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Hep Express Issue 64

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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(1 of 6)
November 8, 2007
ERROR CORRECTED IN DECEMBER 2006 RECOMMENDATIONS FOR ELIMINATING HEPATITIS B TRANSMISSION IN ADULTS

[The following is cross posted from the Immunization Action Coalition's "IAC EXPRESS" electronic newsletter, 10/29/07.]

CDC published "Erratum: Vol. 55, No. RR-16" in the October 26 issue of MMWR. It concerns an error that appeared in the MMWR Recommendations and Reports titled "A Comprehensive Immunization Strategy to Eliminate Transmission of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices (ACIP), Part II: Immunization of Adults," which was published December 8, 2006. The erratum is reprinted below in its entirety.

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In the MMWR Recommendations and Reports "A Comprehensive Immunization Strategy to Eliminate Transmission of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices (ACIP), Part II: Immunization of Adults," an error occurred. In Appendix A, page 28, second column, line 10, the sentence should read, "However, long-term protection has been demonstrated only for persons who have completed a licensed vaccination series and have ever had an anti-HBs concentration of >=10 mIU/mL; persons with an anti-HBs-positive result but who did not complete a vaccine schedule might not have long-term protection from HBV infection."

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To access a web-text (HTML) version of the erratum, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5642a7.htm

To access a ready-to-print (PDF) version of "A Comprehensive Immunization Strategy to Eliminate Transmission of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices (ACIP), Part II: Immunization of Adults," go to:
http://www.cdc.gov/mmwr/PDF/rr/rr5516.pdf

To receive a FREE electronic subscription to MMWR (which includes new ACIP statements), go to:
http://www.cdc.gov/mmwr/mmwrsubscribe.html
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(2 of 6)
November 8, 2007
IAC UPDATES AND ADDS INFORMATION TO ITS HEPATITIS PREVENTION PROGRAMS WEBSITE

IAC's hepatitis prevention programs website features programs that are successfully preventing hepatitis A, B, and/or C in individuals at risk of infection. The content is intended for public health and social service managers who can use the information to start or improve hepatitis prevention programs.

The site now features 80 programs in 11 categories.

The following programs have not previously been featured in Hep Express.

Family Health Centers of San Diego's Viral Hepatitis Education and Integration Project
http://www.hepprograms.org/drug/drug19.asp
This project's primary objectives are to increase knowledge and change attitudes and practices among men who have sex with men and injection drug users.

San Francisco Hep B Free
http://www.hepprograms.org/apia/apia15.asp
Hep B Free creates public and healthcare provider awareness about the importance of the risk of hepatitis B virus infection among Asian Pacific Islander Americans in San Francisco. The program includes vaccination, screening, testing, treatment, and follow-up.

The Wisconsin HIV/STD/Hepatitis Information & Referral Center
http://www.hepprograms.org/std/std24.asp
The Referral Center provides general information on the prevention, transmission, and treatment of HIV and AIDS, sexually transmitted infections, and viral hepatitis. It operates a toll-free 24-hour hotline where callers can ask questions, request information by mail, or receive referrals to testing and related support services around the state.

The following programs recently updated their information.

Hampden County Correctional and Community Health Program (Massachusetts)
http://www.hepprograms.org/juven/juven6.asp

HCV Prevention Education for Inmates (Louisiana)
http://www.hepprograms.org/adult/adult15.asp

HIV and Hepatitis Program, Panhandle Community Services (Nebraska)
http://www.hepprograms.org/std/std17.asp

Florida Department of Health, Hepatitis Prevention Program
http://www.hepprograms.org/drug/drug4.asp

Minnesota Department of Health, Community Clinic Immunization Program
http://www.hepprograms.org/std/std5.asp

New Mexico Hepatitis Prevention Program
http://www.hepprograms.org/drug/drug10.asp

Northeast Indiana Counties HIV Prevention Program
http://www.hepprograms.org/std/std14.asp

Oakland County Children's Village (Michigan)
http://www.hepprograms.org/school/school4.asp

Project HANDI (California)
http://www.hepprograms.org/std/std19.asp

San Diego County HIV, STD and Hepatitis Branch
http://www.hepprograms.org/msm/msm15.asp

Twinrix Vaccination Program (North Carolina)
http://www.hepprograms.org/std/std15.asp

In addition to the program descriptions, the website also offers support group information as follows:

(1) National support organizations for persons living with chronic HBV infection at
http://www.hepprograms.org/support/hepb.asp

There are currently 20 national hepatitis B support groups listed on the hepprograms website. They contain information for a variety of target populations.

(2) National support organizations for persons living with chronic HCV infection at
http://www.hepprograms.org/support/hepc.asp

The national hepatitis C support group section on the hepprograms website contains 22 support groups that address various issues about HCV infection.

(3) Local HBV and HCV support groups, listed by state at http://www.hepprograms.org/support/states.asp

This web section features 108 local viral hepatitis support groups in 20 states. Check this page to see if any could serve you or your patient with information and emotional support. Every effort is made to assure that the information is accurate and current.

If you know of additional HBV or HCV support groups, or have viral hepatitis resources to share (including brochures, manuals, slide sets, photos, or videos), write admin@hepprograms.org and we will consider adding them to the website.

