Issue
Number 517
March 28, 2005
CONTENTS OF THIS ISSUE
- CDC announces the elimination of rubella and congenital
rubella syndrome in the United States
- CDC posts new NIIW resources to the NIP website, offers
a technical assistance teleconference on March 29 and 31
- Note: On March 29, IAC will publish an Unprotected
People report about recent varicella deaths in the United States
- CDC reports on varicella surveillance in Oregon public
elementary schools
- New: The March issue of CDC's Immunization Works
electronic newsletter is now available on the NIP website
- CDC reports on progress toward polio eradication in
Afghanistan and Pakistan in 2004-05
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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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March 28, 2005
CDC ANNOUNCES THE ELIMINATION OF RUBELLA AND CONGENITAL RUBELLA SYNDROME IN
THE UNITED STATES
On March 21, CDC issued a press release announcing a significant public
health achievement: the elimination of rubella and congenital rubella
syndrome in the United States. Also on March 21, MMWR published an
electronic Early Release on the same topic. The press release is reprinted
below in its entirety. The URL for the Early Release is given at the end of
this article.
***********************
For immediate release
March 21, 2005
RUBELLA NO LONGER MAJOR PUBLIC HEALTH THREAT IN THE UNITED STATES
A major public health milestone has been achieved in the United States--the
rubella virus, a major cause of serious birth defects such as deafness and
blindness, also known as congenital rubella syndrome (CRS), is no longer
considered to be a major public health threat in the United States, Dr.
Julie Gerberding, director, Centers for Disease Control and Prevention,
announced at the National Immunization Conference today in Washington, DC.
"The elimination of rubella in the United States is a tremendous step in
protecting the health and well being of pregnant women and infants," said
Dr. Gerberding. "A disease that once seriously harmed tens of thousands of
infants is no longer a major health threat, thanks to a safe and effective
vaccine and successful immunization programs across the country. We should
take pride in this accomplishment, and also recognize that we must maintain
our vigilance or we can see a resurgence of disease."
Currently about 93 percent of the nation's children under age two are
vaccinated against measles, mumps, and rubella, according to the CDC's
National Immunization Survey. More than 95 percent of the nation's children
are vaccinated against rubella by the time they enter school. "The
importance of continuing vaccination cannot be emphasized enough," said Dr.
Steve Cochi, acting director, CDC's National Immunization Program. "Cases of
rubella continue to be brought into the country by worldwide travelers and
because of bordering countries where the disease is active."
During 1964 and 1965 a rubella epidemic in the United States caused an
estimated 12.5 million cases of rubella and 20,000 cases of congenital
rubella syndrome (CRS), which led to more than 11,600 babies born deaf,
11,250 fetal deaths, 2,100 neonatal deaths, 3,580 babies born blind, and
1,800 babies born mentally retarded.
Since reporting of rubella began in 1966, the largest number of rubella
cases reported was in 1969 with 57,686 cases. Following vaccine licensure in
1969 and development of a rubella vaccination program to prevent rubella
infection during pregnancy, rubella incidence fell rapidly. By 1983, fewer
than 1,000 cases were reported per year.
In 1989, CDC established a rubella elimination goal. [D]espite a resurgence
in rubella and measles cases during the measles epidemic from 1989-1991,
reported rubella cases in the 1990s declined to all-time low numbers. From
1990 through 1999, only 117 cases of CRS were reported; 66 of these babies
were born in 1990 and 1991. In 2001, for the first time in history, [fewer]
than 100 cases were reported in the United States. In 2003, there were only
eight rubella cases and one CRS case reported in the United States. In 2004,
there were only nine rubella cases reported in the United States.
Since the mid-1990s, the United States has worked closely with the Pan
American Health Organization (PAHO) and Mexico to improve rubella control in
the Americas. Those efforts have resulted in dramatic reductions of rubella
in many nations of the Americas. In September 2003, ministers of health of
all countries in the Americas resolved to eliminate rubella and CRS by 2010.
Last fall, an independent panel including internationally recognized
immunization experts from academia, the Council for State and Territorial
Epidemiologists (CSTE), the Advisory Committee on Immunization Practices (ACIP),
the American Academy of Pediatrics (AAP), the American Academy of Family
Physicians (AAFP), the Pan American Health Organization, Mexico, and the CDC
concluded that rubella virus in no longer endemic in the United States.
