Issue
Number 467
June 28, 2004
CONTENTS OF THIS ISSUE
- CDC Health Advisory: Missouri reports a confirmed case of measles in a
child adopted from China
- Updated: IAC revises two professional-education pieces on influenza
- VIS translations: Current VIS for trivalent inactivated influenza
vaccine now available in French and Turkish
- June issue of CDC's "Immunization Works!" electronic newsletter now
available on the NIP website
- AMA develops guide to appropriate reimbursement coding for populations
at risk of viral hepatitis
- Immunization Registry Conference scheduled for October 18-20 in
Atlanta
- IAC publishes updated education piece on unusual cases of HBV
transmission
- June issue of "HEP EXPRESS" electronic newsletter now online
- WHO foresees a major polio epidemic in south and west Africa
- CDC reports on progress toward global eradication of polio from
January 2003 through April 2004
- CDC publishes report on animal rabies prevention and control
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ABBREVIATIONS: AAFP, American Academy of Family Physicians; 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; VPD, vaccine-preventable disease; WHO, World Health
Organization.
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June 28, 2004
CDC HEALTH ADVISORY: MISSOURI REPORTS A CONFIRMED CASE OF MEASLES IN A CHILD
ADOPTED FROM CHINA
On June 22, CDC issued an official Health Advisory about a confirmed case of
measles in an adopted child in Missouri. The Health Advisory is reprinted
below in its entirety.
******************
This is an official CDC Health Advisory
Distributed via Health Alert Network
June 22, 2004, 11:33 EDT (11:33 AM EDT)
MEASLES IN AN ADOPTED CHILD FROM CHINA LEADING TO POTENTIAL AIRLINE
EXPOSURE--MISSOURI, JUNE 2004
On June 18, 2004, the Missouri Department of Health and Senior Services (DHSS)
contacted the Centers for Disease Control and Prevention (CDC) to report a
laboratory-confirmed case of measles in a recently adopted child from China.
The child was part of a group of 35 families from 16 states and the United
Kingdom who traveled from China to the United States with their adopted
children. The investigation is ongoing to determine if any of the other
adopted children or family members in this group may have developed measles.
CDC has also contacted Chinese officials to obtain more information.
The 14-month-old child with confirmed measles had onset of rash on June 10th
and was likely infectious while traveling from China to the United States on
the following flights: China Southern Airlines flight #CZ327 arriving in Los
Angeles (LAX) from Guangzhou, China, on June 8, 2004, and Southwest Airlines
flight #1979 from Los Angeles (LAX) to Kansas City, Missouri, on June 9,
2004. Due to challenges in obtaining timely and accurate passenger contact
information, CDC is providing the flight information in lieu of individual
passenger notifications.
Although measles transmission is known to occur on commercial aircraft,
available data suggest the risk of transmission to other passengers is low.
Passengers seated adjacent to a measles-infected person appear to have an
increased risk of infection.
In general, measles is a highly infectious disease that can have severe
complications. The incubation period from exposure to rash onset for measles
is approximately 10 days (range 7-18 days); on rare occasions the incubation
period can be as long as 19-21 days. Persons on these flights who develop
fever and/or rash on or before June 30, 2004, should be evaluated by a
health care provider for measles. Persons with these symptoms should notify
their health care provider of the possible exposure to measles before
visiting a health care facility so that preparations can be made to avoid
exposing other susceptible persons to measles.
Possible cases of measles should be reported to state health departments.
State health departments are asked to report any possible cases under
investigation to CDC ([404] 639-8763 or [770] 488-7100).
Adoptive parents should ensure that they and their families are
appropriately immunized before traveling abroad for adoption and should be
aware of the potential for communicable diseases in children adopted from
international regions.
For more information on imported measles in the United States see:
Amornkul PN, Takahashi H, Bogard AK, Nakata M, Harpaz R, Effler PV. Low risk
of measles transmission after exposure on an international airline flight.
JID 2004;189:81-85.
