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IAC Express 2009 |
| Issue number 792: April 27, 2009 |
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Contents
of this Issue
Select a title to jump to the article. |
- CDC
reports on swine influenza investigation and gives
interim recommendations; many continually updated resources
available for healthcare professionals and the public
- CDC releases new VIS for pneumococcal polysaccharide vaccine
- National Vaccine Advisory Committee's recommendations on
vaccine financing now available online
- Confirmed measles cases reported in Iowa, Maryland,
Pennsylvania, Virginia, and Washington, DC
- Spread the word about the importance of childhood
immunization during National Infant Immunization Week--April
25-May 2
- IAC's Video of the Week features CDC's Dr. Jeanne Santoli
answering moms' tough questions about immunization
- CDC website posts Q&A for providers about Hib vaccine supply
and Hib vaccination coverage
- VIS translation: Interim VIS for pneumococcal conjugate
vaccine now available in Turkish
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| Abbreviations |
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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. |
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Issue 792: April 27, 2009 |
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1. |
CDC reports on swine influenza investigation and gives interim
recommendations; many continually updated resources available for healthcare
professionals and the public
On
April 25, CDC issued an official Health Advisory titled
"Investigation and Interim Recommendations: Swine Influenza
(H1N1)." It is reprinted below in its entirety. The
investigation is ongoing, and many continually updated resources
are available from CDC, WHO, and others. To access an overview
of resources on this fast-moving situation, browse through the
CDC's Swine Influenza (Flu) web section at
http://www.cdc.gov/swineflu For a listing of useful links to
specific information, see the end of this IAC Express article.
CDC, in collaboration with public health officials in California
and Texas, is investigating cases of febrile respiratory illness
caused by swine influenza (H1N1) viruses. As of 11 AM (EDT)
April 25, 2009, 8 laboratory confirmed cases of Swine Influenza
infection have been confirmed in the United States. Four cases
have been reported in San Diego County, California. Two cases
have been reported in Imperial County California. Two cases have
been reported in Guadalupe County, Texas. Of the 8 persons with
available data, illness onsets occurred March 28-April 14, 2009.
Age range was 7-54 y.o. Cases are 63% male.
The viruses contain a unique combination of gene segments that
have not been reported previously among swine or human influenza
viruses in the U.S. or elsewhere. At this time, CDC recommends
the use of oseltamivir or zanamivir for the treatment of
infection with swine influenza viruses. The H1N1 viruses are
resistant to amantadine and rimantadine but not to oseltamivir
or zanamivir. It is not anticipated that the seasonal influenza
vaccine will provide protection against the swine flu H1N1
viruses.
CDC has also been working closely with public health officials
in Mexico, Canada, and the World Health Organization (WHO).
Mexican public health authorities have reported increased levels
of respiratory disease, including reports of severe pneumonia
cases and deaths, in recent weeks. CDC is assisting public
health authorities in Mexico by testing specimens and providing
epidemiological support. As of 11:00 AM (EDT) April 25, 2009, 7
specimens from Mexico at CDC have tested positive for the same
strain of swine influenza A (H1N1) as identified in U.S. cases.
However, no clear data are available to assess the link between
the increased disease reports in Mexico and the confirmation of
swine influenza in a small number of specimens. WHO is
monitoring international cases. Further information on
international cases may be found at:
http://www.who.int/csr/don/2009_04_24/en
Clinicians should consider swine influenza infection in the
differential diagnosis of patients with febrile respiratory
illness and who (1) live in San Diego or Imperial counties,
California, or Guadalupe County, Texas, or traveled to these
counties or (2) who traveled recently to Mexico or were in
contact with persons who had febrile respiratory illness and
were in one of the three U.S. counties or Mexico during the 7
days preceding their illness onset.
Patients who meet these criteria should be tested for influenza,
and specimens positive for influenza should be sent to public
health laboratories for further characterization. Clinicians who
suspect swine influenza virus infections in humans should obtain
a nasopharyngeal swab from the patient, place the swab in a
viral transport medium, refrigerate the specimen, and then
contact their state or local health department to facilitate
transport and timely diagnosis at a state public health
laboratory. CDC requests that state public health laboratories
promptly send all influenza A specimens that cannot be subtyped
to the CDC, Influenza Division, Virus Surveillance and
Diagnostics Branch Laboratory.
Persons with febrile respiratory illness should stay home from
work or school to avoid spreading infections (including
influenza and other respiratory illnesses) to others in their
communities. In addition, frequent hand washing can lessen the
spread of respiratory illness.
CDC has not recommended that people avoid travel to affected
areas at this time. [Editor's Note: During an April 27 press
conference, CDC announced it would be releasing a new travel
advisory for Mexico, recommending that non-essential travel to
Mexico be avoided, and offering steps people can take to avoid
infection if they need to travel to Mexico during this time. For
developing information on this topic, go to
http://www.cdc.gov/swineflu] Recommendations found at
http://wwwn.cdc.gov/travel/contentSwineFluUS.aspx will help
travelers reduce risk of infection and stay healthy.
Clinical guidance on laboratory safety, case definitions,
infection control, and information for the public are available
at: http://www.cdc.gov/swineflu/investigation.htm
Morbidity and Mortality Weekly Reports Dispatch (April 24)
provide detailed information about the initial cases at
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm58d0424a1.htm
For more information about swine flu:
http://www.cdc.gov/swineflu
Additional information is also available by calling (800) CDC-INFO [(800) 232-4636]
To access the 4/25/09 Health Advisory, go to:
http://www.cdc.gov/swineflu/pdf/HAN_042509.pdf
To access CDC's Swine Influenza web section, go to:
http://www.cdc.gov/swineflu
To access a page of listings of online resources for healthcare
professionals and the public titled What's New on the Swine Flu
Site, go to: http://www.cdc.gov/swineflu/whatsnew.htm
To access a page of information and links titled Guidance for
Clinicians & Public Health Professionals, go to:
http://www.cdc.gov/swineflu/guidance
To access links on CDC's Reports & Publications page, go to:
http://www.cdc.gov/swineflu/pubs
To access CDC Press Briefing Transcripts page, go to:
http://www.cdc.gov/swineflu/press
To access a page of general information for the public titled
Questions & Answers: Swine Influenza and You, go to:
http://www.cdc.gov/swineflu/swineflu_you.htm
To access a page of more in-depth information for the public
titled Questions & Answers: Key Facts about Swine Influenza
(Swine Flu), go to: http://www.cdc.gov/swineflu/key_facts.htm
To access a page of information for the Spanish-speaking public
titled Datos importantes sobre la influenza porcina (gripe
porcina), go to:
http://www.cdc.gov/swineflu/espanol/swine_espanol.htm
To access a two-page brochure for the public titled Swine
Influenza in Pigs and People, go to:
http://www.cdc.gov/swineflu/pdf/brochure.pdf
To access information from the American Academy of Pediatrics
about swine flu, go to:
http://www.aap.org/advocacy/releases/may09swineflu.htm
For international information from the WHO web page titled
Disease Outbreak News, go to: http://www.who.int/csr/don/en
To access a WHO press release titled Swine Flu Illness in the
United States and Mexico--Update 2 (dated 4/26/09), go to:
http://www.who.int/csr/don/2009_04_26/en
To access a press release issued by HHS titled HHS Declares
Public Health Emergency for Swine Flu, go to:
http://www.hhs.gov/news/press/2009pres/04/20090426a.html
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2. |
CDC releases new VIS for pneumococcal polysaccharide vaccine
On April 16, CDC issued a VIS for pneumococcal
polysaccharide
vaccine (PPSV); it replaces the VIS for PPSV dated 7/29/97. The
PPSV VIS was updated mainly to reflect new indications for
smokers and adults with asthma, but also to provide a general
formatting facelift.
