Report shows 20-year US immunization program spares millions of children from diseases

Report shows 20-year US immunization program spares millions of children from diseases

   April 24, 2014       SNap(R) Group

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Recent measles outbreaks underscore importance of sustaining high vaccination coverage

The CDC estimates that vaccinations will prevent more than 21 million hospitalizations and 732,000 deaths among children born in the last 20 years. Despite the U.S. immunization program’s success, according to CDC officials, 129 people in the U.S. have been reported to have measles this year in 13 outbreaks, as of April 18.

In 1994, the Vaccines for Children program (VFC) was launched in direct response to a measles resurgence in the United States that caused tens of thousands of cases and over a hundred deaths, despite the availability of a measles vaccine since 1963. The VFC program provides vaccines to children whose parents or caregivers might otherwise be unable to afford them.

This year’s 20th anniversary of the VFC program’s implementation is occurring during an increase in measles cases in the U.S. In 2013, 189 Americans had measles. In 2011, 220 people in the U.S. were reported as having measles--the highest number of annual cases since 1996.

"Thanks to the VFC program, children in our country are no longer at significant risk from diseases that once killed thousands each year,” said CDC Director Tom Frieden, M.D., M.P.H. “Current outbreaks of measles in the U.S. serve as a reminder that these diseases are only a plane ride away. Borders can’t stop measles, but vaccination can.”

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Benefits from Immunization During the Vaccines for Children Program Era — United States, 1994–2013

Benefits from Immunization During the Vaccines for Children Program Era — United States, 1994–2013

   April 24, 2014       SNap(R) Group

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The VFC program has contributed to high immunization rates and a dramatic decline of serious diseases like measles in the U.S. Sustaining high vaccination coverage rates is crucial to protecting children from vaccine-preventable diseases that are still common in other parts of the world. The Vaccines for Children program, which provides vaccines to children whose parents or caregivers might otherwise be unable to afford them, has been highly effective improving the health of U.S. children. For children born in the VFC era (1994-2013), CDC reports that vaccination will prevent an estimated 323 million illnesses, 22 million hospitalizations, and 732,000 deaths over the course of their lifetimes and at a net savings of $295 billion in direct costs and $1.38 trillion in total societal costs. Although the VFC is one of our most successful public-private partnerships for improving public health, ongoing effort is needed to sustain immunization rates and ensure children are staying up-to-date with their vaccinations.

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Surveillance Systems to Track Progress Toward Global Polio Eradication — Worldwide, 2012–2013

Surveillance Systems to Track Progress Toward Global Polio Eradication — Worldwide, 2012–2013

   April 24, 2014       SNap(R) Group

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Weaknesses in detecting and investigating cases of paralysis have prevented early recognition of polio outbreaks in the Middle East, Central Africa and the Horn of Africa in 2013 that would have allowed faster outbreak control. To achieve and certify polio eradication, intensive efforts are needed to strengthen and maintain AFP surveillance throughout the world, including in field investigation and collection of specimens, particularly in countries with current or recent active poliovirus transmission and those countries in proximity to those countries. Polio cases are detected by searching for paralyzed children (acute flaccid paralysis [AFP] surveillance) and testing of stool specimens by the laboratories in a global network. The number of countries in Africa and the Middle East meeting national performance targets for disease detection and collection of adequate specimens declined from 27 (90 percent) in 2012 to 22 (73 percent) in 2013, primarily due to weakness in the African Region. Subnational areas of some countries meeting performance criteria still have severe weaknesses in surveillance. The laboratory network is meeting standards for rapid testing of specimens and identification of polioviruses. Intensive efforts are urgently needed to strengthen and maintain polio surveillance globally in countries of Africa, the Middle East and Asian subcontinent where there is current or recent active poliovirus transmission. Polio-free areas in all parts of the world also need to maintain strong polio surveillance.

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Indoor Firing Ranges and Elevated Blood Lead Levels — United States, 2002–2013

Indoor Firing Ranges and Elevated Blood Lead Levels — United States, 2002–2013

   April 24, 2014       SNap(R) Group

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People using or working around indoor firing ranges are being exposed to lead which can cause harmful health effects. Range owners and patrons should follow available guidance to reduce the exposures. Indoor firing ranges are a source of lead exposure to employees, their families, and range customers. From 2002–2012, 1,987 employees of law enforcement and amusement/ recreation industries had elevated blood lead levels (BLL), defined as >10 micrograms of lead per deciliter of blood, as reported by the Adult Blood Lead Epidemiology Surveillance Program. Other workplace investigations in Washington and California have also documented elevated BLLs among firing range employees and found the potential for “take-home” and community exposure to lead. The Occupational Safety and Health Administration’s lead standard is based on lead toxicity information that is now over 30 years old. Current medical information clearly demonstrates harmful effects at levels well below those allowed in the workplace.

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Occupational Ladder Fall Injuries — United States, 2011

Occupational Ladder Fall Injuries — United States, 2011

   April 24, 2014       SNap(R) Group

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Ladder fall injuries represent a substantial public health burden of preventable injuries for workers including Hispanic, male, and older workers in construction, extraction, installation, maintenance, and repair occupations. Employers, healthcare providers and safety professionals should collaborate to ensure availability and training of safe ladder practices both on and off the job. Ladder fall injuries represent a substantial public health burden of preventable injuries for workers. CDC’s National Institute for Occupational Safety and Health (NIOSH) analyzed data across multiple injury surveillance systems to fully characterize fatal and nonfatal injuries associated with ladder falls among workers in the United States. In 2011, work-related ladder fall injuries resulted in 113 fatalities; an estimated 15,460 nonfatal injuries were reported by employers that involved at least one day away from work; and an estimated 34,000 nonfatal injuries were treated in hospital emergency departments. The findings of this study reinforce the need for workplace safety research to prevent falls, including developing and disseminating innovative technologies to prevent LFIs.

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Diagnostic Error in Medicine Conference

Diagnostic Error in Medicine Conference

   April 24, 2014       SNap(R) Group

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Submit Your Abstract Today for September 14-17 DEM Conference in Atlanta

The Diagnostic Error in Medicine 7th International Conference will be held September 14- 17, 2014, in Atlanta, Georgia.  You are invited to submit abstracts that address the epidemiology of diagnostic error, factors that predispose to diagnostic error, and strategies to reduce diagnostic error or improve detection. As an event dedicated to the problem of diagnostic error, the Diagnostic Error in Medicine Conference will provide instruction, insight, dialogue, and tools to enable health care providers to reduce diagnostic harm.

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Outpatient Diagnostic Errors Affect 1 in 20 Adults

Outpatient Diagnostic Errors Affect 1 in 20 Adults

   April 17, 2014       SNap(R) Group

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A new study co-funded by AHRQ found that diagnostic errors—missed opportunities to make a timely or correct diagnosis based on available evidence—occur in about 5 percent of U.S. adults and that about half of those errors could severely harm patients. The study, “The frequency of diagnostic errors in outpatient care: estimations from three large observational studies involving U.S. adult populations,” was published in the April 21 issue of BMJ Quality & Safety.

The study used data from three previous studies of errors in general primary care diagnosis, colorectal cancer diagnosis and lung cancer diagnosis. In all three studies, diagnostic errors were confirmed through rigorous chart review. Diagnostic errors can harm patients by delaying their treatment. For example, a delayed or incorrect cancer diagnosis could make the disease harder to treat or more deadly. The study is significant because it is based on a large sample size and is the most robust estimate thus far to address the frequency of diagnostic error in routine outpatient care. 

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National report card on food safety indicates more can be done

National report card on food safety indicates more can be done

   April 17, 2014       SNap(R) Group

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The nation’s food safety grades are out and the results are mixed. CDC’s annual report card shows that foodborne infections continue to be an important public health problem in the United States.

The rate of salmonella infections decreased by about nine percent in 2013 compared with the previous three years, bringing it to the rate last observed in the 2006-2008 baseline period. But campylobacter infections, often linked to dairy products and chicken, have risen 13 percent since 2006-2008. Vibrio infections, often linked to eating raw shellfish, were at the highest level observed since active tracking began in 1996; however, rates of infections caused by Vibrio vulnificus, the most severe species, have remained steady. Rates of the other foodborne infections tracked have not changed since the period between 2006 and2008.

“CDC data are essential to gauge how we’re doing in our fight against foodborne illness,” said Robert Tauxe, M.D., M.P.H, deputy director of CDC’s Division of Foodborne, Waterborne and Environmental Diseases. “This year’s data show some recent progress in reducing salmonella rates, and also highlight that our work to reduce the burden of foodborne illness is far from over. To keep salmonella on the decline, we need to work with the food industry and our federal, state and local partners to implement strong actions to control known risks and to detect foodborne germs lurking in unsuspected foods.”

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Public health interventions close health equity gaps among diverse U.S. populations

Public health interventions close health equity gaps among diverse U.S. populations

   April 17, 2014       SNap(R) Group

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Evidence-based interventions at the local and national levels provide promising strategies for reducing racial and ethnic health disparities related to HIV infection rates, immunization coverage, motor vehicle injuries and deaths, and smoking, according to a new report by the CDC’s Office of Minority Health and Health Equity.

The report,published today as an MMWR Supplement, describes CDC-led programs addressing some of the health disparities previously highlighted in the CDC Health Disparities and Inequalities Reports, CHDIR, 2011 and 2013. The CHDIR reports highlight differences in mortality and disease risk for multiple conditions related to behaviors, access to health care, and social determinants of health – the conditions in which people are born, grow, live, age, and work.

“Reducing and eliminating health disparities is central to achieving the highest level of health for all people,” said CDC Director Tom Frieden, M.D., M.P.H. “We can close the gap when it comes to health disparities if we monitor the problem effectively and ensure that there is equal access to all proven interventions.”

