Lorinda Bullock

Although a variety of injectable cosmetic fillers are in high demand, physicians should be aware that rare adverse reactions—like foreign body granulomas—are being reported, according to a case report.

Injectable permanent fillers containing polymethyl methacrylate (PMMA) immersed in a solution of collagen have been implicated in several types of adverse reactions, reported Dr. M.C. da Costa Miguel of the department of oral pathology at the Federal University of Rio Grande do Norte, Brazil, and his colleagues.

Foreign body granulomas only develop in some patients, and this particular granuloma formation caused by a reaction to injectable fillers is only observed in 0.01% of patients, further adding to the diagnostic challenge, the researchers wrote.

Dr. da Costa and his colleagues found the granulomas in a 56-year-old woman after performing a number of examinations. Initial examinations showed a "firm, pink nodule covered with non-ulcerated mucosa located in the right anterior inferior alveolar mucosa." The swelling was painless and moveable. There was no bone involvement, no palpable adenopathies, and the patient showed no symptoms of atopy (Int. J. Oral Maxillofac. Surg. 2009;38:385-7).

Salivary gland mucocoele was considered initiallly. After a biopsy, the researchers found that "immunohistochemical analysis using anti-CD68 antibody confirmed the presence of numerous macrophages and CD68-positive multinucleated giant cells."

The patient was asked if any aesthetic procedure had been performed close to the site of her swelling and she confirmed that she had an injection of a cosmetic filler containing PMMA for lip enlargement about 1 year earlier.

According to Dr. da Costa and his colleagues, what made this case particularly rare was its "unusual clinical presentation as a painless nodule located exclusively inside the oral cavity." They described the lesion as "indistinguishable from other pathologies such as salivary gland mucocoele or soft tissue neoplasm."

Foreign body granulomas can be successfully treated with intralesional or systemic corticosteroids, they noted. In this case, simple surgical excision was performed because it was a well-demarcated lesion.

Dr. da Costa and colleagues reported having no conflicts of interest.

Although a variety of injectable cosmetic fillers are in high demand, physicians should be aware that rare adverse reactions—like foreign body granulomas—are being reported, according to a case report.

Injectable permanent fillers containing polymethyl methacrylate (PMMA) immersed in a solution of collagen have been implicated in several types of adverse reactions, reported Dr. M.C. da Costa Miguel of the department of oral pathology at the Federal University of Rio Grande do Norte, Brazil, and his colleagues.

Foreign body granulomas only develop in some patients, and this particular granuloma formation caused by a reaction to injectable fillers is only observed in 0.01% of patients, further adding to the diagnostic challenge, the researchers wrote.

Dr. da Costa and his colleagues found the granulomas in a 56-year-old woman after performing a number of examinations. Initial examinations showed a "firm, pink nodule covered with non-ulcerated mucosa located in the right anterior inferior alveolar mucosa." The swelling was painless and moveable. There was no bone involvement, no palpable adenopathies, and the patient showed no symptoms of atopy (Int. J. Oral Maxillofac. Surg. 2009;38:385-7).

Salivary gland mucocoele was considered initiallly. After a biopsy, the researchers found that "immunohistochemical analysis using anti-CD68 antibody confirmed the presence of numerous macrophages and CD68-positive multinucleated giant cells."

The patient was asked if any aesthetic procedure had been performed close to the site of her swelling and she confirmed that she had an injection of a cosmetic filler containing PMMA for lip enlargement about 1 year earlier.

According to Dr. da Costa and his colleagues, what made this case particularly rare was its "unusual clinical presentation as a painless nodule located exclusively inside the oral cavity." They described the lesion as "indistinguishable from other pathologies such as salivary gland mucocoele or soft tissue neoplasm."

Foreign body granulomas can be successfully treated with intralesional or systemic corticosteroids, they noted. In this case, simple surgical excision was performed because it was a well-demarcated lesion.

Dr. da Costa and colleagues reported having no conflicts of interest.

Although a variety of injectable cosmetic fillers are in high demand, physicians should be aware that rare adverse reactions—like foreign body granulomas—are being reported, according to a case report.

Injectable permanent fillers containing polymethyl methacrylate (PMMA) immersed in a solution of collagen have been implicated in several types of adverse reactions, reported Dr. M.C. da Costa Miguel of the department of oral pathology at the Federal University of Rio Grande do Norte, Brazil, and his colleagues.

Foreign body granulomas only develop in some patients, and this particular granuloma formation caused by a reaction to injectable fillers is only observed in 0.01% of patients, further adding to the diagnostic challenge, the researchers wrote.

Dr. da Costa and his colleagues found the granulomas in a 56-year-old woman after performing a number of examinations. Initial examinations showed a "firm, pink nodule covered with non-ulcerated mucosa located in the right anterior inferior alveolar mucosa." The swelling was painless and moveable. There was no bone involvement, no palpable adenopathies, and the patient showed no symptoms of atopy (Int. J. Oral Maxillofac. Surg. 2009;38:385-7).

Salivary gland mucocoele was considered initiallly. After a biopsy, the researchers found that "immunohistochemical analysis using anti-CD68 antibody confirmed the presence of numerous macrophages and CD68-positive multinucleated giant cells."

The patient was asked if any aesthetic procedure had been performed close to the site of her swelling and she confirmed that she had an injection of a cosmetic filler containing PMMA for lip enlargement about 1 year earlier.

According to Dr. da Costa and his colleagues, what made this case particularly rare was its "unusual clinical presentation as a painless nodule located exclusively inside the oral cavity." They described the lesion as "indistinguishable from other pathologies such as salivary gland mucocoele or soft tissue neoplasm."

Foreign body granulomas can be successfully treated with intralesional or systemic corticosteroids, they noted. In this case, simple surgical excision was performed because it was a well-demarcated lesion.

Dr. da Costa and colleagues reported having no conflicts of interest.

Medicare and Medicaid beneficiaries living in Arizona and Utah are among the first to test-drive a pilot program that lets them access their personal health records online.

They also can add pertinent information such as their medications, preexisting conditions, and lab results, and electronically share them with their doctors, specialists, and family members.

In a teleconference held by the Centers for Medicare and Medicaid Services to announce the initiative, Department of Health and Human Services Secretary Mike Leavitt emphasized that personal health records (PHRs) are not like electronic health records owned by health care providers. Instead, PHRs are completely under patients' control.

“PHRs can contain a wealth of information entered by patients, their providers, and in some cases their health plan. They can authorize additional users such as a family member or other caregivers. Once a patient sets up a PHR, he or she can then add other information and ask Medicare to populate it with 2 years of previous claims data,” Mr. Leavitt said.

This electronic information would be valuable to both patients and providers, he said. A patient “could have his or her life saved because an emergency room doctor has immediate knowledge of preexisting conditions or an allergy or current medication. Routine medical visits could be made more convenient, quicker, and efficient by reducing unnecessary paperwork and duplicate tests.”

The goal of the initiative, known as the Medicare Personal Health Record Choice Pilot, is to give beneficiaries autonomy over their health care. CMS Acting Administrator Kerry Weems explained that people will have a choice of four service providers that will help them set up their free PHR online: GoogleHealth, HealthTrio, NoMoreClipboard, and PassportMD. The four companies were selected by an administrative contractor, Noridian Administrative Services, Fargo, N.D.

All four companies are “already out functioning in the marketplace” and able to provide secure sites for downloading sensitive information. Functionality, ease of use, compliance with standards, accessibility to providers and family members, and an outreach component to draw Medicare participants to their sites and develop PHRs were among selection criteria, Mr. Weems said.

Mr. Weems said he was unsure how many people could be expected to sign up for the pilot program but noted that the two states have a combined Medicare service population of about 1 million. The states also have a mix of rural and urban residents.

In addition to developing online PHRs, Medicare recently launched a nationwide program that will encourage doctors to enroll in e-prescribing services. Those who participate will receive financial incentives from Medicare, he said.

Medicare and Medicaid beneficiaries living in Arizona and Utah are among the first to test-drive a pilot program that lets them access their personal health records online.

They also can add pertinent information such as their medications, preexisting conditions, and lab results, and electronically share them with their doctors, specialists, and family members.

In a teleconference held by the Centers for Medicare and Medicaid Services to announce the initiative, Department of Health and Human Services Secretary Mike Leavitt emphasized that personal health records (PHRs) are not like electronic health records owned by health care providers. Instead, PHRs are completely under patients' control.

“PHRs can contain a wealth of information entered by patients, their providers, and in some cases their health plan. They can authorize additional users such as a family member or other caregivers. Once a patient sets up a PHR, he or she can then add other information and ask Medicare to populate it with 2 years of previous claims data,” Mr. Leavitt said.

This electronic information would be valuable to both patients and providers, he said. A patient “could have his or her life saved because an emergency room doctor has immediate knowledge of preexisting conditions or an allergy or current medication. Routine medical visits could be made more convenient, quicker, and efficient by reducing unnecessary paperwork and duplicate tests.”

The goal of the initiative, known as the Medicare Personal Health Record Choice Pilot, is to give beneficiaries autonomy over their health care. CMS Acting Administrator Kerry Weems explained that people will have a choice of four service providers that will help them set up their free PHR online: GoogleHealth, HealthTrio, NoMoreClipboard, and PassportMD. The four companies were selected by an administrative contractor, Noridian Administrative Services, Fargo, N.D.

All four companies are “already out functioning in the marketplace” and able to provide secure sites for downloading sensitive information. Functionality, ease of use, compliance with standards, accessibility to providers and family members, and an outreach component to draw Medicare participants to their sites and develop PHRs were among selection criteria, Mr. Weems said.

Mr. Weems said he was unsure how many people could be expected to sign up for the pilot program but noted that the two states have a combined Medicare service population of about 1 million. The states also have a mix of rural and urban residents.

In addition to developing online PHRs, Medicare recently launched a nationwide program that will encourage doctors to enroll in e-prescribing services. Those who participate will receive financial incentives from Medicare, he said.

Medicare and Medicaid beneficiaries living in Arizona and Utah are among the first to test-drive a pilot program that lets them access their personal health records online.

They also can add pertinent information such as their medications, preexisting conditions, and lab results, and electronically share them with their doctors, specialists, and family members.

In a teleconference held by the Centers for Medicare and Medicaid Services to announce the initiative, Department of Health and Human Services Secretary Mike Leavitt emphasized that personal health records (PHRs) are not like electronic health records owned by health care providers. Instead, PHRs are completely under patients' control.

“PHRs can contain a wealth of information entered by patients, their providers, and in some cases their health plan. They can authorize additional users such as a family member or other caregivers. Once a patient sets up a PHR, he or she can then add other information and ask Medicare to populate it with 2 years of previous claims data,” Mr. Leavitt said.

This electronic information would be valuable to both patients and providers, he said. A patient “could have his or her life saved because an emergency room doctor has immediate knowledge of preexisting conditions or an allergy or current medication. Routine medical visits could be made more convenient, quicker, and efficient by reducing unnecessary paperwork and duplicate tests.”

The goal of the initiative, known as the Medicare Personal Health Record Choice Pilot, is to give beneficiaries autonomy over their health care. CMS Acting Administrator Kerry Weems explained that people will have a choice of four service providers that will help them set up their free PHR online: GoogleHealth, HealthTrio, NoMoreClipboard, and PassportMD. The four companies were selected by an administrative contractor, Noridian Administrative Services, Fargo, N.D.

All four companies are “already out functioning in the marketplace” and able to provide secure sites for downloading sensitive information. Functionality, ease of use, compliance with standards, accessibility to providers and family members, and an outreach component to draw Medicare participants to their sites and develop PHRs were among selection criteria, Mr. Weems said.

Mr. Weems said he was unsure how many people could be expected to sign up for the pilot program but noted that the two states have a combined Medicare service population of about 1 million. The states also have a mix of rural and urban residents.

In addition to developing online PHRs, Medicare recently launched a nationwide program that will encourage doctors to enroll in e-prescribing services. Those who participate will receive financial incentives from Medicare, he said.

Medicare and Medicaid beneficiaries living in Arizona and Utah will be among the first to test drive a pilot program that allows them to access their personal health records online starting this month. They also will be able to add pertinent information such as their medications, preexisting conditions, and lab results and then electronically share them with their doctors, specialists, and family members.

During a telephone press conference held by the Centers for Medicare and Medicaid Services to announce the new initiative, Department of Health and Human Services Secretary Mike Leavitt emphasized that personal health records (PHR) are not like electronic health records that are owned by doctors and other health care providers. Instead, PHRs are completely under the control of patients.

"PHRs can contain a wealth of information entered by patients, their providers, and in some cases their health plan. They can authorize additional users such as a family member or other caregivers. Once a patient sets up a PHR, he or she can then add other information and ask Medicare to populate it with 2 years of previous claims data," Mr. Leavitt said.

This electronic information would be valuable to both patients and providers, he said. A patient "could have his or her life saved because an emergency room doctor has immediate knowledge of preexisting conditions or an allergy or current medication. Routine medical visits could be made more convenient, quicker, and efficient by reducing unnecessary paper work and duplicate tests."

The goal of this initiative, known as the Medicare Personal Health Record Choice Pilot, is to give beneficiaries total autonomy over their health care. CMS Acting Administrator Kerry Weems explained that, toward that end, people will have a choice of four service providers that will assist them in setting up their free PHR online: GoogleHealth, HealthTrio, NoMoreClipboard, and PassportMD.

The four companies were selected by an administrative contractor, Noridian Administrative Services, based in Fargo, N.D. Mr. Weems said all four companies are "already out functioning in the marketplace" and able to provide secure sites for downloading sensitive information. Functionality, ease of use, compliance with standards, accessibility to providers and family members, and an outreach component to draw Medicare participants to their sites and develop PHRs were among selection criteria, he said.

Mr. Weems said he was unsure how many people could be expected to sign up for the pilot program but noted that the two states have a combined Medicare service population of about one million.

In addition to the development of online PHRs, Medicare is also launching a nationwide program this month to encourage doctors to enroll in e-prescribing services. Those who participate will receive financial incentives from Medicare, he said.

"This is a real opportunity to demonstrate that health information technology is going to be a real enabler of high-quality health care in the 21st century," Mr. Weems noted.

Medicare and Medicaid beneficiaries living in Arizona and Utah will be among the first to test drive a pilot program that allows them to access their personal health records online starting this month. They also will be able to add pertinent information such as their medications, preexisting conditions, and lab results and then electronically share them with their doctors, specialists, and family members.

During a telephone press conference held by the Centers for Medicare and Medicaid Services to announce the new initiative, Department of Health and Human Services Secretary Mike Leavitt emphasized that personal health records (PHR) are not like electronic health records that are owned by doctors and other health care providers. Instead, PHRs are completely under the control of patients.

"PHRs can contain a wealth of information entered by patients, their providers, and in some cases their health plan. They can authorize additional users such as a family member or other caregivers. Once a patient sets up a PHR, he or she can then add other information and ask Medicare to populate it with 2 years of previous claims data," Mr. Leavitt said.

This electronic information would be valuable to both patients and providers, he said. A patient "could have his or her life saved because an emergency room doctor has immediate knowledge of preexisting conditions or an allergy or current medication. Routine medical visits could be made more convenient, quicker, and efficient by reducing unnecessary paper work and duplicate tests."

The goal of this initiative, known as the Medicare Personal Health Record Choice Pilot, is to give beneficiaries total autonomy over their health care. CMS Acting Administrator Kerry Weems explained that, toward that end, people will have a choice of four service providers that will assist them in setting up their free PHR online: GoogleHealth, HealthTrio, NoMoreClipboard, and PassportMD.

The four companies were selected by an administrative contractor, Noridian Administrative Services, based in Fargo, N.D. Mr. Weems said all four companies are "already out functioning in the marketplace" and able to provide secure sites for downloading sensitive information. Functionality, ease of use, compliance with standards, accessibility to providers and family members, and an outreach component to draw Medicare participants to their sites and develop PHRs were among selection criteria, he said.

Mr. Weems said he was unsure how many people could be expected to sign up for the pilot program but noted that the two states have a combined Medicare service population of about one million.

In addition to the development of online PHRs, Medicare is also launching a nationwide program this month to encourage doctors to enroll in e-prescribing services. Those who participate will receive financial incentives from Medicare, he said.

"This is a real opportunity to demonstrate that health information technology is going to be a real enabler of high-quality health care in the 21st century," Mr. Weems noted.

Medicare and Medicaid beneficiaries living in Arizona and Utah will be among the first to test drive a pilot program that allows them to access their personal health records online starting this month. They also will be able to add pertinent information such as their medications, preexisting conditions, and lab results and then electronically share them with their doctors, specialists, and family members.

During a telephone press conference held by the Centers for Medicare and Medicaid Services to announce the new initiative, Department of Health and Human Services Secretary Mike Leavitt emphasized that personal health records (PHR) are not like electronic health records that are owned by doctors and other health care providers. Instead, PHRs are completely under the control of patients.

"PHRs can contain a wealth of information entered by patients, their providers, and in some cases their health plan. They can authorize additional users such as a family member or other caregivers. Once a patient sets up a PHR, he or she can then add other information and ask Medicare to populate it with 2 years of previous claims data," Mr. Leavitt said.

This electronic information would be valuable to both patients and providers, he said. A patient "could have his or her life saved because an emergency room doctor has immediate knowledge of preexisting conditions or an allergy or current medication. Routine medical visits could be made more convenient, quicker, and efficient by reducing unnecessary paper work and duplicate tests."

The goal of this initiative, known as the Medicare Personal Health Record Choice Pilot, is to give beneficiaries total autonomy over their health care. CMS Acting Administrator Kerry Weems explained that, toward that end, people will have a choice of four service providers that will assist them in setting up their free PHR online: GoogleHealth, HealthTrio, NoMoreClipboard, and PassportMD.

The four companies were selected by an administrative contractor, Noridian Administrative Services, based in Fargo, N.D. Mr. Weems said all four companies are "already out functioning in the marketplace" and able to provide secure sites for downloading sensitive information. Functionality, ease of use, compliance with standards, accessibility to providers and family members, and an outreach component to draw Medicare participants to their sites and develop PHRs were among selection criteria, he said.

Mr. Weems said he was unsure how many people could be expected to sign up for the pilot program but noted that the two states have a combined Medicare service population of about one million.

In addition to the development of online PHRs, Medicare is also launching a nationwide program this month to encourage doctors to enroll in e-prescribing services. Those who participate will receive financial incentives from Medicare, he said.

"This is a real opportunity to demonstrate that health information technology is going to be a real enabler of high-quality health care in the 21st century," Mr. Weems noted.

