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Vaccine coverage and role of school physicians for vaccination was evaluated among 1260 and 840 children respectively, in the State of Berne, in 1998. Vaccine coverage (three doses) was sufficient for diphtheria, tetanus and poliomyelitis (95%), but unsatisfactory for pertussis (90%) and measles-mumps-rubella (MMR, 78-80%). The situation was stable in comparison to the year 1995, only vaccine coverage against Haemophilus influenzae Typ b increased (15-20%). School children of non-Swiss origin, especially those born outside Switzerland had partially low vaccination coverage. The percentage vaccinate was 88%, 84% and 68% for MMR. There was no association between vaccine coverage and school examination by family or school physician. The Swiss Public Office of Health should be more involved with the promotion of vaccinations.
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PMID:[Vaccination of young children, at school entrance and completion in the Bern canton 1998]. 1168 Jan 20

Since the early 1970s, childhood vaccination has prevented millions of illnesses and tens of thousands of deaths. For these health benefits to continue, high levels of vaccination coverage must be attained for each new birth cohort and must be monitored to ensure protection from disease, to characterize undervaccinated populations, and to evaluate effortsto increase coverage. The National Immunization Survey (NIS) provides ongoing national estimates of vaccination coverage among preschool-aged children for the 50 states and 28 selected urban areas. For this report, NIS data collected during 2000 were compared with 1999 data; findings indicate that, during 2000, significant increases were reported on the national level of vaccination coverage with varicella and hepatitis B, and small but statistically significant decreases were reported in coverage with diphtheria, and tetanus toxoid, and pertussis vaccine. Coverage with poliovirus vaccine, Haemophilus influenzae type b vaccine, and measles-mumps-rubella vaccine were not significantly different from 1999. As in previous years, coverage varied among states. To maximize coverage among preschool-aged children, vaccination providers should continue to apply such strategies as reminders and recalls.
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PMID:National, state, and urban area vaccination coverage levels among children aged 19-35 months--United States, 2000. 1178 73

In 1999 there were 88,229 [corrected] notifications of communicable diseases in Australia reported to the National Notifiable Diseases Surveillance System (NNDSS). The number of notifications in 1999 was an increase of 3 per cent on notifications in 1998 (85,227) and the second largest reporting year since the NNDSS commenced in 1991. Notifications in 1999 consisted of 29,977 bloodborne infections (34% of total), 22,255 gastrointestinal infections (25%), 21,704 sexually transmitted infections (25%), 5,986 vector borne infections (7%),5,228 vaccine preventable infections (6%), 1,967 (2%) other bacterial infections (legionella, meningococcal, leprosy and tuberculosis), 1,012 zoonotic infections (1%) and 3 quarantinable infections (0.003%). Notifications of bloodborne viral diseases particularly hepatitis B and hepatitis C and some sexually transmitted infections such as gonorrhoea and chlamydia continue to increase in Australia. Steep declines in vaccine preventable diseases such as Haemophilus influenzae type b, measles, mumps and rubella continued in 1999. This report also summarises data on communicable diseases from other surveillance systems including the Laboratory Virology and Serology Surveillance Scheme (LabVISE) and sentinel general practitioner schemes. In addition this report comments on other important developments in communicable disease control in Australia in 1999.
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PMID:Australia's notifiable diseases status, 1999: annual report of the National Notifiable Diseases Surveillance System. 1180 55

Infections jeopardize children on immunosuppression after organ transplantation. Immunization is protective in healthy children. The aims of this study were to analyze the rate and efficacy of immunization in 62 children undergoing dialysis and renal transplantation (RTPL) between 1987 and 2000. The analysis was based on clinical findings, vaccination certificates, and measurement of specific serum antibodies. A member of the renal unit administered vaccinations. All 62 patients were immunized against diphtheria, tetanus, pertussis, poliomyelitis, measles, mumps, rubella, and hepatitis B. Since introduction in 1991 and 1995, 44 and 42 children were also vaccinated against influenza and Hemophilus influenzae type b, respectively. Of 16 patients with a negative history, 14 were given varicella vaccine; 16 children on peritoneal dialysis (PD) or with nephrotic syndrome were immunized against Streptococcus pneumoniae. All vaccinated patients had detectable serum antibodies against measles, mumps, rubella, varicella, hepatitis B, H. influenzae, and S. pneumoniae. There were 3 infections despite vaccination; 1 patient developed varicella after RTPL and 1 patient on PD had 2 episodes of peritonitis caused by H. influenzae and S. pneumoniae. In conclusion, monitoring and administration of the vaccines by the renal team enabled a high immunization rate. Whether vaccines, as documented by antibody titers, or by the low prevalence in the general population promoted the low prevalence of infections remains open, as there were at least a few vaccination failures.
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PMID:Immunization in children with chronic renal failure. 1218 73

