Immunization Action Coalition and the Hepatitis B Coalition

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Issue Number 414            September 29, 2003

CONTENTS OF THIS ISSUE

  1. CDC releases ACIP recommendations on using live, attenuated influenza vaccine
  2. CDC reports on transmission of hepatitis B and C viruses in U.S. outpatient settings during 2000-02
  3. Read it now: Washington Post article "Measles Cases Rebounding in Affluent Society" accessible until October 5
  4. New: September 2003 issue of "VACCINATE WOMEN" now online
  5. September issue of CDC's "Immunization Works!" available online
  6. CDC issues update on recent U.S. and global influenza activity
  7. American Lung Association encourages flu vaccine for people with asthma and lung disease, as well as senior citizens
  8. CDC notifies readers about FDA approval of INFANRIX for fifth consecutive DTaP vaccine dose
  9. Reminder: Register for CDC's "Epidemiology and Prevention of Vaccine-Preventable Diseases" course in California
  10. CDC notifies readers about status of standards of excellence for immunization registries
  11. CDC issues Health Advisory about a current multi-state outbreak of foodborne hepatitis A
  12. CDC reports on laboratory surveillance for wild and vaccine-derived polioviruses

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September 29, 2003
CDC RELEASES ACIP RECOMMENDATIONS ON USING LIVE, ATTENUATED INFLUENZA VACCINE

The Centers for Disease Control and Prevention (CDC) published "Using Live, Attenuated Influenza Vaccine for Prevention and Control of Influenza: Supplemental Recommendations of the Advisory Committee on Immunization Practices (ACIP)" in the September 26 issue of "MMWR Recommendations and Reports" (MMWR). The summary is reprinted below.

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This report summarizes recommendations by the Advisory Committee on Immunization Practices (ACIP) for using intranasally administered, trivalent, cold-adapted, live, attenuated influenza vaccine (LAIV), which was approved for use in the United States on June 17, 2003, (FluMist, produced by MedImmune, Inc., Gaithersburg, Maryland). LAIV is currently approved for use among healthy persons (i.e., those not at high risk for complications from influenza infection) aged 5-49 years. This report includes information regarding 1) vaccine composition and mechanisms of action; 2) comparison between LAIV and trivalent inactivated influenza vaccine; 3) effectiveness and safety of LAIV; 4) transmission and stability of LAIV viruses; 5) recommendations and contraindications for using LAIV; and 6) dosage and administration of LAIV. This report supplements the 2003 ACIP recommendations regarding prevention and control of influenza (CDC. Prevention and Control of Influenza: Recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 2003;52[No. RR-8]:1-36.)

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Links to the September 26, 2003, Supplemental ACIP Recommendation:
To obtain the complete text of the supplemental recommendations online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5213a1.htm

To obtain a camera-ready (PDF format) copy of the supplemental recommendations, go to:
http://www.cdc.gov/mmwr/PDF/rr/rr5213.pdf

Links to the April 25, 2003, ACIP Recommendation titled "Prevention and Control of Influenza: Recommendations of the Advisory Committee on Immunization Practices (ACIP)": To obtain the complete text of the recommendations online, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5208a1.htm

To obtain a camera-ready (PDF format) copy of the recommendations, go to:
http://www.cdc.gov/mmwr/PDF/rr/rr5208.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 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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September 29, 2003
CDC REPORTS ON TRANSMISSION OF HEPATITIS B AND C VIRUSES IN U.S. OUTPATIENT SETTINGS DURING 2000-02

The Centers for Disease Control and Prevention (CDC) published "Transmission of Hepatitis B and C Viruses in Outpatient Settings--New York, Oklahoma, and Nebraska, 2000-2002" in the September 26 issue of "Morbidity and Mortality Weekly Report" (MMWR). Portions of the article and the complete contents of a box of information about infection-control and safe injection practices are reprinted below.

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[The article's first paragraph]
Transmission of hepatitis B virus (HBV) and hepatitis C virus (HCV) can occur in health-care settings from percutaneous or mucosal exposures to blood or other body fluids from an infected patient or health-care worker. This report summarizes the investigation of four outbreaks of HBV and HCV infections that occurred in outpatient health-care settings. The investigation of each outbreak suggested that unsafe injection practices, primarily reuse of syringes and needles or contamination of multiple-dose medication vials, led to patient-to-patient transmission. To prevent transmission of bloodborne pathogens, all health-care workers should adhere to recommended standard precautions and fundamental infection-control principles, including safe injection practices and appropriate aseptic techniques.

