Issue Number 312            May 13, 2002


  1. Tetanus and diphtheria toxoids can now be obtained by clinicians for wound prophylaxis
  2. New! Almost-foolproof temperature logs for vaccine refrigerators and freezers
  3. "The Immunization Encounter": Live satellite broadcast to examine critical issues on June 27
  4. Hepatitis B Foundation creates informational web-page articles in Chinese and Korean
  5. CDC issues public health dispatch on pertussis in infant adopted from Russia
  6. Free! Copies of NEEDLE TIPS (Fall/Winter 2001-2002 issue) available
  7. NIH Consensus Development Conference on Management of Hepatitis C will take place June 10-12


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May 13, 2002

Beginning in June 2002, tetanus and diphtheria toxoids adsorbed for adult use (Td) will be available to  office-based health care providers in limited quantities for wound prophylaxis, saving many people  unnecessary and costly trips to emergency rooms. For many months, Td has been distributed only to hospitals and public health clinics for critical immunization needs. Aventis Pasteur, the sole supplier of Td, announced the change in availability on May 6.

Deferral of 10-year booster doses of Td is still in effect until further notice, according to a letter from Aventis Pasteur. Booster doses for adults may be reinstated as policy by the end of summer when the supply of Td increases to meet demand.

Office-based health care providers may place advance orders with Aventis for Td online May 13-May 28 at:

Starting May 28, orders may be placed online as above or by telephone at (800) 822-2463 (800-VACCINE).

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May 13, 2002

There may not be a better mousetrap, but there IS a better temperature log for vaccine storage! A new and improved log sheet helps prevent a common human error made when recording daily temperatures.  It's an easy error to make when checking temps twice every day (especially at the end of the day as one's last official act at work): peer into compartment, look at thermometer, note temperature, write temperature down on log, and fail completely to realize that the temperature noted and logged is 2 or 3 degrees too high for the vaccines being stored!

Whoops. Instead of taking action to fix the problem and preserve the vaccines, the person dutifully recording the temperature, with lots of other things on his or her mind, just walks away.

A new and improved monthly log sheet, courtesy of the Michigan Department of Community Health,  makes it harder not to notice when a recorded temperature is out of range. Instead of writing in the temperature on a blank line next to the date and time in an ongoing diary-style log, the recorder locates the temperature in a vertical column of possible temperatures and marks an "X" on that temperature's line under the date of the month, with days 1-31 spanning the top of the page, in the new monthly table-style log. If the "X" lands in a gray-shaded block of horizontal temperature cells, that means the temperature is out of range and you should consult your clinic's protocol for what to do next. Perhaps  the vaccines need to be moved to another refrigerator. Or perhaps the refrigerator door just needs to be  closed more carefully. You may need to call the vaccine manufacturer or your state health department.  A gray temperature cell tells you that you need to do something according to your clinic's protocol.

To obtain a camera-ready (PDF format) copy of the two-page Fahrenheit Temperature Log, go to:

To obtain a camera-ready (PDF format) copy of the two-page Celsius Temperature Log, go to:

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May 13, 2002

On Thursday, June 27, 12:00 noon-2:30 p.m. Eastern Time, the Centers for Disease Control and  Prevention (CDC) will present a live satellite and web broadcast, "The Immunization Encounter: Critical Issues."

Program faculty are William L. Atkinson, M.D., M.P.H.; Judy V. Schmidt, R.N., Ed.D.; and Donna L. Weaver, M.N., R.N; all from the National Immunization Program at CDC. The broadcast program will address best practices at each phase of the vaccination encounter, including intake and screening, vaccine administration, and documentation. For program details, registration, continuing education credit information, and satellite specifications, go to:

You may also obtain further information about registration by calling (800)418-7246 (800-41-TRAIN).

If you are unable to watch the live broadcast and would like to order a videotape, go to the Public Health Training Network website at:

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May 13, 2002

The Hepatitis B Foundation (HBF) has created new web-page articles about hepatitis B for Chinese and Korean readers. These "language chapters" offer accessible and culturally appropriate information for people in high-risk ethnic communities. An English version of each chapter is available for use by family members or health care providers in discussing the material. At less than 40 pages in length, these chapters are more than a brochure and less than a book, touching on many important points about hepatitis B in a single document that can be read in a single sitting.

Each language chapter includes text written by a high-profile community physician. In the Chinese chapter, Dr. Alan Tso, Associate Medical Director of the Chinatown Health Clinic in New York City, writes about hepatitis B among Chinese and other Asian immigrants. In the Korean chapter, Dr. Hie-Won Hann of Thomas Jefferson University tells readers about the current status of hepatitis B in the Korean community.

To view the Chinese chapter web page, go to:

To print a camera-ready (PDF format) copy of the Chinese chapter, go to:

For the English version of the Chinese chapter, go to:

To view the Korean chapter web page, go to:

To print a camera-ready (PDF format) copy of the Korean chapter, go to:

For the English version of the Korean chapter, go to:

For more information, contact the Hepatitis B Foundation by email at or phone at (215) 489-4900.

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May 13, 2002

On May 10, 2002, the Centers for Disease Control and Prevention (CDC) published "Pertussis in an  Infant Adopted from Russia--May 2002" in the Morbidity and Mortality Weekly Report (MMWR). The 10- month-old infant had traveled from Moscow to Raleigh, North Carolina, via New York City on commercial airplanes.

The dispatch reads in part as follows:


Health-care providers and public health officials are advised to consider pertussis when evaluating or notified of a person with an acute illness characterized by cough with paroxysms, whoop, or post-tussive gagging or vomiting. Following are CDC guidelines on the management of patients with pertussis and their contacts:

  • For symptomatic patients, test by culture of nasopharyngeal aspirate or swab; a nasopharyngeal Dacron(TM) swab should be used. Swabs or aspirate should be placed in Regan Lowe transport media if direct inoculation of selective media is not possible.
  • For hospitalized patients, respiratory isolation (droplet precautions) is recommended for at least the first 5 days of antimicrobial treatment.
  • For symptomatic patients, the treatment of choice for pertussis is erythromycin for 14 days. Trimethoprim-sulfamethoxozole is an alternative antibiotic. Limited clinical data suggest that newer  macrolides, such as azithromycin for 5-7 days or clarithromycin for 14 days, might be as effective  as erythromycin in the treatment of pertussis and are alternatives for patients who cannot tolerate erythromycin.
  • For exposed persons, chemoprophylaxis is recommended to limit secondary transmission. Exposure is defined as having face-to-face contact, having direct contact with respiratory, oral, or  nasal secretions, or being in the same room with a coughing pertussis case-patient. The recommended chemoprophylaxis regimen is erythromycin for 14 days. Alternative therapies are the same as for symptomatic patients.
  • Pertussis vaccination should be initiated or continued according to the recommended schedule for exposed children aged <7 years who are undervaccinated or who have received <4 DTaP doses. Exposed children may receive DTaP dose 2 or 3 if 4 weeks have elapsed after dose 1 or 2, respectively. Children may receive DTaP dose 4 as early as age 12 months, and preferably 6 months after dose 3. Children should be administered DTaP dose 5 unless a dose was given within the last 3 years or they are aged 7 or more years.

Additional information about pertussis is available at


To obtain the complete text of the article online, go to:

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:

To obtain a free electronic subscription to the "Morbidity and Mortality Weekly Report" (MMWR), visit CDC's MMWR website at: Select "Free MMWR 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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May 13, 2002

The Immunization Action Coalition (IAC) is giving away bulk copies (up to 210 per request) of the  Fall/Winter issue of Needle Tips to make room for our new Spring/Summer 2002 issue.

If you have an immunization conference or an educational program coming up for health professionals, this is an excellent item to distribute.

Because supplies are limited, it's best to make your request right away. The free copies go quickly. Sorry, we can only mail orders to addresses within the United States.

To request copies, fill out the online form on IAC's website:

You will be asked to supply the following information:

  1. the number of copies you want (maximum 210)
  2. a description of how you plan to use the copies
  3. your name and complete contact information, including mailing address, telephone number, and email address

If you don't have access to the Web, please contact Patti by email ( phone (651-647-9009).

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May 13, 2002

Next month is the National Institutes of Health (NIH) Consensus Development Conference on  Management of Hepatitis C. The conference will be held at the Natcher Conference Center in Bethesda,  Maryland, on Monday, June 10 through the morning of Wednesday, June 12.

The two-and-a-half-day conference will examine the current state of knowledge regarding the management of hepatitis C and identify directions for future research. Session topics will include "The  Burden of Hepatitis C in the U.S.," "Non-invasive Monitoring of Hepatitis C," "Screening for HCC," "Sexual Transmission," and "Hepatitis C and HIV."

For more information about the conference, go to:

To register for the conference online, go to:

You may also register or inquire by phone at (301) 592-3320, fax (301) 593-9433, or email at providing your complete name, mailing address, and phone number. 

About IZ Express

IZ Express is supported in part by Grant No. 1NH23IP922654 from CDC’s National Center for Immunization and Respiratory Diseases. Its contents are solely the responsibility of and do not necessarily represent the official views of CDC.

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Editorial Information

  • Editor-in-Chief
    Kelly L. Moore, MD, MPH
  • Managing Editor
    John D. Grabenstein, RPh, PhD
  • Associate Editor
    Sharon G. Humiston, MD, MPH
  • Writer/Publication Coordinator
    Taryn Chapman, MS
    Courtnay Londo, MA
  • Style and Copy Editor
    Marian Deegan, JD
  • Web Edition Managers
    Arkady Shakhnovich
    Jermaine Royes
  • Contributing Writer
    Laurel H. Wood, MPA
  • Technical Reviewer
    Kayla Ohlde

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