Issue Number 101
July 27, 1999
CONTENTS OF THIS ISSUE
- NVAC sponsors workshop on thimerosal
- CDC publishes report on secondary
cases of hepatitis A in Kansas
- Are your patients heading off to
college? Check out these resources on meningococcal vaccine for college students
- CDC offers slide series on
"Hepatitis A to E"
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July 23, 1999
NVAC SPONSORS WORKSHOP ON THIMEROSAL IN VACCINES
The Centers for Disease Control and Prevention (CDC) published the following announcement
as a "Notice to Readers" in the July 23, 1999, issue of the MMWR:
NATIONAL VACCINE ADVISORY COMMITTEE WORKSHOP ON
THIMEROSAL IN VACCINES
"The National Vaccine Advisory Committee will sponsor a workshop on thimerosal in
vaccines on August 11-12, 1999. The workshop will be held at the Lister Hill Auditorium on
the National Institutes of Health campus, Bethesda, Maryland, and will review use of
thimerosal in vaccines and its reduction and elimination from vaccines. Additional
information is available from the National Vaccine Program Office, CDC, Mailstop A-11,
1600 Clifton Rd, N.E., Atlanta, GA 30333; telephone (404) 639-4450; or from the World-Wide
To obtain a text version of this MMWR article, click here: http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/mm4828a4.htm
For information on how to get a free electronic subscription to the MMWR, see the
instructions that follow article two below.
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July 23, 1999
CDC PUBLISHES REPORT ON SECONDARY CASES OF HEPATITIS A IN KANSAS
The Centers for Disease Control and Prevention (CDC) published the article,
"Ascertainment of Secondary Cases of Hepatitis A -- Kansas, 1996-1997," in the
July 23, 1999, issue of the MMWR.
"Each year, 25,000-30,000 cases of hepatitis A are reported in the United States. The
most common infection source (22%-26%) is household or sexual contact with a person
already infected with hepatitis A virus (HAV) (i.e., the source-patient). In Kansas during
1992-1997, contact with a source-patient was reported by 39% of persons with hepatitis A.
Cases reported in 1996 and 1997 were studied retrospectively to determine the
reasons for the apparently high proportion of secondary cases and to evaluate missed
opportunities for prevention (i.e., postexposure prophylaxis with immune globulin [IG]).
Results of this investigation indicate that persons with hepatitis A often were
classified incorrectly as secondary cases and that some correctly identified secondary
cases represented missed opportunities for prevention."
The editorial note reads in part:
"...Accurate and understandable case definitions are needed to classify primary and
secondary cases of hepatitis A; also, timely and complete case reporting and
investigations are necessary to avoid missing opportunities for prevention.
"In Kansas, the high proportion of reported secondary cases occurred because some of
these cases should have been classified as co-primary or unrelated cases..."
"The Advisory Committee on Immunization Practices recommends IG for persons who have
been exposed to HAV and have not been vaccinated. IG should be given as quickly as
possible after exposure, but no longer than 2 weeks after the last exposure. Situations in
which IG is recommended include close personal contact with a person with hepatitis A,
including household and sexual contacts; contact with HAV-infected persons in day-care
centers, and sometimes following exposure to a foodhandler with hepatitis A. Hepatitis A
vaccination is recommended for preexposure prophylaxis in certain populations and
settings, but is not approved for postexposure prophylaxis.
"Approximately 25% of persons who had had household or sexual contact with a
source-patient were identified too long after exposure to benefit from IG. Health
departments should encourage rapid laboratory reporting of positive serologic test results
and should educate health-care providers about the importance of complete and timely
reporting. Local health department personnel also should be encouraged to conduct prompt
and thorough case investigations to identify contacts for whom IG might be indicated.
"Another 30% of secondary cases occurred among persons who had no household or sexual
contact with a person with hepatitis A but had reported other types of close personal
contact that have been associated with transmission, such as contact with young children
with unrecognized infection, and participating in the practices associated with illegal
drug use. The risk for and the mode of transmission in these circumstances have not
been established and are difficult to assess. An evaluation of the characteristics of each
contact should be conducted to identify exposed persons who are not household or sexual
contacts. Persons who report other types of close personal contact with a hepatitis A
patient should be considered candidates for IG..."
To obtain a text version of this MMWR article, click here: http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/mm4828a3.htm
HOW TO GET A FREE ELECTRONIC SUBSCRIPTION TO THE MMWR
To get a free electronic subscription to the MMWR (delivered weekly), go to the MMWR
website and sign up. When you sign up, you will also automatically begin to receive all
new ACIP statements which are published as MMWR's "Recommendations and Reports."
To get to the MMWR website, click here: http://www2.cdc.gov/mmwr/
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July 27, 1999
ARE YOUR PATIENTS HEADING OFF TO COLLEGE? CHECK OUT THIS INFORMATION ABOUT THE USE OF
MENINGOCOCCAL VACCINE FOR COLLEGE STUDENTS
Your patients or their parents may be asking about meningococcal vaccine after reading
about it in the popular press (e.g., "USA Today" ran two stories on June 1,
1999). Clinicians wishing to obtain more information about meningococcal vaccine for
college students can visit the following websites:
American College Health Association: http://www.acha.org/special-prj/men.htm
American Academy of Pediatrics: http://www.aap.org/new/menvacc798.htm
The Journal of the American Medical Association published the article, "Risk of
Meningococcal Infection in College Students," in its May 26, 1999, issue. To read the
abstract of this article, click here: http://jama.ama-assn.org/issues/v281n20/abs/joc81788.html
You may also want to refer to "Control and Prevention of Meningococcal Disease and
Control and Prevention of Serogroup C Meningococcal Disease: Evaluation and Management of
Suspected Outbreaks" which was published by the Advisory Committee on Immunization
Practices (ACIP) on February 14, 1997. These recommendations were published in the MMWR
and are available on the Internet.
To obtain a camera-ready copy (PDF format) of the complete ACIP statement, click here: ftp://ftp.cdc.gov/pub/Publications/mmwr/RR/RR4605.pdf
This ACIP statement is also available in text format as two separate documents.
For "Control and Prevention of Meningococcal Disease," click here: http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/00046263.htm
For "Control and Prevention of Serogroup C Meningococcal Disease: Evaluation and
Management of Suspected Outbreaks," click here: http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/00046237.htm
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July 27, 1999
CDC OFFERS SLIDE SERIES ON "HEPATITIS A TO E"
Available on the website of the Hepatitis Branch of the Centers for Disease Control and
Prevention (CDC) is a slide series entitled "Epidemiology and Prevention of Viral
Hepatitis A to E: An Overview." The series includes 67 color slides (2" x
2") which feature educational text, tables and graphics. A 21-page slide script is
also provided. To view this training tool, please click here: http://www.cdc.gov/ncidod/diseases/hepatitis/slideset/httoc.htm
The technical notes accompanying the slides can be downloaded as an ASCII text file or as
a WordPerfect document. The slides themselves can be downloaded in Microsoft Powerpoint
format, WMF format, or GIF format. If you are unable to download these files from the
Internet but would like to obtain the set, follow the instructions below. Cost for the
complete series is $65, plus $5 for shipping and handling. For those ordering from outside
the U.S., cost for the series is $75, plus $10 for shipping and handling.
To order the complete slide set, call the National Technical Information Service at:
800-553-6847 and reference order #: AVA19900-SS00INA. You can also fax your request to:
703-605-6900, or send an e-mail to firstname.lastname@example.org