[The article's Editorial Note in its entirety, excluding references]
These four outbreaks are among the largest health-care-related viral hepatitis outbreaks reported in the United States and share several common characteristics. All occurred in outpatient settings and were reported to public health authorities by clinicians who suspected these infections might have been health-care-related. The investigations were resource-intensive and involved notification, testing, and counseling of hundreds of patients. Transmission probably occurred indirectly from patient to patient after exposure to injection equipment that was contaminated with the blood of one or more source patients. All of these outbreaks could have been prevented by adherence to basic principles of aseptic technique for the preparation and administration of parenteral medications.

Health-care-related exposures are a well-recognized but uncommon source of viral hepatitis transmission in the United States. The majority of outbreaks identified previously have been associated with unsafe injection practices, primarily reuse of syringes and needles or contamination of multiple-dose medication vials. However, because the majority of patients with acute HBV or HCV infection are asymptomatic, clusters of patients infected in the health-care setting might be unrecognized. Health-care-related transmission should be suspected when cases are detected among persons without traditional risk factors for infection. State and local health authorities should consider strategies to improve case identification, such as targeting intensive follow-up for persons who typically are at low risk for infection (e.g., persons aged over 60 years).

In the outbreaks described in this report, health-care workers did not adhere to fundamental principles related to safe injection practices, suggesting that they failed to understand the potential of their actions to lead to disease transmission. In addition, deficiencies related to oversight of personnel and failures to follow up on reported breaches in infection-control practices resulted in delays in correcting the implicated practices. To prevent health-care-related transmission of bloodborne viruses, certification and training programs need to reinforce infection-control principles and practices, including aseptic techniques and safe injection practices. These principles should be reviewed with frequent in-service education for health-care staff, including those who work in outpatient settings, and practices should be monitored as part of the institutional oversight process. Finally, written policies and procedures to prevent patient-to-patient transmission of bloodborne pathogens should be established and implemented among all staff involved in direct patient care. CDC is working with professional organizations, advisory groups, and state and local health departments to address these issues.

[Contents of a box of information on infection-control and safe injection practices]
BOX. Infection-control and safe injection practices to prevent patient-to-patient transmission of bloodborne pathogens

Injection safety

  • Use a sterile, single-use, disposable needle and syringe for each injection and discard intact in an appropriate sharps container after use.
     
  • Use single-dose medication vials, prefilled syringes, and ampules when possible. Do not administer medications from single-dose vials to multiple patients or combine left-over contents for use later.
     
  • If multiple-dose vials are used, restrict them to a centralized medication area or for single patient use. Never re-enter a vial with a needle or syringe used on one patient if the vial will be used to withdraw medication for another patient. Store vials in accordance with manufacturer's recommendations and discard if sterility is compromised.
     
  • Do not use bags or bottles of intravenous solution as a common source of supply for multiple patients.
     
  • Use aseptic technique to avoid contamination of sterile injection equipment and medications.

Patient-care equipment

  • Handle patient-care equipment that might be contaminated with blood in a way that prevents skin and mucous membrane exposures, contamination of clothing, and transfer of microorganisms to other patients and surfaces.
     
  • Evaluate equipment and devices for potential cross-contamination of blood. Establish procedures for safe handling during and after use, including cleaning and disinfection or sterilization as indicated.

Work environment

  • Dispose of used syringes and needles at the point of use in a sharps container that is puncture-resistant and leak-proof and that can be sealed before completely full.
     
  • Maintain physical separation between clean and contaminated equipment and supplies.
     
  • Prepare medications in areas physically separated from those with potential blood contamination.
     
  • Use barriers to protect surfaces from blood contamination during blood sampling.
     
  • Clean and disinfect blood-contaminated equipment and surfaces in accordance with recommended guidelines.

Hand hygiene and gloves

  • Perform hand hygiene (i.e., hand washing with soap and water or use of an alcohol-based hand rub) before preparing and administering an injection, before and after donning gloves for performing blood sampling, after inadvertent blood contamination, and between patients.
     
