Immunization Action Coalition and the Hepatitis B Coalition

IAC EXPRESS

Previous issues index

Home page

Issue Number 590            April 3, 2006

CONTENTS OF THIS ISSUE

  1. CDC reports on current mumps epidemic in Iowa
  2. CDC releases updated hepatitis A VIS
  3. New: Two more excellent thimerosal resources from Dr. Paul Offit are now online
  4. Society of Adolescent Medicine's position paper on adolescent immunization published in Journal of Adolescent Health
  5. IAC revises three hepatitis education pieces for patients
  6. CDC updates its Influenza web section
  7. FDA approves the use of the antiviral drug Relenza for preventing influenza, as well as treating it
  8. March 29 issue of Hep Express now available online
  9. May 18–19 are the dates for North Dakota's Vaccination Expedition 2006

----------------------------------------------------------

Back to Top

---------------------------------------------------------------

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.
---------------------------------------------------------------

(1 of 9)
April 3, 2006
CDC REPORTS ON CURRENT MUMPS EPIDEMIC IN IOWA

CDC published "Mumps Epidemic—Iowa, 2006" in the March 30 issue of MMWR Dispatch. The article is reprinted below in its entirety, excluding references.

***********************

In the United States, since 2001, an average of 265 mumps cases (range: 231–293 cases) have been reported each year, and in Iowa, an average of five cases have been reported annually since 1996. However, in 2006, by March 28, a total of 219 mumps cases had been reported in Iowa, and an additional 14 persons with clinically compatible symptoms were being investigated in three neighboring states (11 in Illinois, two in Nebraska, and one in Minnesota) in what has become the largest epidemic of mumps in the United States since 1988. This report summarizes and characterizes the ongoing mumps epidemic in Iowa, the public health response, and recommendations for preventing further transmission.

Mumps is an acute viral infection characterized by fever and nonsuppurative swelling of the salivary glands; an estimated 20%–30% of cases are asymptomatic. Complications can include inflammation of the testicles or ovaries, meningitis/encephalitis, spontaneous abortion, and deafness. During the prevaccine era, nearly everyone in the United States experienced mumps, and 90% of cases occurred among children aged [younger than] 15 years. In 1977, Iowa law mandated 1 dose of measles, mumps, and rubella (MMR) vaccine for entry to public schools; in 1991, the mandate became 2 doses. For the 2004–05 school year, 97% of children entering school in Iowa had received 2 doses of MMR vaccine.

The first reports to the Iowa Department of Public Health (IDPH) of mumps-like illness occurred in December 2005 at a university in eastern Iowa, where several students with glandular swelling were tested; two tested positive for mumps-specific IgM antibodies. In mid-January 2006, an isolate from an unrelated patient was cultured and identified as mumps virus at the University Hygienic Laboratory (Iowa's state public health laboratory). Viral isolates were sent to CDC, and the mumps strain was identified as genotype G. By mid-February, active surveillance had been initiated in seven geographic areas, including the campuses of the three largest universities in Iowa.

Of the 219 cases reported in Iowa, the median patient age was 21 years (range: 3–85 years), with 48% of patients aged 17–25 years; 30% (34 of 114) were known to be college students. Of the 133 patients with investigated vaccine history, 87 (65%) had documentation of receiving 2 doses, 19 (14%) 1 dose, and eight (6%) no doses; vaccine status could not be documented in 19 (14%) patients. Among the 114 patients for whom symptomatic information was available, the most common symptoms were parotitis in 94 (83%) patients, submaxillary/sublingual gland swelling in 46 (40%), fever in 41 (36%), and sore throat in 36 (32%); average duration of illness was 5.1 days. Six (5%) patients reported complications (e.g., orchitis); one suspected case of encephalitis is being investigated. As of March 28, 2006, investigators had determined that only 36 (16%) of the 219 cases were linked epidemiologically (i.e., a source of infection was identified), suggesting frequent unapparent transmission.

The source of the Iowa epidemic is unknown; however, the United Kingdom (UK) experienced a recent mumps epidemic that peaked during 2005 with approximately 56,000 cases and a high attack rate among young adults. The mumps strain in the UK epidemic also was identified as genotype G, and the UK epidemic has been linked to a 2005 mumps outbreak in the United States.

To educate healthcare professionals in Iowa regarding the epidemic and mumps, information has been distributed via Iowa's Health Alert Network (HAN), in weekly electronic newsletters, and via frequent conference calls. The IDPH website has provided biweekly updates, county case counts, fact sheets, and guidance to local health departments and healthcare facilities on case investigations. IDPH recommendations include (1) requesting at least 5 days of isolation for all patients (quarantine is not being used), (2) ensuring that students and staff members on all Iowa college campuses have had 2 doses of MMR or are immune from mumps, (3) assessing vaccination status of all healthcare professionals in Iowa and offering vaccination where appropriate, and (4) sending all specimens collected from possible cases to University Hygienic Laboratory for testing.