Centers for Disease Control and Prevention. Multistate investigation of
measles among adoptees from China--April 9, 2004. MMWR 2004;53:309-310.
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5314a5.htm
Centers for Disease Control and Prevention. Measles among adoptees from
China--April 14, 2004. MMWR 2004;53:309.
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5314a4.htm
Centers for Disease Control and Prevention. Imported measles case associated
with nonmedical vaccine exemption--Iowa, March 2004. MMWR 2004;53:244-246.
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5311a6.htm
Centers for Disease Control and Prevention. Measles outbreak among
internationally adopted children arriving in the United States,
February-March 2001. MMWR 2002;51:1115-1116.
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5149a3.htm
Oster NV, Harpaz R, Redd SB, Papania MJ. International importation of
measles virus--United States, 1993-2001. JID 2004; 189:48-53.
******************
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June 28, 2004
UPDATED: IAC REVISES TWO PROFESSIONAL-EDUCATION PIECES ON INFLUENZA
IAC recently updated two of its professional-education pieces on influenza,
"Standing Orders for Administering Influenza Vaccine to Adults" and "Give
These People Influenza Vaccine!" Both now reflect the ACIP influenza
recommendations published in MMWR on May 28, 2004.*
The revised "Standing Orders for Administering Influenza Vaccine to Adults"
includes information that influenza vaccine is recommended for women who
will be at any stage of pregnancy during influenza season; previously the
vaccine was recommended for women in their 2nd or 3rd trimester of pregnancy
during influenza season. The section on contraindications now contains the
following sentence: "Use of inactivated influenza vaccine is preferred over
LAIV [live attenuated influenza vaccine] for close contacts of severely
immunosuppressed persons during periods when the immunocompromised person
requires a protective environment." Previously, inactivated influenza
vaccine was preferred for close contacts of immunosuppressed persons.
To access a ready-to-copy (PDF) version of the revised "Standing Orders for
Administering Influenza Vaccine to Adults," go to:
http://www.immunize.org/catg.d/p3074.pdf
A web-text (HTML) version of the revised piece is also available. Providers
can modify the HTML version to meet the needs of their clinic or practice.
To access the HTML version, go to:
http://www.immunize.org/catg.d/p3074.htm
The revised "Give These People Influenza Vaccine!" includes the
recommendation that influenza vaccine be given to all children age 6-23
months and to household contacts and out-of-home caregivers of all children
age 0-23 months.
To access a ready-to-copy (PDF) version of the revised "Give These People
Influenza Vaccine!" go to:
http://www.immunize.org/catg.d/2013flu.pdf
To access a web-text (HTML) version of it, go to:
http://www.immunize.org/catg.d/2013flu.htm
* To access a web-text (HTML) version of "Prevention and Control of
Influenza--Recommendations of ACIP," go to
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5306a1.htm
To access a ready-to-copy (PDF) version of it, go to:
http://www.cdc.gov/mmwr/PDF/rr/rr5306.pdf
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June 28, 2004
VIS TRANSLATIONS: CURRENT VIS FOR TRIVALENT INACTIVATED INFLUENZA VACCINE
NOW AVAILABLE IN FRENCH AND TURKISH
Dated 5/24/04, the current VIS for trivalent inactivated influenza vaccine (TIV)
is now available on the IAC website in French and Turkish. IAC is grateful
to Dr. Aicha Ben Moussa and the American Embassy Medical Unit, Tunis,
Tunisia, for the French translation and to Dr. Mustafa Kozanoglu and Dr.
Murat Serbest of Adana, Turkey, for the Turkish translation.
To obtain a ready-to-copy (PDF) version of the TIV VIS in French, go to:
http://www.immunize.org/vis/fr_flu04.pdf
To obtain it in Turkish, go to:
http://www.immunize.org/vis/tu_flu04.pdf
To obtain it in English, go to:
http://www.immunize.org/vis/2flu.pdf
For information about the use of VISs, and for VISs in a total of 31
languages, visit IAC's VIS web section at
http://www.immunize.org/vis
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June 28, 2004
JUNE ISSUE OF CDC'S "IMMUNIZATION WORKS!" ELECTRONIC NEWSLETTER
NOW AVAILABLE ON THE NIP WEBSITE
The June issue of "Immunization Works!" a monthly email
newsletter published by CDC, is available on NIP's 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 June issue has already appeared
in previous issues of "IAC EXPRESS." One issue of particular
importance to the immunization community is a report about
vaccines and autism released May 18 by the Institute of Medicine
(IOM) of the National Academies. Titled "Immunization Safety
Review: Vaccines and Autism," the report concludes that based on
a thorough review of clinical and epidemiological studies,
neither the mercury-based vaccine preservative thimerosal nor
the measles-mumps-rubella (MMR) vaccine is associated with
autism.
"IAC EXPRESS" published an article about the report on May 24.
To access the article, go to:
http://www.immunize.org/genr.d/issue461.htm#n1
A pre-publication version of the report is available online at
http://books.nap.edu/catalog/10997.html?onpi_newsdoc05182004
You can also obtain a copy from the National Academies Press by
calling (202) 334-3313 or (800) 624-6242.
To read an IOM press release about the report, go to:
http://www4.nationalacademies.org/news.nsf/isbn/030909237X?OpenDocument
Following is the text of three articles from the June
"Immunization Works!" not yet covered by "IAC EXPRESS."
************************
OTHER IMMUNIZATION NEWS
IMMUNIZATION AWARENESS DATES SET: The National Foundation for
Infectious Diseases (NFID) and the National Coalition for Adult
Immunization have set the 2004 National Adult Immunization
Awareness Week for September 26 to October 2. This year's theme
is "Immunization: Building a Pathway to a Healthy Tomorrow." The
2005 National Infant Immunization Week will be April 24-30. The
week will coincide with the Pan American Health Organizations'
Vaccine Week in the Americas. Resources for those interested in
celebrating these two events will be made available on the CDC
website at www.cdc.gov
MEETINGS, CONFERENCES, AND RESOURCES
FREE CMES AVAILABLE RELATED TO THE VACCINE ADVERSE EVENT
REPORTING SYSTEM (VAERS): Health care providers may access the
"Vaccine Safety Post-Marketing Surveillance: The Vaccine Adverse
Event Reporting System" with free CMEs through September 19,
2004. To access the CME article, visit
http://www.cdc.gov/nip/vacsafe/VAERS/CME-post-mktg-surv.htm
Additional information related to VAERS is available at
www.vaers.org
CDC SEEKS DIRECTOR, DIVISION OF VIRAL HEPATITIS, NATIONAL CENTER
FOR INFECTIOUS DISEASES: The National Center for Infectious
Diseases at CDC is seeking exceptional candidates for the
position of Director, Division of Viral Hepatitis. The mission
of this Division is to prevent, control, and eliminate hepatitis
virus infections. The Director manages a division budget
exceeding $25 million and approximately 130 professionals and
support staff. The Director is responsible for providing the
scientific, programmatic, and management leadership required for
a program to prevent infection with hepatitis viruses and the
liver disease associated with these infections. Applicants must
possess an MD, PhD, or other earned doctorate in disease
prevention or related health sciences, public health,
epidemiology, microbiology or molecular biology. For more
information, visit www.cdc.gov
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To access the complete June issue from the NIP website, go to:
http://www.cdc.gov/nip/news/newsltrs/imwrks/2004/200406.htm
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June 28, 2004
AMA DEVELOPS GUIDE TO APPROPRIATE REIMBURSEMENT CODING FOR
POPULATIONS AT RISK OF VIRAL HEPATITIS
[The following is cross posted from the Immunization Action
Coalition's "HEP EXPRESS" electronic newsletter, 6/25/04.]
