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Hep Express Issue

Issue Number 47, September 7, 2006
 
Contents of this Issue
1. CDC releases guidelines for the prevention and treatment of sexually transmitted diseases
2. New: August 2006 issue of Vaccinate Women is on the IAC website
3. Updated: IAC makes significant revisions to the professional-education Q&A "Hepatitis B and the Healthcare Worker"
4. Reminder that perinatal hepatitis B virus (HBV) infection is a nationally notifiable condition
5. IAC releases new and revised standing orders for administering vaccines and managing vaccine reactions
6. IAC redesigns home page of website to highlight new information
7. Coming soon: 2005 National Immunization Survey (NIS) results will be published on September 15 in MMWR
8. New: August issue of CDC's Immunization Works electronic newsletter now online
9. Merck is experiencing temporary packaging constraints for adult hepatitis A and B vaccines
10. Free: Two Spanish- and English-language films on immunization now available from Migrant Clinicians Network
11. New: Thai-language VIS now available for hepatitis A vaccines
12. Learn about best injection control practices used in the international arena
13. LiverHope provides information, support, education, and awareness for people with hepatitis
14. Asian American Pacific Islander Health Summit scheduled for September 14-16 in San Jose, CA
15. Asian Pacific American Medical Student Association (APAMSA) National Conference coming October 6-8, 2006
16. Pacific Health Summit coming to Seattle from June 12-14, 2007

ABBREVIATIONS: ACIP, Advisory Committee on Immunization Practices; CDC, Centers for Disease Control and Prevention; DVH, Division of Viral Hepatitis; HAV, hepatitis A virus; HBV, hepatitis B virus; HCV, hepatitis C virus; IAC, Immunization Action Coalition; IDU, injection drug user; MMWR, Morbidity and Mortality Weekly Report; MSM, men who have sex with men; STD, sexually transmitted disease; VIS, Vaccine Information Statement; WHO, World Health Organization.
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September 7, 2006
CDC RELEASES GUIDELINES FOR THE PREVENTION AND TREATMENT OF SEXUALLY TRANSMITTED DISEASES

[The following is cross-posted from the Immunization Action Coalition's "IAC Express" electronic newsletter, August 8, 2006.]

On August 4, 2006, CDC published "Sexually Transmitted Diseases Treatment Guidelines, 2006," in MMWR's Recommendations and Reports.

Excerpts from the summary are reprinted below.

***********************

These guidelines for the treatment of persons who have sexually transmitted diseases (STDs) were developed by CDC after consultation with a group of professionals knowledgeable in the field of STDs who met in Atlanta, Georgia, during April 19-21, 2005. The information in this report updates the Sexually Transmitted Diseases Treatment Guidelines, 2002 (MMWR 2002;51[No.RR-6]). Included in these updated guidelines are an expanded diagnostic evaluation for cervicitis and trichomoniasis. . . revised discussion concerning the sexual transmission of hepatitis C; postexposure prophylaxis after sexual assault; and an expanded discussion of STD prevention approaches.

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Excerpts from the introduction and methods sections are reprinted below.

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Physicians and other healthcare providers play a critical role in preventing and treating sexually transmitted diseases (STDs). These guidelines for the treatment of STDs are intended to assist with that effort. Although these guidelines emphasize treatment, prevention strategies and diagnostic recommendations also are discussed. . .

. . These recommendations were developed in consultation with public and private sector professionals knowledgeable in the treatment of persons with STDs. The recommendations are applicable to various patient-care settings, including family planning clinics, private physicians' offices, managed care organizations, and other primary-care facilities.

These recommendations are meant to serve as a source of clinical guidance: healthcare providers should always consider the individual clinical circumstances of each person in the context of local disease prevalence. These guidelines focus on the treatment and counseling of individual persons and do not address other community services and interventions that are important in STD/human immunodeficiency virus (HIV) prevention.

***********************

The guidelines include (page numbers refer to the PDF version)

  • Clinical prevention guidance, including STD/HIV prevention counseling, prevention methods, partner management, and reporting and confidentiality (page 2)
     
  • The latest information on the presentation, appropriate screening, and treatment of STDs in special populations, including pregnant women, adolescents, children, men who have sex with men, and women who have sex with women (page 6)
     
  • Use of preexposure vaccination against hepatitis B virus (HBV), hepatitis A virus (HAV), and human papillomavirus (HPV) (pages 4 and 69)
     
  • Details for properly managing HBsAg-positive pregnant women under "Special Populations" early in the document (page 6) and under "Hepatitis B" late in the document (page 71)
     
  • Prevention, diagnosis, and treatment of hepatitis C virus (HCV) infection, including a revised discussion concerning the sexual transmission of HCV (page 77)
     
  • Recommendations for evaluation for sexually transmitted infections in adult, adolescent, and child victims of sexual assault/abuse, including guidelines for initial and follow-up evaluations and possible postexposure prophylaxis (including hepatitis B vaccination) (page 80)

Over 18 million cases of STDs occur in the United States each year, with a disproportionate share among young people and racial and ethnic minority populations. The estimated annual direct medical costs of treating STDs and their sequelae are $13 billion. These 2006 guidelines, which update guidelines published in 2002, are an important tool to address this major public health challenge.

To download "Sexually Transmitted Diseases Treatment Guidelines, 2006," in ready-to-print (PDF) format, go to:
http://www.cdc.gov/std/treatment/2006/rr5511.pdf

To access a web-text (HTML) version of the document, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5511a1.htm

Alternatively, you can obtain a print copy by calling CDC's National Prevention Information Network at (800) 458-5231 (M-F 9am-8pm ET).

To read the Dear Colleague letter announcing the release of the 2006 STD guidelines, go to:
http://www.cdc.gov/std/treatment/2006/DearCollSTDTreatmentGuidelines8-4-06.pdf

The guidelines, letter, and other resources can all be accessed
from CDC's STD treatment guidelines web page at
http://www.cdc.gov/std/treatment
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September 7, 2006
NEW: AUGUST 2006 ISSUE OF VACCINATE WOMEN IS ON THE IAC WEBSITE

[The following is cross-posted from the Immunization Action Coalition's "IAC Express" electronic newsletter, August 21, 2006.]

The August 2006 issue of Vaccinate Women is now available on the IAC website. Hard copies were recently mailed to all members of the American College of Obstetricians and Gynecologists (ACOG). This publication was supported by a cooperative grant by the Division of Viral Hepatitis at the Centers for Disease Control and Prevention. It was distributed free of charge by ACOG.

The new issue is filled with reliable, practical information intended to assist obstetricians/gynecologists in providing immunization services in their healthcare settings.

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

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

Please note: The PDF file of the entire issue, linked below, is 759,034 bytes. For tips on downloading and printing PDF files, go to: http://www.immunize.org/nslt.d/tips.htm

To download a ready-to-print (PDF) version of the entire issue, go to: http://www.immunize.org/vw/vw0806.pdf

TO ACCESS INDIVIDUAL ARTICLES
Following are descriptions of and direct links to each of the main Vaccinate Women articles:

"Ask the Experts"
CDC immunization experts William L. Atkinson, MD, MPH, and Andrew T. Kroger, MD, MPH, answer general immunization questions. Hepatitis specialist Eric E. Mast, MD, MPH, answers hepatitis questions.

To access a ready-to-print (PDF) version, go to: http://www.immunize.org/vw/expert6.pdf

Revised in April, the one-page "Guidelines for Standing Orders in Labor & Delivery and Nursery Units to Prevent Hepatitis B Virus Transmission to Newborns," now reflects ACIP's recommendations for preventing hepatitis B virus infections in infants, which were updated in December 2005. The piece includes detailed information for infants born to HBsAg-negative mothers, infants born to HBsAg-positive mothers, and infants born to mothers with unknown HBsAg status.

To access a ready-to-print (PDF) two-page version, go to: http://www.immunize.org/catg.d/p2130per.pdf

To access a web-text (HTML) version, go to: http://www.immunize.org/catg.d/p2130.htm

The "Summary of Recommendations for Adult Immunization" condenses hundreds of pages of recommendations into a handy three-page chart. It was revised in July to add information about the new vaccines to protect against human papillomavirus (HPV) and herpes zoster (shingles) and to update information about influenza vaccines.

To access a ready-to-print (PDF) version, go to: http://www.immunize.org/catg.d/p2011b.pdf

To access a web-text (HTML) version, go to: http://www.immunize.org/catg.d/p2011b.htm

The one-page piece "How to Administer IM and SC Injections to Adults" was revised in July to add information about administering the new vaccines to protect against human papillomavirus (HPV) and herpes zoster (shingles).

