MMWR

Morbidity and Mortality Weekly Report

1. Performance of Rapid Influenza Diagnostic Tests During Two School Outbreaks of 2009 Pandemic Influenza A (H1N1) Virus Infection – Connecticut, 2009

Press Contact: CDC, Division of Media Relations
Phone: (404) 639-3286

Although a positive rapid test for influenza is helpful, a negative test does not at all rule out pandemic influenza A (H1N1) infection. Two school outbreaks of pandemic influenza in May 2009 diagnosed at Greenwich Hospital afforded an opportunity to exam the performance of a rapid diagnostic test in detecting the pandemic virus. The hospital’s Infectious Diseases Section, headed by James R. Sabetta, M.D., with the Greenwich Department of Health and the Connecticut Department of Public Health, compared the results from rapid tests with the reverse transcriptase – polymerase chain reaction assay. A low sensitivity of 47 percent was found for the rapid test. The performance could not be explained by the clinical features of the patients or by the timing of the specimen collection. The results affirm recent CDC recommendations not to use negative rapid tests results for the management of patients with possible 2009 pandemic influenza a (H1N1) infection.

2. Anaplasmosis and Ehrlichiosis – Maine, 2008

Press Contact: CDC, Division of Media Relations
Phone: (404) 639-3286

Anaplasmosis and ehrlichiosis are increasing in prevalence in the United States and providers should assess clinical and ecologic features and include concurrent confirmatory testing for both anaplasmosis and ehrlichiosis or other tickborne diseases when evaluating patients with suspected tickborne illness. During 2007–2008, the number of physician-reported rickettsial tickborne anaplasmosis (Anaplasma phagocytophilum by Ixodes scapularis) cases nearly doubled in Maine, and ehrlichiosis (Ehrlichia chaffeensis by Amblyomma americanum) cases increased more than fourfold. To examine this increase, the Maine Department of Health and Human Services (MDHHS) analyzed the state’s available data on tick burden and physician-reported cases of anaplasmosis and ehrlichiosis during 2000–2008. The findings showed that the ehrlichiosis cases were more likely anaplasmosis cases that were misclassified due to ambiguous terminology, diagnostics with cross reactivity problems (>50 percent), lack of travel history, and a non-endemic vector. Therefore, providers should assess clinical and ecologic features and include concurrent testing for both anaplasmosis and ehrlichiosis or other tickborne diseases when evaluating patients with suspected tickborne illness.

 

3. Progress Toward Measles Control and Measles Morbidity Reduction – African Region, 2001–2008

Press Contact: CDC, Division of Media Relations
Phone: (404) 639-3286

In the World Health Organization African Region, following the implementation of measles control and vaccination strategies, reported measles cases decreased to a historic low of 32,278 in 2008. However, measles outbreaks continue to occur, suggesting that continued efforts are needed to fully implement the recommended strategies in order to sustain recent gains and make further progress in measles control. In 2001, the countries of the World Health Organization African Region (AFR) became part of a global initiative with a goal of reducing measles deaths by 50 percent which was achieved by 2005 and a new goal of 90 percent mortality reduction by 2010 was adopted. During 2001–2008, in AFR, routine measles vaccination coverage increased from 57 percent to 73 percent, approximately 400 million children received measles vaccination during campaigns, and reported measles cases decreased to a historic low of 32,278 in 2008. By 2006, estimated number of measles deaths in AFR declined by approximately 90 percent, compared to 2000 estimates. However, inaccuracies in reported vaccination coverage exist, surveillance remains suboptimal, and measles outbreaks continue to occur. Further progress in measles control will require full implementation of recommended strategies.

4.Updated Recommendations from the Advisory Committee on Immunization Practices (ACIP) for Revaccination of Persons at Prolonged Increased Risk for Meningococcal Disease

Press Contact: CDC, Division of Media Relations
Phone: (404) 639-3286

Persons who are at increased risk for meningococcal disease for prolonged periods of time due to medical conditions or because of prolonged exposure should be revaccinated with quadrivalent meningococcal conjugate vaccine every 5 years. College freshmen living in dormitories who were previously vaccinated with MCV4 are not recommended for revaccination at this time. Because of the high risk for meningococcal disease among certain groups and limited data on duration of protection, ACIP, at its June 2009 meeting, recommended that persons previously vaccinated with either MCV4 or MPSV4 who are at prolonged increased risk for meningococcal disease should be revaccinated with MCV4. Persons who previously were vaccinated at age ≥7 years and are at prolonged increased risk should be revaccinated 5 years after their previous meningococcal vaccine, and persons who previously were vaccinated at ages 2–6 years and are at prolonged increased risk should be revaccinated 3 years after their previous meningococcal vaccine. Persons at prolonged increased risk for meningococcal disease include 1) persons with increased susceptibility such as persistent complement component deficiencies (e.g., C3, properdin, Factor D, and late complement component deficiencies), 2) persons with anatomic or functional asplenia, and 3) persons who have prolonged exposure (e.g., microbiologists routinely working with Neisseria meningitidis, or travelers to or residents of countries where meningococcal disease is hyperendemic or epidemic). ACIP does not recommend revaccination for college freshmen living in dorms who were previously vaccinated with MCV4 at this time.

 

 

 

####

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES