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Issue Number 376            March 31, 2003

CONTENTS OF THIS ISSUE

  1. CDC reports on cardiac adverse events following smallpox vaccination
  2. Available online: Transcript of CDC news conference on Severe Acute Respiratory Syndrome and smallpox vaccine program
  3. New: CDC to introduce Spanish-language and Native American immunization materials during National Infant Immunization Week April 13-19
  4. IOM report urges CDC to assess the progress and safety of its smallpox vaccination program as it prepares for expansion
  5. CDC publishes a worldwide update on Severe Acute Respiratory Syndrome (SARS)
  6. CDC publishes Preliminary Clinical Description of Severe Acute Respiratory Syndrome (SARS)
  7. CDC reports on Egypt's progress in poliomyelitis eradication in 2002
  8. CDC notifies readers about the National Smallpox in Pregnancy Registry
  9. Reminder: NFID Sixth Annual Conference on Vaccine Research set for May 5-7

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March 31, 2003
CDC REPORTS ON CARDIAC ADVERSE EVENTS FOLLOWING SMALLPOX VACCINATION

The Centers for Disease Control and Prevention (CDC) published "Cardiac Adverse Events Following Smallpox Vaccination--United States, 2003" in the March 28 issue of the "Morbidity and Mortality Weekly Report" (MMWR).

The article's two opening paragraphs, which give an overview of the heart-related incidents following smallpox vaccination, are reprinted below in their entirety.

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During January 24-March 21, smallpox vaccine was administered to 25,645 civilian health-care and public health workers in 53 jurisdictions as part of an effort to prepare the United States in the event of  a terrorist attack using smallpox. Seven cases of cardiac adverse events have been reported among civilian vaccinees since the beginning of the smallpox vaccination program. In addition, 10 cases of myopericarditis have been reported among military vaccinees. This report summarizes data on the seven cases reported among civilians and provides background information on recent military vaccinees. Although a causal association between vaccination and adverse cardiac events in the  civilian population is unproven, as a precautionary measure, CDC recommends that persons with physician-diagnosed cardiac disease with or without symptoms (e.g., previous myocardial infarction, angina, congestive heart failure, or cardiomyopathy) be excluded from vaccination during this smallpox preparedness program.

CDC, the Food and Drug Administration, and state health departments are conducting surveillance for  vaccine-associated adverse events among civilian vaccinees; the Department of Defense (DoD) is  conducting surveillance for vaccine-associated adverse events among military vaccinees.

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The closing paragraphs of the Editorial Note contain practical information for clinicians; they are reprinted below in their entirety.

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Because of the reports of myopericarditis and other cardiac adverse events, CDC and DoD are issuing a supplement to the smallpox vaccine information statement, disseminating information to partners and clinicians, and developing strategies to assess prospectively the incidence and potential causal association of cardiac events among vaccine recipients.

Because a causal relation between smallpox vaccination and serious cardiac events cannot be excluded, CDC recommends as a precautionary measure that persons with known cardiac disease with or without symptoms be excluded from vaccination. As more information becomes available, this recommendation might be revised.

Persons receiving smallpox vaccine should be informed that myopericarditis might be associated with smallpox vaccination and that they should seek medical attention if they develop chest pain, shortness of breath, or other symptoms of cardiac disease after smallpox vaccination. For suspected adverse cardiac events among smallpox vaccine recipients, providers should consult with a cardiologist to ensure appropriate diagnostic studies are conducted to facilitate diagnosis and treatment.

Health-care providers needing assistance evaluating a smallpox vaccinee with a serious adverse event should contact their state health department or CDC's Clinician Information Line, telephone (877) 554-4625. This information line, staffed by nurses 24 hours a day, 7 days a week, is a source for general smallpox clinical adverse event information and for assistance with adverse event reporting.

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To obtain the complete text of the article online, including case reports of seven cardiac-adverse events, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5212a2.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5212.pdf

For up-to-date information from CDC on smallpox, visit
http://www.cdc.gov/smallpox

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 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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March 31, 2003
AVAILABLE ONLINE: TRANSCRIPT OF CDC NEWS CONFERENCE ON SEVERE ACUTE RESPIRATORY SYNDROME AND SMALLPOX VACCINE PROGRAM

On March 27, the Centers for Disease Control and Prevention (CDC) held a news briefing for members of the broadcast and print media on Severe Acute Respiratory Syndrome (SARS) and the smallpox vaccine program. James Hughes, MD, director, National Center for Infectious Diseases took questions about SARS, and Walt Orenstein, MD, director, National Immunization Program, took questions about the smallpox vaccine program.

