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Past Updates from the Clinician Registry Listserv:
Update Sent April 04, 2005

NOTE: This document is provided for historical purposes only and may not provide our most accurate and up-to-date information. The most current Clinician's information can be found on the Clinician Home Page.

UPDATES TO INFORMATION AND GUIDANCE
The following updates were made to CDC information and guidance during the period of March 28-April 03, 2005, or reflect last week's current events. If you have any questions on these or other clinical issues, please call our toll-free Clinician Information Line at 877-554-4625 or write to us at coca@cdc.gov.

This update contains new information on the following topics:

VIRAL HEMORRHAGIC FEVERS

Marburg Hemorrhagic Fevers
Provides links to updated information.
http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/marburg.htm

Marburg Hemorrhagic Fever Fact Sheet for the Business Sector
Since October 2004, an outbreak of Marburg hemorrhagic fever (family Filoviridae, which includes Ebola virus) has been reported in Uige Province in northern Angola. This fact sheet provides basic information that may be useful to companies with personnel in the affected region. http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/marburg/business.htm

MMWR Report:
Brief Report: Outbreak of Marburg Virus Hemorrhagic Fever --- Angola, October 1, 2004--March 29, 2005

CDC HAN Update (March 30, 2005):
Outbreak of Marburg Virus Hemorrhagic Fever in Angola

INFLUENZA

Targeting and Collaborations a Big Success; Priority Groups Received Majority of 2004-05 Influenza Vaccine Thanks to 17 Million Healthy Americans Stepping Aside – CDC Press Release
The Centers for Disease Control and Prevention (CDC) announced on March 31st that during the 2004-05 flu season, the majority of the nation’s influenza vaccine went to the people at greatest risk for serious complications from flu, including 6 to 23 month old children, people 65 years of age and older, and people with chronic health conditions. Importantly, despite an unexpected and substantial vaccine shortfall, influenza vaccination coverage levels among adults in priority groups through January nearly reached levels similar to previous years, while coverage levels among adults not in priority groups were approximately half of historic levels. http://www.cdc.gov/od/oc/media/pressrel/r050331.htm

Improving Influenza, Pneumococcal Polysaccharide, and Hepatitis B Vaccination Coverage Among Adults Aged <65 Years at High Risk - MMWR report
The Task Force on Community Preventive Services conducted systematic reviews to evaluate the effectiveness of interventions to improve targeted vaccination coverage. A 1999 report by the Task Force examined the effectiveness of interventions to increase coverage with universally recommended vaccinations.  This report provides additional information about population-based |interventions to improve the coverage of influenza, pneumococcal polysaccharide, and hepatitis B vaccines among populations at risk, briefly describes how the reviews were conducted, and provides information that can help in applying the
interventions locally. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5405a1.htm

Estimated Influenza Vaccination Coverage Among Adults and Children - United States, September 1, 2004 - January 31, 2005 – MMWR report
To monitor influenza vaccination coverage during the 2004-05 season, the Behavioral Risk Factor Surveillance System (BRFSS), an ongoing, state-based, telephone survey of civilian, non-institutionalized persons, added new questions to collect information on priority status and the month and year of vaccination for adults and children. This report is based on analysis of data collected during February 1-27, 2005, regarding respondent-reported receipt of influenza vaccination during September 1, 2004-January 31, 2005. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5412a3.htm

Influenza Vaccine Prebooking and Distribution Strategies for the 2005--06 Influenza Season – MMWR report
For the 2004-05 influenza season, CDC, in coordination with the Advisory Committee on Immunization Practices (ACIP), issued interim influenza vaccine use recommendations after Chiron Corporation announced that none of its inactivated influenza vaccine (Fluvirin®) would be available in the United States. To plan for the upcoming 2005-06 influenza season, CDC has met with influenza vaccine manufacturers, including those intending to apply for approval to sell in the United States, to develop supply projections and distribution strategies, including pre-booking (i.e., advance ordering of vaccine) and partial shipment of orders to those customers who pre-book. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5412a4.htm

AVIAN INFLUENZA

Recent Avian Influenza Outbreaks in Asia
Provides updated information. As of March 31, 2005, there have been 74 human cases of avian influenza A (H5N1) in Vietnam (55), Thailand (17), and Cambodia (2) resulting in 49 deaths. For more information about H5N1 infections in humans, visit the World Health Organization (WHO) website. http://www.cdc.gov/flu/avian/outbreaks/asia.htm

ANTHRAX

Inadvertent Laboratory Exposure to Bacillus anthracis - California, 2004 - MMWR report
On June 9, 2004, the California Department of Health Services (CDHS) was notified of possible inadvertent exposure to Bacillus anthracis spores at Children's Hospital Oakland Research Institute (CHORI), where workers were evaluating the immune response of mice to B. anthracis. This report summarizes the subsequent investigation by CDHS and CDC, including assessment of exposures, administration of postexposure chemoprophylaxis, and serologic testing of potentially exposed workers. The findings underscore the importance of using appropriate biosafety practices and performing adequate sterility testing when working with material believed to contain inactivated B. anthracis organisms. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5412a2.htm

CHEMICAL EMERGENCIES

The link(s) below consist of new or updated case definitions for the following agents, including a clinical description, and laboratory criteria for diagnosis:

Ricin Inhalation, Ricin Ingestion, Plague

Agent Descriptions
Toxic Syndrome Description: Ricin or Abrin Poisoning, Sodium Azide,
Nerve Agent and Organophosphate Pesticide Poisoning

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