In 2000, there were 89,740 notifications of communicable diseases in Australia collected by the National Notifiable Diseases Surveillance System (NNDSS). The number of notifications in 2000 was an increase of 5.9 per cent over those reported in 1999 (84,743) and the largest reporting year since the NNDSS commenced in 1991. Notifications in 2000 consisted of 28,341 bloodborne infections (32% of total), 24,319 sexually transmitted infections (27%), 21,303 gastrointestinal infections (24%), 6,617 vaccine preventable infections (7%), 6,069 vectorborne infections (7%), 2,121 other bacterial infections (legionellosis, meningococcal infection, leprosy and tuberculosis) (2%), 969 zoonotic infections (1%) and only one case of a quarantinable infection. Steep declines in some childhood vaccine preventable diseases such as Haemophilus influenzae type b, measles, mumps and rubella, continued in 2000. In contrast, notifications of pertussis and legionellosis increased sharply in the year. Notifications of bloodborne viral diseases (particularly hepatitis B and hepatitis C) and some sexually transmitted infections such as chlamydia, continue to increase in Australia. This report also summarises data on communicable diseases from other surveillance systems including the Laboratory Virology and Serology Surveillance Scheme (LabVISE) and sentinel general practitioner schemes. In addition this report comments on other important developments in communicable disease control in Australia in 2000.
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PMID:Australia's notifiable diseases status, 2000. Annual report of the National Notifiable Diseases Surveillance System. 1220 70

Malnutrition, one of the world's greatest health problems, is a factor in the death of millions of children each year. Infection is the cause of death in over half these cases. Dietary deficiency, especially of protein, causes serious disturbances in the immune system. The mucus and cutaneous surfaces are the first affected. Studies of the respiratory mucus demonstrate frequent breaches which allow germs to penetrate. Antibodies are synthesized in reduced quantities, lymphocyte counts are often diminished, and reaction with infectious agents is poor. The phagocyte function of polynucleated cells is poor. Malnutrition is often associated with war, ignorance, poverty, and poor hygiene. Deficiencies of iron, vitamin A, and zinc may aggravate immune deficits. Ingestion of contaminated water is the main cause of diarrhea, which is very frequent among the malnourished and may be more serious than among adequately nourished individuals. Colibacillus and salmonella are most frequently isolated. Germs such as shigella, campylobacter, and rotavirus have the same incidence as in well nourished children. Pneumonia is responsible for 4 million deaths in children under 5 annually and is more common in the malnourished. The pathogenic agents may be pneumococci, Hemophilus, or staphylococci. Tuberculosis is also frequent, especially in zones with a prevalence of AIDS. Diagnosis of tuberculosis with cutaneous tests is difficult in the malnourished. Regardless of the pathogenic agent, pneumonia is more serious in the malnourished, and the need for treatment is more urgent. Urinary infections may occur in 10-25% of malnourished children vs. 2% of healthy children. The colibacillus is the most frequent cause. Specticemias, the most severe of infections, are not rare in the malnourished and are usually caused by Salmonella or the colibacillus. 20% of malnourished children are affected by infections acquired in the hospital. Among viral infections affecting them are measles and herpes. The fatality rate from measles may reach 25% in malnourished children. Parasitoses are frequent, but they do not seem to be more serious in malnourished children than in the general population. It is imperative in treating malnourished children to observe rigorous hygiene, use clean water, treat infections early, avoid hospital infections, and apply all available vaccines.
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PMID:[Infections in malnourished infants and children]. 1228 6

