MMWR

Morbidity and Mortality Weekly Report

Anaplasma phagocytophilum Transmitted Through Blood Transfusion – Minnesota, 2007

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Although rare, Anaplasma phagocytophilum, the causative agent of human anaplasmosis, can be transmitted to people through blood transfusions. Physicians should consider the possibility of anaplasmosis in patients who develop compatible illness following a transfusion, and report suspect transfusion-associated cases to local and state health authorities. In November 2007, the Minnesota Department of Health (MDH) was contacted about an A. phagocytophilum infection in a hospitalized Minnesota resident who had recently undergone multiple blood transfusions. A. phagocytophilum causes human anaplasmosis, a tickborne rickettsial disease. A full investigation conducted by MDH determined that the infection likely came from one of the patient′s blood donors. Although transfusion-associated transmission of A. phagocytophilum appears to be rare, reported incidences of anaplasmosis and other tickborne diseases are increasing in the United States. Therefore, physician vigilance for possible transmission of these agents via transfusions also should increase. Physicians should suspect possible rickettsial infection if transfusion recipients develop a severe drop in blood platelets after a transfusion, especially if accompanied by fever. Such signs should lead to rapid assessment for rickettsial agents and, if indicated, immediate treatment with the appropriate antibiotic therapy.

Progress in Introduction of Pneumococcal Conjugate Vaccine – Worldwide, 2000-2008

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Although much progress is being made in the use of pneumococcal vaccine worldwide, these life-saving vaccines are not reaching young children in developing countries that need them most. Pneumococcal disease is a leading cause of childhood mortality globally. Low-income countries, where most of the disease occurs, will benefit most from introduction of pneumococcal conjugate vaccines. As of August 2008, 26 countries offered pneumococcal conjugate vaccines to children as part of national immunization programs or had the vaccine in widespread use; however, none of these countries is a low-income country. The safety and effectiveness of pneumococcal conjugate vaccines justify its use, especially in low-income countries. Much is being done to address historic obstacles to vaccine introduction in both low and middle-income countries. On October 24th, the Pneumococcal Awareness Council of Experts and its partners will issue a Global Call to Action urging access to pneumococcal vaccines for every person who needs them worldwide.

Update: Creutzfeldt-Jakob Disease Associated with Cadaveric Dura Mater Grafts – Japan, 1979-2008

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Because of the long incubation period, possibly exceeding 24.8 years, between the receipt of a dural graft (a cadaver-derived product used by neurosurgeons to patch defects in the substance covering a patient′s brain) and symptom onset, Creutzfeldt-Jakob disease cases associated with dural grafts continue to be identified in Japan, despite preventive measures taken decades earlier. This MMWR submission updates the current status of an ongoing outbreak of dural graft-associated Creutzfeldt-Jakob disease in Japan. CDC played a key role in eliminating the source of the worldwide outbreak in 1987 when the first US case was reported. Despite the manufacturer of the implicated product revising its collection and production procedures at that time as a result of CDC′s investigation, cases continue to be identified due to a long incubation period that may exceed 24.8 years. To date, 132 cases have been reported in Japan, with exposures having occurred during the period 1978-1993. In contrast, only 4 dural graft-associated Creutzfeldt-Jakob disease cases have been reported in the United States.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES