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PubMed2005

Prevention and control of meningococcal disease. Recommendations of the Advisory Committee on Immunization Practices (ACIP).

In January 2005, a tetravalent meningococcal polysaccharide-protein conjugate vaccine ([MCV4] Menactra, manufactured by Sanofi Pasteur, Inc., Swiftwater, Pennsylvania) was licensed for use among persons aged 11-55 years. CDCns Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination of young adolescents (defined in this report as persons aged 11-12 years) with MCV4 at the preadolescent health-care visit (at age 11-12 years). Introducing a recommendation for MCV4 vaccination among young adolescents might strengthen the role of the preadolescent visit and have a positive effect on vaccine coverage among adolescents. For those persons who have not previously received MCV4, ACIP recommends vaccination before high-school entry (at approximately age 15 years) as an effective strategy to reduce meningococcal disease incidence among adolescents and young adults. By 2008, the goal will be routine vaccination with MCV4 of all adolescents beginning at age 11 years. Routine vaccination with meningococcal vaccine also is recommended for college freshmen living in dormitories and for other populations at increased risk (i.e., military recruits, travelers to areas in which meningococcal disease is hyperendemic or epidemic, microbiologists who are routinely exposed to isolates of Neisseria meningitidis, patients with anatomic or functional asplenia, and patients with terminal complement deficiency). Other adolescents, college students, and persons infected with human immunodeficiency virus who wish to decrease their risk for meningococcal disease may elect to receive vaccine. This report updates previous reports from ACIP concerning prevention and control of meningococcal disease. It also provides updated recommendations regarding use of the tetravalent meningococcal polysaccharide vaccine (MPSV4) and on antimicrobial chemoprophylaxis.

Adolescent↗
PubMed2000

Glycopeptide prescribing in a tertiary referral paediatric hospital and applicability of hospital infection control practices advisory committee (HICPAC) guidelines to children.

UNLABELLED: This study was undertaken to investigate the frequency of, indications for and appropriateness of glycopeptide prescription in a paediatric tertiary referral hospital and to assess the usefulness of the Hospital Infection Control Practices Advisory Committee (HICPAC) guidelines. A prospective audit of all systemic glycopeptide prescriptions over a 2-month period was undertaken. Clinical and microbiological data were recorded. Of 2810 hospital admissions, systemic IV glycopeptides were prescribed on 57 occasions to 50 patients, 30 (52.6%) for vancomycin and 27 (47.4%) for teicoplanin. Prescriptions were for 34 males and 23 females aged from 2 weeks to 11 years (mean 15 months; median 9 months). Median hospital stay was 50 days. Glycopeptides were given to the following patient groups: cardiology 7 (12%), prophylaxis for cardiac surgery 11 (19%), post-cardiac surgery 1 (1.8%), oncology 14 (24.6%), post-gastrointestinal tract surgical 8 (14%), general surgical 9 (15. 8%) and medical 7 (12.3%). Twenty three children (41.8%) had central lines in situ. Reason for use of glycopeptide was therapeutic in 7 (12.3%), empiric in 38 (66.7%), and as prophylaxis in 12 (21.1%). Eight (14%) prescriptions met strict HICPAC criteria, but a further 22 (39%) prescriptions were considered appropriate in this high-risk population. Glycopeptides were chosen appropriately for cardiac surgery prophylaxis in a further 10 (18%) but timing and duration of use in this group was inappropriate. Of all prescriptions, use was empiric in 38 (76%) and appropriate cultures were obtained at the time of commencement in only 13 (34%) of these. Glycopeptides were not used for routine surgical prophylaxis or for first-line empiric treatment of febrile neutropenia. CONCLUSIONS: The strict implementation of HICPAC guidelines may not always be appropriate for children at risk of beta-lactam resistant gram-positive infections. Hospital guidelines need to be tailored to the patient population and microbial susceptibility patterns of each institution. Appropriate cultures should be obtained at the time glycopeptide treatment is begun so that duration of exposure can be limited.

Child↗
PubMed2002

The cardiothoracic surgery workforce in Australia: supply and requirements 2000-2011. Report of the Australian Medical Workforce Advisory Committee 2001.

