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Hep Express Issue 71

Issue Number 71, May 20, 2008
 
Contents of this Issue
1. World Hepatitis Alliance launches international initiative
2. CDC announces hepatitis poster contest winners
3. CDC's website features hepatitis information in honor of National Hepatitis Awareness Month and World Hepatitis Day
4. CDC announces viral hepatitis awareness for May
5. CDC reports on acute hepatitis C virus infections attributed to unsafe injection practices in Nevada endoscopy clinic
6. Enhanced surveillance detects hepatitis C virus infection among injection drug users in New York
7. CDC releases revised and expanded national immunization survey data on hepatitis B birth dose
8. CDC's four-part perinatal hepatitis B netconference offers continuing education credit
9. CDC experts update online "Ask the Experts" sections on general immunization, hepatitis A, hepatitis B, and more
10. Hawai`i's Hepatitis Support Network offers information on the prevention and treatment of hepatitis B and C and opportunities for volunteers to become engaged in prevention efforts
11. NIH Consensus Development Conference on the Management of Hepatitis B to be held October 20-22 in Bethesda
12. Journal articles you may have missed

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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May 20, 2008
WORLD HEPATITIS ALLIANCE LAUNCHES INTERNATIONAL INITIATIVE

The World Hepatitis Alliance (WHA), a newly formed nongovernmental organization, has called on governments around the world to do more to improve prevention, diagnosis, and treatment for people living with chronic HBV and HCV.

Part of WHA's outreach included the first World Hepatitis Day on May 19. This international, patient-led initiative was launched in response to the fact that one in 12 people worldwide is living with chronic HBV or HCV infection, yet there is a lack of awareness and political will to prevent and treat infection.

Did You Know?

  • 500 million people worldwide are currently infected with HBV or HCV
  • This number represents more than 10 times the number infected with HIV/AIDS
  • Between them, hepatitis B and C kill 1.5 million people a year
  • One in every three people on the planet has been exposed to either or both viruses
  • Most of the 500 million infected do not know

Charles Gore, president of WHA, said a lack of data highlights the need for greater surveillance at local, national, and international levels. To this end, World Hepatitis Alliance has launched "The Hepatitis Atlas: Completing the Data Map," a resource designed to become the first global public compendium of statistics and information relating to chronic HBV and HCV.

For more information, visit http://www.worldhepatitisday.com or http://www.aminumber12.org (both addresses go to the same website).
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May 20, 2008
CDC ANNOUNCES HEPATITIS POSTER CONTEST WINNERS

The first ever National Viral Hepatitis Poster Contest was held April–May 2008, sponsored by the CDC's Division of Viral Hepatitis and the National Viral Hepatitis Roundtable. Judges consisted of representatives from state health departments, community organizations, a public relations agency, partner organizations, and CDC. Entries were received from the general public and offered creative approaches to raising awareness about viral hepatitis. [Editor's note: this contest was publicized in Hep Express #68 and IAC Express #718.]

The winning entries can be viewed at
http://www.cdc.gov/ncidod/diseases/hepatitis/PContestWinners.htm
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May 20, 2008
CDC'S WEBSITE FEATURES HEPATITIS INFORMATION IN HONOR OF NATIONAL HEPATITIS AWARENESS MONTH AND WORLD HEPATITIS DAY

CDC is currently featuring a link to viral hepatitis information on the home page of its website, http://www.cdc.gov, in honor of National Hepatitis Awareness Month and World Hepatitis Day. The new page includes facts about hepatitis A, B, and C; statistics about viral hepatitis in the United States; and information on preventing HAV, HBV, and HCV infection and associated liver disease.

To access the hepatitis information page directly, go to:
http://www.cdc.gov/Features/ViralHepatitis
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May 20, 2008
CDC ANNOUNCES VIRAL HEPATITIS AWARENESS FOR MAY

[The following is cross posted from the Immunization Action Coalition's "IAC Express" electronic newsletter, 5/19/08.]

CDC published "Viral Hepatitis Awareness--May 2008" in the May 16 issue of MMWR. The announcement is reprinted below in its entirety, excluding one reference.

