FDA Approves First Vaccine for Pregnant Individuals to Prevent RSV in Infants 

On August 21, the U.S. Food and Drug Administration (FDA) approved the Respiratory Syncytial Virus (RSV) vaccine Abrysvo for the active immunization of pregnant individuals at 32 through 36 weeks gestation for the prevention of lower respiratory tract disease (LRTD) and severe LRTD caused by RSV in infants from birth through 6 months of age. 

On August 18, the Maryland Department of Health reported a positive case of locally acquired Plasmodium falciparum malaria infection in a Maryland resident who lives in the National Capital Region. The individual, who was hospitalized and is now recovering, did not travel recently outside of the United States or to other U.S. states with recent locally acquired malaria cases. Malaria is not endemic in any northern regions of the United States. Imported malaria infections have resulted in several cases of local malaria transmission in Virginia in the past. Although local transmission of imported malaria is uncommon in our region, it is most likely to happen during the hottest months of the year when malaria parasites tend to replicate more quickly and higher concentrations of Anopheles mosquitoes are more likely. Healthcare providers should consider malaria in the differential for any patients that may have compatible symptoms and are encouraged to review available resources associated with malaria epidemiology and prevention as well as diagnosis and treatment.

Please see the Centers for Disease Control and Prevention’s (CDC) August 28 Health Alert for more information. 

Mosquito Borne Illness in Virginia 

Vaccine Confidence and Uptake Training for Providers 

The American College of Obstetricians and Gynecologists (ACOG) offers a training course, “Inform to Empower: Building COVID-19 Vaccine Confidence One Conversation at a Time,” for physicians and other obstetric care clinicians. This free, 6-module course offers instruction on the importance of increasing patients' COVID-19 vaccine confidence and techniques to increase vaccination demand. It takes approximately 90 minutes to complete, and Continuing Medical Education credits are provided. 

COVID-19 Vaccine Resources  

As of August 17, mpox vaccine providers need to use the Health Partner Order Portal (HPOP) to procure JYNNEOS vaccines. HPOP is an allocation and management platform that allows providers to request COVID-19 therapeutics and mpox vaccines. Healthcare facilities nationwide utilize this tool for reporting usage, managing inventory, facilitating transfers, and handling wastage. To enroll in HPOP, please use this link to register.  

Vaccine providers will need to report waste related to these procured vaccines in HPOP. If providers opt out of HPOP or have other mpox products in your on-hand inventory that may expire or be wasted in the future, they should promptly report any expired and/or wasted mpox product via the Mpox Vaccine & Medication Wastage tool. Please note that wastage only needs to be reported in one location, either HPOP or through the Mpox Vaccine & Medication Wastage form.  

As a reminder, Virginia law, Section 32.1-46.01, requires that all providers who administer immunization, including mpox, report to VIIS. Should you have any questions or need any guidance on JYNNEOS vaccine orders, we kindly request you email us at MPXquestions@vdh.virginia.gov. 

There has been no change in mpox therapeutics ordering and wastage procedures. For information on Mpox therapeutics, please see VDH Mpox Treatment Guidance webpage. 

Influenza (flu) is a contagious respiratory illness causing mild to severe illnesses. When severe it can result in hospitalization and even death. Preventing transmission of influenza virus and other infectious agents within healthcare settings requires a multi-faceted approach and the core prevention strategies include administration of influenza vaccine, implementation of respiratory hygiene, appropriate management of ill healthcare provider (HCP), and implement infection control precautions. Achieving high influenza vaccination rates of HCP and patients is a critical step in preventing healthcare transmission of influenza from HCP to patients and from patients to HCP. The 2023-24 influenza vaccine combination was updated to best match the flu viruses that research indicates will be most common during the upcoming season. CDC and VDH recommends everyone aged 6 months and older should get a seasonal flu vaccine each year to protect themselves and their loved ones from any serious flu related complications.  

Sentinel Surveillance  

VDH is recruiting healthcare providers to participate in the Influenza Sentinel Surveillance program for the 2023-24 flu season. Influenza (flu) Sentinel Surveillance is one of the surveillance activities that focuses on monitoring flu trends and burden over time in Virginia through active participation from different healthcare providers during the flu season. The program aims to monitor novel strains within the state and provide data for future vaccine formulation decisions. Participation involves collecting specimens from individuals who meet the influenza-like illness (ILI) criteria and is at no cost to the facility or patient(s). These specimens are sent to the state public health lab, the Division of Consolidated Laboratory Services (DCLS), for further testing and subtyping. If your facility is interested in participating in the Influenza Sentinel Surveillance program for the 2023-24 flu season, please reach out to VDH at flu@vdh.virginia.gov. For more information, please visit the influenza sentinel surveillance website.   

Acute Flaccid Myelitis  

VDH would like to make healthcare providers aware of the approaching acute flaccid myelitis (AFM) season and provide resources for evaluating and reporting a suspect AFM case. AFM is a condition that affects the nervous system, specifically the spinal cord. Symptoms of AFM include sudden onset of arm or leg weakness, loss of muscle tone, and loss of reflexes. Severe cases can experience serious neurologic complications and respiratory failure. Healthcare providers should be on alert for cases of AFM between August and November, as cases peak in late summer and early fall. AFM occurs most commonly in young children, many of whom experience a respiratory illness or fever prior to the onset of AFM symptoms.   

Please contact your local health department if you encounter a patient exhibiting sudden onset of limb weakness and an MRI showing a spinal cord lesion(s) with grey matter involvement. Initial specimens should be collected as early as possible and include an upper respiratory tract specimen, CSF, serum, and stool. The most recent AFM case definition can be found here. 

Available Now: The Second Edition of the Regional Infection Prevention and Control Teams in Action Newsletter 

The newsletter discusses the impact of the HAI/AR Infection Prevention Program within VDH on building infection prevention and control capacity across the Commonwealth. It includes details about on-site infection prevention and control (IPC) assessments, healthcare facility IPC strengths and areas for improvement, as well as how facilities perceive the site visits. The newsletter will be released every quarter.