If you have a hepatitis prevention program to share, go to: http://www.hepprograms.org/yourprogram.htm We appreciate your participation in this project!
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(3 of 6)
November 8, 2007
CDC OFFERS PODCAST ON HEALTHY TRAVEL FOR INTERNATIONAL ADOPTIONS

Podcasts are audio files that can be downloaded to your desktop or portable music/video player for convenient listening. CDC has added a new podcast titled "Healthy Travel for International Adoptions" to its Travelers' Health web section.

The number of international adoptions, many from developing countries, has doubled in the last 10 years. This podcast discusses ways adoptive families can protect their own health and the health of their new children.

To access the podcast, go to:
http://www2a.cdc.gov/podcasts/player.asp?f=6960

New to podcasting? CDC offers helpful tips at
http://www2a.cdc.gov/podcasts/podcasthelp.asp

Please note: CDC's Travel Health web section's new address is http://wwwn.cdc.gov/travel
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(4 of 6)
November 8, 2007
MMWR REPORTS ON SYRINGE EXCHANGE PROGRAMS

CDC published "Syringe Exchange Programs--United States, 2005" in the November 9 issue of MMWR. The first paragraph of the article is reprinted below, excluding references.

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Syringe exchange programs (SEPs) provide free sterile syringes in exchange for used syringes to reduce transmission of bloodborne pathogens among injection-drug users (IDUs). SEPs in the United States began as a way to prevent the spread of human immunodeficiency virus (HIV) and other bloodborne infections such as hepatitis B and hepatitis C. The National Institute on Drug Abuse recommends that persons who continue to inject drugs use a new, sterile syringe for each injection. Monitoring syringe exchange activity is an important part of assessing HIV prevention measures in the United States. As of November 2007, a total of 185 SEPs were operating in 36 states, the District of Columbia (DC), and Puerto Rico. This report summarizes a survey of SEP activities in the United States during 2005 and compares the findings with previous SEP surveys. The findings indicated an increase in overall funding for SEPs, including an increase in public funding, and a stabilization in both the number of SEPs operating and the number of syringes exchanged since 2004. This report also documents an expansion of services offered by SEPs, a trend that resulted from an increase in state and local funding. These expanded services are helping protect IDUs and their communities from the spread of bloodborne pathogens and are providing access to health services for a population at high risk. Monitoring of syringe exchange activity should continue. . .

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To access a web-text (HTML) version of the complete MMWR article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5644a4.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5644.pdf
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(5 of 6)
November 8, 2007
HOW'S YOUR STATE DOING? DATA TABLES AND MAPS OF 2006 NIS CHILDHOOD IMMUNIZATION RATES MAKE IT EASY TO FIND OUT

[The following is cross posted from the Immunization Action Coalition's "IAC EXPRESS" electronic newsletter, 10/29/07.]

The CDC website recently posted 2006 National Immunization Survey (NIS) data tables and maps that show estimated immunization rates by state for various childhood vaccines and vaccine series. The data tables present data in two ways for each state and local area--in the aggregate and by race and ethnicity. Maps are color coded, with each state's color indicating the immunization rate the state has achieved for a given vaccine or vaccine series.

To access the data tables and maps, go to: http://www.cdc.gov/vaccines/stats-surv/nis/figures/2006_map.htm Click on the vaccine or vaccine series to be taken to the pertinent data table; click on the word "map" to be taken to the pertinent U.S. map.
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(6 of 6)
November 8, 2007
JOURNAL ARTICLES YOU MAY HAVE MISSED

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

"Hepatitis B Vaccination Coverage Levels among Healthcare Workers in the United States, 2002-2003"
Authors: Simard EP, Miller JT, George PA, et al.
Source: Infect Control Hosp Epidemiol, July 2007, Vol. 28(7):783-90
Click here for abstract.

"The Burden of Liver Cancer in Asians and Pacific Islanders in
the Greater San Francisco Bay Area, 1990 through 2004"
Authors: Chang ET, Keegan TH, Gomez SL, et al.
Source: Cancer, May 15, 2007, Vol. 109(10):2100-8
Click here for abstract.

"Hepatitis B and Liver Cancer Knowledge and Preventive Practices
among Asian Americans in the San Francisco Bay Area, California"
Authors: Wu CA, Lin SY, So SK, Chang ET
Source: Asian Pac J Cancer Prev, January-March 2007, Vol. 8(1):127-34
Click here for abstract.

"The Clinical Significance of Persistently Normal ALT in Chronic
Hepatitis B infection"
Authors: Lai M, Hyatt BJ, Nasser I, Curry M, Afdhal NH
Source: J Hepatol, September 14, 2007, epub ahead of print
Click here for abstract.

"Before It Is Too Late: Hepatitis B Vaccination for All STD Clients"
Author: Ward JW
Source: Sex Transm Dis, September 2007, Vol. 34(9):669-70
No abstract available

"Hepatitis A Vaccine versus Immune Globulin for Postexposure Prophylaxis"
Authors: Victor JC, Monto AS, Surdina TY, et al.
Source: N Engl J Med, October 25, 2007, Vol. 357(17):1685-94
Click here for abstract.

"Prevalence and Correlates of Hepatitis A among Adult Drug Users: The Significance of Incarceration and Race/Ethnicity"
Authors: Latimer WW, Moleka AG, Melnikov A, et al.
Source: Vaccine, October 10, 2007, Vol. 25(41):7125-31
Click here for abstract.


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