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1. Enhanced Collection of Vaccination History For All Invasive Haemophilus influenzae Type b (Hib) or of Unknown Type in Children Less Than 15 years of Age:
For cases occurring between January
1, 1998 and December 31, 2006, CEIP collected additional information
on cases of Haemophilus influenzae infection in persons less
than 15 years of age in which the serotype is either type b (Hib)
or unknown. Information that was collected includes household risk
factors, underlying humoral immune deficiencies and vaccination history.
The objective of this study was to characterize
adherence to guidelines for the prevention of perinatal disease due
to Group B Streptococcus (GBS), hepatitis B virus (HBV), HIV, rubella,
syphilis, Chlamydia trachomatis, gonococcus, and bacterial
vaginosis (BV). A population-based sample of labor and delivery records
in 10 U.S. states that participate in active GBS disease surveillance
were audited. The sampling frame included all births to surveillance-area
residents during 2003–2004 as reported to the Vital Records
Department in each state. From this frame, we selected a stratified
random sample of approximately 6000 live births nationwide (669 records
were abstracted at CEIP). For each birth, we abstracted information
on adherence to prevention guidelines for each infectious agent from
the labor and delivery record . We will use the results of this evaluation
to identify missed opportunities for prevention, formulate recommendations
for increased uptake of the guidelines, prioritize efforts to promote
appropriate prophylaxis, and further inform present prevention strategies.
Active surveillance was conducted for all cases
occurring in 2003, 2004, and 2005. Cases under surveillance were defined
as: sterile site isolates of groups C, F, L, E, P, U, or V ß-hemolytic
Streptococci, including the following (only if ß-hemolytic):
S. dysgalactiae, S. equi, S. iniae, S.
constellatus, S. phocae, S. canis, S. anginosus
(or S. milleri group), S. porcinus, S. intermedius,
S. didelphis. Isolates were collected whenever possible,
forwarded to the Streptococcus Laboratory at CDC and tested there.
Isolate testing included Lancefield grouping, speciation, and emm
The objective of this study was to determine risk
factors for invasive infection with Streptococcus pneumoniae (SPN)
resistant to fluoroquinolones. This study was conducted in response
to concerns that as fluoroquinolones were being used increasingly
as empiric therapy of community-acquired pneumonia in adults, largely
because of concerns over pneumococcal resistance to other antimicrobial
classes, fluoroquinolone resistant strains of invasive pneumococcal
disease in adults were emerging. CEIP enrolled a total of 24 cases
and controls from February 1, 2002 through September 30, 2004. Data
analysis was conducted at CDC, results were presented as an abstract
for a national conference to be held in September 2005, and a final
manuscript is being prepared for publication.
September 1, 2008 we began conducting laboratory-based surveillance
for severe community-onset S. aureus cases hospitalized within San
Francisco County. Surveillance is being implemented to identify persons
0-50 years old with a sterile site or respiratory site S. aureus isolates,
with severe infections requiring hospitalization, but lacking established
risk factors for health care associated S. aureus. Established risk
factors include: a concurrent or recent stay in a hospital or long
term care facility; recent surgery or dialysis and/or having a central
vascular catheter, tracheotomy, gastrostomy, foley catheter; or any
hemodialysis access device in place at time of admission/evaluation.
1. GAS Supplemental Surveillance Form
Data collection for this supplemental form was conducted
for all invasive GAS cases with culture dates between January 1, 2002
and December 31, 2003. Information recorded included variables that
make up the 1993 streptococcal toxic shock syndrome (STSS) case definition,
surgical history, pregnancy/delivery history and residence in a long
term care facilty.
Consensus guidelines to prevent perinatal GBS disease,
a leading cause of infant morbidity and mortality, were released in
1996, recommending the use of one of two strategies for identification
of candidates for chemoprophylaxis during labor: a risk-based protocol
and a screening-based protocol.
In February 2000, a seven-valent protein–polysaccharide
pneumococcal conjugate vaccine (Prevnar,Wyeth Lederle Vaccines) was
licensed for use in infants and young children in the United States.
This was the first vaccine that promised efficacy against pneumococcal
disease in this high-risk age group. One of the main goals of the
study was to measure overall effectiveness of this pneumococcal conjugate
vaccine against invasive disease among children 3 to 59 months old.
The study was conducted at 10 Emerging Infections Program (EIP) sites
in the United States. Cases and controls were enrolled from January
1, 2001 through June 30, 2004. This post licensure study confirmed
pre-licensure results, finding the vaccine highly effective in protecting
infants and young children against invasive pneumococcal disease.