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Hep Express Issue 10

Issue Number 10, October 30, 2003
 
Contents of this Issue
1. CDC's Division of Viral Hepatitis launches Spanish version of its website
2. Human Rights Watch publishes report on government interference in syringe exchange programs
3. Low vaccination rates found among adults at high risk for hepatitis B
4. CDC publishes the Recommended Adult Immunization Schedule  for 2003-04
5. OSHA publishes bulletin on disposal of contaminated needles and blood tube holders
6. October issue of NEEDLE TIPS in the mail and on the Web
7. IAC's revised hepatitis pieces answer common questions
8. Journal articles you might have missed
9. Fall issue of HBF's "B Informed" available online
10. Hepatitis C infection and substance abuse conference scheduled for November 11-13 in Washington, D.C.
11. CDC notifies readers about the International Conference on Women and Infectious Diseases


(1 of 11)
October 30, 2003
CDC'S DIVISION OF VIRAL HEPATITIS LAUNCHES SPANISH VERSION OF ITS WEBSITE
 
The Centers for Disease Control and Prevention's Division of Viral Hepatitis recently created a Spanish mirror site of their viral hepatitis website. Check out the resources available on this site and recommend it to your Spanish-speaking patients, clients, and friends.
 
The website can be accessed directly at
http://www.cdc.gov/spanish/enfermedades/hepatitis
 
The site can also be accessed by clicking on the "CDC en Español" link found throughout the English-language version.

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(2 of 11)
October 30, 2003
HUMAN RIGHTS WATCH PUBLISHES REPORT ON GOVERNMENT INTERFERENCE IN SYRINGE EXCHANGE PROGRAMS
 
The Human Rights Watch has published a report on government interference in sterile syringe exchange programs, using California as a case study. The 57-page report, "Injecting Reason: Human Rights and HIV Prevention for Injection Drug Users," describes "how the ideology of the 'war on drugs' has trumped both reason and reality in the United States and violated the human right of injection drug users to take steps to protect their health."
 
While syringe exchange service are legal in several California counties, the unauthorized possession and distribution of hypodermic syringes is illegal statewide. The report documents cases of individuals being arrested, harassed, searched, and penalized based on possession of sterile syringes and other items obtained at legal syringe exchange programs.
 
The report concludes: "Such hypocrisy not only offends common sense; it may prove fatal to people who inject drugs, their sex partners, their children, and others whose HIV infection is linked to injection drug use. It has been estimated that thousands of HIV infections, and indeed millions of dollars in health care costs, could have been avoided in the United States had the federal government implemented syringe exchange nationally in the 1980s. California, with its patchwork of legal, illegal, and quasi-legal syringe exchanges and its contradictory laws and policies, is a microcosm of this national picture. Its leadership on this issue of critical importance, guided by a respect for the human rights of those most at risk of HIV infection, could reaffirm that life is more precious than ideology."
 
"Injecting Reason: Human Rights and HIV Prevention for Injection Drug Users" can be downloaded at
http://www.hrw.org/reports/2003/usa0903

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(3 of 11)
October 30, 2003
LOW VACCINATION RATES FOUND AMONG ADULTS AT HIGH RISK FOR HEPATITIS B
 
A presentation at the American Academy of Family Physicians Scientific Assembly on October 3, reported on low vaccination rates found among adults at high risk for hepatitis B.
 
Nidhi Jain, MD, MPH, Centers for Disease Control and Prevention (CDC), presented data from CDC's 2000 National Health Interview Survey (NHIS). This survey found that less than one third of adults between the ages of 18 and 49 years who are at high risk for hepatitis B infections receive vaccination.
 
The Medscape article based on this presentation, "Low Vaccination Rates Found Among Adults at High Risk for Hepatitis B," can be read at http://www.medscape.com/viewarticle/462644 You must be a member to access this article. Registration is free.

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(4 of 11)
October 30, 2003
CDC PUBLISHES THE RECOMMENDED ADULT IMMUNIZATION SCHEDULE FOR 2003-04
 
[The following is cross posted from the Immunization Action Coalition's "IAC EXPRESS" electronic newsletter, 10/13/03.]
 
The Centers for Disease Control and Prevention (CDC) published "Notice to Readers: Recommended Adult Immunization Schedule--United States, 2003-2004" in the October 10 issue of "Morbidity and Mortality Weekly Report" (MMWR).
 
The format has been revised to better represent the schedule's two components, by age group and by medical condition, and to better indicate how the footnotes apply to both figures.
 
