Issue Number 620            September 11, 2006

CONTENTS OF THIS ISSUE

  1. New: CDC releases interim VIS for human papillomavirus vaccine
  2. Postexposure prophylaxis urged for those exposed to rabid horse at Tennessee Walking Horse 2006 National Celebration
  3. More than 100 million doses of influenza vaccine will be produced for the U.S. market for 2006-07
  4. Influenza vaccine VISs available in Spanish; other immunization educational pieces now in Arabic, Thai, and Japanese
  5. New: Current Issues in Immunization net conference to focus on avian influenza
  6. New: Federal government launches Pandemic Influenza website in Spanish-language format
  7. Reminder that perinatal hepatitis B virus (HBV) is a nationally notifiable condition
  8. September 7 issue of Hep Express electronic newsletter available online
  9. CDC reports on 2006 measles outbreak in Fiji

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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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September 11, 2006
NEW: CDC RELEASES INTERIM VIS FOR HUMAN PAPILLOMAVIRUS VACCINE

On September 5, CDC released an interim VIS for human papillomavirus (HPV) vaccine. The final VIS will be developed after ACIP recommendations are published in MMWR and the vaccine
is covered by the Vaccine Injury Compensation Program.

To obtain a ready-to-print (PDF) version of the interim VIS from the CDC website, go to:
http://www.cdc.gov/nip/publications/VIS/vis-hpv.pdf

To obtain it from the IAC website, go to:
http://www.immunize.org/vis/hpv.pdf

For information about the use of VISs, and for VISs in more than 30 languages, visit IAC's VIS web section at http://www.immunize.org/vis
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September 11, 2006
POSTEXPOSURE PROPHYLAXIS URGED FOR THOSE EXPOSED TO RABID HORSE AT TENNESSEE WALKING HORSE 2006 NATIONAL CELEBRATION

On September 9, CDC issued a Health Advisory reporting that a horse stabled on the grounds of the Tennessee Walking Horse 2006 National Celebration tested positive for rabies. Approximately 150,000 people attended the event. The Health Advisory is reprinted below in its entirety.

PLEASE NOTE: The CDC'S Health Alert Network (HAN) website has been relocated. If you maintain or contribute to a website that links to the CDC HAN website you should update the link. The new website location is http://www2a.cdc.gov/HAN

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This is an official CDC Health Advisory

Distributed via Health Alert Network
Saturday, September 9, 2006, 20:44 EDT (08:44 PM EDT)

HORSE STABLED AT TENNESSEE WALKING HORSE 2006 NATIONAL CELEBRATION TESTED POSITIVE FOR RABIES

The Tennessee Department of Health (TDH) with the assistance of the Centers for Disease Control and Prevention (CDC) are notifying the approximately 150,000 persons who attended the Tennessee Walking Horse National Celebration in Shelbyville of a confirmed case of rabies in a horse stabled on the grounds during the event. If persons were bitten or came in contact with saliva from this horse (described below) from August 23-31, 2006, while attending the Celebration, they may have been exposed to rabies and are invited to contact TDH for an assessment.

Rabies is a viral infection that nearly always results in fatal encephalitis. Humans may be exposed to rabies primarily through the bite of a rabid animal or when the virus is introduced into fresh open cuts in the skin or onto mucous membranes such as the eyes, mouth, or nose from the saliva of a rabid animal. Attending an event where a rabid animal was present, petting a rabid animal, or contact with the blood, urine, or feces of a rabid animal does not constitute a risk for transmission. If a person is exposed to rabies, a series of shots (postexposure prophylaxis) is highly effective in preventing the disease.

Among the approximate 150,000 persons who attended the Tennessee Walking Horse National Celebration, the number and origin (U.S. states or other countries) of persons who may have been exposed to this horse are unknown. TDH is currently working with event organizers and managers to identify additional mechanisms to contact participants and visitors.

The horse that developed rabies was from Waynesville, Missouri. It was a 3-year-old gelding (neutered male horse), buckskin (cream to tan) in color with a black mane and tail. "Buck" or "Bucky" was described as "small," 14 hands or 56 inches tall at the withers (i.e., the highest area of the shoulders at the base of the neck). He was stabled on the north side of Barn 50 in stall #12, the third from the west end. A bright blue curtain labeled "4J Land and Cattle Company" covered the outside porch of the barn. The potential for contact by the public was very limited when the horse was in its stall but there may have been opportunity for public contact when the horse was taken for rides on the Celebration grounds. The horse was first noted to be ill on August 28. Over the next few days, the horse developed severe neurological signs and, as a result, was euthanized. Persons directly involved in the care of the horse are being assessed for possible rabies exposure and the need for rabies postexposure treatment.

If the individual

  • was bitten by a horse;
  • had contamination of a fresh open wound with saliva from a horse; or
  • had saliva from a horse come in contact with eyes, nose, mouth or other mucous membranes.

Personnel are available to answer additional questions at the Tennessee Department of Health Public Information Line (866) 355-6129.

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To access the Health Advisory, go to:
http://www2a.cdc.gov/HAN/ArchiveSys/ViewMsgV.asp?AlertNum=00248
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September 11, 2006
MORE THAN 100 MILLION DOSES OF INFLUENZA VACCINE WILL BE PRODUCED FOR THE U.S. MARKET FOR 2006-07

On September 6, CDC issued a press release titled "More than 100 million doses of influenza vaccine expected to be available this year." A portion of the press release is reprinted below.

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Influenza vaccine manufacturers report that they expect to produce more than 100 million doses of influenza vaccine for the U.S. market this year. This is at least 17 million more doses of influenza vaccine than has ever been distributed in the past (previous high was 83.1 million doses in 2003) and about 19 million more doses than were distributed last year (81.2 million). According to the information from manufacturers, about 75 million doses will be distributed by the end of October; that would be about 15 million more doses than were distributed by the end of October 2005.

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To access the complete press release, go to:
http://www.cdc.gov/od/oc/media/pressrel/r060906b.htm
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September 11, 2006
INFLUENZA VACCINE VISs AVAILABLE IN SPANISH; OTHER IMMUNIZATION EDUCATIONAL PIECES NOW IN ARABIC, THAI, AND JAPANESE

IAC recently posted the following resources to its website: (1) Spanish-language VIS for injectable trivalent inactivated influenza vaccine (TIV; dated 6/30/06), (2) Spanish-language VIS for intranasal live attenuated influenza vaccine (LAIV; dated 6/30/06),(3) Arabic-language VIS for MMR vaccine (dated 1/15/03), (4) Thai-language interim VIS for meningococcal vaccine (dated 10/7/05), and (5) Japanese-language version of the IAC patient-education piece "After the shots. . . what to do if your child has discomfort" (dated 9/04).

IAC gratefully acknowledges the California Department of Health Services (Davis, CA) for the Spanish and Arabic translations, Asian Pacific Health Care Venture (Los Angeles) for the Thai translation, and Arnett Clinic (Lafayette/West Lafayette, IN) for the Japanese translation.

VACCINE INFORMATION STATEMENTS
To obtain a ready-to-print (PDF) version of the VIS for TIV vaccine in Spanish, go to:
http://www.immunize.org/vis/spflu06.pdf

To obtain it in English, go to:
http://www.immunize.org/vis/2flu.pdf

To obtain a ready-to-print (PDF) version of the VIS for LAIV vaccine in Spanish, go to:
http://www.immunize.org/vis/spliveflu06.pdf

To obtain it in English, go to:
http://www.immunize.org/vis/liveflu.pdf

To obtain a ready-to-print (PDF) version of the VIS for MMR vaccine in Arabic, go to:
http://www.immunize.org/vis/ab_mmr03.pdf

To obtain it in English, go to:
http://www.immunize.org/vis/mmr03.pdf

To obtain a ready-to-print (PDF) version of the interim VIS for meningococcal vaccine in Thai, go to:
http://www.immunize.org/vis/th_men05.pdf

To obtain it in English, go to:
http://www.immunize.org/vis/menin05.pdf

For information about the use of VISs, and for VISs in more than 30 languages, visit IAC's VIS web section at http://www.immunize.org/vis

AFTER THE SHOTS . . .
To obtain a ready-to-print (PDF) version of "After the shots . . . what to do if your child has discomfort" Japanese go to:
http://www.immunize.org/catg.d/p4015-13.pdf

To obtain it in English, go to:
http://www.immunize.org/catg.d/p4015.pdf
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September 11, 2006
NEW: CURRENT ISSUES IN IMMUNIZATION NET CONFERENCE TO FOCUS ON AVIAN INFLUENZA

Scheduled for October 12, from noon to 1PM ET, the net conference Current Issues in Immunization is designed to provide clinicians with up-to-date information on immunization. The program's focus will be on avian influenza.

This is a limited-registration event. Registration will close when the course is full or on October 10 (midnight ET). To register, go to: http://www2.cdc.gov/nip/isd/ciinc

The program will combine a telephone audio conference and simultaneous online visual content. Participants can join the Q&A session by telephone or Internet (requires Internet access and a separate phone line). For instructions and system requirements, go to:
http://www.cdc.gov/nip/ed/ciinc/instructions.htm

For additional information, go to: nipinfo@cdc.gov
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September 11, 2006
NEW: FEDERAL GOVERNMENT LAUNCHES PANDEMIC INFLUENZA WEBSITE IN SPANISH-LANGUAGE FORMAT

On August 30, the federal government Pandemic Influenza website (www.pandemicflu.gov) launched a Spanish-language sister site. To access it, go to: http://www.pandemicflu.gov/espanol
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September 11, 2006
REMINDER THAT PERINATAL HEPATITIS B VIRUS (HBV) IS A NATIONALLY NOTIFIABLE CONDITION

[The following is cross posted from IAC's Hep Express electronic newsletter, 9/7/06.]

CDC and the Council of State and Territorial Epidemiologists would like to remind healthcare providers that perinatal HBV infection is a nationally notifiable condition. Perinatal HBV infection is one of more than 50 nationally notifiable conditions that are reported on a weekly basis from state health departments to CDC through the Nationally Notifiable Diseases Surveillance System (NNDSS). All confirmed cases of perinatal HBV infection should be reported to CDC through the NNDSS as soon as they are identified. The NNDSS surveillance case definition for perinatal HBV infection is HBsAg-positivity in any infant age 1-24 months who was born in the United States or in U.S. territories to an HBsAg-positive mother.

Reporting for perinatal HBV infection should be done by the person or organization that identifies the HBV infection (e.g., laboratories, physicians, perinatal hepatitis B coordinators, nurse practitioners). These entities should collaborate with the program in each state that is responsible for NNDSS reporting; in most states, this is the communicable disease program. The NNDSS event code (disease code) for perinatal HBV infection cases is 10104. If you are not currently reporting through NNDSS or are not sure if cases are being reported, please work with your state program to initiate reporting and to determine what data are required to complete the case report. Guidelines for Viral Hepatitis including perinatal HBV infection surveillance can be found at http://www.cdc.gov/ncidod/diseases/hepatitis/resource/PDFs/revised_GUIDELINES_formatted5.pdf
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September 11, 2006
SEPTEMBER 7 ISSUE OF HEP EXPRESS ELECTRONIC NEWSLETTER AVAILABLE ONLINE

The September 7 issue of Hep Express, an electronic newsletter published by IAC, is now available online. It is intended for health professionals, program planners, and advocates involved in prevention, screening, and treatment of viral hepatitis.

IAC Express has already covered some of the information presented in the September 7 Hep Express; titles of articles we have not yet covered follow.

  • Coming soon: 2005 National Immunization Survey (NIS) results will be published on September 15 in MMWR
  • Merck is experiencing temporary packaging constraints for adult hepatitis A and B vaccines
  • Learn about best injection control practices used in the international arena
  • LiverHope provides information, support, education, and awareness for people with hepatitis
  • Asian Pacific American Medical Student Association (APAMSA) National Conference coming October 6-8, 2006
  • Pacific Health Summit coming to Seattle from on June 12-14, 2007

To access the September 7 issue, go to:
http://www.hepprograms.org/hepexpress/issue47.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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September 11, 2006
CDC REPORTS ON 2006 MEASLES OUTBREAK IN FIJI

CDC published "Measles Outbreak and Response—Fiji, February-May 2006" in the September 8 issue of MMWR. Portions of a summary made available to the press are reprinted below.

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This report describes the epidemiologic finings, public health response, and potential causes of a February-May 2006, measles outbreak that produced 132 cases in Fiji. In September 2005, the 37 countries and areas of the World Health Organization (WHO) Western Pacific Region (WPR) established a goal to eliminate measles in the region by 2012. The 2006 measles outbreak in Fiji, like the 2003 Marshall Islands outbreak in this region, underscores the importance of maintaining high population immunity in order to prevent future outbreaks caused by importation of measles disease.

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To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5535a3.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5535.pdf

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

About IZ Express

IZ Express is supported in part by Grant No. 1NH23IP922654 from CDC’s National Center for Immunization and Respiratory Diseases. Its contents are solely the responsibility of Immunize.org and do not necessarily represent the official views of CDC.

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Editorial Information

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    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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