Guest guest Posted November 20, 2004 Report Share Posted November 20, 2004 > > HEP EXPRESS > Viral hepatitis news from the Immunization Action Coalition > > Combined Federal Campaign #0233 > Federal employees, including military, may contribute > to IAC by using code #0233 on their pledge cards. > =========================================================== > Issue Number 23 November 18, 2004 > > CONTENTS OF THIS ISSUE > > 1. CDC reports 89% decrease in acute hepatitis B infection > among U.S. children and adolescents during 1990-2002 > 2. VIS translations: New hepatitis A vaccine VIS now > available in eight additional languages > 3. CDC creates viral hepatitis slide show for high school > students > 4. New York initiative provides free hepatitis B vaccine to > hospitals adopting a universal birth dose policy > 5. Report on Illinois hospital practices related to > hepatitis B birth dose available online > 6. CDC issues notice about false-positive HBsAg tests > 7. Updated: IAC revises two hepatitis-related education > pieces > 8. October issue of " Vaccinate Adults " is on the Web > 9. New issue of " Viral Hepatitis " available on VHPB website > ---------------------------------------------------------------- > > 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. > ---------------------------------------------------------------- > > (1 of 9) > November 18, 2004 > CDC REPORTS 89% DECREASE IN ACUTE HEPATITIS B INFECTION AMONG > U.S. CHILDREN AND ADOLESCENTS DURING 1990-2002 > > [The following is cross posted from the Immunization Action > Coalition's " IAC EXPRESS " electronic newsletter, 11/8/04.] > > CDC published " Acute Hepatitis B Among Children and Adolescents > --United States, 1990-2002 " in the November 5 issue of MMWR. The > article is reprinted below in its entirety, excluding > references, two figures, and a table. > > *********************** > > Since the 1991 adoption of a comprehensive strategy to eliminate > hepatitis B virus (HBV) transmission in the United States, the > incidence of acute hepatitis B cases has declined steadily. > Declines have been greatest among children born after the 1991 > recommendations for universal infant hepatitis B vaccination > were implemented. In 1995, the elimination strategy was expanded > to include routine vaccination of all adolescents aged 11-12 > years and, in 1999, to include children aged <18 years who had > not been vaccinated previously. To describe the epidemiology of > acute hepatitis B in children and adolescents in the United > States, CDC analyzed notifiable disease surveillance data > collected during 1990-2002 and data collected during 2001-2002 > through enhanced surveillance of reported cases of acute > hepatitis B in children born after 1990. This report summarizes > the results of that analysis, which indicated that the rate of > acute hepatitis B in children and adolescents decreased 89% > during 1990-2002 and that racial disparities in hepatitis B > incidence have narrowed. Many confirmed cases in persons born > after 1990 occurred among international adoptees and other > children born outside the United States. Continued > implementation of the hepatitis B elimination strategy and > accurate surveillance data to monitor the impact of vaccination > are necessary to sustain the decline of acute hepatitis B among > children. > > Cases of acute hepatitis B were reported weekly to CDC by all 50 > states and the District of Columbia. Acute hepatitis B rates > were calculated per 100,000 population by using population > denominators from the U.S. Census Bureau. Acute hepatitis B was > defined as an acute illness with (1) discrete onset of symptoms > and jaundice or elevated serum aminotransferase levels and (2) > laboratory evidence of either IgM antibody to hepatitis B core > antigen (IgM anti-HBc) or hepatitis B surface antigen (HBsAg). > Since March 2001, CDC has conducted enhanced hepatitis B > surveillance, contacting states to confirm all reported cases of > acute hepatitis B in persons born after 1990. State surveillance > staff members were asked to verify each of the items in the case > definition and provide information regarding vaccination history > and country of birth. If errors were identified during this > process, states were asked to correct the information in an > updated submission to CDC. > > National Surveillance > During 1990-2002, a total of 13,829 cases of acute hepatitis B > were reported in the United States among persons aged <=19 > years. The incidence of reported cases declined steadily during > this period, from 3.03 per 100,000 population in 1990 to 0.34 in > 2002, representing a decline of 89%. The incidence among > adolescents aged 15-19 years was consistently higher than the > incidence among younger age groups, ranging from 8.69 per > 100,000 population in 1990 to 1.13 in 2002. Children and > adolescents in all age groups experienced steep declines in > incidence during 1990-2002; incidence declined 94% among > children aged 0-4 years, 92% among children aged 5-9 years, > 93% among those aged 10-14 years, and 87% among adolescents aged > 15-19 years. > > Among children and adolescents aged <=19 years in 1990, > incidence per 100,000 population was highest among Asian/Pacific > Islanders (A/PIs) (6.74) and blacks (4.29); whites had the > lowest race-specific incidence (1.39). Differences in incidence > between whites and A/PIs and between whites and blacks were 5.34 > and 2.90, respectively. From 1990 to 2002, rates declined 92% > among A/PIs, 88% among whites, 88% among blacks, and 84% among > American Indians/Alaskan Natives (AI/ANs). In 2002, the highest > incidence per 100,000 population was among A/PIs (0.55), > followed by blacks (0.51), AI/ANs (0.43), and whites (0.16); > since 1990, differences in incidence between whites and A/PIs > and whites and blacks declined by 93% and 88%, respectively. > > Case Investigations > Follow-up investigations conducted by CDC and state and local > health departments verified 19 case reports from 2001 and 2002 > as cases of acute hepatitis B among children born after 1990. Of > the verified case reports, 12 (60%) involved males, eight (42%) > involved children aged <2 years, and 11 (58%) involved children > born in the United States. Seven (37%) reported race as A/PI, > five (26%) as white, four (21%) as black, and three (16%) as > unknown. Eight (42%) cases were reported in children born > outside the United States, including six international adoptees > (32%). Receipt of >=1 dose of hepatitis B vaccine was confirmed > in three (16%) cases. Vaccination status was unknown for 12 > cases (63%). > > Editorial Note: > The incidence of acute hepatitis B cases in U.S. children and > adolescents decreased during the era of universal childhood > vaccination. This decline coincided with an increase in > hepatitis B vaccination coverage among children aged 19-35 > months, from 16% in 1992 to 90% in 2002, and among adolescents > aged 13-15, from nearly 0 in 1992 to 67% in 2002. > > Declines in incidence were observed for children of all races, > including A/PIs, whose rates historically have been higher than > the national average. Because of the disproportionate burden of > hepatitis B in A/PI communities, A/PI children were among the > first groups for whom hepatitis B vaccination was recommended. > The reduction of the disparity between A/PIs and other children > is consistent with recent observations noting a decline in > seroprevalence of HBV infection and successful implementation of > routine hepatitis B vaccination among Asians who have recently > immigrated to the United States. However, of the 11 verified > cases during 2001-02 of acute hepatitis B among children born in > the United States, three (27%) involved A/PIs. Although the > national origins of these children's household members are > unknown, the substantial proportion of A/PIs suggests that > horizontal transmission of HBV among first-generation Asians > might be a persistent problem. > > The higher incidence among older adolescents (aged 15-19 years) > likely is attributable to their having been born before > universal infant hepatitis B vaccination was recommended in > 1991. Incidence among older adolescents is expected to decline > further as the vaccinated cohort ages and as 1999 > recommendations to vaccinate all previously unvaccinated persons > aged 0-18 years are fully implemented. The expected decline in > rates among adolescents also might be augmented by laws in 32 > states requiring proof of hepatitis B vaccination before entry > into middle school. > > Follow-up information obtained through surveillance of reported > cases suggests that children born outside the United States, > especially international adoptees, represent a substantial > proportion of cases. Cases of acute hepatitis B among > international adoptees might result from undervaccination and > increased risk for exposure while living in areas with high > prevalence of chronic HBV infection. International adoptees are > exempt from U.S. regulations that bar entry to immigrants > without documentation of hepatitis B vaccination. Studies have > demonstrated that international adoptees exhibit low rates of > protective titers of antibodies to vaccine-preventable diseases > upon arrival in the United States, including adoptees with > written evidence of age-appropriate vaccination provided by the > birth country. Appropriate evaluation and remediation of the > immunization status of international adoptees has been promoted > through national guidelines; however, the extent to which these > guidelines have been implemented is unknown. > > Despite the decline in acute hepatitis B cases among children in > the United States, the presence of confirmed cases highlights > the importance of infant vaccination and timely completion of > the 3-dose vaccination series. The vaccination series should be > started at birth, preferably before the newborn is discharged > from the hospital. Infants born to women who are HBsAg positive > or who have not had prenatal HBsAg testing should receive the > first dose of hepatitis B vaccine within 12 hours of birth. > Beginning the vaccination series at birth decreases the risk for > perinatal HBV transmission and predicts successful completion of > the series. > > Although enhanced surveillance data from verified case reports > suggest that international adoptees and other children born > outside the United States might particularly benefit from future > prevention efforts, many case reports lacked risk factor > information. As the incidence of acute hepatitis B among > children and adolescents declines, accurate surveillance data > become increasingly important to monitor the effect of > immunization recommendations. Continued efforts of local, state, > and national surveillance staff to improve data quality are > critical to eliminating HBV transmission in the United States. > > *********************** > > To access a web-text (HTML) version of the complete article, > go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5343a4.htm > > To access a ready-to-copy (PDF) version of this issue of MMWR, > go to: http://www.cdc.gov/mmwr/PDF/wk/mm5343.pdf > > To receive a FREE electronic subscription to MMWR, go to: > http://www.cdc.gov/mmwr/mmwrsubscribe.html > ---------------------------------------------------------------- > > (2 of 9) > November 18, 2004 > VIS TRANSLATIONS: NEW HEPATITIS A VACCINE VIS NOW AVAILABLE IN > EIGHT ADDITIONAL LANGUAGES > > [The following is cross posted from the Immunization Action > Coalition's " IAC EXPRESS " electronic newsletter, 11/1/04.] > > Dated 8/4/04, the current version of the VIS for hepatitis A > vaccine is now available on the IAC website in eight additional > languages: Arabic, Armenian, Cambodian, Farsi, Haitian Creole, > Hmong, Korean, and Vietnamese. IAC gratefully acknowledges the > Massachusetts Department of Public Health for the Haitian Creole > translation and the California Department of Health Services for > the remaining translations. > > PLEASE NOTE: When hepatitis A vaccine is added to the Vaccine > Injury Compensation Program's injury table, presumably later in > 2004, another hepatitis A vaccine VIS will be issued. To avoid > large printing expenses, print off only as many of the 8/4/04 > VISs as you anticipate needing for the next several months. > > To obtain a ready-to-copy (PDF) version of the VIS for hepatitis > A vaccine in ARABIC, go to: > http://www.immunize.org/vis/ab_hpa04.pdf > > To obtain it in ARMENIAN, go to: > http://www.immunize.org/vis/ar_hpa04.pdf > > To obtain it in CAMBODIAN, go to: > http://www.immunize.org/vis/ca_hpa04.pdf > > To obtain it in FARSI, go to: > http://www.immunize.org/vis/fa_hpa04.pdf > > To obtain it in HAITIAN CREOLE, go to: > http://www.immunize.org/vis/ha_hpa04.pdf > > To obtain it in HMONG, go to: > http://www.immunize.org/vis/hm_hpa04.pdf > > To obtain it in KOREAN, go to: > http://www.immunize.org/vis/ko_hpa04.pdf > > To obtain it in VIETNAMESE, go to: > http://www.immunize.org/vis/vn_hpa04.pdf > > To obtain it in ENGLISH, go to: > http://www.immunize.org/vis/v-hepa.pdf > > For information about the use of VISs, and for VISs in a total > of 32 languages, visit IAC's VIS web section at > http://www.immunize.org/vis > ---------------------------------------------------------------- > > (3 of 9) > November 18, 2004 > CDC CREATES VIRAL HEPATITIS SLIDE SHOW FOR HIGH SCHOOL STUDENTS > > CDC's Division of Viral Hepatitis has developed a three-part > slide set for high school students, designed to give adolescents > basic information and raise awareness about HAV, HBV, and HCV. > The set can be used as a resource for science or health > projects, as an outline for a teaching tool, or as reference > material to inform others (e.g., family, friends). > > To view or download this resource, go to: > http://www.cdc.gov/ncidod/diseases/hepatitis/resource/training/hs_slideset.htm > ---------------------------------------------------------------- > > (4 of 9) > November 18, 2004 > NEW YORK INITIATIVE PROVIDES FREE HEPATITIS B VACCINE TO > HOSPITALS ADOPTING A UNIVERSAL BIRTH DOSE POLICY > > The Hepatitis B Birth Dose Program is an initiative of the New > York State Department of Health (NYSDOH) that provides free > hepatitis B vaccine to any birthing hospital in New York State > that agrees to adopt a universal hepatitis B birth dose policy. > Since October 2003, the program has enrolled 50 (out of 113) > upstate and 25 (out of 45) New York City birthing hospitals. > > Hospitals may participate in the program by submitting a brief > application, along with their birth dose policy, to NYSDOH for > review. The policy must clearly show that all newborns will be > routinely vaccinated against hepatitis B at birth regardless of > maternal hepatitis B surface antigen status, infant's insurance > status, or individual physician preference. > > The provision of hepatitis B vaccine to all infants at birth > provides a safety net to high-risk infants who do not receive > appropriate prophylactic treatment against HBV transmission at > birth, and to infants who are exposed to HBV postnatally from > another family member or caregiver. > > In a 2002 survey of New York State birthing hospitals, cost of > vaccine was identified as a barrier to vaccinating infants at > birth by many hospitals. Through this new program, NYSDOH hopes > to eliminate additional hospital costs for vaccine purchase > while improving hospital compliance with recommended standards > of care. > > Questions regarding the program can be directed to Perinatal > Hepatitis B Program Manager Herlihy, RN, MS, at > (518) 473-4437 or EJH04@... > ---------------------------------------------------------------- > > (5 of 9) > November 18, 2004 > REPORT ON ILLINOIS HOSPITAL PRACTICES RELATED TO HEPATITIS B > BIRTH DOSE AVAILABLE ONLINE > > The Illinois Chapter of the American Academy of Pediatrics (AAP) > and the Illinois Department of Public Health collaborated on a > study titled: " Report of Illinois Birthing Hospital Practices > with Respect to the Administration of the Hepatitis B Birth Dose > Vaccine and Hospital Participation in the Vaccines for Children- > Plus Program. " > > The first four study objectives were > > (1) Assess Illinois birthing hospital practices and policies > with respect to administration of the hepatitis B vaccine > to newborns prior to hospital discharge. > (2) Identify strategies to increase the hepatitis B birth > dose vaccination rate in Illinois. > (3) Determine how many Illinois birthing hospitals are > currently enrolled in the Vaccines for Children-Plus > (VFC-Plus) program. [VFC-Plus provides hospitals with > vaccines, such as that for hepatitis B, for children who > do not have insurance or for whom private insurance will > not pay.] > (4) Identify factors impacting enrollment/non-enrollment into > the VFC-Plus program. > > The study found that the establishment of hospital policies, and > more importantly, written standing orders for administration of > the hepatitis B birth dose correlated with significantly higher > hepatitis B birth dose administration rates. Hospitals enrolled > in the Illinois VFC-Plus program demonstrated significantly > higher hepatitis B birth dose vaccination rates when compared > with non-enrolled hospitals. > > The study is an excellent example of collaboration between a > state public health department and the state AAP chapter and can > be used to stimulate discussion and planning in other states. > > To read the report online, go to: > http://www.illinoisaap.org/HepBFinalReport.pdf > ---------------------------------------------------------------- > > (6 of 9) > November 18, 2004 > CDC ISSUES NOTICE ABOUT FALSE-POSITIVE HBsAg TESTS > > [The following is cross posted from the Immunization Action > Coalition's " IAC EXPRESS " electronic newsletter, 11/1/04.] > > CDC recently posted the following notice on the Viral Hepatitis > section of the National Center for Infectious Diseases' (NCID) > website. > > ********************* > > FALSE-POSITIVE HBsAg TESTS NOTED > > BD and Abbott Diagnostics have initiated an investigation > concerning the increased rate of initial and/or repeat reactive > results for the AUSZYME Monoclonal test when using BD Vacutainer > SST Plus tubes. As described in the AUSZYME package insert, > reactive specimens should be repeated in duplicate. If either of > the repeats is positive, the sample should then be tested with a > licensed neutralizing confirmatory test, such as the HBsAg > Confirmatory Assay. Only those specimens in which the HBsAg can > be neutralized by the confirmatory test procedure may be > designated as positive for HBsAg. All highly sensitive > immunoassay systems have a potential for nonspecific reactions. > The specificity of a repeatedly reactive specimen can be > confirmed by neutralization tests. > > ********************* > > To access the notice, go to: > http://www.cdc.gov/ncidod/diseases/hepatitis/new.htm#top Click > on the link titled " False positive HBsAg tests noted. " > > For additional technical or product-related information, read > the BD technical bulletin at > http://www.bd.com/vacutainer/pdfs/techbulletins/Abbott_Diagnostics_17september20\ 04.pdf > > If you have identified a cluster of infants born to false- > positive HBsAg mothers, who because of the false-positive > results, have been monitored as if they were born to HBsAg- > positive mothers, please call A. Wang, MD, MPH, at NCID > at (404) 371-5953. > ---------------------------------------------------------------- > > (7 of 9) > November 18, 2004 > UPDATED: IAC REVISES TWO HEPATITIS-RELATED EDUCATION PIECES > > IAC recently revised two of its long-standing hepatitis B > education pieces. > > " Hepatitis B Shots Are Recommended for All New Babies " is a > brochure targeted at expectant or new parents who might question > the need for, or timing of, infant vaccination against HBV. > > To access a ready-to-copy (PDF) version of " Hepatitis B Shots > Are Recommended for All New Babies, " go to: > http://www.immunize.org/catg.d/p4110bab.pdf > > To access a web-text (HTML) version of it, go to: > http://www.immunize.org/catg.d/p4110bab.htm > > " Hepatitis B Information for Asian and Pacific Islander > Americans " was created to answer the questions of Asian and > Pacific Islander Americans (APIA), including immigrants and > refugees, as well as persons of APIA descent born in the United > States. The revised version includes an updated list of related > organizations that readers might wish to contact. > > To access a ready-to-copy (PDF) version of " Hepatitis B > Information for Asian and Pacific Islander Americans, " go to: > http://www.immunize.org/catg.d/4190apia.pdf > > To access a web-text (HTML) version of it, go to: > http://www.immunize.org/catg.d/4190apia.htm > ---------------------------------------------------------------- > > (8 of 9) > November 18, 2004 > OCTOBER ISSUE OF " VACCINATE ADULTS " IS ON THE WEB > > IAC recently mailed the latest issue of " VACCINATE ADULTS " > (October 2004) to 100,000 health professionals and others who > work in the field of immunization. Packed with immunization > resources for health professionals and patients, the 12-page > issue is well worth downloading. All articles and education > pieces, except editorials, have been thoroughly reviewed by > immunization and hepatitis experts at CDC. > > PLEASE NOTE: Current as of September 2004, the resources in the > October " VACCINATE ADULTS " do not contain the most recent > information on influenza vaccine and vaccine supply. On October > 5, ACIP developed interim influenza vaccine recommendations in > response to Chiron Corporation's announcement that its trivalent > inactivated influenza vaccine will not be available in the > United States for the 2004-05 influenza season. The information > in the interim recommendations is not reflected in any of the > influenza information published in the October " VACCINATE > ADULTS. " > > HOW TO READ " VACCINATE ADULTS " 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/va > > The PDF file of the entire issue, linked below, is large at > 608,197 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 a ready-to-copy (PDF) version of the October issue, > go to: http://www.immunize.org/va/va14.pdf > ---------------------------------------------------------------- > > (9 of 9) > November 18, 2004 > NEW ISSUE OF " VIRAL HEPATITIS " AVAILABLE ON VHPB WEBSITE > > The Viral Hepatitis Prevention Board (VHPB) website has been > updated to include a new issue of the publication " Viral > Hepatitis. " > > " Viral Hepatitis, " Volume 13, Number 1, is prepared from > material presented at the VHPB meeting on March 11-12, 2004, in > Sevilla, Spain. The topic of this meeting was " Hepatitis B > vaccine: long-term efficacy, booster policy, and impact of HBV > mutants on hepatitis B vaccination programmes. " > > To access the ready-to-copy (PDF) versions of this issue, > go to: http://www.vhpb.org/Default.asp?navItem=newsletters > > To access the home page of the VHPB website, go to: > http://www.vhpb.org > > =================================================================== > We hope you will forward this e-newsletter to others. > > Managing editor: A. , DDS, MPH > Copy editor: Dale > Editorial assistant: Janelle Tangonan > ISSN: 1547-6375 > > To subscribe or change your HEP EXPRESS email address, or to view > past issues, please visit http://www.hepprograms.org/hepexpress > > This publication is supported by Grant No. U50/CCU523259 from > the Division of Viral Hepatitis at the Centers for Disease Control > and Prevention. Its contents are solely the responsibility of IAC > and do not necessarily represent the official views of CDC. > Circulation: 1,951 > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 