Issue Number 557            October 10, 2005

CONTENTS OF THIS ISSUE

  1. Updated interim VIS for meningococcal vaccine has information about possible association between Menactra and Guillain-Barre syndrome
  2. New: NIP website posts the latest information about VISs currently under development
  3. New: Minnesota infant contracts vaccine-derived polio virus; NIP website posts page of FAQs about polio
  4. Researchers reconstruct the 1918 pandemic influenza virus with hope of learning how to avert future pandemics
  5. Updated: Five IAC pieces related to viral hepatitis have been revised
  6. New: Alaska mandates education about meningococcal disease and vaccine for college students; three more states let pharmacists vaccinate
  7. New: October 5 issue of Hep Express electronic newsletter now available online
  8. New: UNICEF issues Progress for Children, a report card on worldwide childhood immunization

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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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October 10, 2005
UPDATED INTERIM VIS FOR MENINGOCOCCAL VACCINE HAS INFORMATION ABOUT POSSIBLE ASSOCIATION BETWEEN MENACTRA AND GUILLAIN-BARRE SYNDROME

On October 7, NIP posted this announcement to the News page of its section on Vaccine Information Statements:

"In light of reports of several cases of Guillain-Barre Syndrome following vaccination with meningococcal conjugate vaccine (Menactra), the VIS has been revised to include information about the potential association between the vaccine and the disease. Dated 10/7/05, the revised VIS is available now and should be used." To access the News page, go to: http://www.cdc.gov/nip/publications/VIS/vis-news.htm Click on Meningococcal to go to the pertinent information.

To access the updated interim VIS from the NIP website, go to:
http://www.cdc.gov/nip/publications/VIS/vis-mening.pdf

To access it from the VIS section of the IAC website, go to:
http://www.immunize.org/vis/menin05.pdf

For information about the use of VISs, and for VISs in a total of 33 languages, visit IAC's VIS web section at http://www.immunize.org/vis
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October 10, 2005
NEW: NIP WEBSITE POSTS THE LATEST INFORMATION ABOUT VISs CURRENTLY UNDER DEVELOPMENT

VISs for several vaccines are currently under development. For those interested in the progress of VIS development, the NIP website has added a News page to its section on Vaccine Information Statements. To access it, go to: http://www.cdc.gov/nip/publications/VIS/vis-news.htm
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October 10, 2005
NEW: MINNESOTA INFANT CONTRACTS VACCINE-DERIVED POLIO VIRUS; NIP WEBSITE POSTS PAGE OF FAQs ABOUT POLIO

On October 1, the Minnesota Department of Health (MDH) issued a press release about an immunocompromised infant who became infected with the virus that causes polio. On October 3, the NIP website posted a page of FAQs (frequently asked questions) about polio for the public. Portions of the MDH press release are reprinted below; the link to NIP's page of FAQs is given at the end of this article.

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INFECTION WITH POLIO VIRUS REPORTED IN MINNESOTA INFANT
Child has no symptoms of paralytic disease; officials say general public is not at risk

The Minnesota Department of Health (MDH) is investigating a reported case of infection with the virus that causes polio in an infant from central Minnesota.

The infant, who had previously been diagnosed with immune system problems, does not have symptoms of the paralytic illness that can sometimes result from a polio infection. The infant is currently hospitalized. Further information regarding the infant cannot be released due to state and federal data practices laws.

Health Department officials emphasize that only people who have had direct contact with the infant--including unimmunized healthcare providers and family members--are at any risk of illness in connection with this case. At this time, no additional cases of infection with the poliovirus have been reported in connection with the infant. The general public is at no risk from this case.

This is the first case of polio infection reported in the U.S. since 2000, when use of live-virus oral polio vaccine was discontinued in the U.S. All polio vaccinations in the U.S. are now done with an injected, killed-virus vaccine. . . .

MDH officials say the virus strain found in the Minnesota infant appears to be a variant of the strain used in the oral vaccine, which is still used in some parts of the world. . . .

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To access the complete press release, go to:
http://www.health.state.mn.us/news/pressrel/polio100105.html

To access NIP's page of FAQs about polio, go to:
http://www.cdc.gov/nip/diseases/polio/faqs.htm
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October 10, 2005
RESEARCHERS RECONSTRUCT THE 1918 PANDEMIC INFLUENZA VIRUS WITH HOPE OF LEARNING HOW TO AVERT FUTURE PANDEMICS

On October 7, the journal Science reported on new research findings derived from the successful reconstruction of the virus that caused the 1918-19 influenza pandemic. The article, "Characterization of the reconstructed 1918 Spanish influenza pandemic virus," was written by TM Tumpey and his colleagues at CDC. The complete text is available only to members of the American Association for the Advancement of Science, which publishes Science. The abstract is available at PubMed. On October 6, the journal Nature published "The 1918 flu virus is resurrected," a special report on the risks and benefits of reconstructing the virus.

In response to the publication of the Science and Nature articles, the National Institute of Allergy and Infectious Disease (NIAID) and CDC each issued news releases about the virus reconstruction, and CDC posted a Q&A section about it. Portions of the NIAID news release are reprinted below. Links to it, the CDC news release, the Q&A section, the abstract of the Science article, and the Nature special report are given at the end of this article.