To establish a national profile of the current cardiothoracic surgery workforce and advise the Australian Government on workforce requirements to 2011, the Cardiothoracic Surgery Workforce Working Party brought down a report in May 2001 to The Australian Medical Workforce Advisory Committee. The survey data were taken from half the current Fellows of the Royal Australian College of Surgeons engaged in cardiothoracic surgery. Australian cardiothoracic surgeons are typically middle-aged males working more than 60 h per week. Their work has both private and public sector components and most surgeons provide services in both cardiac and thoracic surgery to an average catchment of 180 000 people. Concentrated in the capital cities, mainly on the eastern seaboard, they devote 90% of their working hours to service delivery, with little time spent in research and developmental aspects of their profession, or in administrative roles. The committee provided 10-year projections for surgical services, predicting an annual growth in service requirements of 1.8% in Australia to 2011. The report concludes that maintenance of the present intake of surgical trainees at five per year - offset by the projected retirements of 2.7 surgeons annually - will be sufficient to meet demand. This conclusion is based on an assumption of a decade of unchanged national health structures and patterns of workforce participation and service delivery.

Journal Article↗
PubMed1999

Prevention of hepatitis A through active or passive immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP).

Routine vaccination of children is the most effective way to reduce hepatitis A incidence nationwide over time. Since licensure of hepatitis A vaccine in 1995, this strategy has been implemented incrementally, starting with the recommendation of the Advisory Committee on Immunization Practices (ACIP) in 1996 to vaccinate children living in communities with the highest rates of infection and disease. These updated recommendations represent the next phase of this hepatitis A immunization strategy. Vaccination of children living in states and communities with consistently elevated rates of hepatitis A will provide protection from disease and is expected to reduce the overall incidence of hepatitis A. This report updates the ACIP's 1996 recommendations on the prevention of hepatitis A through immunization (MMWR 1996;45:[No. RR-151) and includes a) new data about the epidemiology of hepatitis A; b) recent findings about the effectiveness of community-based hepatitis A vaccination programs; and c) recommendations for the routine vaccination of children in states, counties, and communities with rates that are twice the 1987-1997 national average or greater (i.e., > or = 20 cases per 100,000 population) and consideration of routine vaccination of children in states, counties, and communities with rates exceeding the 1987-1997 national average (i.e., > or = 10 but <20 cases per 100,000 population). Unchanged in this report are previous recommendations regarding the vaccination of persons in groups at increased risk for hepatitis A or its adverse consequences and recommendations regarding the use of immune globulin for protection against hepatitis A.

Adult↗
PubMedDate not supplied

A comprehensive assessment of National Health Program Guidelines in Canada: management review and redirections. Guidelines developed under the auspices of the Federal, Provincial and Territorial Advisory Committee on Institutional and Medical Services (ACIMS).

A comprehensive audit of the Health Program Guidelines in Canada was undertaken between January and September 1992. This review examined the strategic effectiveness and operational efficiency of the guidelines developed under the auspices of the Federal, Provincial and Territorial Advisory Committee on Institutional and Medical Services (ACIMS). To assess the perceived management utility of the guidelines, over 185 structured mail questionnaires were sent to a random representative sample of health care managers stratified by type of health-related organization and Canadian province and territory. With a response rate of over 80.5%, a profile of management perceptions of the need for the current Program Guidelines was created. In tandem an internal review of the efficiency and effectiveness of the design and development of the Guidelines was conducted using over 45 structured interviews with key informants. Both components of the comprehensive audit provided the basis of report recommendations that are relevant to the Canadian health system community.

Canada↗
PubMed2000

Endocrine-disrupting chemicals: prepubertal exposures and effects on sexual maturation and thyroid function in the male rat. A focus on the EDSTAC recommendations. Endocrine Disrupter Screening and Testing Advisory Committee.

Puberty in mammalian species is a period of rapid interactive endocrine and morphological changes. Therefore, it is not surprising that exposure to a variety of pharmaceutical and environmental compounds has been shown to dramatically alter pubertal development. This concern was recognized by the Endocrine Disrupter Screening and Testing Advisory Committee (EDSTAC) that acknowledged the need for the development and standardization of a protocol for the assessment of the impact of endocrine-disrupting compounds (EDC) in the pubertal male and recommended inclusion of an assay of this type as an alternative test in the EDSTAC tier one screen (EPA, 98). The pubertal male protocol was designed to detect alterations of pubertal development, thyroid function, and hypothalamic-pituitary-gonadal (HPG) system peripubertal maturation. In this protocol, intact 23-day-old weanling male rats are exposed to the test substance for 30 days during which pubertal indices are measured. After necropsy, reproductive and thyroid tissues are weighed and evaluated histologically and serum taken for hormone analysis. The purpose of this review was to examine the available literature on pubertal development in the male rat and evaluate the efficacy of the proposed protocol for identifying endocrine-disrupting chemicals. The existing data indicate that this assessment of puberty in the male rat is a simple and effective method to detect the EDC activity of pesticides and toxic substances.

Animals↗
PubMed1994

Preventing the Spread of Vancomycin Resistance--A Report from the Hospital Infection Control Practices Advisory Committee prepared by the Subcommittee on Prevention and Control of Antimicrobial-Resistant Microorganisms in Hospitals; comment period and public meeting--CDC. Notice.

This notice is a request for review and comment of the draft document, Preventing the Spread of Vancomycin Resistance--A Report From the Hospital Infection Control Practices Advisory Committee (HICPAC) Prepared by the Subcommittee on Prevention and Control of Antimicrobial-Resistant Microorganisms in Hospitals. The draft document was prepared in collaboration with the National Center for Infectious Diseases (NCID), CDC, and representatives of the American Hospital Association, American Society for Microbiology, Association for Professionals in Infection Control and Epidemiology, Infectious Diseases Society of America, Society for Healthcare Epidemiology of America, and Surgical Infection Society.

Centers for Disease Control and Prevention, U.S.↗
PubMedDate not supplied

Post-marketing surveillance of drugs. The spontaneous reporting scheme: role of the Adverse Drug Reactions Advisory Committee.

Post-marketing surveillance of drugs in Australia operates predominantly through the spontaneous reporting of suspected adverse drug reactions (ADRs). Approximately 50% of reports are submitted by hospitals and the rest by individual doctors, pharmacists and dentists. Some 4500 reports ("blue cards") are now reviewed annually by the Adverse Drug Reactions Advisory Committee (ADRAC) and its Secretariat. The register of ADRs has now accumulated more than 65,000 reports. Collations and analyses of data derived from the review process are published to increase awareness by health professionals of drug associated morbidity. Continued educational efforts by professional bodies and regulatory agencies will play a key role in rationalising drug use and reducing drug induced disease.

Australia↗
PubMedDate not supplied

Health consequences of using smokeless tobacco: summary of the Advisory Committee's report to the Surgeon General.

On March 25, 1986, the Surgeon General of the Public Health Service released a report that detailed the results of the first comprehensive, indepth review of the relationship between smokeless tobacco use and health. This review, prepared under the auspices of the Surgeon General's Advisory Committee on the Health Consequences of Using Smokeless Tobacco, is summarized in this article. In the United States, smokeless tobacco is used predominantly in the forms of chewing tobacco and snuff. During the past 20 years, the production and consumption of these products have risen significantly in marked contrast to the decline in smokeless tobacco use during the first half of the century. National estimates indicate that more than 12 million persons age 12 and older in the United States used some form of smokeless tobacco in 1985, and half of these were regular users. The highest rates of smokeless tobacco use occurred among adolescent and young adult males. Examination of the relevant epidemiologic, experimental, and clinical data revealed that oral use of smokeless tobacco is a significant health risk. This behavior can cause cancer in humans, and the evidence is strongest for cancer of the oral cavity, particularly at the site of tobacco placement. Smokeless tobacco use can also lead to the development of noncancerous oral conditions, particularly, oral leukoplakias and gingival recession. Further, the levels of nicotine in the body resulting from smokeless tobacco can lead to nicotine addiction and dependence.

Adolescent↗
PubMed1990

National Advisory Committee on Immunization (NACI).

As the epidemiology of measles evolves and new data become available, it is essential to review the current vaccination policy and make any necessary adjustments. The result of such a review process is the following new statement on the recommended use of measles vaccine in Canada issued by the National Advisory Committee on Immunization. There may be further changes in the future as more data become available.

