Table Of Content

Epidemiology and Prevention o/ Vaccine-Preventable Diseases V HEAD WS4 INFLUCNZA rMIUMONIA I *»*TmMmmM4nMtt wreixsrtiaciMm isuiTvoESTcmsmvoau MfrUt^vn:^ SAFER HEALTHIER PEOPLE ™ • - Department of Health and Human Services Centers for Disease Control and Prevention Epidemiology and Ppovention of Vaccine-Ppoventable Diseases DITION NATIONAL INSTITUTES OF HEALTH NIH LIBRARY JANUARY JUL2 2006 BLDG 10, 10 CENTER DR BETHESDA, MD, 20892-1150 Edited by: WilliamAtkinson, MD, MPH Jennifer Hamborsky, MPH, CHES Lynne McIntyre, MALS Charles [Skip] Wolfe Layout and Design: Susie P. Childrey ThisbookwasproducedbytheEducation,InformationandPartnershipBranch,NationalImmunizationProgram,CentersforDisease ControlandPrevention,whoissolelyresponsibleforitscontent. ItwasprintedanddistributedbythePublicHealthFoundation. For additionalcopies,contactthePublicHealthFoundationat877-252-1200orwebsitehttp://bookstore.phf.org/. Suggested Citation: CentersforDiseaseControlandPrevention.EpidemiologyandPreventionofVaccine-PreventableDiseases.AtkinsonW,HamborskyJ, McIntyreL,WolfeS,eds.Sthed.WashingtonDC;PublicHealthFoundation,2006. Useoftrade namesandcommercial sources isforidentificationonlyanddoes not implyendorsement bythe PublicHealthServicesorthe U.S. DepartmentofHealthand HumanServices. Referencestonon-CDCsiteson theInternetareprovidedasaserviceto readersand donotconstituteorimply endorsementoftheseorganizationsortheirprogramsbyCDCortheU.S. DepartmentofHealthand Human Services. CDC isnot responsibleforthecontentofthesesites. URLaddresseswerecurrentasofthedateofpublication. Department of Health and Human Services Centers for Disease Control, and prevention On the Cover A montage of images from the history of immunization. Clockwise from upper left: John Enders, who with his colleagues Thomas Weller and Fred Robbins first grew poliovirus in human cell culture in 1948; the May 1980 edition of World Health magazine announcing the eradication of smallpox; a vaccine jet injector, developed in 1967; a molecule of immunoglobulin G type (IgG), a critical component of the receptor theory of immunity developed MMR by Paul Ehrlich in 1897; vaccine, first licensed in 1971; an influenza warning poster developed by the Chicago Public Health Department in 1918; Edward Jenner, who developed the first vaccine (smallpox) in 1796; a Polio Pioneer button, given to the children who volunteered for the Francis Field Trial of poliovirus vaccine in 1954; a Drinker respirator (iron lung), which saved the lives of thousands of people paralyzed by polio in the 1940s and 1950s; and Hippocrates, a Greek physician who described diphtheria, epidemic jaundice (probably hepatitis A), and other diseases in the 5th century BCE. He was — said to have originated the medical maxim primum non nocere first, do no harm. ... . i! ij Table Contents 1 Principles of Vaccination immunologyandVaccine-Preventable Diseases ....1 Classification ofVaccines ....4 Selected References ....8 2 General Recommendations on Immunization Timing and Spacing ofVaccines ....9 Adverse Reactions FollowingVaccination ...15 Contraindications and Precautions toVaccination .. ...IB Invalid ContraindicationstoVaccination ... 22 Screening forContraindications and Precautions ... 25 Selected References . ..26 3 Immunization Strategies for Healthcare Practices and Providers The Need forStrategies to Increase Immunization Levels .. .29 TheAFIXApproach ...31 Other Essential Strategies . ..36 Selected References ...41 4 Vaccine Safety The Importance ofVaccineSafetyPrograms . ..43 Sound Immunization Recommendations and Policy. . ...44 Methods ofMonitoringVaccineSafety . ..45 Vaccine InjuryCompensation ...5D The Immunization Provider’s Role ...5D Selected References ...55 5 Diphtheria Carynebacteriumdiphtheriae 57 ... Pathogenesis 57 .. . Clinical Features .. .57 Complications 59 .. . LaboratoryDiagnosis .. .59 Medical Management 6D .. . Epidemiology . .61 SecularTrends inthe United States ...62 Diphtheria Toxoid ...63 Vaccination Schedule and Use 64 ... Adverse Reactions FollowingVaccination 65 .. . Contraindications and PrecautionstoVaccination . ....65 Vaccine Storage and Handling 66 .. . Suspect Case Investigation and Control ...66 Selected References 67 . .. 