MMWR News Synopsis for August 28, 2014

National, State, and Selected Local Area Vaccination Coverage Among Children Aged 19–35 Months — United States, 2013

CDC Media Relations
404-639-3286

Vaccine-preventable diseases can strike at an early age and can be especially serious for infants and very young children. Vaccination is one of the most important things parents can do to protect their children’s health. The vast majority of parents are making sure that their children get vaccinated against potentially serious diseases, according to data from CDC’s 2013 National Immunization Survey (NIS) published in this week’s Morbidity and Mortality Weekly Report (MMWR). The NIS monitors vaccination coverage among children aged19-35 months in the United States. Vaccination coverage increased or remained stable for all routinely recommended childhood vaccines in 2013. However, coverage varies by state, and low coverage levels can leave states and communities vulnerable to outbreaks of potentially serious vaccine-preventable diseases. Even states with high vaccine coverage levels may have groups of people who are unvaccinated, leaving communities vulnerable to disease outbreaks.

Two Cases of Delayed Hemolysis After Parenteral Artesunate Therapy for Malaria — United States, 2008–2013

CDC Media Relations
404-639-3286

Post-artemisinin delayed hemolysis – a short-term but severe anemia — sometimes occurs following injectable artesunate treatment and probably results from a delayed clearance of once-infected red blood cells and not artesunate toxicity. Parenteral artesunate is a safe treatment for severe malaria. Intravenous artesunate is the first-line World Health Organization-recommended treatment for severe malaria associated with improved survival compared with other treatments. However, post-artemisinin delayed hemolysis (PADH) has occasionally been reported. Reports of PADH raised questions about artesunate safety. An updated review of the literature and data from the U.S. malaria surveillance system revealed 20 new PADH cases, including, for the first time, two U.S. cases. A few case-patients required blood transfusions. /There were no PADH-associated deaths among patients with complete follow-up information. Recent research suggests that PADH likely results from delayed removal of once-infected red blood cells, and not drug toxicity. Clinicians should be aware of the potential for PADH when using artesunate. However, intravenous artesunate should remain as the first-line treatment for severe malaria in countries where it is licensed for use.

Assessment of Rabies Exposure Risk Among U.S. Air Force Basic Trainees — Texas, January 2014

Mr. Joe Bela
Director, 59 MDW Public Affairs
Office: 210-292-7688/7074
Email: 59mdw.pa@us.af.mil

Rabies postexposure prophylaxis is recommended for persons who are bitten or scratched by a bat if that bat is either unavailable for testing or tests positive for rabies. It is also recommended for persons who might have had an exposure of which they are unaware (e.g., waking in a room with a bat or being near a bat while having a condition that might result in a lack of awareness of a bat bite). In shared sleeping quarters, such as in military basic training, many people may be exposed at one time. In January 2014, a number of Mexican free-tailed bats were seen in the sleeping quarters of a U.S. Air Force basic military training dormitory at Joint Base San Antonio – Lackland, Texas. Exposure to bats while sleeping is a known risk for acquiring rabies, a viral disease that is almost uniformly fatal if not treated before symptoms begin. In this outbreak investigation, over 900 U.S. Air Force basic trainees and training instructors were interviewed for potential exposure to bats, and 200 trainees received rabies postexposure prophylaxis, consisting of one injection of human rabies immune globulin and the four-dose rabies vaccination series. There were no serious adverse effects and no rabies cases have occurred.

Closure of Varicella-Zoster Virus–Containing Vaccines Pregnancy Registry — United States, 2013

CDC Media Relations
404-639-3286

Although there has been substantial progress toward polio eradication in Africa, all countries remain at risk for poliovirus outbreaks as long as poliovirus circulation continues anywhere. To reach eradication, governments at the national and subnational levels will need to remain committed, implement strategic immunization activities, and undertake preparedness measures to lower risk. Elimination of polio from Africa as early as 2015 is possible but iwill require the continued commitment of all African national governments. The international community must also remain united and support African governments in addressing the risks of polio outbreaks and ensuring they can respond quickly. Vulnerabilities in immunization delivery put a polio-free future at risk. In the past 18 months alone there have been two multi-country polio outbreaks in Africa due to chronic weaknesses in immunization service systems. To stop the current outbreaks, prevent additional spread, and interrupt transmission concerted efforts are still needed to raise childhood immunity in the second half of 2014 across Africa but particularly in Nigeria.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES