IAC Express 2011 |
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Issue number 951: September 6, 2011 |
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as well as other FREE IAC periodicals. |
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Contents
of this Issue
Select a title to jump to the article. |
- CDC
publishes MMWR Early Release about recent swine-origin influenza A (H3N2)
virus infections in Indiana and Pennsylvania children
- CDC
reports on vaccination coverage of children ages 19-35 months
- IAC
updates its handout on influenza vaccine products available for the U.S.
2011-12 influenza season
- Bulk
quantities of the 2011-12 Influenza Vaccine Pocket Guides and PPSV Pocket
Guides are available--FREE!--from the National Influenza Vaccine Summit
- IAC's
Video of the Week explores the pros and cons of physicians' refusing to
see patients who decline vaccination
- Spotlight
on immunize.org: IAC's Featured Resources
- AAP
releases policy statement on recommendations for influenza immunization of
children and makes influenza resources available on Red Book Online
- AAP
releases an updated policy statement on recommendations for use of
quadrivalent and monovalent varicella vaccines in children
- CDC's
September 15 Net Conference to focus on influenza
- CDC
publishes report on a measles outbreak in Indiana during June-July 2011
- CDC
gives providers information for patients about febrile seizures related to
simultaneous administration of PCV13 and TIV vaccines
- CDC
updates information for clinicians on influenza vaccination, vaccine
safety, and antiviral medications
- 2011-12
influenza vaccine VISs now available in Amharic and Thai
- CDC
publishes report on a human rabies death in Wisconsin in 2010
- IAC's
popular laminated versions of the 2011 U.S. immunization schedules are
available. Order a supply for your workplace today!
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Award-winning DVD! "Immunization Techniques: Best Practices with Infants,
Children, and Adults"--from the California Department of Public Health,
Immunization Branch
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VICNetwork to host September 21 webinar on promoting influenza vaccination
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Minnesota immunization conference planned for October 20-21
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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 951: September 6, 2011 |
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1. |
CDC publishes MMWR Early Release
about recent swine-origin influenza A (H3N2) virus infections in Indiana and
Pennsylvania children
On September 2, CDC published "Swine-Origin
Influenza A
(H3N2) Virus Infection in Two Children--Indiana and
Pennsylvania, July-August 2011" as an electronic MMWR Early
Release. Portions of the article and the Editorial Note are
reprinted below.
Influenza A viruses are endemic in many animal species,
including humans, swine, and wild birds, and sporadic cases
of transmission of influenza A viruses between humans and
animals do occur, including human infections with avian-origin influenza A viruses (i.e., H5N1 and H7N7) and swine-origin influenza A viruses (i.e., H1N1, H1N2, and H3N2).
Genetic analysis can distinguish animal origin influenza
viruses from the seasonal human influenza viruses that
circulate widely and cause annual epidemics. This report
describes two cases of febrile respiratory illness caused by
swine-origin influenza A (H3N2) viruses identified on August
19 and August 26, 2011, and the current investigations. No
epidemiologic link between the two cases has been
identified, and although investigations are ongoing, no
additional confirmed human infections with this virus have
been detected. These viruses are similar to eight other
swine-origin influenza A (H3N2) viruses identified from
previous human infections over the past 2 years, but are
unique in that one of the eight gene segments (matrix [M]
gene) is from the 2009 influenza A (H1N1) virus. The
acquisition of the M gene in these two swine-origin
influenza A (H3N2) viruses indicates that they are
"reassortants" because they contain genes of the swine-origin influenza A (H3N2) virus circulating in North
American pigs since 1998 and the 2009 influenza A (H1N1)
virus that might have been transmitted to pigs from humans
during the 2009 H1N1 pandemic. However, reassortments of the
2009 influenza A (H1N1) virus with other swine influenza A
viruses have been reported previously in swine. Clinicians
who suspect influenza virus infection in humans with recent
exposure to swine should obtain a nasopharyngeal swab from
the patient for timely diagnosis at a state public health
laboratory and consider empiric neuraminidase inhibitor
antiviral treatment to quickly limit potential human
transmission.
