Immunization Action Coalition and the Hepatitis B Coalition

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Issue Number 439            January 27, 2004

CONTENTS OF THIS ISSUE

  1. CDC reports on human death associated with bat rabies
  2. CDC issues an update of U.S. influenza activity for January 11-17
  3. January 30 is the date for "Influenza and Beyond: Responding to Vaccine-Preventable Diseases" satellite broadcast/webcast
  4. New: January issue of "NEEDLE TIPS" is in the mail and on the Web
  5. New: January issue of CDC's "Immunization Works!" electronic newsletter is posted on the IAC website
  6. February 19 is the first satellite broadcast of "Epidemiology and Prevention of Vaccine-Preventable Diseases 2004"
  7. CDC reports on reduction in measles mortality in West Africa
  8. "Points Across: Strategies for Creating Health Messages that Work" conference scheduled for March 25 in Columbia, MD

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ABBREVIATIONS: AAP, American Academy of Pediatrics; ACIP, Advisory Committee on Immunization Practices; CDC, Centers for Disease Control and Prevention; FDA, Food and Drug Administration; IAC, Immunization Action Coalition; MMWR Morbidity and Mortality Weekly Report; NIP, National Immunization Program; VIS, Vaccine Information Statement; WHO, World Health Organization.
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January 27, 2004
CDC REPORTS ON HUMAN DEATH ASSOCIATED WITH BAT RABIES

CDC published "Human Death Associated with Bat Rabies--California, 2003" in the January 23 issue of MMWR. Portions of the article's opening paragraph and of a summary made available to the press are reprinted below.

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[From the article's opening paragraph]
Rabies is a rapidly progressive, incurable viral encephalitis that is, with rare exceptions, transmitted by the bite of an infected mammal. On September 14, 2003, a previously healthy man aged 66 years who resided in Trinity County, California, died from rabies approximately 6 weeks after being bitten by a bat. This report summarizes the investigation by the Trinity and Shasta County Health Departments and the California Department of Health Services . . . .

[From the press summary]
The only documented [rabies] survivors have received rabies prophylaxis BEFORE the onset of illness. . . . Medical professionals need to reemphasize to the public that if direct contact with bats has occurred, exposed persons should immediately 1) thoroughly disinfect and wash the wound, 2) capture the animal safely for diagnostic submission, 3) contact the local Department of Health, and 4) see a physician for evaluation about the need for post-exposure prophylaxis.

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To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5302a4.htm

To access a ready-to-copy (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5302.pdf

To receive a FREE electronic subscription to MMWR (which includes new ACIP statements), go to:
http://www.cdc.gov/mmwr/mmwrsubscribe.html
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January 27, 2004
CDC ISSUES AN UPDATE OF U.S. INFLUENZA ACTIVITY FOR JANUARY 11-17

CDC published "Update: Influenza Activity--United States, January 11-17, 2004" in the January 23 issue of MMWR. Portions of the article are reprinted below.

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The number of states reporting widespread influenza activity continued to decrease during the reporting week of January 11-17, 2004. Health departments in five states reported widespread influenza activity. A total of 31 states and New York City reported regional activity, eight states reported local activity, and sporadic activity was reported by six states, the District of Columbia, Guam, and Puerto Rico. The percentage of outpatient visits for influenza-like illness (ILI) continued to decrease in all surveillance regions during the week ending January 17. For the first time since the reporting week ending November 8, 2003, the national percentage for ILI (2.0%) declined below the national baseline of 2.5%. The percentage of specimens testing positive for influenza also decreased, but the percentage of deaths attributed to pneumonia and influenza (P&I) was unchanged. . . .

Antigenic Characterization
Of the 573 influenza viruses collected by U.S. laboratories since October 1, 2003, and characterized antigenically by CDC, 565 were influenza A (H3N2) viruses, two were influenza A (H1) viruses, and six were influenza B viruses. The hemagglutinin proteins of the influenza A (H1) viruses were similar antigenically to the hemagglutinin of the vaccine strain A/New Caledonia/20/99. Of the 565 influenza A(H3N2) isolates that have been characterized, 106 (18.8%) were similar antigenically to the vaccine strain A/Panama/2007/99 (H3N2), and 459 (81.2%) were similar to a drift variant, A/Fujian/411/2002 (H3N2). Five influenza B viruses characterized were similar antigenically to B/Sichuan/379/99 and one was similar antigenically to B/Hong Kong/330/2001.