Rubella is prevented through vaccination. Rubella vaccine is recommended for
all children and for adolescents and adults without documented evidence of
immunity. It is especially important to verify that all women of
childbearing age are immune to rubella before they get pregnant.
Although it is available as a single preparation, it is recommended that
rubella vaccine be given as MMR vaccine (protecting against measles, mumps,
and rubella). The first dose of MMR should be given on or after the first
birthday; the recommended range is from 12-15 months. The second dose is
usually given when the child is 4-6 years old, or before he or she enters
kindergarten or first grade. Maintaining high coverage and rubella
population immunity in the United States among children and adults will be
important to maintain the benefits of achieving rubella elimination.
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To access a web-text (HTML) version of the press release, go to:
http://www.cdc.gov/od/oc/media/pressrel/r050321.htm
MMWR EARLY RELEASE
CDC published "Achievements in Public Health: Elimination of Rubella and
Congenital Rubella Syndrome--United States, 1969-2004" in the March 21 issue
of MMWR Early Release.
To access a web-text (HTML) version of it, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm54e321a1.htm
To access a ready-to-print (PDF) version of it, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm54e321.pdf
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March 28, 2005
CDC POSTS NEW NIIW RESOURCES TO THE NIP WEBSITE, OFFERS A TECHNICAL
ASSISTANCE TELECONFERENCE ON MARCH 29 AND 31
The March issue of CDC's Immunization Works electronic newsletter features
information about resources for National Infant Immunization Week (NIIW).
The information is reprinted below in its entirety.
****************
NATIONAL INFANT IMMUNIZATION WEEK: National Infant Immunization Week (NIIW)
will be held April 24-30, 2005. This week is set aside annually to promote,
through community events, the benefits of immunizations and highlight the
importance of vaccinating children by the age of 2. This year, NIIW will
again be held in conjunction with the Pan American Health Organization's
Vaccination Week in the Americas (VWA), April 23-30, 2005. The U.S. and 35
countries in the Western Hemisphere will promote the need for routine
vaccinations for infants and children.
To assist communities in promoting infant immunization during NIIW-VWA, CDC
has English- and Spanish-language resources to support local NIIW
activities. Materials and planning tools are available online at
www.cdc.gov/nip/events/niiw/2005/05default.htm and include
- Posters
- Web Buttons and Banners
- Television Public Service Announcements (PSAs);
available online the week of March 28
- Radio Public Service Announcements (PSAs);
available online the week of March 28
- Sample Key Messages
- Sample Media Advisory
- Sample Proclamations
- Stickers
- And more!
New this year--NIP will provide two
teleconferences so that program coordinators, health departments,
coalitions, and others can learn about the 2005 Spanish- and
English-language childhood campaign materials, television PSA satellite
downlink information, and tips for local placement of the campaign,
especially through minority media outlets. Teleconferences will be held on
March 29 at noon-1 p.m. (EST) and March 31 at 3 p.m.–4 p.m. (EST), and will
be led by NIP's childhood campaign contractor, HMA Associates, Inc., a
nationally recognized full-service multicultural marketing firm comprising
social marketing and public relations veterans with a variety of
communications backgrounds. To register for the teleconference and receive
connection information and materials, please email Cindy Alvarez at
ctg7@cdc.gov
Numerous events are planned in the United States to celebrate NIIW-VWA.
Other activities are also scheduled throughout the Western Hemisphere as
part of VWA. Find out how others will celebrate NIIW-VWA, and let us know
what you are doing to promote childhood immunization during the week, by
adding your events to the national NIIW-VWA event listing located at
http://www.cdc.gov/nip/events/niiw/2005/05activity.htm
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To access this information from the March issue of Immunization Works, go
to:
http://www.cdc.gov/nip/news/newsltrs/imwrks/2005/200503.htm#other
For additional material from the March issue of Immunization Works, see
article #5 below.
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March 28, 2005
NOTE: ON MARCH 29, IAC WILL PUBLISH AN UNPROTECTED PEOPLE REPORT ABOUT
RECENT VARICELLA DEATHS IN THE UNITED STATES
On March 29, IAC will publish an IAC Express Unprotected People report
about three recent varicella deaths in the United States. The report is
based on information reported to CDC by public health professionals in
Arizona, Arkansas, and New York.
