MMWR – Morbidity and Mortality Weekly Report

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1. Occupational Highway Transportation Deaths Among Workers Aged ≥55 Years — United States, 2003–2010

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In light of high rates of fatal motor vehicle crashes among older workers, employer policies and programs (e.g., flexible scheduling, trip planning, information on the effects of medications on driving, and health screenings) can help older workers drive more safely on the job. Workers aged 65 and older had three times the rate of fatal motor vehicle crashes at work compared to workers aged 18 to 54 years, according to a National Institute for Occupational Safety and Health study of data for 2003-2010. This result was seen across nearly all demographic groups, industries, and occupations. Employer-led safety programs that support safe driving practices and compliance with safety regulations and traffic laws are key to preventing workplace motor vehicle crashes for all workers. Workers aged 55 years or older who drive for work might experience the declines in vision, range of motion, and cognitive abilities associated with normal aging. Employers can address these risk factors through initiatives such as flexible scheduling, trip planning, information on the effects of medications on driving, and health screenings. Also, workers can be encouraged to get regular health exams and screening.

2. Japanese Encephalitis Surveillance and Immunization — Asia and the Western Pacific, 2012

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Japanese encephalitis (JE) is an important public health problem, but this serious disease is preventable by vaccination. Safe and effective vaccines are available, and prequalification by the World Health Organization is pending. However, to ensure further progress toward JE control, the following are needed: measures to maintain and improve awareness of JE disease burden, technical and financial support from international agencies and donors, and sustained national commitment. Japanese encephalitis (JE) virus is a leading cause of encephalitis in Asia, causing about 68,000 JE cases annually. JE is a mosquito-borne disease, with a 20–30 percent case-fatality rate and sequelae occurring in 30–50 percent of survivors. JE is not treatable, but is preventable by immunization. A review of surveillance and immunization program data in the 24 countries in Asia and the Western Pacific region with JE virus transmission risk showed that three quarters of countries conducted JE surveillance and almost half had a JE immunization program in 2012. This represents substantial progress in JE control since the 1990s, which has been spurred by an increase in funding, availability of improved vaccines, and growing international attention to the disease. However, many challenges still remain in controlling JE.

3. Polio Field Census Conducted Among Underserved Populations — Nigeria, 2012–2013

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Through NSTOP, highly educated and culturally competent Nigerian public health professionals are expanding access to previously unreached settlements, thus improving the polio vaccination coverage in Northern Nigeria and contributing to the end of polio. Nigeria remains one of the last bastions of polio as one of only three countries where poliovirus circulation has never been interrupted. Although vaccination of all children under age 5 years is a primary goal of campaigns, nomadic, scattered, border, and otherwise hard to reach settlements in Northern Nigeria harbor a disproportionately high number of unvaccinated children. The Nigerian Stop Transmission of Polio (NSTOP) program, established through national and international partnerships, implemented a vaccination outreach program for previously unreached settlements. This innovation enhanced community engagement and has led to the recognition of tens of thousands of previously unreached children, who can now be vaccinated during each polio vaccination campaign.

4. Investigational Drug for the Treatment of Free-Living Ameba Infections Now Available Directly from CDC

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CDC has a potentially life-saving drug available for physicians to use in the treatment of free-living ameba infections. Infections caused by free-living amebae (FLA), which includes the “brain-eating ameba” Naegleria fowleri, are severe and life-threatening and effective treatment is lacking. Miltefosine has shown activity against FLA in the laboratory. As an investigative drug, miltefosine has limited availability in the United States. CDC now has an expanded access investigational new drug (IND) protocol in effect with the Food and Drug Administration to make miltefosine available directly from CDC for treatment of FLA in the United States. Clinicians who suspect they have a patient with FLA infection who could benefit from treatment with miltefosine should contact CDC to consult with an FLA expert.

5. Notes from the Field

Eye Injuries Sustained at a Foam Party — Collier County, Florida 2012

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES