The Advisory Committee forward Immu...

The Advisory Committee forward Immunization Practices (ACIP) of the Center for Disease hinder and Prevention (CDC) has updated its recommendations onward pneumococcal vaccination for cochlear implant candidates and recipients. The recommendations are available online at www.cdc.gov/mmwr/preview/mmwrhtml/mm5231a5.htm.

In October 2002 the CDC praiseed that all persons with cochlear implants receive age-appropriate pneumococcal vaccination with 7-valent pneumococcal conjugate vaccine (PCV7) 23-valent pneumococcal polysaccharide vaccine (PPV23) or the couple according to the ACIP schedules for living bodys at high risk. The CDC issued these recommendations onward the basis of preliminary data suggesting an increased risk for pneumococcal meningitis in human frames with cochlear implants. Findings of a latter investigation by the CDC, the U sustenance and Drug Adminisration, and state health departments support this recommendation. Children younger than six years with a cochlear implant have a substantially greater risk for having pneumococcal meningitis, compared with children in the general population of the same age. about children who are candidates for cochlear implants have pre-existing anatomic factors that might contribute to an increased risk for meningitis; however, the modern study was not designed to assess this association.

Because the rate for pneumococcal meningitis is higher in children with cochlear implants, and because Streptococcus pneumoniae is the most numerous common pathogen causing bacterial meningitis in cochlear implant recipients of all ages with meningitis of known etiology, the ACIP praises the following for persons who have or are scheduled to receive a cochlear implant:

* Children younger than 24 month with cochlear implants should receive PCV7 as is universally recommended; children with a lapse in vaccination should be vaccinated according to the catch-up schedule issued after the PCV7 shortage resolv (available online at www.cdc.gov/mmwr/preview/mmwrhtml/mm5219a6.htm).

* Children 24 to 59 month of age with cochlear implants who have not received PCV7 should be vaccinated according to the high-risk schedule (available online at www.cdc.gov/mmwr/preview/mmwrhtml/rr4909a1.htm#tab8); children with a lapse in vaccination should be vaccinated according to the catch-up schedule (above) for parts at high risk issued after the PCV7 shortage resolv Children who have complet the PCV7 series should receive PPV23 more than couple months after vaccination with PCV7

* individuals five to 64 years of age with cochlear implants should receive PPV23 according to the schedule used for bodily substances with chronic illnesses; a single dose is indicated.

* [i]role[/i]s planning to receive a cochlear implant should be up-to-date upon age-appropriate pneumococcal vaccination more than pair weeks before surgery, if possible.

Physicians should review vaccination records of their patients who are cochlear implant recipients or candidates to make secure they have received pneumococcal vaccinations based onward the age-appropriate schedules for bodily substances at high risk. In addition, all cases of meningitis should be reported to state health departments according to state requirements. Because information about s pneumoniae serotypes causing pneumococcal meningitis in someones with cochlear implants is limited, physicians are encouraged to impel isolates to their state health department, which can forward isolates to the CDC where serotyping can be performed to determine whether the emblem is included in the vaccines.

COPYRIGHT 2003 American Academy of Family Physicians

COPYRIGHT 2003 Gale Group