On November 7, 2022, dengue virus (DENV), which is not endemic in the continental United States (1), was identified in a Maricopa County, Arizona resident by reverse transcription–polymerase chain reaction (RT-PCR) testing at Arizona State Public Health Laboratory (ASPHL). The patient (patient A) was admitted to a hospital on October 19 for a dengue-like illness, 7 days after traveling to and remaining in Mexicali, Mexico for <4 hours. Patient A was hospitalized for 3 days and subsequently recovered. Maricopa County Environmental Services Department (MCESD) conducted retrospective testing for DENV in samples collected from 21 mosquito pools located within 5 miles (8 km) of patient A’s residence during October 1–November 3. A sample collected from one mosquito pool (pool A) on October 5 was positive for DENV. Whole genome sequencing by CDC’s Dengue Branch later revealed that closely related DENV-3 strains not known to be circulating in the patient’s travel region were identified in both patient A and pool A, suggesting local DENV transmission.

BACKGROUND: Following one to five years of antibiotic mass drug administration (MDA) for the elimination of trachoma as a public health problem, programmes must conduct impact surveys to inform decisions on whether MDA is still needed. These decisions are currently based on the prevalence of trachomatous inflammation-follicular (TF), which, after MDA, correlates poorly with prevalence of ocular Chlamydia trachomatis infection. METHODOLOGY/PRINCIPAL FINDINGS: Impact surveys in six evaluation units (EUs) of Malawi were used as a platform to explore associations between the prevalence of TF, ocular C. trachomatis infection and anti-Pgp3 antibodies one year after the third annual round of MDA. Participants were examined for trachoma using the World Health Organization simplified grading system. Ocular swabs and dried blood spots (DBS) were collected from children aged 1-9 years. Swabs were tested for C. trachomatis DNA using GeneXpert. DBS were assayed for anti-Pgp3 antibodies using ELISA. EU-level prevalence of TF in children aged 1-9 years ranged from 4.7% (95% CI 3.4-6.3) to 7.2% (95% CI 5.8-8.9). Prevalence of C. trachomatis infection in children ranged from 0.1% (95% CI 0.0-0.6) to 0.7% (95% CI 0.3-1.3) while Pgp3 seroprevalence ranged from 6.9% (95% CI 5.4-8.6) to 12.0% (95% CI 10.1-14.0) and increased with age. CONCLUSIONS/SIGNIFICANCE: Based on current global policy, the prevalence of TF indicates that a further year of antibiotic MDA is warranted in four of six EUs yet the very low levels of infection cast doubt on the universal applicability of TF-based cut-offs for antibiotic MDA. Pgp3 seroprevalence was similar to that reported following MDA in other settings that have reached the elimination target however the predictive value of any particular level of seropositivity with respect to risk of subsequent infection recrudescence is, as yet, unknown.

The Mine Improvement and New Emergency Response Act (MINER Act) of 2006 (PL 109-236, 2006) established the Office of Mine Safety and Health, functioning as the Office of Mine Safety and Health Research (OMSHR) within the National Institute for Occupational Safety and Health (NIOSH) and provided authority for awarding contracts related to the development and implementation of new mine technology and equipment. The OMSHR external contracts program was formed in accordance with the MINER Act and has since issued more than 150 contracts focused on worker health and safety. Initial funding for this program was provided by the United States Congress through two emergency supplemental appropriations and was focused on emergency oxygen supply, communications and tracking, and refuge chambers (also referred to as refuge alternatives). Since the MINER Act, Congress has continued to fund the program through the annual NIOSH mining appropriation.

Lead is toxic to all human organ systems, resulting in adverse health effects that include impaired kidney function, elevated blood pressure, and neurologic health effects (1). Lead primarily enters the body through inhalation and ingestion, but direct absorption through the skin can occur (2). According to 2014 national lead surveillance data, >94% of the 3,616 U.S. adults with elevated blood lead levels (BLLs) whose exposure source was known were exposed at work (3). | | Because of concerns about employees’ occupational lead exposures, a Missouri bullet manufacturing company that melts lead ingots and casts them into bullets asked CDC’s National Institute for Occupational Safety and Health (NIOSH) to conduct a health hazard evaluation. In October 2017, NIOSH visited the worksite to determine the routes and extent of lead exposure among employees and the prevalence of elevated BLLs and to assess controls in place to protect employees from lead exposure.

This paper provides a suitability determination of international standards for evaluating electrical and electronic systems and line powered apparatus as an alternative to the Mine Safety and Health Administration (MSHA) criteria for two-fault intrinsic safety (IS) approval. The primary issue is to demonstrate that international equipment evaluation standards will provide at least the same level of protection for miners as the MSHA requirements. The secondary issue is to identify additional benefits that may be derived from the use of the "entity concept" in the approval process, such as potential cost savings and an easier and quicker path for the introduction of new technology.

This paper provides a determination of the equivalent level of protection of the international standards relative to similar criteria used by the U.S. Mine Safety and Health Administration (MSHA) to approve two-fault intrinsically safe (IS) stand-alone equipment. U.S. mining law requires such a determination for MSHA to use alternatives to existing standards. The primary issue is to demonstrate that the international standards for equipment evaluation will provide at least the same level of protection for miners as the document currently used by MSHA.