  • Wear gloves for procedures that might involve contact with blood and change gloves between patients.

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To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5238a1.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5238.pdf
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September 29, 2003
READ IT NOW: WASHINGTON POST ARTICLE "MEASLES CASES REBOUNDING IN AFFLUENT SOCIETY" ACCESSIBLE UNTIL OCTOBER 5

In the article "Measles Cases Rebounding in Affluent Society," Washington Post staff writer David Brown uses the decreasing rate of MMR (measles-mumps-rubella) vaccination in England, and the consequent increase in measles incidence, as a point of departure in discussing the concept of herd immunity. In conversational language, Brown explains herd immunity and how near-universal vaccination of a population can break the chain of person-to-person transmission of vaccine-preventable diseases. Health professionals may find the article useful in addressing the concerns of some vaccine-hesitant parents.

Published on September 22, the article can be accessed on the "Washington Post" website for 14 days from the date it was posted. To access the article until October 5, go to:
http://www.washingtonpost.com/wp-dyn/articles/A44227-2003Sep21.html
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September 29, 2003
NEW: SEPTEMBER 2003 ISSUE OF "VACCINATE WOMEN" NOW ONLINE

The September 2003 issue of "VACCINATE WOMEN" is now available on the website of the Immunization Action Coalition (IAC). Hard copies were mailed last week to all members of the American College of Obstetricians and Gynecologists (ACOG). This publication was supported by a cooperative grant by the Division of Viral Hepatitis at the Centers for Disease Control and Prevention. It was distributed free of charge by ACOG.

The new issue is filled with reliable, practical information intended to assist obstetricians/gynecologists in providing immunization services in their health care settings.

Here are three ways to access "VACCINATE WOMEN" or its featured articles online. (1) View each of the five main articles by clicking on the direct links below. (2) Download any article from the publication's table of contents toward the end of this article. (3) Download the entire issue from the Web by clicking the link at the very end of this article.

Following are descriptions of and direct links to each of the main "VACCINATE WOMEN" articles:

  1. "Ask the Experts"
    CDC immunization expert William L. Atkinson, MD, MPH, answers general immunization questions. Hepatitis specialists Eric Mast, MD, and Linda A. Moyer, RN, answer hepatitis questions.
     
    PDF: http://www.immunize.org/vw/expert3.pdf

     
  2. "States Report Hundreds of Medical Errors in Perinatal Hepatitis B Prevention"
    Written by IAC's epidemiologist consultant, Teresa Asper Anderson, DDS, MPH, and executive director, Deborah L. Wexler, MD, this article summarizes data collected from state and local hepatitis B coordinators. Based on reports of more than 500 errors regarding perinatal hepatitis B prevention, the article makes a compelling case for giving the birth dose of hepatitis B vaccine to ALL newborns before hospital discharge.
     
    HTML: http://www.immunize.org/catg.d/p2062.htm
    PDF: http://www.immunize.org/catg.d/p2062.pdf
     
  3. "How to Administer IM and SC Injections to Adults"
    This invaluable one-page professional-education sheet presents information and drawings that instruct professionals on which vaccines are administered IM and which SC, where on the body each is administered, which needle size is appropriate for each, and proper needle insertion for each.
     
    PDF (PDF file is in two-page format):
    http://www.immunize.org/catg.d/p2020.pdf
     
  4. "Standing Orders for Administering Hepatitis B Vaccine to Adults" and "Standing Orders for Administering Influenza Vaccine to Adults"
    Each of these one-page professional-education sheets covers the purpose, policy, and procedure for using standing orders to administer these vaccines, as well as information about medical contraindications, precautions, and maintaining medical and personal immunization records.
     
    Standing Orders for Administering Hepatitis B Vaccine to Adults
    PDF: http://www.immunize.org/vw/hepb3.pdf

    Standing Orders for Administering Influenza Vaccine to Adults
    PDF: http://www.immunize.org/vw/flu3.pdf
     
  5. "Seize the Day: Get Ready for Influenza Vaccination Season NOW!"
    In less than a page, Deborah L. Wexler, MD, IAC's executive director, gives medical professionals five practical, easy-to-implement suggestions for getting themselves and their staff up to speed in time for influenza vaccination season.
     
    PDF: http://www.immunize.org/vw/back3.pdf

To view a table of contents with links to the text version (HTML format) of individual articles, go to:
http://www.immunize.org/vw

To download a camera-ready copy (PDF) format of the entire September 2003 issue (289,311 bytes), go to:
http://www.immunize.org/vw/vw0903.pdf

WARNING: The PDF format of the entire publication is a very large file, and some printers are unable to print a file of this size. For some helpful tips on downloading and printing PDF files, click here: http://www.immunize.org/nslt.d/tips.htm

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September 29, 2003
SEPTEMBER ISSUE OF CDC'S "IMMUNIZATION WORKS!" NOW AVAILABLE ONLINE

"Immunization Works!" a monthly email newsletter published by the Centers for Disease Control and Prevention (CDC), offers members of the immunization community information about current topics. Some of the information in the September issue has already appeared in previous issues of "IAC EXPRESS." Following is the text of one article we have not covered.

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Parents Guide to Childhood Immunization is Recognized: The CDC produced booklet "Parents Guide to Childhood Immunization" has been recognized with a Bronze Award by the 10th Annual National Health Information Awards Program. This awards program, the most comprehensive competition of its kind, is organized by the Health Information Resource Center, a national clearinghouse for consumer health information programs and materials. In 2003, nearly 1,100 entries were submitted by a wide variety of leading organizations in the consumer health field. The Parents Guide is available in both English and Spanish can be found at www.cdc.gov/nip/publications/Parents-Guide/default.htm#order

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To access the entire September issue from the website of the Immunization Action Coalition, go to:
http://www.immunize.org/news.d/news903.htm
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September 29, 2003
CDC ISSUES UPDATE ON RECENT U.S. AND GLOBAL INFLUENZA ACTIVITY

The Centers for Disease Control and Prevention (CDC) published "Update: Influenza Activity--United States and Worldwide, May-September, 2003" in the September 26 issue of "Morbidity and Mortality Weekly Report" (MMWR). A summary made available to the press is reprinted below.

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The best time to receive influenza vaccine is during October or November.

During May–September 2003, influenza A(H3N2) viruses were the most frequently reported influenza virus type/subtype worldwide, but influenza A(H1) and B viruses also circulated. The influenza virus type/subtype that will predominate and the severity of influenza-related disease activity for the 2003–04 influenza season cannot be predicted. Influenza vaccine is recommended for persons at high risk for developing influenza-related complications, health-care workers, and household contacts of high risk persons. The optimal time for influenza vaccination is during October–November. Influenza vaccine supply should be adequate during October–November, therefore, influenza vaccination can proceed for all high-risk and healthy persons, individually and through mass campaigns, as soon as vaccine is available.

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To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5238a4.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5238.pdf
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September 29, 2003
AMERICAN LUNG ASSOCIATION ENCOURAGES FLU VACCINE FOR PEOPLE WITH ASTHMA AND LUNG DISEASE, AS WELL AS SENIOR CITIZENS

On September 19, the American Lung Association announced a campaign that encourages people with asthma and lung disease, as well as senior citizens, to be vaccinated against influenza. The text of the announcement follows.

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AMERICAN LUNG ASSOCIATION LAUNCHES FLU SHOT AWARENESS CAMPAIGN TO TARGET PEOPLE WITH ASTHMA, LUNG DISEASE AND THE ELDERLY
September 19, 2003

Nearly 20.3 million Americans, 6.3 million of them under the age of 18, have asthma. People with asthma are more likely to develop serious complications and die from the flu than those who do not have asthma, and hospitalization rates for people with asthma increase two to three-fold during major flu epidemics.

Until recently, experts were concerned that the flu vaccine may worsen or exacerbate current asthma. But research indicates that giving the flu vaccination to every child with asthma means more than 100,000 kids would be spared a trip to the hospital, at a savings of $398 million a year.

More than 36,000 Americans die each year from influenza and related complications. Despite the risks, only 10 percent of children and 39 percent of adults with asthma get vaccinated. According to the American Lung Association, the flu shot is the only approved form of vaccine for people in high-risk groups, including those with asthma and lung disease as well as the elderly. People are advised to "stick with the flu shot," as it is literally their best shot at staying healthy this year.

