December 2001

• December 14, 2001
  Notice to Readers: Revised ACIP Recommendation for Avoiding Pregnancy After Receiving a Rubella-Containing Vaccine
  On October 18, 2001, the ACIP reviewed data from several sources indicating that no cases of congenital rubella syndrome (CRS) had been identified among infants born to women who were vaccinated inadvertently against rubella within 3 months or early in pregnancy. On the basis of these data, ACIP shortened its recommended period to avoid pregnancy after receipt of rubella-containing vaccine from 3 months to 28 days...
• December 7, 2001
  Influenza Activity -- United States, 2001-02 Season
  This report summarizes influenza activity in the United States during September 30-November 24, 2001, when the viruses isolated most frequently were influenza A (H3N2)...Vaccine supplies are plentiful and influenza vaccine should continue to be offered during December and later...

November 2001

• November 30, 2001
  Simultaneous Administration of Varicella Vaccine & Other Recommended Childhood Vaccines---U.S., 1995-1999
  This report summarizes an evaluation of the ACIP recommendations, which found that a decrease in Var effectiveness occurred when Var was administered <30 days after MMR; therefore, as currently recommended, physicians should administer Var simultaneously with MMR or wait at least 30 days if the vaccines are administered separately...
  
• November 30, 2001
  Update: Adverse Events Associated with Anthrax Prophylaxis Among Postal Employees---NJ, NY City, and the D.C. Metropolitan Area, 2001
  During October 26-November 6, 2001, an epidemiologic evaluation to detect adverse events associated with antimicrobial prophylaxis was conducted among 8,424 postal employees who had been offered antimicrobial prophylaxis for 60 days...
  
• November 30, 2001
  Update: Investigation of Bioterrorism-Related Inhalational Anthrax---Connecticut, 2001
  The source of exposure to B. anthracis for the 94-year-old CT resident remains unknown. The genetic characteristics of B. anthracis isolated from this patient links this case with the previous bioterrorism-related cases of anthrax. However, this patient differed from most previously identified cases in both epidemiologic characteristics and potential sources of exposure...
  
• Special Report of CONSUMER REPORTS ONLINE (11/26/01)
  "How should you respond to ‘‘flulike’’ symptoms?"
  The flu season is under way, and this year, amid unprecedented public alarm about biological weapons, you may react to any "flulike" symptoms with more than the usual concern... Also, check out "A Guide to Flulike Symptoms".
  
• November-December, 2001, Vol. 7, No. 6
  Advanced Age a Risk Factor for Illness Temporally Associated with Yellow Fever Vaccination
  For elderly travelers, the risk for severe illness and death due to YF infection should be balanced against the risk for systemic illness due to YF vaccine...
  
• November-December, 2001, Vol. 7, No. 6
  Bioterrorism-Related Inhalational Anthrax: The First 10 Cases Reported in the United States
  From October 4 to November 2, 2001, the first 10 confirmed cases of inhalational anthrax caused by intentional release of Bacillus anthracis were identified in the U.S. Epidemiologic investigation indicated...(includes detailed case descriptions as well as graphic images)...
  
• November-December, 2001, Vol. 7, No. 6
  Developing New Smallpox Vaccines
  New stockpiles of smallpox vaccine are required as a contingency for protecting civilian and military personnel against deliberate dissemination of smallpox virus by terrorists or unfriendly governments. The smallpox vaccine in the current stockpile consists of...
  
• November 16, 2001
  Update: Investigation of Bioterrorism-Related Anthrax
  This report updates the investigation of bioterrorism-related anthrax and the provision of antimicrobial prophylaxis to exposed persons and highlights CDC assistance to other countries investigating cases of bioterrorism-related anthrax...
  
• November 16, 2001
  Notice to Readers: Update: Interim Recommendations for Antimicrobial Prophylaxis for Children and Breastfeeding Mothers and Treatment of Children with Anthrax
  Ciprofloxacin or doxycycline is recommended for antimicrobial prophylaxis and treatment of adults and children with Bacillus anthracis infection associated with the recent bioterrorist attacks in the United States...
  
• November 9, 2001
  Update: Investigation of Bioterrorism-Related Anthrax and Adverse Events from Antimicrobial Prophylaxis
  CDC and state and local public health authorities continue to investigate cases of bioterrorism-related anthrax. As of November 7, a total of 22 cases of anthrax have been identified according to the CDC surveillance case definition...
  
• November 9, 2001
  Nationwide Campaign for Vaccination of Adults Against Rubella and Measles -- Costa Rica, 2001
  This report highlights successful aspects of the campaign, including effective planning, cooperation among government ministries, social mobilization, the use of house-to-house vaccination teams, daily coverage reports from local staff, vaccine safety monitoring, and strategies for ensuring a sufficient national blood supply...
  
• November 9, 2001
  Notice to Readers: Considerations for Distinguishing Influenza-Like Illness from Inhalational Anthrax
  This notice describes the clinical evaluation of persons who are not known to be at increased risk for anthrax but who have symptoms of influenza-like illness (ILI). Clinicians evaluating persons with ILI should consider a combination of epidemiologic, clinical, and, if indicated, laboratory and radiographic test results to evaluate the likelihood that inhalational anthrax is the basis for ILI symptoms...
  
• November 9, 2001
  Notice to Readers: Interim Guidelines for Investigation of and Response to Bacillus Anthracis Exposures
  Environmental testing to detect B. anthracis on surfaces or in the air can be used to investigate known or suspected exposure events...
  
• November 2, 2001
  Update: Investigation of Bioterrorism-Related Anthrax and Interim Guidelines for Clinical Evaluation of Persons with Possible Anthrax
  This report updates findings as of October 31, and includes interim guidelines for the clinical evaluation of persons with possible anthrax. A total of 21 cases (16 confirmed and five suspected) of bioterrorism-related anthrax have been reported. Until the source of these intentional exposures is eliminated, clinicians and laboratorians should be alert for clinical evidence of Bacillus anthracis infection. Epidemiologic investigation of these cases and surveillance to detect new cases of bioterrorism-associated anthrax continues...
  
• November 2, 2001
  Notice to Readers: Updated Recommendations for Antimicrobial Prophylaxis Among Asymptomatic Pregnant Women After Exposure to Bacillus Anthracis
  The antimicrobial of choice for initial prophylactic therapy among asymptomatic pregnant women exposed to Bacillus anthracis is ciprofloxacin, 500 mg twice a day for 60 days. In instances in which the specific B. anthracis strain has been shown to be penicillin-sensitive, prophylactic therapy with amoxicillin, 500 mg three times a day for 60 days, may be considered...
  
• November 2, 2001
  Notice to Readers: Interim Recommendations for Protecting Workers from Exposure to Bacillus Anthracis in Work Sites in which Mail is Handled or Processed
  CDC has developed interim recommendations to assist personnel responsible for occupational health and safety in developing a comprehensive program to reduce potential cutaneous or inhalational exposures to Bacillus anthracis spores among workers in work sites in which mail is handled or processed. Such work sites include post offices, mail distribution/handling centers, bulk mail centers, air mail facilities, priority mail processing centers, public and private mail rooms, and other settings in which workers are responsible for handling and processing mail...
• November 2001 issue of CONSUMER REPORTS ONLINE
  "Missed shots"
  Interviews with vaccine experts and a review of statistics and studies of adult immunization show that widespread ignorance, complacency, and underfunding have converged to discourage––or, rather, fail to encourage––adult immunization against familiar but potentially deadly diseases such as influenza, pneumonia, hepatitis, and tetanus. (For a list of potentially serious diseases preventable by adult vaccines, see "Vaccination details". Also, check out the "Toll of Vaccine Neglect" article...
  
