725 | Immunize.org

IAC Express 2008
Issue number 725: April 21, 2008

Contents of this Issue Select a title to jump to the article.
It's National Infant Immunization Week! AAP publishes recommendations for influenza immunization of children for 2007-08 CDC reports interim results of a 2008 study of influenza vaccine effectiveness in Marshfield, WI CDC reports on U.S. influenza activity from September 30, 2007, through April 5, 2008, and on composition of the 2008-09 influenza vaccine CDC urges U.S. travelers to Israel to protect themselves from measles CDC reports on U.S. rotavirus vaccination coverage and adherence to the ACIP-recommended vaccination schedule New: Child/teen screening questionnaire now in Spanish, Arabic, Chinese, French, Korean, Russian, and Vietnamese New: Multi-vaccine VIS in Spanish, Chinese, and Tagalog; hepatitis B vaccine VIS in Thai; HPV vaccine VIS in Polish April 16 issue of IAC's Hep Express electronic newsletter now online Important: Be sure to give influenza vaccine throughout the influenza season--through the spring months CDC publishes recommendations for animal rabies prevention and control CDC reports on laboratory-acquired vaccinia infections and vaccinia exposure in the U.S. during 2005-07

Abbreviations

AAFP, American Academy of Family Physicians; AAP, American Academy of Pediatrics; ACIP, Advisory Committee on Immunization Practices; AMA, American Medical Association; CDC, Centers for Disease Control and Prevention; FDA, Food and Drug Administration; IAC, Immunization Action Coalition; MMWR, Morbidity and Mortality Weekly Report; NCIRD, National Center for Immunization and Respiratory Diseases; NIVS, National Influenza Vaccine Summit; VIS, Vaccine Information Statement; VPD, vaccine-preventable disease; WHO, World Health Organization.

Issue 725: April 21, 2008

It's National Infant Immunization Week!

CDC published "Notice to Readers: National Infant Immunization Week--April 19-26, 2008" in the April 18 issue of MMWR. The notice is reprinted below in its entirety, excluding references.

The week of April 19-26, 2008, is National Infant Immunization Week (NIIW) and Vaccination Week in the Americas (VWA). Immunization is one of the most effective ways to protect infants and children from potentially serious diseases. During the week, hundreds of communities throughout the United States are expected to sponsor activities to emphasize the health benefits of timely vaccination and the importance to parents, healthcare providers, and communities of maintaining high vaccination coverage. One message stressed during this week will be the key role of the ongoing relationship among parents and their children's healthcare providers in vaccination programs. CDC encourages parents to talk to their healthcare providers about vaccinations at any time.

The week's activities provide an opportunity to showcase the success of vaccination in saving the lives and protecting the health of children. The currently recommended childhood vaccination schedule includes vaccines that prevent infectious diseases such as measles, polio, whooping cough, some forms of meningitis and pneumonia, and liver cancer. An analysis of the impact of seven vaccines showed that they would prevent approximately 33,500 deaths and 14 million illnesses per annual birth cohort.

NIIW-VWA events held in collaboration with CDC and state and local health departments will be hosted in Rhode Island, Connecticut, and Washington. Events held in collaboration with CDC, state and local health departments, the United States-Mexico Border Health Commission, and the Pan American Health Organization (PAHO), will be hosted in communities along the U.S.-Mexico border, with kick-off events held in El Paso, Texas, and Sunland Park, New Mexico. In all locations, events will include education activities for healthcare providers, media briefings, and immunization clinics.

VWA, sponsored by PAHO, targets children and other vulnerable and underserved populations who have low vaccination coverage rates, in all countries in the Western hemisphere. To support NIIW and VWA events nationwide, CDC provides annually updated English- and Spanish-language planning guides, campaign materials, and public relations tools. These include timely key messages, radio public service announcements, and sample media kits. These resources and event listings are available at http://www.cdc.gov/vaccines/events/niiw Additional information about VWA is available at http://www.paho.org/english/dd/pin/vw2008.htm

To access a web-text (HTML) version of the notice, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5715a5.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5715.pdf

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

AAP publishes recommendations for influenza immunization of children for 2007-08

The April issue of Pediatrics, a journal of the American Academy of Pediatrics (AAP), includes a policy statement made by AAP's Committee on Infectious Diseases. Titled "Prevention of Influenza: Recommendations for Influenza Immunization of Children, 2007–2008," the statement includes the following sections: (1) abstract, (2) purpose of recommendations and rationale, (3) epidemiology of influenza, (4) clinical manifestations of influenza, (5) vaccines, (6) timing of influenza vaccine administration, (7) contraindications and precautions, (8) recommendations, and (9) future needs and research. A link to the complete policy statement is given at the end of this IAC Express article. The abstract is reprinted below in its entirety.

The American Academy of Pediatrics recommends annual influenza immunization for all children with high-risk conditions who are 6 months of age and older, for all healthy children ages 6 through 59 months, for all household contacts and out-of-home caregivers of children with high-risk conditions and of healthy children younger than 5 years, and for all healthcare professionals.

To more fully protect against the morbidity and mortality of influenza, increased efforts are needed to identify and immunize all children at high risk and all healthy children ages 6 through 59 months and to inform their parents when annual immunizations are due. Previously unimmunized children who are at least 6 months of age but younger than 9 years should receive 2 doses of influenza vaccine, given 1 month apart, beginning as soon as possible on the basis of local availability during the influenza season. If children in this cohort received only 1 dose for the first time in the previous season, it is recommended that 2 doses be administered in the current season. This recommendation applies only to the influenza season that follows the first year that a child younger than 9 years receives influenza vaccine. A child who then also fails to receive 2 doses the next year should be given only 1 dose per year from that point on. Influenza vaccine should also continue to be offered throughout the influenza season, even after influenza activity has been documented in a community.

On the basis of global surveillance of circulating virus strains, the influenza vaccine may change from year to year; indeed, 1 of the 3 strains in the 2007–2008 vaccine is different from the previous year's vaccine. All healthcare professionals, influenza campaign organizers, and public health agencies should develop plans for expanding outreach and infrastructure to immunize all children for whom influenza vaccine is recommended. Appropriate prioritization of administering influenza vaccine will also be necessary when vaccine supplies are delayed or limited. Because the influenza season often extends into March, immunization against influenza is recommended to continue through late winter and early spring. Lastly, it is recommended that for the 2007–2008 season, and likely beyond, healthcare professionals do not prescribe amantadine or rimantadine for influenza treatment or chemoprophylaxis, because widespread resistance to these antiviral medications now exists among influenza A viral strains. However, oseltamivir and zanamivir can be prescribed for treatment or chemoprophylaxis, because influenza A and B strains remain susceptible.

To access the complete policy statement, go to:
http://pediatrics.aappublications.org/cgi/content/full/121/4/e1016

CDC reports interim results of a 2008 study of influenza vaccine effectiveness in Marshfield, WI

CDC published "Interim Within-Season Estimate of the Effectiveness of Trivalent Inactivated Influenza Vaccine--Marshfield, Wisconsin, 2007-08 Influenza Season" in the April 18 issue of MMWR. Portions of the article are reprinted below. On April 17, CDC held a media briefing related to the article; a link to a transcript of the briefing is given at the end of this IAC Express article.

This report summarizes interim results of a 2008 case-control study to estimate the effectiveness of trivalent inactivated influenza vaccine for prevention of medically attended, laboratory-confirmed influenza during the 2007-08 influenza season, when most circulating influenza A (H3N2) and B viruses were suboptimally matched to the vaccine strains. Despite the suboptimal match between two of three vaccine strains and circulating influenza strains, overall vaccine effectiveness (VE) in the study population during January 21-February 8, 2008, was 44%. These findings demonstrate that, in any season, assessment of the clinical effectiveness of influenza vaccines cannot be determined solely by laboratory evaluation of the degree of antigenic match between vaccine and circulation strains. . . .

During January 21-February 8, 2008, a total of 1,779 patients were assessed for study eligibility after a clinical encounter for acute respiratory illness or febrile illness. A total of 850 (48%) did not meet eligibility criteria; 773 (91%) of exclusions resulted from absence of feverishness, chills, or cough or an illness duration 8 days or longer. Of the 929 eligible patients, 639 (69%) consented to the study and were tested for influenza infection. Final enrollment for this interim analysis was reduced to 616 patients after exclusion of 23 partially immunized children who had received only 1 of 2 recommended vaccine doses.

Influenza was detected by reverse transcription-polymerase chain reaction (RT-PCR) in 191 (31%) enrollees; 75% of influenza infections were type A. Distribution by sex was similar for patients who tested positive and patients who tested negative for influenza; however, the median age was higher for patients who tested positive (21 years) than those who tested negative (10 years). Approximately 19% of patients who tested positive and 39% of those who tested negative had been vaccinated against influenza.

The overall interim estimate of VE was 44%; the estimate was higher among persons in the healthy group aged 5-49 years (54%). The overall estimate of VE for prevention of medically attended influenza A infections was 58%. No VE was observed for prevention of medically attended influenza B infections. . . .

These preliminary data based on study enrollment during January 21-February 8 suggest several conclusions. First, when assessing VE, laboratory data on antigenic characterization of circulating influenza viruses compared with vaccine strains should be interpreted together with data on the clinical effectiveness of vaccination in preventing laboratory-confirmed influenza illnesses. Although two of three vaccine strains were not optimally matched with circulating viruses this season, an interim VE estimate suggests that vaccination provided substantial protection against medically attended acute respiratory illness in this study population. In addition, intraseason estimates of VE, such as those from this analysis, might be useful to public health authorities and medical practitioners in their communications about the benefits of vaccination, especially late in the influenza season. Such data also might be helpful to practitioners when evaluating the need for antiviral treatment and prophylaxis for their patients. Therefore, creating systems that enable collection and dissemination of timely VE data during an influenza season are a priority for CDC. Finally, healthcare providers should be aware of the types and subtypes of influenza circulating in their communities over the course of each influenza season. If influenza B strains predominate during the remainder of this season, providers can anticipate an increased risk for vaccine failures and should consider early use of antiviral medications for treatment and prophylaxis of persons at high risk for complications from influenza infection.

To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5715a1.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5715.pdf

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

To access the transcript of the April 17 media briefing, go to: http://www.cdc.gov/od/oc/media/transcripts/2008/t080417.htm

CDC reports on U.S. influenza activity from September 30, 2007, through April 5, 2008, and on composition of the 2008-09 influenza vaccine

CDC published "Update: Influenza Activity--United States, September 30, 2007-April 5, 2008, and Composition of the 2008-09 Influenza Vaccine" in the April 18 issue of MMWR. Portions of the article are reprinted below.

This report summarizes U.S. influenza activity since September 30, 2007, the start of the 2007-08 influenza season, and updates the previous summary. Low levels of influenza activity were reported from October through early December. Activity increased from mid-December and peaked in mid-February.

Viral Surveillance
During September 30, 2007-April 5, 2008, World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories in the United States reported testing 185,938 specimens for influenza viruses, and 34,380 (18.5%) tested positive. Of these, 25,456 (74.0%) were influenza A viruses, and 8,924 (26.0%) were influenza B viruses. A total of 7,715 (30.3%) of the 25,456 influenza A viruses have been subtyped: 2,110 (27.3%) were influenza A (H1N1) viruses, and 5,605 (72.7%) were influenza A (H3N2) viruses. The percentage of specimens testing positive for influenza first exceeded 10% during the week ending January 12 and peaked at 32.0% during the week ending February 16. For the week ending April 5, 13.2% of specimens tested for influenza were positive. Although influenza A (H1N1) viruses predominated through mid-January, the proportion of reported influenza viruses that were A (H3N2) viruses increased rapidly during January, and during the week ending January 26, influenza A (H3N2) became the predominant virus for the season overall.