To access the complete conference transcript, go to:
http://www.cdc.gov/od/oc/media/transcripts/t030327.htm

The conference was audio webcast. To listen online, go to:
http://www.videonewswire.com/cdc/032703/reg.html
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March 31, 2003
NEW: CDC TO INTRODUCE SPANISH-LANGUAGE AND NATIVE AMERICAN IMMUNIZATION MATERIALS DURING NATIONAL INFANT IMMUNIZATION WEEK APRIL 13-19

Set for April 13-19, this year's National Infant Immunization Week (NIIW) will introduce two new promotional materials: an educational campaign, "The Promise," and a poster, "Protect the Circle of Life, Immunize Our Nations."

"The Promise" campaign materials include a 30-second Spanish-language public service announcement (PSA), a Spanish-language immunization booklet, and a 30-second English-language PSA. The campaign will kick off in Los Angeles with a press conference hosted by the Immunization Coalition of Los Angeles County and the Los Angeles County Immunization Program on April 11. The Spanish-language PSA will be distributed to more than 100 Spanish-language television stations; the English-language PSA will be distributed to state and local health departments.

Designed for Native American and Alaska Native populations, the poster "Protect the Circle of Life, Immunize Our Nations," reflects the importance of infant immunization, as well as the importance of vaccination throughout the life span. The poster will be unveiled during NIIW at a ceremony in Talihina, OK, hosted by the Southeast Oklahoma Area Health Education Center, Choctaw Nation of Oklahoma, Carl Albert State College, and Oklahoma State Department of Health.

Now in its tenth year, NIIW emphasizes immunizing infants against 11 vaccine-preventable diseases by the age of two. The National Immunization Program of the Centers for Disease Control and Prevention offers individuals NIIW web pages containing sample public relations materials, posters, flyers, web-link icons, tri-fold brochures, and other resources.

To access these materials, go to the NIIW web pages at
http://www.cdc.gov/nip/publications/niiw

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March 31, 2003
IOM REPORT URGES CDC TO ASSESS THE PROGRESS AND SAFETY OF ITS SMALLPOX VACCINATION PROGRAM AS IT PREPARES FOR EXPANSION

On March 27, the Institute of Medicine (IOM) issued a news release summarizing the content of IOM's second report advising the Centers for Disease Control and Prevention (CDC) on the implementation of the national smallpox vaccination program. CDC sponsored the report. A private, nonprofit institution, IOM provides health policy advice under a Congressional charter granted to the National Academy of Sciences.

Titled "Review of the Centers for Disease Control and Prevention's Smallpox Vaccination Program Implementation--Letter Report #2," the report recommends that CDC comprehensively evaluate the program and its outcomes to improve its implementation and protect vaccinees and the public. It also advises CDC to work with states to decide what more, if anything, is needed to achieve smallpox preparedness.

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To access the news release, go to:
http://www4.nationalacademies.org/news.nsf/isbn/NI000498?OpenDocument

To access the full report from the National Academies Press, go to:
http://www.nap.edu/catalog/10657.html?onpi_newsdoc032703

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March 31, 2003
CDC PUBLISHES A WORLDWIDE UPDATE ON SEVERE ACUTE RESPIRATORY SYNDROME (SARS)

The Centers for Disease Control and Prevention (CDC) published "Update: Outbreak of Severe Acute Respiratory SyndromeŚWorldwide, 2003" in the March 28 issue of the "Morbidity and Mortality  Weekly Report" (MMWR). The article's two opening paragraphs are reprinted below in their entirety.

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CDC continues to support the World Health Organization (WHO) in the investigation of a multicountry outbreak of unexplained atypical pneumonia referred to as severe acute respiratory syndrome (SARS). This report includes summaries of the epidemiologic investigations and public health responses in several affected locations where CDC is collaborating with international and national health authorities. This report also describes an unusual cluster of cases associated with a hotel in Hong Kong and identifies the potential etiologic agent of SARS. Epidemiologic and laboratory investigations of SARS are ongoing.

