Issue Number 116            October 4, 1999

CONTENTS OF THIS ISSUE

  1. CDC publishes updated ACIP statement on hepatitis A
  2. CDC publishes article on polio in Iraq
  3. October is Child Health Month
  4. CDC reports on healthier mothers and babies

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(1)
October 1, 1999
CDC PUBLISHES UPDATED ACIP STATEMENT ON HEPATITIS A

On October 1, 1999, the Advisory Committee on Immunization Practices (ACIP) released the updated statement, "Prevention of Hepatitis A Through Active or Passive Immunization." This report includes new information which builds on the earlier recommendations for the use of hepatitis A vaccine which
were published in 1996.

The "Summary" statement for this recommendation reads as follows:

Routine vaccination of children is the most effective way to reduce hepatitis A incidence nationwide over time. Since licensure of hepatitis A vaccine in 1995, this strategy has been implemented incrementally, starting with the  recommendation of the Advisory Committee on Immunization Practices (ACIP) in 1996 to vaccinate children living in communities with the highest rates of infection and disease. These updated recommendations represent the next phase of this hepatitis A immunization strategy. Vaccination of children living in states and communities with consistently elevated rates of hepatitis A will provide protection from disease and is expected to reduce the overall incidence of hepatitis A.

This report updates the ACIP's 1996 recommendations on the prevention of hepatitis A through immunization (MMWR 1996;45: [No. RR-15]) and includes a) new data about the epidemiology of hepatitis A; b) recent findings about the  effectiveness of community-based hepatitis A vaccination programs; and c) recommendations for the routine vaccination of children in states, counties, and communities with rates that are twice the 1987-1997 national average or greater (i.e., greater than or equal to 20 cases per 100,000 population) and consideration of routine vaccination of children in states, counties, and communities with rates exceeding the 1987-1997 national average (i.e., greater than or equal to 10 but less than 20 cases per 100,000 population). Unchanged in this report are previous recommendations regarding the vaccination of persons in groups at increased risk for hepatitis A or its adverse consequences and recommendations regarding the use of immune globulin for protection against hepatitis A.

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To obtain a camera-ready copy (PDF format) of the new ACIP statement on hepatitis A, visit: ftp://ftp.cdc.gov/pub/Publications/mmwr/rr/rr4812.pdf

The text version (HTML format) of this ACIP statement can be found at:  http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/rr4812a1.htm

Continuing education credit (CME, CEU, and CNE) is available by reading the recommendations and completing the test included in the camera-ready version of the document (PDF format only). 

NOTE: HEPATITIS A VACCINE AVAILABILITY THROUGH THE VACCINES FOR CHILDREN (VFC) PROGRAM

In accordance with ACIP guidelines and state policy, the VFC program will cover the purchase of hepatitis A vaccine for VFC-eligible children.

It is recommended that interested providers and/or parents contact their state health department immunization program to determine applicability or for more information. To obtain the phone numbers of state health department VFC  coordinators, go to: http://www.immunize.org/nslt.d/n18/coord18.htm

To obtain a copy of the VFC resolution on hepatitis A vaccine, visit CDC's VFC website at: http://www.cdc.gov/nip/vfc/ click on "ACIP Resolutions,"  then scroll down to "Hepatitis A" and "click."

For information on how to obtain a free electronic subscription to the MMWR, see the instructions that follow article four below.
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(2)
October 1, 1999
CDC PUBLISHES ARTICLE ON POLIO IN IRAQ

The Centers for Disease Control and Prevention (CDC) published a "Public Health Dispatch" entitled "Outbreak of Poliomyelitis -- Iraq, 1999" in the October 1, 1999, issue of the MMWR.

According to this MMWR report, "Since May 1999, 86 cases of acute flaccid paralysis (AFP) have been reported in Iraq... Before this outbreak, the last confirmed cases of wild polioviruses occurred in Iraq during April-May 1997."  Factors contributing to the outbreak include declining routine vaccination coverage in many areas and insufficient National Immunization Days coverage, especially among high-risk populations. "...The outbreak presents a challenge to the polio eradication initiative in Iraq and threatens reintroduction of virus into neighboring countries, especially Iran, Jordan, Syria, and Turkey."

To read the text version (HTML format) of this MMWR article, visit: http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/mm4838a4.htm

For information on how to obtain a free electronic subscription to the MMWR, see the instructions that follow article four below. 
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(3)
October 1, 1999
OCTOBER IS CHILD HEALTH MONTH

The Centers for Disease Control and Prevention (CDC) published the following announcement entitled "National Child Health Month -- October 1999" in the October 1, 1999, issue of the MMWR:

"Since 1992, the American Academy of Pediatrics (AAP) has designated October as Child Health Month to increase public awareness of the value of preventive health care for children. This year, Child Health Day is October 4.  To promote the health of the approximately 78 million children and teenagers in the United States, CDC recommends the following for children and parents.  Children should 1) learn to wash their hands to prevent infections; 2) eat breakfast before going to school; 3) not smoke and avoid the smoke of others; and 4) exercise and play safely and appropriately use protective gear.  Parents should 1) read to and be actively involved with their children; 2) get their children vaccinated; 3) get their children health-care insurance; 4) check for health hazards in their home and eliminate them; 5) place children  weighing less than 40 lbs in child safety seats and all others in safety belts in rear seats of automobiles; 6) seek medical advice if their child is slow to learn; and 7) avoid tobacco use and limit alcohol use. In addition, women of child-bearing age should take vitamins with folic acid to prevent certain birth defects."

Additional information about Child Health Month is available from AAP, telephone (847) 981-7871, or on the World Wide Web at:  http://www.aap.org/
http://salud.unm.edu/asthma/chm/Childmo.htm
http://www.census.gov/population/www/estimates/uspop.html
http://www.hrsa.dhhs.gov/childhealth/outreach.htm

To obtain a text version of this MMWR announcement (HTML format), visit:  http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4838a3.htm

The Immunization Action Coalition (IAC) has print materials regarding child immunization. You can download these items from IAC's website including "When Do Children and Teens Need Vaccinations?" in English and Spanish. 

To obtain a camera-ready copy (PDF format) of "When do children and teens need vaccinations?" go to: http://www.immunize.org/catg.d/when1.pdf
For the text version (HTML format) of this item in English, go to: http://www.immunize.org/nslt.d/n17/when1.htm

To obtain a camera-ready copy (PDF format) of this item in Spanish, "Cuando necesitan sus vacunas los ninos y adolescentes?" go to: http://www.immunize.org/catg.d/p4050-01.pdf
For the text version (HTML format) of this item in Spanish, go to: http://www.immunize.org/catg.d/p4050-01.htm

For a complete listing of IAC's immunization education print materials, visit: http://www.immunize.org/catg.d/free.htm

For information on how to obtain a free electronic subscription to the MMWR, see the instructions that follow article four below.
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(4)
October 1, 1999
CDC REPORTS ON HEALTHIER MOTHERS AND BABIES

The Centers for Disease Control and Prevention (CDC) published "Healthier Mothers and Babies" as part of their "Achievements in Public Health, 1900-1999" series in the October 1, 1999, issue of the MMWR.

From 1915 through 1997, the infant mortality rate declined more than 90%, and from 1900 through 1997, the maternal mortality rate declined almost 99%. According to the report's introductory statement, "environmental interventions, improvements in nutrition, advances in clinical medicine, improvements in access to health care, improvements in surveillance and monitoring of disease, increases in education levels, and improvements in standards of living contributed to this remarkable decline." Despite these improvements in maternal and infant mortality rates, significant disparities by race and ethnicity persist. 

To read the text version (HTML format) of this MMWR article, go to:
http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/mm4838a2.htm

HOW TO OBTAIN A FREE ELECTRONIC SUBSCRIPTION TO THE MMWR
To obtain a free electronic subscription to the MMWR (delivered weekly), go to the MMWR website and sign up. When you sign up, you will automatically begin to receive all new ACIP statements which are published as MMWR's  "Recommendations and Reports." To go to the MMWR website, click here: http://www2.cdc.gov/mmwr/

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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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