To access a ready-to-print (PDF) version, go to: http://www.immunize.org/catg.d/p2020A.pdf

Revised in July, the two-page checklist "Screening Questionnaire for Adult Immunization" now has updated information on the following vaccines: MMR, varicella, nasal-spray influenza (LAIV), and pertussis-containing vaccine for adults (Tdap).

To access a ready-to-print (PDF) version, go to: http://www.immunize.org/catg.d/p4065scr.pdf

To access a web-text (HTML) version, go to: http://www.immunize.org/catg.d/p4065scr.htm

The two-page checklist "Do I Need Any Vaccinations Today?" was revised in July to add information about the new vaccines to protect against human papillomavirus (HPV) and herpes zoster (shingles) and to update information about the following vaccines: pneumococcal, Tdap, and MMR.

To access a ready-to-print (PDF) version, go to: http://www.immunize.org/catg.d/4036need.pdf

To access a web-text (HTML) version, go to: http://www.immunize.org/catg.d/4036need.htm
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September 7, 2006
UPDATED: IAC MAKES SIGNIFICANT REVISIONS TO THE PROFESSIONAL-EDUCATION Q&A "HEPATITIS B AND THE HEALTHCARE WORKER"

[The following is cross-posted from the Immunization Action Coalition's "IAC Express" electronic newsletter, August 28, 2006.]

With the assistance and review of CDC, IAC recently revised and added to the three-page professional-education piece titled "Hepatitis B and the Healthcare Worker."

The document contains frequently asked questions with corresponding answers that are written briefly and can be quickly read. Many questions have been identified by our readers during their work in caring for patients with hepatitis B virus (HBV) infection or in dealing with their own hepatitis B issues. The document discusses the uses and importance of hepatitis B vaccine and the methodology used to administer the vaccine. Questions and answers also address the efficacy, immunogenicity, and safety of the vaccine. Many answers concern what steps to take when official recommendations are not followed. The document also has a table detailing the recommendations for postexposure prophylaxis after percutaneous or mucosal exposure to HBV in an occupational setting. Finally, chronic HBV infection in healthcare workers is discussed.

To access a ready-to-print (PDF) version of the revised piece, go to: http://www.immunize.org/catg.d/2109hcw.pdf

To access a web-text (HTML) version, go to: http://www.immunize.org/catg.d/2109hcw.htm
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September 7, 2006
REMINDER THAT PERINATAL HEPATITIS B VIRUS (HBV) INFECTION IS A NATIONALLY NOTIFIABLE CONDITION

CDC and the Council of State and Territorial Epidemiologists would like to remind healthcare providers that perinatal HBV infection is a nationally notifiable condition. Perinatal HBV infection is one of more than 50 nationally notifiable conditions that are reported on a weekly basis from state health departments to CDC through the Nationally Notifiable Diseases Surveillance System (NNDSS). All confirmed cases of perinatal HBV infection should be reported to CDC through the NNDSS as soon as they are identified. The NNDSS surveillance case definition for perinatal HBV infection is HBSAg-positivity in any infant age 1-24 months who was born in the United States or in U.S. territories to an HBsAg-positive mother.

Reporting for perinatal HBV infection should be done by the person or organization that identifies the HBV infection (e.g., laboratories, physicians, perinatal hepatitis B coordinators, nurse practitioners). These entities should collaborate with the program in each state that is responsible for NNDSS reporting; in most states, this is the communicable disease program. The NNDSS event code (disease code) for perinatal HBV infection cases is 10104. If you are not currently reporting through NNDSS or are not sure if cases are being reported, please work with your state program to initiate reporting and to determine what data are required to complete the case report. Guidelines for Viral Hepatitis Surveillance including perinatal HBV infection surveillance can be found at: http://www.cdc.gov/ncidod/diseases/hepatitis/resource/PDFs/revised_GUIDELINES_formatted5.pdf
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September 7, 2006
IAC RELEASES NEW AND REVISED STANDING ORDERS FOR ADMINISTERING VACCINES AND MANAGING VACCINE REACTIONS

[The following excerpt is cross-posted from the Immunization Action Coalition's "IAC Express" electronic newsletter, September 5, 2006.]

IAC has posted new and revised standing orders for vaccine administration for adults, children, and teens and a new piece on the management of vaccine reactions for children and teens on its website.

The viral hepatitis standing orders protocols are listed below along with their release dates.

"Standing Orders for Administering Hepatitis A Vaccine to Children & Teens" (7/06)

"Standing Orders for Administering Hepatitis B Vaccine to Children & Teens" (5/06)

"Standing Orders for Administering Hepatitis A Vaccine to Adults" (7/06)

"Standing Orders for Administering Hepatitis B Vaccine to Adults" (12/03)

"Medical Management of Vaccine Reactions in Children and Teens" (8/06)

"Medical Management of Vaccine Reactions in Adult Patients" (12/03)

"Guidelines for Standing Orders in Labor & Delivery and Nursery Units to Prevent Hepatitis B Virus Transmission to Newborns" (4/06)

Links to all these standing orders and medical management protocols are available on one web page at http://www.immunize.org/standingorders

IAC will be releasing an updated version of "Standing Orders for Administering Hepatitis B Vaccine" in the near future.
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September 7, 2006
IAC REDESIGNS HOME PAGE OF WEBSITE TO HIGHLIGHT NEW INFORMATION

[The following is cross-posted from the Immunization Action Coalition's "IAC Express" electronic newsletter, September 5, 2006.]

IAC recently modified the home page of its website for healthcare professionals to make it easier to find what's new. Prominently placed at the top of the home page are two new links titled "New Releases" and "What's New at IAC."

"New Releases" includes information from federal agencies on vaccine licensures, recommendations, and resources. Look here first for newly released VISs from CDC, recommendations from ACIP, vaccine policy statements from AAP, and clinically relevant press releases.

"What's New at IAC" lists new and revised materials on our website in date order. This page includes both print pieces and web pages created by IAC.

To access these new pages, go to http://www.immunize.org and click on the new links under "Welcome!" Don't forget to bookmark them for easy future reference!
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September 7, 2006
COMING SOON: 2005 NATIONAL IMMUNIZATION SURVEY (NIS) RESULTS WILL BE PUBLISHED ON SEPTEMBER 15 IN MMWR

The 2005 National Immunization Survey (NIS) results are scheduled to be published in the September 15 issue of MMWR. The information will include 2005 vaccine coverage tables similar to the ones found on the following web page: http://www.cdc.gov/nip/coverage
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(8 of 16)
September 7, 2006
NEW: AUGUST ISSUE OF CDC'S IMMUNIZATION WORKS ELECTRONIC NEWSLETTER NOW ONLINE

The August issue of Immunization Works, a monthly email newsletter published by CDC, is available on CDC's website. The newsletter offers members of the immunization community non- proprietary information about current topics. CDC encourages its wide dissemination.

MEETINGS, CONFERENCES & RESOURCES

PROMOTE HCW VACCINATION: CDC has recently updated posters and flyers for healthcare worker (HCW) vaccinations, "Healthcare Workers! Are your vaccinations up-to-date?" The updated materials reflect the Advisory Committee on Immunization Practices' (ACIP's) new pertussis vaccine recommendations. They can be downloaded and printed in black and white or commercial quality color from http://www.cdc.gov/nip/publications/default.htm#healthcare

GET SMART: CDC's "Get Smart, Know When Antibiotics Work" campaign offers an electronic newsletter. Readers may view past issues and subscribe at http://www.cdc.gov/drugresistance/community/news.htm

To access the complete August issue from the NIP website, go to: http://www.cdc.gov/nip/news/newsltrs/imwrks/2006/200608.htm
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September 7, 2006
MERCK IS EXPERIENCING TEMPORARY PACKAGING CONSTRAINTS FOR ADULT HEPATITIS A AND B VACCINES

Merck is currently experiencing temporary packaging constraints affecting the immediate availability of the adult formulations of hepatitis A and hepatitis B vaccines. Customers may experience backorders for these adult vaccines and may contact 1-800-MERCK-90 [1-800-637-2590] for current information about availability. Updates will also be provided on this website as they become available. Access the following website for more information: http://www.cdc.gov/nip/news/shortages/default.htm#Which
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September 7, 2006
FREE: TWO SPANISH- AND ENGLISH-LANGUAGE FILMS ON IMMUNIZATION NOW AVAILABLE FROM MIGRANT CLINICIANS NETWORK

[The following is cross-posted from the Immunization Action Coalition's "IAC Express" electronic newsletter, August 14, 2006.]

