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MMWR – Morbidity and Mortality Weekly Report

News Summary for October 27, 2011

1. Invasive Group A Streptococcus in a Skilled Nursing Facility — Pennsylvania, 2009—2010

Christine Cronkright
Director of Communications
Pennsylvania Department of Health
(717) 787-1783

In September 2010, the Pennsylvania Department of Health was notified of a cluster of invasive group A Streptococcus (GAS) infections among residents of a skilled nursing facility specializing in neurologic and pulmonary care. The investigators determined that, during October 12, 2009–September 22, 2010 at the facility, 10 residents had noninvasive GAS infection, and 13 had invasive GAS infection; two residents with invasive infection died. The investigation identified infection prevention lapses and an association between two or more wounds and GAS infection.  Long-term–care facilities, including skilled nursing facilities, should investigate single cases of invasive GAS infection and ensure that infection prevention measures are fully implemented.Nursing facilities need strong infection prevention programs, with emphasis on hand hygiene and wound care to prevent potentially severe health-care–associated outbreaks of GAS infection.

2.Progress Toward Global Eradication of Dracunculiasis, January 2010—June 2011

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

With fewer than 1,800 dracunculiasis cases reported in 2010 (the lowest annual total ever), only three endemic countries remaining, and 98 percent of cases in shrinking endemic areas of South Sudan, the global Guinea Worm Eradication Program is closer than ever to the goal of stopping transmission by the end of 2012. In 1986, the World Health Assembly called for the elimination of dracunculiasis (Guinea worm disease), a parasitic infection in humans caused by Dracunculus medinensis. At that time, an estimated 3.5 million cases were occurring annually in 20 countries in Africa and Asia.  Since then, tremendous progress has been made towards global dracunculiasis eradication.  In 2010, 1,793 cases were reported from the three remaining endemic countries (Ethiopia, Mali, and South Sudan) and Chad, which is experiencing an ongoing outbreak.  Of the 814 cases reported during January–June 2011, 98 percent were reported from 358 villages in South Sudan. Insecurity in areas of South Sudan and Mali currently poses the greatest threat to the interruption of transmission and the success of the global dracunculiasis eradication campaign.

3. Notice of CDC’s Discontinuation of Investigational Pentavalent (ABCDE) Botulinum Toxoid Vaccine for Workers at Risk of Occupational Exposure to Botulinum Toxins

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

Based on evidence of declining immunogenicity, decreased product potency, increased occurrence of injection site-related adverse reactions, and the age of the product, CDC no longer recommends investigational pentavalent (ABCDE) botulinum toxoid (PBT) for vaccination of workers at risk for occupational exposure to botulinum serotypes A, B, C, D, and E, and will no longer distribute PBT after November 30, 2011. Although investigational PBT was provided on the recognition of potential protective benefit, a serologic correlate of protection was never defined. This change might affect persons working in public health laboratories, research facilities, and manufacturing institutions who work with botulinum toxin or neurotoxin-producing species of Clostridium. Laboratory workers performing research on botulinum toxin should continue to adhere strictly to study-specific safety protocols designed to prevent exposures.


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