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May 2008 marks the 13th anniversary of Hepatitis Awareness Month in the United States. May 19 is World Hepatitis Day, which recognizes the importance of global commitments to prevent liver disease and cancer caused by viral hepatitis. This issue of MMWR includes a report on an outbreak of acute hepatitis C associated with unsafe injection practices at an endoscopy clinic and a report on hepatitis C virus (HCV) infections among young injection-drug users. Both reports highlight the role of viral hepatitis surveillance in detecting outbreaks and populations at risk. Development of effective state and local surveillance for acute and chronic viral hepatitis is a public health priority.

HCV infection is the most common bloodborne illness, the leading cause of chronic liver disease, and the primary indication for liver transplantation in the United States. HCV is spread primarily through exposure to infectious blood; injection-drug use is the major contributor to HCV transmission in the United States. Although HCV infection can result in acute illness, most of its effects on the liver, including cirrhosis and liver cancer, are not apparent until years after exposure. Many of the estimated 3.2 million persons living with chronic HCV infection in the United States are unaware of their infection status.

CDC recommends HCV testing for persons at risk. Persons with HCV infection also should be assessed regularly for severity of liver disease, onset of liver cancer, and the need for treatment. Additional information about viral hepatitis is available at http://www.cdc.gov/hepatitis

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To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5719a1.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5719.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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May 20, 2008
CDC REPORTS ON ACUTE HEPATITIS C VIRUS INFECTIONS ATTRIBUTED TO UNSAFE INJECTION PRACTICES IN NEVADA ENDOSCOPY CLINIC

[The following is cross posted from the Immunization Action Coalition's "IAC Express" electronic newsletter, 5/19/08.]

CDC published "Acute Hepatitis C Virus Infections Attributed to Unsafe Injection Practices at an Endoscopy Clinic--Nevada, 2007" in the May 16 issue of MMWR. Portions of the article are reprinted below, including the complete text of a box titled "Injection safety recommendations."

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On January 2, 2008, the Nevada State Health Division (NSHD) contacted CDC concerning surveillance reports received by the Southern Nevada Health District (SNHD) regarding two persons recently diagnosed with acute hepatitis C. A third person with acute hepatitis C was reported the following day. This raised concerns about an outbreak because SNHD typically confirms four or fewer cases of acute hepatitis C per year. Initial inquiries found that all three persons with acute hepatitis C underwent procedures at the same endoscopy clinic (clinic A) within 35-90 days of illness onset. A joint investigation by SNHD, NSHD, and CDC was initiated on January 9, 2008. The epidemiologic and laboratory investigation revealed that hepatitis C virus (HCV) transmission likely resulted from reuse of syringes on individual patients and use of single-use medication vials on multiple patients at the clinic. Health officials advised clinic A to stop unsafe injection practices immediately, and approximately 40,000 patients of the clinic were notified about their potential risk for exposure to HCV and other bloodborne pathogens. This report focuses on the six cases of acute hepatitis C identified during the initial investigation, which is ongoing; additional cases of acute hepatitis C associated with exposures at clinic A might be identified. Comprehensive measures involving viral hepatitis surveillance, healthcare provider education, public awareness, professional oversight, licensing, and improvements in medical devices can help detect and prevent transmission of HCV and other bloodborne pathogens in healthcare settings. . . .

BOX. Injection safety recommendations

  • Never administer medications from the same syringe for more than one patient, even if the needle is changed.
  • Consider a syringe or needle contaminated after it has been used to enter or connect to a patient's intravenous infusion bag or administration set.
  • Do not enter a vial with a used syringe or needle.
  • Never use medications packaged as single-use vials for more than one patient.
  • Assign medications packaged as multi-use vials to a single patient whenever possible.
  • Do not use bags or bottles of intravenous solution as a common source of supply for more than one patient.
  • Follow proper infection-control practices during the preparation and administration of injected medications.
    . . . .

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To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5719a2.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5719.pdf
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May 20, 2008
ENHANCED SURVEILLANCE DETECTS HEPATITIS C VIRUS INFECTION AMONG INJECTION DRUG USERS IN NEW YORK

[The following is cross posted from the Immunization Action Coalition's "IAC Express" electronic newsletter, 5/19/08.]

CDC published "Use of Enhanced Surveillance for Hepatitis C Virus Infection to Detect a Cluster Among Young Injection-Drug Users--New York, November 2004-April 2007" in the May 16 issue of MMWR. A press summary of the article is reprinted below in its entirety.

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Establishing effective systems that reliably detect hepatitis C virus (HCV) infections among all populations could have a lasting effect on HCV disease control.

Surveillance for hepatitis C is challenging due to the nature of the disease and the effort required to collect complete information. When resources are limited, algorithms to prioritize cases for investigation can guide targeted response initiatives to get affected people needed help and prevent additional hepatitis C infections. During the summer of 2007, the New York State and Erie County departments of health investigated a cluster of hepatitis C among adolescents and young adults in Erie County. The major risk factor reported was intravenous drug use. The departments cooperated to investigate the cluster and implement interventions that included education, testing, and referral to medical, mental health, and addiction therapy. This demonstrates the utility of enhanced surveillance to guide effective resource deployment.

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To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5719a3.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5719.pdf
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May 20, 2008
CDC RELEASES REVISED AND EXPANDED NATIONAL IMMUNIZATION SURVEY DATA ON HEPATITIS B BIRTH DOSE

[The following is cross posted from the Immunization Action Coalition's "IAC Express" electronic newsletter, 5/19/08.]

CDC recently released revised 2006 National Immunization Survey (NIS) data about hepatitis B vaccination coverage rates within two days of life, as well as new information about hepatitis B vaccination coverage rates within one and three days of life.

To access this table directly in Excel format, click here.

You can also access NIS birth dose data from 2003-2006 on the Perinatal Hepatitis B Coordinator Resource Center web page at
http://www.cdc.gov/ncidod/diseases/hepatitis/resource/perinatalhepB.htm

Those interested in the specifics of the revision of the data can read "A Special Note for the April 2008 Revision" at
http://www.cdc.gov/vaccines/stats-surv/nis/data/april2008revision.doc
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May 20, 2008
CDC'S FOUR-PART PERINATAL HEPATITIS B NETCONFERENCE OFFERS CONTINUING EDUCATION CREDIT

In April, CDC provided training to state and local project perinatal hepatitis coordinators via a four-part netconference. This series is now available online to all interested parties. Continuing education credit can be obtained after completing each segment. The segment topics include case identification, case management, assessment and evaluation, and the delivery hospital as safety net. Each session is approximately 75 minutes in length.

The Essentials of Perinatal Hepatitis B Prevention: A Training Series for Coordinators and Cases Managers netconference series can be accessed at http://www2a.cdc.gov/vaccines/ed/hepbtraining
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May 20, 2008
CDC EXPERTS UPDATE ONLINE "ASK THE EXPERTS" SECTIONS ON GENERAL IMMUNIZATION, HEPATITIS A, HEPATITIS B, AND MORE

Vaccination experts at CDC recently reviewed and updated information on 15 of IAC's online "Ask the Experts" Q&A sections, including the general immunization, hepatitis A, and hepatitis B sections. All of IAC's "Ask the Experts" Q&As are reviewed and updated annually.

To access the revised Q&As on general immunization, go to:
http://www.immunize.org/askexperts/experts_general.asp

To access the revised Q&As on hepatitis A, go to:
http://www.immunize.org/askexperts/experts_hepa.asp

To access the revised Q&As on hepatitis B, go to:
http://www.immunize.org/askexperts/experts_hepb.asp

Other sections that have been updated include diphtheria, Hib, HPV, influenza, MMR, meningococcal, pneumococcal conjugate, rotavirus, tetanus, varicella, and zoster.

