Issue
Number 376
March 31, 2003
CONTENTS OF THIS ISSUE
- CDC reports on cardiac adverse events following
smallpox vaccination
- Available online: Transcript of CDC news
conference on Severe Acute Respiratory Syndrome and smallpox vaccine
program
- New: CDC to introduce Spanish-language and
Native American immunization materials during National Infant Immunization
Week April 13-19
- IOM report urges CDC to assess the progress and
safety of its smallpox vaccination program as it prepares for expansion
- CDC publishes a worldwide update on Severe Acute
Respiratory Syndrome (SARS)
- CDC publishes Preliminary Clinical Description
of Severe Acute Respiratory Syndrome (SARS)
- CDC reports on Egypt's progress in poliomyelitis
eradication in 2002
- CDC notifies readers about the National Smallpox
in Pregnancy Registry
- Reminder: NFID Sixth Annual Conference on
Vaccine Research set for May 5-7
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March 31, 2003
CDC REPORTS ON CARDIAC ADVERSE EVENTS FOLLOWING SMALLPOX VACCINATION
The Centers for Disease Control and Prevention (CDC) published "Cardiac
Adverse Events Following Smallpox Vaccination--United States, 2003" in the
March 28 issue of the "Morbidity and Mortality Weekly Report" (MMWR).
The article's two opening paragraphs, which give an overview of the
heart-related incidents following smallpox vaccination, are reprinted below
in their entirety.
***********************
During January 24-March 21, smallpox vaccine was administered to 25,645
civilian health-care and public health workers in 53 jurisdictions as part
of an effort to prepare the United States in the event of a terrorist
attack using smallpox. Seven cases of cardiac adverse events have been
reported among civilian vaccinees since the beginning of the smallpox
vaccination program. In addition, 10 cases of myopericarditis have been
reported among military vaccinees. This report summarizes data on the seven
cases reported among civilians and provides background information on recent
military vaccinees. Although a causal association between vaccination and
adverse cardiac events in the civilian population is unproven, as a
precautionary measure, CDC recommends that persons with physician-diagnosed
cardiac disease with or without symptoms (e.g., previous myocardial
infarction, angina, congestive heart failure, or cardiomyopathy) be excluded
from vaccination during this smallpox preparedness program.
CDC, the Food and Drug Administration, and state health departments are
conducting surveillance for vaccine-associated adverse events among
civilian vaccinees; the Department of Defense (DoD) is conducting
surveillance for vaccine-associated adverse events among military vaccinees.
***********************
The closing paragraphs of the Editorial Note contain practical information
for clinicians; they are reprinted below in their entirety.
***********************
Because of the reports of myopericarditis and other cardiac adverse events,
CDC and DoD are issuing a supplement to the smallpox vaccine information
statement, disseminating information to partners and clinicians, and
developing strategies to assess prospectively the incidence and potential
causal association of cardiac events among vaccine recipients.
Because a causal relation between smallpox vaccination and serious cardiac
events cannot be excluded, CDC recommends as a precautionary measure that
persons with known cardiac disease with or without symptoms be excluded from
vaccination. As more information becomes available, this recommendation
might be revised.
Persons receiving smallpox vaccine should be informed that myopericarditis
might be associated with smallpox vaccination and that they should seek
medical attention if they develop chest pain, shortness of breath, or other
symptoms of cardiac disease after smallpox vaccination. For suspected
adverse cardiac events among smallpox vaccine recipients, providers should
consult with a cardiologist to ensure appropriate diagnostic studies are
conducted to facilitate diagnosis and treatment.
Health-care providers needing assistance evaluating a smallpox vaccinee with
a serious adverse event should contact their state health department or
CDC's Clinician Information Line, telephone (877) 554-4625. This information
line, staffed by nurses 24 hours a day, 7 days a week, is a source for
general smallpox clinical adverse event information and for assistance with
adverse event reporting.
***********************
To obtain the complete text of the article online, including case reports of
seven cardiac-adverse events, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5212a2.htm
To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5212.pdf
For up-to-date information from CDC on smallpox, visit
http://www.cdc.gov/smallpox
HOW TO OBTAIN A FREE ELECTRONIC SUBSCRIPTION TO THE MMWR:
To obtain a free electronic subscription to the "Morbidity and Mortality
Weekly Report" (MMWR), visit CDC's MMWR website at:
http://www.cdc.gov/mmwr Select
"Free Subscription" from the menu at the left of the screen. Once you have
submitted the required information, weekly issues of the MMWR and all new
ACIP statements (published as MMWR's "Recommendations and Reports") will
arrive automatically by email.