Adolescent↗
PubMed1981

Tasmanian Thyroid Advisory Committee. Study in disease surveillance, 1950-1979.

Tasmania has had a long-standing endemic goitre problem. Attempts over the period from 1949 to 1965 to correct iodine deficiency in school-children and young women met with only partial success. In 1966, iodization of bread was introduced with suitable legislative authority. Within six months, an increased incidence of thyrotoxicosis was noted in thyroid clinics in Launceston and Hobart. In 1967, a Thyroid Advisory Committee was set up to advise the Minister of Health. This Committee included clinicians, nutritionists, epidemiologists, and subsequently veterinarians and dairy technologists as well as members of public health departments. A number of contributions to the scientific literature have been made by individual members. However, the major function of the Committee has been to provide multidisciplinary investigation and review of findings related to the increased incidence of thyrotoxicosis. The Committee has played an important role in an area of environmental surveillance. It provides a useful precedent for the monitoring of other environmental situations-and a reminder of the need to anticipate unexpected health consequences after community intervention measures.

Adolescent↗
PubMed2000

Advice on the response from public and environmental health to the detection of cryptosporidial oocysts in treated drinking water. PHLS Advisory Committee on Water and the Environment.

New water quality regulations in the United Kingdom (UK) will lead to the regular sampling of water supplies for the presence of cryptosporidial oocysts. It is likely therefore that consultants in communicable disease control (CCDCs) and environmental health officers (EHOs) will be informed of the presence of oocysts in water supplies rather more often. These guidelines were developed, by an ad hoc working group of the PHLS Advisory Committee on Water and the Environment, to help CCDCs and EHOs respond to such reports. The implications for public health of oocysts in treated water supplies is still not fully understood. Nevertheless, on the basis of the available evidence, these guidelines suggest an approach to planning, to deciding what information is required on initial contact, and an approach to health risk assessment. The guidelines also suggest possible strategies for managing such situations. It is accepted, however, that the vast majority of reports of positive samples will require no intervention. It is essential that CCDCs and EHOs work well with their colleagues in the water companies in undertaking a health risk assessment and responding appropriately.

Animals↗
PubMed1999

Recommendations for the use of Lyme disease vaccine. Recommendations of the Advisory Committee on Immunization Practices (ACIP)

This report provides recommendations for use of a newly developed recombinant outer-surface protein A (rOspA) Lyme disease vaccine (LYMErix, SmithKline Beecham Pharmaceuticals) for persons aged 15-70 years in the United States. The purpose of these recommendations is to provide health-care providers, public health authorities, and the public with guidance regarding the risk for acquiring Lyme disease and the role of vaccination as an adjunct to preventing Lyme disease. The Advisory Committee on Immunization Practices recommends that decisions regarding vaccine use be made on the basis of assessment of individual risk, taking into account both geographic risk and a person's activities and behaviors relating to tick exposure.

Adolescent↗
PubMed2001

Development of community- and state-based immunization registries. CDC response to a report from the National Vaccine Advisory Committee.

Immunization registries are confidential, population-based computerized systems that contain information regarding children's vaccinations. Registries provide a critical tool for increasing and sustaining vaccination coverage. A national health objective for 2010 is to increase to 95% the proportion of children aged <6 years who participate in fully operational population-based immunization registries. According to 2000 data, 24% of U.S. children are participating in population-based immunization registries. In 1998, to facilitate community- and state-based immunization registry development in the United States, the National Vaccine Advisory Committee (NVAC) launched the Initiative on Immunization Registries. Through public hearings and parent focus groups, NVAC identified four concerns that needed to be addressed to increase registry participation: a) protecting each person's privacy and the confidentiality of registry information; b) ensuring participation of vaccination providers and recipients; c) overcoming technical and operational challenges; and d) determining resources needed to develop and maintain immunization registries. In January 1999, NVAC approved the report Development of Community- and State-Based Immunization Registries (available at ; accessed July 30, 2001). The following report summarizes NVAC's recommendations and describes CDC's National Immunization Program activities in response to NVAC's recommendations.

Centers for Disease Control and Prevention, U.S.↗
PubMed1992

Pertussis vaccination: acellular pertussis vaccine for reinforcing and booster use--supplementary ACIP statement. Recommendations of the Immunization Practices Advisory Committee (ACIP).

This supplementary statement provides information on and recommendations for the use of diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP). One such vaccine was recently licensed, ACEL-IMMUNE.* This vaccine is licensed for use only as the fourth and fifth doses of diphtheria, tetanus, and pertussis vaccination; it is not licensed for the initial three-dose series in infants and children, regardless of age. At least one other DTaP product is anticipated to be licensed in the future for use as the fourth and fifth doses. The current Immunization Practices Advisory Committee (ACIP) statement on diphtheria, tetanus, and pertussis issued August 8, 1991, gives general recommendations on pertussis prevention, including the use of whole-cell pertussis vaccines for primary and booster vaccination (1).

Child, Preschool↗
PubMed1999

Guideline for Prevention of Surgical Site Infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee.

EXECUTIVE SUMMARY The "Guideline for Prevention of Surgical Site Infection, 1999" presents the Centers for Disease Control and Prevention (CDC)'s recommendations for the prevention of surgical site infections (SSIs), formerly called surgical wound infections. This two-part guideline updates and replaces previous guidelines.1,2 Part I, "Surgical Site Infection: An Overview," describes the epidemiology, definitions, microbiology, pathogenesis, and surveillance of SSIs. Included is a detailed discussion of the pre-, intra-, and postoperative issues relevant to SSI genesis. Part II, "Recommendations for Prevention of Surgical Site Infection," represents the consensus of the Hospital Infection Control Practices Advisory Committee (HICPAC) regarding strategies for the prevention of SSIs.3 Whenever possible, the recommendations in Part II are based on data from well-designed scientific studies. However, there are a limited number of studies that clearly validate risk factors and prevention measures for SSI. By necessity, available studies have often been conducted in narrowly defined patient populations or for specific kinds of operations, making generalization of their findings to all specialties and types of operations potentially problematic. This is especially true regarding the implementation of SSI prevention measures. Finally, some of the infection control practices routinely used by surgical teams cannot be rigorously studied for ethical or logistical reasons (e.g., wearing vs not wearing gloves). Thus, some of the recommendations in Part II are based on a strong theoretical rationale and suggestive evidence in the absence of confirmatory scientific knowledge.It has been estimated that approximately 75% of all operations in the United States will be performed in "ambulatory," "same-day," or "outpatient" operating rooms by the turn of the century.4 In recommending various SSI prevention methods, this document makes no distinction between surgical care delivered in such settings and that provided in conventional inpatient operating rooms. This document is primarily intended for use by surgeons, operating room nurses, postoperative inpatient and clinic nurses, infection control professionals, anesthesiologists, healthcare epidemiologists, and other personnel directly responsible for the prevention of nosocomial infections. This document does not: Specifically address issues unique to burns, trauma, transplant procedures, or transmission of bloodborne pathogens from healthcare worker to patient, nor does it specifically address details of SSI prevention in pediatric surgical practice. It has been recently shown in a multicenter study of pediatric surgical patients that characteristics related to the operations are more important than those related to the physiologic status of the patients.5 In general, all SSI prevention measures effective in adult surgical care are indicated in pediatric surgical care. Specifically address procedures performed outside of the operating room (e.g., endoscopic procedures), nor does it provide guidance for infection prevention for invasive procedures such as cardiac catheterization or interventional radiology. Nonetheless, it is likely that many SSI prevention strategies also could be applied or adapted to reduce infectious complications associated with these procedures. Specifically recommend SSI prevention methods unique to minimally invasive operations (i.e., laparoscopic surgery). Available SSI surveillance data indicate that laparoscopic operations generally have a lower or comparable SSI risk when contrasted to open operations.6-11 SSI prevention measures applicable in open operations (e.g., open cholecystectomy) are indicated for their laparoscopic counterparts (e.g., laparoscopic cholecystectomy). Recommend specific antiseptic agents for patient preoperative skin preparations or for healthcare worker hand/forearm antisepsis. Hospitals should choose from products recommended for these activitie

Humans↗