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Concerns Regarding a New Culture Method for Borrelia burgdorferi Not Approved for the Diagnosis of Lyme Disease

Concerns Regarding a New Culture Method for Borrelia burgdorferi Not Approved for the Diagnosis of Lyme Disease

   April 17, 2014       SNap(R) Group

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Some tests for Lyme disease are not adequately validated and can be misleading to patients and health care providers. Recently, CDC has received inquiries regarding a test that uses a novel culture method to identify Borrelia burgdorferi, the spirochete that causes Lyme disease. Published methods and results for this test were reviewed by CDC. The review raised serious concerns about false-positive results caused by laboratory contamination and the potential for misdiagnosis and improper treatment of patients. This situation highlights the importance of FDA clearance/approval of diagnostic tests, which provides assurance that the test itself has adequate analytical and clinical validation and is safe and effective. CDC recommends that laboratory tests cleared by FDA be used to aid in the routine diagnosis of Lyme disease. 

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Incidence and Trends of Infection with Pathogens Transmitted Commonly Through Food — Foodborne Diseases Active Surveillance Network, 10 Sites, 2006–2013

Incidence and Trends of Infection with Pathogens Transmitted Commonly Through Food — Foodborne Diseases Active Surveillance Network, 10 Sites, 2006–2013

   April 17, 2014       SNap(R) Group

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The partnership of state public health and community organizations can play an Progress in preventing foodborne illnesses has been limited. Salmonella infections decreased slightly in 2013 compared with the preceding 3 years, and are back to levels seen in 2006–2008. The frequency of most other infections tracked in Foodborne Diseases Active Surveillance Network (FoodNet) has not changed much at all; however, Vibrio infections increased in 2013. These findings highlight the need to continue to identify and address food safety gaps that can be targeted for action.Foodborne diseases continue to be an important public health problem in the United States. Progress in preventing these infections has been limited in recent years, as evidenced by a modest decrease in the incidence of Salmonella and an increase in incidence of Vibrio. FoodNet, a foodborne disease surveillance component of CDC's Emerging Infections Program, conducts surveillance in 10 U.S. sites for all laboratory-confirmed infections caused by selected pathogens transmitted commonly through food to help assess whether efforts to decrease illnesses are succeeding. This report describes 2013 surveillance data and trends since 2006; the information contributes to our understanding of the human health impact of foodborne diseases.

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Blood Lead Levels Among Children Aged 1–5 Years — Zamfara State, Nigeria, June–July 2012

Blood Lead Levels Among Children Aged 1–5 Years — Zamfara State, Nigeria, June–July 2012

   April 17, 2014       SNap(R) Group

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Much has been done to address the problems of lead exposure in Zamfara, Nigeria, since the lead poisoning crisis of 2010. New and safer processing techniques that control dust and residual ore wastes, a better understanding of potential exposure to lead contaminated foodstuffs, continued blood lead surveillance, chelation therapy when warranted and environmental cleanup of hazardous sites remain critical. Since 2010, Nigerian government officials and the international community have responded to childhood lead poisoning caused by the processing of lead-containing gold ore in Zamfara State, Nigeria. Widespread education, surveys of high-risk villages, testing and surveillance of blood lead levels (BLLs), medical treatment, and environmental clean-up have all been implemented. To evaluate the current prevalence of lead poisoning and dangerous work practices, a population-based assessment of children’s blood lead levels and ore processing techniques was conducted during June–July 2012. Unlike earlier studies, this assessment found few children in need of medical treatment, lower average BLLs, and less exposure of children to dangerous work practices. Although work remains, when these strategies are successfully implemented, a sustained reduction of blood lead levels in children is possible.

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Coccidioidomycosis Among Cast and Crew Members at an Outdoor Television Filming — California, 2012

Coccidioidomycosis Among Cast and Crew Members at an Outdoor Television Filming — California, 2012

   April 17, 2014       SNap(R) Group

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Anita Gore

Deputy Director, Office of Public Affairs

California Department of Public Health

(916) 440-7259

anita.gore@cdph.ca.gov

Workers, employers, and medical providers should recognize that employees can be exposed to Valley Fever even if they are not directly engaged in soil disruptive work. In 2012, more than 4,000 Californians were diagnosed with Valley Fever, a potentially serious disease caused by inhaling fungal spores common in Central and Southern California. Occupationally acquired Valley Fever most often occurs in people whose work involves digging or working in soil, such as construction workers, military personnel, or archaeologists. However, this study highlights Valley Fever in a group of workers whose occupations do not typically put them at risk of Valley Fever exposure. —The study reports on several members of the cast and crew of a popular TV series who became ill shortly after filming outdoor scenes in Ventura County. Workers, employers, and medical providers should be aware that employees working outdoors in Coccidioides (a fungus that lives in soils)prevalent areas might be exposed to Valley Fever from recent soil disturbances or windy conditions, even if they are not working in the soil.

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