Summarized in this article are the major recommendations of the Fourteenth Meeting of the Caribbean Expanded Program on Immunization (EPI) Managers held in Castries, Saint Lucia, in November 1997. The emphasis of the meeting was surveillance of measles, poliomyelitis, rubella, and congenital rubella syndrome. Although the English-speaking Caribbean has been free of indigenous measles transmission for 6 years and global eradication of poliomyelitis is achievable, the risk of disease importation remains. Average immunization coverage rates for all 19 countries in the Caribbean region were: DPT, 89%; OPV, 89%; measles-containing vaccine, 92%; and BCG, 95%. Pockets of low coverage remain in remote rural areas and dense urban areas and immunization rates are below 90% in Suriname, Grenada, Guyana, and Belize. Two new vaccines--hepatitis B and Haemophilus influenzae type b--are being administered by the private sector in the English-speaking Caribbean and will be available through the public sector within 3 years. Many Caribbean countries have already developed surveillance systems for adverse events following immunizations.
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PMID:Caribbean meeting stresses surveillance. 1229 6

The Children's Vaccine Initiative's (CVI) strategic plan for making high-quality vaccines available to all of the world's children was first drafted in 1992-93 as a blueprint for the activities of the international vaccine community broadly working together as the CVI coalition. The goal was to protect all children against the major infectious diseases. The CVI task force on strategic planning met in April to update the plan relative to the current stage of immunization affairs and accomplishments with an eye to moving ahead during the next 10-15 years. While the vision of protecting children against infectious diseases remains, it will be quite a while before it is realized; modern vaccines are much more complex and expensive than the earlier vaccines used against polio, tetanus, measles, tuberculosis, pertussis, and diphtheria. The task force set 2005 as the deadline for expanding the scope of use of licensed vaccines for Haemophilus influenzae type b, hepatitis B, rubella, and measles. The task force chairman comments upon the feasibility of the new targets, the CVI's interest in the developing world, CVI's weaknesses, and the current state of affairs.
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PMID:A plan for immediate action, a vision for the future. Interview [with John La Montagne]. 1229 13

In August 1996, health officials, program managers, epidemiologists, laboratory representatives, UNICEF, Rotary International, and Pan American Health Organization staff attended the VII Andean EPI Meeting in Quito, Ecuador, to review the progress of the Expanded Program on Immunization (EPI). All Andean countries have conducted catch-up measles vaccination campaigns targeting children 9 months to 15 years old. These campaigns achieved 90% vaccine coverage and a strong reduction in measles incidence (only 7 confirmed cases in 1996). Follow-up campaigns were conducted during 1995-1996 in Colombia, Peru, and Chile. They were expected in Bolivia, Ecuador, Peru, and Venezuela during 1997-1999. The Andean countries implemented a national surveillance system for measles in 1995. Meeting representatives made eight recommendations regarding measles. For example, health officials should reach and maintain routine vaccination coverage greater than 95% for children 12-23 months old in each municipality. Laboratory representatives proposed recommendations on uniform criteria for measles diagnosis. The last indigenous wild poliovirus in the Americas was isolated in 1991. Imported wild poliovirus remains a concern. The Andean countries are expanding surveillance of neonatal tetanus activities. Since 1989 the frequency of neonatal tetanus has been falling in the Andean region, especially in Bolivia and Peru. The impact of migration on the control of neonatal tetanus should be a higher priority. Participants repeated the need for systematic use and continuous monitoring of EPI indicators (e.g., vaccination coverage). Three countries plan on analyzing surveys on missed opportunities for vaccination in 1996. Three countries presented progress reports on hepatitis B vaccination and surveillance. Participants issued recommendations on quality control of vaccines. The responsibility for quality control lies with the manufacturers and the government. Vaccines for invasive diseases (e.g., Haemophilus influenzae type b) may be included in national EPI programs.
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PMID:Andean region: measles on the way out. 1232 May 47

The 12th Technical Advisory Group Meeting on Vaccine-Preventable Diseases (TAG) was held in Guatemala during September 8-12, 1997. Created in 1985 during the polio eradication campaign, TAG meets every 2 years and is the leading forum to promote regional initiatives to control and eliminate vaccine-preventable diseases. One of the group's main objectives has been to strengthen the policy dialogue upon immunization among governments in the region and participating agencies. Some of TAG's major conclusions and recommendations are presented with regard to immunization in a changing policy environment, measles eradication, poliomyelitis, neonatal tetanus, rubella and congenital rubella, hepatitis B, yellow fever, Haemophilus influenzae type B (Hib), vaccines of quality, and research and development in the regional vaccine initiative.
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PMID:SVI technical advisory group meets. 1234 24


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