To access the 4/16/09 VIS for PPSV, go to:
http://www.immunize.org/vis/pneum3.pdf
For information about the use of VISs, and for VISs in more than
35 languages, visit IAC's VIS web section at
http://www.immunize.org/vis
For general information about VISs from CDC's website go to:
http://www.cdc.gov/vaccines/pubs/vis
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3. |
National Vaccine Advisory Committee's recommendations on vaccine financing
now available online
CDC published "Notice to Readers: National
Vaccine Advisory Committee Recommendations on Vaccine Financing" in the April
24 issue of MMWR. The first paragraph of the notice is reprinted below.
In September 2008, the National Vaccine Advisory Committee
(NVAC), a federal advisory group, approved a series of
recommendations to improve vaccine financing systems in the
United States. These 24 recommendations, the final product of 2
years of work, were developed with broad input and consensus
from stakeholders, including healthcare providers, consumers,
insurers, vaccine manufacturers, state and local public health
authorities, and state and local government and Medicaid
agencies. . .
The final report is titled "Assuring Vaccination of Children and
Adolescents without Financial Barriers: Recommendations from the
National Vaccine Advisory Committee (NVAC) U.S. Department of
Health and Human Services" and is available at
http://www.hhs.gov/nvpo/nvac/NVACVFWGReport.pdf
For a complete listing of NVAC reports and recommendations, go
to: http://www.hhs.gov/nvpo/nvac/reports.html
To access a web-text (HTML) version of the MMWR notice, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5815a8.htm
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4. |
Confirmed measles cases reported in Iowa, Maryland, Pennsylvania, Virginia,
and Washington, DC
On April 21, the Center for Infectious Diseases
Research &
Policy (CIDRAP) at the University of Minnesota issued a press
release titled "States Sound Alarms over Measles Cases."
Portions of the press release are reprinted below.
Health officials in the Washington, DC, area today said they
were working to identify people who may have been exposed to a
patient with measles, as officials in other states, including
Virginia, Iowa, and Pennsylvania, were responding to three other
recent measles exposures. . . .
Virginia's health department announced in a press release today
that it had confirmed its first measles case of the year, in a
Prince William county resident with no known link to the
Washington, DC, case. Virginia officials are in the process of
notifying people who may have been exposed to the patient at
various sites between April 10 and 15.
Meanwhile, the Iowa Department of Public Health (IDPH) on April
16 reported measles in a child from the northwestern part of the
state. The department said that it and local officials were
determining who may have been exposed to the disease and
investigating the source of the child's infection. . . .
One week earlier, the Pennsylvania Department of Health (PDH)
reported that the source of a recent measles outbreak involving
six patients in the southwestern part of the state was a
traveler from India who arrived in the United States on March 7.
In an earlier statement the PDH said the confirmed case-patients
included three members of a Westmoreland County family--two
children under age 5, who had not received the measles-mumps-rubella (MMR) vaccine, and their 33-year-old father, who had
received only a single dose of the vaccine as a child. . . .
The spate of recent measles cases raises concerns like those
expressed last year, when measles cases climbed to 138, after
averaging about 50 a year between 2004 and 2007, according to
the April 17 issue of Morbidity and Mortality Weekly Report
(MMWR). As of Apr 11, the CDC had already recorded 14 measles cases this year.
Rising measles cases herald a worrisome drop in overall U.S.
vaccination rates, the CDC said in an August 2008 MMWR update on
the disease. "Measles is one of the first diseases to reappear
when vaccination coverage rates fall," the agency said. . . .
To access the complete CIDRAP press release, go to:
http://www.cidrap.umn.edu/cidrap/content/other/news/apr2109measles-br.html
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5. |
Spread the word about the importance of childhood immunization during
National Infant Immunization Week--April 25-May 2
On April 23, CDC issued a press release titled
"National Infant
Immunization Week Highlights Importance of Protecting Infants
from Life-Threatening Diseases." It is available in English and
Spanish. Portions of it are reprinted below.
The Centers for Disease Control and Prevention will launch
National Infant Immunization Week (NIIW) with events beginning
April 25 and continuing through May 2, 2009. Parents, caregivers
and healthcare providers will be reminded of the benefits of
vaccination and the importance of routine childhood vaccination.
"Immunization is one of the single most important steps parents
can take to help assure their children grow up to be strong and
healthy. We prevent millions of cases of disease and thousands
of deaths in children each year through immunization," said Dr.
Anne Schuchat, director of CDC's National Center for
Immunization and Respiratory Diseases. "NIIW provides a chance
for us to remember how important vaccines are and renew our
efforts to make sure no child needlessly suffers from a vaccine-preventable disease." . . . .
There are now vaccines to protect children against 14 diseases
before age 2. Despite recent gains in infant immunization
coverage, more than 20 percent of the nation's 2-year-olds are
not fully immunized against infectious diseases to which they
are especially vulnerable.
"The unnecessary death of even one child from a vaccine-preventable disease is tragic. Immunization is critical because
many of the bacteria and viruses that cause these life-threatening diseases still circulate in our country," Dr.
Schuchat said. "We have seen unfortunate resurgence of some of
these illnesses recently."
For more information please visit
http://www.cdc.gov/vaccines/events/niiw or call (800) CDC-INFO
[(800) 232-4636].
To access the English version of the complete press release, go
to: http://www.cdc.gov/media/pressrel/2009/r090423.htm
To access the Spanish version of the complete press release, go
to: http://www.cdc.gov/media/pressrel/2009/rs090423.htm
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6. |
IAC's Video of the Week features CDC's Dr. Jeanne Santoli answering moms'
tough questions about immunization
IAC encourages IAC Express readers to watch a
6.5-minute video that NCIRD staff developed after they had talked with
parents across the country. Titled "Get the Picture: Childhood
Immunizations," the video is intended to be a model that health professionals
can use to answer tough questions that real moms have about childhood
immunizations. Note: To view the video, you may need to install Adobe Flash
Player.
The video will be available on the home page of IAC's website through May 3.
To access it, go to:
http://www.immunize.org and click on the image under the words Video of
the Week, which you'll find toward the top of the page. It may take a few
moments for the video to begin playing; please be patient!
Remember to bookmark IAC's home page to view a new video every Monday. While
you're at our home page, we encourage you to browse around--you're sure to
find resources and information that will enhance your practice's immunization
delivery.
To view IAC's video collection, go to:
http://www.vaccineinformation.org/video
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7. |
CDC website posts Q&A for providers about Hib vaccine supply and Hib
vaccination coverage
On April 21, CDC added this Q&A to the NCIRD
website: "Vaccines and Preventable Diseases: Hib Vaccine--Q&As for Providers
about Hib Vaccine Supply and Hib Vaccination Coverage."
To access it, go to:
http://www.cdc.gov/vaccines/vpd-vac/hib/faqs-hcp-supply-coverage.htm
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8. |
VIS
translation: Interim VIS for pneumococcal conjugate vaccine now available in
Turkish
The current version (dated 12/09/08) of the
interim VIS for
pneumococcal conjugate vaccine (PCV7) is now available on the
IAC website in Turkish. IAC gratefully acknowledges Mustafa
Kozanoglu, MD, and Murat Serbest, MD, for the translation.
To obtain the interim VIS for PCV7 vaccine in Turkish, go to:
http://www.immunize.org/vis/tupnPCV7.pdf
To obtain the interim VIS for PCV7 vaccine in English, go to:
http://www.immunize.org/vis/pnPCV7.pdf
For information about the use of VISs, and for VISs in more than
35 languages, visit IAC's VIS web section at
http://www.immunize.org/vis
For general information about VISs from CDC's website go to:
http://www.cdc.gov/vaccines/pubs/vis
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