P&I Mortality Surveillance
During the week ending January 17, P&I accounted for 10.3% of all deaths reported through the 122 Cities Mortality Reporting System. This percentage is again above the epidemic threshold of 8.1% . . . .

Weekly updates on influenza activity will be published in MMWR during the influenza season. Additional information about influenza activity is available from CDC at http://www.cdc.gov/flu

Influenza-Associated Deaths in Children Aged <18 Years
As of January 20, 2004, CDC had received reports of 111 influenza-associated deaths in U.S. residents aged <18 years. This update is based on preliminary data reported from 33 states. All patients had evidence of influenza virus infection detected by rapid-antigen testing or other laboratory tests. Among reported deaths, 56 (50.5%) were male. The median age was 4 years (range 1 month-17 years). Of the 64 children aged <5 years, 38 were aged 6 months-23 months. Twenty-one children had high-risk medical conditions that put them at increased risk for complications from influenza. Of the children whose influenza vaccination status was reported, three were vaccinated according to recommendations, and 49 were not vaccinated.

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To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5302a5.htm

To access a ready-to-copy (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5302.pdf
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January 27, 2004
JANUARY 30 IS THE DATE FOR "INFLUENZA AND BEYOND: RESPONDING TO VACCINE-PREVENTABLE DISEASES" SATELLITE BROADCAST/WEBCAST

A national satellite broadcast and webcast, "Influenza and Beyond: Responding to Vaccine-Preventable Disease," is scheduled from 2 pm to 3 pm ET on January 30. The program will focus on identifying best practices for improving adult immunization rates. Program sponsors are the School of Public Health, University of North Carolina at Chapel Hill and CDC.

COURSE OVERVIEW, AUDIENCE, AND FACULTY
The course will cover the following: the effectiveness of current vaccines, barriers to adult immunization, strategies to improve adult immunization rates, and the Racial and Ethnic Disparities in Immunization Initiative (READII).

The course is intended for public health leaders and professionals from local and state government agencies, hospitals, clinics, boards of health, community based health organizations, academic institutions, federal agencies, and others who seek to learn more about the public health response to vaccine-preventable diseases.

The faculty includes William L. Roper, MD, MPH, Dean, School of Public Health, University of North Carolina at Chapel Hill; Walter A. Orenstein, MD, Assistant Surgeon General and Director, NIP, CDC; Kristin L. Nichol, MD, MPH, MBA, Professor of Medicine, University of Minnesota, and Chief of Medicine, Minneapolis Veterans Administration Medical Center; and Hugh H. Tilson, MD, DrPH, Clinical Professor, Epidemiology and Health Policy, School of Public Health, University of North Carolina at Chapel Hill.

To access a comprehensive course overview from the website of the Public Health Grand Rounds, go to: http://www.publichealthgrandrounds.unc.edu/flu/about.htm

For more information on course content, email grand.rounds@sph.unc.edu or call (919) 843-9261.

REGISTRATION AND CONTINUING EDUCATION CREDIT
To register online, go to: http://www.publichealthgrandrounds.unc.edu/flu/partreg.htm Online registration must be completed to receive continuing education credit.

For more information about registration, call (800) 418-7246 or email ce@cdc.gov

HANDOUTS
Handouts will be posted on the Public Health Grand Rounds website on January 28; additional handouts may be added later. To access handouts, go to: http://www.publichealthgrandrounds.unc.edu/flu/handouts.htm

POST-PROGRAM DISCUSSION
Content experts from CDC will facilitate an online discussion from January 30 through February 6. Course participants are invited to ask questions and share their best practices. To participate in the discussion, go to: http://www.publichealthgrandrounds.unc.edu/flu/after.htm beginning January 30.

TECHNICAL INFORMATION
Webcast and satellite downlink information is available at
http://www.publichealthgrandrounds.unc.edu/flu/how.htm

Information about satellite coordinates is available at
http://www.publichealthgrandrounds.unc.edu/flu/satellite.htm
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January 27, 2004
NEW: JANUARY ISSUE OF "NEEDLE TIPS" IS IN THE MAIL AND ON THE WEB

The hard copy of the new "NEEDLE TIPS and the Hepatitis B Coalition News" should be arriving soon in the mail boxes of 130,000 health professionals and others who work in the field of immunization. If you haven't received yours, you can access the entire issue or selected articles from the IAC website. Immunization and hepatitis experts at CDC have reviewed each article and education piece in the issue for accuracy (with the exception of editorials).

Among the materials available for photocopying is the newly released "Recommended Childhood and Adolescent Immunization Schedule--United States, January-June 2004." The January issue has several practical pieces on storing and administering vaccines, including "CDC's Guidelines for Maintaining and Managing the Vaccine Cold Chain," "Vaccine Handling Tips," "Temperature Logs (Fahrenheit and Celsius) for Vaccines," and "Administering Vaccines: Dose, Route, Site, and Needle Size." The issue also includes three hepatitis resources: an editorial, "Prevent Viral Hepatitis: Vaccinate!"; an updated patient-education piece, "Every Week Hundreds of Sexually Active People Get Hepatitis B"; and a new professional-education piece, "Standing Orders for Administering Hepatitis B Vaccine to Adolescents and Adults." This is information you won't find anywhere else; we hope you'll peruse the table of contents (given below) and read articles that interest you online.

HOW TO READ "NEEDLE TIPS" ON THE WEB
You can download the entire issue from the Web or view selected articles from the table of contents below.

To view the table of contents with links to individual articles, go to:
http://www.immunize.org/nt

Please note: The PDF file of the entire January 2004 issue, linked below, is large at 744,318 bytes. Some printers cannot print such a large file. For tips on downloading and printing PDF files, go to: http://www.immunize.org/nslt.d/tips.htm

To download the entire PDF version of the January 2004 issue, go to: http://www.immunize.org/nslt.d/n29/n29.pdf

SUMMARIES OF INDIVIDUAL ARTICLES AND FEATURES
Summaries of "NEEDLE TIPS" articles and features are below, followed by URLs.

  • "Ask the Experts"
    CDC immunization expert William Atkinson, MD, MPH, and viral hepatitis experts Linda Moyer, RN, and Eric Mast, MD, answer readers' questions.
     
    HTML: http://www.immunize.org/nslt.d/n29/expert29.htm
    PDF: http://www.immunize.org/nslt.d/n29/expert29.pdf
     
  • "Prevent Viral Hepatitis: Vaccinate!"
    Citing the distressing statistic that nearly 80,000 persons in the United States become infected with hepatitis B virus (HBV) each year, this editorial urges health professionals to identify and vaccinate adults with behavioral risk factors for HBV infection.
     
    PDF: http://www.immunize.org/nslt.d/n29/viralhepatitis.pdf
     
  • "Vaccine Highlights"
    A digest of recent recommendations and news about vaccines, vaccine resources, and Vaccine Information Statements.
     
    HTML: http://www.immunize.org/nslt.d/n29/vaccin29.htm
    PDF: http://www.immunize.org/nslt.d/n29/vaccin29.pdf
     
  • "Recommended Childhood and Adolescent Immunization Schedule--United States, January-June 2004"
    Formatted for easy photocopying, this two-page resource includes catch-up schedules for children and adolescents who start late or are more than one month behind in getting vaccinated.
     
    PDF: http://www.immunize.org/cdc/child-schedule.pdf
     
  • "Administering Vaccines: Dose, Route, Site, and Needle Size"
    This one-page professional-education sheet summarizes information on administering 12 vaccines and four combination vaccines commonly given to children, adolescents, and adults.
     
    HTML: http://www.immunize.org/catg.d/p3085.htm
    PDF: http://www.immunize.org/catg.d/p3085.pdf
     
  • "What If You Don't Immunize Your Child?"
    Updated in November 2003, this duo-fold patient brochure clearly outlines the individual and social consequences of not immunizing children.
     
    HTML: http://www.immunize.org/catg.d/p4017.htm
    PDF: http://www.immunize.org/catg.d/p4017.pdf
     
  • "Every Week Hundreds of Sexually Active People Get Hepatitis B"
    This recently revised duo-fold patient brochure succinctly describes the facts associated with hepatitis B: what it is, who gets it, how they get it, how to prevent it, and more.
     
    HTML: http://www.immunize.org/catg.d/4112std.htm
    PDF: http://www.immunize.org/catg.d/4112std.pdf
     
  • "Standing Orders for Administering Hepatitis B Vaccine to Adolescents and Adults"
    This one-page sheet outlines the purpose, policy, and procedures for using standing orders for hepatitis B vaccine administration and presents information about contraindications, precautions, and administration techniques.
     
    PDF: http://www.immunize.org/nslt.d/n29/orders.pdf
     
  • "CDC's Guidelines for Maintaining and Managing the Vaccine Cold Chain"
    Reprinted from the October 24, 2003 MMWR, this article presents current information on recommended vaccine storage temperatures, storage requirements, and temperature monitoring.
     
    HTML: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5242a6.htm
    PDF: http://www.immunize.org/nslt.d/n29/coldchain.pdf
     
  • "Vaccine Handling Tips"
    Updated in November 2003, this one-page sheet summarizes basic information on vaccine storage.
     
    PDF: http://www.immunize.org/catg.d/p3048.pdf
     
  • "Temperature Logs (Fahrenheit and Celsius) for Vaccines"
    This one-page sheet provides URLs for Fahrenheit and Celsius temperature logs; each log has space for recording a month's worth of temperatures.
     
    One-page sheet with URLs for both temperature logs
    PDF: http://www.immunize.org/nslt.d/n29/templogs.pdf
     
    Fahrenheit temperature log
    PDF: http://www.immunize.org/catg.d/p3039.pdf

    Celsius temperature log
    PDF: http://www.immunize.org/news.d/celsius.pdf
     
  • "How's Your State Doing?"
    This chart shows influenza immunization rates by state for adults 50-64 years of age and those >=65 years, as well as pneumococcal vaccination rates for those >=65 years. It also shows which states mandate influenza and pneumococcal vaccination in long-term care facilities and which authorize pharmacists to vaccinate.
     
    PDF: http://www.immunize.org/nslt.d/n29/state29.pdf
     
  • "IAC's Catalog and Order Form"
    Order materials for patients and clinic staff here.
     
    HTML: http://www.immunize.org/nslt.d/n17/catalg1.htm
    PDF: http://www.immunize.org/nslt.d/n29/catalog.pdf
     
  • "Letter from the Executive Director: Your Yearly Contribution Promotes Immunization!"
    IAC's Executive Director, Deborah L. Wexler, MD, shows how much good your money does when you contribute to IAC.
     
    HTML: http://www.immunize.org/nslt.d/n29/back29.htm
    PDF: http://www.immunize.org/nslt.d/n29/back29.pdf

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January 27, 2004
NEW: JANUARY ISSUE OF CDC'S "IMMUNIZATION WORKS!" ELECTRONIC NEWSLETTER IS POSTED ON THE IAC WEBSITE

The January issue of "Immunization Works!" a monthly email newsletter published by CDC, is available on the IAC website. The newsletter offers members of the immunization community non-proprietary information about current topics. CDC encourages its wide dissemination.

Some of the information in the January issue has already appeared in previous issues of "IAC EXPRESS." Following is the text of three articles we have not covered.

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OTHER IMMUNIZATION NEWS

MEASLES INITIATIVE CONTINUES: The American Red Cross, along with CDC, United Nations Foundation, World Health Organization, and United Nations Children's Fund continue to support the Measles Initiative, a 5-year program to control measles death in Africa by vaccinating 200 million children in 36 sub-Saharan countries by 2005. While most Americans barely remember the disease, measles kills nearly 800,000 children, a half million of those in Africa alone. This fact makes measles the single leading vaccine-preventable cause of death among children in Africa, yet it can be easily prevented with a simple vaccination. At the initiative's mid-way point, more than 106 million children have been vaccinated in 24 countries, saving 194,000 young lives. For more information about the Measles Initiative visit www.measlesinitiative.org

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MEETINGS, CONFERENCES, AND RESOURCES

ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES: The Advisory Committee on Immunization Practices (ACIP) will hold its next meeting February 24-25, 2004, at the Marriott Century Center in Atlanta, Georgia. The meeting is open to the general public. For more information on the meeting visit www.cdc.gov/nip

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NEW CDC PUBLICATIONS: CDC has several new publications available on immunization related issues. All items are free of charge and can be ordered by using the NIP online order form at www.cdc.gov/nip/publications The new items include:

  • Vaccine Information Statements (Provider Set with all current VISs)
  • 2004 Adult Immunization Schedule (8.5 x 11 and pocket-size laminated cards)
  • Guide to Contraindications
  • Standards for Adult Immunization Practices
  • Standards for Child and Adolescent Immunization Practices

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To access a ready-to-copy (PDF) version of the entire January issue of "Immunization Works!" go to:
http://www.immunize.org/news.d/news0104.pdf
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January 27, 2004
FEBRUARY 19 IS THE FIRST SATELLITE BROADCAST OF "EPIDEMIOLOGY AND PREVENTION OF VACCINE-PREVENTABLE DISEASES 2004"

A live, four-part satellite broadcast by CDC, "Epidemiology and Prevention of Vaccine Preventable Diseases," is scheduled from noon to 3:30 pm ET on four consecutive Thursdays: February 19 and 26, and March 4 and 11. This live, interactive program will provide the most current information available in the constantly changing field of immunization. The broadcast will feature a Q&A session in which participants nationwide can interact with the course instructors by toll-free telephone lines.

