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发表于 2005-2-24 11:16
> HEP EXPRESS
> Viral hepatitis news from the Immunization Action Coalition
> ===========================================================
> Issue Number 26 February 22, 2005
>
> CONTENTS OF THIS ISSUE
>
> 1. CDC's draft ACIP hepatitis B recommendations
> available online for your review and comments
> 2. Dr. John Ward accepts position as director of CDC's
> Division of Viral Hepatitis
> 3. CDC reports on hepatitis A vaccination coverage among U.S.
> children ages 24-35 months during 2003
> 4. National Institutes of Health releases Action Plan for
> Liver Disease Research
> 5. DHHS adds HBV and HCV to list of known carcinogens
> 6. CDC reports African Americans have twice the incidence rate
> for hepatitis B and Streptococcus pneumoniae as whites
> 7. EPA publishes updated guidance about safe needle/sharps
> disposal
> 8. Hepatitis B Foundation establishes new research institute
> 9. New resources about preventing occupational exposure to
> bloodborne pathogens available
> 10. Resources for safer tattooing in prisons available online
> 11. Journal articles you may have missed
> ----------------------------------------------------------------
>
> ABBREVIATIONS: ACIP, Advisory Committee on Immunization
> Practices; CDC, Centers for Disease Control and Prevention; DVH,
> Division of Viral Hepatitis; HAV, hepatitis A virus; HBV,
> hepatitis B virus; HCV, hepatitis C virus; IAC, Immunization
> Action Coalition; IDU, injection drug user; MMWR, Morbidity and
> Mortality Weekly Report; MSM, men who have sex with men; STD,
> sexually transmitted disease; VIS, Vaccine Information
> Statement; WHO, World Health Organization.
> ----------------------------------------------------------------
>
> (1 of 11)
> February 22, 2005
> CDC'S DRAFT ACIP HEPATITIS B RECOMMENDATIONS AVAILABLE ONLINE
> FOR YOUR REVIEW AND COMMENTS
>
> CDC's Division of Viral Hepatitis has posted draft hepatitis B
> recommendations online at
> http://www.cdc.gov/ncidod/diseases/hepatitis/b/HBV_ACIP_Recs.pdf
>
> The hepatitis B working group of the ACIP developed the proposed
> recommendations. A discussion vote to adopt the recommendations
> is scheduled for the June 29-30 ACIP meeting. CDC is currently
> encouraging feedback from health professionals and the public on
> the proposed statement. Please email comments to
> [email protected] before March 4, 2005.
> ----------------------------------------------------------------
>
> (2 of 11)
> February 22, 2005
> DR. JOHN WARD ACCEPTS POSITION AS DIRECTOR OF CDC'S DIVISION OF
> VIRAL HEPATITIS
>
> [The following is cross posted from the Immunization Action
> Coalition's "IAC EXPRESS" electronic newsletter, 01/18/05.]
>
> On January 6, Dr. James M. Hughes, director of the National
> Center for Infectious Diseases (NCID), announced that Dr. John
> Ward has accepted the position of director, Division of Viral
> Hepatitis. The text of Dr. Hughes' announcement is reprinted
> below in its entirety.
>
> ****************
>
> I am pleased to announce that Dr. John Ward has accepted the
> position of director, Division of Viral Hepatitis (DVH). Dr.
> Ward most recently served as editor of the Morbidity and
> Mortality Weekly Report (MMWR) and as acting director of the
> Division of Scientific Communications, in the proposed National
> Center for Health Marketing, National Coordinating Center for
> Health Information and Service.
>
> Dr. Ward received his MD from the University of Alabama School
> of Medicine in Birmingham and completed an internship and
> residency in internal medicine at the University of Alabama
> Hospitals. In addition to his EIS [Epidemic Intelligence
> Service] training, he received postgraduate training in tropical
> medicine at the London School of Tropical Medicine and Hygiene,
> in pediatric immunology at the Royal Children's Hospital in
> Melbourne, Australia, and in infectious diseases as a CDC
> assignee at the University of Washington Medical Center in
> Seattle. He joined CDC in 1984 as an EIS officer in the
> Epidemiology Section of what was then known as the AIDS
> Activity, NCID. He remained in CDC's evolving AIDS program
> through 1998, working on many high-profile investigations and
> serving in various leadership positions including section chief
> and then later branch chief of the Surveillance Branch in the
> Division of HIV/AIDS, NCID. He became editor of the MMWR in
> 1998.
>
> The recipient of numerous CDC and PHS [Public Health Service]
> awards, Dr. Ward is a member of the Emory University School of
> Medicine clinical faculty and is active on many public health
> planning and steering committees. He is the author or coauthor
> of more than 100 scientific publications and serves as a peer
> reviewer for numerous journals including the American Journal of
> Public Health, JAMA [Journal of the American Medical
> Association], and Annals of Internal Medicine.
>
> Please join me both in thanking Dr. Eric Mast for his excellent
> service as acting director, DVH, for the past six months and in
> congratulating John and supporting him in his new position.
>
> ****************
> ----------------------------------------------------------------
>
> (3 of 11)
> February 22, 2005
> CDC REPORTS ON HEPATITIS A VACCINATION COVERAGE AMONG U.S.
> CHILDREN AGES 24-35 MONTHS DURING 2003
>
> [The following is cross posted from the Immunization Action
> Coalition's "IAC EXPRESS" electronic newsletter, 02/21/05.]
>
> CDC published "Hepatitis A Vaccination Coverage Among Children
> Aged 24-35 Months--United States, 2003" in the February 18 issue
> of MMWR. The article is reprinted below in its entirety with the
> exception of one table, one figure, and references.
>
> ***********************
>
> Hepatitis A vaccine was first licensed in the United States in
> 1995. In 1996, the Advisory Committee on Immunization Practices
> (ACIP) recommended vaccination of children aged >=24 months in
> populations with the highest incidence of hepatitis A (e.g.,
> American Indian/Alaska Native [AI/AN], Asian/Pacific Islander,
> and selected Hispanic and religious communities). In 1999, these
> guidelines were expanded to recommend routine vaccination for
> children residing in 11 states where average annual hepatitis A
> incidence during 1987-1997 was at least 20 per 100,000
> population (twice the national average) and to consider routine
> vaccination for children in six states where average annual
> incidence was 10-20 per 100,000 population. This report is the
> first national analysis of hepatitis A vaccination coverage
> among children. The results indicate that, in 2003, vaccination
> coverage levels with at least 1 dose of hepatitis A vaccine for
> children aged 24-35 months varied from 6.4% to 72.7% in areas
> where routine vaccination is recommended. In addition, hepatitis
> A vaccination coverage rates for children aged 24-35 months are
> lower than overall rates for other vaccines recommended for
> children. Sustaining and improving vaccination coverage among
> young children is needed to ensure continued declines in
> hepatitis A incidence in the United States.
>
> The National Immunization Survey (NIS) provides annual estimates
> of vaccination coverage as of the time of household interview
> among children aged 19-35 months for the 50 states and 28
> selected urban areas. In 2003, NIS began to collect data
> regarding hepatitis A vaccination coverage. Hepatitis A vaccine
> is a 2-dose regimen (administered at least 6 months apart)
> licensed for use in children aged >=24 months. Hepatitis A
> vaccination coverage data were limited to children aged 24-35
> months and calculated by considering children who had received
> at least 1 vaccine dose. To collect vaccination data for all
> age-eligible children, NIS uses a quarterly, random-digit-
> dialing sample of telephone numbers for each of the 78 survey
> areas and determines vaccination status from healthcare provider
> records. During 2003, information on vaccination history was
> collected from telephone interviews for 19,979 children;
> provider verified vaccination records were available for 13,731
> (68.7%).