This season, more influenza A viruses than influenza B viruses have been identified in all surveillance regions. However, for weeks 13 and 14 (March 23-April 5), more influenza B than influenza A viruses were reported. Among influenza A viruses, influenza A (H3N2) has predominated in the East North Central, East South Central, Mid-Atlantic, New England, South Atlantic, West North Central, and West South Central regions, and influenza A (H1N1) has predominated in the Mountain and Pacific regions.

Composition of the 2008-09 Influenza Vaccine
The Food and Drug Administration's Vaccines and Related Biological Products Advisory Committee recommended that the 2008-09 trivalent influenza vaccine for the United States contain A/Brisbane/59/2007-like (H1N1), A/Brisbane/10/2007-like (H3N2), and B/Florida/4/2006-like viruses. This represents a change in all three components from the 2007-08 influenza vaccine formulation used in the United States. These recommendations were based on antigenic analyses of recently isolated influenza viruses, epidemiologic data, post-vaccination serologic studies in humans, and the availability of candidate vaccine strains and reagents. . . .

Pneumonia and Influenza-Related Mortality
Pneumonia and influenza (P&I) was listed as an underlying or contributing cause of death for 8.9% of all deaths reported through the 122 Cities Mortality Reporting System for the week ending April 5, 2008. This percentage was above the epidemic threshold of 6.9% for the week and marked the thirteenth consecutive week that the proportion of all deaths attributed to P&I was above the epidemic threshold. The proportion of deaths from P&I exceeded the epidemic threshold during week ending January 5 and peaked at 9.1% during the week ending March 15.

Influenza-Related Pediatric Mortality
During September 30, 2007-April 5, 2008, a total of 65 pediatric deaths among children aged <18 years associated with laboratory-confirmed influenza were reported from 26 states, New York City, and Chicago through the National Notifiable Diseases Surveillance System. The median age of decedents was 4.5 years (range: 1 month to 17.8 years). During the preceding three influenza seasons, the total number of influenza-related pediatric deaths reported to CDC ranged from 46 to 74. . . .

To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5715a4.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5715.pdf

CDC urges U.S. travelers to Israel to protect themselves from measles

On April 14, CDC issued a press release, "CDC Urges Travelers to Israel to Protect Themselves from Measles: Concern raised over Americans traveling to Israel for Passover." It is reprinted below in its entirety.

As Americans travel to Israel for the Jewish holiday of Passover, the Centers for Disease Control and Prevention advises all travelers to ensure they are protected from measles before departing, because of a measles outbreak in Israel. Since September, more than 900 cases of measles have been reported in Israel, with about 700 cases in the cities of Jerusalem and Beit Shemesh.

The outbreak has raised concern that Americans traveling to Israel for Passover, which is celebrated April 19–27, may be exposed to measles and could become ill if they have never had measles or have not been properly vaccinated.

CDC recommends that

Travelers who plan to go to Israel check their immunization status and visit their doctor if they are not immune to measles or are unsure of immunity status.
Unvaccinated travelers should get vaccinated as early as possible before leaving for Israel.
Travelers returning from Israel should see a healthcare provider if they develop signs or symptoms of measles. Travelers who develop fever and other symptoms of measles while still in Israel should get prompt medical attention before returning to the United States. Contact U.S. consular services at the U.S. Embassy in Tel Aviv or the U.S. Consulate General in Jerusalem for assistance in locating healthcare providers.
Travelers with fever and other symptoms of measles should limit their contact with others as much as possible, to prevent the potential spread of the disease.
Clinicians seeing a patient with fever and other symptoms of measles should ask about vaccination history and any recent international travel.

Measles is a highly contagious respiratory illness spread by contact with an infected person, through coughing and sneezing. Measles virus can also remain active and contagious for up to 2 hours on infected surfaces. Symptoms include rash, high fever, cough, runny nose, and red, watery eyes. Some people with measles can also get an ear infection, diarrhea, serious lung infection, or, even more rarely, inflammation of the brain (encephalitis).

The disease can be especially severe in people who are malnourished or have a weak immune system. In the United States, most people born before 1957--or those who have had a documented case of measles, laboratory evidence of immunity, or received two doses of measles, mumps, rubella (MMR) vaccine or measles vaccine--are considered immune.

Vaccination even shortly before or after exposure may prevent disease or lessen the symptoms in people who are infected with measles. Immune globulin given up to six days after exposure may prevent disease among people at high risk for complications of measles (such as pregnant women, people with weak immune systems, and children).

For more information about the measles outbreak in Israel and measles precautions, please visit http://wwwn.cdc.gov/travel/contentMeasles.aspx For more information on general travel precautions when traveling to Israel for Passover, please visit http://wwwn.cdc.gov/travel/contentIsraelPassover.aspx

To access the press release, go to:
http://www.cdc.gov/od/oc/media/pressrel/2008/r080414a.htm

CDC reports on U.S. rotavirus vaccination coverage and adherence to the ACIP-recommended vaccination schedule

CDC published "Rotavirus Vaccination Coverage and Adherence to the Advisory Committee on Immunization Practices (ACIP)-Recommended Vaccination Schedule--United States, February 2006-May 2007" in the April 18 issue of MMWR. Portions of the article are reprinted below.

Worldwide, rotavirus is the leading cause of severe gastroenteritis in children aged <5 years. In February 2006, a new human-bovine rotavirus vaccine, RotaTeq (Merck & Co., Inc., Whitehouse Station, New Jersey), was recommended by the Advisory Committee on Immunization Practices (ACIP) for routine vaccination of U.S. infants. Three doses of RotaTeq are recommended at ages 2, 4, and 6 months. The first dose should be administered between ages 6 and 12 weeks, and vaccination should not be initiated for infants aged >12 weeks. Subsequent doses should be administered at 4-10 week intervals, with all doses administered by age 32 weeks. This schedule is consistent with the ages at which RotaTeq was administered during prelicensure trials, and ACIP has recommended that RotaTeq only be administered at the ages for which safety and efficacy data are available. In 1999, a previous rhesus-human rotavirus vaccine, RotaShield (Wyeth Laboratories, Inc., Marietta, Pennsylvania), was withdrawn voluntarily from the U.S. market by the manufacturer because it was associated with intussusception, a form of bowel obstruction. The greatest risk for intussusception was noted after the first dose of RotaShield. Data from a large-scale, prelicensure safety trial and postlicensure monitoring do not indicate an association between the current RotaTeq vaccine and intussusception. CDC assessed rotavirus vaccination coverage among U.S. infants during February 2006-May 2007 and examined adherence to the ACIP-recommended vaccination schedule. This report summarizes the results of that assessment . . .

Rotavirus vaccination coverage in the United States increased during the year after the February 2006 ACIP recommendation, and by May 2007, nearly half of infants aged 3 months in immunization information systems (IIS) sentinel sites had received 1 dose of rotavirus vaccine. Although the majority of healthcare providers in these systems appear to be administering the vaccine as recommended, the findings in this report suggest that some infants are receiving their first dose of rotavirus vaccine outside of the ACIP-recommended schedule. . . .

Although these initial findings on rotavirus vaccination coverage are encouraging, public health professionals should continue to monitor vaccination coverage, identify potential barriers to vaccination, and increase vaccination coverage to levels similar to those for other recommended infant vaccines. In addition, healthcare providers should remain vigilant in following the ACIP-recommended vaccination schedule for rotavirus vaccine and are reminded to report any adverse events to the Vaccine Adverse Events Reporting System.

To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5715a2.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5715.pdf

New: Child/teen screening questionnaire now in Spanish, Arabic, Chinese, French, Korean, Russian, and Vietnamese

IAC now offers its popular "Screening Questionnaire for Child and Teen Immunization" in Spanish, Arabic, Chinese, French, Korean, Russian, and Vietnamese, in addition to English. Links to all follow.

For Spanish version of "Screening Questionnaire for Child and Teen Immunization," go to:
http://www.immunize.org/catg.d/p4060-01.pdf

For Arabic version of "Screening Questionnaire for Child and Teen Immunization," go to:
http://www.immunize.org/catg.d/p4060-20.pdf

For Chinese version of "Screening Questionnaire for Child and Teen Immunization," go to:
http://www.immunize.org/catg.d/p4060-08.pdf

For French version of "Screening Questionnaire for Child and Teen Immunization," go to:
http://www.immunize.org/catg.d/p4060-10.pdf

For Korean version of "Screening Questionnaire for Child and Teen Immunization," go to:
http://www.immunize.org/catg.d/p4060-09.pdf

For Russian version of "Screening Questionnaire for Child and Teen Immunization," go to:
http://www.immunize.org/catg.d/p4060-07.pdf

For Vietnamese version of "Screening Questionnaire for Child and Teen Immunization," go to:
http://www.immunize.org/catg.d/p4060-05.pdf

For English version of "Screening Questionnaire for Child and Teen Immunization," go to:
http://www.immunize.org/catg.d/p4060.pdf

For a continually updated listing (in date order) of IAC's new and revised website materials, go to: http://www.immunize.org/new Click on "html" or "pdf" to view the pertinent resource.

New: Multi-vaccine VIS in Spanish, Chinese, and Tagalog; hepatitis B vaccine VIS in Thai; HPV vaccine VIS in Polish

Dated 1/30/08, the multi-vaccine VIS is now available in Spanish, Chinese, and Tagalog. Dated 7/18/07, the interim VIS for hepatitis B vaccine is now available in Thai. Dated 2/2/07 the interim VIS for human papillomavirus (HPV) vaccine is now available in Polish. IAC gratefully acknowledges the California Department of Public Health, Immunization Branch, for the multi-vaccine VIS translations; Asian Pacific Health Care Venture of Los Angeles for the hepatitis B vaccine VIS translation, and the Illinois Chapter of the American Academy of Pediatrics for the HPV vaccine VIS translation.

Multi-vaccine VIS
To access Spanish version of the multi-vaccine VIS, go to:
http://www.immunize.org/vis/sp_multi.pdf

To access Chinese version of the multi-vaccine VIS, go to:
http://www.immunize.org/vis/ch_multi.pdf

To access Tagalog version of the multi-vaccine VIS, go to:
http://www.immunize.org/vis/ta_multi.pdf

To access English version of the multi-vaccine VIS, go to:
http://www.immunize.org/vis/vis_multi1.pdf

Hepatitis B vaccine VIS (interim)
To access Thai version of the hepatitis B vaccine VIS, go to:
http://www.immunize.org/vis/th_hpb01.pdf

To access English version of the hepatitis B vaccine VIS, go to:
http://www.immunize.org/vis/hepb01.pdf

NOTE: The interim VIS for hepatitis B vaccine comes in additional languages, including Spanish. To access them, go to: http://www.immunize.org/vis/vis_hepb.asp Click on the link to the pertinent language.

HPV vaccine VIS (interim)
To access Polish version of the HPV vaccine VIS, go to:
http://www.immunize.org/vis/po_hpv.pdf

To access English version of the HPV vaccine VIS, go to:
http://www.immunize.org/vis/hpv.pdf

NOTE: The interim VIS for HPV vaccine comes in additional languages, including Spanish. To access them, go to: http://www.immunize.org/vis/vis_hpv.asp Click on the link to the pertinent language.