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To access the announcement and a video of an interview with Michael S. Niederman, MD, Chairman, Department of Medicine, Winthrop University Hospital, go to:
http://www.prnewswire.com/broadcast/11293/11293_consumer.html
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September 29, 2003
CDC NOTIFIES READERS ABOUT FDA APPROVAL OF INFANRIX FOR FIFTH CONSECUTIVE DTaP VACCINE DOSE

The Centers for Disease Control and Prevention (CDC) published "Notice to Readers: FDA Approval of Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine Adsorbed, (INFANRIX) for Fifth Consecutive DTaP Vaccine Dose" in the September 26 issue of "Morbidity and Mortality Weekly Report" (MMWR). The notice is reprinted below in its entirety, excluding references.

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On July 8, 2003, the U.S. Food and Drug Administration (FDA) approved the use of Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine Adsorbed (DTaP) (INFANRIX, SmithKline Beecham Biologicals, Rixensart, Belgium) as a fifth dose for children aged 4-6 years after 4 previous doses of INFANRIX. INFANRIX had been previously approved for the first 4 doses in the DTaP vaccination series. Sufficient data are now available to establish the frequency of adverse events after a fifth dose of INFANRIX at age 4-6 years in children who have received 4 previous doses of INFANRIX.

The frequency of local injection site reactions (erythema and swelling) increases with successive doses of INFANRIX. In two German studies, 93 and 390 children, respectively, received a fifth dose of INFANRIX at age 4-6 years after 4 previous doses of INFANRIX. Among solicited adverse events, swelling of 5 cm (2 inches) or more in the injected limb within the 3 days after vaccination was reported in 15% and 20% of the vaccinees, respectively. Extensive swelling of the injected limb was reported spontaneously by parents of nine (9.7%) and 25 (6.4%) vaccinees, respectively, in these two studies.

The Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics, and the American Academy of Family Physicians recommend that children routinely receive a series of 5 doses of vaccine against diphtheria, tetanus, and pertussis before age 7 years. ACIP recommends that the first 4 doses be administered at ages 2, 4, 6, and 15-18 months and the fifth dose at age 4-6 years.

Data are limited on the safety, immunogenicity, and efficacy of using DTaP vaccines from different manufacturers for successive doses of the DTaP series. ACIP recommends that, whenever feasible, the same brand of DTaP should be used for all doses of the series but that vaccination should not be deferred because the type of DTaP used for previous doses is not available or is unknown. In such situations, any of the available licensed DTaP vaccines can be used to continue or complete the series.

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To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5238a9.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5238.pdf
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September 29, 2003
REMINDER: REGISTER FOR CDC'S "EPIDEMIOLOGY AND PREVENTION OF VACCINE-PREVENTABLE DISEASES" COURSE IN CALIFORNIA

The Centers for Disease Control and Prevention (CDC) course "Epidemiology and Prevention of Vaccine-Preventable Diseases" will be offered this fall in two locations in California. The two-day courses will be held in Torrance (Los Angeles area) on November 17-18 and in Sacramento on November 20-21. Space is available in Torrance; only limited space is available in Sacramento. The registration deadline is November 1.

This course provides the latest information for providers on immunizations and the diseases they can prevent. Information includes the following: updates on schedules, contraindications, standard immunization practices, vaccine-preventable diseases, and vaccine management and safety. Participants will receive the course textbook, "Epidemiology and Prevention of Vaccine-Preventable Diseases" (the Pink Book), as well as other immunization materials.

Continuing education credits will be offered for various professions based on 15 hours of instruction.

To access a course flyer and registration form, go to:
http://www.cdc.gov/nip/ed/CAFlier2003.pdf

For information, contact Melissa Dahlke at mdahlke@dhs.ca.gov or (510) 540-2379.
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September 29, 2003
CDC NOTIFIES READERS ABOUT STATUS OF STANDARDS OF EXCELLENCE FOR IMMUNIZATION REGISTRIES

The Centers for Disease Control and Prevention (CDC) published "Notice to Readers: Immunization Registry Standards of Excellence in Support of Core Immunization Program Strategies" in the September 26 issue of "Morbidity and Mortality Weekly Report" (MMWR). The notice is reprinted below in its entirety, excluding references.

