Immunization Action Coalition and the Hepatitis B Coalition

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Issue Number 313            May 20, 2002

CONTENTS OF THIS ISSUE

  1. CDC publishes new guidelines for treatment of sexually transmitted diseases
  2. Institute of Medicine report addresses lower-quality health care among minorities
  3. Last call for abstracts for Hepatitis Coordinators Conference--deadline May 31
  4. Hepatitis Foundation International CD assists listeners with "Sorting Out the Diagnostics"
  5. World Health Organization publishes position paper on rabies vaccination
  6. CDC updates guidelines for using antiretroviral agents in HIV patients
  7. Watch for an IAC DOUBLE EXPRESS later this week for news on public smallpox forums to be held in June

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May 20, 2002
CDC PUBLISHES NEW GUIDELINES FOR TREATMENT OF SEXUALLY TRANSMITTED DISEASES

On May 10, 2002, the Centers for Disease Control and Prevention (CDC) published "Sexually Transmitted Diseases Treatment Guidelines 2002" in the Morbidity and Mortality Weekly Report  (MMWR) Recommendations and Reports Series (vol. 51, no. RR-6). This is the first update to these guidelines since 1998. Although treatment is emphasized, diagnosis and prevention also are discussed. The section titled "Vaccine-Preventable STDs" covers hepatitis A and hepatitis B incidence, exposure, transmission, incubation, diagnosis, prevention, pre- and post-vaccination serologic testing, and treatment.

The introduction to the section on vaccine-preventable STDs reads as follows:

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The most effective means to prevent transmission of infectious diseases, including STDs, is through preexposure immunization. Vaccines are available for prevention of HAV and HBV, both of which can be transmitted sexually. Vaccines are under development or are undergoing clinical trials for other STDs, including HIV, HPV, and HSV; however, current efforts regarding vaccination focus largely on integrating use of currently available vaccines into STD prevention and treatment activities.

Every person seeking treatment for an STD should be considered a candidate for hepatitis B vaccination, and some persons (e.g., MSM and injection-drug users) should be considered for hepatitis A vaccination. Evaluation for vaccination is most effectively done through a screening and education process that both inquires about risk factors for infection (e.g., sex partners and use of illegal drugs), educates patients about the importance of vaccination, and excludes persons who are not candidates for vaccination (e.g., laboratory confirmed diagnosis of infection and previous vaccination).

Although it is uncommon, patients may present with signs, symptoms, or laboratory findings of acute or chronic viral hepatitis. When this occurs, a precise diagnosis must be made and appropriate clinical services provided, including postexposure immunization of contacts and medical referral.

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To obtain the complete text of the report online, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5106a1.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/rr/rr5106.pdf

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 at: http://www.cdc.gov/mmwr 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 arrive automatically by email.
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May 20, 2002
INSTITUTE OF MEDICINE REPORT ADDRESSES LOWER-QUALITY HEALTH CARE AMONG MINORITIES

The Institute of Medicine (IOM), at the urging of Congress, embarked on a year-long study of the extent of those racial and ethnic differences in the quality of health care received by patients in the United  States that cannot be accounted for by known factors such as inability to make insurance co-payments and access to care. The final report of this study was released in March.

"Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care" documents disparities in testing and treatment for cardiovascular disease, cancer, diabetes, stroke, and HIV/AIDS, among other illnesses. The report assesses potential causes of disparities and potential solutions.

Immunization is mentioned or discussed in chapters on Data Collection and Monitoring, the Rationing of Health Care for American Indians/Alaska Natives, and the Civil Rights Dimension of Racial and Ethnic Disparities in Health Status.

"Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care" is currently available for reading or downloading on the website of the National Academy Press (NAP), which is publishing the report in book form. For the table of contents with chapter links, go to: http://www.nap.edu/books/030908265X/html/

To order a copy of the forthcoming book "Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care" ($35.96 if purchased online) or a prepublication manuscript version ($40 if purchased online), go to: http://www.nap.edu/catalog/10260.html

For more information, call the National Academy Press at (800) 624-6242.
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May 20, 2002
LAST CALL FOR ABSTRACTS FOR HEPATITIS COORDINATORS CONFERENCE--DEADLINE MAY 31

The Hepatitis Coordinators Conference, to be held January 27-30, 2003, in San Antonio, Texas, will be organized around topic categories that focus on viral hepatitis prevention, treatment, counseling, and testing.

Conference planners are still accepting abstracts for presentations and workshops that "demonstrate effective implementation of programs" in one of the five categories listed in the official Call for Abstracts. These categories are, briefly, special populations; program administration issues; working in health-related settings; surveillance; and outreach.

The deadline for abstract submission for the Conference is Friday, May 31, 2002.

