MMWR News Synopsis for December 15, 2016

Resurgence of Progressive Massive Fibrosis in Coal Miners — Eastern Kentucky, 2016

CDC Media Relations
404-639-3286

Effective dust control, enhanced educational outreach, and improved medical surveillance are needed to protect U.S. coal miners. The prevalence of coal workers’ pneumoconiosis fell precipitously after implementation of the Coal Mine Health and Safety Act and reached historic lows in the 1990s, with the most severe form, progressive massive fibrosis (PMF), nearly eradicated. Since that time, increases in the prevalence and severity of coal worker’s pneumoconiosis have occurred, especially in central Appalachia. During January 2015–August 2016, 60 PMF cases were identified through a single radiologist’s practice in eastern Kentucky. This cluster was not identified through the national surveillance program.

Assessing Change in Avian Influenza A (H7N9) Virus Infections During the Fourth Epidemic — China, 2013–2016

CDC Media Relations
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Although there is no evidence of increased human-to-human transmissibility of A(H7N9) viruses during the fourth epidemic (September 2015-August 2016), the continued geographic spread of infections, the identification of novel reassortant viruses, and the pandemic potential of the virus underscore the importance of rigorous A(H7N9) virus surveillance and continued risk assessment among humans and poultry in China and neighboring countries to rapidly detect, control, and prevent the spread of A(H7N9) to the global community. Since human infections with avian influenza A (H7N9) virus were first reported by the Chinese Center for Disease Control and Prevention (China CDC) in March 2013, China has experienced four influenza A (H7N9) virus epidemics. As of August 31, 2016, mainland China had reported a total of 775 laboratory-confirmed human infections with A (H7N9) virus from 16 provinces and three municipalities during the four epidemics. Whereas age and sex distribution and exposure history in the fourth epidemic (September 2015-August 2016) were similar to those in the first three epidemics, the fourth epidemic demonstrated a greater proportion of infected persons living in rural areas, a continued geographic spread of the virus, and a longer epidemic period. The genetic markers of mammalian adaptation and antiviral resistance remained similar across each epidemic, and viruses from the fourth epidemic remained antigenically well matched to current candidate vaccine viruses. There is no evidence of increased human-to-human transmissibility of A (H7N9) viruses.

Leading Causes of Cancer Mortality — Caribbean Region, 2003–2013

CDC Media Relations
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The leading causes of cancer deaths in the Caribbean region for both males and females can largely be reduced and prevented through strategies such as primary prevention, early detection, and management and treatment of patients with cancer. Prevention strategies include HPV vaccination and screening for cervical cancer, screening for breast cancer, and avoiding smoking for lung cancer. In the Caribbean region, cancer is the second leading cause of death with an estimated 87,430 cancer-related deaths reported in 2012. Prostate cancers are the leading cause of cancer deaths among Caribbean men accounting for 18 percent to 47 percent of cancer deaths, followed by lung cancers accounting for 5 percent to 24 percent of cancer deaths. Breast cancers are the leading causes of cancer deaths among Caribbean women accounting for 14 percent to 30 percent of cancer deaths followed by cervical cancers accounting for 4 percent to 18 percent of cancer deaths.

Monitoring of Persons with Risk for Exposure to Ebola Virus — United States, November 3, 2014–December 27, 2015

CDC Media Relations
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This landmark public health response demonstrates the robust infrastructure and sustained monitoring capacity of local, state, and territorial health authorities in the U.S. as a part of a response to an international public health emergency. In 2014-2015, West Africa experienced the largest Ebola outbreak in history. In October 2014, after the first case of imported Ebola in the U.S., CDC issued monitoring and movement guidance to address potential transmission of the disease in the U.S. This guidance provided recommendations for monitoring of persons potentially exposed to Ebola in an effort to isolate, test, and, if necessary, treat symptomatic travelers and other persons. Overall, 29,789 people were monitored, with >99% successfully completing 21-day monitoring. No person under monitoring was diagnosed with Ebola. The overall success in monitoring resulted, in part, because of the vigilance of state, local, and territorial health departments and the preparedness infrastructure that enabled jurisdictions to fully implement CDC monitoring and movement guidance.

Use of a 2-Dose Schedule for Human Papillomavirus Vaccination — Updated Recommendations of the Advisory Committee on Immunization Practices

CDC Media Relations
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Two doses of HPV vaccine protect girls and boys who start getting vaccinated at age 9 through 14 years. In a policy statement issued today, CDC reduced the number of HPV vaccine doses recommended for younger adolescents. CDC now recommends two doses of HPV vaccine for girls and boys who start the vaccine series at age 9 through 14 years. The two doses should be given 6 to 12 months apart, increasing flexibility for patients, parents, and health care providers. The change was based on scientific evidence that two doses work just as well as three doses in girls and boys in this age group. Three doses are still recommended for older teens and young adults. CDC continues to recommend routine HPV vaccination at age 11 or 12 years; the series can be started at age 9 years. HPV vaccines are highly safe and effective and are routinely recommended for both girls and boys to prevent cancer-causing HPV infections.

Notes from the Field: 

New Delhi Metallo-β-Lactamase–Producing Carbapenem-Resistant Enterobacteriaceae Identified in Patients Without Known Health Care Risk Factors — Colorado, 2014–2016

QuickStats:

Use of Equipment or Assistance for Getting Around Among Persons Aged ≥50 Years — National Health Interview Survey, 2014–2015.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES