MMWR News Synopsis for August 2, 2018

School District Crisis Preparedness, Response, and Recovery Plans — United States, 2006, 2012, and 2016

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During the past 10 years, more school districts have adopted policies to protect children and effectively respond and recover from natural disasters, infectious diseases, and other threats. Despite this progress, gaps in achieving school preparedness goals at the national level persist, and progress in many essential areas is minimal. Emergencies can happen at any time and anywhere, even during a school day. Schools play a critical role in helping children stay safe before, during, and after emergencies. School-based emergency preparedness plans are essential to protect children and effectively respond to and recover from natural disasters, emerging infectious diseases, and other threats. Since 9/11, school districts throughout the U.S. have been adopting policies and plans for crisis preparedness, response, and recovery to advance preparedness planning and improve school safety. Being prepared for any emergency is a high priority and it is possible to monitor national progress towards specific preparedness objectives using the Healthy People 2020 objective (PREP-5) to “increase the percentage of school districts that require schools to include specific topics in their crisis preparedness, response, and recovery plans. Although the majority of school districts have plans to address mental health needs and family reunification after an emergency, nationally, about one in four districts fall short of these goals, and one in three school districts do not have policies in place to prepare for an infectious disease outbreak.

Characteristics of Tianeptine Exposures Reported to the National Poison Data System — United States, 2000–2017

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CDC reports on a possible emerging public health risk: a significant increase in calls to U.S. poison control centers related to tianeptine, an unapproved antidepressant drug that is known to have opioid-like adverse effects, including dependence and withdrawal. Tianeptine is a medication approved for the treatment of depression and anxiety in some countries in Europe, Asia, and Latin America but it is not FDA-approved for use in the U.S. CDC has found that calls to U.S. poison control centers about tianeptine exposures significantly increased from 2014 to 2017, suggesting a possible emerging public health risk. Tianeptine exposures appear to be primarily occurring because of misuse or intentional abuse for its opioid-like effects. Misuse or intentional abuse of this drug can lead to severe adverse health effects, dependence, and withdrawal. Health care providers should be vigilant for potential cases of tianeptine abuse or withdrawal and consult poison control centers for management.

Coal Workers’ Pneumoconiosis-Attributable Years of Potential Life Lost to Life Expectancy and Before Age 65 Years — United States, 1999–2016

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Black lung disease (coal workers’ pneumoconiosis) is a preventable occupational lung disease caused by inhaling coal mine dust and can lead to premature death. Results from this study indicate that during 1999-2016, workers who died of black lung disease at age 25 or older lost more years of life relative to their life expectancies. This suggests increased severity and rapid progression of black lung disease. To assess trends in premature death attributed to black lung disease, CDC analyzed death certificates from 1999-2016. On average, the years of potential life lost from overall life expectancy increased for coal mine workers age 25 years or older. This increase is likely due to the rapid progression of black lung disease and its severity, found particularly in the central Appalachian region: Kentucky, Virginia, and West Virginia. The continuing occurrence of premature deaths from black lung underscores the need for prevention of hazardous exposures to coal mine dust, the need for early disease detection, and provision of appropriate medical care to workers with black lung.

Rat Lungworm Infection Associated with Central Nervous System Disease — Eight U.S. States, January 2011–January 2017

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Although infection with the parasite that causes rat lungworm disease, or angiostrongyliasis, typically occurs in Asia and the Pacific Islands, including Hawaii, CDC describes infection with the parasite in 12 people in the continental United States. Ingestion of snails or slugs containing larvae of the parasite that causes rat lungworm disease (Angiostrongylus cantonensis) may result in angiostrongyliasis, an illness that can cause inflammation of the lining of the brain (meningitis). Angiostrongyliasis typically occurs in Asia and the Pacific Islands, including Hawaii; however, this report identifies 12 angiostrongyliasis cases in the continental United States. Most of these infections were associated with eating contaminated raw vegetables. Healthcare providers, especially those in the southern United States, should consider this parasitic illness in patients with inflammation of the lining of the brain.

Deaths Related to Hurricane Irma — Florida, Georgia, and North Carolina, September 4–October 10, 2017

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Power outages can be particularly dangerous for people who are already ill. Understanding the need for detailed information on circumstance of hurricane-related deaths and how these different circumstances may overlap can assist public health practitioners in developing more effective interventions to prevent deaths in future disasters. During Hurricane Irma, power outages – which disrupted air conditioning and electricity-dependent oxygen treatments – were particularly dangerous for people with chronic disease, according to an analysis of death certificates from Florida, Georgia, and North Carolina. The analysis revealed a group of deaths affected by two different circumstances: 1) existing medical condition and 2) power outage. Paying attention to overlapping circumstances of death can help public health practitioners target interventions and messaging. For example, deaths jointly associated with existing medical condition exacerbation and power outage could be minimized by prioritizing power restoration to vulnerable populations such as elderly persons and those with chronic diseases who are especially prone to heat-related illness.

Progress Toward Poliomyelitis Eradication — Afghanistan, January 2017–May 2018

Sustained efforts to vaccinate all children against wild poliovirus must continue to end its transmission. To achieve wild polio virus type 1 (WPV1) eradication, Afghanistan and global partners must continue to maintain and regain access for supplementary immunization activities (SIAs) in security-challenged areas, strengthen oversight of SIAs in accessible areas to reduce the number of missed children, and coordinate with authorities in Pakistan to track and vaccinate high-risk mobile populations in their shared transit corridors. In 2017, fourteen WPV1 cases were confirmed in Afghanistan, compared with 13 in 2016. From January-May 2018, eight WPV1 cases were reported, which was twice the number of cases reported from January-May 2017. The number of polio-affected districts in Afghanistan increased from six in 2016 to 14 in 2017 (including WPV1 cases and positive environmental samples). Polio cases in 2018 have been limited to two regions bordering Pakistan known as the Southern and Northern corridors. We are making continued progress in reaching children everywhere and finding the virus where it persists.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICESExternal

CDC works 24/7 protecting America’s health, safety, and security. Whether diseases start at home or abroad, are curable or preventable, chronic or acute, or from human activity or deliberate attack, CDC responds to America’s most pressing health threats. CDC is headquartered in Atlanta and has experts located throughout the United States and the world.

Page last reviewed: August 2, 2018