The Bureau of Epidemiology is available 24 hours a day, 7 days a week for consultation at our main number (SunCom 205-4401 or 850/245-4401) PLEASE NOTE: Consultation after 5 p.m. & on weekends is intended for emergencies.

The national shortage of Td vaccine is addressed in a recently-published Notice to Readers: Deferral of Routine Booster Doses of Tetanus and Diphtheria Toxoids for Adolescents and Adults, Morbidity and Mortality Weekly Report (MMWR), May 25, 2001 / Volume 50(20); Pages 418,427. The article advocates the delay of all routine Td boosters in adolescents and adults until 2002 to assure vaccine availability for priority indications. For all other indications, the Notice to Readers recommends that Td use should follow existing recommendations, which include:

• Persons traveling to a country where the risk for diphtheria is high
• Persons requiring tetanus vaccination for prophylaxis in wound management
• Persons who have received less than three doses of any vaccine containing tetanus and diphtheria toxoids
• Pregnant women who have not been vaccinated with Td during the preceding 10 years

Based on the advisory, the Florida Department of Health recommends that any student needing Td vaccine to meet Florida's seventh grade immunization requirement be issued an extended temporary medical exemption for one year. The full text of the recommendation can be found on the Centers for Disease Control and Prevention’s (CDC) Web site at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5020a8.htm.

All persons involved with the administration of immunizations and/or disease surveillance should read and become familiar with the above recommendations.

LONDON: Human trials to test a vaccine against West Nile virus (WNV) could

begin early next year, according to the head of a small British firm

enlisted to help fight the disease. Acambis, a biotechnology firm based in

Cambridge, England, is in the final stages of testing its ChimeriVax (WNV

vaccine) on animals and is gearing up for human trials, the firm's Chief

Executive John Brown told Reuters on Wed 23 May 2001. "In a couple of

months we should be able to say that we have something that is suitable for

human studies and we could have a human trial in the first quarter of next

year," he said.

The mosquito-borne WNV was unknown in North America until 2 years ago, when

it caused the death of 7 people in the New York City area. The [virus],

which can cause inflammation of the brain and most often affects the

elderly and those with weakened immune systems, has since spread along the

East Coast. Now there are fears the virus, which has also infected

thousands of birds and numerous horses, could sweep through the warm,

southeastern states with their large populations [of senior citizens].

Brown cautioned that the Acambis vaccine was still 3 or 4 years from

reaching the market, even if it successfully completed clinical trials. The

firm's research is being funded by a 3-million-dollar US government grant;

the potential market for the vaccine is estimated at 300 million dollars.

The Acambis vaccine is based on the 60-year-old yellow fever vaccine, the

safest anti-viral vaccine known to man, Brown said. Yellow fever [virus] is

closely related to WNV and adapting the yellow fever vaccine to protect

against WNV was a relatively simple task for Acambis scientists. "It was a

cut-and-paste job. We took the yellow fever vaccine [virus, and deleted

the structural information region of the genome and substituted the

corresponding WNV sequence] ," Brown said. [Yellow fever virus and WNV are

both members of the genus _Flavivirus_. of the family _Flaviviridae_.

However, they belong to distinct serogroups within the genus. WNV is

included in the Japanese encephalitis virus group and yellow fever virus is

a member of the yellow fever virus group. - Mod.CP].

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[A vaccine is available in Israel to protect domestic geese against WNV

infection. This vaccine is an attenuated strain of Israel turkey

meningoencephalitis virus (a member of the Ntaya serogroup of the genus

_Flavivirus_), which has been in use in Israel for 24 years in turkeys.

Experience has shown that it can be used safely in geese. This vaccine has

not been used in other vertebrates.

"The Office of Performance Improvement is pleased to announce a series of seven prerecorded Principles of Public Health presentations, by nationally recognized speakers, which will be delivered via satellite broadcast . These presentations are sponsored by the Missouri Department of Health, the Centers for Disease Control and Prevention, Public Health Training Network and Saint Louis University - School of Public Health.

The purpose, target audience, schedules and registration procedures, for sites outside Tallahassee, are outlined in the attached documents.

We encourage your participation. If you have questions, please let me know. Thanks"

For information regarding vaccine supplies, please contact Al Sulkes, Bureau of Immunization, at (800) 483-2543. For questions concerning the recommendations, call Phyllis Yambor, R.N., Bureau of Immunization, at (850) 245-4342 or SunCom 205-4342.