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Synopsis for July 19, 2002

The MMWR is embargoed until 12 Noon, ET, Thursdays.

  1. Tetanus ― Puerto Rico, 2002
  2. Pertussis Deaths ― United States, 2000
  3. Hepatitis B Vaccination Among High-Risk Adolescents and Adults ― San Diego, California 1998–2001

Note: There is no telebriefing scheduled for July 18, 2002.

Synopsis for July 19, 2002

Tetanus ― Puerto Rico, 2002

Tetanus vaccine is inexpensive, safe, and effective.

Francisco Alvarado-Ramy, MD

Puerto Rico Department of Health
(787) 274–5527

Between February and May 2002, the Puerto Rico Department of Health (PRDOH) received reports of three tetanus cases, two of which were fatal. None of the three persons had a definite history of prior vaccination with tetanus toxoid and none was younger than 60 years of age. This is consistent with the experience of the United States as a whole where tetanus is associated with lack of vaccination or incomplete vaccination, and more frequently occurs in older age groups. The increased risk in older persons is thought due to the greater likelihood that they never received a primary vaccination series or might not have received subsequent tetanus boosters. Now that the tetanus vaccine shortage has ended, health-care providers should review the vaccination status of all patients and administer tetanus vaccine (Td) as indicated.


Pertussis Deaths ― United States, 2000

Medical care providers should consider pertussis as a cause of new cough illness in persons of all ages.

Kris Bisgard, MD

CDC, National Immunization Program
(404) 639–8255
(Alternate: Kelly Plott, same phone number)

In 2000, 17 pertussis (i.e., whooping cough) deaths were reported in the United States. All deaths occurred in U.S.-born infants who became sick before 4 months of age. Infants vulnerable to Bordetella pertussis infection are those aged <6 months or those who have not yet received 3 doses of diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine. B. pertussis can be transmitted to vulnerable infants by infected parents, siblings, and others. To help prevent additional cases of pertussis, antibiotics can be used to treat persons with pertussis and their close contacts, including exposed infants. Timely vaccination of infants and children according to current recommendations remains the most effective way for parents and health-care providers to prevent pertussis. Infants should receive the first DTaP vaccine at age 2 months, followed by doses at ages 4, 6, and 15–18 months, and a booster dose at age 4–6 years.


Hepatitis B Vaccination Among High-Risk Adolescents and Adults ― San Diego, California 1998–2001

San Diego County has implemented a community-wide hepatitis B vaccination program for high-risk adolescents and adults.

Joanna Buffington, MD, MPH

CDC, National Center for Infectious Diseases
(404) 371–5460

The program has been integrated into existing programs that serve high risk persons, such as clinics for the treatment of sexually transmitted diseases. Approximately 1.2 million persons in the United States have chronic HBV infection, and an estimated 4,000 – 5,000 persons die each year from HBV-related liver diseases. Despite the availability of a safe and effective vaccine that has been recommended for persons at high risk of infection with hepatitis B virus (HBV) infection for more than 20 years, adults and older adolescents with high-risk sex and drug behaviors are still not getting routinely vaccinated.


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This page last reviewed July 18, 2002

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