CDC MMWR News Synopsis for March 17, 2016

MMWR- Morbidity and Mortality Weekly Report

MMWR News Synopsis for March 17, 2016

Human Rabies — Missouri, 2014

Rabies is an important zoonotic disease that causes rapidly progressive fatal encephalitis. Human cases are almost always fatal once symptoms occur. In the United States, rabies virus is a rare cause of rapidly progressive encephalitis. It is important for clinicians to have a high index of suspicion for rabies when presented with rapidly progressive encephalitis cases of unknown etiology, regardless of the existence or absence of an accompanying animal exposure. Public health officials should include the following key messages in rabies prevention education campaigns: 1) continue to warn the public about the risk associated with undetected bat exposures, and: 2) encourage caregivers and family members of case-patients with rapidly progressive encephalitis to notify the medical team caring for the patient of any possible animal exposures. Lastly, we must underscore the importance of the use of standard precautions, or higher level precautions, based on the differential diagnosis list when caring for patients with clinical diseases of unknown infectious disease etiologies.

Use of Vaccinia Virus Smallpox Vaccine in Laboratory and Health Care Personnel at Risk for Occupational Exposure to Orthopoxviruses — Recommendations of the Advisory Committee on Immunization Practices, 2015

Vaccination with ACAM2000 is expected to benefit persons at risk for occupational exposure to orthopoxviruses, given the ability of vaccinia virus smallpox vaccines to induce cross-protective immunity against other viruses within the orthopoxvirus genus. The Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination with live smallpox (vaccinia) vaccine (ACAM2000) for laboratory personnel who directly handle: 1) cultures or 2) animals contaminated or infected with replication-competent vaccinia virus, recombinant vaccinia viruses derived from replication-competent vaccinia strains (i.e., those that are capable of causing clinical infection and producing infectious virus in humans), or other orthopoxviruses that infect humans (e.g., monkeypox, cowpox, and variola) (recommendation category: A, evidence type 2). Health-care personnel (e.g., physicians and nurses) who currently treat or anticipate treating patients with vaccinia virus infections and whose contact with replication-competent vaccinia viruses is limited to contaminated materials (e.g., dressings) and persons administering ACAM2000 smallpox vaccine who adhere to appropriate infection prevention measures can be offered vaccination with ACAM2000 (recommendation category: B, evidence type 2).

Building and Strengthening Infection Control Strategies to Prevent Tuberculosis — Nigeria, 2015

Implementation of tuberculosis (TB) infection control measures are key to preventing the spread of TB in health facilities and reducing the global burden of TB. TB is the number one cause of infectious disease deaths globally. Transmission in health care facilities is a frequently source of TB infection, and persons living with HIV and health care workers are at increased risk for TB infection. Infection control measures to reduce the transmission of TB in health-care facilities are not well implemented in many high-burden and resource-limited settings, and a lack of TB infection control in health-care facilities has resulted in outbreaks of TB and drug-resistant TB. An initiative focused on training health-care workers, identifying TB infection control gaps, and using a continuous quality-improvement approach to implement and monitor infection control measures was implemented in Nigeria, which has the fourth-highest number of TB cases globally. The approach resulted in substantial improvements in infection control practices, and scale-up of these measures might lead to a reduction in TB transmission globally.

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