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Statement
October 5, 2005

UNMASKING THE 1918 INFLUENZA VIRUS: An Important Step Toward Pandemic Influenza Preparedness

Anthony S. Fauci, MD, director, National Institute of Allergy and Infectious Diseases, National Institutes of Health,and Julie L. Gerberding, MD, MPH, director, Centers for Disease Control and Prevention

The mysteries of the 1918-1919 influenza pandemic, [which] killed an estimated 50 million people across the globe, are finally beginning to be solved. Two scientific papers published this week provide insights into the virus that caused the most deadly influenza outbreak in modern history. This virus was unusual because it spread so quickly, was so deadly, and exacted its worst toll among the young and healthy. In just over one year, the virus infected one-third of the world's population with death rates approximately 50 times higher than those associated with regular seasonal influenza.

The harsh reality of the 1918 pandemic is never far from the minds of scientists and public health officials who are monitoring the current influenza outbreak occurring in Asia. Since December 2003, a strain of influenza virus that usually infects only birds has sickened at least 116 people and killed 60 in Thailand, Vietnam, Cambodia, and Indonesia. . . [K]nown as H5N1 avian influenza A virus, . . . the virus is not easily passed from birds to humans, and thankfully, is not efficiently spread from one person to another when it does cross species. However, influenza viruses are notoriously capable of changing, and should the avian virus develop the ability to spread easily among people, a worldwide influenza pandemic could ensue, potentially rivaling in impact the 1918-1919 pandemic.

Understanding why and how influenza virus can reach global proportions and cause so many deaths is now an urgent imperative. The new research findings, published in the journals Science and Nature, provide critical clues to the genesis of the 1918 pandemic and why it was so lethal. The findings reveal essential information to help us speed our preparation for--and potentially thwart--the next influenza pandemic. For the first time, researchers have deciphered the entire gene sequence of the 1918 virus and have used sophisticated techniques to assemble viruses that bear some or all of these genes so their effects can be understood. Importantly, they have identified gene sequences that may predict when an influenza virus strain is likely to spread among humans. . . .

. . . [S]ome have understandably questioned whether these research findings should be reported in scientific journals because of concern that this knowledge could be used by those with nefarious intent. . . .

The rationale for publishing the results and making them widely available to the scientific community is to encourage additional research at a time when we desperately need to engage the scientific community and accelerate our ability to prevent pandemic influenza. It would be impossible and counterproductive to attempt to enforce a worldwide ban on conducting research on the 1918 influenza virus or similar viruses because of fear of the misuse of such knowledge. Likewise, the dissemination of information emanating from this research should not be suppressed; rather, we must foster a culture of responsibility among the scientific community such that research is conducted under the safest possible conditions and research results are presented openly and responsibly for the purpose of improving human health. . . .

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To access the complete NIAID news release, go to:
http://www3.niaid.nih.gov/news/newsreleases/2005/0510state.htm

To access the CDC news release, go to:
http://www.cdc.gov/od/oc/media/pressrel/r051005.htm

To access CDC's Questions & Answers: Reconstruction of the 1918 Influenza Pandemic Virus, go to:
http://www.cdc.gov/flu/about/qa/1918flupandemic.htm

To access a web-text (HTML) version of the abstract of the Science article, click here.

To access a ready-to-print (PDF) version of the Nature special report, go to:
http://www.nature.com/nature/journal/v437/n7060/pdf/437794a.pdf

To access a web-text (HTML) version of it, go to:
http://www.nature.com/nature/journal/v437/n7060/full/437794a.html
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October 10, 2005
UPDATED: FIVE IAC PIECES RELATED TO VIRAL HEPATITIS HAVE BEEN REVISED

[The following is cross posted from IAC's Hep Express electronic newsletter, 10/05/05.]

IAC recently updated the following five print pieces.

(1) "Brief Introduction to Hepatitis B for Parents of Adopted Children" by S.J. Schwarzenberg, MD, University of Minnesota, was revised slightly to take into account new treatment options for chronic HBV [hepatitis B virus] infection.

To obtain the document in ready-to-print (PDF) format, go to:
http://www.immunize.org/catg.d/4150intr.pdf

To obtain it in web-text (HTML) format, go to:
http://www.immunize.org/catg.d/4150intr.htm

(2) "You are not alone! Information for young adults who are chronically infected with HBV" by S.J. Schwarzenberg, MD, University of Minnesota; and K. Wainwright, RN, Alaska Area Native Health Service, Anchorage, was revised slightly to take into account new treatment options for chronic HBV infection.

To obtain the document in ready-to-print (PDF) format, go to:
http://www.immunize.org/catg.d/4118.pdf

To obtain it in web-text (HTML) format, go to:
http://www.immunize.org/catg.d/4118.htm

(3) "If you, your parents, or your children were born in any of these places. . ." was revised slightly to take into account new treatment options for chronic HBV infection.