Case Reports
Patient A. On August 17, 2011, CDC was notified by the
Indiana State Department of Health Laboratories of a
suspected case of swine-origin influenza A (H3N2) infection
in a boy aged <5 years. The boy, who had received influenza
vaccine in September 2010, experienced onset of fever,
cough, shortness of breath, diarrhea, and sore throat on
July 23, 2011. He was brought to a local emergency
department (ED) where a respiratory specimen later tested
positive for influenza A (H3). The boy was discharged home,
but was not treated with influenza antiviral medications. He
has multiple chronic health conditions, returned to the ED
on July 24, 2011, and was hospitalized for treatment of
those health problems, which had worsened. The boy was
discharged home on July 27, 2011, and has since recovered
from this illness. As part of routine CDC-supported
influenza surveillance, the respiratory specimen collected
on July 24, 2011, was forwarded to the Indiana State
Department of Health Laboratories, where polymerase chain
reaction (PCR) testing identified a suspect swine-origin
influenza A (H3N2) virus on August 17, 2011. The specimen
was forwarded to CDC where the findings were confirmed
through genome sequencing on August 19, 2011.
No direct exposure to swine was identified for this child;
however, a caretaker reported direct contact with
asymptomatic swine in the weeks before the boy's illness
onset and provided care to the child 2 days before illness
onset. No respiratory illness was identified in any of the
child's family or close contacts, the boy's caretaker, or in
the family or contacts of the caretaker.
Patient B. On August 24, 2011, CDC was notified by the
Pennsylvania Department of Health of a suspected case of
swine-origin influenza A (H3N2) virus infection in a girl
aged <5 years. The girl, who had received influenza vaccine
in September 2010, experienced acute onset of fever,
nonproductive cough, and lethargy on August 20, 2011. She
was brought to a local hospital ED where a nasopharyngeal
swab tested positive for influenza A by rapid influenza
diagnostic test. She was not treated with influenza
antiviral medications and was discharged home the same day.
The girl has completely recovered from this illness.
A nasopharyngeal swab and nasal wash specimen were obtained
at the ED and forwarded to the Pennsylvania State Department
of Health Bureau of Laboratories for additional testing as
part of routine CDC-supported influenza surveillance. On
August 23, 2011, the state public health laboratory
identified a suspected swine-origin influenza A (H3N2) virus
by PCR testing, and both specimens were forwarded to CDC. On
August 26, 2011, genome sequencing confirmed the virus as
swine-origin influenza A (H3N2). On August 16, 2011, the
girl was reported to have visited an agricultural fair where
she had direct exposure to swine and other animals. No
additional illness in the girl's family or close contacts
has been identified, but illness in other fair attendees
continues to be investigated. No additional confirmed swine-origin influenza virus infections have been identified thus
far. . . .
Editorial Note
The lack of known direct exposure to pigs in one of the two
cases described in this report suggests the possibility that
limited human-to-human transmission of this influenza virus
occurred. Likely transmission of swine-origin influenza A
(H3N2) virus from close contact with an infected person has
been observed in past investigations of human infections
with swine-origin influenza A virus, but has not resulted in
sustained human-to-human transmission. Preliminary evidence
from the investigation of the Indiana case shows no ongoing
transmission. No influenza illness has been identified, but
if additional chains of transmission are identified, rapid
intervention is warranted [to] try to prevent further spread
of the virus. Clinicians should consider swine-origin
influenza A virus infection as well as seasonal influenza
virus infections in the differential diagnosis of patients
with febrile respiratory illness who have been near pigs.
Clinicians who suspect influenza virus infection in humans
with recent exposure to swine, should obtain a
nasopharyngeal swab from the patient, place the swab in a
viral transport medium, contact their state or local health
department to facilitate transport and timely diagnosis at a
state public health laboratory, and consider empiric
neuraminidase inhibitor antiviral treatment. CDC requests
that state public health laboratories send all suspected
swine-origin influenza A specimens to the CDC, Influenza
Division, Virus Surveillance and Diagnostics Branch
Laboratory.
To access the Early Release, go to:
http://www.cdc.gov/mmwr/pdf/wk/mm60e0902.pdf
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2. |
CDC reports on vaccination coverage of children ages 19-35 months
CDC published "National and State Vaccination
Coverage Among
Children Aged 19-35 Months--United States, 2010" in the
September 2 issue of MMWR. The first paragraph is reprinted
below.
The National Immunization Survey (NIS) monitors vaccination
coverage among children aged 19-35 months using a random-digit-dialed sample of telephone numbers of households to
evaluate childhood immunization programs in the United
States. This report describes the 2010 NIS coverage
estimates for children born during January 2007-July 2009.
Nationally, vaccination coverage increased in 2010 compared
with 2009 for >=1 dose of measles, mumps, and rubella
vaccine (MMR), from 90.0% to 91.5%; >=4 doses of
pneumococcal conjugate vaccine (PCV), from 80.4% to 83.3%;
the birth dose of hepatitis B vaccine (HepB), from 60.8% to
64.1%; >=2 doses of hepatitis A vaccine (HepA), from 46.6%
to 49.7%; rotavirus vaccine, from 43.9% to 59.2%; and the
full series of Haemophilus influenzae type b (Hib) vaccine,
from 54.8% to 66.8%. Coverage for poliovirus vaccine
(93.3%), MMR (91.5%), >=3 doses HepB (91.8%), and varicella
vaccine (90.4%) continued to be at or above the national
health objective targets of 90% for these vaccines. The
percentage of children who had not received any vaccinations
remained low (<1%). For most vaccines, no disparities by
racial/ethnic group were observed, with coverage for other
racial/ethnic groups in 2010 similar to or higher than
coverage among white children. However, disparities by
poverty status still exist. Maintaining high vaccination
coverage levels is important to reduce the burden of
vaccine-preventable diseases and prevent a resurgence of
these diseases in the United States, particularly in
undervaccinated populations.
To access the full article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6034a2.htm
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3. |
IAC updates its handout on influenza vaccine products available for the U.S.
2011-12 influenza season
IAC recently revised its professional-education
handout
"Influenza Vaccine Products for the 2011-12 Influenza
Season." It now has two pages (it formerly had one), new
Medicare codes, and information on administering intradermal
influenza vaccine.
Go to: http://www.immunize.org/catg.d/p4072.pdf
IAC's Handouts for Patients and Staff web section offers
healthcare professionals and the public approximately 250
FREE English-language handouts (many also available in
translation), which we encourage website users to print out,
copy, and distribute widely. To access all of IAC's free
handouts, go to: http://www.immunize.org/handouts
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4. |
Bulk quantities of the 2011-12 Influenza Vaccine Pocket Guides and PPSV
Pocket Guides are available--FREE!--from the National Influenza Vaccine
Summit
To aid in efforts to vaccinate against influenza
and
pneumococcal disease, the Immunization Action Coalition is
inviting IAC Express readers to place orders now for bulk
quantities of the National Influenza Vaccine Summit's 2011-12 Influenza Vaccine Pocket Information Guide and
Pneumococcal Polysaccharide Vaccination (PPSV) Pocket Guide.
Both are free--you can order them in the hundreds or
thousands!
These laminated, 3.75 x 6.75-inch, 2-color cards serve as a
convenient reference for front-line healthcare professionals
who vaccinate patients. Place a bulk order now, and your
organization will be ready to educate healthcare
professionals at upcoming immunization training sessions and
conferences. Each staff person who administers influenza or
PPSV vaccine needs these handy resources.
THE 2011-12 INFLUENZA POCKET GUIDE PROVIDES THE FOLLOWING
INFORMATION:
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Important points for healthcare providers
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Indications, contraindications, and precautions for the
injectable, intradermal, and intranasal influenza
vaccines
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Clear direction regarding which children ages 6 months
through 8 years need 2 doses of influenza vaccine this
year
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Dosage, route of administration, and indicated age group
for all the various influenza vaccine products
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Talking points for discussing influenza vaccination with
patients
See an image of the influenza vaccine pocket guide at
http://www.immunize.org/pocketguides/pocketguide_flu.pdf
The influenza pocket guide also serves as a reminder to keep
giving influenza vaccine throughout influenza season
(through the spring months).