COURSE OVERVIEW, AUDIENCE, AND FACULTY
Intended to improve U.S. immunization practices, the course will cover principles of vaccination, general recommendations on immunization, strategies to improve immunization coverage levels, and specific information about vaccine-preventable diseases and the vaccines that prevent them.

The course is intended for physicians, nurses, nurse practitioners, physician assistants, DoD paraprofessionals, pharmacists, and others who either give immunizations or set policy for their offices, clinics, or communicable disease/infection control programs.

The faculty is drawn from NIP. It includes William Atkinson, MD, MPH; Donna Weaver, MN, RN; Sharon Roy, MD, MPH; and Andrew Kroger, MD, MPH.

To access a comprehensive course overview from the website of the Public Health Training Network, go to: http://www.phppo.cdc.gov/PHTN//epv04

For more information on course content, email nipinfo@cdc.gov

REGISTRATION AND CONTINUING EDUCATION CREDIT
Individual registration began January 22. To register online, visit the Training and Continuing Education Online System at http://www.phppo.cdc.gov/phtnonline Participants must use the online system to receive continuing education credit.

For more information about registration, call (800) 418-7246 or email ce@cdc.gov

COURSE MATERIALS
Participants are strongly encouraged to buy a copy of the primary course text, "Epidemiology and Prevention of Vaccine-Preventable Disease" (the "Pink Book," 8th edition, 2004). It is available from the Public Health Foundation for $29. To order, call (877) 252-1200 or go to: http://bookstore.phf.org/prod171.htm

TECHNICAL INFORMATION
Webcast information and viewing options are available at
http://www.phppo.cdc.gov/phtn/webcast/epv04

Technical support for the webcast is available at
http://www.phppo.cdc.gov/phtn/webcast/techsupport.asp
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January 27, 2004
CDC REPORTS ON REDUCTION IN MEASLES MORTALITY IN WEST AFRICA

CDC published "Measles Mortality Reductionó-West Africa, 1996-2002" in the January 23 issue of MMWR. The article's opening paragraph is reprinted below.

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The World Health Organization (WHO) estimates that, during 2000, measles accounted for approximately 777,000 deaths worldwide, of which 452,000 (58%) occurred in Africa. In response, in 2000, WHO's African Regional Office (AFRO) adopted a plan to reduce measles mortality >50% by 2005. The plan recommended 1) increasing measles vaccination by strengthening routine health services; 2) providing a second opportunity for measles vaccination for all children, primarily through wide-age-range supplemental immunization activities (SIAs); 3) enhancing measles surveillance; and 4) improving management of measles cases. The initial wide-age-range SIA targets all children aged 9 months-14 years, regardless of history of measles disease or vaccination. Follow-up SIAs are needed 3-5 years after the initial SIA to provide a second opportunity for vaccination to children born since the previous SIA (i.e., those aged 9 months-4 years). During the 1990s, the countries of the Americas and seven countries in southern Africa used this strategy to reduce the number of measles deaths to near zero. This report describes the recent implementation of this strategy in three West African countries, where reported measles cases declined 83%-97% during the first year after SIAs. Successful implementation of this strategy by other African countries should result in achieving the goal of >50% reduction in measles mortality by 2005.

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To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5302a2.htm

To access a ready-to-copy (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5302.pdf
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January 27, 2004
"POINTS ACROSS: STRATEGIES FOR CREATING HEALTH MESSAGES THAT WORK" CONFERENCE SCHEDULED FOR MARCH 25 IN COLUMBIA, MD

A social marketing and health literacy conference, "Points Across: Strategies for Creating Health Messages that Work," will be held March 25 in Columbia, MD. The deadline for "early bird" registration is February 6.

Intended for health educators, outreach workers, nurses, public health administrators, government officials, and community leaders, the conference is sponsored by the Maryland Partnership for Prevention, Inc., Maryland's immunization coalition.

To access conference and registration information, go to:
http://www.edcp.org/pdf/MPP_Points_Across_Conference_Brochure.pdf

For additional information, call (410) 902-4677.    

 

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 January 28, 2004