20, 2004 Report Share Posted November 20, 2004 > > HEP EXPRESS > Viral hepatitis news from the Immunization Action Coalition > > Combined Federal Campaign #0233 > Federal employees, including military, may contribute > to IAC by using code #0233 on their pledge cards. > =========================================================== > Issue Number 23 November 18, 2004 > > CONTENTS OF THIS ISSUE > > 1. CDC reports 89% decrease in acute hepatitis B infection > among U.S. children and adolescents during 1990-2002 > 2. VIS translations: New hepatitis A vaccine VIS now > available in eight additional languages > 3. CDC creates viral hepatitis slide show for high school > students > 4. New York initiative provides free hepatitis B vaccine to > hospitals adopting a universal birth dose policy > 5. Report on Illinois hospital practices related to > hepatitis B birth dose available online > 6. CDC issues notice about false-positive HBsAg tests > 7. Updated: IAC revises two hepatitis-related education > pieces > 8. October issue of " Vaccinate Adults " is on the Web > 9. New issue of " Viral Hepatitis " available on VHPB website > ---------------------------------------------------------------- > > 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. > ---------------------------------------------------------------- > > (1 of 9) > November 18, 2004 > CDC REPORTS 89% DECREASE IN ACUTE HEPATITIS B INFECTION AMONG > U.S. CHILDREN AND ADOLESCENTS DURING 1990-2002 > > [The following is cross posted from the Immunization Action > Coalition's " IAC EXPRESS " electronic newsletter, 11/8/04.] > > CDC published " Acute Hepatitis B Among Children and Adolescents > --United States, 1990-2002 " in the November 5 issue of MMWR. The > article is reprinted below in its entirety, excluding > references, two figures, and a table. > > *********************** > > Since the 1991 adoption of a comprehensive strategy to eliminate > hepatitis B virus (HBV) transmission in the United States, the > incidence of acute hepatitis B cases has declined steadily. > Declines have been greatest among children born after the 1991 > recommendations for universal infant hepatitis B vaccination > were implemented. In 1995, the elimination strategy was expanded > to include routine vaccination of all adolescents aged 11-12 > years and, in 1999, to include children aged <18 years who had > not been vaccinated previously. To describe the epidemiology of > acute hepatitis B in children and adolescents in the United > States, CDC analyzed notifiable disease surveillance data > collected during 1990-2002 and data collected during 2001-2002 > through enhanced surveillance of reported cases of acute > hepatitis B in children born after 1990. This report summarizes > the results of that analysis, which indicated that the rate of > acute hepatitis B in children and adolescents decreased 89% > during 1990-2002 and that racial disparities in hepatitis B > incidence have narrowed. Many confirmed cases in persons born > after 1990 occurred among international adoptees and other > children born outside the United States. Continued > implementation of the hepatitis B elimination strategy and > accurate surveillance data to monitor the impact of vaccination > are necessary to sustain the decline of acute hepatitis B among > children. > > Cases of acute hepatitis B were reported weekly to CDC by all 50 > states and the District of Columbia. Acute hepatitis B rates > were calculated per 100,000 population by using population > denominators from the U.S. Census Bureau. Acute hepatitis B was > defined as an acute illness with (1) discrete onset of symptoms > and jaundice or elevated serum aminotransferase levels and (2) > laboratory evidence of either IgM antibody to hepatitis B core > antigen (IgM anti-HBc) or hepatitis B surface antigen (HBsAg). > Since March 2001, CDC has conducted enhanced hepatitis B > surveillance, contacting states to confirm all reported cases of > acute hepatitis B in persons born after 1990. State surveillance > staff members were asked to verify each of the items in the case > definition and provide information regarding vaccination history > and country of birth. If errors were identified during this > process, states were asked to correct the information in an > updated submission to CDC. > > National Surveillance > During 1990-2002, a total of 13,829 cases of acute hepatitis B > were reported in the United States among persons aged <=19 > years. The incidence of reported cases declined steadily during > this period, from 3.03 per 100,000 population in 1990 to 0.34 in > 2002, representing a decline of 89%. The incidence among > adolescents aged 15-19 years was consistently higher than the > incidence among younger age groups, ranging from 8.69 per > 100,000 population in 1990 to 1.13 in 2002. Children and > adolescents in all age groups experienced steep declines in > incidence during 1990-2002; incidence declined 94% among > children aged 0-4 years, 92% among children aged 5-9 years, > 93% among those aged 10-14 years, and 87% among adolescents aged > 15-19 years. > > Among children and adolescents aged <=19 years in 1990, > incidence per 100,000 population was highest among Asian/Pacific > Islanders (A/PIs) (6.74) and blacks (4.29); whites had the > lowest race-specific incidence (1.39). Differences in incidence > between whites and A/PIs and between whites and blacks were 5.34 > and 2.90, respectively. From 1990 to 2002, rates declined 92% > among A/PIs, 88% among whites, 88% among blacks, and 84% among > American Indians/Alaskan Natives (AI/ANs). In 2002, the highest > incidence per 100,000 population was among A/PIs (0.55), > followed by blacks (0.51), AI/ANs (0.43), and whites (0.16); > since 1990, differences in incidence between whites and A/PIs > and whites and blacks declined by 93% and 88%, respectively. > > Case Investigations > Follow-up investigations conducted by CDC and state and local > health departments verified 19 case reports from 2001 and 2002 > as cases of acute hepatitis B among children born after 1990. Of > the verified case reports, 12 (60%) involved males, eight (42%) > involved children aged <2 years, and 11 (58%) involved children > born in the United States. Seven (37%) reported race as A/PI, > five (26%) as white, four (21%) as black, and three (16%) as > unknown. Eight (42%) cases were reported in children born > outside the United States, including six international adoptees > (32%). Receipt of >=1 dose of hepatitis B vaccine was confirmed > in three (16%) cases. Vaccination status was unknown for 12 > cases (63%). > > Editorial Note: > The incidence of acute hepatitis B cases in U.S. children and > adolescents decreased during the era of universal childhood > vaccination. This decline coincided with an increase in > hepatitis B vaccination coverage among children aged 19-35 > months, from 16% in 1992 to 90% in 2002, and among adolescents > aged 13-15, from nearly 0 in 1992 to 67% in 2002. > > Declines in incidence were observed for children of all races, > including A/PIs, whose rates historically have been higher than > the national average. Because of the disproportionate burden of > hepatitis B in A/PI communities, A/PI children were among the > first groups for whom hepatitis B vaccination was recommended. > The reduction of the disparity between A/PIs and other children > is consistent with recent observations noting a decline in > seroprevalence of HBV infection and successful implementation of > routine hepatitis B vaccination among Asians who have recently > immigrated to the United States. However, of the 11 verified > cases during 2001-02 of acute hepatitis B among children born in > the United States, three (27%) involved A/PIs. Although the > national origins of these children's household members are > unknown, the substantial proportion of A/PIs suggests that > horizontal transmission of HBV among first-generation Asians > might be a persistent problem. > > The higher incidence among older adolescents (aged 15-19 years) > likely is attributable to their having been born before > universal infant hepatitis B vaccination was recommended in > 1991. Incidence among older adolescents is expected to decline > further as the vaccinated cohort ages and as 1999 > recommendations to vaccinate all previously unvaccinated persons > aged 0-18 years are fully implemented. The expected decline in > rates among adolescents also might be augmented by laws in 32 > states requiring proof of hepatitis B vaccination before entry > into middle school. > > Follow-up information obtained through surveillance of reported > cases suggests that children born outside the United States, > especially international adoptees, represent a substantial > proportion of cases. Cases of acute hepatitis B among > international adoptees might result from undervaccination and > increased risk for exposure while living in areas with high > prevalence of chronic HBV infection. International adoptees are > exempt from U.S. regulations that bar entry to immigrants > without documentation of hepatitis B vaccination. Studies have > demonstrated that international adoptees exhibit low rates of > protective titers of antibodies to vaccine-preventable diseases > upon arrival in the United States, including adoptees with > written evidence of age-appropriate vaccination provided by the > birth country. Appropriate evaluation and remediation of the > immunization status of international adoptees has been promoted > through national guidelines; however, the extent to which these > guidelines have been implemented is unknown. > > Despite the decline in acute hepatitis B cases among children in > the United States, the presence of confirmed cases highlights > the importance of infant vaccination and timely completion of > the 3-dose vaccination series. The vaccination series should be > started at birth, preferably before the newborn is discharged > from the hospital. Infants born to women who are HBsAg positive > or who have not had prenatal HBsAg testing should receive the > first dose of hepatitis B vaccine within 12 hours of birth. > Beginning the vaccination series at birth decreases the risk for > perinatal HBV transmission and predicts successful completion of > the series. > > Although enhanced surveillance data from verified case reports > suggest that international adoptees and other children born > outside the United States might particularly benefit from future > prevention efforts, many case reports lacked risk factor > information. As the incidence of acute hepatitis B among > children and adolescents declines, accurate surveillance data > become increasingly important to monitor the effect of > immunization recommendations. Continued efforts of local, state, > and national surveillance staff to improve data quality are > critical to eliminating HBV transmission in the United States. > > *********************** > > To access a web-text (HTML) version of the complete article, > go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5343a4.htm > > To access a ready-to-copy (PDF) version of this issue of MMWR, > go to: http://www.cdc.gov/mmwr/PDF/wk/mm5343.pdf > > To receive a FREE electronic subscription to MMWR, go to: > http://www.cdc.gov/mmwr/mmwrsubscribe.html > ---------------------------------------------------------------- > > (2 of 9) > November 18, 2004 > VIS TRANSLATIONS: NEW HEPATITIS A VACCINE VIS NOW AVAILABLE IN > EIGHT ADDITIONAL LANGUAGES > > [The following is cross posted from the Immunization Action > Coalition's " IAC EXPRESS " electronic newsletter, 11/1/04.] > > Dated 8/4/04, the current version of the VIS for hepatitis A > vaccine is now available on the IAC website in eight additional > languages: Arabic, Armenian, Cambodian, Farsi, Haitian Creole, > Hmong, Korean, and Vietnamese. IAC gratefully acknowledges the > Massachusetts Department of Public Health for the Haitian Creole > translation and the California Department of Health Services for > the remaining translations. > > PLEASE NOTE: When hepatitis A vaccine is added to the Vaccine > Injury Compensation Program's injury table, presumably later in > 2004, another hepatitis A vaccine VIS will be issued. To avoid > large printing expenses, print off only as many of the 8/4/04 > VISs as you anticipate needing for the next several months. > > To obtain a ready-to-copy (PDF) version of the VIS for hepatitis > A vaccine in ARABIC, go to: > http://www.immunize.org/vis/ab_hpa04.pdf > > To obtain it in ARMENIAN, go to: > http://www.immunize.org/vis/ar_hpa04.pdf > > To obtain it in CAMBODIAN, go to: > http://www.immunize.org/vis/ca_hpa04.pdf > > To obtain it in FARSI, go to: > http://www.immunize.org/vis/fa_hpa04.pdf > > To obtain it in HAITIAN CREOLE, go to: > http://www.immunize.org/vis/ha_hpa04.pdf > > To obtain it in HMONG, go to: > http://www.immunize.org/vis/hm_hpa04.pdf > > To obtain it in KOREAN, go to: > http://www.immunize.org/vis/ko_hpa04.pdf > > To obtain it in VIETNAMESE, go to: > http://www.immunize.org/vis/vn_hpa04.pdf > > To obtain it in ENGLISH, go to: > http://www.immunize.org/vis/v-hepa.pdf > > For information about the use of VISs, and for VISs in a total > of 32 languages, visit IAC's VIS web section at > http://www.immunize.org/vis > ---------------------------------------------------------------- > > (3 of 9) > November 18, 2004 > CDC CREATES VIRAL HEPATITIS SLIDE SHOW FOR HIGH SCHOOL STUDENTS > > CDC's Division of Viral Hepatitis has developed a three-part > slide set for high school students, designed to give adolescents > basic information and raise awareness about HAV, HBV, and HCV. > The set can be used as a resource for science or health > projects, as an outline for a teaching tool, or as reference > material to inform others (e.g., family, friends). > > To view or download this resource, go to: > http://www.cdc.gov/ncidod/diseases/hepatitis/resource/training/hs_slideset.htm > ---------------------------------------------------------------- > > (4 of 9) > November 18, 2004 > NEW YORK INITIATIVE PROVIDES FREE HEPATITIS B VACCINE TO > HOSPITALS ADOPTING A UNIVERSAL BIRTH DOSE POLICY > > The Hepatitis B Birth Dose Program is an initiative of the New > York State Department of Health (NYSDOH) that provides free > hepatitis B vaccine to any birthing hospital in New York State > that agrees to adopt a universal hepatitis B birth dose policy. > Since October 2003, the program has enrolled 50 (out of 113) > upstate and 25 (out of 45) New York City birthing hospitals. > > Hospitals may participate in the program by submitting a brief > application, along with their birth dose policy, to NYSDOH for > review. The policy must clearly show that all newborns will be > routinely vaccinated against hepatitis B at birth regardless of > maternal hepatitis B surface antigen status, infant's insurance > status, or individual physician preference. > > The provision of hepatitis B vaccine to all infants at birth > provides a safety net to high-risk infants who do not receive > appropriate prophylactic treatment against HBV transmission at > birth, and to infants who are exposed to HBV postnatally from > another family member or caregiver. > > In a 2002 survey of New York State birthing hospitals, cost of > vaccine was identified as a barrier to vaccinating infants at > birth by many hospitals. Through this new program, NYSDOH hopes > to eliminate additional hospital costs for vaccine purchase > while improving hospital compliance with recommended standards > of care. > > Questions regarding the program can be directed to Perinatal > Hepatitis B Program Manager Herlihy, RN, MS, at > (518) 473-4437 or EJH04@... > ---------------------------------------------------------------- > > (5 of 9) > November 18, 2004 > REPORT ON ILLINOIS HOSPITAL PRACTICES RELATED TO HEPATITIS B > BIRTH DOSE AVAILABLE ONLINE > > The Illinois Chapter of the American Academy of Pediatrics (AAP) > and the Illinois Department of Public Health collaborated on a > study titled: " Report of Illinois Birthing Hospital Practices > with Respect to the Administration of the Hepatitis B Birth Dose > Vaccine and Hospital Participation in the Vaccines for Children- > Plus Program. " > > The first four study objectives were > > (1) Assess Illinois birthing hospital practices and policies > with respect to administration of the hepatitis B vaccine > to newborns prior to hospital discharge. > (2) Identify strategies to increase the hepatitis B birth > dose vaccination rate in Illinois. > (3) Determine how many Illinois birthing hospitals are > currently enrolled in the Vaccines for Children-Plus > (VFC-Plus) program. [VFC-Plus provides hospitals with > vaccines, such as that for hepatitis B, for children who > do not have insurance or for whom private insurance will > not pay.] > (4) Identify factors impacting enrollment/non-enrollment into > the VFC-Plus program. > > The study found that the establishment of hospital policies, and > more importantly, written standing orders for administration of > the hepatitis B birth dose correlated with significantly higher > hepatitis B birth dose administration rates. Hospitals enrolled > in the Illinois VFC-Plus program demonstrated significantly > higher hepatitis B birth dose vaccination rates when compared > with non-enrolled hospitals. > > The study is an excellent example of collaboration between a > state public health department and the state AAP chapter and can > be used to stimulate discussion and planning in other states. > > To read the report online, go to: > http://www.illinoisaap.org/HepBFinalReport.pdf > ---------------------------------------------------------------- > > (6 of 9) > November 18, 2004 > CDC ISSUES NOTICE ABOUT FALSE-POSITIVE HBsAg TESTS > > [The following is cross posted from the Immunization Action > Coalition's " IAC EXPRESS " electronic newsletter, 11/1/04.] > > CDC recently posted the following notice on the Viral Hepatitis > section of the National Center for Infectious Diseases' (NCID) > website. > > ********************* > > FALSE-POSITIVE HBsAg TESTS NOTED > > BD and Abbott Diagnostics have initiated an investigation > concerning the increased rate of initial and/or repeat reactive > results for the AUSZYME Monoclonal test when using BD Vacutainer > SST Plus tubes. As described in the AUSZYME package insert, > reactive specimens should be repeated in duplicate. If either of > the repeats is positive, the sample should then be tested with a > licensed neutralizing confirmatory test, such as the HBsAg > Confirmatory Assay. Only those specimens in which the HBsAg can > be neutralized by the confirmatory test procedure may be > designated as positive for HBsAg. All highly sensitive > immunoassay systems have a potential for nonspecific reactions. > The specificity of a repeatedly reactive specimen can be > confirmed by neutralization tests. > > ********************* > > To access the notice, go to: > http://www.cdc.gov/ncidod/diseases/hepatitis/new.htm#top Click > on the link titled " False positive HBsAg tests noted. " > > For additional technical or product-related information, read > the BD technical bulletin at > http://www.bd.com/vacutainer/pdfs/techbulletins/Abbott_Diagnostics_17september20\ 04.pdf > > If you have identified a cluster of infants born to false- > positive HBsAg mothers, who because of the false-positive > results, have been monitored as if they were born to HBsAg- > positive mothers, please call A. Wang, MD, MPH, at NCID > at (404) 371-5953. > ---------------------------------------------------------------- > > (7 of 9) > November 18, 2004 > UPDATED: IAC REVISES TWO HEPATITIS-RELATED EDUCATION PIECES > > IAC recently revised two of its long-standing hepatitis B > education pieces. > > " Hepatitis B Shots Are Recommended for All New Babies " is a > brochure targeted at expectant or new parents who might question > the need for, or timing of, infant vaccination against HBV. > > To access a ready-to-copy (PDF) version of " Hepatitis B Shots > Are Recommended for All New Babies, " go to: > http://www.immunize.org/catg.d/p4110bab.pdf > > To access a web-text (HTML) version of it, go to: > http://www.immunize.org/catg.d/p4110bab.htm > > " Hepatitis B Information for Asian and Pacific Islander > Americans " was created to answer the questions of Asian and > Pacific Islander Americans (APIA), including immigrants and > refugees, as well as persons of APIA descent born in the United > States. The revised version includes an updated list of related > organizations that readers might wish to contact. > > To access a ready-to-copy (PDF) version of " Hepatitis B > Information for Asian and Pacific Islander Americans, " go to: > http://www.immunize.org/catg.d/4190apia.pdf > > To access a web-text (HTML) version of it, go to: > http://www.immunize.org/catg.d/4190apia.htm > ---------------------------------------------------------------- > > (8 of 9) > November 18, 2004 > OCTOBER ISSUE OF " VACCINATE ADULTS " IS ON THE WEB > > IAC recently mailed the latest issue of " VACCINATE ADULTS " > (October 2004) to 100,000 health professionals and others who > work in the field of immunization. Packed with immunization > resources for health professionals and patients, the 12-page > issue is well worth downloading. All articles and education > pieces, except editorials, have been thoroughly reviewed by > immunization and hepatitis experts at CDC. > > PLEASE NOTE: Current as of September 2004, the resources in the > October " VACCINATE ADULTS " do not contain the most recent > information on influenza vaccine and vaccine supply. On October > 5, ACIP developed interim influenza vaccine recommendations in > response to Chiron Corporation's announcement that its trivalent > inactivated influenza vaccine will not be available in the > United States for the 2004-05 influenza season. The information > in the interim recommendations is not reflected in any of the > influenza information published in the October " VACCINATE > ADULTS. " > > HOW TO READ " VACCINATE ADULTS " 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/va > > The PDF file of the entire issue, linked below, is large at > 608,197 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 a ready-to-copy (PDF) version of the October issue, > go to: http://www.immunize.org/va/va14.pdf > ---------------------------------------------------------------- > > (9 of 9) > November 18, 2004 > NEW ISSUE OF " VIRAL HEPATITIS " AVAILABLE ON VHPB WEBSITE > > The Viral Hepatitis Prevention Board (VHPB) website has been > updated to include a new issue of the publication " Viral > Hepatitis. " > > " Viral Hepatitis, " Volume 13, Number 1, is prepared from > material presented at the VHPB meeting on March 11-12, 2004, in > Sevilla, Spain. The topic of this meeting was " Hepatitis B > vaccine: long-term efficacy, booster policy, and impact of HBV > mutants on hepatitis B vaccination programmes. " > > To access the ready-to-copy (PDF) versions of this issue, > go to: http://www.vhpb.org/Default.asp?navItem=newsletters > > To access the home page of the VHPB website, go to: > http://www.vhpb.org > > =================================================================== > We hope you will forward this e-newsletter to others. > > Managing editor: A. , DDS, MPH > Copy editor: Dale > Editorial assistant: Janelle Tangonan > ISSN: 1547-6375 > > To subscribe or change your HEP EXPRESS email address, or to view > past issues, please visit http://www.hepprograms.org/hepexpress > > This publication is supported by Grant No. U50/CCU523259 from > the Division of Viral Hepatitis at the Centers for Disease Control > and Prevention. Its contents are solely the responsibility of IAC > and do not necessarily represent the official views of CDC. > Circulation: 1,951 > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 20, 2004 Report Share Posted November 20, 2004 > > HEP EXPRESS > Viral hepatitis news from the Immunization Action Coalition > > Combined Federal Campaign #0233 > Federal employees, including military, may contribute > to IAC by using code #0233 on their pledge cards. > =========================================================== > Issue Number 23 November 18, 2004 > > CONTENTS OF THIS ISSUE > > 1. CDC reports 89% decrease in acute hepatitis B infection > among U.S. children and adolescents during 1990-2002 > 2. VIS translations: New hepatitis A vaccine VIS now > available in eight additional languages > 3. CDC creates viral hepatitis slide show for high school > students > 4. New York initiative provides free hepatitis B vaccine to > hospitals adopting a universal birth dose policy > 5. Report on Illinois hospital practices related to > hepatitis B birth dose available online > 6. CDC issues notice about false-positive HBsAg tests > 7. Updated: IAC revises two hepatitis-related education > pieces > 8. October issue of " Vaccinate Adults " is on the Web > 9. New issue of " Viral Hepatitis " available on VHPB website > ---------------------------------------------------------------- > > 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. > ---------------------------------------------------------------- > > (1 of 9) > November 18, 2004 > CDC REPORTS 89% DECREASE IN ACUTE HEPATITIS B INFECTION AMONG > U.S. CHILDREN AND ADOLESCENTS DURING 1990-2002 > > [The following is cross posted from the Immunization Action > Coalition's " IAC EXPRESS " electronic newsletter, 11/8/04.] > > CDC published " Acute Hepatitis B Among Children and Adolescents > --United States, 1990-2002 " in the November 5 issue of MMWR. The > article is reprinted below in its entirety, excluding > references, two figures, and a table. > > *********************** > > Since the 1991 adoption of a comprehensive strategy to eliminate > hepatitis B virus (HBV) transmission in the United States, the > incidence of acute hepatitis B cases has declined steadily. > Declines have been greatest among children born after the 1991 > recommendations for universal infant hepatitis B vaccination > were implemented. In 1995, the elimination strategy was expanded > to include routine vaccination of all adolescents aged 11-12 > years and, in 1999, to include children aged <18 years who had > not been vaccinated previously. To describe the epidemiology of > acute hepatitis B in children and adolescents in the United > States, CDC analyzed notifiable disease surveillance data > collected during 1990-2002 and data collected during 2001-2002 > through enhanced surveillance of reported cases of acute > hepatitis B in children born after 1990. This report summarizes > the results of that analysis, which indicated that the rate of > acute hepatitis B in children and adolescents decreased 89% > during 1990-2002 and that racial disparities in hepatitis B > incidence have narrowed. Many confirmed cases in persons born > after 1990 occurred among international adoptees and other > children born outside the United States. Continued > implementation of the hepatitis B elimination strategy and > accurate surveillance data to monitor the impact of vaccination > are necessary to sustain the decline of acute hepatitis B among > children. > > Cases of acute hepatitis B were reported weekly to CDC by all 50 > states and the District of Columbia. Acute hepatitis B rates > were calculated per 100,000 population by using population > denominators from the U.S. Census Bureau. Acute hepatitis B was > defined as an acute illness with (1) discrete onset of symptoms > and jaundice or elevated serum aminotransferase levels and (2) > laboratory evidence of either IgM antibody to hepatitis B core > antigen (IgM anti-HBc) or hepatitis B surface antigen (HBsAg). > Since March 2001, CDC has conducted enhanced hepatitis B > surveillance, contacting states to confirm all reported cases of > acute hepatitis B in persons born after 1990. State surveillance > staff members were asked to verify each of the items in the case > definition and provide information regarding vaccination history > and country of birth. If errors were identified during this > process, states were asked to correct the information in an > updated submission to CDC. > > National Surveillance > During 1990-2002, a total of 13,829 cases of acute hepatitis B > were reported in the United States among persons aged <=19 > years. The incidence of reported cases declined steadily during > this period, from 3.03 per 100,000 population in 1990 to 0.34 in > 2002, representing a decline of 89%. The incidence among > adolescents aged 15-19 years was consistently higher than the > incidence among younger age groups, ranging from 8.69 per > 100,000 population in 1990 to 1.13 in 2002. Children and > adolescents in all age groups experienced steep declines in > incidence during 1990-2002; incidence declined 94% among > children aged 0-4 years, 92% among children aged 5-9 years, > 93% among those aged 10-14 years, and 87% among adolescents aged > 15-19 years. > > Among children and adolescents aged <=19 years in 1990, > incidence per 100,000 population was highest among Asian/Pacific > Islanders (A/PIs) (6.74) and blacks (4.29); whites had the > lowest race-specific incidence (1.39). Differences in incidence > between whites and A/PIs and between whites and blacks were 5.34 > and 2.90, respectively. From 1990 to 2002, rates declined 92% > among A/PIs, 88% among whites, 88% among blacks, and 84% among > American Indians/Alaskan Natives (AI/ANs). In 2002, the highest > incidence per 100,000 population was among A/PIs (0.55), > followed by blacks (0.51), AI/ANs (0.43), and whites (0.16); > since 1990, differences in incidence between whites and A/PIs > and whites and blacks declined by 93% and 88%, respectively. > > Case Investigations > Follow-up investigations conducted by CDC and state and local > health departments verified 19 case reports from 2001 and 2002 > as cases of acute hepatitis B among children born after 1990. Of > the verified case reports, 12 (60%) involved males, eight (42%) > involved children aged <2 years, and 11 (58%) involved children > born in the United States. Seven (37%) reported race as A/PI, > five (26%) as white, four (21%) as black, and three (16%) as > unknown. Eight (42%) cases were reported in children born > outside the United States, including six international adoptees > (32%). Receipt of >=1 dose of hepatitis B vaccine was confirmed > in three (16%) cases. Vaccination status was unknown for 12 > cases (63%). > > Editorial Note: > The incidence of acute hepatitis B cases in U.S. children and > adolescents decreased during the era of universal childhood > vaccination. This decline coincided with an increase in > hepatitis B vaccination coverage among children aged 19-35 > months, from 16% in 1992 to 90% in 2002, and among adolescents > aged 13-15, from nearly 0 in 1992 to 67% in 2002. > > Declines in incidence were observed for children of all races, > including A/PIs, whose rates historically have been higher than > the national average. Because of the disproportionate burden of > hepatitis B in A/PI communities, A/PI children were among the > first groups for whom hepatitis B vaccination was recommended. > The reduction of the disparity between A/PIs and other children > is consistent with recent observations noting a decline in > seroprevalence of HBV infection and successful implementation of > routine hepatitis B vaccination among Asians who have recently > immigrated to the United States. However, of the 11 verified > cases during 2001-02 of acute hepatitis B among children born in > the United States, three (27%) involved A/PIs. Although the > national origins of these children's household members are > unknown, the substantial proportion of A/PIs suggests that > horizontal transmission of HBV among first-generation Asians > might be a persistent problem. > > The higher incidence among older adolescents (aged 15-19 years) > likely is attributable to their having been born before > universal infant hepatitis B vaccination was recommended in > 1991. Incidence among older adolescents is expected to decline > further as the vaccinated cohort ages and as 1999 > recommendations to vaccinate all previously unvaccinated persons > aged 0-18 years are fully implemented. The expected decline in > rates among adolescents also might be augmented by laws in 32 > states requiring proof of hepatitis B vaccination before entry > into middle school. > > Follow-up information obtained through surveillance of reported > cases suggests that children born outside the United States, > especially international adoptees, represent a substantial > proportion of cases. Cases of acute hepatitis B among > international adoptees might result from undervaccination and > increased risk for exposure while living in areas with high > prevalence of chronic HBV infection. International adoptees are > exempt from U.S. regulations that bar entry to immigrants > without documentation of hepatitis B vaccination. Studies have > demonstrated that international adoptees exhibit low rates of > protective titers of antibodies to vaccine-preventable diseases > upon arrival in the United States, including adoptees with > written evidence of age-appropriate vaccination provided by the > birth country. Appropriate evaluation and remediation of the > immunization status of international adoptees has been promoted > through national guidelines; however, the extent to which these > guidelines have been implemented is unknown. > > Despite the decline in acute hepatitis B cases among children in > the United States, the presence of confirmed cases highlights > the importance of infant vaccination and timely completion of > the 3-dose vaccination series. The vaccination series should be > started at birth, preferably before the newborn is discharged > from the hospital. Infants born to women who are HBsAg positive > or who have not had prenatal HBsAg testing should receive the > first dose of hepatitis B vaccine within 12 hours of birth. > Beginning the vaccination series at birth decreases the risk for > perinatal HBV transmission and predicts successful completion of > the series. > > Although enhanced surveillance data from verified case reports > suggest that international adoptees and other children born > outside the United States might particularly benefit from future > prevention efforts, many case reports lacked risk factor > information. As the incidence of acute hepatitis B among > children and adolescents declines, accurate surveillance data > become increasingly important to monitor the effect of > immunization recommendations. Continued efforts of local, state, > and national surveillance staff to improve data quality are > critical to eliminating HBV transmission in the United States. > > *********************** > > To access a web-text (HTML) version of the complete article, > go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5343a4.htm > > To access a ready-to-copy (PDF) version of this issue of MMWR, > go to: http://www.cdc.gov/mmwr/PDF/wk/mm5343.pdf > > To receive a FREE electronic subscription to MMWR, go to: > http://www.cdc.gov/mmwr/mmwrsubscribe.html > ---------------------------------------------------------------- > > (2 of 9) > November 18, 2004 > VIS TRANSLATIONS: NEW HEPATITIS A VACCINE VIS NOW AVAILABLE IN > EIGHT ADDITIONAL LANGUAGES > > [The following is cross posted from the Immunization Action > Coalition's " IAC EXPRESS " electronic newsletter, 11/1/04.] > > Dated 8/4/04, the current version of the VIS for hepatitis A > vaccine is now available on the IAC website in eight additional > languages: Arabic, Armenian, Cambodian, Farsi, Haitian Creole, > Hmong, Korean, and Vietnamese. IAC gratefully acknowledges the > Massachusetts Department of Public Health for the Haitian Creole > translation and the