Minnesota Department of Health (MDH) Bug Bytes
January 7, 2003
Vol. 4: No. 1
Topics in this Issue:
1. Influenza and Poppies
2. Smallpox Vaccination Plans Continue
3. Proposed New Immunization Requirements
1. Influenza and Poppies
We have had our first influenza isolate for this season in
a two-month old boy from Hennepin County. The infant was infected
with an influenza A H1N1 New Caledonia-like strain, that is
one of the strains included in this year's vaccine. He was
hospitalized for several days and recovered.
It's still not too late to get a flu shot, and there are ample supplies of influenza vaccine remaining. Persons at highest risk for influenza complications who should be vaccinated include: anyone 65 years of age or older; residents of nursing homes and other long-term care facilities; anyone over six months of age with a chronic condition of the heart, circulatory system or respiratory system, including asthma; anyone over six months of age who has been hospitalized or required ongoing medical attention during the past year for a chronic metabolic disorder (such as diabetes), kidney problems, a blood disorder, or immune system problems (such as HIV infection, or an immune system suppressed by medication, chemotherapy or radiation treatment); children and teenagers who are receiving ongoing medical treatment with aspirin, which could place them at risk of developing Reye's Syndrome if they get influenza; healthy children 6-23 months; and women who will be in the second or third trimester of pregnancy during influenza season. In addition, the following should also receive influenza vaccine: close contacts with any of those mentioned above, people 50-64 years of age, health care workers, and anyone else who wants to prevent getting the flu.
On January 28, 1918, Dr. John McCrae died of pneumonia and meningitis. It is likely that these were complications due to influenza, from the pandemic influenza event of 1918 (i.e. the "Spanish flu"). McCrae was a Canadian pathologist and infectious disease specialist who volunteered for military service during WWI. After the 1915 Second Battle of Ypres, while performing the burial service of a friend, McCrae wrote the poem "In Flanders Field" ("In Flanders field, the poppies blow Between the crosses row by row…) often recited on Memorial Day. It was after this that the tradition began of wearing poppies to honor the veterans who have died.
2. Smallpox Vaccination Plans Continue
As discussed in the last issue of Bug Bytes, we have been
planning for vaccinating selected patient health care providers
and public health workers for smallpox. Voluntary vaccination
will be offered to health care providers who would provide
around the clock care for a smallpox case for the first 7-10
days. This offer is made at every hospital in Minnesota capable
of hospitalizing a smallpox patient in a negative air pressure
isolation room. The health care team would include emergency
room staff, intensive care unit staff, general medical unit
staff, medical house staff, medical specialists (infectious
disease, dermatology, ophthalmology, pathology, surgery, anesthesiology),
infection control professionals, respiratory therapists, radiology
technicians, security personnel, and housekeeping staff. The
public health workers would include vaccinators and disease
investigators who would have face-to-face contact with smallpox
case-patients.
Our plan calls for vaccinating approximately 5-10,000 persons
in Minnesota. We may begin vaccinating as early as January
24. More information on smallpox is on the CDC and MDH websites
at http://www.bt.cdc.gov/agent/smallpox/index.asp
and http://www.health.state.mn.us/bioterrorism/
smallpox/index.html.
3. Proposed New Immunization
Requirements
We intend to adopt new immunization requirements after a public
hearing. The changes include: requiring chickenpox vaccine
for children in childcare, kindergarten and seventh grade;
requiring pneumococcal vaccine for children under two years
old in childcare; allowing vaccine doses administered four
or fewer days before the minimum age required in law to be
considered valid in order to be consistent with nationally
established general recommendations; and modifying the requirement
for hepatitis B so that a hepatitis B vaccine licensed for
an alternative dosing schedule is valid for purposes of the
hepatitis B vaccination requirement. A public hearing on these
changes will be held on Friday, February 28, 2003 at 9:00
a.m. at the MDH Snelling Office Park building, 1645 Energy
Park Drive, St. Paul.
More information on the rules and comment making process
is at http://www.health.state.mn.us/divs/dpc/
adps/immrule.htm.
Bug Bytes is a combined effort of the Infectious Disease Epidemiology, Prevention and Control Division and the Public Health Laboratory Division of MDH. We provide Bug Bytes as a way to say THANK YOU to the infection control professionals, laboratorians, local public health professionals, and health care providers who assist us.
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