Annals
Established in 1927 by the American College of Physicians

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3 June 2014 Annals of Internal Medicine Tip Sheet

Below is information about articles being published in Annals of Internal Medicine. The information is not intended to substitute for the full article as a source of information. Annals of Internal Medicine attribution is required for all coverage.

1. Measles outbreaks prompt concern about physician knowledge gaps

Vaccination refusal and importation of the disease has led to increased incidence of measles in the United States. Before widespread vaccination, approximately 500,000 measles cases occurred annually, resulting in 500 deaths and 48,000 hospitalizations. Vaccination programs helped to eradicate endemic measles by the year 2000, reducing the median number of cases per year to 60. But in just the first three months of 2014, 106 measles cases were reported, prompting health officials to become concerned. Measles is one of the most contagious infectious diseases known. Most postelimination measles cases have been due to outbreaks that can be linked imported disease. The author of a new commentary being published in Annals of Internal Medicine (http://www.annals.org/article.aspx?doi=10.7326/M14-0892) says many clinicians have never seen measles and now need to become familiar with the deadly disease so that they can apply the necessary control measures to contain it. Physicians should maintain a high level of suspicion for measles in returned travelers with a fever accompanied by rash. This is especially important because measles rash may be confused with other viral rashes, Kawasaki disease, or scarlet fever. The author suggests that physicians talk to their patients about the importance of measles vaccination and be vigilant about recognizing infection and implementing control measures to prevent further spread in health care facilities.

2. Viral hepatitis remains a major health concern in the U.S.

Experts comment on HHS 2014-2016 Viral Hepatitis Action Plan
Untreated chronic viral hepatitis affects between 3.5 and 5.3 million Americans and continues to fuel rising incidences of progressive liver disease, liver failure, and liver cancer. In 2011, the U.S. Department of Health and Human Services (HHS) unveiled the nationís first coordinated national approach to tackling viral hepatitis with the Action Plan for the Prevention, Care and Treatment of Viral Hepatitis in the United States. Priorities set by the action plan represent a call to action to advance both the prevention and treatment of viral hepatitis. Health policies, such as the Affordable Care Act, bring health insurance coverage to those who may have been previously denied coverage for a preexisting condition of chronic viral hepatitis. In addition, new awareness campaigns and screening recommendations may help hundreds of thousands of infected patients learn their viral hepatitis status. Still, the authors of a new commentary being published in Annals of Internal Medicine (http://www.annals.org/article.aspx?doi=10.7326/M14-0404) say more can be done. The updated 2014-2016 HHS Viral Hepatitis Action Plan builds on the goals outlined in 2011 but spells out specific actions to be undertaken by federal partners. It also expands the focus on evaluation with additional metrics to monitor the planís major goals. The authors are encouraged by the new plan and call for further commitments to advance the goal of decreasing morbidity and mortality from viral hepatitis.