Synopsis for June 29, 2001

MMWR articles are embargoed until 4 p.m. E.S.T. Thursday.

1. Hepatitis B Outbreak in a State Correctional Facility, 2000
2. Influenza and Pneumococcal Vaccination Levels Among Persons Aged > 65 Years — United States, 1999
3. Routinely Recommended HIV Testing at a Busy, Urban, Urgent Care Center — Atlanta, Georgia, 2000

MMWR Reports & Recommendations
June 29, 2001/Vol. 50/No. RR-11

Contact: Elise Beltrami, M.D.
CDC, National Center for Infectious Diseases
(404) 498–1242 (1240)

This report updates and consolidates all previous U.S. Public Health Service recommendations for the management of health-care personnel (HCP) who have occupational exposure to blood and other body fluids that might contain hepatitis B virus (HBV), hepatitis C virus (HCV), or human immunodeficiency virus (HIV). In addition, this report outlines several special circumstances (e.g., delayed exposure report, unknown source person, pregnancy in the exposed person, resistance of the source virus to antiretroviral agents, or toxicity of the PEP regimen) when consultation with local experts and/or the National Clinicians' Post-Exposure Prophylaxis Hotline ([PEPline] 1-888-448-4911) is advised.

Synopsis for June 29, 2001

Hepatitis B Outbreak in a State Correctional Facility, 2000

Hepatitis B vaccination would prevent ongoing transmission in correctional facilities, as well as infection in inmates after they are released into the community.

Eleven cases of acute hepatitis B were identified among inmates at a long-term, state correctional facility. All case-patients had been incarcerated for more than 6 months, indicating transmission occurred in the correctional facility. The investigation also identified 10 inmates with previously unrecognized chronic infection, who could be sources for transmission. Sex with another male was the identified risk factor for infection in this outbreak. However, a high proportion of inmates reported engaging in other behaviors while incarcerated that could potentially transmit infection. Hepatitis B vaccine is recommended for inmates in long-term correctional facilities to prevent transmission of hepatitis B virus.

Influenza and Pneumococcal Vaccination Levels Among Persons Aged > 65 Years — United States, 1999

Racial and ethnic disparities in vaccination coverage among adults 65 years and older continued from 1997 to 1999.

The latest findings from the Behavioral Risk Factor Surveillance System highlight both successes and continued challenges in protecting persons 65 years and older against complications from influenza infection and pneumococcal disease by vaccination. Successes include: 1) achievement in 1998-99 of the 60% national 2000 objective for flu vaccination nationally (67%); 2) this was also accomplished in most states; and 3) continued improvement in pneumococcal vaccination to 54% in 1999, with coverage in 24 states near or exceeding 60%. Challenges to achieving the national 2010 objective of 90% coverage among persons aged 65 years and older include: a possible plateau in flu vaccination coverage by 1999; delays in the distribution of influenza vaccine observed during the 2000-01 influenza season and projected for 2001-02; and continued racial/ethnic and socioeconomic disparities.

Routinely Recommended HIV Testing at a Busy, Urban, Urgent Care Center — Atlanta, Georgia, 2000

A key goal in CDC’s strategic HIV prevention plan is to increase the proportion of HIV-infected individuals who are aware of their HIV status.

In this study, conducted at an urgent care clinic located in an area with high HIV prevalence, CDC researchers found that when providers routinely recommended HIV testing (compared to only recommending HIV testing selectively, based on symptoms and/or risk behavior): more than twice as many patients were tested (2,787 compared to 1,100); 27 additional HIV infections were newly detected (74 compared to 47); twice as many patients learned their HIV test results (55 compared to 28); and twice as many infected patients entered into medical care (26 compared to 13). Additionally, patients with HIV often were diagnosed earlier in the course of their HIV infection. Given the benefits of early knowledge of one’s HIV status, CDC recommends that, in areas with high HIV prevalence, voluntary HIV testing should be routinely recommended in all clinical settings.

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