MMWR

Morbidity and Mortality Weekly Report

Adult Respiratory Distress Syndrome in Persons with Tick-Borne Relapsing Fever — Three States, 2004–2005

PRESS CONTACT: CDC Division of Media Relations
(404) 639-3286

Tickborne relapsing fever (TBRF) infections may be more serious than generally recognized, and can lead to the development of adult respiratory distress syndrome (ARDS). It is essential that TBRF is promptly diagnosed by examining blood smears, and managed using appropriate antimicrobials and closely observing patients during the initial phases of treatment. Three cases of severe Tickborne relapsing fever (TBRF) associated with adult respiratory distress syndrome (ARDS) were identified in residents of California, Nevada, and Washington in 2004-2005. A case review and epidemiologic investigation suggest that ARDS is more common than previously recognized in TBRF and can occur in persons without predisposing conditions. TBRF is a bacterial illness that is usually less severe, and characterized by intermittent periods of fever. It is caused by certain species of Borrelia and transmitted through brief and painless bites from Ornithodoros ticks. The best way to prevent TBRF is not to allow rodents to live in homes or shelters. Health care professionals should also be educated on how to recognize early symptoms, especially in endemic areas. The optimal way to manage TBRF is to promptly diagnose it by examining blood smears, using appropriate antimicrobials, and closely observing patients during the initial phases of treatment.

Emergence of Highly Resistant Serotype 19A Streptococcus pneumoniae — Massachusetts, 2001–2006

PRESS CONTACT: Boston Medical Center
Dr. Kathy Hsu or Dr. Stephen Pelton
(617) 414-7408

The increase in disease due to serotype 19A is small in comparison to the dramatic declines seen in overall pneumococcal disease. Infection with the bacteria Streptococcus pneumoniae can cause severe, life-threatening illnesses such as blood stream infections, pneumonia and meningitis. Pneumococcal conjugate vaccine (PCV7) was licensed for use in the United States in 2000 and targets the pneumococcal strains that caused most antibiotic-resistant infections before PCV7 introduction. CDC estimates that during 2006 alone, PCV7 prevented approximately 30,000 cases of the severest forms of pneumococcal disease among people of all ages. However, the Massachusetts Department of Public Health has noted a recent increase in some strains not covered by the vaccine, in particular a type known as serotype 19A that can be resistant to antibiotics. The increase in disease due to serotype 19A is small in comparison to the dramatic declines seen in overall pneumococcal disease. Vaccination remains the most effective way of preventing pneumococcal disease.

Update: Prevention of Hepatitis A after Exposure to Hepatitis A Virus and in International Travelers. Updated Recommendations of the Advisory Committee on Immunization Practices (ACIP)

PRESS CONTACT: CDC Division of Media Relations
(404) 639-3286

The ACIP now recommends that hepatitis A vaccine is preferred to immune globulin to prevent hepatitis A for persons aged 12 months to 40 years who have been exposed to hepatitis A virus. This report provides updated recommendations of the Advisory Committee on Immunization Practices (ACIP) for the prevention of hepatitis A after exposure to hepatitis A virus and before international travel. The ACIP now recommends that hepatitis A vaccine is preferred to immune globulin to prevent hepatitis A for persons aged 12 months to 40 years who have been exposed to hepatitis A virus. Additionally, for travelers with imminent departure to countries endemic for hepatitis A, the ACIP now recommends that one dose of hepatitis A vaccine administered at any time before departure can provide adequate protection for most healthy persons. The ability to use hepatitis A vaccine for postexposure prophylaxis provides a number of public health advantages, including the induction of active immunity and longer protection, greater ease of administration, higher acceptability and availability, and a cost per dose that is similar to immune globulin. The greater availability and ease of administration of hepatitis A vaccine might increase the number of persons who receive prophylaxis after exposure to hepatitis A virus.

West Nile Virus Update

PRESS CONTACT: CDC Division of Media Relations
(404) 639-3286

No summary available

Recommended Adult Immunization Schedule — United States, October 2007–September 2008

PRESS CONTACT: CDC Division of Media Relations
(404) 639-3286

Vaccines are not just for children; adults need them too. This annual CDC publication provides timely, updated information on vaccines for adults. The Advisory Committee on Immunization Practices (ACIP) annually reviews the recommended Adult Immunization Schedule to ensure that the schedule reflects current recommendations for licensed vaccines. The updated Recommended Adult Schedule for October 2007-September 2008 is intended to provide guidance for health care and public health personnel on the indications for use of vaccines for adults.

####

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES