Integrating Viral Hepatitis Screening and Prevention Services into an Urban Chemical Dependency Treatment Facility for American Indians and Alaska Natives

American Indian/Alaska Natives (AI/AN) patients at an urban residential chemical dependency treatment center participated in a viral hepatitis prevention project. Project activities integrated into patients’ treatment programs included viral hepatitis and human immunodeficiency virus (HIV) risk factor screening, education and counseling, laboratory testing, and hepatitis A and B vaccination. Of 928 AI/AN admissions, 585 (63%) completed risk factor screening assessment. Of these, 436 (75%) received at least one vaccination, viral hepatitis testing, or both. Of 322 patients tested, 91 (28%) were hepatitis C virus (HCV) antibody positive. Lack of pre-existing immunity to vaccine-preventable viral hepatitis infection was common: 132 (45%) were susceptible to hepatitis A and 224 (70%) were susceptible to hepatitis B infection. Chemical dependency treatment centers serving urban AI/AN provide important opportunities for implementing viral hepatitis prevention programs for high-risk populations and for improving ongoing efforts to reduce the disparate impact of chronic liver disease in AI/ AN people

SARS Surveillance during Emergency Public Health Response, United States, March–July 2003

In response to the emergence of severe acute respiratory syndrome (SARS), the United States established national surveillance using a sensitive case definition incorporating clinical, epidemiologic, and laboratory criteria. Of 1,460 unexplained respiratory illnesses reported by state and local health departments to the Centers for Disease Control and Prevention from March 17 to July 30, 2003, a total of 398 (27%) met clinical and epidemiologic SARS case criteria. Of these, 72 (18%) were probable cases with radiographic evidence of pneumonia. Eight (2%) were laboratory-confirmed SARS-coronavirus (SARS-CoV) infections, 206 (52%) were SARS-CoV negative, and 184 (46%) had undetermined SARS-CoV status because of missing convalescent-phase serum specimens. Thirty-one percent (124/398) of case-patients were hospitalized; none died. Travel was the most common epidemiologic link (329/398, 83%), and mainland China was the affected area most commonly visited. One case of possible household transmission was reported, and no laboratory-confirmed infections occurred among healthcare workers. Successes and limitations of this emergency surveillance can guide preparations for future outbreaks of SARS or respiratory diseases of unknown etiology