THE PPSV POCKET GUIDE PROVIDES THE FOLLOWING INFORMATION:
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Indications for vaccination with PPSV, contraindications,
and precautions
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Indications for vaccination with 2 doses of PPSV and
intervals between doses
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Dosage and routes of administration
See an image of the PPSV pocket guide at
http://www.immunize.org/pocketguides/pocketguide_ppsv.pdf
The 2011-12 influenza pocket guide and PPSV pocket guide are
designed to be used by healthcare professionals only; THEY
ARE NOT PATIENT HANDOUTS.
HOW TO ORDER
Place your order at http://www.preventinfluenza.org/pocketguides There is no
cost for the pocket guides, shipping, or handling within the
U.S. They're going fast, so to avoid disappointment, place
your order ASAP!
If you have questions, email admininfo@immunize.org
BACKGROUND
For background information on the pocket guides, see
http://www.immunize.org/express/issue949.asp#n3
Thanks for your dedication to immunization, and don't forget
to keep vaccinating against influenza through the spring
months!
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5. |
IAC's Video of the Week explores the pros and cons of physicians' refusing to
see patients who decline vaccination
IAC encourages IAC Express readers to watch a
5-minute video
segment from The Today Show titled "Should Doctors Ban Kids
Who Aren't Vaccinated?" In the segment, NBC's chief medical
correspondent, Dr. Nancy Snyderman, and pediatrician Dr.
Lisa Thornton discuss the growing number of doctors who, in
an attempt to keep their offices safe from the spread of
disease, refuse to see parents/patients who choose not to
vaccinate.
The video will be available on the home page of IAC's
website through September 11. To access it, go to:
http://www.immunize.org and click on the image under the
words Video of the Week.
Remember to bookmark IAC's home page to view a new video
every Monday.
To access the archives of IAC's Videos of the Week, go to:
http://www.immunize.org/votw
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6. |
Spotlight on immunize.org: IAC's Featured Resources
Looking for noteworthy immunization resources for
patients
and healthcare staff? Look no further. IAC's Featured
Resources section is a frequently updated listing of links
to timely, practical, and cool resources from our
immunization partners.
To access Featured Resources, visit
http://www.immunize.org/news/featured-resources.asp
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7. |
AAP releases policy statement on recommendations for influenza immunization
of children and makes influenza resources available on Red Book Online
On September 2, the American Academy of
Pediatrics (AAP)
published a policy statement online (ahead of print) made by
AAP's Committee on Infectious Diseases. Titled
"Recommendations for Prevention and Control of Influenza in
Children, 2011-2012," this statement updates the current
recommendations for routine use of trivalent seasonal
influenza vaccine and antiviral medications for the
prevention and treatment of influenza in children.
The full text and abstract of the statement are available at
no charge. To access the full text, go
here.
To access the abstract, go
here.
INFLUENZA RESOURCES ON RED BOOK ONLINE
AAP's Committee on Infectious Diseases has compiled a
comprehensive list of influenza resources to serve as a
centralized point of reference for vaccine guidance,
prevention, treatment, payment, policies, news, and other
information pertaining to influenza for infants, children,
adolescents, and young adults.
To access the resources, go to the Influenza Resource Page
of AAP's Red Book Online at
http://aapredbook.aappublications.org/flu Some links may
require member or subscriber log-in. The resources are
updated frequently; be sure to check back often.
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8. |
AAP
releases an updated policy statement on recommendations for use of quadrivalent
and monovalent varicella vaccines in children
On August 28, the American Academy of Pediatrics
(AAP)
published an online version of "Policy Statement--Prevention
of Varicella: Update of Recommendations for Use of
Quadrivalent and Monovalent Varicella Vaccines in Children."
A portion of the policy statement is reprinted below.
POLICY OR RECOMMENDATION
The routinely recommended ages for measles, mumps, rubella,
and varicella vaccination continue to be 12 through 15
months for dose 1 and 4 through 6 years for dose 2. The
American Academy of Pediatrics recommends for the first dose
at ages 12 through 47 months that either MMR and varicella
vaccines [be] administered separately or MMRV can be used.
Use of separate MMR and varicella vaccines averts the slight
increase in risk of fever and febrile seizures after
MMRV administration but at the cost of the pain associated
with an extra injection and the risk of an infant falling
behind schedule if all vaccines indicated at that visit are
not given. Providers who are considering administering MMRV
should discuss the benefits and risks of both vaccination
options with the parents or caregivers. Because parents need
to be fully aware of the slight increase in risk of febrile
seizures with the combination MMRV compared with separate
MMR and varicella injections at the same visit, providers
who face barriers to clearly communicating these benefits
and risks for any reason (e.g., language barriers)
should administer MMR and varicella vaccines separately.
The risk of febrile seizures is not increased in older
children who receive the second dose of MMRV. Therefore,
when the first dose of measles, mumps, rubella, and
varicella vaccines is administered at ages 48 months and
older, and for dose 2 at any age (15 months through 12
years), use of the MMRV generally is preferred over separate
injections of its equivalent component vaccines (i.e., MMR
and varicella vaccines) because of the decreased
number of injections required with the MMRV.
A personal or family (such as sibling or parent) history of
seizures is now a precaution for MMRV vaccination. Children
with a personal or family history of seizures generally
should be vaccinated with MMR and varicella vaccines,
because the risks of using the MMRV in this group of
children generally outweigh the benefits. . . .
The full text of the updated policy statement is available
at no cost, as is the abstract. To access the full text, go
here.
To access the abstract, go
here.
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9. |
CDC's September 15 Net Conference to focus on influenza
The next "Current Issues in Immunization" Net
Conference
will be held on September 15 from noon to 1 PM Eastern Time.
Carolyn Bridges, MD, and others from CDC will make
presentations on influenza. Andrew Kroger, MD, MPH, will
moderate the discussion.
Registration is limited and will close on September 13 or
when the course is full. To register, go to:
http://www2.cdc.gov/vaccines/ed/ciinc
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10. |
CDC publishes report on a measles outbreak in Indiana during June-July 2011
CDC published "Notes from the Field: Measles
Outbreak--Indiana, June-July 2011" in the September 2 issue of MMWR.
Portions of the article are reprinted below.
On June 20, 2011, an emergency department (ED) physician
reported five epidemiologically linked measles cases to the
Indiana State Department of Health. The subsequent
investigation identified a total of 14 confirmed cases in
northeast Indiana. Of these, 10 were laboratory-confirmed,
and four were among household contacts of persons with
laboratory-confirmed measles. Of the 14 patients, 13 were
unvaccinated persons in the same extended family. The
nonfamily member was a child aged 23 months who had received
1 dose of measles, mumps, and rubella vaccine 4 months
before illness onset. Four of the 14 patients were males;
median age was 11.5 years (range: 15 months-27 years). One
patient was a woman in week 32 of pregnancy who was
hospitalized for acute pneumonitis.
The index patient was an unvaccinated U.S. resident aged 24
years who noted a rash on June 3 during a return flight from
Indonesia, where measles is endemic. The patient was
admitted to an Indiana hospital during June 7-9 and treated
for presumed dengue fever. Measles was not considered, and
the patient was not isolated. The outbreak was unrecognized
until June 20, when five family members visited an ED after
experiencing onset of measles symptoms at various times over
the previous few days. Subsequently, measles genotype D9, a
strain endemic in Indonesia, was isolated from
nasopharyngeal swabs from two of these patients.
A contact investigation involving approximately 780 persons
included follow-up of exposures at a church (approximately
150 persons), a factory (approximately 300 persons), and in
a bus ridden by school-aged children who had traveled out of
state. . . .
As of August 26, 198 cases and 15 outbreaks of measles had
been confirmed in the United States, the highest number
since 1996 (CDC, unpublished data, 2011). Of the 198 cases,
179 (90%) were associated with U.S. residents traveling
internationally. Of the 15 outbreaks, the outbreak in
Indiana is the second largest. With ongoing importation and
suboptimal vaccination rates among specific populations,
measles outbreaks might continue to occur. In addition to
providing accurate information on the risks and benefits of
vaccines and making vaccination accessible, state and local
health departments should continue to investigate contacts
of suspected measles patients to institute control measures
to prevent measles transmission in the community. Parents
should be reminded, as children return to school, to check
their children's vaccination status for measles, mumps, and
rubella vaccine and all other recommended vaccines.
To access the full article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6034a5.htm
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11. |
CDC gives providers information for patients about febrile seizures related
to simultaneous administration of PCV13 and TIV vaccines
CDC recently posted a brief note about a sentence
that
appears in the 2011-12 VIS for trivalent inactivated
influenza vaccine (TIV; injectable). The sentence mentions that an increased
risk of febrile seizures exists when TIV and pneumococcal conjugate vaccine
(PCV13) are given to young children simultaneously. The brief note, which is
reprinted below, gives providers information they can share
with patients about this issue. A more detailed explanation
will be published on CDC's website at a future date.
The 2011-2012 inactivated influenza vaccine VIS states that
"young children who get inactivated flu vaccine and
pneumococcal vaccine (PCV13) at the same time appear to be
at increased risk for seizures caused by fever."
ACIP chose to include this statement on the VIS to inform
parents of this potential risk. However, additional
information has not yet been published to help providers
respond to parents' questions.
Increased rates of febrile seizures have been reported among
children, especially those 12 through 23 months of age, who
received simultaneous vaccination with TIV and PCV13,
compared with children who received these vaccines
separately. However, because there are risks associated with
delaying either of these vaccines, ACIP does not recommend
administering them at separate visits or deviating from the
recommended vaccine schedule in any way.
Febrile seizures are not uncommon, occurring in 2% to 5% of
all children; and they are generally benign. Healthcare
providers should be prepared to discuss parents' questions
about this issue, including questions about fever and
febrile seizures.
More detailed information will soon be available on CDC's
website, and will be updated as additional data become
available.
To access the note, which is titled "Febrile Seizures
Associated with TIV & PCV13," go to:
http://www.cdc.gov/vaccines/pubs/vis/tiv-pcv-note.htm
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12. |
CDC updates information for clinicians on influenza vaccination, vaccine
safety, and antiviral medications
CDC recently updated the following three web
pages of
influenza information for clinicians.
(1) "Influenza Vaccination: A Summary for Clinicians"
http://www.cdc.gov/flu/professionals/vaccination/vax-summary.htm
(2) "Seasonal Influenza Vaccine Safety: A Summary for
Clinicians"
http://www.cdc.gov/flu/professionals/vaccination/vaccine_safety.htm
(3) "2011-2012 Influenza Antiviral Medications: A Summary
for Clinicians"
http://www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm
To access CDC's continually updated influenza information
for professionals and patients/parents, go to:
http://www.cdc.gov/flu/whatsnew.htm
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13. |
2011-12 influenza vaccine VISs now available in Amharic and Thai
The 2011-12 VIS for inactivated influenza (TIV)
vaccine and
the 2011-12 VIS for live, intranasal influenza (LAIV)
vaccine are now available in Amharic (spoken in Ethiopia)
and Thai. IAC gratefully acknowledges the Minnesota
Department of Health and the DSMA Ethiopian Orthodox
Tewahedo Church Parish Nursing Program, Minneapolis, MN, for
the Amharic translations, and Asian Pacific Health Care
Venture, Inc., for the Thai translations.
To access the new translations of the VIS for TIV, as well
as the English version, go to:
http://www.immunize.org/vis/vis_flu_inactive.asp
To access the new translations of the VIS for LAIV, as well
as the English version, go to:
http://www.immunize.org/vis/vis_flu_live.asp
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
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14. |
CDC publishes report on a human rabies death in Wisconsin in 2010
CDC published "Human Rabies--Wisconsin, 2010" in
the
September 2 issue of MMWR. The first paragraph is reprinted
below.
In late December 2010, a male resident of Wisconsin, aged 70
years, sought treatment for progressive right shoulder pain,
tremors, abnormal behavior, and dysphagia at an emergency
department (ED). He was admitted for observation and treated
with benzodiazepines and haloperidol, a neuroleptic, for
presumed alcohol withdrawal syndrome. The next day, he had
rhabdomyolysis, fever, and rigidity, and neuroleptic
malignant syndrome was diagnosed. The neuroleptic was
discontinued, but the patient's clinical status worsened,
with encephalopathy, respiratory failure, acute renal
failure requiring hemodialysis, and episodes of cardiac
arrest. With continued clinical deterioration, additional
causes were considered, including rabies. On hospital day
12, rabies virus antigens and nucleic acid were detected in
the nuchal skin biopsy and rabies virus nucleic acid in
saliva specimens sent to CDC. A rabies virus variant
associated with silver-haired bats (Lasionycteris
noctivagans) was identified. The patient died on hospital
day 13. His spouse reported that they had been selling
firewood, and bats had been present in the woodpile;
however, the man had not reported a bat bite. Two relatives
and five healthcare workers potentially exposed to the man's
saliva received postexposure prophylaxis. This case
highlights the variable presentations of rabies and the ease
with which a diagnosis of rabies can be missed in a
clinically challenging patient with comorbidities.
Clinicians should consider rabies in the differential
diagnosis for patients with progressive encephalitis or
neurologic illness of unknown etiology, and caregivers
should take precautions to avoid exposure to body fluids.
Continued public education regarding risks for rabies virus
exposure during interactions with wildlife, particularly
bats, is important.
To access the full article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6034a3.htm
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15. |
IAC's popular laminated versions of the 2011 U.S. immunization schedules are
available. Order a supply for your workplace today!
IAC's laminated versions of the 2011 U.S.
child/teen and
adult immunization schedules are covered with a tough,
washable coating that lets them stand up to a year's worth
of use in every area of your workplace where immunizations
are given. Each has six pages (i.e., three double-sided
pages) and is folded to measure 8.5" by 11".
Laminated schedules are printed in color for easy reading,
come complete with essential tables and footnotes, and
include contraindications and precautions--a feature that
will help you make an on-the-spot determination about the
safety of vaccinating patients of any age.
PRICING
1-4 copies: $7.50 each
5-19 copies: $5.50 each
20-99 copies: $4.50 each
To view images of the laminated schedules, or to order
online or download an order form, go to:
http://www.immunize.org/shop/laminated-schedules.asp
For quotes on customizing or placing orders in excess of 999
schedules, call (651) 647-9009 or email admininfo@immunize.org
To learn about other essential immunization resources
available for purchase from IAC, go to: http://www.immunize.org/shop
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16. |
Award-winning DVD! "Immunization Techniques: Best Practices with Infants,
Children, and Adults"--from the California Department of Public Health,
Immunization Branch
The California Department of Public Health (CDPH),
Immunization Branch, has updated its award-winning training
video, "Immunization Techniques: Best Practices with
Infants, Children, and Adults." The 25-minute program can be
used to train new employees and to refresh the skills of
experienced staff. The video demonstrates the skills and
techniques needed to administer vaccines to patients of all
ages.
Prices start at $17 each for 1-9 copies and are greatly
reduced for large orders, dropping to $3 each for 1,000-1,499 copies.
To learn more about the DVD, and find out how to order it,
go to: http://www.immunize.org/dvd
For quotes on larger quantities, call (651) 647-9009 or
email admininfo@immunize.org
The Immunization Action Coalition is the only nationwide
vendor of the DVD.
Note for healthcare settings located in California: Contact
your local health department immunization program for a free
copy.
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17. |
VICNetwork to host September 21 webinar on promoting influenza vaccination
The Virtual Immunization Communication Network (VICNetwork)
is hosting "What's New with the Flu? Info and Strategies for
Healthcare Personnel and Health Communicators" on September
21 at 11 AM Pacific time/2 PM Eastern time. The presenter is
Litjen (L.J.) Tan, MS, PhD, director, Medicine and Public
Health, American Medical Association, and co-chair, National
Influenza Vaccine Summit.
For additional information, and to register for the webinar,
go to: http://vicnetwork.org
VICNetwork is a project of the National Public Health
Information Coalition in collaboration with the California
Immunization Coalition.
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18. |
Minnesota immunization conference planned for October 20-21
The Minnesota Department of Health's "Got Your
Shots?" immunization conference will be held in Brooklyn Park, MN, on October
20-21. The conference focuses on helping parents make informed decisions
about immunization. Continuing education credit is available to participants.
For comprehensive conference information, go to:
http://www.health.state.mn.us/divs/idepc/immunize/conference/index.html
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