Past Updates from the Clinician Registry Listserv
Update Sent January 22, 2008
NOTE: This document is provided for historical purposes only and may not provide our most accurate and up-to-date information. The most current Clinician's information can be found on the Clinician Home Page.
Today's topics Include:
- Recall of Am2Pat Prefilled Syringes
- Recommendations Regarding Use of OTC Cough and Cold Products
- Brucella
- MRSA in Men Who Have Sex with Men
- Avian Influenza
- Seasonal Influenza
- Real-Time Test for Respiratory Viruses
- Travelers' Health
- Food Borne Illness
Recall of Am2Pat Prefilled Syringes
Update: Recall of Am2Pat Prefilled Syringes Because of Possible Serratia Contamination - CDC - Jan 17
CDC has been notified that Am2Pat intends to extend the recall of prefilled heparin and saline flush syringes to encompass all distributed lots of these products, because of concerns these syringes may be contaminated with Serratia marcescens. On December 20, 2007, Am2Pat recalled one lot of prefilled heparin flush syringes (http://www.fda.gov/oc/po/firmrecalls/am2pat12_07.html). CDC has been informed that the recall will now apply to all prefilled heparin and saline flush syringes made by Am2Pat. These syringes were manufactured by Am2Pat and may be labeled as: Am2Pat, Sierra Pre-filled, or B. Braun. These products will all bear the National Drug Code or NDC prefix of: 64054. They have been distributed to in-patient and out-patient facilities and directly to patients by home-care companies. Patients and clinicians should immediately stop using these products. Persons who have questions regarding the manufacturer of prefilled syringes they are using should call the supply company that provided the syringes. Local health departments who identify cases of Serratia bloodstream infections among patients who might have been exposed to these products are asked to report to their state health departments, who in turn are asked to contact David Blossom, Division of Healthcare Quality Promotion, CDC, at dblossom@cdc.gov or (404) 639-4514.
Recommendations Regarding Use of OTC Cough and Cold Products
Products should not be used in children under 2 years of age - FDA - Jan.17
The FDA today issued a Public Health Advisory for parents and caregivers, recommending that over-the-counter (OTC) cough and cold products should not be used to treat infants and children less than 2 years of age because serious and potentially life-threatening side effects can occur from such use. OTC cough and cold products include decongestants, expectorants, antihistamines, and antitussives (cough suppressants) for the treatment of colds. There are a wide variety of rare, serious adverse events reported with cough and cold products. They include death, convulsions, rapid heart rates, and decreased levels of consciousness. The announcement does not include the FDA's final recommendation about use of OTC cough and cold medicines in children ages 2 to 11 years. The agency's review of data for 2-to-11-year-olds is continuing.
http://www.fda.gov/bbs/topics/NEWS/2008/NEW01778.html
Brucella
Update: Potential Exposures to Attenuated Vaccine Strain Brucella abortus RB51 During a Laboratory Proficiency Test - MMWR - Jan 18
In November 2007, New York State Department of Health (NYSDOH) officials notified CDC of potential exposures to attenuated vaccine strain Brucella abortus RB51 (RB51) in multiple clinical laboratories that participated in a Laboratory Preparedness Survey (LPS) proficiency test. NYSDOH conducted a survey of participating laboratories and identified 17 laboratories that reported handling the RB51 sample in a manner placing lab workers at potential risk for exposure. Subsequently, CDC recommended that public health officials conduct a review of biosafety practices at all LPS-participating laboratories to identify any additional RB51 exposures. This report summarizes the results of investigations in 36 states, two cities, one county, and the District of Columbia. As of January 14, 2008, follow-up by public health officials with LPS-participating laboratories throughout the United States identified a total of 916 laboratory workers in 254 laboratories with potential RB51 exposure. The results highlight the need for routine adherence to recommended biosafety practices when working with infectious organisms, particularly during widespread infectious-disease events, including bioterrorism attacks. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5702a2.htm
Laboratory-Acquired Brucellosis - Indiana and Minnesota, 2006 - MMWR - Jan 18
In November 2006, two cases of brucellosis in microbiologists at two clinical laboratories were reported to state health departments in Indiana and Minnesota. This report summarizes the investigation conducted jointly by the Minnesota Department of Health, Indiana State Department of Health, and CDC, provides guidance on safe laboratory handling of Brucella spp., and makes recommendations for responding to Brucella laboratory exposures. The results of that investigation determined that 146 workers at the two laboratories had been exposed to Brucella and that, although two Brucella isolates had been handled by both laboratories, infections in the two microbiologists were caused by two unrelated isolates. Because Brucella spp. pose a risk for aerosol-transmitted infection, CDC recommended risk assessment for all Brucella-exposed laboratory workers, postexposure prophylaxis (PEP) for those at high risk, surveillance for symptoms of disease, and serologic follow-up with workers. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5702a3.htm
MRSA in Men Who Have Sex with Men
CDC Statement on MRSA in Men Who Have Sex with Men - Jan 16
MRSA is a common cause of skin infections throughout the United States. These infections occur in men, women, adults, children, and persons of all races and sexual orientations, and are known to be transmitted by close skin-to-skin contact. In this issue of the Annals of Internal Medicine, Diep et al looked at isolates of MRSA - USA300 strains containing a particular plasmid associated with additional drug resistance. The paper shows that multidrug-resistant USA300 has emerged as an important source of disease among men who have sex with men (MSM) in 2 geographically distinct communities. MRSA is typically transmitted through skin-to-skin contact, which occurs during a variety of activities, including sex. There is no evidence at this time to suggest that it MRSA is a sexually-transmitted infection in the classical sense. Therefore, CDC believes that our recommended prevention measures for CA-MRSA in general are also the most appropriate response to the strains described among MSM. http://www.cdc.gov/od/oc/media/pressrel/2008/t080116.htm
Avian Influenza
Avian influenza – situation in Indonesia - WHO update - Jan. 21
The Ministry of Health of Indonesia has announced a new case of human infection of H5N1 avian influenza. An 8-year-old male from Tangerang District, Banten Province developed symptoms on 7 January 2008, was hospitalized on 16 January and died in an AI referral hospital on 18 January. Investigations into the source of his infection are ongoing, however initial reports indicate the case lived in close proximity to a chicken slaughter house. Of the 119 cases confirmed to date in Indonesia, 97 have been fatal.