• November 2001 issue of CONSUMER REPORTS ONLINE
  "The Lyme Vaccine Controversy"
  The three-year-old LYMErix vaccine against Lyme disease is becoming as controversial as nearly everything else about this tick-borne bacterial infection. A Philadelphia law firm has filed a class-action suit against the maker on behalf of clients whose vaccinations allegedly put them at increased risk of developing arthritis. The Food and Drug Administration (FDA) has taken the unusual step of holding a public hearing on the vaccine's safety and initiating its own investigation...

October 2001

• October 26, 2001
  Update: Investigation of Bioterrorism-Related Anthrax and Interim Guidelines for Exposure Management and Antimicrobial Therapy, October 2001
  This report updates previous findings, provides new information on case investigations in two additional areas, presents the susceptibility patterns of Bacillus anthracis isolates, and provides interim recommendations for managing potential threats and exposures and for treating anthrax...
• October 19, 2001
  Recognition of Illness Associated with the Intentional Release of a Biologic Agent
  This report provides basic guidance that can be implemented to improve recognition of potential biological agents. This report includes basic information for healthcare providers for recognizing anthrax, plague, botulism, smallpox, inhalational tularemia, and hemorrhagic fever...
  
• October 19, 2001
  Update: Investigation of Anthrax Associated with Intentional Exposure and Interim Public Health Guidelines, October 2001
  This report includes information on the three clinical forms of anthrax (inhalation, gastrointestinal and cutaneous); recommended postexposure treatment regimens; handling letters/packages and environmental management of exposed areas; handling laboratory specimens possibly infected with anthrax (for healthcare providers); and handling anthrax and other biological agent threats (for the general public)...
  
• October 5, 2001
  Vaccination Coverage Among Children Enrolled in Head Start Programs and Licensed Child Care Centers and Entering School -- U.S. and Selected Reporting Areas, 1999-2000 School Year
  Undervaccinated children enrolled in child care centers and schools are vulnerable to outbreaks of vaccine-preventable disease. One of the national health objectives for 2010 is to maintain >95% vaccination coverage among children attending licensed child care centers and kindergarten...
• IOM Report October 1, 2001
  Vaccines & Thimerosal: A New IOM Report. Immunization Safety Review: Thimerosal-Containing Vaccines and Neurodevelopmental Disorders (2001)
  The IOM Immunization Safety Review Committee’s most important conclusions were 1) that the evidence is inadequate to accept or reject a causal relationship between exposure to thimerosal from vaccines and the neurodevelopmental disorders of autism, attention deficit hyperactivity disorder (ADHD), and speech or language delay, and 2) that although the hypothesis that exposure to thimerosal-containing vaccines could be associated with neurodevelopmental disorders is not established and rests on indirect and incomplete information, primarily from analogies with methyl mercury and levels of maximum mercury exposure from vaccines given in children, the hypothesis is biologically plausible...

September 2001

• September 28, 2001
  Progress Toward Poliomyelitis Eradication -- Angola, Democratic Republic of Congo, Ethiopia, and Nigeria, January 2000-July 2001
  This report summarizes progress toward polio eradication in Angola, DR Congo, Ethiopia, and Nigeria during January 2000-July 2001, and indicates that 11 of 12 cases of wild poliovirus in AFR were identified in these priority countries during January-July 2001...
  
• September 28, 2001
  Update: Influenza Activity -- U.S. and Worldwide, May-September 2001
  This report summarizes influenza activity in the United States and worldwide during May-September 25; influenza A (H1N1), A (H3N2), and B viruses continued to circulate worldwide and were associated with mild to moderate levels of activity. This activity underscores the need to follow the recommendations of the Advisory Committee on Immunization Practices (ACIP) for the timely vaccination of persons at high risk for influenza-related complications...
  
