Executive summary. The report of the Advisory Committee on Head Start Quality and Expansion.
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These recommendations include information on two vaccines recently licensed for use among infants: Haemophilus b Conjugate Vaccine (PRP-T [ActHIB, OmniHIB]), manufactured by Pasteur Mérieux Vaccins, and TETRAMUNE, manufactured by Lederle Laboratories/Praxis Biologics. This statement also updates recommendations for use of other available Haemophilus b vaccines (PRP-D [ProHIBiT]; HbOC [HibTITER]; and PRP-OMP [PedvaxHIB]) for infants and children.
These recommendations update information on the vaccine available for controlling influenza during the 1993-94 influenza season (superseding MMWR 1992;41(No. RR-9):1-17.) The principal changes include information about a) the influenza strains in the trivalent vaccine for 1993-94, b) the effectiveness of influenza vaccine, and c) side effects and adverse reactions. Antiviral agents also have an important role in the control of influenza. Recommendations for the use of antiviral agents will be published later in 1993 as Part II of these recommendations.
Polysaccharide vaccines against diseases caused by Neisseria meningitidis serogroups A and C meningococci are now licensed in the United States. They are prepared as monovalent and as bivalent antigens. This statement summarizes available information on these antigen and offers guidance regarding their role in the control of epidemics of meningococcal disease in the civilian population of the U. S.
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According to the case reporting system, the number of malaria cases accounted for 73,955 in the nation (Taiwan not included) in 1992, the incidence being 6.391 per a hundred thousand, and the lethal cases caused by malaria were 52 in number. In comparison with the data of 1991, the case number declined by 27,681 and the incidence, by 27.99%. In areas where there were no reported malaria cases or the incidence was below 1/1000, the residents totalled 1.0566 billion, whereas incidence of 1-10/1000 was noted in areas with people of 84.5 million, and 10.1-100/1000 in areas with people of 16 million. In a border city of Yunnan where resided merely 10,000 people, the incidence was more than 100 per 10,000. In the southern part, except for the resurgence of the disease in Guangxi, a decrease in the incidence at various extents was demonstrated in the other 6 provinces. Nonetheless, incidence fluctuation was revealed in some prefectures and cities, and the occurrence of several focal outbreaks was also recorded. Malaria cases in the preceding 7 provinces/autonomous region totalled 55,896, amounting to 75.6% of the entire number of malaria cases in China. In the middle and eastern parts, apart from the increase in case number due to the expansion of exogenous cases in Hunan, steady diminution of malaria incidence was evidenced in the other 8 provinces/municipality. The reported malaria cases for these areas were 17,819, accounting for 24.1% of the total cases in the country.(ABSTRACT TRUNCATED AT 250 WORDS)
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Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterium that can colonize or infect people. MRSA strains are not more virulent than methicillin susceptible strains. Colonized and infected patients represent the most important reservoir of MRSA in hospitals. MRSA is transmitted by direct person-to-person contact, usually on the hands of health care workers. Limiting the spread of MRSA is desirable because the organism is resistant to oxacillin, nafcillin, cephalosporins, and imipenem. Treatment of choice for MRSA infection is usually intravenous vancomycin. The preferred methods for antimicrobial susceptibility testing of S. aureus include oxacillin-salt screening plates, microdilution broth tests with 2% NaCI, and disk diffusion tests incubated for 24 hours at 35 degrees C. Hospitals and LTCFs should monitor the incidence of nosocomial transmission of MRSA in their facility. Hospital admission because of MRSA infection is acceptable medical practice because treatment can best be accomplished in an acute care setting. However, given special circumstances, treatment of MRSA infection can be accomplished in an extended care facility or at home. This decision is based on the clinical judgement of the attending physician. Hospital admission solely because of MRSA colonization is unwarranted. MRSA colonization is not a contraindication to discharge from an acute care hospital to home or another facility. When a hospitalized patient who is colonized with MRSA no longer needs to receive acute nursing care (i.e. their MRSA infection and/or other acute medical problems are under control), they can be discharged. If they are discharged to another institution, that institution should be notified in advance that the patient is colonized with MRSA.
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The following recommendations on hepatitis B vaccine from NACI will appear in the 4th edition of the Canadian Immunization Guide scheduled for publication in autumn 1993. They contain updated information on the epidemiology of hepatitis B in Canada and response to hepatitis B vaccine. In addition to vaccinating targeted high-risk populations, routine childhood immunization is now recommended although details on the preferred target age group and schedule are not yet finalized. There are some changes to the sections on pre-exposure immunization, post-exposure management, routine boosters (no longer needed), and post-vaccination serology. Finally, the statement incorporates the new vaccine dosages for infants and children for Merck Sharp and Dohme's Recombivax HB, approved January 1992, and SmithKline Beecham's Engerix-B, approved September 1992.
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Japanese encephalitis (JE) vaccine was available in the United States from 1983 through 1987 on an investigational basis, through travel clinics in collaboration with CDC (1). JE vaccine manufactured by Biken and distributed by Connaught Laboratories, Inc. (Japanese encephalitis virus vaccine, inactivated, JE-VAX), was licensed on December 10, 1992, to meet the needs of increasing numbers of U.S. residents traveling to Asia and to accommodate the needs of the U.S. military.