Synopsis for September 21, 2006

The MMWR is embargoed until Thursday, 12 PM EST.

1. Malaria – Great Exuma, Bahamas, May-June 2006
2. Inadvertent Misadministration of Meningococcal Conjugate Vaccine – United States, 2005
3. Effects of Measles-Control Activities – African Region 1999-2005
4. Influenza Update – United States, 2006

Malaria – Great Exuma, Bahamas, May-June 2006

Malaria can be introduced in countries that are not considered endemic for the disease, and health authorities and travelers should be alert to that risk. In May-June 2006, 19 cases of malaria were reported as having been acquired in the island of Great Exuma, The Bahamas. Four of these cases were in travelers from North America and Europe, and most of the other cases were in residents of the Bahamas. This outbreak is unusual because The Bahamas is not considered endemic for malaria. Investigations by the Ministry of Health and the Pan American Health Organization suggest that malaria was introduced into the Bahamas by immigrants from Haiti. Following prompt interventions by the government of the Bahamas (detection and treatment of cases, insecticide spraying and treatment of mosquito breeding sites), the outbreak was contained within one month, with no more cases detected since June 19 2006. The elimination of malaria from the island of Hispaniola (shared by Haiti and the Dominican Republic), the only Caribbean island where malaria still remains endemic, is a desirable objective.

Inadvertent Misadministration of Meningococcal Conjugate Vaccine – United States, 2005

Menactra is licensed for intramuscular administration only. The inadvertent misadministration was most likely due to the fact that the older meningococcal vaccine, MPSV4, is licensed for subcutaneous (beneath the skin) administration and has been in use for nearly 30 years, whereas MCV4 is licensed only for intramuscular administration. The CDC investigation determined that despite the misadministration, persons vaccinated subcutaneously were sufficiently protected and revaccination was not necessary. Also, the frequency and nature of adverse events such as local reactions among persons vaccinated subcutaneously was similar to that reported from the MCV4 licensure trials.

Effects of Measles-Control Activities – African Region 1999-2005

This study demonstrates that the strategies used in the accelerated measles control program in the WHO African Region, when implemented effectively, can result in a sharp drop in measles cases. Reported measles cases in 32 African countries were reduced by 93 percent -- from nearly 203,000 in 1999 to just over 14,000 in 2005 – as a result of large-scale vaccination campaigns, improvements in routine immunization services, case management, and surveillance activities. The remaining children in Africa not yet vaccinated against measles will be targeted for vaccination campaigns by the end of 2006. Successful control of measles in these countries is important to reducing child mortality and reaching global goals of measles mortality reduction. Measles is the leading vaccine-preventable cause of death worldwide, causing nearly half a million deaths annually.

Influenza Update – United States, 2006

No Summary Available

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