widespread availability of an effective and safe vaccine."

To obtain the text version (HTML format) of this MMWR article, go to: http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/mm4849a3.htm

HOW TO OBTAIN A FREE ELECTRONIC SUBSCRIPTION TO THE MMWR
To obtain a free electronic subscription to the "Morbidity and Mortality Weekly Report" (MMWR), visit CDC's MMWR website listed below. Select "Free MMWR Subscription" from the menu at the left of the screen. Once you have submitted the required information, weekly issues of the MMWR and all new ACIP statements (published as MMWR's "Recommendations and Reports") will automatically arrive in your e-mail box. To go to the MMWR website, visit: http://www2.cdc.gov/mmwr/

 

Immunization Action Coalition1573 Selby AvenueSt. Paul MN 55104
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This page was updated on December 22, 1999