Despite control efforts and a highly vaccinated population, this epidemic has spread across Iowa and potentially to neighboring states. Ongoing investigations will focus on identifying actual vaccine coverage on college campuses, potential modes of mumps transmission, and the effectiveness of 1 or 2 doses of MMR.

***********************

To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm55d330a1.htm

To access a ready-to-print (PDF) version of this issue of MMWR Dispatch, go to: http://www.cdc.gov/mmwr/PDF/wk/mm55d330.pdf

To receive a FREE electronic subscription to MMWR (which includes new ACIP statements), go to:
http://www.cdc.gov/mmwr/mmwrsubscribe.html
---------------------------------------------------------------

Back to Top

(2 of 9)
April 3, 2006
CDC RELEASES UPDATED HEPATITIS A VIS

[The following is cross posted from IAC's Hep Express electronic newsletter, 3/29/06.]

On March 21, 2006, CDC posted an updated hepatitis A VIS that takes into account the licensing of hepatitis A vaccines for children 12 months and older and the ACIP recommendation for routine hepatitis A vaccination of all children age one year. The previous hepatitis A VIS, dated 1/09/06, was an interim version.

To obtain a ready-to-copy (PDF) version of the hepatitis A VIS, go to:
http://www.immunize.org/vis/v-hepa.pdf

Please note that the new VIS (dated 3/21/06) is currently available only in English.

For information about the use of VISs, and for VISs in up to 33 languages, visit IAC's VIS web section at http://www.immunize.org/vis
---------------------------------------------------------------

Back to Top

(3 of 9)
April 3, 2006
NEW: TWO MORE EXCELLENT THIMEROSAL RESOURCES FROM DR. PAUL OFFIT ARE NOW ONLINE

If you are looking for authoritative information on the topic of thimerosal and vaccine safety, the websites of the Vaccine Education Center (VEC) of Children's Hospital of Philadelphia and of Every Child By Two (ECBT) may be able to help you. Both resources are the work of Paul Offit, MD. An immunization expert, Dr. Offit is chief, Division of Infectious Diseases, Children's Hospital of Philadelphia, and professor of pediatrics and Maurice R. Hilleman Professor of Vaccinology, University of Pennsylvania School of Medicine.

FROM THE VEC WEBSITE
VEC recently posted a summary for parents of the evidence explaining that thimerosal is not a cause of autism. To access it, go to:
http://www.chop.edu/consumer/jsp/division/generic.jsp?id=75751

FROM THE ECBT WEBSITE
ECBT recently posted the audio file and podcast of a conference call Dr. Offit conducted with members of the media on March 15. The call begins with his review of the scientific evidence disproving that the thimerosal in vaccines is a cause of autism. The call concludes with his answers to questions from the press.

To access the audio file, go to: http://72.32.4.217/ecbt/vaccinesafety.htm Scroll down and click on the link titled Dr. Paul Offit Discussing Vaccine Safety and Autism.

To access the podcast, open your PC software and copy the following URL to the podcast location:
http://www.ecbt.org/OffitBroadcast.rss
---------------------------------------------------------------

Back to Top

(4 of 9)
April 3, 2006
SOCIETY OF ADOLESCENT MEDICINE'S POSITION PAPER ON ADOLESCENT IMMUNIZATION PUBLISHED IN JOURNAL OF ADOLESCENT HEALTH

"Adolescent immunizations: A position paper of the Society for Adolescent Medicine" was published in the March issue of the Journal of Adolescent Health. The abstract is reprinted below.

********************

ABSTRACT
New vaccines are being targeted to help protect the adolescent population from disease. The Society for Adolescent Medicine strongly urges compliance with adolescent vaccination recommendations provided by the Advisory Committee on Immunization Practices. These vaccines will significantly impact the health and well-being of the adolescent population. To enhance vaccination compliance and access to prevention health care and promotion, the Society supports linking vaccination to the three distinct comprehensive preventive health care visits already recommended by multiple organizations during early, middle, and late adolescence. In addition, multiple provider strategies should be used to increase vaccination rates among adolescents.

********************

To access the entire paper, go to:
http://www.adolescenthealth.org/PositionPaper_Immunization.pdf
---------------------------------------------------------------

Back to Top

(5 of 9)
April 3, 2006
IAC REVISES THREE HEPATITIS EDUCATION PIECES FOR PATIENTS

[The following is cross posted from IAC's Hep Express electronic newsletter, 3/29/06.]

IAC recently updated three hepatitis-related print pieces intended for patients/clients. All three were revised to take into account the new ACIP recommendations for hepatitis A vaccination and the change in hepatitis A vaccine licensures.

To access a ready-to-print (PDF) version of "Hepatitis A is a serious liver disease," go to:
http://www.immunize.org/catg.d/p4080.pdf

To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/p4080a.htm

To access a ready-to-print (PDF) version of "Should You Be Vaccinated Against Hepatitis A? A screening questionnaire for adults," go to:
http://www.immunize.org/catg.d/2190hepa.pdf

To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/2190hepa.htm

To access a ready-to-print (PDF) version of "Hepatitis A, B, and C: Learn the differences," go to:
http://www.immunize.org/catg.d/p4075abc.pdf

To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/p4075abc.htm
---------------------------------------------------------------

Back to Top

(6 of 9)
April 3, 2006
CDC UPDATES ITS INFLUENZA WEB SECTION

CDC recently updated eight pages of its Influenza web section. Six pages were updated on March 31 as a result of the FDA approving the antiviral medication zanamivir for treatment of influenza (see article #7 below); two pages were updated to reflect the spread of avian influenza to animals in Jordan.

  1. Antiviral agents for influenza: Background information for clinicians (posted 3/31/06)
  2. Antiviral drugs and influenza (posted 3/31/06)
  3. Avian influenza infection in humans (posted 3/31/06)
  4. Antiviral agents for influenza: Dosage (posted 3/31/06)
  5. Recommendations for using antiviral agents for influenza (posted 3/31/06)
  6. Antiviral agents for influenza: Indications for use (posted 3/31/06)
  7. Embargo of birds from specified countries [Jordan added to embargo] (posted 3/29/06)
  8. Avian influenza: Current situation [Jordan added to list of countries reporting animal cases] (posted 3/27/06)

To access these materials, go to: http://www.cdc.gov/flu/whatsnew.htm#updated and click on the pertinent links.

To access a broad range of continually updated information on seasonal influenza, avian influenza, and pandemic influenza, go to: http://www.cdc.gov/flu
---------------------------------------------------------------

Back to Top

(7 of 9)
April 3, 2006
FDA APPROVES THE USE OF THE ANTIVIRAL DRUG RELENZA FOR PREVENTING INFLUENZA, AS WELL AS TREATING IT

On March 29, FDA issued a press release announcing that it has approved the use of Relenza for preventing influenza. Previously, the drug was licensed only for influenza treatment. The opening paragraph of the press release is reprinted below.

*****************

For immediate release
March 29, 2006

FDA APPROVES A SECOND DRUG FOR THE PREVENTION OF INFLUENZA A AND B IN ADULTS AND CHILDREN

The Food and Drug Administration (FDA) today approved the use of Relenza (zanamivir for inhalation) for prevention (prophylaxis) of influenza (flu) in adults and children 5 years of age and older. Relenza, an antiviral medication, was previously approved for the treatment of influenza A and B virus infections in adults and children. Tamiflu (oseltamivir phosphate) previously was approved for both prevention and treatment of flu; today's approval of Relenza for prevention provides Americans with another option for the prevention of influenza A and B infections. . . .

*****************

To access the complete press release, go to:
http://www.fda.gov/bbs/topics/news/2006/new01341.html
---------------------------------------------------------------

Back to Top

(8 of 9)
April 3, 2006
MARCH 29 ISSUE OF HEP EXPRESS NOW AVAILABLE ONLINE

The March 29 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 March 29 issue; titles of articles we have not yet covered follow.

  • LOLA sponsors second Hepatitis C March in New York City on May 18
  • International HBV Meeting scheduled for September 17–20 in Vancouver, Canada
  • SIGN 2005 meeting report now online
  • National Task Force on Hepatitis B: Focus on Asian and Pacific Islander Americans works to reduce hepatitis B-related mortality and morbidity
  • Dr. Raymond Schinazi receives HBF scientific award for 2005

To access the March 29 issue, go to:
http://www.hepprograms.org/hepexpress/issue42.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
---------------------------------------------------------------

Back to Top

(9 of 9)
April 3, 2006
MAY 18–19 ARE THE DATES FOR NORTH DAKOTA'S VACCINATION EXPEDITION 2006

Vaccination Expedition 2006: A North Dakota Adventure will feature presentations by two nationally recognized immunization experts, William Atkinson, MD, MPH, from CDC's National Immunization Program, and Paul Offit, MD, from the Vaccine Education Center at Children's Hospital of Philadelphia.

Sponsored by Grand Forks Public Health, the conference will be held in the Alerus Center in Grand Forks on May 18–19. For registration and program information email Kathy Dunn at kdunn@grandforksgov.com or call (701) 787-8100.

 

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 April 3, 2006