A survey providing the first estimates for human papillomavirus vaccination found that 25% of girls aged 13–17 years had received at least one dose of the vaccine, according to a briefing by the Centers for Disease Control and Prevention.

“This was very good for a first-year measurement for a new vaccine,” said Dr. Lance Rodewald, director of the division of immunization services at the CDC's National Center for Immunization and Respiratory Diseases.

But while coverage rates for routinely recommended vaccines among U.S. teens are increasing, the number of adolescents fully immunized against diseases such as pertussis and meningitis is not yet at the 90% goal set by a government-led initiative.

The Healthy People 2010 initiative set goals for youths 13–15 years of age with three doses of hepatitis B vaccine; two doses of measles, mumps, and rubella vaccine; one dose of tetanus-diphtheria or tetanus, diphtheria, and acellular pertussis vaccine; and one dose of varicella vaccine for those who had not had chickenpox.

Healthy People 2010 did not include a goal for the HPV vaccine because it is still so new. The quadrivalent human papillomavirus (HPV4) is complete at three doses. Dr. Rodewald reported that an estimated 2.5 million 13- to 17-year-old girls have received the vaccine to date.

Dr. Rodewald presented results from the second National Immunization Survey (NIS-Teen), which he described as a national “report card on the implementation of the vaccines.” During the last quarter of 2007, parents of children between the ages of 13 and 17 years were interviewed about their child's vaccination history. The survey included 3,000 adolescents as participants, split almost evenly between boys and girls. The 13- to 17-year age group was selected because, according to Dr. Rodewald, the vaccines are targeted to 11- and 12-year-olds.

For HPV in particular, Dr. Rodewald said, 11- and 12-year-olds have a “very strong and robust” immune response that adds further protection that will last through the later, riskier periods. He also said the HPV vaccine can provide up to 6 years of protection. “You always want to vaccinate before the period where there could be disease, and so it's very important to vaccinate before the onset of sexual activity, and 11- and 12-year-olds, of course, is before the onset of sexual activity, so this provides protection in anticipation of exposure later on in life,” he said.

The numbers for the Tdap were also particularly encouraging, Dr. Rodewald said. Vaccinations increased from 10.8% in 2006 to 30.4%. For a “new vaccine in its second year of recommendation,” he said, 30.4% “is very good because it usually takes 6–9 years to achieve the desired 90% coverage.”

Compared with the 2006 estimates, Dr. Rodewald said, other areas of improvement included the following:

▸ Vaccination coverage levels for three or more doses of hepatitis B and two or more doses of MMR vaccine were more than 80%, very close to the Healthy People 2010 goal.

▸ The one-dose coverage of varicella vaccine, which protects against chickenpox, was 75.7%, but coverage with the new recommended two doses was low at 18.8% among preteens and teens without previous history of the disease.

▸ Of the adolescents surveyed, 32.4% received the meningococcal conjugate vaccination, compared with 11.7% in 2006.

Dr. Rodewald thanked and congratulated parents, doctors, and nurses for actively getting young children and adolescents vaccinated to improve the survey numbers, but he also encouraged them to continue to make sure these patients get the proper immunizations.

“The bottom line for the report card is we've got a great start for teens, but we need to keep this positive momentum going in order to provide the protection from infectious diseases that all teens should have.”

A survey providing the first estimates for human papillomavirus vaccination found that 25% of girls aged 13–17 years had received at least one dose of the vaccine, according to a briefing by the Centers for Disease Control and Prevention.

“This was very good for a first-year measurement for a new vaccine,” said Dr. Lance Rodewald, director of the division of immunization services at the CDC's National Center for Immunization and Respiratory Diseases.

But while coverage rates for routinely recommended vaccines among U.S. teens are increasing, the number of adolescents fully immunized against diseases such as pertussis and meningitis is not yet at the 90% goal set by a government-led initiative.

The Healthy People 2010 initiative set goals for youths 13–15 years of age with three doses of hepatitis B vaccine; two doses of measles, mumps, and rubella vaccine; one dose of tetanus-diphtheria or tetanus, diphtheria, and acellular pertussis vaccine; and one dose of varicella vaccine for those who had not had chickenpox.

Healthy People 2010 did not include a goal for the HPV vaccine because it is still so new. The quadrivalent human papillomavirus (HPV4) is complete at three doses. Dr. Rodewald reported that an estimated 2.5 million 13- to 17-year-old girls have received the vaccine to date.

Dr. Rodewald presented results from the second National Immunization Survey (NIS-Teen), which he described as a national “report card on the implementation of the vaccines.” During the last quarter of 2007, parents of children between the ages of 13 and 17 years were interviewed about their child's vaccination history. The survey included 3,000 adolescents as participants, split almost evenly between boys and girls. The 13- to 17-year age group was selected because, according to Dr. Rodewald, the vaccines are targeted to 11- and 12-year-olds.

For HPV in particular, Dr. Rodewald said, 11- and 12-year-olds have a “very strong and robust” immune response that adds further protection that will last through the later, riskier periods. He also said the HPV vaccine can provide up to 6 years of protection. “You always want to vaccinate before the period where there could be disease, and so it's very important to vaccinate before the onset of sexual activity, and 11- and 12-year-olds, of course, is before the onset of sexual activity, so this provides protection in anticipation of exposure later on in life,” he said.

The numbers for the Tdap were also particularly encouraging, Dr. Rodewald said. Vaccinations increased from 10.8% in 2006 to 30.4%. For a “new vaccine in its second year of recommendation,” he said, 30.4% “is very good because it usually takes 6–9 years to achieve the desired 90% coverage.”

Compared with the 2006 estimates, Dr. Rodewald said, other areas of improvement included the following:

▸ Vaccination coverage levels for three or more doses of hepatitis B and two or more doses of MMR vaccine were more than 80%, very close to the Healthy People 2010 goal.

▸ The one-dose coverage of varicella vaccine, which protects against chickenpox, was 75.7%, but coverage with the new recommended two doses was low at 18.8% among preteens and teens without previous history of the disease.

▸ Of the adolescents surveyed, 32.4% received the meningococcal conjugate vaccination, compared with 11.7% in 2006.

Dr. Rodewald thanked and congratulated parents, doctors, and nurses for actively getting young children and adolescents vaccinated to improve the survey numbers, but he also encouraged them to continue to make sure these patients get the proper immunizations.

“The bottom line for the report card is we've got a great start for teens, but we need to keep this positive momentum going in order to provide the protection from infectious diseases that all teens should have.”

A survey providing the first estimates for human papillomavirus vaccination found that 25% of girls aged 13–17 years had received at least one dose of the vaccine, according to a briefing by the Centers for Disease Control and Prevention.

“This was very good for a first-year measurement for a new vaccine,” said Dr. Lance Rodewald, director of the division of immunization services at the CDC's National Center for Immunization and Respiratory Diseases.

But while coverage rates for routinely recommended vaccines among U.S. teens are increasing, the number of adolescents fully immunized against diseases such as pertussis and meningitis is not yet at the 90% goal set by a government-led initiative.

The Healthy People 2010 initiative set goals for youths 13–15 years of age with three doses of hepatitis B vaccine; two doses of measles, mumps, and rubella vaccine; one dose of tetanus-diphtheria or tetanus, diphtheria, and acellular pertussis vaccine; and one dose of varicella vaccine for those who had not had chickenpox.

Healthy People 2010 did not include a goal for the HPV vaccine because it is still so new. The quadrivalent human papillomavirus (HPV4) is complete at three doses. Dr. Rodewald reported that an estimated 2.5 million 13- to 17-year-old girls have received the vaccine to date.

Dr. Rodewald presented results from the second National Immunization Survey (NIS-Teen), which he described as a national “report card on the implementation of the vaccines.” During the last quarter of 2007, parents of children between the ages of 13 and 17 years were interviewed about their child's vaccination history. The survey included 3,000 adolescents as participants, split almost evenly between boys and girls. The 13- to 17-year age group was selected because, according to Dr. Rodewald, the vaccines are targeted to 11- and 12-year-olds.

For HPV in particular, Dr. Rodewald said, 11- and 12-year-olds have a “very strong and robust” immune response that adds further protection that will last through the later, riskier periods. He also said the HPV vaccine can provide up to 6 years of protection. “You always want to vaccinate before the period where there could be disease, and so it's very important to vaccinate before the onset of sexual activity, and 11- and 12-year-olds, of course, is before the onset of sexual activity, so this provides protection in anticipation of exposure later on in life,” he said.

The numbers for the Tdap were also particularly encouraging, Dr. Rodewald said. Vaccinations increased from 10.8% in 2006 to 30.4%. For a “new vaccine in its second year of recommendation,” he said, 30.4% “is very good because it usually takes 6–9 years to achieve the desired 90% coverage.”

Compared with the 2006 estimates, Dr. Rodewald said, other areas of improvement included the following:

▸ Vaccination coverage levels for three or more doses of hepatitis B and two or more doses of MMR vaccine were more than 80%, very close to the Healthy People 2010 goal.

▸ The one-dose coverage of varicella vaccine, which protects against chickenpox, was 75.7%, but coverage with the new recommended two doses was low at 18.8% among preteens and teens without previous history of the disease.

▸ Of the adolescents surveyed, 32.4% received the meningococcal conjugate vaccination, compared with 11.7% in 2006.

Dr. Rodewald thanked and congratulated parents, doctors, and nurses for actively getting young children and adolescents vaccinated to improve the survey numbers, but he also encouraged them to continue to make sure these patients get the proper immunizations.

“The bottom line for the report card is we've got a great start for teens, but we need to keep this positive momentum going in order to provide the protection from infectious diseases that all teens should have.”

Twenty-five percent of girls aged 13–17 had received at least one dose of the human papillomavirus vaccine, according to results from the second National Immunization Survey (NIS-Teen).

“This was very good for a first-year measurement for a new vaccine,” Dr. Lance Rodewald, director of the division of immunization services at the Centers for Disease Control and Prevention's National Center for Immunization and Respiratory Diseases, said during a briefing.

But while coverage rates for routinely recommended vaccines among U.S. teens are increasing, the number of adolescents fully immunized against diseases such as pertussis and meningitis is not yet at the 90% goal set by a government-led initiative.

The Healthy People 2010 initiative set goals for youths 13–15 years of age with three doses of hepatitis B vaccine, two doses of measles, mumps, and rubella vaccine, one dose of tetanus-diphtheria or tetanus, diphtheria, and acellular pertussis vaccine, and one dose of varicella vaccine for those who had not had chickenpox.

Healthy People 2010 did not include a goal for the HPV vaccine because it is still so new. The quadrivalent human papillomavirus (HPV4) is complete at three doses. Dr. Rodewald said an estimated 2.5 million 13- to 17-year-old girls have received the vaccine to date.

Dr. Rodewald presented results from the second NIS-Teen, which he described as a national “report card on the implementation of the vaccines.” During the last quarter of 2007, parents of children between the ages of 13 and 17 were interviewed about their child's vaccination history. The survey included 3,000 adolescents as participants, split almost evenly between boys and girls.

The 13- to 17-year-old age group was selected because, according to Dr. Rodewald, the vaccines are targeted to 11- and 12-year-olds.

For HPV in particular, Dr. Rodewald said, 11- and 12-year-olds have a “very strong and robust” immune response that adds further protection that will last through the later, riskier periods. He also said the HPV vaccine can provide up to 6 years of protection.

“You always want to vaccinate before the period where there could be disease, and so it's very important to vaccinate before the onset of sexual activity, and 11- and 12-year-olds, of course, is before the onset of sexual activity, so this provides protection in anticipation of exposure later on in life,” he said.

The numbers for the Tdap were also particularly encouraging, Dr. Rodewald said. Vaccinations increased from 10.8% in 2006 to 30.4%. For a “new vaccine in its second year of recommendation,” he said, 30.4% “is very good because it usually takes 6–9 years to achieve the desired 90% coverage.”

Compared with the 2006 estimates, Dr. Rodewald said, other areas of improvement included the following:

▸ Vaccination coverage levels for three or more doses of hepatitis B and two or more doses of MMR vaccine were more than 80%, very close to the Healthy People 2010 goal.

▸ The one dose coverage of varicella vaccine, which protects against chickenpox, was 75.7%, but coverage with the new recommended two doses was low at 18.8% among preteens and teens without previous history of the disease.

▸ Of the adolescents surveyed, 32.4% received the meningococcal conjugate vaccination, compared with 11.7% in 2006.

Dr. Rodewald thanked and congratulated parents, doctors, and nurses for actively getting young children and adolescents vaccinated to improve the survey numbers, but he also encouraged them to continue to make sure these patients get the proper immunizations.

“The bottom line for the report card is we've got a great start for teens, but we need to keep this positive momentum going in order to provide the protection from infectious diseases that all teens should have.”

Twenty-five percent of girls aged 13–17 had received at least one dose of the human papillomavirus vaccine, according to results from the second National Immunization Survey (NIS-Teen).

“This was very good for a first-year measurement for a new vaccine,” Dr. Lance Rodewald, director of the division of immunization services at the Centers for Disease Control and Prevention's National Center for Immunization and Respiratory Diseases, said during a briefing.

But while coverage rates for routinely recommended vaccines among U.S. teens are increasing, the number of adolescents fully immunized against diseases such as pertussis and meningitis is not yet at the 90% goal set by a government-led initiative.

The Healthy People 2010 initiative set goals for youths 13–15 years of age with three doses of hepatitis B vaccine, two doses of measles, mumps, and rubella vaccine, one dose of tetanus-diphtheria or tetanus, diphtheria, and acellular pertussis vaccine, and one dose of varicella vaccine for those who had not had chickenpox.

Healthy People 2010 did not include a goal for the HPV vaccine because it is still so new. The quadrivalent human papillomavirus (HPV4) is complete at three doses. Dr. Rodewald said an estimated 2.5 million 13- to 17-year-old girls have received the vaccine to date.

Dr. Rodewald presented results from the second NIS-Teen, which he described as a national “report card on the implementation of the vaccines.” During the last quarter of 2007, parents of children between the ages of 13 and 17 were interviewed about their child's vaccination history. The survey included 3,000 adolescents as participants, split almost evenly between boys and girls.

The 13- to 17-year-old age group was selected because, according to Dr. Rodewald, the vaccines are targeted to 11- and 12-year-olds.

For HPV in particular, Dr. Rodewald said, 11- and 12-year-olds have a “very strong and robust” immune response that adds further protection that will last through the later, riskier periods. He also said the HPV vaccine can provide up to 6 years of protection.

“You always want to vaccinate before the period where there could be disease, and so it's very important to vaccinate before the onset of sexual activity, and 11- and 12-year-olds, of course, is before the onset of sexual activity, so this provides protection in anticipation of exposure later on in life,” he said.

The numbers for the Tdap were also particularly encouraging, Dr. Rodewald said. Vaccinations increased from 10.8% in 2006 to 30.4%. For a “new vaccine in its second year of recommendation,” he said, 30.4% “is very good because it usually takes 6–9 years to achieve the desired 90% coverage.”

Compared with the 2006 estimates, Dr. Rodewald said, other areas of improvement included the following:

▸ Vaccination coverage levels for three or more doses of hepatitis B and two or more doses of MMR vaccine were more than 80%, very close to the Healthy People 2010 goal.

▸ The one dose coverage of varicella vaccine, which protects against chickenpox, was 75.7%, but coverage with the new recommended two doses was low at 18.8% among preteens and teens without previous history of the disease.

▸ Of the adolescents surveyed, 32.4% received the meningococcal conjugate vaccination, compared with 11.7% in 2006.

Dr. Rodewald thanked and congratulated parents, doctors, and nurses for actively getting young children and adolescents vaccinated to improve the survey numbers, but he also encouraged them to continue to make sure these patients get the proper immunizations.

“The bottom line for the report card is we've got a great start for teens, but we need to keep this positive momentum going in order to provide the protection from infectious diseases that all teens should have.”

Twenty-five percent of girls aged 13–17 had received at least one dose of the human papillomavirus vaccine, according to results from the second National Immunization Survey (NIS-Teen).

“This was very good for a first-year measurement for a new vaccine,” Dr. Lance Rodewald, director of the division of immunization services at the Centers for Disease Control and Prevention's National Center for Immunization and Respiratory Diseases, said during a briefing.

But while coverage rates for routinely recommended vaccines among U.S. teens are increasing, the number of adolescents fully immunized against diseases such as pertussis and meningitis is not yet at the 90% goal set by a government-led initiative.

The Healthy People 2010 initiative set goals for youths 13–15 years of age with three doses of hepatitis B vaccine, two doses of measles, mumps, and rubella vaccine, one dose of tetanus-diphtheria or tetanus, diphtheria, and acellular pertussis vaccine, and one dose of varicella vaccine for those who had not had chickenpox.

Healthy People 2010 did not include a goal for the HPV vaccine because it is still so new. The quadrivalent human papillomavirus (HPV4) is complete at three doses. Dr. Rodewald said an estimated 2.5 million 13- to 17-year-old girls have received the vaccine to date.

Dr. Rodewald presented results from the second NIS-Teen, which he described as a national “report card on the implementation of the vaccines.” During the last quarter of 2007, parents of children between the ages of 13 and 17 were interviewed about their child's vaccination history. The survey included 3,000 adolescents as participants, split almost evenly between boys and girls.

The 13- to 17-year-old age group was selected because, according to Dr. Rodewald, the vaccines are targeted to 11- and 12-year-olds.

For HPV in particular, Dr. Rodewald said, 11- and 12-year-olds have a “very strong and robust” immune response that adds further protection that will last through the later, riskier periods. He also said the HPV vaccine can provide up to 6 years of protection.

“You always want to vaccinate before the period where there could be disease, and so it's very important to vaccinate before the onset of sexual activity, and 11- and 12-year-olds, of course, is before the onset of sexual activity, so this provides protection in anticipation of exposure later on in life,” he said.

The numbers for the Tdap were also particularly encouraging, Dr. Rodewald said. Vaccinations increased from 10.8% in 2006 to 30.4%. For a “new vaccine in its second year of recommendation,” he said, 30.4% “is very good because it usually takes 6–9 years to achieve the desired 90% coverage.”

Compared with the 2006 estimates, Dr. Rodewald said, other areas of improvement included the following:

▸ Vaccination coverage levels for three or more doses of hepatitis B and two or more doses of MMR vaccine were more than 80%, very close to the Healthy People 2010 goal.

▸ The one dose coverage of varicella vaccine, which protects against chickenpox, was 75.7%, but coverage with the new recommended two doses was low at 18.8% among preteens and teens without previous history of the disease.

▸ Of the adolescents surveyed, 32.4% received the meningococcal conjugate vaccination, compared with 11.7% in 2006.

Dr. Rodewald thanked and congratulated parents, doctors, and nurses for actively getting young children and adolescents vaccinated to improve the survey numbers, but he also encouraged them to continue to make sure these patients get the proper immunizations.

“The bottom line for the report card is we've got a great start for teens, but we need to keep this positive momentum going in order to provide the protection from infectious diseases that all teens should have.”

A survey providing the first estimates for human papillomavirus vaccination found that 25% of girls aged 13–17 had received at least one dose of the vaccine, according to the Centers for Disease Control and Prevention.

“This was very good for a first-year measurement for a new vaccine,” said Dr. Lance Rodewald, director of the division of immunization services at the CDC's National Center for Immunization and Respiratory Diseases.

But while coverage rates for routinely recommended vaccines among U.S. teens are increasing, the number of adolescents fully immunized against diseases such as pertussis and meningitis is not yet at the 90% goal set by a government-led initiative.

The Healthy People 2010 initiative set goals for youths 13–15 years of age with three doses of hepatitis B vaccine, two doses of measles, mumps, and rubella vaccine, one dose of tetanus-diphtheria or tetanus, diphtheria, and acellular pertussis vaccine, and one dose of varicella vaccine for those who had not had chickenpox.

Healthy People 2010 did not include a goal for the HPV vaccine because it is still so new. The quadrivalent human papillomavirus (HPV4) is complete at three doses. Dr. Rodewald said an estimated 2.5 million 13- to 17-year-old girls have received the vaccine to date.

At a briefing, Dr. Rodewald presented results from the second National Immunization Survey (NIS-Teen), which he described as a national “report card on the implementation of the vaccines.”

During the last quarter of 2007, parents of children between the ages of 13 and 17 were interviewed about their child's vaccination history. The survey included 3,000 adolescents as participants, split almost evenly between boys and girls. The 13- to 17-year-old age group was selected because, according to Dr. Rodewald, the vaccines are targeted to 11- and 12-year-olds.

For HPV in particular, Dr. Rodewald said, 11- and 12-year-olds have a “very strong and robust” immune response that adds further protection that will last through the later, riskier periods. He also said the HPV vaccine can provide up to 6 years of protection.

“You always want to vaccinate before the period where there could be disease, and so it's very important to vaccinate before the onset of sexual activity, and [ages 11 and 12 years], of course, is before the onset of sexual activity, so this provides protection in anticipation of exposure later on in life,” he said.

The numbers for the Tdap were also particularly encouraging, Dr. Rodewald said. Vaccinations increased from 10.8% in 2006 to 30.4%. For a “new vaccine in its second year of recommendation [30.4%] is very good because it usually takes 6 to 9 years to achieve the desired 90% coverage.”

Compared with the 2006 estimates, Dr. Rodewald said, other areas of improvement included the following:

▸ Vaccination coverage levels for three or more doses of hepatitis B and two or more doses of MMR vaccine were more than 80%, very close to the Healthy People 2010 goal.

▸ The one dose coverage of varicella vaccine, which protects against chickenpox, was 75.7%, but coverage with the new recommended two doses was low at 18.8% among preteens and teens without previous history of the disease.

▸ Of the adolescents surveyed, 32.4% received the meningococcal conjugate vaccination, compared with 11.7% in 2006.

Dr. Rodewald praised parents, doctors, and nurses for getting young children and adolescents vaccinated to improve the survey numbers, but he also encouraged them to continue to make sure these patients get the proper immunizations.

“The bottom line for the report card is we've got a great start for teens, but we need to keep this positive momentum going in order to provide the protection from infectious diseases that all teens should have.”

A survey providing the first estimates for human papillomavirus vaccination found that 25% of girls aged 13–17 had received at least one dose of the vaccine, according to the Centers for Disease Control and Prevention.

“This was very good for a first-year measurement for a new vaccine,” said Dr. Lance Rodewald, director of the division of immunization services at the CDC's National Center for Immunization and Respiratory Diseases.

But while coverage rates for routinely recommended vaccines among U.S. teens are increasing, the number of adolescents fully immunized against diseases such as pertussis and meningitis is not yet at the 90% goal set by a government-led initiative.

The Healthy People 2010 initiative set goals for youths 13–15 years of age with three doses of hepatitis B vaccine, two doses of measles, mumps, and rubella vaccine, one dose of tetanus-diphtheria or tetanus, diphtheria, and acellular pertussis vaccine, and one dose of varicella vaccine for those who had not had chickenpox.

Healthy People 2010 did not include a goal for the HPV vaccine because it is still so new. The quadrivalent human papillomavirus (HPV4) is complete at three doses. Dr. Rodewald said an estimated 2.5 million 13- to 17-year-old girls have received the vaccine to date.

At a briefing, Dr. Rodewald presented results from the second National Immunization Survey (NIS-Teen), which he described as a national “report card on the implementation of the vaccines.”

During the last quarter of 2007, parents of children between the ages of 13 and 17 were interviewed about their child's vaccination history. The survey included 3,000 adolescents as participants, split almost evenly between boys and girls. The 13- to 17-year-old age group was selected because, according to Dr. Rodewald, the vaccines are targeted to 11- and 12-year-olds.

For HPV in particular, Dr. Rodewald said, 11- and 12-year-olds have a “very strong and robust” immune response that adds further protection that will last through the later, riskier periods. He also said the HPV vaccine can provide up to 6 years of protection.

“You always want to vaccinate before the period where there could be disease, and so it's very important to vaccinate before the onset of sexual activity, and [ages 11 and 12 years], of course, is before the onset of sexual activity, so this provides protection in anticipation of exposure later on in life,” he said.

The numbers for the Tdap were also particularly encouraging, Dr. Rodewald said. Vaccinations increased from 10.8% in 2006 to 30.4%. For a “new vaccine in its second year of recommendation [30.4%] is very good because it usually takes 6 to 9 years to achieve the desired 90% coverage.”

Compared with the 2006 estimates, Dr. Rodewald said, other areas of improvement included the following:

▸ Vaccination coverage levels for three or more doses of hepatitis B and two or more doses of MMR vaccine were more than 80%, very close to the Healthy People 2010 goal.

▸ The one dose coverage of varicella vaccine, which protects against chickenpox, was 75.7%, but coverage with the new recommended two doses was low at 18.8% among preteens and teens without previous history of the disease.

▸ Of the adolescents surveyed, 32.4% received the meningococcal conjugate vaccination, compared with 11.7% in 2006.

Dr. Rodewald praised parents, doctors, and nurses for getting young children and adolescents vaccinated to improve the survey numbers, but he also encouraged them to continue to make sure these patients get the proper immunizations.

“The bottom line for the report card is we've got a great start for teens, but we need to keep this positive momentum going in order to provide the protection from infectious diseases that all teens should have.”

A survey providing the first estimates for human papillomavirus vaccination found that 25% of girls aged 13–17 had received at least one dose of the vaccine, according to the Centers for Disease Control and Prevention.

“This was very good for a first-year measurement for a new vaccine,” said Dr. Lance Rodewald, director of the division of immunization services at the CDC's National Center for Immunization and Respiratory Diseases.

But while coverage rates for routinely recommended vaccines among U.S. teens are increasing, the number of adolescents fully immunized against diseases such as pertussis and meningitis is not yet at the 90% goal set by a government-led initiative.

The Healthy People 2010 initiative set goals for youths 13–15 years of age with three doses of hepatitis B vaccine, two doses of measles, mumps, and rubella vaccine, one dose of tetanus-diphtheria or tetanus, diphtheria, and acellular pertussis vaccine, and one dose of varicella vaccine for those who had not had chickenpox.

Healthy People 2010 did not include a goal for the HPV vaccine because it is still so new. The quadrivalent human papillomavirus (HPV4) is complete at three doses. Dr. Rodewald said an estimated 2.5 million 13- to 17-year-old girls have received the vaccine to date.

At a briefing, Dr. Rodewald presented results from the second National Immunization Survey (NIS-Teen), which he described as a national “report card on the implementation of the vaccines.”

During the last quarter of 2007, parents of children between the ages of 13 and 17 were interviewed about their child's vaccination history. The survey included 3,000 adolescents as participants, split almost evenly between boys and girls. The 13- to 17-year-old age group was selected because, according to Dr. Rodewald, the vaccines are targeted to 11- and 12-year-olds.

For HPV in particular, Dr. Rodewald said, 11- and 12-year-olds have a “very strong and robust” immune response that adds further protection that will last through the later, riskier periods. He also said the HPV vaccine can provide up to 6 years of protection.

“You always want to vaccinate before the period where there could be disease, and so it's very important to vaccinate before the onset of sexual activity, and [ages 11 and 12 years], of course, is before the onset of sexual activity, so this provides protection in anticipation of exposure later on in life,” he said.

The numbers for the Tdap were also particularly encouraging, Dr. Rodewald said. Vaccinations increased from 10.8% in 2006 to 30.4%. For a “new vaccine in its second year of recommendation [30.4%] is very good because it usually takes 6 to 9 years to achieve the desired 90% coverage.”

Compared with the 2006 estimates, Dr. Rodewald said, other areas of improvement included the following:

▸ Vaccination coverage levels for three or more doses of hepatitis B and two or more doses of MMR vaccine were more than 80%, very close to the Healthy People 2010 goal.