6 Tetanus Clostridiumtetani ..69 Pathogenesis 70 .. . Clinical Features ...70 Milestones in the History of Vaccination 400bce 1100s 1721 1796 Hippocratesdescribesdiphtheria, Variolationforsmallpoxfirst Variolationintroduced EdwardJennerinoculatesJamesPhipps epidemicjaundice,and reportedinChina intoGreatBritain withcowpox,and callstheprocedure otherconditions vaccination [“vacca”is Latinforcow]. Ill Table of Contents Complications 71 LaboratoryDiagnosis 71 Medical Management 71 Wound Management 72 Epidemiology 72 SecularTrends in the United States 73 I Tetanus Toxoid 74 I Vaccination Schedule and Use 75 Adverse Reactions Following Vaccination 76 Contraindications and Precautions toVaccination 77 Vaccine Storage and Handling 77 Selected References 78 7 Pertussis Bordetellapertussis 79 Pathogenesis 79 Clinical Features 79 Complications 80 Laboratory Diagnosis 81 Medical Management 82 Epidemiology 83 SecularTrends in the United States 83 Case Definition 84 PertussisVaccines 85 Vaccination Schedule and Use 87 CombinationVaccines Containing DTaP 89 OtherOTaP Issues 91 Adverse Reactions FollowingVaccination 92 Contraindications and PrecautionstoVaccination 94 Vaccine Storage and Handling 95 Selected References 95 8 Poliomyelitis Poliovirus 97 Pathogenesis 97 Clinical Features 98 Laboratory Diagnosis 99 Epidemiology 99 I SecularTrends in the United States 100 PoliovirusVaccines 101 I Vaccination Schedule and Use 103 PolioVaccination ofAdults 104 Adverse Reactions FollowingVaccination 106 Contraindications and PrecautionstoVaccination 107 VaccineStorage and Handling 107 Outbreak Investigation and Control 108 i Polio Eradication 108 Postpolio Syndrome 109 Selected References 109 Milestones in the History of Vaccination 1870 1884 1885 1887 1900 LouisPasteurcreatesthe Pasteurcreatesthefirst Pasteurfirstuses InstitutPasteur Paul Ehrlichformulates firstliveattenuatedbacterial liveattenuatedviralvaccine rabiesvaccineinahuman established receptortheoryofimmunity! vaccine[chickencholera] [rabies] IV Table of Contents 9 Haemophilus influenzaeType b (Hib) Haemophilusinfluenzae in Pathogenesis 112 Clinical Features 113 LaboratoryDiagnosis 113 Medical Management 114 Epidemiology 114 SecularTrends in the United States 115 Haemophilusinfluenzaetype bVaccines 117 Vaccination Schedule and Use 118 CombinationVaccines 120 Adverse Reactions FollowingVaccination 122 Contraindications and Precautions toVaccination 122 VaccineStorage and Handling 123 Surveillance and Reporting ofHib Disease 123 Selected References 123 10 Measles MeaslesVirus 125 Pathogenesis 125 Clinical Features 126 Complications 126 LaboratoryDiagnosis 128 Epidemiology 129 SecularTrends in the United States 130 Classification ofMeasles Cases 133 MeaslesVaccine 134 Vaccination Schedule and Use 135 Adverse Reactions FollowingVaccination 139 Contraindications and Precautions toVaccination 140 VaccineStorage and Handling 143 Selected References 144 Mumps 1 1 MumpsVirus 145 Pathogenesis 145 Clinical Features 145 Complications 146 LaboratoryDiagnosis 147 Epidemiology 147 SecularTrends in the United States 148 Case Definition 149 MumpsVaccine 149 VaccinationSchedule and Use 149 Adverse Reactions FollowingVaccination 151 Contraindications and PrecautionstoVaccination 152 VaccineStorage and Handling 153 Selected References 154 Milestones in the History of Vaccination J 1901 1909 1919 1923 1926 FirstNobelPrizeinMedicine TheobaldSmithdiscoversa CalmetteandGuerincreateBCG, Firstwhole-cellpertussisvaccinetested RamonandChristianZoeller tovonBehringfor methodforinactivating thefirstliveattenuated GastonRamondevelops developtetanustoxoid diphtheriaantitoxin diphtheriatoxin bacterialvaccineforhumans diphtheriatoxoid V Table of Contents 12 Rubella Rubella Virus 155 i Pathogenesis 155 Clinical Features 155 Complications 156 Congenital Rubella Syndrome 156 Laboratory Diagnosis 157 Epidemiology 159 SecularTrends inthe United States 159 Classification of Rubella Cases 160 RubellaVaccine 161 Vaccination Schedule and Use 162 Rubella Immunity 164 iI Adverse Reactions FollowingVaccination 165 Contraindications and PrecautionstoVaccination 166 RubellaVaccination ofWomen ofChildbearingAge 167 Vaccine Storage and Handling 168 Strategiesto Decrease Rubella and CRS 169 Selected References 169 13 Varicella Varicella ZosterVirus 171 Pathogenesis 171 Clinical Features 171 Complications 173 LaboratoryDiagnosis 175 Epidemiology 176 SecularTrends inthe United States 177 VaricellaVaccine 178 