CDC explains testing procedure. Centers for Disease Control and Prevention

Guidelines from the Centers for Disease Control and Prevention (CDC) January 1993 bulletin on HIV testing procedures state that doctors should not tell patients HIV-positive results until confirmatory tests are done. The first step in the process is an ELISA screening test, which detects HIV-antibodies. A reactive result should not be considered positive until confirmatory tests are done. A more specific antibody test, such as the Western blot or immunofluorescence assay, should be used. The confirmatory test is essential since antibodies for diseases other than HIV sometimes react to an ELISA screen.     

CDC suspends testing of newborns. Centers for Disease Control and Prevention

The Centers for Disease Control and Prevention (CDC) has announced the suspension of their anonymous HIV testing program for newborn infants. The announcement came on the heels of legislation introduced by Gary Ackerman, D-N.Y., requiring states to tell parents or other legal guardians if their newborn babies test positive for HIV antibodies. CDC officials said the survey was useful in tracking the epidemic, but it was time to reevaluate whether the $10 million annual cost could be better spent preventing HIV infection among women and newborns. The CDC advocates the implementation of their proposed guidelines, for physicians to counsel all pregnant women about their HIV risks and offer, but not require, testing. Those who test positive for HIV antibodies should be given nonjudgmental information about the risks and benefits of taking AZT. The CDC cites a recent study which shows that pregnant women may reduce by two-thirds the risk of transmitting HIV to their babies if they take the antiviral drug AZT during pregnancy, labor and delivery. If the decision to suspend the survey becomes final, activists are concerned that Ackerman might change the legislation to mandate testing of all pregnant women. The CDC plans to convene a panel of outside experts to evaluate its guidelines for counseling and voluntary testing.     

CDC sets timetable for recommending HIV reporting. Centers for Disease Control and Prevention

The Centers for Disease Control and Prevention (CDC) informed State health directors that it will release guidelines on recommended HIV reporting practices in January 1998. This date gives State legislatures time to deliberate revising their own surveillance policies as soon as the 1998 sessions begin. According to the CDC timetable, States that decide to conduct HIV case surveillance would begin collecting data for a full year beginning in January 1999. Currently, 30 states track HIV cases among adults and adolescents, and all States (except Maryland and Texas) and territories use names to identify people with AIDS. A move to HIV case reporting is expected to enhance understanding of the epidemiology of the epidemic and target resources. Two policy advocates, the National Association of People with AIDS and the American Civil Liberties Union, reject name-based HIV reporting practices and advocate the use of unique or coded identifiers.     

Guidelines for the prevention of intravascular catheter-related infections. Centers for Disease Control and Prevention.

These guidelines have been developed for practitioners who insert catheters and for persons responsible for surveillance and control of infections in hospital, outpatient, and home health-care settings. This report was prepared by a working group comprising members from professional organizations representing the disciplines of critical care medicine, infectious diseases, health-care infection control, surgery anesthesiology interventional radiology pulmonary medicine, pediatric medicine, and nursing. The working group was led by the Society of Critical Care Medicine (SCCM), in collaboration with the Infectious Disease Society of America (IDSA), Society for Healthcare Epidemiology ofAmerica (SHEA), Surgical Infection Society (SIS), American College of Chest Physicians (ACCP), American Thoracic Society (ATS), American Society of Critical Care Anesthesiologists (ASCCA), Association for Professionals in Infection Control and Epidemiology (APIC), Infusion Nurses Society (INS), Oncology Nursing Society (ONS), Society of Cardiovascular and Interventional Radiology (SCVIR), American Academy of Pediatrics (AAP), and the Healthcare Infection Control Practices Advisory Committee (HICPAC) of the Centers for Disease Control and Prevention (CDC) and is intended to replace the Guideline for Prevention of Intravascular Device-Related Infections published in 1996 These guidelines are intended to provide evidence-based recommendations for preventing catheter-related infections. Major areas of emphasis include 1) educating and training health-care providers who insert and maintain catheters; 2) using maximal sterile barrier precautions during central venous catheter insertion; 3) using a 2% chlorhexidine preparation for skin antisepsis; 4) avoiding routine replacement of central venous catheters as a strategy to prevent infection; and 5) using antiseptic/antibiotic impregnated short-term central venous catheters if the rate of infection is high despite adherence to other strategies (i.e., education and training, maximal sterile barrier precautions, and 2% chlorhexidine for skin antisepsis). These guidelines also identify performance indicators that can be used locally by health-care institutions or organizations to monitor their success in implementing these evidence-based recommendations.     

Group warns CDC against forcing States to adopt name reporting. Centers for Disease Control and Prevention

A coalition of 49 AIDS organizations and civil rights groups are fighting an "aggressive push" by the Centers for Disease Control and Prevention (CDC) to institute name-based HIV case surveillance. The coalition's joint statement warns that name-based reporting would produce inaccurate data, because it would result in people delaying or declining HIV testing and healthcare to avoid having their names reported. The statement was released as CDC prepared to issue guidelines recommending that States report names. States will not be required to use this approach; however, in order to be eligible for Federal funding, States will have to meet performance criteria that other tracking methods may not meet. Another drawback of name-based reporting, opponents say, is the reallocation of resources away from HIV education and prevention programs. Several organizations in the coalition are identified.     

Prevention and control of infections with hepatitis viruses in correctional settings. Centers for Disease Control and Prevention.

This report consolidates previous recommendations and adds new ones for preventing and controlling infections with hepatitis viruses in correctional settings. These recommendations provide guidelines for juvenile and adult correctional systems regarding 1) identification and investigation of acute viral hepatitis; 2) preexposure and postexposure immunization for hepatitis A and hepatitis B; 3) prevention of hepatitis C virus infection and its consequences; 4) health education; and 5) release planning. Implementation of these recommendations can reduce transmission of infections with hepatitis viruses among adults at risk in both correctional facilities and the outside community. These recommendations were developed after consultation with other federal agencies and specialists in the fields of corrections, correctional health care, and public health at a meeting in Atlanta, March 5-7, 2001. This report can serve as a resource for those involved in planning and implementing health-care programs for incarcerated persons.     

New CDC director. Centers for Disease Control and Prevention

On October 5, 1998, Dr. Jeffrey Koplan will be appointed the director of the Centers for Disease Control and Prevention (CDC). Dr. Koplan has been in the health field for many years, more recently as the president of the Prudential Center for Health Care Research. The CDC deputy director will remain as the acting director until October, when Dr. Koplan takes office. Dr. Koplan replaces Dr. David Satcher, who was named the surgeon general in February 1998.     

Guidelines for designing rapid assessment surveys of HIV seroprevalence among hospitalized patients. Centers for Disease Control and Prevention.

The Centers for Disease Control and Prevention has developed guidelines for determining HIV seroprevalence among patients seeking medical care at acute-care hospitals. The guidelines enable hospital staff members to perform a simple, rapid, and inexpensive survey to determine seroprevalence among the patient population, protecting the anonymity of those who are tested. The guidelines are based on national experience with large-scale anonymous, unlinked HIV serosurveys. The data from a rapid assessment survey are particularly useful for evaluating the need to provide routine, voluntary HIV counseling and testing and treatment for HIV infection. Beyond that, such data can be used in targeting education efforts, in reinforcing the use of appropriate universal precautions, in resource allocation, and in determining the need for further studies of HIV infection among the population in the hospital catchment area.     

Guidelines for using the QuantiFERON-TB test for diagnosing latent Mycobacterium tuberculosis infection. Centers for Disease Control and Prevention.

Until 2001, the only test used to diagnose latent tuberculosis infection (LTBI) was the tuberculin skin test (TST). However, in 2001, a new test (QuantiFERON-TB or QFT; manufactured by Cellestis Limited, Carnegie, Victoria, Australia) that measures the release of interferon-gamma in whole blood in response to stimulation by purified protein derivative was approved by the Food and Drug Administration. This statement provides interim recommendations for using and interpreting QFT. As with TST, interpretation and indicated applications of QFT differ for persons according to their risk for LTBI and for developing tuberculosis (TB). This report provides guidance for public health officials, health-care providers, and laboratorians with responsibility for TB control activities in the United States in their efforts to incorporate QFT testing for detecting and treating LTBI. Regardless of the test used to identify LTBI, testing should be primarily targeted at diagnosing infected patients who will benefit from treatment.     

浅谈疾病预防控制中心的质量管理

国家级、省级、市县级疾病预防控制中心（以下简称疾控中心）肩负着全社会卫生防病、处理突发公共卫生事件、保障人民身体健康和生命安全的重任。为了完成上述任务，疾控中心的检测实验室为社会提供的检测数据必须确保公正可靠。因此，从收样到检测全过程以及报告审核到签发等各个环节需要有严格的质量管理制度。我们依据计量认证审查认可（验收）评审准则编制了较完整的质量手册及程序文件，制定了严格的管理制度，从而保证了检测的规范化，具体做法如下。     

CDC to revisit 1991 advice on HIV-positive doctors. Centers for Disease Control and Prevention

The Centers for Disease Control and Prevention (CDC) is reexamining its 1991 guidelines to prevent doctors from infecting patients with HIV during invasive medical procedures. The original guidelines were a response to the Florida case where a dentist infected six patients, although the route of infection was never identified. There have been no additional reports of infected health care workers spreading HIV to patients. The disclosure rules in the 1991 recommendations are controversial, and say that health care workers need to disclose their HIV-positive status, even for procedures deemed safe by an expert panel. Because doctors fear that such disclosure will effectively end their careers, many forgo HIV testing if they suspect they have been infected.     

Prevalence of antibody to hepatitis C virus in hemodialysis patients.

The prevalence of hepatitis C virus infection in hemodialysis patients in Japan was examined using sera from 418 patients from six dialysis units in 1989. The authors made use of an enzyme-linked immunosorbent assay (Ortho Diagnostics). Antibody to hepatitis C virus (anti-HCV) was detected in 127 patients (30.4%), the frequency varying from 20.0% to 34.9% in different units. The mean prevalence of anti-HCV was 20 times higher than that in blood donors. Anti-HCV positivity was not associated with antibody to hepatitis B core antigen, which was not a surrogate marker for non-A, non-B hepatitis agents in this study. Another striking finding of this study was that 84.3% of the anti-HCV-positive patients had normal liver function. Anti-HCV positivity correlated positively with the number of blood transfusions and increased with the duration of hemodialysis; however, it was 22.1% even in 113 patients never given blood transfusion. Acquisition of hepatitis C virus by dialysis patients is, therefore, not only through blood transfusions but also because of hepatitis C virus present within the unit itself. Liver dysfunction in the anti-HCV-positive patients was rare.