Past Updates from the Clinician Registry Listserv:
Update Sent April 18, 2005

NOTE: This document is provided for historical purposes only and may not provide our most accurate and up-to-date information. The most current Clinician's information can be found on the Clinician Home Page.

UPDATES TO INFORMATION AND GUIDANCE
The following updates were made to CDC information and guidance during the period of April 11-17, 2005, or reflect last week's current events. If you have any questions on these or other clinical issues, please call our toll-free Clinician Information Line at 877-554-4625 or write to us at coca@cdc.gov.

This update contains new information on the following topics:

• Influenza (H2N2)
• Viral Hemorrhagic Fevers (VHF)
• Tuberculosis (TB)
• Surveillance
• Preparedness
• Tsunami

INFLUENZA (H2N2)

Influenza A (H2N2) Situation
CDC, HHS, and the World Health Organization are working with the College
of American Pathologists (CAP) and other providers of proficiency testing panels
to ensure that influenza A/H2N2 samples sent to U.S. laboratories and laboratories
in 17 other countries are destroyed immediately. The A/H2N2 samples sent out
are similar to the A/H2N2 viruses that circulated in humans in 1957 at the beginning
of the Asian influenza pandemic. http://www.cdc.gov/flu/h2n2situation.htm

CDC Health Update: Instructions for Monitoring Health of Laboratory
Workers and for Destroying Influenza A (H2N2) Samples
On April 13, 2005, CDC issued a Health Advisory describing the inadvertent
distribution of influenza A (H2N2) samples to domestic and international laboratories
and recommending that those samples be destroyed immediately. This update
provides instructions for 1) monitoring for and reporting influenza-like illness among
laboratory workers who might have been exposed to the A (H2N2) samples and 2)
destroying influenza A (H2N2) samples by use of autoclaves, incineration, or
chemical decontamination. http://www.cdc.gov/flu/han041505.htm

Questions and Answers: Influenza A (H2N2) Panels
http://www.cdc.gov/flu/h2n2panelsqa.htm

Telebriefing Transcript - Update on Distribution of H2N2 Influenza Strain
Transcript of April 13^th press briefing with CDC Director, Julie Gerberding, MD, MPH.
http://www.cdc.gov/od/oc/media/transcripts/t050413.htm

CDC Health Advisory (HAN): CDC & WHO recommend that sample panels
of influenza A/H2N2 be destroyed – April 13, 2004
http://www2a.cdc.gov/han/ArchiveSys/ViewMsgV.asp?AlertNum=00227

WHO Statement: International response to the distribution of a H2N2
influenza virus for laboratory testing: Risk considered low for laboratory
workers & the public
http://www.who.int/csr/disease/influenza/h2n2_2005_04_12/en/

Questions and Answers on the Executive Order Adding Potentially
Pandemic Influenza Viruses to the List of Quarantinable Diseases
http://www.cdc.gov/ncidod/dq/qa_influenza_amendment_to_eo_13295.htm

VIRAL HEMORRHAGIC FEVERS (VHF)

Interim Guidance about Marburg Virus Infection for U.S. Citizens Living Abroad - updated
U.S. citizens living abroad should be aware that on March 23, 2005, the World
Health Organization (WHO) confirmed Marburg virus (family Filoviridae, which
includes Ebola virus) as the causative agent of an outbreak of viral hemorrhagic
fever (VHF) in Uige Province in northern Angola.  This document provides
recommendations for U.S. citizens living abroad.  For more information, please
see the link below. http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/marburg/abroad.htm

Information for Travelers - updated
http://www.cdc.gov/travel/other/marburg_vhf_angola_2005.htm

Interim Guidance for Humanitarian Workers - updated
http://www.cdc.gov/travel/other/marburghf/marburg_vhf_humanitarian_2005.htm

Interim Guidance for Airline Flight Crews, Cargo and Cleaning Personnel,
and Personnel Interacting with Arriving Passengers
http://www.cdc.gov/travel/other/marburghf/marburg_airlines_2005.htm

Marburg Hemorrhagic Fever Fact Sheet for the Business Sector - updated
http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/marburg/business.htm

TUBERCULOSIS (TB)

National Plan for Reliable Tuberculosis Laboratory Services Using a Systems Approach – MMWR Report
The report of the Association of Public Health Laboratories Task Force presents a
framework to improve the future of TB laboratory services and describes the role of
the laboratory in TB treatment and control, Task Force processes, general principles
and benchmarks, and steps for the dissemination of the Task Force recommendations.
This MMWR expands on the Task Force report by describing specific actions and
performance measures to guide development and implementation of an integrated
system for providing TB laboratory services. CDC and the Association of Public Health
Laboratories have developed these guidelines so that laboratorians, clinicians, public
health officials, administrators, and funding entities can work together to ensure that
health-care providers and TB-control officials have the information needed to treat TB
patients, prevent TB transmission, and ultimately eliminate TB in the United States.
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5406a1.htm

SURVEILLANCE

Bio-Detection Surveillance: The 2005 Early Aberration Reporting System
(EARS) Workshop

Date: June 11-13, 2005
Location: Miami, Florida, USA

Please see the link for more details:
http://www.bt.cdc.gov/surveillance/ears/2005workshop.asp

PREPAREDNESS

Preparedness Today:  What You Need to Know
The American Red Cross and the Centers for Disease Control and Prevention (CDC)
have teamed up to answer common questions and provide guidance on steps to protect
you and your loved ones. This site provides guidance on what kinds of emergency
supplies to put aside and advice on how, from food and water to disaster supplies kits.
http://www.redcross.org/preparedness/

TSUNAMI

Health Concerns Associated with Disaster Victim Identification After a Tsunami
--- Thailand, December 26, 2004--March 31, 2005 – MMWR Report
The number of persons confirmed dead from the Indian Ocean tsunami that struck on
December 26, 2004, had exceeded 174,000 as of March 31, 2005; the majority of
decedents were buried or cremated without being identified. In contrast, in Thailand,
disaster victim identification (DVI) continues, with approximately 1,800 persons identified
among the 5,395 persons confirmed dead; of the dead, approximately 50% were not
citizens of Thailand. This large-scale, multinational effort faced immediate challenges,
including establishment of four temporary morgues, implementation of safeguards against
environmental and occupational health hazards, and coordination of forensic procedures
and safety protocols among Thai and international forensic teams. Public health and other
agencies performing large-scale DVI in temporary morgues might consider implementing
the recommendations and procedures described in this report.
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5414a1.htm

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