▸ The one dose coverage of varicella vaccine, which protects against chickenpox, was 75.7%, but coverage with the new recommended two doses was low at 18.8% among preteens and teens without previous history of the disease.

▸ Of the adolescents surveyed, 32.4% received the meningococcal conjugate vaccination, compared with 11.7% in 2006.

Dr. Rodewald praised parents, doctors, and nurses for getting young children and adolescents vaccinated to improve the survey numbers, but he also encouraged them to continue to make sure these patients get the proper immunizations.

“The bottom line for the report card is we've got a great start for teens, but we need to keep this positive momentum going in order to provide the protection from infectious diseases that all teens should have.”

The Food and Drug Administration approved a new test that can diagnose human influenza infections, including the highly pathogenic influenza A (H5N1) virus, and produce results within 4 hours.

The device, known as the Human Influenza Virus Real-Time RT-PCR Detection and Characterization Panel (rRT-PCR Flu Panel), was developed by the Centers for Disease Control and Prevention. It is able to detect and identify the most commonly circulating human influenza viruses using a molecular biology technique that can “differentiate between seasonal and novel influenza,” according to a written statement released jointly by the FDA and CDC.

The ability to distinguish those differences facilitates speedier diagnoses, Dr. Frank Torti, FDA principal deputy commissioner and chief scientist, said in the statement.

“It will also provide qualified laboratories with a means to rapidly detect new influenza viruses that have not been identified yet and that could pose a pandemic risk,” Dr. Torti commented.

Dr. Julie Gerberding, director of the CDC, emphasized the value of having a tool that can test multiple samples at the same time and produce results faster.

Representatives of the FDA and the CDC said the device isolates and amplifies viral genetic material present in secretions taken from a patient's nose or throat. That material is analyzed by another device, called the Applied Biosystems 7500 Fast Dx, which was approved simultaneously with the rRT-PCR Flu Panel.

The test will be available to CDC-qualified laboratories as soon as the end of this year. Some labs will be eligible to receive reagents free of charge to aid in the testing process.

The CDC, Applied Biosystems Inc., and the Association of Public Health Laboratories collaborated on the development of the new test.

The H5N1 virus is of particular concern to researchers because it can circulate widely among people, raising the threat of a pandemic.

According to World Health Organization data, there have been 387 cases and 245 deaths from the virus worldwide since 2003.

The Food and Drug Administration approved a new test that can diagnose human influenza infections, including the highly pathogenic influenza A (H5N1) virus, and produce results within 4 hours.

The device, known as the Human Influenza Virus Real-Time RT-PCR Detection and Characterization Panel (rRT-PCR Flu Panel), was developed by the Centers for Disease Control and Prevention. It is able to detect and identify the most commonly circulating human influenza viruses using a molecular biology technique that can “differentiate between seasonal and novel influenza,” according to a written statement released jointly by the FDA and CDC.

The ability to distinguish those differences facilitates speedier diagnoses, Dr. Frank Torti, FDA principal deputy commissioner and chief scientist, said in the statement.

“It will also provide qualified laboratories with a means to rapidly detect new influenza viruses that have not been identified yet and that could pose a pandemic risk,” Dr. Torti commented.

Dr. Julie Gerberding, director of the CDC, emphasized the value of having a tool that can test multiple samples at the same time and produce results faster.

Representatives of the FDA and the CDC said the device isolates and amplifies viral genetic material present in secretions taken from a patient's nose or throat. That material is analyzed by another device, called the Applied Biosystems 7500 Fast Dx, which was approved simultaneously with the rRT-PCR Flu Panel.

The test will be available to CDC-qualified laboratories as soon as the end of this year. Some labs will be eligible to receive reagents free of charge to aid in the testing process.

The CDC, Applied Biosystems Inc., and the Association of Public Health Laboratories collaborated on the development of the new test.

The H5N1 virus is of particular concern to researchers because it can circulate widely among people, raising the threat of a pandemic.

According to World Health Organization data, there have been 387 cases and 245 deaths from the virus worldwide since 2003.

The Food and Drug Administration approved a new test that can diagnose human influenza infections, including the highly pathogenic influenza A (H5N1) virus, and produce results within 4 hours.

The device, known as the Human Influenza Virus Real-Time RT-PCR Detection and Characterization Panel (rRT-PCR Flu Panel), was developed by the Centers for Disease Control and Prevention. It is able to detect and identify the most commonly circulating human influenza viruses using a molecular biology technique that can “differentiate between seasonal and novel influenza,” according to a written statement released jointly by the FDA and CDC.

The ability to distinguish those differences facilitates speedier diagnoses, Dr. Frank Torti, FDA principal deputy commissioner and chief scientist, said in the statement.

“It will also provide qualified laboratories with a means to rapidly detect new influenza viruses that have not been identified yet and that could pose a pandemic risk,” Dr. Torti commented.

Dr. Julie Gerberding, director of the CDC, emphasized the value of having a tool that can test multiple samples at the same time and produce results faster.

Representatives of the FDA and the CDC said the device isolates and amplifies viral genetic material present in secretions taken from a patient's nose or throat. That material is analyzed by another device, called the Applied Biosystems 7500 Fast Dx, which was approved simultaneously with the rRT-PCR Flu Panel.

The test will be available to CDC-qualified laboratories as soon as the end of this year. Some labs will be eligible to receive reagents free of charge to aid in the testing process.

The CDC, Applied Biosystems Inc., and the Association of Public Health Laboratories collaborated on the development of the new test.

The H5N1 virus is of particular concern to researchers because it can circulate widely among people, raising the threat of a pandemic.

According to World Health Organization data, there have been 387 cases and 245 deaths from the virus worldwide since 2003.

The Food and Drug Administration approved a new test that can diagnose human influenza infections, including the highly pathogenic influenza A (H5N1) virus, and produce results within 4 hours.

The device, known as the Human Influenza Virus Real-Time RT-PCR Detection and Characterization Panel (rRT-PCR Flu Panel), was developed by the Centers for Disease Control and Prevention. It is able to detect and identify the most commonly circulating human influenza viruses using a molecular biology technique that can "differentiate between seasonal and novel influenza," according to a written statement released jointly by the FDA and CDC.

The ability to distinguish those differences facilitates speedier diagnoses, Dr. Frank Torti, FDA principal deputy commissioner and chief scientist said in the statement. "It will also provide qualified laboratories with a means to rapidly detect new influenza viruses that have not been identified yet and that could pose a pandemic risk."

Dr. Julie Gerberding, director of the CDC, emphasized the value of having a tool that can test multiple samples at the same time and produce results faster.

The FDA and CDC said the device isolates and amplifies viral genetic material present in secretions taken from a patient's nose or throat. That material is analyzed by another device approved simultaneously with the rRT-PCR Flu Panel, called the Applied Biosystems 7500 Fast Dx.

The test will be available to CDC-qualified laboratories as soon as this fall, and some labs will be able to receive free of charge reagents to aid in the testing process. The CDC, Applied Biosystems Inc., and the Association of Public Health Laboratories collaborated on the development of the new test.

The Food and Drug Administration approved a new test that can diagnose human influenza infections, including the highly pathogenic influenza A (H5N1) virus, and produce results within 4 hours.

The device, known as the Human Influenza Virus Real-Time RT-PCR Detection and Characterization Panel (rRT-PCR Flu Panel), was developed by the Centers for Disease Control and Prevention. It is able to detect and identify the most commonly circulating human influenza viruses using a molecular biology technique that can "differentiate between seasonal and novel influenza," according to a written statement released jointly by the FDA and CDC.

The ability to distinguish those differences facilitates speedier diagnoses, Dr. Frank Torti, FDA principal deputy commissioner and chief scientist said in the statement. "It will also provide qualified laboratories with a means to rapidly detect new influenza viruses that have not been identified yet and that could pose a pandemic risk."

Dr. Julie Gerberding, director of the CDC, emphasized the value of having a tool that can test multiple samples at the same time and produce results faster.

The FDA and CDC said the device isolates and amplifies viral genetic material present in secretions taken from a patient's nose or throat. That material is analyzed by another device approved simultaneously with the rRT-PCR Flu Panel, called the Applied Biosystems 7500 Fast Dx.

The test will be available to CDC-qualified laboratories as soon as this fall, and some labs will be able to receive free of charge reagents to aid in the testing process. The CDC, Applied Biosystems Inc., and the Association of Public Health Laboratories collaborated on the development of the new test.

The Food and Drug Administration approved a new test that can diagnose human influenza infections, including the highly pathogenic influenza A (H5N1) virus, and produce results within 4 hours.

The device, known as the Human Influenza Virus Real-Time RT-PCR Detection and Characterization Panel (rRT-PCR Flu Panel), was developed by the Centers for Disease Control and Prevention. It is able to detect and identify the most commonly circulating human influenza viruses using a molecular biology technique that can "differentiate between seasonal and novel influenza," according to a written statement released jointly by the FDA and CDC.

The ability to distinguish those differences facilitates speedier diagnoses, Dr. Frank Torti, FDA principal deputy commissioner and chief scientist said in the statement. "It will also provide qualified laboratories with a means to rapidly detect new influenza viruses that have not been identified yet and that could pose a pandemic risk."

Dr. Julie Gerberding, director of the CDC, emphasized the value of having a tool that can test multiple samples at the same time and produce results faster.

