Synopsis for October 19, 2006

The MMWR is embargoed until Thursday, 12 PM EST.

1. STD Prevention Counseling Practices and HPV Opinions Among Clinicians with Adolescent Patients – United States, 2004
2. Vaccination Coverage Among Children Entering School – United States, 2005-06 School Year
3. Varicella Surveillance Practices – United States, 2004

STD Prevention Counseling Practices and HPV Opinions Among Clinicians with Adolescent Patients – United States, 2004

In a national survey of sexually transmitted disease (STD) prevention practices among nearly 3,000 adolescent health care providers, CDC researchers found that the majority report providing STD risk assessment (81%) to their adolescent patients. Such assessments are critical, given that nearly half of the roughly 19 million new STD infections occurring annually in the U.S. are believed to occur among people aged 15 to 24. Ninety percent of providers reported that they usually or always recommended condoms for STD prevention; 76 percent recommended monogamy/limiting sex partners; and 54 percent recommended abstinence. Of providers who mostly see adolescents in their practices (at least 75 percent of their patients were under age 18), 93 percent report providing STD prevention counseling, and more than half reported specifically discussing human papillomavirus (HPV), the most common STD among those under 25. When asked their opinion regarding HPV prevention strategies, most providers agreed that abstinence, monogamy, limiting sex partners, and consistent condom use are effective methods and believed counseling on these strategies should be provided. However, less than a quarter of providers believed patients would adopt these strategies for the long term. Study authors believe the findings will help guide future provider education efforts.

Vaccination Coverage Among Children Entering School – United States, 2005-06 School Year  

Much progress has been made toward the implementation of case-based surveillance for varicella as recommended by CSTE in 2002. Those states that have not yet implemented case-based surveillance should consider starting with a gradual approach to full implementation by starting with sentinel site surveillance and then expanding to statewide surveillance when feasible. Varicella became a reportable disease in the United States in 1972, with states reporting weekly aggregate data to the National Notifiable Disease Surveillance System (NNDSS). In 1981, varicella reporting was removed from the national notifiable diseases list because reporting of this common disease was becoming a burden in the absence of a vaccine. This action was followed by additional changes in varicella surveillance practices. In 1995, varicella vaccine was licensed and added to the routine childhood vaccination schedule. In 2002, the Council of State and Territorial Epidemiologists (CSTE) recommended that varicella case-based surveillance be implemented in all states by 2005; in 2003, varicella was again added to the national notifiable diseases list to allow for monitoring of the effect of varicella vaccine on varicella incidence. In 2004, to assess the progress in varicella surveillance in the United States, CDC surveyed immunization program managers in selected public health jurisdictions. This report describes the results of that survey, which indicated that substantial progress has been made toward the implementation of case-based surveillance as recommended by CSTE in 2002. As of 2004, however, 28 jurisdictions still had not implemented case-based surveillance. To monitor the effect of the vaccination program on the changing epidemiology of varicella disease, every state should conduct case-based surveillance for varicella. This is particularly important in light of the 2006 recommendation by the Advisory Committee on Immunization Practices for a routine second dose of varicella vaccine for children aged 4-6 years because enhanced surveillance is needed to further monitor varicella epidemiology.

Varicella Surveillance Practices – United States, 2004

Much progress has been made toward the implementation of case-based surveillance for varicella as recommended by CSTE in 2002. Those states that have not yet implemented case-based surveillance should consider starting with a gradual approach to full implementation by starting with sentinel site surveillance and then expanding to statewide surveillance when feasible. Varicella became a reportable disease in the United States in 1972, with states reporting weekly aggregate data to the National Notifiable Disease Surveillance System (NNDSS). In 1981, varicella reporting was removed from the national notifiable diseases list because reporting of this common disease was becoming a burden in the absence of a vaccine. This action was followed by additional changes in varicella surveillance practices. In 1995, varicella vaccine was licensed and added to the routine childhood vaccination schedule. In 2002, the Council of State and Territorial Epidemiologists (CSTE) recommended that varicella case-based surveillance be implemented in all states by 2005; in 2003, varicella was again added to the national notifiable diseases list to allow for monitoring of the effect of varicella vaccine on varicella incidence. In 2004, to assess the progress in varicella surveillance in the United States, CDC surveyed immunization program managers in selected public health jurisdictions. This report describes the results of that survey, which indicated that substantial progress has been made toward the implementation of case-based surveillance as recommended by CSTE in 2002. As of 2004, however, 28 jurisdictions still had not implemented case-based surveillance. To monitor the effect of the vaccination program on the changing epidemiology of varicella disease, every state should conduct case-based surveillance for varicella. This is particularly important in light of the 2006 recommendation by the Advisory Committee on Immunization Practices for a routine second dose of varicella vaccine for children aged 4-6 years because enhanced surveillance is needed to further monitor varicella epidemiology.

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This page last reviewed November 9, 2006

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