To obtain a copy of the Call for Abstracts and the Abstract Format instructions, go to: http://www.immunize.org/news.d/abstract.pdf

For more information on the Hepatitis Coordinators Conference as it becomes available, visit IAC's Calendar of Events page at: http://www.immunize.org/calendar

You may also direct questions to Valerie Curry, CDC Division of Viral Hepatitis, by email at vcc0@cdc.gov
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May 20, 2002
HEPATITIS FOUNDATION INTERNATIONAL CD ASSISTS LISTENERS WITH "SORTING OUT THE DIAGNOSTICS"

The Hepatitis Foundation International (HFI) has produced "Hepatitis B: Sorting Out the Diagnostics," an  audio CD that outlines the diagnostic process for hepatitis B, covering laboratory tests, serology, and more. Discussion of case studies helps consolidate the information provided. Speakers on the hour-long  CD are Harold Margolis, M.D., Centers for Disease Control and Prevention (CDC); Anna Lok, M.D.,  University of Michigan Medical School; Raymond S. Koff, M.D., University of Massachusetts Memorial Medical Center; Christine J. Bruno, M.D., S.E. Permanente Medical Group; and R. Palmer Beasley, M.D., University of Texas School of Public Health.

HFI President Thelma King Thiel says, "Our goal here is to help the primary care doctors pre-screen more effectively, avoid running up costs by choosing the correct lab tests, refer to specialists more appropriately, and better cope with their patients on a human level."

The cost of the CD is $6.00. To order "Hepatitis B: Sorting Out the Diagnostics," call (800) 891-0707 or fax (973) 857-5044.

For more information about HFI, go to: http://www.hepfi.org
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May 20, 2002
WORLD HEALTH ORGANIZATION PUBLISHES POSITION PAPER ON RABIES VACCINATION

The World Health Organization (WHO) has published a new position paper on rabies vaccines in the Weekly Epidemiological Record (WER) (vol. 14, no. 77). WHO position papers offer an important  perspective on global disease epidemiology and vaccine use for all vaccinators.

The WHO Rabies Vaccines Position Paper reads in part as follows:

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It is estimated that each year at least 50,000 people die from rabies, and more than 10 million receive post-exposure vaccination against this disease. Children aged 5-15 years are at particular risk. More than 99% of all human deaths from rabies occur in Asia, Africa and South America; India alone reports 30,000 deaths annually. . . .

In about 100 countries, rabies is enzootic in both wild and domestic animals and poses a potential threat  to a considerable proportion of the more than 2.5 billion people living in these areas. Some island states  such as Iceland, Japan and the United Kingdom, and European states such as Belgium, Finland, France, Greece, Norway, Portugal, Spain, Sweden and Switzerland, are now considered free of rabies. Until 1995, Australia was considered to be rabies-free, but in 1996 a rabies-related lyssavirus (type 7) was discovered in flying foxes, a bat species. . . .

Among human infections, rabies is believed to be the tenth most common cause of death. Once clinical symptoms have occurred, the disease is almost invariably fatal. However, reporting is often incomplete and the estimated 50,000 deaths per year may be an underestimate.

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To obtain a copy of the WHO Rabies Vaccines Position Paper in WER online, go to: http://www.who.int/wer/pdf/2002/wer7714.pdf

The Immunization Action Coalition (IAC) is compiling a web page of the WHO vaccine position papers. We will announce the quick link to this page in the summer in IAC EXPRESS.
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May 20, 2002
CDC UPDATES GUIDELINES FOR USING ANTIRETROVIRAL AGENTS IN HIV PATIENTS

On May 17, 2002, the Centers for Disease Control and Prevention (CDC) published "Guidelines for Using Antiretroviral Agents Among HIV-Infected Adults and Adolescents: Recommendations of the Panel on Clinical Practices for Treatment of HIV" in the Morbidity and Mortality Weekly Report (MMWR)  Recommendations and Reports Series (vol. 51, no. RR-7). This report updates the 1998 guidelines.

To obtain the text of the report online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5107a1.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/rr/rr5107.pdf
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May 20, 2002
WATCH FOR AN IAC DOUBLE EXPRESS LATER THIS WEEK FOR NEWS ON PUBLIC SMALLPOX FORUMS TO BE HELD IN JUNE

The recent effort to build stores of smallpox vaccine, spurred by concerns about a possible risk of deliberate smallpox release by terrorists, has generated national dialogue on the current recommendations for the use of smallpox vaccine. The Advisory Committee on Immunization Practices (ACIP) and the National Vaccine Advisory Committee (NVAC) are reviewing the current recommendations with the aim of developing additional recommendations for the use of smallpox vaccine "both pre-event and, should an event actually occur, post-exposure," according to a bulletin posted by the Centers for Disease Control and Prevention (CDC). The recommendations are expected in late June.

As part of its recommendations review process, the ACIP-NVAC smallpox workgroup is inviting  comments and suggestions from health care professionals, emergency responders, and all interested or potentially affected people on the use of smallpox vaccine. This includes the general public.

Public forums on smallpox vaccine will be held on June 6 in San Francisco and New York and on June 8 in St. Louis and San Antonio. Times and exact locations will be announced later this week in a special  IAC Double Express issue, as well as the public comment webpage address on CDC's web site when it becomes available. 

 

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  May 20, 2002