The FDA and CDC said the device isolates and amplifies viral genetic material present in secretions taken from a patient's nose or throat. That material is analyzed by another device approved simultaneously with the rRT-PCR Flu Panel, called the Applied Biosystems 7500 Fast Dx.

The test will be available to CDC-qualified laboratories as soon as this fall, and some labs will be able to receive free of charge reagents to aid in the testing process. The CDC, Applied Biosystems Inc., and the Association of Public Health Laboratories collaborated on the development of the new test.

A survey providing the first estimates for human papillomavirus vaccination found that 25% of girls aged 13–17 had received at least one dose of the vaccine, according to a briefing by the Centers for Disease Control and Prevention.

"This was very good for a first-year measurement for a new vaccine," said Dr. Lance Rodewald, director of the division of immunization services at the CDC's National Center for Immunization and Respiratory Diseases.

But while coverage rates for routinely recommended vaccines among U.S. teens are increasing, the number of adolescents fully immunized against diseases such as pertussis and meningitis is not yet at the 90% goal set by a government-led initiative.

The Healthy People 2010 initiative set goals for youths 13–15 years of age with three doses of hepatitis B vaccine, two doses of measles, mumps, and rubella vaccine, one dose of tetanus-diphtheria or tetanus, diphtheria, and acellular pertussis vaccine, and one dose of varicella vaccine for those who had not had chickenpox.

Healthy People 2010 did not include a goal for the HPV vaccine because it is still so new. The quadrivalent human papillomavirus (HPV4) is complete at three doses. Dr. Rodewald said an estimated 2.5 million 13- to 17-year-old girls have received the vaccine to date.

Dr. Rodewald presented results from the second National Immunization Survey (NIS-Teen), which he described as a national "report card on the implementation of the vaccines." During the last quarter of 2007, parents of children between the ages of 13 and 17 were interviewed about their child's vaccination history. The survey included 3,000 adolescents as participants, split almost evenly between boys and girls. The 13- to 17-year-old age group was selected because, according to Dr. Rodewald, the vaccines are targeted to 11- and 12-year-olds.

For HPV in particular, Dr. Rodewald said, 11- and 12-year-olds have a "very strong and robust" immune response that adds further protection that will last through the later, riskier periods. He also said that the HPV vaccine can provide up to 6 years of protection.

"You always want to vaccinate before the period where there could be disease, and so it's very important to vaccinate before the onset of sexual activity, and 11- and 12-year-olds, of course, is before the onset of sexual activity, so this provides protection in anticipation of exposure later on in life," he said.

The numbers for the Tdap were also particularly encouraging, Dr. Rodewald said. Vaccinations increased from 10.8% in 2006 to 30.4%. For a "new vaccine in its second year of recommendation," he said, 30.4% "is very good because it usually takes 6–9 years to achieve the desired 90% coverage."

Compared with the 2006 estimates, Dr. Rodewald said, other areas of improvement included the following:

▸ Vaccination coverage levels for three or more doses of hepatitis B and two or more doses of MMR vaccine were more than 80%, very close to the Healthy People 2010 goal.

▸ The one dose coverage of varicella vaccine, which protects against chickenpox, was 75.7%, but coverage with the new recommended two doses was low at 18.8% among preteens and teens without previous history of the disease.

▸ Of the adolescents surveyed, 32.4% received the meningococcal conjugate vaccination, compared with 11.7% in 2006.

To further emphasize the seriousness of these diseases if young people are not vaccinated, Dr. Rodewald noted that while pertussis is well controlled among young children, it is on the rise in teens and young adults. Prior to the 2005–2006 recommendations, he said that meningococcal disease, which is the leading cause of bacterial meningitis, and HPV have not been preventable through routine vaccination. He also mentioned that 4,000 women die from cervical cancer a year—most of those cases being caused by HPV strains.

A survey providing the first estimates for human papillomavirus vaccination found that 25% of girls aged 13–17 had received at least one dose of the vaccine, according to a briefing by the Centers for Disease Control and Prevention.

"This was very good for a first-year measurement for a new vaccine," said Dr. Lance Rodewald, director of the division of immunization services at the CDC's National Center for Immunization and Respiratory Diseases.

But while coverage rates for routinely recommended vaccines among U.S. teens are increasing, the number of adolescents fully immunized against diseases such as pertussis and meningitis is not yet at the 90% goal set by a government-led initiative.

The Healthy People 2010 initiative set goals for youths 13–15 years of age with three doses of hepatitis B vaccine, two doses of measles, mumps, and rubella vaccine, one dose of tetanus-diphtheria or tetanus, diphtheria, and acellular pertussis vaccine, and one dose of varicella vaccine for those who had not had chickenpox.

Healthy People 2010 did not include a goal for the HPV vaccine because it is still so new. The quadrivalent human papillomavirus (HPV4) is complete at three doses. Dr. Rodewald said an estimated 2.5 million 13- to 17-year-old girls have received the vaccine to date.

Dr. Rodewald presented results from the second National Immunization Survey (NIS-Teen), which he described as a national "report card on the implementation of the vaccines." During the last quarter of 2007, parents of children between the ages of 13 and 17 were interviewed about their child's vaccination history. The survey included 3,000 adolescents as participants, split almost evenly between boys and girls. The 13- to 17-year-old age group was selected because, according to Dr. Rodewald, the vaccines are targeted to 11- and 12-year-olds.

For HPV in particular, Dr. Rodewald said, 11- and 12-year-olds have a "very strong and robust" immune response that adds further protection that will last through the later, riskier periods. He also said that the HPV vaccine can provide up to 6 years of protection.

"You always want to vaccinate before the period where there could be disease, and so it's very important to vaccinate before the onset of sexual activity, and 11- and 12-year-olds, of course, is before the onset of sexual activity, so this provides protection in anticipation of exposure later on in life," he said.

The numbers for the Tdap were also particularly encouraging, Dr. Rodewald said. Vaccinations increased from 10.8% in 2006 to 30.4%. For a "new vaccine in its second year of recommendation," he said, 30.4% "is very good because it usually takes 6–9 years to achieve the desired 90% coverage."

Compared with the 2006 estimates, Dr. Rodewald said, other areas of improvement included the following:

▸ Vaccination coverage levels for three or more doses of hepatitis B and two or more doses of MMR vaccine were more than 80%, very close to the Healthy People 2010 goal.

▸ The one dose coverage of varicella vaccine, which protects against chickenpox, was 75.7%, but coverage with the new recommended two doses was low at 18.8% among preteens and teens without previous history of the disease.

▸ Of the adolescents surveyed, 32.4% received the meningococcal conjugate vaccination, compared with 11.7% in 2006.

To further emphasize the seriousness of these diseases if young people are not vaccinated, Dr. Rodewald noted that while pertussis is well controlled among young children, it is on the rise in teens and young adults. Prior to the 2005–2006 recommendations, he said that meningococcal disease, which is the leading cause of bacterial meningitis, and HPV have not been preventable through routine vaccination. He also mentioned that 4,000 women die from cervical cancer a year—most of those cases being caused by HPV strains.

A survey providing the first estimates for human papillomavirus vaccination found that 25% of girls aged 13–17 had received at least one dose of the vaccine, according to a briefing by the Centers for Disease Control and Prevention.

"This was very good for a first-year measurement for a new vaccine," said Dr. Lance Rodewald, director of the division of immunization services at the CDC's National Center for Immunization and Respiratory Diseases.

But while coverage rates for routinely recommended vaccines among U.S. teens are increasing, the number of adolescents fully immunized against diseases such as pertussis and meningitis is not yet at the 90% goal set by a government-led initiative.

The Healthy People 2010 initiative set goals for youths 13–15 years of age with three doses of hepatitis B vaccine, two doses of measles, mumps, and rubella vaccine, one dose of tetanus-diphtheria or tetanus, diphtheria, and acellular pertussis vaccine, and one dose of varicella vaccine for those who had not had chickenpox.

Healthy People 2010 did not include a goal for the HPV vaccine because it is still so new. The quadrivalent human papillomavirus (HPV4) is complete at three doses. Dr. Rodewald said an estimated 2.5 million 13- to 17-year-old girls have received the vaccine to date.

Dr. Rodewald presented results from the second National Immunization Survey (NIS-Teen), which he described as a national "report card on the implementation of the vaccines." During the last quarter of 2007, parents of children between the ages of 13 and 17 were interviewed about their child's vaccination history. The survey included 3,000 adolescents as participants, split almost evenly between boys and girls. The 13- to 17-year-old age group was selected because, according to Dr. Rodewald, the vaccines are targeted to 11- and 12-year-olds.

For HPV in particular, Dr. Rodewald said, 11- and 12-year-olds have a "very strong and robust" immune response that adds further protection that will last through the later, riskier periods. He also said that the HPV vaccine can provide up to 6 years of protection.

"You always want to vaccinate before the period where there could be disease, and so it's very important to vaccinate before the onset of sexual activity, and 11- and 12-year-olds, of course, is before the onset of sexual activity, so this provides protection in anticipation of exposure later on in life," he said.

The numbers for the Tdap were also particularly encouraging, Dr. Rodewald said. Vaccinations increased from 10.8% in 2006 to 30.4%. For a "new vaccine in its second year of recommendation," he said, 30.4% "is very good because it usually takes 6–9 years to achieve the desired 90% coverage."