• September 21, 2001
  FDA Approval for a Combined Hepatitis A and B Vaccine
  On May 11, 2001, the Food and Drug Administration (FDA) licensed a combined hepatitis A and B vaccine (Twinrix^®) for use in persons aged >18 years. Twinrix is manufactured and distributed by GlaxoSmithKline Biologicals (Rixensart, Belgium), and is made of the antigenic components used in Havrix and Engerix-B (GlaxoSmithKline). The antigenic components in Twinrix have been used routinely in separate single antigen vaccines in the United States since 1995 and 1989 as hepatitis A and B vaccines, respectively...
  
• September 21, 2001
  West Nile Virus Activity --U. S., Sept. 12--18, 2001
  This report summarizes surveillance data for West Nile virus (WNV) infection reported to CDC through ArboNET and verified by states and jurisdictions as of Sept. 18, 2001. During the week of Sept. 12--18, three human cases of WNV encephalitis were reported, all in Connecticut; no deaths were reported. During the same period among animal...
  
• September 13, 2001
  Decreased Availability of Pneumococcal conjugate Vaccine (PCV-7)
  Deliveries of Prevanar, the new Pneumococcal Conjugate Vaccine (PCV-7), marketed by Wyeth Lederie Vaccines, have been delayed resulting in shortages for some providers and health departments. State immunization programs, private providers and local health departments have reported to NIP difficulty in obtaining enough PCV-7 to immunize all children from whom the vaccine is recommended...

August 2001

• August 31, 2001
  Progress Toward Poliomyelitis Eradication -- South-East Asia, January 2000-June 2001
  Since the World Health Assembly resolved in 1988 to eradicate poliomyelitis globally, the estimated number of polio cases worldwide has declined 99%. This report summaries polio eradication activities during January 2000-June 2001 in SEAR, where wild poliovirus transmission had declined rapidly and is occurring primarily in northern India...
• August 24, 2001
  Outbreak of Pneumococcal Pneumonia Among Unvaccinated Residents of a Nursing Home -- New Jersey, April 2001
  Seven cases of pneumococcal pneumonia with bacteremia among residents of a nursing home were reported to the Hamilton Township Department of Health, New Jersey...four residents died...This report summarizes results of the investigation, which underscore the importance of providing pneumococcal polysaccharide vaccine (PPV) to elderly residents of long-term care facilities (LTCFs)...
• August 10, 2001
  Effectiveness of a Middle School Vaccination Law -- California, 1999--2001
  Because many adolescents are not up-to-date for all of these vaccines, 43 states have developed middle school entrance requirements or laws for one or more of these vaccines.
• August 3, 2001
  Fever, Jaundice, and Multiple Organ System Failure Associated With 17D-Derived Yellow Fever Vaccination, 1996--2001
  Seven cases of multiple organ system failure (MOSF) in recipients of 17D-derived yellow fever (YF) vaccine were presented at the June 2001 ACIP meeting...This notice summarizes these cases and describes an enhanced surveillance program designed to refine risk estimates and improve histopathologic documentation of MOSF potentially associated with YF vaccination...
• August 3, 2001
  National, State, and Urban Area Vaccination Coverage Levels Among Children Aged 19-35 Months -- United States, 2000
  The National Immunization Survey (NIS) provides ongoing national estimates of vaccination coverage among preschool-aged children for the 50 states and 28 selected urban areas. For this report, NIS data collected during 2000 were compared with 1999 data; findings indicate that, during 2000...
• August 2001 issue of CONSUMER REPORTS ONLINE
  "Vaccines: An issue of trust--Misinformation and government foot-dragging are fanning fears"
  Ninety percent of pediatricians and 60 percent of family doctors recently surveyed by University of Michigan researchers said they cared for at least one child whose parent refused immunization. A study in Colorado found that unimmunized children were 22 times more likely to contract measles and 6 times more likely to contract pertussis (whooping cough) than vaccinated children...

