CDC Media Relations: MMWR News Synopsis for July 16, 1999

Press Summaries

July 16, 1999

MMWR articles are embargoed until 4 p.m. Eastern time on Thursday.

MMWR Synopsis	Intussusception Among Recipients of Rotavirus Vaccine — United States, 1998-1999 Outbreak of Salmonella Serotype Muenchen Infections Associated with Unpasteurized Orange Juice — United States and Canada, June 1999 Progress Toward Measles Elimination — Southern Africa, 1996-1998
Notice to Readers	Recommendations of the Advisory Committee on Immunization Practices: Revised Recommendations for Routine Polio Vaccination
Fact Sheet	Salmonella

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Synopsis July 16, 1999

Intussusception Among Recipients of Rotavirus Vaccine — United States, 1998-1999
The use of rotavirus vaccine should be postponed until November 1999.

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

CDC recommends that healthcare providers and parents postpone use of the rotavirus vaccine for infants, at least until November 1999, based on early surveillance reports of intussusception (a type of bowel obstruction) among some infants who received rotavirus vaccine. Although intussusceptions occur among infants who have not received rotavirus vaccine, CDC will be collecting additional data in the next several months that may indicate more clearly whether the rotavirus vaccine increases the risk of intussusception. An estimated 1.5 million doses of rotavirus vaccine have been administered to infants since it was licensed on August 31, 1998. As of July 7, 1999, the Vaccine Adverse Event Reporting System has received 15 reports of intussusception. Although cases of intussusception following rotavirus vaccine have been reported, it has not been established that these cases were caused by the vaccine.

Outbreak of Salmonella Serotype Muenchen Infections Associated with Unpasteurized Orange Juice — United States and Canada, June 1999
Salmonella, associated with unpasteurized orange juice, has caused illness in the United States and Canada.

PRESS CONTACT:
Ellen Steinberg
CDC, National Center for Infectious Diseases
(404) 639-2206

As of July 13, 1999, there have been 209 confirmed cases of Salmonella serotype Muenchen reported from 14 states and 2 Canadian provinces. An additional 62 cases are under investigation. Illness is associated with drinking unpasteurized orange juice. On June 25, 1999, the Food and Drug Administration issued a recall of the juice produced by Sun Orchard (Arizona). The juice is distributed to Arizona, California, Colorado, Nevada, New Mexico, Oregon, Texas, Utah, Washington, Wisconsin; and the provinces of Alberta and British Columbia. Four persons were hospitalized. There have been do deaths. S. Muenchen is one of approximately 2,400 Salmonella serotypes that cause illness in people. S. Muenchen accounts for about 1.6% of human Salmonella cases.

Progress Toward Measles Elimination — Southern Africa, 1996-1998
Mass immunization campaigns conducted in six southern African countries resulted in high vaccination coverage and measles cases and deaths decreased substantially.

PRESS CONTACT:
Dalya Guris, M.D., M.P.H.
CDC, National Immunization Program
(404) 639-8252

Since 1995, six southern African nations (Botswana, Malawi, Namibia, South Africa, Swaziland, and Zimbabwe) have launched measles-elimination initiatives in accordance with the recommendations of the World Health Organization African Regional Office. Strategies include programs to 1) achieve routine vaccination coverage of >95% with one dose of measles vaccine administered at 9 months; 2) implement a one-time national measles vaccination campaign ("catch-up" campaign) to interrupt indigenous transmission of measles; 3) implement periodic national measles campaigns ("follow-up" campaigns) to maintain interruption of transmission; and 4) establish sensitive measles surveillance with laboratory confirmation.

Notice to Readers

Recommendations of the Advisory Committee on Immunization Practices: Revised Recommendations for Routine Polio Vaccination

On June 17, 1999, the ACIP recommended that an all inactivated polio vaccine (IPV) schedule for routine childhood polio immunization be used in the United States. As of January 1, 2000, all children should receive four doses of IPV at 2 months, 4 months, 6-18 months, and 4-6 years of age. Oral polio vaccine should be used only for special circumstances:

Contact: Rebecca Prevots, M.D.
CDC, National Immunization Program
(404) 639-8252

Salmonella

July 16, 1999
Contact: Division of Media Relations
(404) 639-3286

Salmonella is actually a group of bacteria that can cause diarrheal illness in people. Salmonella has been known to cause illness in people for over 100 years.
Every year, approximately 800,000 to 4 million cases of Salmonella result in 500 deaths in the United States. Children are the most likely to get Salmonella. Young children, the elderly, and the immunocompromised are the most likely to have severe infections.
Symptoms of Salmonella include diarrhea, fever, and abdominal cramps that develop 12 to 72 hours after infection. The illness usually lasts 4 to 7 days, and most persons recover without treatment.
If the patient becomes severely dehydrated or the infection spreads from the intestines. Persons with severe diarrhea may require rehydration, often with intravenous fluids. Antibiotics are not usually necessary unless the infection spreads from the intestines.
Salmonella passes from the feces of people or animals, to other people or other animals. There are many different kinds of Salmonella bacteria. Salmonella serotype Typhimurium and Salmonella serotype Enteritidis are the most common in the United States.
Contaminated foods usually look and smell normal. Contaminated foods are often of animal origin, such as beef, poultry, milk, or eggs, but all foods, including vegetables may become contaminated. Food may also become contaminated by the unwashed hands of an infected person handling such food.
Salmonella may also be found in the feces of some pets. Reptiles are particularly likely to harbor the bacteria.
Some Salmonella bacteria have become resistant to antibiotics, largely as a result of the use of antibiotics to promote the growth of feed animals.
There is no vaccine to prevent Salmonella. Therefore, to prevent infection

Do not eat raw or undercooked eggs, poultry, or meat. Raw eggs may be unrecognized in some foods such as homemade hollandaise sauce, caesar and other salad dressings, tiramisu, homemade ice cream, homemade mayonnaise, cookie dough, and frostings.
Poultry and meat, including hamburgers, should be well-cooked, not pink in the middle. Persons also should not consume raw or unpasteurized milk or other dairy products. Produce should be thoroughly washed before consuming.
Cross-contamination of foods should be avoided. Uncooked meats should be keep separate from produce, cooked foods, and ready-to-eat foods. Hands, cutting boards, counters, knives, and other utensils should be washed thoroughly after handling uncooked foods. Hand should be washed before handling any food, and between handling different food items.
Persons infected with Salmonella should not prepare food or pour water for others until they have been shown to no longer be carrying the Salmonella bacterium.
Wash your hands after contact with animal feces. Since reptiles are particularly likely to have Salmonella, everyone should immediately wash their hands after handling reptiles. Reptiles (including turtles) are not appropriate pets for small children and should not be in the same house as an infant.

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