Measles outbreaks associated with imported disease are likely to continue in the US. Participants in international events, international travelers, and persons with routine exposure to such travelers might be at greater risk of measles. To reduce the impact of imported cases, high measles, mumps, and rubella vaccine coverage rates should be maintained throughout the US, and support should continue for global measles control and elimination.

Background A routine 2-dose varicella vaccination program was adopted in 2007 in the United States to help further decrease varicella disease and prevent varicella outbreaks. We describe trends and characteristics of varicella outbreaks reported to CDC during 2005–2012 from 9 states. Methods Data on varicella outbreaks collected by 9 state health departments were submitted to CDC using the CDC outbreak reporting worksheet. Information was collected on dates of the outbreak, outbreak setting, and number of cases by outbreak; aggregate data was provided on the numbers of outbreak-related cases by age group, vaccination status, and laboratory confirmation. Results Nine hundred and twenty-nine outbreaks were reported from the 6 states which provided data for each year during 2005–2012. Based on data from these 6 states, the number of outbreaks declined by 78%, decreasing from 147 in 2005 to 33 outbreaks in 2012 (p=0.0001). There were a total of 1,015 varicella outbreaks involving 13,595 cases reported by the 9 states from 2005–2012. The size and duration of outbreaks declined significantly over time (p<0.001). The median size of outbreaks was 12, 9, and 7 cases and median duration of outbreaks was 38, 35, and 26 days during 2005–2006, 2007–2009, and 2010–2012 respectively. Majority of outbreaks (95%) were reported from schools, declining from 97% in 2005–2006 to 89% in 2010–2012. Sixty-five percent of outbreak-related cases occurred among 5–9 year olds, with the proportion declining from 76% in 2005–2006 to 45% during 2010–2012. Conclusions The routine 2-dose varicella vaccination program appears to have significantly reduced the number, size, and duration of varicella outbreaks in the U.S.

SYNOPSISObjective. The goals of this study were to estimate seroprevalence of prior hepatitis B infection among high-risk adolescents and to determine the costeffectiveness of prevaccination immunity screening.Methods. The authors computed a "break-even" seroprevalence level calculated from current vaccine and administration costs. They then conducted a seroprevalence study of hepatitis B core antibody using sera previously submitted for syphilis serology from four-hundred adolescent and adult clients of sexually transmitted disease clinics. Finally, the authors compared age groupspecific seroprevalence rates to the computed break-even seroprevalence.Results. Levels of prior hepatitis B infection for all age groups were lower than the break-even seroprevalence standard from which cost-effectiveness was calculated.Conclusions. From the findings of this study, the authors concluded that routine preimmunization screening for prior hepatitis B infection would not be cost-effective for this population.

From the findings of this study, the authors concluded that routine preimmunization screening for prior hepatitis B infection would not be cost-effective for this population.

The introduction of specific International Classification of Diseases-10th revision code for rotavirus in 1999 prompted us to examine the US mortality data for 1999-2007 to validate rotavirus-coded deaths. Of 38 rotavirus-coded deaths identified in the national multiple cause-of-death database, results of laboratory testing could be obtained for 21 deaths, all of which had confirmation of rotavirus by either microbiologic or histopathologic testing.