The American Medical Association (AMA) has joined with CDC to
help protect MSM [men who have sex with men] and other at-risk
individuals from HBV [hepatitis B virus] and HAV [hepatitis A
virus] infection. On March 8, 2004, four CDC divisions released
a "Dear Colleague" letter urging health care professionals to
help prevent STDs among MSM. At the same time, CDC launched a
section of related online resources at
http://www.cdc.gov/ncidod/diseases/hepatitis/msm
In order to complement this program and assist physicians in
implementing this call to action, the AMA created a trifold
pocket guide to appropriate reimbursement coding for immunizing
populations at risk against hepatitis B and hepatitis A. You can
download "Coding Guidelines for Vaccine-Preventable Hepatitis
(VPH)" at
http://www.ama-assn.org/ama1/pub/upload/mm/36/ama_hep_coding_trifo.pdf
A hotline phone number is also available for answers about
reimbursement on a patient-by-patient basis: (888) 822-2749.
GlaxoSmithKline underwrites this service; information is given
regardless of the vaccine used.
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June 28, 2004
IMMUNIZATION REGISTRY CONFERENCE SCHEDULED FOR OCTOBER 18-20
IN ATLANTA
The 5th Immunization Registry Conference will be held October
18-20 at the Crowne Plaza Ravinia in Atlanta. The deadline for
submitting abstracts is July 16; the early-bird registration
deadline is August 20.
Expected to bring together more than 450 local, state, federal,
and private sector immunization registry partners, the
conference is intended to promote knowledge and information
about the development and use of immunization registries. The
conference will give participants programmatic, technical, and
scientific information that will improve the use of immunization
registries. It will also provide a forum to build support for
registries, enhance collaboration, promote multiple and
innovative uses of registry data, explore alternative funding
strategies, and demonstrate registry successes.
For information about the conference program, abstract
submission, registration, accommodations, and more, go to:
http://www.cdc.gov/nip/registry/irc
For questions and additional information, contact the conference
planning team by email at nipirc@cdc.gov or by phone at
(404) 639-8225.
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June 28, 2004
IAC PUBLISHES UPDATED EDUCATION PIECE ON UNUSUAL CASES OF
HBV TRANSMISSION
[The following is cross posted from the Immunization Action
Coalition's "HEP EXPRESS" electronic newsletter, 6/25/04.]
In June, IAC published an education piece titled "Unusual Cases
of Hepatitis B Virus Transmission." This piece replaces the 1994
article "No Risk?? No Way!!"
The updated document may be useful to both health professionals
and selected members of the public. It was developed to respond
to parents who question the necessity of vaccinating infants
against HBV [hepatitis B virus] because they believe that only
sexually promiscuous persons or drug users could ever become
infected with the virus. The piece presents 21 scenarios of HBV
transmission via medical procedures, team sports, day care,
school, and more. All cases were reported in peer-reviewed
journals and citations are provided.
"Unusual Cases of Hepatitis B Virus Transmission" is available
in ready-to-copy (PDF) format at
http://www.immunize.org/catg.d/p2100nrs.pdf
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June 28, 2004
JUNE ISSUE OF "HEP EXPRESS" ELECTRONIC NEWSLETTER NOW ONLINE
The June 25 issue of "HEP EXRESS," an electronic newsletter
published by IAC, is now available online. Published since
March 2003, "HEP EXPRESS" is intended for health and social
service professionals involved in the prevention and treatment
of viral hepatitis. The following are among the articles
included in the June 25 issue:
-
AMA's coding reimbursement guide for providers who serve
populations at risk of viral hepatitis (see article
#5 above)
-
State hepatitis C prevention activities posted on
CDC's website
-
CDC's web-based hepatitis B disease burden model
-
IAC's updated education piece on unusual cases of
hepatitis B virus transmission (see article #7 above)
To access the June 25 issue, go to:
http://www.hepprograms.org/hepexpress/issue18.asp
To sign up for a free subscription to "HEP EXPRESS," go to:
http://www.hepprograms.org/hepexpress/signup.asp
To access previous issues of "HEP EXPRESS," go to:
http://www.hepprograms.org/hepexpress/index.asp
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June 28, 2004
WHO FORESEES A MAJOR POLIO EPIDEMIC IN SOUTH AND WEST AFRICA
On June 22, WHO issued a press release warning that countries
in south and west Africa are on the brink of the largest polio
epidemic in recent years. The disease could paralyze thousands
of children in the fall, which is polio "high season" in the
region.
Epidemiological data indicate that transmission of wild
poliovirus is accelerating alarmingly in the region. To date
in 2004, polio has paralyzed five times as many of the
region's children as it had during the same period in 2003.
Epidemiologists and other polio experts believe a public health
tragedy could be averted if massive, synchronized immunization
campaigns were held across 22 African countries in October and
November, reaching 74 million children.
To access the press release from the WHO website, go to:
http://www.who.int/mediacentre/releases/2004/pr45/en/print.html
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June 28, 2004
CDC REPORTS ON PROGRESS TOWARD GLOBAL ERADICATION OF POLIO FROM
JANUARY 2003 THROUGH APRIL 2004
CDC published "Progress Toward Global Eradication of Poliomyelitis--January 2003-April 2004" in the June 25 issue of
MMWR. A summary made available to the press is reprinted below
in its entirety.
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While substantial progress has been made in Asia and northern
Africa, intense transmission in Nigeria jeopardizes the goal of
polio eradication globally. To interrupt transmission, polio-endemic countries must intensify supplemental immunization
activities (SIAs), countries affected by importations need to
continue emergency response campaigns throughout 2004 and 2005,
and emergency SIAs should be launched in 22 west and central
African countries.
The World Health Assembly resolved to eradicate poliomyelitis
globally in 1988. Since then, implementation of eradication
strategies reduced the number of polio-endemic countries from
>125 to 6 in 2003. Global polio cases decreased from 1,918 in
2002 to 784 in 2003, and 185 through April 2004.
India reported 83 percent of all global polio cases in 2002 and
in response intensified SIAs in 2003. India, Egypt, and Pakistan
have recorded the lowest level of transmission during the second
half of 2003 and are at record lows in 2004.
Nigeria has reported the largest number of cases in 2003 and
2004. Low SIA quality and suspension of SIAs in some [Nigerian]
states led to intense transmission in northern Nigeria,
re-infection of previously polio-free areas within the country,
and exportation of poliovirus to 9 previously polio-free
countries.
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To access a web-text (HTML) version of the complete article, go
to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5324a5.htm
To access a ready-to-copy (PDF) version of this issue of MMWR,
go to: http://www.cdc.gov/mmwr/PDF/wk/mm5324.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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June 28, 2004
CDC PUBLISHES REPORT ON ANIMAL RABIES PREVENTION AND CONTROL
The Centers for Disease Control and Prevention (CDC) published
"Compendium of Animal Rabies Prevention and Control, 2004:
National Association of State Public Health Veterinarians, Inc.
(NASPHV)" in the June 25 issue of "MMWR Recommendations and
Reports." CDC noted the following: "This report is being
published as a courtesy to both the National Association of
State Public Health Veterinarians, Inc., and to the MMWR
readership. Its publication does not imply endorsement by CDC."
The introductory paragraph is reprinted below in its entirety,
excluding references.
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Rabies is a fatal viral zoonosis and a serious public health
problem. The purpose of this compendium is to provide
information to veterinarians, public health officials, and
others concerned with rabies prevention and control. These
recommendations serve as the basis for animal rabies-control
programs throughout the United States and facilitate
standardization of procedures among jurisdictions, thereby
contributing to an effective national rabies-control program.
This document is reviewed annually and revised as necessary.
Parenteral vaccination procedure recommendations are contained
in Part I; Part II details the principles of rabies control; all
animal rabies vaccines licensed by the United States Department
of Agriculture (USDA) and marketed in the United States are
listed in Part III.
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To obtain a web-text (HTML) version of the report online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5309a1.htm
To obtain a ready-to-copy (PDF) version of it, go to:
http://www.cdc.gov/mmwr/PDF/rr/rr5309.pdf |