Compared with the 2006 estimates, Dr. Rodewald said, other areas of improvement included the following:

▸ Vaccination coverage levels for three or more doses of hepatitis B and two or more doses of MMR vaccine were more than 80%, very close to the Healthy People 2010 goal.

▸ The one dose coverage of varicella vaccine, which protects against chickenpox, was 75.7%, but coverage with the new recommended two doses was low at 18.8% among preteens and teens without previous history of the disease.

▸ Of the adolescents surveyed, 32.4% received the meningococcal conjugate vaccination, compared with 11.7% in 2006.

To further emphasize the seriousness of these diseases if young people are not vaccinated, Dr. Rodewald noted that while pertussis is well controlled among young children, it is on the rise in teens and young adults. Prior to the 2005–2006 recommendations, he said that meningococcal disease, which is the leading cause of bacterial meningitis, and HPV have not been preventable through routine vaccination. He also mentioned that 4,000 women die from cervical cancer a year—most of those cases being caused by HPV strains.

Metabolic syndrome is associated with type 2 diabetes but not cardiovascular disease in elderly patients, according to study findings.

Criteria for metabolic syndrome were developed to help improve understanding of the links between insulin resistance and vascular disease, wrote Dr. Naveed Sattar of the University of Glasgow (Scotland) and colleagues.

Nevertheless, the clinical role of these criteria, which were “designed to predict people at risk of events of cardiovascular disease (CVD) or diabetes, remains contentious,” they noted. Few studies have been able to simultaneously link metabolic syndrome to risk for both diabetes and coronary heart disease, and “to establish whether prediction of both end points can be usefully achieved by one set of criteria,” the investigators wrote.

Dr. Sattar and his associates analyzed data from their Prospective Study of Pravastatin in the Elderly at Risk (PROSPER) and corroborated the data in another prospective study, the British Regional Heart Study (BRHS). The PROSPER study comprised 4,812 nondiabetic men and women aged 70–82 years who had either preexisiting vascular disease or raised risk of such disease. The BRHS study comprised 2,737 nondiabetic men aged 60–79 years (Lancet 2008 May 22 [doi:10.1016/S0140-6736(08)60602-9]).

In both studies, Dr. Sattar and his associates were able to establish five components of the metabolic syndrome: body mass index or waist circumference, triglyceride levels, glucose cutoff points, HDL cholesterol level, and blood pressure. In both studies, all five components were associated with risk of new onset diabetes, but “cutoff points for fasting glucose, triglyceride, and waist circumference had no association with risk of incident coronary heart disease in either study despite strong associations with incident diabetes,” they wrote.

In the PROSPER study, there were 772 cases of incident CVD and 287 cases of incident diabetes diagnosed over a 3.2-year period. Metabolic syndrome was not associated with an increased risk of CVD in those without CVD at baseline (hazard ratio 1.07), but was associated with a more than fourfold increased risk of diabetes (HR 4.41).

The BRHS study had similar results—even with patients who had preexisting cardiovascular disease. A total of 440 cases of CVD and 105 cases of diabetes occurred during the follow-up of 7 years. In this study, metabolic syndrome was associated with only a small increased risk of CVD (HR 1.27), but a more than sevenfold increased risk of diabetes (HR 7.47).

“Results from this study show that metabolic syndrome has negligible clinical association with incident vascular events in elderly people despite strong associations with risk for incident type 2 diabetes in two prospective studies,” Dr. Sattar and his colleagues wrote.

“Our clear finding in both studies of substantial differing diabetes versus cardiovascular disease associations of metabolic syndrome and its components should aid better general understanding of differing risk patterns for these two diseases, which therefore should not be considered together. Our findings should help other investigators to think about their data in a similar critical way.”

The investigators declared no potential conflicts of interest. The metabolic syndrome analysis for PROSPER was funded by a Diabetes UK project grant.

Metabolic syndrome is associated with type 2 diabetes but not cardiovascular disease in elderly patients, according to study findings.

Criteria for metabolic syndrome were developed to help improve understanding of the links between insulin resistance and vascular disease, wrote Dr. Naveed Sattar of the University of Glasgow (Scotland) and colleagues.

Nevertheless, the clinical role of these criteria, which were “designed to predict people at risk of events of cardiovascular disease (CVD) or diabetes, remains contentious,” they noted. Few studies have been able to simultaneously link metabolic syndrome to risk for both diabetes and coronary heart disease, and “to establish whether prediction of both end points can be usefully achieved by one set of criteria,” the investigators wrote.

Dr. Sattar and his associates analyzed data from their Prospective Study of Pravastatin in the Elderly at Risk (PROSPER) and corroborated the data in another prospective study, the British Regional Heart Study (BRHS). The PROSPER study comprised 4,812 nondiabetic men and women aged 70–82 years who had either preexisiting vascular disease or raised risk of such disease. The BRHS study comprised 2,737 nondiabetic men aged 60–79 years (Lancet 2008 May 22 [doi:10.1016/S0140-6736(08)60602-9]).

In both studies, Dr. Sattar and his associates were able to establish five components of the metabolic syndrome: body mass index or waist circumference, triglyceride levels, glucose cutoff points, HDL cholesterol level, and blood pressure. In both studies, all five components were associated with risk of new onset diabetes, but “cutoff points for fasting glucose, triglyceride, and waist circumference had no association with risk of incident coronary heart disease in either study despite strong associations with incident diabetes,” they wrote.

In the PROSPER study, there were 772 cases of incident CVD and 287 cases of incident diabetes diagnosed over a 3.2-year period. Metabolic syndrome was not associated with an increased risk of CVD in those without CVD at baseline (hazard ratio 1.07), but was associated with a more than fourfold increased risk of diabetes (HR 4.41).

The BRHS study had similar results—even with patients who had preexisting cardiovascular disease. A total of 440 cases of CVD and 105 cases of diabetes occurred during the follow-up of 7 years. In this study, metabolic syndrome was associated with only a small increased risk of CVD (HR 1.27), but a more than sevenfold increased risk of diabetes (HR 7.47).

“Results from this study show that metabolic syndrome has negligible clinical association with incident vascular events in elderly people despite strong associations with risk for incident type 2 diabetes in two prospective studies,” Dr. Sattar and his colleagues wrote.

“Our clear finding in both studies of substantial differing diabetes versus cardiovascular disease associations of metabolic syndrome and its components should aid better general understanding of differing risk patterns for these two diseases, which therefore should not be considered together. Our findings should help other investigators to think about their data in a similar critical way.”

The investigators declared no potential conflicts of interest. The metabolic syndrome analysis for PROSPER was funded by a Diabetes UK project grant.

Metabolic syndrome is associated with type 2 diabetes but not cardiovascular disease in elderly patients, according to study findings.

Criteria for metabolic syndrome were developed to help improve understanding of the links between insulin resistance and vascular disease, wrote Dr. Naveed Sattar of the University of Glasgow (Scotland) and colleagues.

Nevertheless, the clinical role of these criteria, which were “designed to predict people at risk of events of cardiovascular disease (CVD) or diabetes, remains contentious,” they noted. Few studies have been able to simultaneously link metabolic syndrome to risk for both diabetes and coronary heart disease, and “to establish whether prediction of both end points can be usefully achieved by one set of criteria,” the investigators wrote.

Dr. Sattar and his associates analyzed data from their Prospective Study of Pravastatin in the Elderly at Risk (PROSPER) and corroborated the data in another prospective study, the British Regional Heart Study (BRHS). The PROSPER study comprised 4,812 nondiabetic men and women aged 70–82 years who had either preexisiting vascular disease or raised risk of such disease. The BRHS study comprised 2,737 nondiabetic men aged 60–79 years (Lancet 2008 May 22 [doi:10.1016/S0140-6736(08)60602-9]).

In both studies, Dr. Sattar and his associates were able to establish five components of the metabolic syndrome: body mass index or waist circumference, triglyceride levels, glucose cutoff points, HDL cholesterol level, and blood pressure. In both studies, all five components were associated with risk of new onset diabetes, but “cutoff points for fasting glucose, triglyceride, and waist circumference had no association with risk of incident coronary heart disease in either study despite strong associations with incident diabetes,” they wrote.

In the PROSPER study, there were 772 cases of incident CVD and 287 cases of incident diabetes diagnosed over a 3.2-year period. Metabolic syndrome was not associated with an increased risk of CVD in those without CVD at baseline (hazard ratio 1.07), but was associated with a more than fourfold increased risk of diabetes (HR 4.41).

The BRHS study had similar results—even with patients who had preexisting cardiovascular disease. A total of 440 cases of CVD and 105 cases of diabetes occurred during the follow-up of 7 years. In this study, metabolic syndrome was associated with only a small increased risk of CVD (HR 1.27), but a more than sevenfold increased risk of diabetes (HR 7.47).

“Results from this study show that metabolic syndrome has negligible clinical association with incident vascular events in elderly people despite strong associations with risk for incident type 2 diabetes in two prospective studies,” Dr. Sattar and his colleagues wrote.

“Our clear finding in both studies of substantial differing diabetes versus cardiovascular disease associations of metabolic syndrome and its components should aid better general understanding of differing risk patterns for these two diseases, which therefore should not be considered together. Our findings should help other investigators to think about their data in a similar critical way.”

The investigators declared no potential conflicts of interest. The metabolic syndrome analysis for PROSPER was funded by a Diabetes UK project grant.