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JCAHO lobbies for sign-off on patient safety law; Measles hits record low, imported cases remain; Public comment sought on CDC vaccine safety efforts.

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JCAHO lobbies for sign-off on patient safety law

Bill recently approved by U.S. Senate

The Joint Commission on Accreditation of Healthcare Organizations is hailing the U.S. Senate’s recent passage of the bipartisan Patient Safety and Quality Improvement Act.

"Allowing health care errors and serious events to be reported in a voluntary and confidential manner, without the threat of legal repercussions, will provide new opportunities for all of us to learn from mistakes and actively pursue specific improvements in patient safety," Dennis S. O’Leary, MD, Joint Commission president, said in a statement. "The single most important thing Congress can do to enhance patient safety is to enact this legislation," he added.

The House of Representatives passed a similar bill in 2003, and the Joint Commission is lobbying for "an expeditious and successful conference between the House and Senate followed by President Bush’s sign-off" on the legislation.

Citing the 1999 Institute of Medicine report that sparked the patient safety movement, the legislation cites the following goals:

1. encourage a culture of safety and quality in the U.S. health care system by providing for legal protection of information reported voluntarily for the purposes of quality improvement and patient safety;

2. ensure accountability by raising standards and expectations for continuous quality improvements in patient safety. t

Measles hits record low, imported cases remain

Herd immunity puts flight to virus

With high rates of immunity in the population, measles infections have fallen to record lows in the United States. During 2001-2003, state and local health departments reported a total of 216 cases.

In data for 2002 only, a record low measles incidence of 0.15 cases per million population was reported, representing a 59% decrease from the incidence reported in 2000, which had been the lowest previously, the Centers for Disease Control and Prevention (CDC) reports.

During 2001-2003, of the total 216 measles cases reported, 96 (44%) were imported, and 120 were indigenous. But even among the indigenous cases, nearly half could be linked to imported cases. The findings underscore caution despite a record low number of cases since measles became a nationally reportable disease in the United States in 1912.

Although measles is no longer endemic in the United States, imported cases continue to cause occasional limited transmission of measles. Even limited transmission can result in measles-associated deaths.

The small number of import-linked cases after an importation demonstrates that population immunity to measles in the United States is sufficiently high to avoid sustained transmission of measles virus. The high levels of immunity result from high levels (more than 90%) of vaccine coverage with one dose of MCV among preschool children and the required two doses of MCV for children attending school.

Maintaining high levels of immunity through high vaccine coverage levels is essential to limit spread from imported cases and prevent measles from again becoming endemic in the United States, the CDC advises. t

Public comment sought on CDC vaccine safety efforts

Is there ability to detect emerging adverse events?

The Centers for Disease Control and Prevention (CDC) is seeking public comments regarding the current state of the agency’s vaccine safety program. Comments should focus on the objectives listed below:

1. Review the structure, function, credibility, effectiveness, efficiency, and support of CDC’s vaccine safety program and assess how it can be maximized and sustained.

  • Assess the program’s ability to detect emerging or rare adverse events.
  • Assess the capacity of the program to provide comprehensive monitoring of the growing number of vaccines.

2. Review the intramural and extramural collaborative activities of the vaccine safety program and determine their effectiveness and efficiency.

  • Assess additional steps CDC can institute to enhance coordination with other federal agencies and partners, including consumer and advocacy groups.

3. Determine the optimal organizational location for vaccine safety activities within the CDC to ensure scientific objectivity, transparency, and oversight, while at the same time, ensuring program priorities are established appropriately and are relevant to the immunization program and other stakeholder needs.

The CDC will post presentations of facts about CDC’s vaccine safety activities on the CDC web site so the public can make informed comments about the objectives listed above.

For a link to the information, go to www.cdc.gov/od/vaccsafe/comments.htm. The public comment period will end on Oct. 12, 2004.