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

April 16 issue of IAC's Hep Express electronic newsletter now online

The April 16 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 April 16 Hep Express; titles of articles we have not yet covered follow.

World Hepatitis Day is May 19
Asian Liver Center develops brochure about the business response to employees with HBV [hepatitis B virus] infection
American Association of Nurse Anesthetists condemns unsafe injection practices
Take advantage of free continuing education opportunities
Latino Organization for Liver Awareness Hepatitis C Walk will take place May 15; free HCV [hepatitis C virus] testing offered to NYC residents
Hepatitis C Network of Windsor, Ontario, will hold its annual conference May 15
Hepatitis B Foundation's B Informed Patient Conference scheduled for June 27-28 in Los Angeles
2008 International HBV Meeting to take place August 17-21 in San Diego
Viral Hepatitis Prevention Board updates its website with new meeting report
Journal articles you may have missed

To access the April 16 issue, go to:
http://www.hepprograms.org/hepexpress/issue69.asp

To sign up for a free subscription to Hep Express, go to:
http://www.immunize.org/subscribe

To access previous issues of Hep Express, go to:
http://www.hepprograms.org/hepexpress

10.

Important: Be sure to give influenza vaccine throughout the influenza season--through the spring months

Influenza is currently circulating, and vaccination should continue through the spring months. Visit the following websites often to find the information you need to keep vaccinating. Both are continually updated with the latest resources.

The National Influenza Vaccine Summit website at
http://www.preventinfluenza.org

CDC's Seasonal Flu web section at http://www.cdc.gov/flu

11.

CDC publishes recommendations for animal rabies prevention and control

CDC published "Compendium of Animal Rabies Prevention and Control, 2008: National Association of State Public Health Veterinarians, Inc. (NASPHV)" in the April 18 issue of MMWR Recommendations and Reports. The introductory paragraphs are reprinted below.

Rabies is a fatal viral zoonosis and a serious public health problem. The disease is an acute, progressive encephalitis caused by a lyssavirus. Although the United States has been declared free of canine rabies virus variant transmission, multiple viral variants are maintained in wild mammal populations, and there is always a risk of reintroduction of canine rabies. All mammals are believed to be susceptible to the disease, and for purposes of this document, use of the term "animal" refers to mammals.

The recommendations in this compendium serve as a basis for animal rabies prevention-and-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. The most current version replaces all previous versions. These recommendations do not supersede state and local laws or requirements. Principles of rabies prevention and control are detailed in Part I; recommendations for parenteral vaccination procedures are presented in Part II; and all animal rabies vaccines licensed by the U. S. Department of Agriculture (USDA) and marketed in the United States are listed in Part III. . . .

To obtain a web-text (HTML) version of the recommendations online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5702a1.htm

To obtain a ready-to-copy (PDF) version, go to:
http://www.cdc.gov/mmwr/PDF/rr/rr5702.pdf

12.

CDC reports on laboratory-acquired vaccinia infections and vaccinia exposure in the U.S. during 2005-07

CDC published "Laboratory-Acquired Vaccinia Exposures and Infections--United States, 2005-2007" in the April 18 issue of MMWR. A portion of a summary made available to the press is reprinted below.

Vaccinia virus (VACV) is used in research laboratories, and accidental inoculation in the laboratory can result in severe infection. The Advisory Committee on Immunization Practices (ACIP) recommends vaccination with the vaccinia (smallpox) vaccine at least every 10 years for researchers who have contact with non-attenuated strains of VACV. In this MMWR, 5 recent instances of laboratory-related VACV exposure, including 4 infections and 2 hospitalizations, are described. In all instances, the researchers recovered, but had not met ACIP recommendations for vaccination. These observations underscore the need for laboratory researchers and occupational health clinics to review vaccination status of researchers who handle non-attenuated VACV strains [and to] reinforce laboratory safety practices.

To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5715a3.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5715.pdf

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