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March 28, 2005
CDC REPORTS ON VARICELLA SURVEILLANCE IN OREGON PUBLIC ELEMENTARY SCHOOLS
CDC published "Varicella Surveillance in Public Elementary
Schools--Multnomah County, Oregon, 2002-2004" in the March 25 issue of
MMWR. A portion of a summary made available to the press is reprinted
below.
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Varicella vaccination may be reducing the occurrence of chickenpox in
Multnomah County public elementary schools: cases reported for the 2003-04
school year were 30 percent lower than [for] the previous school year, and
the actual numbers were small (86 and 114, respectively). Surveillance for
chickenpox is being conducted in Multnomah County public elementary
schools by the Oregon Department of Health Services and the Multnomah
Education Services District. Reports of chickenpox cases are collected
from school nurses.
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To access a web-text (HTML) version of the complete article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5411a3.htm
To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5411.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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March 28, 2005
NEW: THE MARCH ISSUE OF CDC'S IMMUNIZATION WORKS ELECTRONIC NEWSLETTER IS
NOW AVAILABLE ON THE NIP WEBSITE
The March 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 March issue has already appeared in
previous issues of IAC Express. Following is the text of four articles we
have not covered. One article, "National Infant Immunization Week,"
appears in this issue of IAC Express as article #2 (above).
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50TH ANNIVERSARY OF THE SALK POLIO VACCINE: April 12, 1955, heralds a
unique moment in our contemporary culture. That was the date that
culminated more than 17 years of unparalleled research that led to the
development and distribution of the first inactivated poliovirus vaccine
by Dr. Jonas Salk and other colleagues. The development of the vaccine was
an accomplishment that ended an era of global fear of a dreaded contagious
disease, and in the process, reshaped the conduct of science, the funding
of science, and the public's role in the support of science. These efforts
impacted the way that public health was administered and advanced the
general understanding of ways basic scientific research benefited humanity
though collaboration between academic, philanthropic, and government
institutions. April 12, 2005, marks the 50th anniversary of the
announcement that a safe, potent, and effective vaccine against polio had
been found.
The fight against polio brought together communities in a national
collaboration that at that time was the largest human cooperative effort
in history. In the days leading up to the vaccine's approval, children in
communities across the United States participated in the field trials as
America's "Polio Pioneers." Thousands of healthcare workers and lay people
volunteered their time to assist with the vaccine field trials, the
largest ever in United States history. Millions of Americans participated
by raising funds in their communities to support the larger research
effort and a single goal: victory over polio.
Although polio was eliminated from the Americas in 1994, the disease still
circulates in Asia and Africa, paralyzing the world's most vulnerable
children. In a continually shrinking world, polio and other
vaccine-preventable diseases remain only a plane ride away. The Global
Polio Eradication Initiative, spearheaded by the World Health
Organization, Rotary International, CDC, and UNICEF, was begun in 1988.
That year, an estimated 350,000 children were paralyzed with polio
worldwide; in 2004, polio cases had fallen to just over 1,200 cases
globally. The Initiative's success will be a triumph of international
cooperation, attesting to our ability to unite across borders and
differences to conquer global public health issues.
Since the introduction of the vaccine, great strides have been made in
significantly reducing the health impact of vaccine-preventable diseases
on children and adults worldwide. We can now protect children from more
than 12 vaccine-preventable diseases, and disease rates have been reduced
by 99% in the U.S. Yet, without diligent efforts to maintain immunization
programs in the U.S. and strengthen them worldwide, the diseases seen 50
years ago remain a threat to our children.
Commemorative Events
Public events, which will be occurring on April 12, include the opening of
a year-long exhibit at the Smithsonian's National Museum of American
History on "Whatever Happened to Polio," as well as symposiums at the
University of Michigan (where the trials were conducted) and the
University of Pittsburgh (where the vaccine was discovered).
In an effort to promote the anniversary, CDC has information related to
the anniversary available on our website. The information includes
timelines, background information, links to key organizations, and general
promotional materials. The information may be found at
http://www.cdc.gov/nip/events/polio-vacc-50th
This day is a powerful marker that can be used to create sustainable,
proactive awareness and action in vaccine-preventable diseases and public
health nationally and globally. As we approach the 50th anniversary of the
discovery of polio vaccine, we have a unique opportunity to leverage
history to create a better future for our children.