>
> Among children aged 24-35 months residing in the 11 states where
> routine hepatitis A vaccination is recommended, 50.9% (95%
> confidence interval [CI] = 47.6%-54.2%; range among states:
> 6.4%-72.7%) received at least 1 dose of hepatitis A vaccine.
> Among children aged 24-35 months residing in the six states
> where routine hepatitis A vaccination should be considered,
> 25.0% (CI = 21.8%-28.2%; range: 0.6%-32.3%) had received at
> least 1 dose of hepatitis A vaccine. Among children aged 24-35
> months residing in the 33 states without a specific
> recommendation, 1.4% (CI = 1.0%-1.8%; range: 0.0%-4.3%) had
> received at least 1 dose of hepatitis A vaccine. Two states
> (Alaska and Arizona) and four urban areas had coverage estimates
> >60%. Hispanic and AI/AN children had higher coverage rates than
> non-Hispanic white or black children in areas where routine
> vaccination is recommended or should be considered.
>
> Editorial Note:
>
> The national hepatitis A vaccination coverage estimates
> described in this report indicate that, in 2003, current
> hepatitis A childhood vaccination recommendations were being
> implemented in many states. However, coverage varied among areas
> and populations, likely because of targeted programs within
> these states. For example, higher coverage in El Paso County,
> Texas (71%), compared with the overall Texas coverage rate
> (32%), likely is attributable to vaccination requirements in
> Texas border counties for all children attending child care
> programs.
>
> Vaccination coverage also varied by race/ethnicity. Higher
> coverage among Hispanic and AI/AN children than among children
> of other racial/ethnic populations might be related to greater
> disease recognition in these populations and local and national
> vaccination recommendations that have identified these
> populations as having higher hepatitis A rates.
>
> The findings in this report are subject to at least three
> limitations. First, NIS is a telephone survey; although
> statistical weights adjust for nonresponse and households
> without telephones, some bias might remain. Second, although NIS
> relies on provider-verified vaccination histories, incomplete
> records or reporting could result in underestimates of coverage.
> Finally, although national estimates are reliable, estimates for
> states and urban areas and for racial/ethnic populations should
> be interpreted with caution.
> The 1999 ACIP hepatitis A prevention recommendations encouraged
> state and local immunization programs to analyze their
> surveillance data and implement vaccination strategies that
> address the epidemiology of hepatitis A in their areas. The
> variation by state in coverage among children aged 24-35 months
> likely reflects the varying vaccination strategies adopted by
> state and local public health officials in response to the ACIP
> recommendations. Higher coverage among Hispanic and AI/AN
> children is one indication that vaccination efforts targeting
> children at higher risk for illness have been successful.
>
> These data do not provide information on why hepatitis A
> vaccination coverage for children aged 24-35 months remains
> below that for other childhood vaccinations in most areas where
> it is recommended. Low coverage rates for young children might
> be the result of (1) a focus by healthcare providers and
> immunization programs on vaccinating older children, (2) the few
> areas with hepatitis A vaccine mandates, or (3) the lack of a
> licensed hepatitis A vaccine that can be administered to
> children aged <24 months. Sustaining and improving vaccination
> coverage among young children is needed to ensure continued
> declines in hepatitis A incidence in the United States.
>
> ***********************
>
> To access a web-text (HTML) version of this article, go t
> http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5406a1.htm
>
> To access a ready-to-copy (PDF) version of this issue of MMWR,
> go t http://www.cdc.gov/mmwr/PDF/wk/mm5406.pdf
>
> To receive a FREE electronic subscription to MMWR (which
> includes new ACIP statements), go t
> http://www.cdc.gov/mmwr/mmwrsubscribe.html
> ----------------------------------------------------------------
>
> (4 of 11)
> February 22, 2005
> NATIONAL INSTITUTES OF HEALTH RELEASES ACTION PLAN FOR LIVER
> DISEASE RESEARCH
>
> The National Institutes of Health (NIH) has developed an Action
> Plan for Liver Disease Research. The goal of the Action Plan is
> to advance research on liver and biliary diseases with the aim
> of decreasing the burden of liver and biliary diseases in the
> United States.