To obtain the document in ready-to-print (PDF) format, go to:
http://www.immunize.org/catg.d/p4170ref.pdf

To obtain it in web-text (HTML) format, go to:
http://www.immunize.org/catg.d/p4170.htm

(4) "Should you be tested for hepatitis C? A screening questionnaire for adults" was updated to reflect current information and encourage testing and treatment when indicated.

To obtain the document in ready-to-print (PDF) format, go to:
http://www.immunize.org/catg.d/2192hepc.pdf

To obtain it in web-text (HTML) format, go to:
http://www.immunize.org/catg.d/2192hepc.htm

(5) "If you have HIV infection, which vaccinations do you need?" is a substantially revised version of the 1997 print piece "Shots for Adults with HIV."

To obtain the document in ready-to-print (PDF) format, go to:
http://www.immunize.org/catg.d/p4041hiv.pdf

To obtain it in web-text (HTML) format, go to
http://www.immunize.org/catg.d/p4041hiv.htm
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October 10, 2005
NEW: ALASKA MANDATES EDUCATION ABOUT MENINGOCOCCAL DISEASE AND VACCINE FOR COLLEGE STUDENTS; THREE MORE STATES LET PHARMACISTS VACCINATE.

In recent months four states have made changes in their vaccination requirements. Here's an update:

Alaska. The governor signed a bill May 17 that requires all post-secondary educational institutions to provide information on meningococcal disease and the vaccine to all students who intend to reside in campus housing for the first time. The requirement became effective May 18.

IAC has compiled information about all states that have meningococcal-prevention mandates for colleges and universities. To access the information, 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

Arizona, Connecticut, and Vermont. These three states now authorize pharmacists to vaccinate. This brings the number of states granting pharmacists permission to vaccinate to 44.

IAC has compiled information about all states that authorize pharmacists to vaccinate. To access the information, go to:
http://www.immunize.org/laws/pharm.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/pharmmap.pdf

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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October 10, 2005
NEW: OCTOBER 5 ISSUE OF HEP EXPRESS ELECTRONIC NEWSLETTER NOW AVAILABLE ONLINE

The October 5 issue of Hep Express, an electronic newsletter published by IAC, is now available online. It is intended for health and social service professionals involved in the prevention and treatment of viral hepatitis. IAC Express has already covered some of the information presented in the October 5 Hep Express; titles of articles we have not already covered follow.

  • November 1 is deadline for sponsor and exhibitor registration for National Viral Hepatitis Prevention Conference
  • IAC adds Spanish-language resource section to its hepatitis prevention programs website
  • CDC adds Spanish-language viral hepatitis FAQs
  • Clinical Care Options offers continuing education opportunities related to viral hepatitis
  • Michigan offers hepatitis C conference on October 27; early registration deadline is October 7

To access the October 5 issue, go to:
http://www.hepprograms.org/hepexpress/issue35.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
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October 10, 2005
NEW: UNICEF ISSUES PROGRESS FOR CHILDREN, A REPORT CARD ON WORLDWIDE CHILDHOOD IMMUNIZATION

On September 29, UNICEF issued a press release announcing the publication of the most current edition of Progress for Children, the organization's report card on worldwide childhood immunization. Portions of the press release are reprinted below; links to Progress for Children are given at the end of this article.

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ONE IN FOUR INFANTS STILL AT RISK FROM VACCINE PREVENTABLE DISEASES
An estimated 27 million children and 40 million pregnant women not immunized each year; 41 countries protecting fewer children than over a decade ago.

New country-by-country data reveal inadequate progress on protecting children and women from vaccine-preventable diseases, despite the availability of low-cost vaccines, according to a UNICEF study released today.

Each year since 1990, immunization with routine vaccines has reached more than 70 percent of children worldwide. At the UN General Assembly Special Session in 2002, the international community adopted the specific target of immunizing by 2010 at least 90 percent of children under one year of age in each country.

This edition of Progress for Children shows that 103 countries are already protecting 90 percent of their children against vaccine-preventable diseases and another 16 are making steady progress. However in 74 countries programs have not kept up, or progress is too slow. . . .

Some 10.6 million children under five die every year. Around two-thirds of these deaths are preventable, including an estimated 1.4 million deaths from vaccine-preventable diseases. The major killers are measles, haemophilus influenzae type b (Hib), whooping cough (pertussis), and neonatal tetanus. These diseases are all preventable with vaccines that are currently available.

In the near future, an additional 1.1 million deaths could be prevented with vaccines against pneumococcus and rotavirus, which are important causes of severe pneumonia and diarrhea in developing countries. In total, immunization programs could reduce deaths among children under five by almost one-quarter, if coverage of more than 90 per cent can be attained for routine immunization. . . .

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To access the complete press release, go to:
http://www.unicef.org/media/media_28400.html

To order a free copy of the 2005 edition of Progress for Children online, or to access it in ready-to-print (PDF) and web-text (HTML) formats, go to: http://www.unicef.org/publications/index_28135.html Scroll down, and click on the appropriate option.

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Editorial Information

  • Editor-in-Chief
    Kelly L. Moore, MD, MPH
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    John D. Grabenstein, RPh, PhD
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    Courtnay Londo, MA
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