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Progress continues to be made in achieving the national health objective for 2010 of increasing to 95% the proportion of children aged less than 6 years in a fully operational population-based immunization registry. Approximately 44% of children are registry participants. Much of the developmental focus of these confidential tracking systems has been on identifying and achieving minimum technical capabilities, such as ensuring data security and confidentiality, timely data access, and standardized data exchange.

In 2001, to ensure that immunization registries can support required core immunization program activity areas, CDC, the American Immunization Registry Association, and the Association of Immunization Managers formed the Programmatic Registry Operations Workgroup (PROW). Standards of excellence were written to specify how registries can support vaccine management, provider quality assurance, service delivery, consumer information, vaccine-preventable disease surveillance, and vaccination coverage assessment. In February 2003, the National Vaccine Advisory Committee endorsed these efforts. Additional information about these standards of excellence is available at http://www.immregistries.org/pdf/PROWstandardscomp1.pdf


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To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5238a10.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5238.pdf
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September 29, 2003
CDC ISSUES HEALTH ADVISORY ABOUT A CURRENT MULTI-STATE OUTBREAK OF FOODBORNE HEPATITIS A

On September 26, the Centers for Disease Control and Prevention (CDC) issued a Health Advisory, "Multi-state, Foodborne Hepatitis A Outbreak--Tennessee, Georgia, September 2003." According to CDC, a Health Advisory "provides important information for a specific incident or situation; [it] may not require immediate action." The advisory is reprinted below in its entirety.

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This is an official CDC Health Advisory
September 26, 2003

MULTI-STATE, FOODBORNE HEPATITIS A OUTBREAK--TENNESSEE, GEORGIA, SEPTEMBER 2003

On September 18, the Knox County (Tennessee) Health Department (KCHD) alerted EpiX that four cases of hepatitis A had occurred in food handlers employed at the O'Charley's Restaurant. At this time there are at least 57 cases of hepatitis A associated with O'Charley's Restaurants in Tennessee, and several others associated with O'Charley's Restaurants in Georgia and potentially in at least one additional state. Most cases identified to date have onset dates clustered around early to mid-September. An investigation to determine the source of the outbreak is underway. Cases of hepatitis A should be interviewed regarding exposure to O'Charley's Restaurants. O'Charley's is a regional chain with restaurants located in Alabama, Arkansas, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Mississippi, Missouri, North Carolina, Ohio, South Carolina, Tennessee, Virginia, and West Virginia. Cases of hepatitis A associated with this outbreak should be reported to CDC directly and to state or local health departments; available serum should be frozen and saved for molecular testing at CDC. Please call Dr. Joe Amon at CDC (404) 371-5461 to report cases and arrange shipment of serum.

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To access the Health Advisory, go to:
http://www.phppo.cdc.gov/HAN/Documents/AlertDocs/156.asp

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September 29, 2003
CDC REPORTS ON LABORATORY SURVEILLANCE FOR WILD AND VACCINE-DERIVED POLIOVIRUSES

The Centers for Disease Control and Prevention (CDC) published "Laboratory Surveillance for Wild and Vaccine-Derived Polioviruses, January 2002-June 2003" in the September 26 issue of "Morbidity and Mortality Weekly Report" (MMWR). A summary made available to the press is reprinted below.

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During the final stages of polio eradication, the laboratory network provides critical molecular evidence to track down the remaining strains of polioviruses.

After the 1988 World Health Assembly resolution to eradicate poliomyelitis, the Global Laboratory Network for Poliomyelitis Eradication was established by the World Health Organization (WHO). During January 2002-June 2003, the global laboratory network for polioviruses has continued to provide critical input and meet the challenges of the polio eradication initiative. It played a key role in providing substantial evidence for the eradication of wild type 2 poliovirus and interruption of wild poliovirus transmission in the Western Pacific Region. In the seven remaining polio endemic countries, the network has provided timely virologic evidence of where poliovirus is circulating, which is critical for guiding activities aimed at interrupting transmission. To ensure the achievement and maintenance of polio eradication globally, the continued support for the laboratory network by national governments and WHO partner agencies is essential.

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To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5238a5.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5238.pdf

 

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 October 2, 2003