As of March 26, a total of 1,323 suspected and/or probable SARS cases have been reported to WHO from 14 locations, using the WHO case definition or country-specific variations. These reported SARS cases include 49 deaths (case-fatality proportion: 4%). The Chinese authorities have reported 792 suspected/probable cases, including 31 deaths, which occurred in Guangdong province during November 16, 2002-February 28, 2003.

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To obtain the complete text of the article online, go to
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5212a1.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5212.pdf
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March 31, 2003
CDC PUBLISHES PRELIMINARY CLINICAL DESCRIPTION OF SEVERE ACUTE RESPIRATORY SYNDROME (SARS)

The Centers for Disease Control and Prevention (CDC) published "Preliminary Clinical Description of Severe Acute Respiratory Syndrome" in the March 28 issue of the "Morbidity and Mortality Weekly Report" (MMWR). Originally published March 21 in the web-based "MMWR Dispatch," the article has not been available in hard-copy format until now.

The article discusses the disease's incubation period, symptoms, severity, and treatment.

To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5212a5.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5212.pdf
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March 31, 2003
CDC REPORTS ON EGYPT'S PROGRESS IN POLIOMYELITIS ERADICATION IN 2002

The Centers for Disease Control and Prevention (CDC) published "Progress Toward Poliomyelitis Eradication--Egypt, 2002" in the March 28 issue of the "Morbidity and Mortality Weekly Report" (MMWR). A summary made available to the press is reprinted below in its entirety.

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Despite recent progress, surveillance and vaccination activities need further improvements to interrupt poliovirus transmission in Egypt.

Egypt made significant progress toward poliovirus eradication during 2002. The ability to find poliomyelitis cases has been improved and over 1 million additional children have been vaccinated in national vaccination campaigns. Only 7 cases of polio were identified during 2002. Genetic analyses of viruses isolated both from cases and from sewage indicate that transmission has been reduced to fewer lineages. The primary objective in Egypt now is to maintain and extend these improvements.

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To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5212a4.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5212.pdf
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March 31, 2003
CDC NOTIFIES READERS ABOUT THE NATIONAL SMALLPOX IN PREGNANCY REGISTRY

The Centers for Disease Control and Prevention (CDC) published a Notice to Readers, "National Smallpox Vaccine in Pregnancy Registry" in the March 28 issue of the "Morbidity and Mortality Weekly Report" (MMWR). It is printed below in its entirety, excluding references.

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Smallpox vaccine is known to cause fetal vaccinia, a very rare but serious complication of exposure to smallpox vaccine during pregnancy. Fewer than 50 cases have been reported, three of which occurred in the United States in 1924, 1959, and 1968. Affected pregnancies have been reported in women vaccinated in all three trimesters, in primary vaccinees, and in those being revaccinated, and in nonvaccinated contacts of vaccinees. Because a risk for infection to the fetus is possible in the pre-event setting, smallpox vaccination is not recommended for pregnant women or anyone with close physical contact to a pregnant woman (e.g., a household member or sex partner).

CDC has established the National Smallpox Vaccine in Pregnancy Registry, a surveillance system to monitor the outcomes in women who inadvertently received smallpox vaccine during pregnancy, became pregnant within 28 days after vaccination, or were a close contact with a vaccinee within 28 days. Exposed pregnant women should contact their health-care providers or their state health department for assistance in enrolling in the registry. Health-care providers and staff from state health departments are encouraged to report all exposed pregnant women to the registry. Reports should be routed through CDC, telephone (877) 554-4625 or (404) 639-8253.

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To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5212a6.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5212.pdf
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March 31, 2003
REMINDER: NFID'S SIXTH ANNUAL CONFERENCE ON VACCINE RESEARCH SET FOR MAY 5-7

The National Foundation for Infectious Diseases (NFID) announced the Sixth Annual Conference on Vaccine Research will take place May 5-7 at the Crystal Gateway Marriott, Arlington, VA.

Intended to further networking and scientific collaboration among vaccine researchers, the conference will focus on basic immunology, vaccine development, clinical testing, and vaccine regulation.

For information, contact Sharon Cooper-Kerr by phone at (301) 656-0003, extension 14 or 19; by fax at (301) 907-0878; or by email at scooper-kerr@nfid.org or vaccine@nfid.org

 

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 March 31, 2003