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OTHER IMMUNIZATION NEWS
DISCONTINUATION OF NATIONAL REPORTING OF INVASIVE PNEUMOCOCCAL DISEASE IN
CHILDREN VACCINATED WITH PNEUMOCOCCAL CONJUGATE VACCINE (PCV7): CDC is no
longer requesting reports of cases of invasive pneumococcal disease
occurring in children who have received the pneumococcal conjugate
vaccine. For the last several years, CDC has requested these reports and
has been analyzing the strains to evaluate possible vaccine failures.
Because the number of reported cases in vaccinated children is now
adequate to permit analysis, and surveillance data indicate that the
disease rates have dropped dramatically, these reports are no longer
needed. In special situations requiring the typing of pneumococci, CDC
should be contacted at (404) 639-2215. We are grateful for the efforts of
those who have participated in this reporting system during the last few
years.
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CDC VACCINE SAFETY ACTIVITIES: CDC is taking an initial series of four
steps to build a more robust vaccine safety activity to keep pace with the
increasing number and combinations of recommended immunizations,
especially for children under 2. CDC's initial steps to strengthen efforts
to protect children's health and safety include the following:
- Increasing the resources for
immunization safety research and immunization safety activities,
- Working with sister agencies in the
Department of Health and Human Services to define vaccine safety
research and safety monitoring priorities and agenda for addressing
gaps,
- Separating the vaccine safety activity
from CDC's immunization education and recommendation programs and moving
the vaccine safety activity to CDC's Office of the Chief of Science, and
- Emphasizing the transparency of CDC's
science and research work regarding immunization safety issues with
continued communication between it and concerned parents, public
officials, and healthcare professionals.
When making immunization recommendations, CDC
is committed to a scientifically thorough and transparent decision process.
We intend to make our safety program even stronger and respect ongoing input
from those who share our concerns. Although no single step can satisfy
everyone, we believe these new actions will help reassure the public that we
are absolutely committed to protecting our children's health and safety.
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MEETINGS, CONFERENCES, AND RESOURCES
CDC-WIDE RESEARCH AGENDA: CDC is developing a CDC-Wide Research Agenda and
invites the public to provide input during four Public Participation
Meetings held during March 2005. Meetings have already been held in
Washington, DC, and Atlanta, GA. A meeting is scheduled in Seattle, WA,
March 24 and in Columbus, OH, March 31. To attend these meetings, please
register at
http://www.maximumtechnology.com/cdcreg.htm Additional information
on development of the CDC-Wide Research Agenda is available by visiting
www.cdc.gov/od/ophr/cdcra.htm
The Infectious Diseases Workgroup has developed agenda themes specific to
immunization. Other topics of interests are integrated generally across many
of the other five workgroups--Health Promotion; Environmental and
Occupational Health and Injury Prevention; Health Information and Services;
Global Health; and Community Preparedness and Response. Future opportunities
for comment on the CDC-Wide Research agenda will be announced in the Federal
Register in June 2005.
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To access the complete March issue from the NIP website, go to:
http://www.cdc.gov/nip/news/newsltrs/imwrks/2005/200503.htm
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March 28, 2005
CDC REPORTS ON PROGRESS TOWARD POLIO ERADICATION IN AFGHANISTAN AND
PAKISTAN IN 2004-05
CDC published "Progress Toward Poliomyelitis Eradication--Afghanistan
and Pakistan, January 2004-February 2005" in the March 25 issue of MMWR.
A portion of a summary made available to the press is reprinted below.
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Although poliomyelitis remained endemic in six countries at the end of
2003, progress toward interrupting poliovirus transmission continued
during 2004 in Afghanistan and Pakistan, which with India are the only
countries in Asia where poliomyelitis is endemic. From 2003 to 2004, the
number of reported polio cases decreased approximately 50 percent in
both countries. Although the quality of national and sub-national
immunization campaigns is improving, children are still being missed.
The achievements to date toward eradicating polio in Afghanistan and
Pakistan would not have been possible without continued support from the
international polio partnership, especially from political and health
leaders at national, provincial, and district levels in both countries.
With continued support, elimination of poliomyelitis in both countries
can be accomplished by the end of 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/mm5411a4.htm
To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5411.pdf |