Vaccination Schedule and Use 18D Varicella Immunity 182 Adverse Reactions FollowingVaccination 183 Contraindications and Precautions toVaccination 184 Transmission ofVaricellaVaccineVirus 186 t1 VaccineStorage and Handling 186 Varicella ZosterImmuneGlobulin [VZIG] 188 SpecialVaricella ExposureSituations 19D AntiviralTherapy 19D Selected References 191 14 Hepatitis A •1I HepatitisAVirus 193 Pathogenesis 193 Clinical Features 194 Complications 194 LaboratoryDiagnosis 194 Medical Management 195 Epidemiology 195 SecularTrends inthe UnitedStates 197 wiiic9wuii«;a in i.nt; nia»Eury ui unwincitiun Sb- 1927 1931 1936 1948 1954 Yellowfevervirusisolated Goodpasturedescribesa ThomasFrancisandThomasMagill JohnEndersandcolleagues EndersandPeeblesisolatemeaslesvisru^^ techniqueforviralculturein developthefirst isolateLansingTypeIIpoliovirus FrancisFieldTrial 9 hens'eggs inactivatedinfluenzavaccine inhumancellline ofinactivatedpoliovaccine vi Table of Contents Case Definition 198 HepatitisAVaccine 198 r Vaccination Schedule and Use 199 I Adverse Reactions FollowingVaccination 203 Contraindications and PrecautionstoVaccination 203 ! Vaccine Storage and Handling 204 I Postexposure Managementwith Immune Glohulin 204 i j Selected References 205 IS Hepatitis B i Hepatitis BVirus 207 ij Clinical Features 208 Complications 209 I LaboratoryDiagnosis 209 j Medical Management 211 I Epidemiology 211 j' SecularTrends inthe United States 213 Hepatitis R Prevention Strategies 215 Hepatitis RVaccine 215 { Vaccination Schedule and Use 218 I OtherGroupsWho May Be Candidates forHepatitis BVaccine 223 SerologicTesting ofVaccine Recipients 224 j Postexposure Management 226 Adverse Reactions Following Vaccination 229 Contraindications and Precautions toVaccination 230 Vaccine Storage and Handling 230 j Selected References 230 16 Influenza i Influenza Virus 233 I Pathogenesis 235 Clinical Features 235 Complications 236 Impactof Influenza 236 Laboratory Diagnosis 237 Epidemiology 238 SecularTrends in the United States 239 InfluenzaVaccine 239 Vaccination Schedule and Use 241 Adverse Reactions FollowingVaccination 246 Contraindications and Precautions toVaccination 248 Vaccine Storage and Handling 249 Year2010 Objectives and Coverage Levels 250 Strategies for Improving InfluenzaVaccine Coverage. ..250 Antiviral Agents for Influenza 251 Nosocomial Influenza Control 252 Influenza Surveillance 252 Selected References 252 Milestones in the History of Vaccination 1955 1961 1963 1965 1966 Inactivatedpoliovaccine Humandiploidcellline Measlesvaccinelicensed Bifurcatedneedlefor WorldHealthAssemblycallsfor licensed developed Trivalentoralpoliovaccinelicensed smallpoxvaccinelicensed globalsmallpoxeradication Table of Contents 17 Pneumococcal Disease Streptococcuspneumoniae 255 Clinical Features 256 Laboratory Diagnosis 258 Medical Management 258 Epidemiology 259 SecularTrends in the United States 259 Pneumococcal Vaccines 260 Vaccination Schedule and Use 262 Adverse Reactions Following Vaccination 265 Contraindications and Precautions toVaccination 266 Vaccine Storage and Handling 266 Goals and Coverage Levels 267 Selected References 267 18 Meningococcal Disease Neisseriameningitidis 269 Pathogenesis 270 Clinical Features 270 Laboratory Diagnosis 271 Medical Management 272 4 Epidemiology 272 SecularTrends in the United States 273 Meningococcal Vaccines 274 Vaccination Schedule and Use 275 Adverse Reactions Following Vaccination 277 Contraindications and Precautions toVaccination 278 Vaccine Storage and Handling 278 Surveillance and Reporting of Meningococcal Disease. . 278 Antimicrobial Chemoprophylaxis 278 Selected References 279 19 Smallpox Variola and OtherOrthopoxviruses 281 Pathogenesis 282 Clinical Features 282 Complications 286 Differential Diagnosis 286 Laboratoryand Pathology Diagnosis 289 Medical Management 291 I Epidemiology 292 f ) I SecularTrends 293 Smallpox Eradication 293 Case Definition 294 I Smallpox [Vaccinia]Vaccine 295 Vaccination Schedule and Use 298 Adverse Reactions FollowingVaccination 299 Contraindications and Precautions toVaccination 302 Milestones in the History of Vaccination 1967 1969 1971 1977 1979 MauriceHillemandevelops StanleyPlotkindevelops RA23/7 MMRvaccinelicensed Lastindigenouscaseofsmallpox Lastwild poliovirus Jeryl Lynnstrainofmumpsvirus strainofrubellavirus [Somalia] transmissionintheU.S. viii