The 2003-2004 Adult Immunization Schedule is available at
http://www.cdc.gov/nip/recs/adult-schedule.pdf
 
To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5240a6.htm
 
To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5240.pdf
 
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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(5 of 11)
October 30, 2003
OSHA PUBLISHES BULLETIN ON DISPOSAL OF CONTAMINATED NEEDLES AND BLOOD TUBE HOLDERS
 
A new Safety and Health Information Bulletin issued by OSHA on October 15, 2003, explains the Agency's policy on the disposal of contaminated needles and blood tube holders following blood drawing procedures.
 
"Disposal of Contaminated Needles and Blood Tube Holders Used for Phlebotomy" provides relevant information regarding OSHA's policy on the prohibition of contaminated needle removal from medical devices. This Safety and Health Information Bulletin is not a standard or regulation, and it creates no new legal obligations. The Bulletin is advisory in nature, informational in content, and is intended to assist employers in providing a safe and healthful workplace.
 
To read or download "Disposal of Contaminated Needles and Blood Tube Holders Used for Phlebotomy," go to:
http://www.osha.gov/dts/shib/shib101503.html

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(6 of 11)
October 30, 2003
OCTOBER ISSUE OF NEEDLE TIPS IN THE MAIL AND ON THE WEB

[The following is cross posted from the Immunization Action Coalition's "IAC EXPRESS" electronic newsletter, 10/20/03.]

The hard copy of the new "NEEDLE TIPS and the Hepatitis B Coalition News" should be arriving soon in the mail boxes of 150,000 health professionals. If you haven't received yours, you can access the entire issue or selected articles from the website of the Immunization Action Coalition (IAC). Immunization and hepatitis experts at the federal Centers for Disease Control and Prevention (CDC) have reviewed each article and education piece in the issue for accuracy (with the exception of editorials).

Just in time for this year's influenza vaccination season, the new issue has abundant information about influenza vaccination, including information on how to access printable versions of the most recent Vaccine Information Statements for the inactivated influenza vaccine and the new live, intranasal influenza vaccine. In addition, the issue allocates several pages to explaining the complex topic of hepatitis B prevention, diagnosis, and treatment among health care professionals and the general public. Lastly, we devote two pages each to summarizing the recommendations for childhood and adult immunization. This is information you won't find anywhere else; we hope you'll peruse the table of contents (given below) and read articles that interest you online.

HOW TO READ "NEEDLE TIPS" ON THE WEB
You can download the entire issue from the Web or view selected articles from the table of contents below.

To view the table of contents with links to individual articles, go to: http://www.immunize.org/nt

Please note: The PDF file of the entire October 2003 issue, linked below, is large at 891,883 bytes. Some printers cannot print such a large file. For tips on downloading and printing PDF files, go to: http://www.immunize.org/nslt.d/tips.htm

To download the entire PDF version of the October 2003 issue, go to:
http://www.immunize.org/nslt.d/n28/n28.pdf

SUMMARIES OF INDIVIDUAL ARTICLES AND FEATURES
Summaries of "NEEDLE TIPS" articles and features are below, followed by URLs.

  1. "Ask the Experts"
    CDC immunization expert William Atkinson, MD, MPH, and viral hepatitis experts Linda Moyer, RN, and Eric Mast, MD, answer readers' questions.
     
    HTML: http://www.immunize.org/nslt.d/n28/exprt28.htm
    PDF: http://www.immunize.org/nslt.d/n28/exprt28.pdf

     

  2. "What Others Say About IAC"
    Here's a sampling of comments culled from letters of support for our work written by health professionals from many segments of the immunization community.
     
    HTML: http://www.immunize.org/nslt.d/n28/lett28.htm
    PDF: http://www.immunize.org/nslt.d/n28/lett28.pdf
     

  3. "Vaccine Highlights"
    A digest of recent recommendations and news about vaccines, vaccine resources, and Vaccine Information Statements.
     
    HTML: http://www.immunize.org/nslt.d/n28/vaccin28.htm
    PDF: http://www.immunize.org/nslt.d/n28/vaccin28.pdf
     

  4. "Give These People Influenza Vaccine!"
    This one-page professional education sheet has the latest information on the populations for whom influenza vaccine is recommended or encouraged.
     
    HTML: http://www.immunize.org/catg.d/2013flu.htm
    PDF: http://www.immunize.org/catg.d/2013flu.pdf
     

  5. "Summary of Rules for Childhood Immunization"
    Adapted from recommendations made by the Advisory Committee on Immunization Practices, American Academy of Pediatrics, and American Association of Family Physicians, this two-page reference sheet summarizes information about thirteen vaccines, including the ages at which children should receive them, the catch-up schedule for each, and contraindications for each.
     
    HTML: http://www.immunize.org/nslt.d/n17/rules1.htm
    PDF: http://www.immunize.org/catg.d/rules1.pdf
     

  6. "Summary of Recommendations for Adult Immunization"
    Adapted from recommendations made by the Advisory Committee on Immunization Practices, this two-page sheet outlines information about nine vaccines commonly given to adults, including details about the populations for whom each is recommended, the routine and catch-up schedule for each, and contraindications for each.
     
    HTML: http://www.immunize.org/catg.d/p2011b.htm
    PDF: http://www.immunize.org/catg.d/p2011b.pdf
     

  7. "Hepatitis B and the Health Care Worker"
    Updated in September, this two-page reference sheet explains which health care workers require hepatitis B vaccine, serologic testing, and postexposure prophylaxis.
     
    HTML: http://www.immunize.org/catg.d/2109hcw.htm
    PDF: http://www.immunize.org/catg.d/2109hcw.pdf

     

  8. "Questions Frequently Asked About Hepatitis B" by Deborah L. Wexler, MD, IAC Executive Director
    Updated in September, this four-page reference document discusses hepatitis B routes of infection, symptoms, testing, treatment, and prevention.
     
    HTML: http://www.immunize.org/catg.d/p4090.htm
    PDF: http://www.immunize.org/catg.d/p4090.pdf
     

  9. "How's Your State Doing?"
    Updated in August, this chart shows childhood immunization rates by state for the 4:3:1:3:3:1 series and for hepatitis B and varicella vaccines. It also shows the state school-entry requirements and implementation dates for childhood hepatitis B and varicella vaccination.
     
    PDF: http://www.immunize.org/nslt.d/n28/state28.pdf
     

  10. "Vaccine Information Statement (VIS): Inactivated Influenza Vaccine" and "Vaccine Information Statement (VIS): Live, Intranasal Influenza Vaccine"
    CDC's most recent VISs for these two vaccines.
     
    Inactivated influenza vaccine VIS
    PDF: http://www.immunize.org/vis/2flu.pdf

    Live intranasal influenza vaccine VIS
    PDF: http://www.immunize.org/vis/liveflu03.pdf
     

  11. "IAC's Publications and Resources Order Form"
    Order materials for patients and clinic staff here.
     
    HTML: http://www.immunize.org/nslt.d/n17/catalg1.htm
    PDF: http://www.immunize.org/nslt.d/n28/catalog.pdf
     

  12. "Letter from the Executive Director: Stay in Touch to Keep Receiving NEEDLE TIPS!"
    IAC's Executive Director, Deborah L. Wexler, MD, encourages her colleagues to support IAC by becoming contributors.
     
    HTML: http://www.immunize.org/nslt.d/n28/back28.htm
    PDF: http://www.immunize.org/nslt.d/n28/back28.pdf

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(7 of 11)
October 30, 2003
IAC'S REVISED HEPATITIS PIECES ANSWER COMMON QUESTIONS

Each week, the Immunization Action Coalition (IAC) receives approximately 100 emails and phone calls from health professionals and members of the public. Week after week, at least half the questions are about hepatitis B.

One of the most common questions deals with the who, what, where, when, and why of hepatitis B vaccination and testing for health care workers. Because of the continued confusion about this subject, IAC worked with the Centers for Disease Control and Prevention (CDC) to expand its educational piece, "Hepatitis B and the Health Care Worker."

"Hepatitis B and the Health Care Worker"
HTML: http://www.immunize.org/catg.d/2109hcw.htm
PDF: http://www.immunize.org/catg.d/2109hcw.pdf

Another piece, "Hepatitis A, B, and C: Learn the Differences," was updated to include all current treatment options for hepatitis B and C.

"Hepatitis A, B, and C: Learn the Differences"
HTML: http://www.immunize.org/catg.d/p4075abc.htm
PDF: http://www.immunize.org/catg.d/p4075abc.pdf

The Coalition also made minor revisions to its comprehensive hepatitis B piece for the public, "Questions Frequently Asked About Hepatitis B."

"Questions Frequently Asked About Hepatitis B"
HTML: http://www.immunize.org/catg.d/p4090.htm
PDF: http://www.immunize.org/catg.d/p4090.pdf

Finally, IAC's popular two-page reference sheets of immunization rules have been updated to include all the newest recommendations. These guides include information about vaccines commonly given to children and adults, including details about the target population, the routine and catch-up schedule for each, and contraindications.

"Summary of Rules for Childhood Immunization"
HTML: http://www.immunize.org/nslt.d/n17/rules1.htm
PDF: http://www.immunize.org/catg.d/rules1.pdf

"Summary of Recommendations for Adult Immunization"
HTML: http://www.immunize.org/catg.d/p2011b.htm
PDF: http://www.immunize.org/catg.d/p2011b.pdf

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(8 of 11)
October 30, 2003
JOURNAL ARTICLES YOU MIGHT HAVE MISSED

The following recent journal articles present research related to viral hepatitis prevention or treatment.

"The Use of Needle Exchange by Young Injection Drug Users"
Authors: Bailey SL, Huo D, Garfein RS, Ouellet LJ
Source: Journal of Acquired Immune Deficiency Syndromes,
September 1, 2003, Vol. 34(1):67-70
Click here for abstract

"Parental Knowledge, Attitudes, and Practices Associated with Not Receiving Hepatitis A Vaccine in a Demonstration Project in Butte County, California"
Authors: Bardenheier B, Gonzalez IM, Washington ML, et al
Source: Pediatrics, October 2003, Vol. 112(4):e269
http://pediatrics.aappublications.org/cgi/content/abstract/112/4/e269

"Global Progress Towards Universal Childhood Hepatitis B Vaccination, 2003"
Source: Weekly Epidemiological Record, October 17, 2003,
Vol. 78(42):366-370
http://www.who.int/wer/2003/en/wer7842.pdf

"A National Survey of Genitourinary Medicine Clinic Attenders Provides Little Evidence of Sexual Transmission of Hepatitis C Virus Infection"
Authors: Balogun MA, Ramsay ME, Parry JV, et al
Source: Sexually Transmitted Infections, August 2003, Vol. 79(4):301-6
Click here for abstract

"A Model for Integrating Hepatitis C Services into an HIV/AIDS Program"
Authors: Stringari-Murray S, Clayton A, Chang J
Source: Journal of the Association of Nurses in AIDS Care,
September/October 2003, Vol. 14(5):95S-107S
Click here for abstract

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(9 of 11)
October 30, 2003
FALL ISSUE OF HBF'S "B INFORMED" AVAILABLE ONLINE
 
The Fall 2003 issue of "B Informed," the newsletter of the Hepatitis B Foundation (HBF), is available online. This issue includes highlights from the third annual HBF Patient Conference, an article on the impact of hepatitis B on families, and much information about drug research and clinical trials.
 
The current issue of "B Informed", as well as archived issues, can be read or downloaded at no charge from the HBF website at http://www.hepb.org/02-0107.hepb To receive "B Informed" through the U.S. mail, please send your name and full address to info@hepb.org and HBF will add your name to their confidential mailing list.
 
The HBF website offers many other resources, including the continually updated "HBF Drug Watch." To access the home page go to: http://www.hepb.org

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(10 of 11)
October 30, 2003
HEPATITIS C INFECTION AND SUBSTANCE ABUSE CONFERENCE SCHEDULED FOR NOVEMBER 11-13 IN WASHINGTON, D.C.
 
"Hepatitis C Infection and Substance Abuse: Medical Management and Developing Models of Integrated Care" is scheduled for November 11–13 in Washington, D.C. This conference is a follow-up to the NIH Consensus Conference on the Medical Management of Hepatitis C and is sponsored by the National Institute on Drug Abuse (NIDA), the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the Division of AIDS of the National Institute of Allergy and Infectious Diseases (NIAID), the Office of AIDS Research (OAR), the Department of Veterans Affairs (VA), and the Health Resources and Services Administration (HRSA).
 
The conference will address a wide range of clinical issues and identify important research gaps related to treatment of hepatitis C infection in individuals with current (or a history of) substance use/abuse. Since many issues are similar for populations with mono-infection or co-infection with HIV, the two-day conference will address both populations. For agenda and registration information, visit the conference website at http://nidaconferences.csrincorporated.com

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(11 of 11)
October 30, 2003
CDC NOTIFIES READERS ABOUT THE INTERNATIONAL CONFERENCE ON WOMEN AND INFECTIOUS DISEASES
 
[The following is cross posted from the Immunization Action Coalition's "IAC EXPRESS" electronic newsletter, 10/20/03.]
 
The Centers for Disease Control and Prevention (CDC) published "Notice to Readers: International Conference on Women and Infectious Diseases" in the October 17 issue of "Morbidity and Mortality Weekly Report" (MMWR). The notice is reprinted below in its entirety.
 
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CDC's National Center for Infectious Diseases in collaboration with numerous partners, is planning the International Conference on Women and Infectious Diseases to be held February 27-28, 2004, in Atlanta, Georgia, at the Atlanta Marriott Marquis. The goal of the conference is to enhance prevention and control of infectious diseases among women worldwide. Featured topics include the impact of globalization, women and human immunodeficiency virus/acquired immunodeficiency syndrome, perinatal infectious diseases, vaccinations, and links between infectious and chronic diseases. Other topics include infectious disease disparities, sex-appropriate interventions, effective health communications, and cultural competence in preventing infectious diseases among women. Additional information is available from CDC, telephone (404) 371-5312 or (404) 371-5311. Information about registration is available at http://www.womenshealthconf.org
 
 ***********************
 
To obtain the complete text of the notice online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5241a6.htm
 
To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5241.pdf


Nastad
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nastad@nastad.org
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nastad@nastad.org

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