California Department of Health Services for > the remaining translations. > > PLEASE NOTE: When hepatitis A vaccine is added to the Vaccine > Injury Compensation Program's injury table, presumably later in > 2004, another hepatitis A vaccine VIS will be issued. To avoid > large printing expenses, print off only as many of the 8/4/04 > VISs as you anticipate needing for the next several months. > > To obtain a ready-to-copy (PDF) version of the VIS for hepatitis > A vaccine in ARABIC, go to: > http://www.immunize.org/vis/ab_hpa04.pdf > > To obtain it in ARMENIAN, go to: > http://www.immunize.org/vis/ar_hpa04.pdf > > To obtain it in CAMBODIAN, go to: > http://www.immunize.org/vis/ca_hpa04.pdf > > To obtain it in FARSI, go to: > http://www.immunize.org/vis/fa_hpa04.pdf > > To obtain it in HAITIAN CREOLE, go to: > http://www.immunize.org/vis/ha_hpa04.pdf > > To obtain it in HMONG, go to: > http://www.immunize.org/vis/hm_hpa04.pdf > > To obtain it in KOREAN, go to: > http://www.immunize.org/vis/ko_hpa04.pdf > > To obtain it in VIETNAMESE, go to: > http://www.immunize.org/vis/vn_hpa04.pdf > > To obtain it in ENGLISH, go to: > http://www.immunize.org/vis/v-hepa.pdf > > For information about the use of VISs, and for VISs in a total > of 32 languages, visit IAC's VIS web section at > http://www.immunize.org/vis > ---------------------------------------------------------------- > > (3 of 9) > November 18, 2004 > CDC CREATES VIRAL HEPATITIS SLIDE SHOW FOR HIGH SCHOOL STUDENTS > > CDC's Division of Viral Hepatitis has developed a three-part > slide set for high school students, designed to give adolescents > basic information and raise awareness about HAV, HBV, and HCV. > The set can be used as a resource for science or health > projects, as an outline for a teaching tool, or as reference > material to inform others (e.g., family, friends). > > To view or download this resource, go to: > http://www.cdc.gov/ncidod/diseases/hepatitis/resource/training/hs_slideset.htm > ---------------------------------------------------------------- > > (4 of 9) > November 18, 2004 > NEW YORK INITIATIVE PROVIDES FREE HEPATITIS B VACCINE TO > HOSPITALS ADOPTING A UNIVERSAL BIRTH DOSE POLICY > > The Hepatitis B Birth Dose Program is an initiative of the New > York State Department of Health (NYSDOH) that provides free > hepatitis B vaccine to any birthing hospital in New York State > that agrees to adopt a universal hepatitis B birth dose policy. > Since October 2003, the program has enrolled 50 (out of 113) > upstate and 25 (out of 45) New York City birthing hospitals. > > Hospitals may participate in the program by submitting a brief > application, along with their birth dose policy, to NYSDOH for > review. The policy must clearly show that all newborns will be > routinely vaccinated against hepatitis B at birth regardless of > maternal hepatitis B surface antigen status, infant's insurance > status, or individual physician preference. > > The provision of hepatitis B vaccine to all infants at birth > provides a safety net to high-risk infants who do not receive > appropriate prophylactic treatment against HBV transmission at > birth, and to infants who are exposed to HBV postnatally from > another family member or caregiver. > > In a 2002 survey of New York State birthing hospitals, cost of > vaccine was identified as a barrier to vaccinating infants at > birth by many hospitals. Through this new program, NYSDOH hopes > to eliminate additional hospital costs for vaccine purchase > while improving hospital compliance with recommended standards > of care. > > Questions regarding the program can be directed to Perinatal > Hepatitis B Program Manager Herlihy, RN, MS, at > (518) 473-4437 or EJH04@... > ---------------------------------------------------------------- > > (5 of 9) > November 18, 2004 > REPORT ON ILLINOIS HOSPITAL PRACTICES RELATED TO HEPATITIS B > BIRTH DOSE AVAILABLE ONLINE > > The Illinois Chapter of the American Academy of Pediatrics (AAP) > and the Illinois Department of Public Health collaborated on a > study titled: " Report of Illinois Birthing Hospital Practices > with Respect to the Administration of the Hepatitis B Birth Dose > Vaccine and Hospital Participation in the Vaccines for Children- > Plus Program. " > > The first four study objectives were > > (1) Assess Illinois birthing hospital practices and policies > with respect to administration of the hepatitis B vaccine > to newborns prior to hospital discharge. > (2) Identify strategies to increase the hepatitis B birth > dose vaccination rate in Illinois. > (3) Determine how many Illinois birthing hospitals are > currently enrolled in the Vaccines for Children-Plus > (VFC-Plus) program. [VFC-Plus provides hospitals with > vaccines, such as that for hepatitis B, for children who > do not have insurance or for whom private insurance will > not pay.] > (4) Identify factors impacting enrollment/non-enrollment into > the VFC-Plus program. > > The study found that the establishment of hospital policies, and > more importantly, written standing orders for administration of > the hepatitis B birth dose correlated with significantly higher > hepatitis B birth dose administration rates. Hospitals enrolled > in the Illinois VFC-Plus program demonstrated significantly > higher hepatitis B birth dose vaccination rates when compared > with non-enrolled hospitals. > > The study is an excellent example of collaboration between a > state public health department and the state AAP chapter and can > be used to stimulate discussion and planning in other states. > > To read the report online, go to: > http://www.illinoisaap.org/HepBFinalReport.pdf > ---------------------------------------------------------------- > > (6 of 9) > November 18, 2004 > CDC ISSUES NOTICE ABOUT FALSE-POSITIVE HBsAg TESTS > > [The following is cross posted from the Immunization Action > Coalition's " IAC EXPRESS " electronic newsletter, 11/1/04.] > > CDC recently posted the following notice on the Viral Hepatitis > section of the National Center for Infectious Diseases' (NCID) > website. > > ********************* > > FALSE-POSITIVE HBsAg TESTS NOTED > > BD and Abbott Diagnostics have initiated an investigation > concerning the increased rate of initial and/or repeat reactive > results for the AUSZYME Monoclonal test when using BD Vacutainer > SST Plus tubes. As described in the AUSZYME package insert, > reactive specimens should be repeated in duplicate. If either of > the repeats is positive, the sample should then be tested with a > licensed neutralizing confirmatory test, such as the HBsAg > Confirmatory Assay. Only those specimens in which the HBsAg can > be neutralized by the confirmatory test procedure may be > designated as positive for HBsAg. All highly sensitive > immunoassay systems have a potential for nonspecific reactions. > The specificity of a repeatedly reactive specimen can be > confirmed by neutralization tests. > > ********************* > > To access the notice, go to: > http://www.cdc.gov/ncidod/diseases/hepatitis/new.htm#top Click > on the link titled " False positive HBsAg tests noted. " > > For additional technical or product-related information, read > the BD technical bulletin at > http://www.bd.com/vacutainer/pdfs/techbulletins/Abbott_Diagnostics_17september20\ 04.pdf > > If you have identified a cluster of infants born to false- > positive HBsAg mothers, who because of the false-positive > results, have been monitored as if they were born to HBsAg- > positive mothers, please call A. Wang, MD, MPH, at NCID > at (404) 371-5953. > ---------------------------------------------------------------- > > (7 of 9) > November 18, 2004 > UPDATED: IAC REVISES TWO HEPATITIS-RELATED EDUCATION PIECES > > IAC recently revised two of its long-standing hepatitis B > education pieces. > > " Hepatitis B Shots Are Recommended for All New Babies " is a > brochure targeted at expectant or new parents who might question > the need for, or timing of, infant vaccination against HBV. > > To access a ready-to-copy (PDF) version of " Hepatitis B Shots > Are Recommended for All New Babies, " go to: > http://www.immunize.org/catg.d/p4110bab.pdf > > To access a web-text (HTML) version of it, go to: > http://www.immunize.org/catg.d/p4110bab.htm > > " Hepatitis B Information for Asian and Pacific Islander > Americans " was created to answer the questions of Asian and > Pacific Islander Americans (APIA), including immigrants and > refugees, as well as persons of APIA descent born in the United > States. The revised version includes an updated list of related > organizations that readers might wish to contact. > > To access a ready-to-copy (PDF) version of " Hepatitis B > Information for Asian and Pacific Islander Americans, " go to: > http://www.immunize.org/catg.d/4190apia.pdf > > To access a web-text (HTML) version of it, go to: > http://www.immunize.org/catg.d/4190apia.htm > ---------------------------------------------------------------- > > (8 of 9) > November 18, 2004 > OCTOBER ISSUE OF " VACCINATE ADULTS " IS ON THE WEB > > IAC recently mailed the latest issue of " VACCINATE ADULTS " > (October 2004) to 100,000 health professionals and others who > work in the field of immunization. Packed with immunization > resources for health professionals and patients, the 12-page > issue is well worth downloading. All articles and education > pieces, except editorials, have been thoroughly reviewed by > immunization and hepatitis experts at CDC. > > PLEASE NOTE: Current as of September 2004, the resources in the > October " VACCINATE ADULTS " do not contain the most recent > information on influenza vaccine and vaccine supply. On October > 5, ACIP developed interim influenza vaccine recommendations in > response to Chiron Corporation's announcement that its trivalent > inactivated influenza vaccine will not be available in the > United States for the 2004-05 influenza season. The information > in the interim recommendations is not reflected in any of the > influenza information published in the October " VACCINATE > ADULTS. " > > HOW TO READ " VACCINATE ADULTS " 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/va > > The PDF file of the entire issue, linked below, is large at > 608,197 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 a ready-to-copy (PDF) version of the October issue, > go to: http://www.immunize.org/va/va14.pdf > ---------------------------------------------------------------- > > (9 of 9) > November 18, 2004 > NEW ISSUE OF " VIRAL HEPATITIS " AVAILABLE ON VHPB WEBSITE > > The Viral Hepatitis Prevention Board (VHPB) website has been > updated to include a new issue of the publication " Viral > Hepatitis. " > > " Viral Hepatitis, " Volume 13, Number 1, is prepared from > material presented at the VHPB meeting on March 11-12, 2004, in > Sevilla, Spain. The topic of this meeting was " Hepatitis B > vaccine: long-term efficacy, booster policy, and impact of HBV > mutants on hepatitis B vaccination programmes. " > > To access the ready-to-copy (PDF) versions of this issue, > go to: http://www.vhpb.org/Default.asp?navItem=newsletters > > To access the home page of the VHPB website, go to: > http://www.vhpb.org > > =================================================================== > We hope you will forward this e-newsletter to others. > > Managing editor: A. , DDS, MPH > Copy editor: Dale > Editorial assistant: Janelle Tangonan > ISSN: 1547-6375 > > To subscribe or change your HEP EXPRESS email address, or to view > past issues, please visit http://www.hepprograms.org/hepexpress > > This publication is supported by Grant No. U50/CCU523259 from > the Division of Viral Hepatitis at the Centers for Disease Control > and Prevention. Its contents are solely the responsibility of IAC > and do not necessarily represent the official views of CDC. > Circulation: 1,951 > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 20, 2004 Report Share Posted November 20, 2004 > > HEP EXPRESS > Viral hepatitis news from the Immunization Action Coalition > > Combined Federal Campaign #0233 > Federal employees, including military, may contribute > to IAC by using code #0233 on their pledge cards. > =========================================================== > Issue Number 23 November 18, 2004 > > CONTENTS OF THIS ISSUE > > 1. CDC reports 89% decrease in acute hepatitis B infection > among U.S. children and adolescents during 1990-2002 > 2. VIS translations: New hepatitis A vaccine VIS now > available in eight additional languages > 3. CDC creates viral hepatitis slide show for high school > students > 4. New York initiative provides free hepatitis B vaccine to > hospitals adopting a universal birth dose policy > 5. Report on Illinois hospital practices related to > hepatitis B birth dose available online > 6. CDC issues notice about false-positive HBsAg tests > 7. Updated: IAC revises two hepatitis-related education > pieces > 8. October issue of " Vaccinate Adults " is on the Web > 9. New issue of " Viral Hepatitis " available on VHPB website > ---------------------------------------------------------------- > > 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. > ---------------------------------------------------------------- > > (1 of 9) > November 18, 2004 > CDC REPORTS 89% DECREASE IN ACUTE HEPATITIS B INFECTION AMONG > U.S. CHILDREN AND ADOLESCENTS DURING 1990-2002 > > [The following is cross posted from the Immunization Action > Coalition's " IAC EXPRESS " electronic newsletter, 11/8/04.] > > CDC published " Acute Hepatitis B Among Children and Adolescents > --United States, 1990-2002 " in the November 5 issue of MMWR. The > article is reprinted below in its entirety, excluding > references, two figures, and a table. > > *********************** > > Since the 1991 adoption of a comprehensive strategy to eliminate > hepatitis B virus (HBV) transmission in the United States, the > incidence of acute hepatitis B cases has declined steadily. > Declines have been greatest among children born after the 1991 > recommendations for universal infant hepatitis B vaccination > were implemented. In 1995, the elimination strategy was expanded > to include routine vaccination of all adolescents aged 11-12 > years and, in 1999, to include children aged <18 years who had > not been vaccinated previously. To describe the epidemiology of > acute hepatitis B in children and adolescents in the United > States, CDC analyzed notifiable disease surveillance data > collected during 1990-2002 and data collected during 2001-2002 > through enhanced surveillance of reported cases of acute > hepatitis B in children born after 1990. This report summarizes > the results of that analysis, which indicated that the rate of > acute hepatitis B in children and adolescents decreased 89% > during 1990-2002 and that racial disparities in hepatitis B > incidence have narrowed. Many confirmed cases in persons born > after 1990 occurred among international adoptees and other > children born outside the United States. Continued > implementation of the hepatitis B elimination strategy and > accurate surveillance data to monitor the impact of vaccination > are necessary to sustain the decline of acute hepatitis B among > children. > > Cases of acute hepatitis B were reported weekly to CDC by all 50 > states and the District of Columbia. Acute hepatitis B rates > were calculated per 100,000 population by using population > denominators from the U.S. Census Bureau. Acute hepatitis B was > defined as an acute illness with (1) discrete onset of symptoms > and jaundice or elevated serum aminotransferase levels and (2) > laboratory evidence of either IgM antibody to hepatitis B core > antigen (IgM anti-HBc) or hepatitis B surface antigen (HBsAg). > Since March 2001, CDC has conducted enhanced hepatitis B > surveillance, contacting states to confirm all reported cases of > acute hepatitis B in persons born after 1990. State surveillance > staff members were asked to verify each of the items in the case > definition and provide information regarding vaccination history > and country of birth. If errors were identified during this > process, states were asked to correct the information in an > updated submission to CDC. > > National Surveillance > During 1990-2002, a total of 13,829 cases of acute hepatitis B > were reported in the United States among persons aged <=19 > years. The incidence of reported cases declined steadily during > this period, from 3.03 per 100,000 population in 1990 to 0.34 in > 2002, representing a decline of 89%. The incidence among > adolescents aged 15-19 years was consistently higher than the > incidence among younger age groups, ranging from 8.69 per > 100,000 population in 1990 to 1.13 in 2002. Children and > adolescents in all age groups experienced steep declines in > incidence during 1990-2002; incidence declined 94% among > children aged 0-4 years, 92% among children aged 5-9 years, > 93% among those aged 10-14 years, and 87% among adolescents aged > 15-19 years. > > Among children and adolescents aged <=19 years in 1990, > incidence per 100,000 population was highest among Asian/Pacific > Islanders (A/PIs) (6.74) and blacks (4.29); whites had the > lowest race-specific incidence (1.39). Differences in incidence > between whites and A/PIs and between whites and blacks were 5.34 > and 2.90, respectively. From 1990 to 2002, rates declined 92% > among A/PIs, 88% among whites, 88% among blacks, and 84% among > American Indians/Alaskan Natives (AI/ANs). In 2002, the highest > incidence per 100,000 population was among A/PIs (0.55), > followed by blacks (0.51), AI/ANs (0.43), and whites (0.16); > since 1990, differences in incidence between whites and A/PIs > and whites and blacks declined by 93% and 88%, respectively. > > Case Investigations > Follow-up investigations conducted by CDC and state and local > health departments verified 19 case reports from 2001 and 2002 > as cases of acute hepatitis B among children born after 1990. Of > the verified case reports, 12 (60%) involved males, eight (42%) > involved children aged <2 years, and 11 (58%) involved children > born in the United States. Seven (37%) reported race as A/PI, > five (26%) as white, four (21%) as black, and three (16%) as > unknown. Eight (42%) cases were reported in children born > outside the United States, including six international adoptees > (32%). Receipt of >=1 dose of hepatitis B vaccine was confirmed > in three (16%) cases. Vaccination status was unknown for 12 > cases (63%). > > Editorial Note: > The incidence of acute hepatitis B cases in U.S. children and > adolescents decreased during the era of universal childhood > vaccination. This decline coincided with an increase in > hepatitis B vaccination coverage among children aged 19-35 > months, from 16% in 1992 to 90% in 2002, and among adolescents > aged 13-15, from nearly 0 in 1992 to 67% in 2002. > > Declines in incidence were observed for children of all races, > including A/PIs, whose rates historically have been higher than > the national average. Because of the disproportionate burden of > hepatitis B in A/PI communities, A/PI children were among the > first groups for whom hepatitis B vaccination was recommended. > The reduction of the disparity between A/PIs and other children > is consistent with recent observations noting a decline in > seroprevalence of HBV infection and successful implementation of > routine hepatitis B vaccination among Asians who have recently > immigrated to the United States. However, of the 11 verified > cases during 2001-02 of acute hepatitis B among children born in > the United States, three (27%) involved A/PIs. Although the > national origins of these children's household members are > unknown, the substantial proportion of A/PIs suggests that > horizontal transmission of HBV among first-generation Asians > might be a persistent problem. > > The higher incidence among older adolescents (aged 15-19 years) > likely is attributable to their having been born before > universal infant hepatitis B vaccination was recommended in > 1991. Incidence among older adolescents is expected to decline > further as the vaccinated cohort ages and as 1999 > recommendations to vaccinate all previously unvaccinated persons > aged 0-18 years are fully implemented. The expected decline in > rates among adolescents also might be augmented by laws in 32 > states requiring proof of hepatitis B vaccination before entry > into middle school. > > Follow-up information obtained through surveillance of reported > cases suggests that children born outside the United States, > especially international adoptees, represent a substantial > proportion of cases. Cases of acute hepatitis B among > international adoptees might result from undervaccination and > increased risk for exposure while living in areas with high > prevalence of chronic HBV infection. International adoptees are > exempt from U.S. regulations that bar entry to immigrants > without documentation of hepatitis B vaccination. Studies have > demonstrated that international adoptees exhibit low rates of > protective titers of antibodies to vaccine-preventable diseases > upon arrival in the United States, including adoptees with > written evidence of age-appropriate vaccination provided by the > birth country. Appropriate evaluation and remediation of the > immunization status of international adoptees has been promoted > through national guidelines; however, the extent to which these > guidelines have been implemented is unknown. > > Despite the decline in acute hepatitis B cases among children in > the United States, the presence of confirmed cases highlights > the importance of infant vaccination and timely completion of > the 3-dose vaccination series. The vaccination series should be > started at birth, preferably before the newborn is discharged > from the hospital. Infants born to women who are HBsAg positive > or who have not had prenatal HBsAg testing should receive the > first dose of hepatitis B vaccine within 12 hours of birth. > Beginning the vaccination series at birth decreases the risk for > perinatal HBV transmission and predicts successful completion of > the series. > > Although enhanced surveillance data from verified case reports > suggest that international adoptees and other children born > outside the United States might particularly benefit from future > prevention efforts, many case reports lacked risk factor > information. As the incidence of acute hepatitis B among > children and adolescents declines, accurate surveillance data > become increasingly important to monitor the effect of > immunization recommendations. Continued efforts of local, state, > and national surveillance staff to improve data quality are > critical to eliminating HBV transmission in the United States. > > *********************** > > To access a web-text (HTML) version of the complete article, > go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5343a4.htm > > To access a ready-to-copy (PDF) version of this issue of MMWR, > go to: http://www.cdc.gov/mmwr/PDF/wk/mm5343.pdf > > To receive a FREE electronic subscription to MMWR, go to: > http://www.cdc.gov/mmwr/mmwrsubscribe.html > ---------------------------------------------------------------- > > (2 of 9) > November 18, 2004 > VIS TRANSLATIONS: NEW HEPATITIS A VACCINE VIS NOW AVAILABLE IN > EIGHT ADDITIONAL LANGUAGES > > [The following is cross posted from the Immunization Action > Coalition's " IAC EXPRESS " electronic newsletter, 11/1/04.] > > Dated 8/4/04, the current version of the VIS for hepatitis A > vaccine is now available on the IAC website in eight additional > languages: Arabic, Armenian, Cambodian, Farsi, Haitian Creole, > Hmong, Korean, and Vietnamese. IAC gratefully acknowledges the > Massachusetts Department of Public Health for the Haitian Creole > translation and the California Department of