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March 31, 2003
AVAILABLE ONLINE: TRANSCRIPT OF CDC NEWS CONFERENCE ON SEVERE ACUTE
RESPIRATORY SYNDROME AND SMALLPOX VACCINE PROGRAM
On March 27, the Centers for Disease Control and Prevention (CDC) held a
news briefing for members of the broadcast and print media on Severe Acute
Respiratory Syndrome (SARS) and the smallpox vaccine program. James Hughes,
MD, director, National Center for Infectious Diseases took questions about
SARS, and Walt Orenstein, MD, director, National Immunization Program, took
questions about the smallpox vaccine program.
To access the complete conference transcript, go to:
http://www.cdc.gov/od/oc/media/transcripts/t030327.htm
The conference was audio webcast. To listen online, go to:
http://www.videonewswire.com/cdc/032703/reg.html
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March 31, 2003
NEW: CDC TO INTRODUCE SPANISH-LANGUAGE AND NATIVE AMERICAN IMMUNIZATION
MATERIALS DURING NATIONAL INFANT IMMUNIZATION WEEK APRIL 13-19
Set for April 13-19, this year's National Infant Immunization Week (NIIW)
will introduce two new promotional materials: an educational campaign, "The
Promise," and a poster, "Protect the Circle of Life, Immunize Our Nations."
"The Promise" campaign materials include a 30-second Spanish-language public
service announcement (PSA), a Spanish-language immunization booklet, and a
30-second English-language PSA. The campaign will kick off in Los Angeles
with a press conference hosted by the Immunization Coalition of Los Angeles
County and the Los Angeles County Immunization Program on April 11. The
Spanish-language PSA will be distributed to more than 100 Spanish-language
television stations; the English-language PSA will be distributed to state
and local health departments.
Designed for Native American and Alaska Native populations, the poster
"Protect the Circle of Life, Immunize Our Nations," reflects the importance
of infant immunization, as well as the importance of vaccination throughout
the life span. The poster will be unveiled during NIIW at a ceremony in
Talihina, OK, hosted by the Southeast Oklahoma Area Health Education Center,
Choctaw Nation of Oklahoma, Carl Albert State College, and Oklahoma State
Department of Health.
Now in its tenth year, NIIW emphasizes immunizing infants against 11
vaccine-preventable diseases by the age of two. The National Immunization
Program of the Centers for Disease Control and Prevention offers individuals
NIIW web pages containing sample public relations materials, posters,
flyers, web-link icons, tri-fold brochures, and other resources.
To access these materials, go to the NIIW web pages at
http://www.cdc.gov/nip/publications/niiw
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March 31, 2003
IOM REPORT URGES CDC TO ASSESS THE PROGRESS AND SAFETY OF ITS SMALLPOX
VACCINATION PROGRAM AS IT PREPARES FOR EXPANSION
On March 27, the Institute of Medicine (IOM) issued a news release
summarizing the content of IOM's second report advising the Centers for
Disease Control and Prevention (CDC) on the implementation of the national
smallpox vaccination program. CDC sponsored the report. A private, nonprofit
institution, IOM provides health policy advice under a Congressional charter
granted to the National Academy of Sciences.
Titled "Review of the Centers for Disease Control and Prevention's Smallpox
Vaccination Program Implementation--Letter Report #2," the report recommends
that CDC comprehensively evaluate the program and its outcomes to improve
its implementation and protect vaccinees and the public. It also advises CDC
to work with states to decide what more, if anything, is needed to achieve
smallpox preparedness.
**********************
To access the news release, go to:
http://www4.nationalacademies.org/news.nsf/isbn/NI000498?OpenDocument
To access the full report from the National Academies Press, go to:
http://www.nap.edu/catalog/10657.html?onpi_newsdoc032703
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March 31, 2003
CDC PUBLISHES A WORLDWIDE UPDATE ON SEVERE ACUTE RESPIRATORY SYNDROME (SARS)
The Centers for Disease Control and Prevention (CDC) published "Update:
Outbreak of Severe Acute Respiratory Syndrome邑orldwide, 2003" in the March
28 issue of the "Morbidity and Mortality Weekly Report" (MMWR). The
article's two opening paragraphs are reprinted below in their entirety.
***********************
CDC continues to support the World Health Organization (WHO) in the
investigation of a multicountry outbreak of unexplained atypical pneumonia
referred to as severe acute respiratory syndrome (SARS). This report
includes summaries of the epidemiologic investigations and public health
responses in several affected locations where CDC is collaborating with
international and national health authorities. This report also describes an
unusual cluster of cases associated with a hotel in Hong Kong and identifies
the potential etiologic agent of SARS. Epidemiologic and laboratory
investigations of SARS are ongoing.
As of March 26, a total of 1,323 suspected and/or probable SARS cases have
been reported to WHO from 14 locations, using the WHO case definition or
country-specific variations. These reported SARS cases include 49 deaths
(case-fatality proportion: 4%). The Chinese authorities have reported 792
suspected/probable cases, including 31 deaths, which occurred in Guangdong
province during November 16, 2002-February 28, 2003.
***********************
To obtain the complete text of the article online, go to
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5212a1.htm
To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5212.pdf
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March 31, 2003
CDC PUBLISHES PRELIMINARY CLINICAL DESCRIPTION OF SEVERE ACUTE RESPIRATORY
SYNDROME (SARS)
The Centers for Disease Control and Prevention (CDC) published "Preliminary
Clinical Description of Severe Acute Respiratory Syndrome" in the March 28
issue of the "Morbidity and Mortality Weekly Report" (MMWR). Originally
published March 21 in the web-based "MMWR Dispatch," the article has not
been available in hard-copy format until now.
The article discusses the disease's incubation period, symptoms, severity,
and treatment.
To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5212a5.htm
To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5212.pdf
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March 31, 2003
CDC REPORTS ON EGYPT'S PROGRESS IN POLIOMYELITIS ERADICATION IN 2002
The Centers for Disease Control and Prevention (CDC) published "Progress
Toward Poliomyelitis Eradication--Egypt, 2002" in the March 28 issue of the
"Morbidity and Mortality Weekly Report" (MMWR). A summary made available to
the press is reprinted below in its entirety.
***********************
Despite recent progress, surveillance and vaccination activities need
further improvements to interrupt poliovirus transmission in Egypt.
Egypt made significant progress toward poliovirus eradication during 2002.
The ability to find poliomyelitis cases has been improved and over 1 million
additional children have been vaccinated in national vaccination campaigns.
Only 7 cases of polio were identified during 2002. Genetic analyses of
viruses isolated both from cases and from sewage indicate that transmission
has been reduced to fewer lineages. The primary objective in Egypt now is to
maintain and extend these improvements.
***********************
To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5212a4.htm
To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5212.pdf
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March 31, 2003
CDC NOTIFIES READERS ABOUT THE NATIONAL SMALLPOX IN PREGNANCY REGISTRY
The Centers for Disease Control and Prevention (CDC) published a Notice to
Readers, "National Smallpox Vaccine in Pregnancy Registry" in the March 28
issue of the "Morbidity and Mortality Weekly Report" (MMWR). It is printed
below in its entirety, excluding references.
**********************
Smallpox vaccine is known to cause fetal vaccinia, a very rare but serious
complication of exposure to smallpox vaccine during pregnancy. Fewer than 50
cases have been reported, three of which occurred in the United States in
1924, 1959, and 1968. Affected pregnancies have been reported in women
vaccinated in all three trimesters, in primary vaccinees, and in those being
revaccinated, and in nonvaccinated contacts of vaccinees. Because a risk for
infection to the fetus is possible in the pre-event setting, smallpox
vaccination is not recommended for pregnant women or anyone with close
physical contact to a pregnant woman (e.g., a household member or sex
partner).
CDC has established the National Smallpox Vaccine in Pregnancy Registry, a
surveillance system to monitor the outcomes in women who inadvertently
received smallpox vaccine during pregnancy, became pregnant within 28 days
after vaccination, or were a close contact with a vaccinee within 28 days.
Exposed pregnant women should contact their health-care providers or their
state health department for assistance in enrolling in the registry.
Health-care providers and staff from state health departments are encouraged
to report all exposed pregnant women to the registry. Reports should be
routed through CDC, telephone (877) 554-4625 or (404) 639-8253.
**********************
To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5212a6.htm
To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5212.pdf
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March 31, 2003
REMINDER: NFID'S SIXTH ANNUAL CONFERENCE ON VACCINE RESEARCH SET FOR MAY 5-7
The National Foundation for Infectious Diseases (NFID) announced the Sixth
Annual Conference on Vaccine Research will take place May 5-7 at the Crystal
Gateway Marriott, Arlington, VA.
Intended to further networking and scientific collaboration among vaccine
researchers, the conference will focus on basic immunology, vaccine
development, clinical testing, and vaccine regulation.
For information, contact Sharon Cooper-Kerr by phone at (301) 656-0003,
extension 14 or 19; by fax at (301) 907-0878; or by email at
scooper-kerr@nfid.org or
vaccine@nfid.org
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