>
> At present, an estimated 5.5 million Americans have chronic
> liver disease or cirrhosis, and more than 20 million have
> gallbladder disease. The impact of liver and biliary diseases
> is considerable, whether viewed in terms of the number of
> individuals affected; the severity of the disease and its
> frequency of fatality; the economic costs to the U.S. health
> system; as well as those disease outcomes that are less readily
> quantifiable, but are important on a personal scale, such as
> disability and quality of life.
>
> The Action Plan for Liver Disease Research can be downloaded
> from the National Institute of Diabetes & Digestive & Kidney
> Diseases website at
> http://www.niddk.nih.gov/fund/divisions/ddn/ldrb/ldrb_action_plan.htm
>
> Free single copies can be ordered by calling 800-891-5389, or by
> emailing [email protected] and providing your name,
> mailing address, telephone number, and email address.
> ----------------------------------------------------------------
>
> (5 of 11)
> February 22, 2005
> DHHS ADDS HBV AND HCV TO LIST OF KNOWN CARCINOGENS
>
> The U.S. Department of Health and Human Services (DHHS) has
> added 17 new substances to the list of cancer-causing agents
> included in the Eleventh Edition of the Report on Carcinogens.
> The report now lists 246 carcinogens, 58 of which are "known" to
> cause cancer in humans and 188 of which are "reasonably
> anticipated" to cause cancer.
>
> For the first time, the report includes three viruses, the
> hepatitis B virus (HBV), the hepatitis C virus (HCV), and the
> human papillomavirus (HPV), all added to the "known" carcinogen
> category.
>
> To read or download the Eleventh Edition of the Report on
> Carcinogens go t http://ntp.niehs.nih.gov/ntp/roc/toc11.html
> ----------------------------------------------------------------
>
> (6 of 11)
> February 22, 2005
> CDC REPORTS AFRICAN AMERICANS HAVE TWICE THE INCIDENCE RATE FOR
> HEPATITIS B AND STREPTOCOCCUS PNEUMONIAE AS WHITES
>
> [The following is cross posted from the Immunization Action
> Coalition's "IAC EXPRESS" electronic newsletter, 01/18/05.]
>
> CDC published "Racial Disparities in Nationally Notifiable
> Diseases--United States, 2002" in the January 14 issue of MMWR.
> The January 14 issue is the third in a MMWR series that focuses
> on racial/ethnic health disparities. An analysis of surveillance
> data collected in 2002 indicates that incidence rates are at
> least two times greater for African Americans than for white
> Americans for eight of 42 nationally notifiable diseases. Among
> those are two vaccine-preventable diseases, hepatitis B and
> Streptococcus pneumoniae. Portions of an article dealing with
> these issues are reprinted below.
>
> ***********************
>
> Infectious diseases are a major cause of morbidity, mortality,
> and disability in the United States and often affect
> racial/ethnic populations disproportionately. Eliminating racial
> disparities is a goal of many of the national health objectives
> for 2010. To estimate racial disparities in the incidence of
> nationally notifiable infectious diseases by race/ethnicity, CDC
> reviewed 2002 data from the Nationally Notifiable Diseases
> Surveillance System (NNDSS), collected through the National
> Electronic Telecommunications System for Surveillance (NETSS).
> This report summarizes the results of that analysis, which
> indicated that incidence rates were at least two times greater
> for blacks than whites for eight of 42 nationally notifiable
> diseases . . . . for hepatitis B, [the rates were] 3.9 for
> blacks and 1.5 for whites; and for Streptococcus pneumoniae
> (i.e., invasive, drug resistant), 1.5 for blacks and 0.7 for
> whites.
>
> ***********************
>
> To access a web-text (HTML) version of the complete article, go
> t http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5401a4.htm
>
> To access a ready-to-copy (PDF) version of this issue of MMWR,
> go t http://www.cdc.gov/mmwr/PDF/wk/mm5401.pdf
> --------------------------------------------------------------
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