http://www.who.int/csr/don/2008_01_21/en/index.html
Cumulative Number of Confirmed Human Cases of Avian Influenza A/H5N1- WHO - Jan. 21
http://www.who.int/csr/disease/avian_influenza/country/cases_table_2008_01_21/en/index.htmll
Seasonal Influenza
Weekly Report: Influenza Summary Update - Jan. 18
During week 2 (January 6 - 12, 2008), influenza activity continued to increase in the United States. Two hundred eighty-three (9.8%) specimens tested by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories were positive for influenza. The proportion of deaths attributed to pneumonia and influenza was equal to the epidemic threshold. The proportion of outpatient visits for influenza-like illness (ILI) was above national baseline levels, and the proportion of outpatient visits for acute respiratory illness (ARI) was below national baseline levels. The East North Central, Mountain, Pacific, West North Central, and West South Central regions reported ILI above their region-specific baselines. Four states reported widespread influenza activity; 11 states reported regional influenza activity; the District of Columbia and15 states reported local influenza activity; 19 states reported sporadic influenza activity; and one state reported no influenza activity.
http://www.cdc.gov/flu/weekly/index.htm
Weekly US Map - Jan. 18
http://www.cdc.gov/flu/weekly/usmap.htm
Real-Time Test for Respiratory Viruses
FDA Clears for Marketing Real-Time Test for Respiratory Viruses - FDA - Jan.18
The FDA has cleared for marketing a test that simultaneously detects four common respiratory viruses, including the flu, in a patient’s respiratory secretions. The ProFlu+ test provides results in as few as three hours. Other diagnostic tests for respiratory viruses are fast but not as accurate or are accurate but not as rapid. The real-time test employs a multiplex platform that allows several tests to be processed using the same sample to detect influenza A virus, influenza B virus, and respiratory syncytial virus A and B (RSV). These viruses can cause influenza, an infection of the airways called bronchiolitis, and pneumonia. All are among the leading causes of lower respiratory tract infections.
http://www.fda.gov/bbs/topics/NEWS/2008/NEW01780.html
Travelers' Health
Outbreak Notice: Yellow Fever Alert for Brazil - CDC - Jan.18
On January 8, 2008, the Brazilian Ministry of Health (MOH) announced a yellow fever disease alert for tourists and diplomats residing in Brazil, due to a number of suspected and confirmed human yellow fever cases during December 2007 and January 2008. As of January 16, 2008, 10 confirmed cases of Yellow Fever have been reported, including seven deaths. The Brazilian MOH alert states that travelers to “areas of risk” for yellow fever should be vaccinated 10 days before going to such areas. In addition to areas previously identified in CDC’s guidance to travelers, the Brazilian MOH has identified two additional states with yellow fever risk: the northern part of Espiritu Santo and the western part of Santa Catarina.
http://wwwn.cdc.gov/travel/contentYellowFeverBrazil.aspx
Yellow Fever Vaccine Shortage - CDC - Jan.17
The Centers for Disease Control and Prevention (CDC) has recently become aware of a temporary shortage of single-dose vials of YF-VAX®, the only yellow fever vaccine marketed in the United States. The 5-dose vials of YF-VAX® continue to be available in sufficient supply. According to the manufacturer, sanofi pasteur, there is no shortage of the vaccine itself, but there is a temporary issue related to the specialized production equipment necessary to insert the vaccine into single-dose vials. To accommodate all travelers who need this vaccine, clinics administering vaccine are advised to attempt to schedule vaccinations to efficiently use 5-dose vials. According to the manufacturer’s package insert, YF-VAX® must be used within one hour of reconstitution.
http://wwwn.cdc.gov/travel/contentYellowFeverVaccineShortage.aspx
Food Borne Illness
FDA Warns Public of Possible Botulism Risk: New Era Recall Expanded for Canned Green Beans and Garbanzo Beans - FDA - Jan.18
The U.S. Food and Drug Administration (FDA) today announced that New Era Canning Company, New Era, Mich., is expanding its product recall because of potential Clostridium botulinum (C. botulinum) contamination to all canned green beans and garbanzo beans distributed by the company nationwide over the last five years. C. botulinum can cause botulism, a serious and sometimes life-threatening condition. The affected cans are large institutional-sized containers, weighing approximately six and a half pounds. To date, no illnesses have been reported to the FDA; however, consumers should not consume these products, even if they appear to be normal, because of the potential serious risk to health. Consumers who have the affected products or who have used them in recipes should immediately throw the cans and food away.
http://www.fda.gov/bbs/topics/NEWS/2008/NEW01782.html
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Page last modified January 22, 2008
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