Health Services for > the remaining translations. > > PLEASE NOTE: When hepatitis A vaccine is added to the Vaccine > Injury Compensation Program's injury table, presumably later in > 2004, another hepatitis A vaccine VIS will be issued. To avoid > large printing expenses, print off only as many of the 8/4/04 > VISs as you anticipate needing for the next several months. > > To obtain a ready-to-copy (PDF) version of the VIS for hepatitis > A vaccine in ARABIC, go to: > http://www.immunize.org/vis/ab_hpa04.pdf > > To obtain it in ARMENIAN, go to: > http://www.immunize.org/vis/ar_hpa04.pdf > > To obtain it in CAMBODIAN, go to: > http://www.immunize.org/vis/ca_hpa04.pdf > > To obtain it in FARSI, go to: > http://www.immunize.org/vis/fa_hpa04.pdf > > To obtain it in HAITIAN CREOLE, go to: > http://www.immunize.org/vis/ha_hpa04.pdf > > To obtain it in HMONG, go to: > http://www.immunize.org/vis/hm_hpa04.pdf > > To obtain it in KOREAN, go to: > http://www.immunize.org/vis/ko_hpa04.pdf > > To obtain it in VIETNAMESE, go to: > http://www.immunize.org/vis/vn_hpa04.pdf > > To obtain it in ENGLISH, go to: > http://www.immunize.org/vis/v-hepa.pdf > > For information about the use of VISs, and for VISs in a total > of 32 languages, visit IAC's VIS web section at > http://www.immunize.org/vis > ---------------------------------------------------------------- > > (3 of 9) > November 18, 2004 > CDC CREATES VIRAL HEPATITIS SLIDE SHOW FOR HIGH SCHOOL STUDENTS > > CDC's Division of Viral Hepatitis has developed a three-part > slide set for high school students, designed to give adolescents > basic information and raise awareness about HAV, HBV, and HCV. > The set can be used as a resource for science or health > projects, as an outline for a teaching tool, or as reference > material to inform others (e.g., family, friends). > > To view or download this resource, go to: > http://www.cdc.gov/ncidod/diseases/hepatitis/resource/training/hs_slideset.htm > ---------------------------------------------------------------- > > (4 of 9) > November 18, 2004 > NEW YORK INITIATIVE PROVIDES FREE HEPATITIS B VACCINE TO > HOSPITALS ADOPTING A UNIVERSAL BIRTH DOSE POLICY > > The Hepatitis B Birth Dose Program is an initiative of the New > York State Department of Health (NYSDOH) that provides free > hepatitis B vaccine to any birthing hospital in New York State > that agrees to adopt a universal hepatitis B birth dose policy. > Since October 2003, the program has enrolled 50 (out of 113) > upstate and 25 (out of 45) New York City birthing hospitals. > > Hospitals may participate in the program by submitting a brief > application, along with their birth dose policy, to NYSDOH for > review. The policy must clearly show that all newborns will be > routinely vaccinated against hepatitis B at birth regardless of > maternal hepatitis B surface antigen status, infant's insurance > status, or individual physician preference. > > The provision of hepatitis B vaccine to all infants at birth > provides a safety net to high-risk infants who do not receive > appropriate prophylactic treatment against HBV transmission at > birth, and to infants who are exposed to HBV postnatally from > another family member or caregiver. > > In a 2002 survey of New York State birthing hospitals, cost of > vaccine was identified as a barrier to vaccinating infants at > birth by many hospitals. Through this new program, NYSDOH hopes > to eliminate additional hospital costs for vaccine purchase > while improving hospital compliance with recommended standards > of care. > > Questions regarding the program can be directed to Perinatal > Hepatitis B Program Manager Herlihy, RN, MS, at > (518) 473-4437 or EJH04@... > ---------------------------------------------------------------- > > (5 of 9) > November 18, 2004 > REPORT ON ILLINOIS HOSPITAL PRACTICES RELATED TO HEPATITIS B > BIRTH DOSE AVAILABLE ONLINE > > The Illinois Chapter of the American Academy of Pediatrics (AAP) > and the Illinois Department of Public Health collaborated on a > study titled: " Report of Illinois Birthing Hospital Practices > with Respect to the Administration of the Hepatitis B Birth Dose > Vaccine and Hospital Participation in the Vaccines for Children- > Plus Program. " > > The first four study objectives were > > (1) Assess Illinois birthing hospital practices and policies > with respect to administration of the hepatitis B vaccine > to newborns prior to hospital discharge. > (2) Identify strategies to increase the hepatitis B birth > dose vaccination rate in Illinois. > (3) Determine how many Illinois birthing hospitals are > currently enrolled in the Vaccines for Children-Plus > (VFC-Plus) program. [VFC-Plus provides hospitals with > vaccines, such as that for hepatitis B, for children who > do not have insurance or for whom private insurance will > not pay.] > (4) Identify factors impacting enrollment/non-enrollment into > the VFC-Plus program. > > The study found that the establishment of hospital policies, and > more importantly, written standing orders for administration of > the hepatitis B birth dose correlated with significantly higher > hepatitis B birth dose administration rates. Hospitals enrolled > in the Illinois VFC-Plus program demonstrated significantly > higher hepatitis B birth dose vaccination rates when compared > with non-enrolled hospitals. > > The study is an excellent example of collaboration between a > state public health department and the state AAP chapter and can > be used to stimulate discussion and planning in other states. > > To read the report online, go to: > http://www.illinoisaap.org/HepBFinalReport.pdf > ---------------------------------------------------------------- > > (6 of 9) > November 18, 2004 > CDC ISSUES NOTICE ABOUT FALSE-POSITIVE HBsAg TESTS > > [The following is cross posted from the Immunization Action > Coalition's " IAC EXPRESS " electronic newsletter, 11/1/04.] > > CDC recently posted the following notice on the Viral Hepatitis > section of the National Center for Infectious Diseases' (NCID) > website. > > ********************* > > FALSE-POSITIVE HBsAg TESTS NOTED > > BD and Abbott Diagnostics have initiated an investigation > concerning the increased rate of initial and/or repeat reactive > results for the AUSZYME Monoclonal test when using BD Vacutainer > SST Plus tubes. As described in the AUSZYME package insert, > reactive specimens should be repeated in duplicate. If either of > the repeats is positive, the sample should then be tested with a > licensed neutralizing confirmatory test, such as the HBsAg > Confirmatory Assay. Only those specimens in which the HBsAg can > be neutralized by the confirmatory test procedure may be > designated as positive for HBsAg. All highly sensitive > immunoassay systems have a potential for nonspecific reactions. > The specificity of a repeatedly reactive specimen can be > confirmed by neutralization tests. > > ********************* > > To access the notice, go to: > http://www.cdc.gov/ncidod/diseases/hepatitis/new.htm#top Click > on the link titled " False positive HBsAg tests noted. " > > For additional technical or product-related information, read > the BD technical bulletin at > http://www.bd.com/vacutainer/pdfs/techbulletins/Abbott_Diagnostics_17september20\ 04.pdf > > If you have identified a cluster of infants born to false- > positive HBsAg mothers, who because of the false-positive > results, have been monitored as if they were born to HBsAg- > positive mothers, please call A. Wang, MD, MPH, at NCID > at (404) 371-5953. > ---------------------------------------------------------------- > > (7 of 9) > November 18, 2004 > UPDATED: IAC REVISES TWO HEPATITIS-RELATED EDUCATION PIECES > > IAC recently revised two of its long-standing hepatitis B > education pieces. > > " Hepatitis B Shots Are Recommended for All New Babies " is a > brochure targeted at expectant or new parents who might question > the need for, or timing of, infant vaccination against HBV. > > To access a ready-to-copy (PDF) version of " Hepatitis B Shots > Are Recommended for All New Babies, " go to: > http://www.immunize.org/catg.d/p4110bab.pdf > > To access a web-text (HTML) version of it, go to: > http://www.immunize.org/catg.d/p4110bab.htm > > " Hepatitis B Information for Asian and Pacific Islander > Americans " was created to answer the questions of Asian and > Pacific Islander Americans (APIA), including immigrants and > refugees, as well as persons of APIA descent born in the United > States. The revised version includes an updated list of related > organizations that readers might wish to contact. > > To access a ready-to-copy (PDF) version of " Hepatitis B > Information for Asian and Pacific Islander Americans, " go to: > http://www.immunize.org/catg.d/4190apia.pdf > > To access a web-text (HTML) version of it, go to: > http://www.immunize.org/catg.d/4190apia.htm > ---------------------------------------------------------------- > > (8 of 9) > November 18, 2004 > OCTOBER ISSUE OF " VACCINATE ADULTS " IS ON THE WEB > > IAC recently mailed the latest issue of " VACCINATE ADULTS " > (October 2004) to 100,000 health professionals and others who > work in the field of immunization. Packed with immunization > resources for health professionals and patients, the 12-page > issue is well worth downloading. All articles and education > pieces, except editorials, have been thoroughly reviewed by > immunization and hepatitis experts at CDC. > > PLEASE NOTE: Current as of September 2004, the resources in the > October " VACCINATE ADULTS " do not contain the most recent > information on influenza vaccine and vaccine supply. On October > 5, ACIP developed interim influenza vaccine recommendations in > response to Chiron Corporation's announcement that its trivalent > inactivated influenza vaccine will not be available in the > United States for the 2004-05 influenza season. The information > in the interim recommendations is not reflected in any of the > influenza information published in the October " VACCINATE > ADULTS. " > > HOW TO READ " VACCINATE ADULTS " 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/va > > The PDF file of the entire issue, linked below, is large at > 608,197 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 a ready-to-copy (PDF) version of the October issue, > go to: http://www.immunize.org/va/va14.pdf > ---------------------------------------------------------------- > > (9 of 9) > November 18, 2004 > NEW ISSUE OF " VIRAL HEPATITIS " AVAILABLE ON VHPB WEBSITE > > The Viral Hepatitis Prevention Board (VHPB) website has been > updated to include a new issue of the publication " Viral > Hepatitis. " > > " Viral Hepatitis, " Volume 13, Number 1, is prepared from > material presented at the VHPB meeting on March 11-12, 2004, in > Sevilla, Spain. The topic of this meeting was " Hepatitis B > vaccine: long-term efficacy, booster policy, and impact of HBV > mutants on hepatitis B vaccination programmes. " > > To access the ready-to-copy (PDF) versions of this issue, > go to: http://www.vhpb.org/Default.asp?navItem=newsletters > > To access the home page of the VHPB website, go to: > http://www.vhpb.org > > =================================================================== > We hope you will forward this e-newsletter to others. > > Managing editor: A. , DDS, MPH > Copy editor: Dale > Editorial assistant: Janelle Tangonan > ISSN: 1547-6375 > > To subscribe or change your HEP EXPRESS email address, or to view > past issues, please visit http://www.hepprograms.org/hepexpress > > This publication is supported by Grant No. U50/CCU523259 from > the Division of Viral Hepatitis at the Centers for Disease Control > and Prevention. Its contents are solely the responsibility of IAC > and do not necessarily represent the official views of CDC. > Circulation: 1,951 > > Quote Link to comment Share on other sites More sharing options...
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