July 2001

• July 13, 2001
  Control and Prevention of Rubella: Evaluation and Management of Suspected Outbreaks, Rubella in Pregnant Women, and Surveillance for Congenital Rubella Syndrome
  Outbreaks of rubella continue to occur in the United States despite widespread use of the measles-mumps-rubella (MMR) vaccine... To address this change in disease epidemiology, CDC's National Immunization Program (NIP) developed the following recommendations in conjunction with public health officials in the field...
• July 13, 2001
  Notice to Readers: Delayed Influenza Vaccine Availability for 2001--02 Season and Supplemental Recommendations of the Advisory Committee on Immunization Practices
  Because of the 2001--02 influenza season vaccine delay and the large number of doses projected for distribution in November and December, the Advisory Committee on Immunization Practices (ACIP) has developed supplemental recommendations...

June 2001

• June 22, 2001
  Notice to Readers: Availability of Health Information for International Travel
  CDC's Division of Global Migration and Quarantine (DQ), National Center for Infectious Diseases has released the 2001--2002 edition of Health Information for International Travel (The Yellow Book). The new edition contains updated vaccination information... The Yellow Book can be purchased from the Public Health Foundation, telephone (877) 252-1200 or at http://bookstore.phf.org*(exit). DQ will no longer distribute the book.
  
• June 22, 2001
  Measles Incidence Before and After Supplementary Vaccination Activities --- Lusaka, Zambia, 1996-2000
  Zambia is a sub-Saharan African country (2000 population: nine million)... In Zambia, measles is one of the five major causes of morbidity and mortality among children aged <5 years... This report summarizes measles incidence, measured by the number of patients presenting to selected medical facilities...
  
• June 22, 2001
  Vaccinia (Smallpox) Vaccine Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2001 -- Supplemental Recommendations - Feb. 26, 2003
  These revised recommendations regarding vaccinia (smallpox) vaccine update the previous Advisory Committee on Immunization Practices (ACIP) recommendations (MMWR 1991;40; No. RR-14:1--10) and include current information regarding...
• June 15, 2001
  Progress Toward Poliomyelitis Eradication -- West and Central Africa, 1999--2000
  This report summarizes the routine polio vaccination coverage, surveillance for acute flaccid paralysis (AFP) during 1999 and 2000, and the synchronization of national immunization days (NIDs) against polio during 2000 and early 2001...
• June 8, 2001
  Update: Influenza Activity -- United States and Worldwide, 2000--01 Season, and Composition of the 2001-02 Influenza Vaccine
  This report summarizes U.S.* and worldwide influenza activity during the 2000--01 influenza season and describes the composition of the 2001--02 influenza vaccine.

May 2001

• May 25, 2001
  Deferral of Routine Booster Doses of Tetanus and Diphtheria Toxoids - Shortage Update
  To assure vaccine availability for priority indications, all routine Td boosters in adolescents and adults should be delayed until 2002.

April 2001

• April 27, 2001
  Progress Toward Global Poliomyelitis Eradication, 2000
  This report summarizes the status of the eradication effort and describes the remaining tasks to be completed to reach global polio eradication.
• IOM Report April 24, 2001
  IOM Report--Immunization Safety Review: Measles-Mumps-Rubella Vaccine and Autism (exit)
  The CDC and the National Institutes of Health recognized the need for an independent group to carefully examine the hypothesized MMR-autism link and address other vaccine-safety issues as well. These agencies engaged the Institute of Medicine (IOM), which in turn appointed the Immunization Safety Review Committee. The results of the committee's assessment of the issue are described in this report.

March 2001

• March 24, 2001
  Shortage of Tetanus and Diphtheria Toxoids
  Currently in the US, doses of Tetanus and Diphtheria Toxoids (Td) are in short supply. The following information provides background on the shortage, the expected timeframe of the shortage, and a list of priorities for using the available Td doses during the shortage.
• March 13, 2001
  2001 National Immunization Conference May 29- June 1; Marriott Marquis, Atlanta, GA.
  The 35th National Immunization Conference will provide a forum to explore innovative strategies for developing programs, policies, and research to promote immunization for all ages today for a healthier tomorrow. Federal, state and local public health officials and practitioners; immunization providers; educators; and anyone involved with or interested in immunization are welcome to attend.

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