Immunization Action Coalition and the Hepatitis B Coalition

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Issue Number 467            June 28, 2004

CONTENTS OF THIS ISSUE

  1. CDC Health Advisory: Missouri reports a confirmed case of measles in a child adopted from China
  2. Updated: IAC revises two professional-education pieces on influenza
  3. VIS translations: Current VIS for trivalent inactivated influenza vaccine now available in French and Turkish
  4. June issue of CDC's "Immunization Works!" electronic newsletter now available on the NIP website
  5. AMA develops guide to appropriate reimbursement coding for populations at risk of viral hepatitis
  6. Immunization Registry Conference scheduled for October 18-20 in Atlanta
  7. IAC publishes updated education piece on unusual cases of HBV transmission
  8. June issue of "HEP EXPRESS" electronic newsletter now online
  9. WHO foresees a major polio epidemic in south and west Africa
  10. CDC reports on progress toward global eradication of polio from January 2003 through April 2004
  11. 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.

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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."

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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

 

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 June 28, 2004