To access the index of "Ask the Experts" sections, go to:
http://www.immunize.org/askexperts
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May 20, 2008
HAWAI`I'S HEPATITIS SUPPORT NETWORK OFFERS INFORMATION ON THE PREVENTION AND TREATMENT OF HEPATITIS B AND C AND OPPORTUNITIES FOR VOLUNTEERS TO BECOME ENGAGED IN PREVENTION EFFORTS

The Hepatitis Support Network of Hawai`i is the oldest hepatitis prevention, education, treatment, and support organization in the Hawaiian Islands. The network engages a coalition of individuals and organizations to advocate for treatment resources for persons chronically infected with HBV or HCV. The network also works to increase awareness about hepatitis B and hepatitis C and to promote early testing, vaccination, and treatment. Additional network programs include a hepatitis prison ministry, viral hepatitis presentations, special events with free HBV and HCV screening, a peer case-management program for people living with chronic HBV infection, and a monthly support group.

For more information on the Hepatitis Support Network of Hawai`i's activities, go to: http://hepatitis.idlinks.com

The Hepatitis Support Network of Hawai`i is a component of Access to Care Today (ACT), a 501(c)3 nonprofit organization. The staff is largely volunteer. To view descriptions of volunteer staff needs, go to: https://volunteer.united-e-way.org/auw/org/opp/8370479.html
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May 20, 2008
NIH CONSENSUS DEVELOPMENT CONFERENCE ON THE MANAGEMENT OF HEPATITIS B TO BE HELD OCTOBER 20-22 IN BESTHEDA

The National Institute of Health's Consensus Development Conference on the Management of Hepatitis B will be held October 20-22, in Bethesda, MD. This conference is sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases and the Office of Medical Applications of Research.

Speakers and attendees at this conference will discuss issues related to the benefits and risks of current therapeutic options for HBV infection, including which persons should be treated what measures are appropriate to monitor therapy and assess outcomes, and what are the greatest needs for future research.

For more information, including the preliminary agenda, go to: http://consensus.nih.gov/2008/2008HepatitisBCDC120main.htm
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May 20, 2008
JOURNAL ARTICLES YOU MAY HAVE MISSED

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

"The Effect of Vaccinated Children on Increased Hepatitis B Immunization Among High-Risk Adults"
Authors: Koya DL, Hill EG, Darden PM
Source: Am J Public Health, May 2008, Vol. 98(5):832-8
Click here for abstract.

"The Young Men's Survey Phase II: Hepatitis B Immunization and Infection Among Young Men Who Have Sex With Men"
Authors: Weinbaum CM, Lyerla R, Mackellar DA, et al.
Source: Am J Public Health, May 2008, Vol. 98(5):839-45
Click here for abstract.

"Racial Differences in the Evaluation and Treatment of Hepatitis C Among Veterans: A Retrospective Cohort Study"
Authors: Rousseau CM, Ioannou GN, Todd-Stenberg JA, et al.
Source: Am J Public Health, May 2008, Vol. 98(5):846-52
Click here for abstract.

"High Prevalence of Hepatitis C Virus Infection Among Immigrants from the Former Soviet Union in the New York City Metropolitan Area: Results of a Community-Based Screening Program"
Authors: Batash S, Khaykis I, Raicht RF, Bini EJ
Source: Am J Gastroenterol, April 2008, Vol. 103(4):922-7
Click here for abstract.

"Home Health Care Registered Nurses and the Risk of Percutaneous Injuries: A Pilot Study"
Authors: Gershon RR, Pogorzelska M, Qureshi KA, Sherman M
Source: Am J Infect Control, April 2008, Vol. 36(3):165-72
Click here for abstract.

"The National Study to Prevent Blood Exposure in Paramedics: Exposure Reporting"
Authors: Boal WL, Leiss JK, Sousa S, Lyden JT, Li J, Jagger J
Source: Am J Ind Med, March 2008, Vol. 51(3):213-22
Click here for abstract.

"A Randomized Intervention Trial to Reduce the Lending of Used Injection Equipment Among Injection Drug Users Infected with Hepatitis C"
Authors: Latka MH, Hagan H, Kapadia F, et al.
Source: Am J Public Health, May 2008, Vol. 98(5):853-61
Click here for abstract.

"Prevalence of Hepatitis C Virus Infection Among Injection Drug Users in the United States, 1994-2004"
Authors: Amon JJ, Garfein RS, Ahdieh-Grant L, et al.
Source: Clin Infect Dis, May 5, 2008 [Epub ahead of print]
Click here for abstract.


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