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MMWR – Morbidity and Mortality Weekly Report

News Summary for December 22, 2011

1. Transmission of Hepatitis C Virus by Transplanted Organs and Tissues — Kentucky and Massachusetts, 2011

CDC
Division of News & Electronic Media           
(404) 639-3286

This report highlights the limitation of HCV antibody testing and the need for consideration of HCV NAT screening for organ donors.  A donor transmitted hepatitis C virus (HCV) to recipients of two kidneys and one blood vessel tissue patch because of problems with testing.  Because the donor likely was recently infected, the antibody test did not detect infection.  In addition, an HCV nucleic acid test (NAT) performed for tissue screening was incorrectly read. Ultimately, repeat NAT testing confirmed the donor was HCV positive at the time of donation. HCV antibody testing alone might not be adequate to detect disease in organ donors with recent infection; HCV NAT screening for organ donors should be considered to prevent such transmissions. Also, word about possible risk of disease transmission was not received by one surgeon implanting tissue until after the vessel had already been implanted, resulting in further infection.  Without a real-time communication network, implantation of infected tissue occurred after recognition of the infected kidney recipients. Rapid communication of information on suspected transplantation transmission to all agencies involved in organ and tissue procurement is necessary to prevent future and similar events.

2. Food Safety Epidemiology Capacity in State Health Departments — United States, 2010

University of Michigan
School of Public Health
(734) 936-1623

Ensuring adequate epidemiology capacity in foodborne disease programs is essential for the timely detection, investigation, control, and prevention of foodborne disease outbreaks. In order to reach full program capacity to effectively address food borne diseases, states need more epidemiologists working in food safety with additional training opportunities for existing staff, greater investment in information technologies to improve detection and response capacity, and continued progress in building the relationship between state and local health departments and the collaborating federal agencies responsible for the control and prevention of food borne disease.  The 2010 CSTE Food Safety Epidemiology Capacity Assessment found that in 2010, states reported a need for 304 more FTEs working in food safety to reach full program capacity, with the greatest demand for master’s level epidemiologists. Barriers reported most often by states to investigating foodborne outbreaks included delayed notification of the outbreak, lack of sufficient number of foodborne safety staff, lower prioritization of investigations, lack of ability to pay overtime, and lack of adequate epidemiology expertise.

3. Recommendations on the Use of Quadrivalent Human Papillomavirus Vaccine in Males — Advisory Committee on Immunization Practices (ACIP), 2011

CDC
Division of News & Electronic Media           
(404) 639-3286

CDC recommends quadrivalent HPV vaccine (Gardasil) for all boys at ages 11 or 12 years. Quadrivalent HPV vaccine is also recommended for boys and young men aged 13 through 21 years. Quadrivalent HPV vaccine is safe and effective for men through age 26 years, but to have most benefit, it is best given to young men and boys; men aged 22 through 26 years may receive vaccine.  Men who have sex with men (MSM, or gay/bisexual men) and men with an immunocompromising condition, such as HIV infection, should receive the vaccine through age 26 years. This HPV vaccine recommendation for males replaces the guidance provided by ACIP in October, 2009, that vaccine may be given to males aged 9 through 26 years.  Quadrivalent HPV was found to have high efficacy for prevention of genital warts and anal precancers in men. With these recommendations in place, HPV vaccine is now recommended for all boys and girls at age 11 or 12 years.  One vaccine (quadrivalent HPV vaccine, Gardasil) is recommended for males. Two vaccines (Gardasil and Cervarix) are available for females, and either is recommended.

4. Use of Hepatitis B Vaccination for Adults with Diabetes Mellitus: Recommendations of the Advisory Committee on Immunization Practices (ACIP)

CDC
Division of News & Electronic Media           
(404) 639-3286

Infection control practice in diabetes care and glucose monitoring is critical to prevent infections carried in small amounts of blood. Persons with diagnosed diabetes are at increased risk of hepatitis B infection.  This occurs through exposure to small (even invisible) amounts of blood from an infected person who earlier used a shared medical or glucose-monitoring device.  Hepatitis B virus can infect the body fluids of persons who do not know they carry it.  The virus is stable outside the body and easily transmitted.  Exposures can occur, for example, when finger-stick devices or blood glucose monitors designed for one individual are used for more than one person without appropriate cleaning or infection control practice.  For this reason, the Advisory Committee on Immunization Practices (ACIP) recommended hepatitis B vaccination for all unvaccinated adults with diabetes through age 59 years, and hepatitis B vaccination for older, unvaccinated adults with diabetes at the discretion of their physician.  Initiatives are ongoing to improve infection control training of staff responsible for providing or assisting with diabetes care, and to improve the design and labeling of devices used in diabetes monitoring and treatment.

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