The Migrant Clinicians Network (MCN) recently announced that its Migrant Immunization Initiative has developed two short films on immunization. Available in both English and Spanish and in DVD and VHS formats, one of the films covers hepatitis A vaccine. The film is about 10 minutes long.

Intended for the use of clinicians who serve low-literate Spanish- or English-speaking patients, the films should be used in clinical settings for educating migrant, mobile, or underserved populations. The films are available free of charge; postage is free to U.S. addresses. Clinicians who receive the films will be asked to complete a questionnaire to evaluate the films' effectiveness.

To order the films online, go to: http://www.migrantclinician.org/excellence/immunizations Or download the order form, complete it, and fax it to MCN at (512) 327-0719, or email it to ihargrove@migrantclinician.org
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September 7, 2006
NEW: THAI-LANGUAGE VIS NOW AVAILABLE FOR HEPATITIS A VACCINE

The current version of the VIS for hepatitis A vaccine (dated 3/21/06) is now available on the IAC website in Thai. IAC gratefully acknowledges Asian Pacific Health Care Venture for the translations.

VIS FOR HEPATITIS A VACCINE
To obtain a ready-to-print (PDF) version in Thai, go to: http://www.immunize.org/vis/th_hpa06.pdf

To obtain it in English, go to: http://www.immunize.org/vis/v-hepa.pdf
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September 7, 2006
LEARN ABOUT BEST INJECTION CONTROL PRACTICES USED IN THE INTERNATIONAL ARENA

The Bulletin of the World Health Organization has published a paper titled "Best infection control practices for intradermal, subcutaneous, and intramuscular needle injections." The object of this paper is to draw up evidence-based guidelines to make injection practices safer. The paper includes an excellent summary of these safer injection practices with an international emphasis. To view the paper as a ready-to-print (PDF) document, go to: http://www.uqconnect.net/signfiles/Files/BestPracticesJul2003.pdf
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September 7, 2006
LIVERHOPE PROVIDES INFORMATION, SUPPORT, EDUCATION, AND AWARENESS PEOPLE WITH HEPATITIS

LiverHope is a nonprofit organization that provides support, promotes education, generates awareness, and advocates for quality medical care for all people with hepatitis in the Minneapolis and St. Paul area of Minnesota. Although the information on their website is intended for Minnesota residents, there is much that applies to people living in other areas. LiverHope also publishes a newsletter.

To visit the LiverHope website, go to: http://www.liverhope.com
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September 7, 2006
ASIAN AMERICAN PACIFIC ISLANDER HEALTH SUMMIT SCHEDULED FOR SEPTEMBER 14-16 IN SAN JOSE, CA

[The following is cross-posted from the Immunization Action Coalition's "IAC Express" electronic newsletter, August 21, 2006.]

The 2006 Asian American Pacific Islander Health Summit will be held in San Jose, CA, on September 14-16. It is sponsored by the Asian & Pacific Islander American Health Forum and the Association of Asian Pacific Community Health Organizations.

Workshops are planned to discuss hepatitis B within the AAPI community. For comprehensive information, including the program agenda and registration options, go to: http://www.apiahf.org/events/summit2006/AAPIsummit2006.html
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September 7, 2006
ASIAN PACIFIC AMERICAN MEDICAL STUDENT ASSOCIATION (APAMSA) NATIONAL CONFERENCE COMING OCTOBER 6-8, 2006

For more information go to: www.apamsa.org
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September 7, 2006
PACIFIC HEALTH SUMMIT COMING TO SEATTLE FROM JUNE 12-14, 2007

The overarching theme for the Pacific Health Summit 2006 is "Connecting Science, Innovation, and Policy for a Healthier World." The summit is co-presented by The National Bureau of Asian Research and the Fred Hutchinson Cancer Research Center. The four major building blocks for this health-based model include:

  • Promotion of health
  • Prevention of disease
  • Early detection of disease
  • Early treatment of disease

For more information on this meeting go to: http://pacifichealthsummit.org


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