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| Press Summaries | |
MMWR articles are embargoed until 4 p.m. Eastern time on Thursday. |
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Click here
for MMWR home page. Synopsis March 5, 1999 Hemolysis Associated with 25%
Human Albumin Diluted with Sterile Water -- United States, 1994-1998 |
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| PRESS CONTACT: Juan Alonso-Echanove, M.D. CDC, National Center for Infectious Diseases (404) 639-6441 |
Human albumin is a sterile solution used in the management of several medical conditions. It is available in various concentrations, all of them formulated for immediate infusion without admixture. Large volumes of 5% albumin are commonly used during therapeutic plasma exchange. When commercial 5% albumin is not available, 25% albumin diluted to a 5% concentration with 0.9% NaCl or, when sodium load is of concern, 5% glucose can be used. If sterile water is used as the diluent, the final product will be hypotonic. Hemolysis may occur as a result of infusing hypotonic solutions to patients, and it can be associated with several complications. Since 1994, in the United States, 10 patients have been reported to suffer hemolysis associated with the infusion of 25% albumin diluted with sterile water for injection. Of these, six developed acute renal failure and another one disseminated intravascular coagulopathy that resulted in death. |
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Availability of Immune Globulin Intravenous for
Treatment of Immune Deficient Patients Since 1997, the United States has had a shortage of Immunoglobulin, intravenous (IGIV). |
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| PRESS CONTACT: Theresa Smith, M.D. CDC, National Center for Infectious Diseases (404) 639-6413 |
IGIV is a life-saving treatment for patients with primary immunodeficiency. A survey conducted by the Immune Deficiency Foundation in 1998, found that of the 268 physicians that responded to the survey, 86% reported difficulty obtaining IGIV. The Food and Drug Administration (FDA) estimates that in 1997 there was a 20% IGIV shortfall, and in 1998 a 30% shortfall. FDA attributes the shortage to production problems, withdrawals for risk of contamination with Creutzfeldt-Jakob Disease (CJD), export of IGIV, changes in packaging, and increased use for both FDA-approved and non-approved indications. The FDA sent a letter to doctors reminding them of the six approved uses for IGIV, and recommended that priority for IGIV use be given to patients who have FDA-approved indications for its use. |
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Nosocomial Group A Streptococcal Infections Associated
with Asymptomatic Health-Care Workers -- Maryland and California, 1997 Hospital-acquired group A strep infections are rare events and may indicate subsequent illness that is preventable. |
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| PRESS CONTACT: Division of Media Relations CDC, Office of Communication (404) 639-3286 |
Group A Streptococcal (GAS) infection is a rare but serious cause of hospital-acquired postpartum and postoperative infections. GAS may be transmitted to patients by asymptomatic healthcare workers who are carrying the organism. When a single episode of postoperative or postpartum GAS is identified, enhanced surveillance and epidemiologic investigation, including screening of healthcare workers, may prevent additional cases. Healthcare workers identified as carriers should refrain from patient care while being treated. The majority of GAS infections are relatively mild illnesses, such as "strep throat" or impetigo. Occasionally, however, these bacteria can reach parts of the body where bacteria are not usually found, such as the blood, deep muscle and fat tissue, or the lungs, and can cause invasive infections. |
| Notice to Readers: | "Conference on Needle-Free Injection Technology" |
| CDC, the U.S. Agency for International Development, the World Health Organization, the Program for Appropriate Technology in Health, and the Association of Needle-Free Injection Manufacturers are co-sponsors of the conference that will be held March 31-April 1999, in Bethesda, Maryland. For more information visit this CDC website http://www.cdc.gov/nip/dev/conference1999-03-31.htm | |
Group A StreptococcusMarch 5, 1999 Group A Streptococcus (GAS) is a bacterium commonly found in the throat and on the skin. GAS can be present in the throat or on the skin and cause no symptoms of disease. The majority of GAS infections are relatively mild, such as "strep throat" or impetigo. Occasionally, however, these bacteria can reach parts of the body where bacteria are not usually found, such as the blood, deep muscle and fat tissue, or the lungs, and can cause invasive infections. GAS is spread by direct contact with secretions from the nose and throat of infected persons or by contact with infected wounds or sores on the skin. The risk of spreading the infection is highest when a person is ill, such as with "strep throat" or an infected wound. Two of the most severe but least common forms of invasive GAS disease are necrotizing fasciitis and streptococcal toxic shock syndrome. Necrotizing fasciitis (sometimes described as "the flesh-eating bacteria") is a destructive infection of muscle and fat tissue. Streptococcal toxic shock syndrome is a rapidly progressing infection causing shock and injury to internal organs such as the kidneys, liver, and lungs. CDC estimates that 500 to 1,500 cases of necrotizing fasciitis and 2,000 to 3,000 cases of streptococcal toxic shock syndrome occur each year in the United States. Approximately 20% of patients with necrotizing fasciitis die, and 60% of patients with streptococcal toxic shock syndrome die. In contrast, several million persons get "strep throat" and impetigo annually. Few people who come in contact with a virulent strain of GAS will develop invasive GAS disease; many will have a routine throat or skin infection, and most will have no symptoms whatsoever. GAS infections can be treated with many different antibiotics. Early treatment may reduce the risk of death in cases of invasive disease, although even appropriate therapy does not prevent death in every case. It is always important to complete the entire course of antibiotics as prescribed. The spread of all types of GAS infections may be reduced by good handwashing, especially after coughing and sneezing, before preparing foods and before eating. Persons with sore throats should be seen by a doctor who can perform tests to find out whether it is "strep throat"; if so, the person should stay home from work, school, or day care until 24 hours or more after taking an antibiotic. All wounds should be kept clean and watched for possible signs of infection: increasing redness, swelling, drainage, and pain at the wound site. A person with signs of an infected wound, especially if fever develops, should seek medical care. |
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