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MMWR – Morbidity and Mortality Weekly Report

1.Varicella Death of an Unvaccinated, Previously Healthy Adolescent — Ohio, 2009

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Varicella (chickenpox) is usually a mild disease, but it can result in severe complications and death. Infants, adults, and immunocompromised people are at increased risk for severe varicella. However, the majority of varicella-related hospitalizations and deaths occur among healthy people. We describe a case of varicella in a previously healthy, unvaccinated 15-year-old that resulted in death. This death may have been prevented by varicella vaccination, which is safe and >95% effective at protecting severe varicella and death. This case serves as a reminder of the importance of routine vaccination of children and catch-up vaccination of older children and adolescents to prevent varicella and its serious complications later in life when disease may be more severe. A highly effective and safe vaccine is available to protect against varicella and its severe complications. Eligible people without evidence of immunity to varicella should receive two doses of the vaccine.

2. Transmission of Strongyloides stercoralis Through Transplantation of Solid Organs — Pennsylvania, 2012

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Strongyloides infection, caused by an intestinal parasite in the tropics and subtropics, can be transmitted from organ donors to recipients. CDC reports that three transplant recipients who received organs from the same donor were infected with the parasite Strongyloides. Infected organ donors may transmit Strongyloides to transplant recipients. Organ transplant recipients are at increased risk of severe disease because their immune systems are affected by the medications they are given. Screening of donors from Strongyloides-endemic areas should be considered to help protect organ recipients. This will allow for preventative treatment of the recipient if infection is confirmed in the donor. Rapid communication among transplant centers and organ procurement organizations is also vital to protect organ recipients when there is a concern for disease transmission.

3. Human Contacts with Oral Rabies Vaccine Baits Distributed for Wildlife Rabies Management — Ohio, 2012

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Baits laden with oral rabies vaccines play an important role in the management of rabies in wildlife. Individuals that come across these baits should avoid touching them; and, also not allow their pets to come into contact with the baits. If a sighting or contact occurs, individuals should call the number on the bait or the local health department. Baits laden with oral rabies vaccines are important for the management of rabies in wildlife. A new oral rabies vaccine consisting of recombinant human adenovirus type 5 vector is being field tested in the United States. Another oral rabies vaccine consisting of recombinant vaccinia vector (V-RG) has been used in the United States for more than 20 years. Though rare, there is a risk of human infection from these vaccines. Out of over 138 million V-RG baits that have been dropped, two human infections have occurred. Baiting strategies therefore attempt to minimize human contact. This article reports that there were no adverse events that occurred in humans or pets during an oral rabies vaccine baiting operation in Ohio in 2012.

4. Evaluating Surveillance Indicators Supporting the Global Polio Eradication Initiative, 2011–2012

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Poliovirus transmission is at an all-time low:  While surveillance has improved in some countries from 2011 to 2012, further strengthening is needed to ensure that all poliovirus spread is promptly detected. During 2011-2012 the Global Polio Eradication Initiative made significant progress. Polio eradication was declared a global programmatic public health emergency in 2012 resulting in focused efforts and notable gains. The number of countries with WPV (wild poliovirus) transmission decreased from 16 to five; WPV cases decreased from 650 to 223; and India was removed from the endemic country list  leaving only three polio endemic countries (Afghanistan, Pakistan and Nigeria). A surveillance system is in place to track progress in polio eradication. The surveillance system searches for new onset paralysis with testing of stool specimens in an accredited laboratory, which is part of a global laboratory network. This is complemented in some specific areas with testing of sewage for poliovirus.



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