Issue Number 425            November 17, 2003

CONTENTS OF THIS ISSUE

  1. CDC Health Advisory: Consumers advised that recent hepatitis A outbreaks have been associated with green onions
  2. CDC reports on first human death associated with raccoon rabies
  3. Wisconsin enacts legislation requiring college students to receive meningococcal and hepatitis B information
  4. IAC posts new and revised Asian-language translations of the 2003-04 inactivated influenza VIS on its website
  5. Free: Bulk copies of the latest issue of "NEEDLE TIPS" (October 2003) are just a click away
  6. Last chance: Adult Immunization Record Card available by the carton at half-price--while supplies last
  7. December 15 is the deadline for abstracts for the National Conference on Immunization Coalitions

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November 17, 2003
CDC HEALTH ADVISORY: CONSUMERS ADVISED THAT RECENT HEPATITIS A OUTBREAKS HAVE BEEN ASSOCIATED WITH GREEN ONIONS

On November 15, the Centers for Disease Control and Prevention (CDC) issued the following official CDC Health Advisory. CDC notes that a Health Advisory "provides important information for a specific incident or situation; [it] may not require immediate action." It is reprinted below in its entirety.

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This is an official CDC Health Advisory

Distributed via Health Alert Network
November 15, 2003 19:28 EST (7:28 PM EST)

FROM FDA: CONSUMERS ADVISED THAT RECENT HEPATITIS A OUTBREAKS HAVE BEEN ASSOCIATED WITH GREEN ONIONS

The Food and Drug Administration is advising the public that several recent hepatitis A outbreaks have been associated with eating raw or undercooked green onions (scallions). Hepatitis A is a liver disease that develops within 6 weeks of an exposure. Hepatitis A is usually mild and characterized by jaundice (yellow discoloration of the skin), fatigue, abdominal pain, loss of appetite, nausea, diarrhea, and fever. It can occasionally be severe, especially in people with liver disease.

Hepatitis A outbreaks associated with raw or undercooked green onions served in restaurants occurred in Tennessee, North Carolina, and Georgia in September. Another outbreak of hepatitis A among patrons of a single restaurant occurred in Pennsylvania during late October and early November, although the source of the outbreak has not yet been determined. CDC and the State of Pennsylvania have an investigation underway to determine if a specific food is associated with the Pennsylvania outbreak, and if so, the exact source. The source of the green onions in the Tennessee outbreak is Mexico. FDA is continuing to investigate and is working with Mexican authorities to assess appropriate measures. FDA offers the following advice to consumers concerned about the possibility of getting hepatitis A from green onions:

  • Cook green onions thoroughly. This minimizes the risk of illness by reducing or eliminating the virus. Cook in a casserole or saute in a skillet.
     
  • Check food purchased at restaurants and delicatessens and ask whether menu items contain raw or lightly cooked green onions. Consumers who wish to reduce the risk of contracting hepatitis should avoid food that contains raw green onions and specifically request that raw or lightly cooked green onions not be added to their food. Foods such as freshly prepared salsa and green salads often contain raw green onions.

FDA, CDC, and the States are actively investigating the outbreaks in an attempt to determine the exact source of the green onions associated with the outbreaks and how they became contaminated, so that corrective action can be taken.

While the investigations are ongoing, FDA will closely monitor the safety of green onions and will take further actions as necessary to protect consumers. Consumers who have recently eaten raw or lightly cooked green onions do not need to take any specific measures, but should monitor their health. Consumers who are experiencing symptoms that could be hepatitis A should consult their health care providers or the local health department. FDA ON THE INTERNET: www.fda.gov

For information about hepatitis A:
http://www.cdc.gov/ncidod/diseases/hepatitis/a/faqa.htm

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November 17, 2003
CDC REPORTS ON FIRST HUMAN DEATH ASSOCIATED WITH RACCOON RABIES

The Centers for Disease Control and Prevention (CDC) published "First Human Death Associated with Raccoon Rabies--Virginia, 2003" in the November 14 issue of "Morbidity and Mortality Weekly Report" (MMWR). A summary made available to the press is reprinted below in its entirety.

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Human rabies is a rare, but fatal, disease in the United States.

On March 10, 2003, a previously healthy man aged 25 years who resided and worked in northern Virginia died with a diagnosis of meningoencephalitis of unknown etiology after a 3-week illness. Testing of tissue samples at CDC revealed viral inclusions suggestive of Negri bodies, and subsequent tests confirmed a diagnosis of rabies. Genetic sequencing identified a rabies virus variant associated with raccoons, but how the patient acquired infection remains unknown. This report summarizes the investigation of the first documented case of a human death from raccoon rabies in the United States. Human rabies can be prevented by avoiding exposure to suspicious animals, vaccinating and supervising pets, and seeking prompt medical attention if a bite occurs.

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To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5245a4.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5245.pdf

HOW TO OBTAIN A FREE ELECTRONIC SUBSCRIPTION TO THE MMWR:
To obtain a free electronic subscription to "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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November 17, 2003
WISCONSIN ENACTS LEGISLATION REQUIRING COLLEGE STUDENTS TO RECEIVE MENINGOCOCCAL AND HEPATITIS B INFORMATION

The Wisconsin State Legislature passed legislation requiring public and private post-secondary educational institutions to give all enrolled students information about meningococcal and hepatitis B diseases and vaccines. In addition, students residing in a residence hall or dormitory are required to provide documentation if they have received immunization against the two diseases. The governor approved the legislation October 16; it goes into effect January 1, 2004.

The Immunization Action Coalition (IAC) has compiled information about all states that have meningococcal and hepatitis B prevention mandates for colleges and universities.

To access information on meningococcal mandates for colleges and universities, go to: http://www.immunize.org/laws/menin.htm

This information is also depicted visually on a map of the United States. To access the map, go to:
http://www.immunize.org/laws/meninmap.pdf

To access information on hepatitis B mandates for colleges and universities, go to: http://www.immunize.org/laws/hepbcollege.htm

This information is also depicted visually on a map of the United States. To access the map, go to:
http://www.immunize.org/laws/hepbcolmap.pdf

For information about state mandates for other vaccines, including vaccines for adults, go to:
http://www.immunize.org/laws

We depend on our readers to help us stay informed and ensure our website contains the most current and accurate information available. Please let us know when any changes occur in your state by emailing us at admin@immunize.org
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November 17, 2003
IAC POSTS NEW AND REVISED ASIAN-LANGUAGE TRANSLATIONS OF THE 2003-04 INACTIVATED INFLUENZA VIS ON ITS WEBSITE

The Immunization Action Coalition (IAC) recently posted the 2003-04 inactivated influenza VIS on its website in Cambodian, Hmong, and Tagalog. Previously, the 2003-04 inactivated influenza VIS was not available in these languages. In addition, IAC replaced the Chinese- and Vietnamese-language 2003-04 inactivated influenza VISs with slightly revised versions. IAC gratefully acknowledges the California Department of Health Services for the translations.

To access the 2003-04 inactivated influenza VIS in Cambodian, go to: http://www.immunize.org/vis/ca_flu03.pdf

To access the 2003-04 inactivated influenza VIS in Chinese, go to: http://www.immunize.org/vis/ch_flu03.pdf

To access the 2003-04 inactivated influenza VIS in Hmong, go to:
http://www.immunize.org/vis/hm_flu03.pdf

To access the 2003-04 inactivated influenza VIS in Tagalog, go to: http://www.immunize.org/vis/ta_flu03.pdf

To access the 2003-04 inactivated influenza VIS in Vietnamese, go to: http://www.immunize.org/vis/vn_flu03.pdf

To access the 2003-04 inactivated influenza VIS in English, go to:
http://www.immunize.org/vis/2flu.pdf

For information on the use of VISs, and for VISs in a total of 30 languages, visit IAC's VIS web page at http://www.immunize.org/vis
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November 17, 2003
FREE: BULK COPIES OF THE LATEST ISSUE OF "NEEDLE TIPS" (OCTOBER 2003) ARE JUST A CLICK AWAY

The Immunization Action Coalition (IAC) is giving away bulk copies (up to 200 per request) of the October 2003 issue of "NEEDLE TIPS" to make room for our January 2004 issue.

If you have an immunization conference or an educational program coming up for health professionals, this 24-page publication is an excellent item to distribute. It's packed with information that can make many aspects of immunization go more smoothly. The October issue includes a wealth of information on influenza vaccination as well as updated professional-education material about hepatitis B.

Because supplies are limited, it's best to make your request right away. The free copies go quickly. Sorry, we can only mail orders to addresses within the United States.

To request copies, fill out the online form on IAC's website:
http://www.immunize.org/oldnt

You will be asked to supply the following information:

  • The number of copies you want (maximum 200)
  • A description of how you plan to use the copies
  • Your name and complete contact information, including mailing address, telephone number, and email address

For further information, please contact Pat Storti, office administrator, by email at pat@immunize.org
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November 17, 2003
LAST CHANCE: ADULT IMMUNIZATION RECORD CARD AVAILABLE BY THE CARTON AT HALF-PRICE--WHILE SUPPLIES LAST

Our printer's error creates a wonderful opportunity for you to stock up on one or more cartons of the Immunization Action Coalition (IAC) Adult Immunization Record Card--and pay only half the price you'd expect! We are offering a 3,750-card carton to "IAC EXPRESS" readers for the marked-down price of $131.25, plus shipping. Your typical cost would be $262.50 per carton.

We can offer the card at this price because our printer mistakenly printed cards with the "old" design, which included space for a patient's social security number. Cards with the "new" design, which are not available at half price, have space for a patient number instead.

The Adult Immunization Record Card is extremely popular. Since introducing it in May 2002, IAC has shipped more than a million cards to health care providers across the United States. Health professionals find the card invaluable for educating patients that immunization is a lifelong process and for giving patients the means to keep a lifetime record of their immunization status.

Printed on smudge-proof, rip-proof, waterproof paper, the card comes pre-folded to fit in a wallet. Its bright canary-yellow color makes it easy to spot among credit cards and other items.

To view a copy of the "new" design online, go to: https://www.immunize.org/adultizcards/index.htm Remember, the half-price card is identical to the online card with one exception: The half-price card has "Social Security Number" instead of "Patient Number."

You can place an order for a 3,750-card carton (or more) of the half-price card in two ways: (1) fax your order to us at (651) 647-9131 or (2) send an email to the following address: admin@immunize.org Include your complete shipping information (your name, shipping address, and daytime phone number). Please include your fax number in your fax or email to us, and we will fax you a confirmation of your order and an expected shipping date. We accept payment by check, purchase order, or credit card; we will ship in 2-3 weeks. You pay shipping charges.

Orders will be filled only for multiples of 3,750 (e.g., 7,500, 11,250, 15,000, etc.) and will be shipped IN THE ORDER WE RECEIVE THEM until supplies are depleted. Don't delay!
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November 17, 2003
DECEMBER 15 IS THE DEADLINE FOR ABSTRACTS FOR THE NATIONAL CONFERENCE ON IMMUNIZATION COALITIONS

Scheduled for September 20-22, 2004, the sixth National Conference on Immunization Coalitions will be held in Norfolk, VA. It will provide training on creating, leading, and sustaining effective local or state coalitions and partnerships that address childhood, adolescent, and adult immunization. The deadline for submitting abstracts electronically is December 15.

For information on submitting an abstract, go to:
http://www.cme.hsc.usf.edu/coph/immcoal

For information on the conference program, contact Annemarie Beardsworth by phone at (401) 222-5658 or by email at annemarieb@doh.state.ri.us

For information on conference logistics, contact the conference administrator, Tracey Ryan, by phone at (813) 974-6682 or by email at tryan@hsc.usf.edu

About IZ Express

IZ Express is supported in part by Grant No. 1NH23IP922654 from CDC’s National Center for Immunization and Respiratory Diseases. Its contents are solely the responsibility of Immunize.org and do not necessarily represent the official views of CDC.

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Editorial Information

  • Editor-in-Chief
    Kelly L. Moore, MD, MPH
  • Managing Editor
    John D. Grabenstein, RPh, PhD
  • Associate Editor
    Sharon G. Humiston, MD, MPH
  • Writer/Publication Coordinator
    Taryn Chapman, MS
    Courtnay Londo, MA
  • Style and Copy Editor
    Marian Deegan, JD
  • Web Edition Managers
    Arkady Shakhnovich
    Jermaine Royes
  • Contributing Writer
    Laurel H. Wood, MPA
  • Technical Reviewer
    Kayla Ohlde

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