Trachoma is caused by Chlamydia trachomatis (Ct). It is targeted for global elimination as a public health problem. In 2014, a population-based cross-sectional study was performed in two previously trachoma-endemic areas of The Gambia. Participants of all ages from Lower River Region (LRR) (N = 1028) and Upper River Region (URR) (N = 840) underwent examination for trachoma and had blood collected for detection of antibodies against the Ct antigen Pgp3, by ELISA. Overall, 30 (1.6%) individuals had active trachoma; the prevalence in children aged 1-9 years was 3.4% (25/742) with no statistically significant difference in prevalence between the regions. There was a significant difference in overall seroprevalence by region: 26.2% in LRR and 17.1% in URR (p < 0.0001). In children 1-9 years old, seroprevalence was 4.4% in LRR and 3.9% in URR. Reversible catalytic models using information on age-specific seroprevalence demonstrated a decrease in the transmission of Ct infection in both regions, possibly reflecting the impact of improved access to water, health and sanitation as well as mass drug administration campaigns. Serological testing for antibodies to Ct antigens is potentially useful for trachoma programmes, but consideration should be given to the co-endemicity of sexually transmitted Ct infections.

The Health Hazard Evaluation Program of the National Institute for Occupational Safety and Health evaluated a steel building materials manufacturer. The employer requested the evaluation because of concerns about optical radiation hazards from a plasma arc cutting system and the need to clarify eye protection requirements for plasma operators, other employees, and visitors. The strength of the ultraviolet radiation, visible radiation (light), and infrared radiation generated by the plasma arc cutter was measured at various distances from the source and at different operating amperages. Investigators also observed employees performing the plasma arc cutting. Optical radiation above safe levels for the unprotected eyes in the ultraviolet-C, ultraviolet-B, and visible light ranges were found during plasma arc cutting. In contrast, infrared and ultraviolet-A radiation levels during plasma arc cutting were similar to background levels. The highest non-ionizing radiation exposures occurred when no welding curtains were used. A plasma arc welding curtain in place did not eliminate optical radiation hazards to the plasma arc operator or to nearby employees. In most instances, the measured intensities for visible light, UV-C, and UV-B resulted in welding shade lens numbers that were lower than those stipulated in the OSHA Filter Lenses for Protection Against Radiant Energy table in 29 CFR 1910.133(a)(5). (1) Investigators recommended using a welding curtain that enclosed the plasma arc, posting optical radiation warning signs in the plasma arc cutter area, installing audible or visual warning cues when the plasma arc cutter was operating, and using welding shades that covered the plasma arc cutter operator's face to protect skin from ultraviolet radiation hazards.

The Mine Improvement and New Emergency Response Act of 2006 (MINER Act Public Law 109-236) was passed by Congress in response to three major underground coal mine accidents in the United States that claimed the lives of 19 miners. The Act resulted in substantial changes in the underground coal industry relative to the use of technology for mine escape, rescue, disaster response and other areas where the lack of these technologies contributed to the fatalities caused by these tragedies. This year marks the 10th anniversary of the MINER Act, which makes it an opportune time to reflect on the events that led to its passage, the changes that have been made since then, and the work that remains to be done.

Responding to a request by corrections agency management, we investigated coccidioidomycosis in prison employees in central California, a coccidioidomycosis-endemic area. We identified 103 cases of coccidioidomycosis that occurred over 4.5 years. As a result, we recommended training and other steps to reduce dust exposure among employees and thus potential exposure to Coccidioides.

The National Institute for Occupational Safety and Health (NIOSH) conducted a health hazard evaluation (HHE) of a semi-automated caster/slitter operation at a steel mill in response to employee concerns of “bloody noses and dirty nasal passages.” We met with employer and employee representatives; observed work processes, practices, and workplace conditions; reviewed the results of previous environmental sampling conducted by the steel mill; and held confidential interviews with employees to discuss health and workplace concerns. We collected personal breathing zone (PBZ) and general area (GA) air samples for minerals, metals, and carbon monoxide (CO) and evaluated the ventilation systems in the cut-off and slitter control booths (small enclosed rooms that were raised off the main work floor), the shippers’ control room, and two breakrooms.

The National Institute for Occupational Safety and Health (NIOSH) received a technical assistance request for a health hazard evaluation from a federal government property manager. The request concerned nausea; headache; and eye, nose, throat, and respiratory irritation among employees at an office leased by the property manager. Employees believed that a persistent chemical odor in the office might be responsible for these symptoms. We met with employer and employee representatives, observed the office layout and workplace conditions, and spoke with employees. We measured temperature, relative humidity (RH), carbon dioxide (CO2), and carbon monoxide (CO) in the office. For comparison, we also took general area air samples for hydrogen sulfide (H2S), formaldehyde, and volatile organic compounds (VOCs) in the office and in two nearby businesses in the same building. We collected two bulk samples of carpet from the office and analyzed them for VOC emissions. We also sent each office employee a survey asking if he or she smelled an odor while at work and if he or she had health concerns associated with this odor.

Twenty-five years into the HIV/AIDS epidemic, we are at a crossroads in caring for HIV-infected women in the USA. Integrating comprehensive reproductive health and family planning services with HIV care for women in our care holds the promise of having healthier families and is an important element in moving toward the elimination of perinatal transmission of HIV. We are writing to give a voice to recommendations made by two expert panels of HIV clinicians and women's health experts in the USA who met in 2008 to discuss how to perform this feat of integrating reproductive health and HIV care. | Childbearing continues to be an important part of the lives of many of our patients, both female and male, living with HIV infection. Approximately, 8000 HIV-infected women give birth per year in the USA [1]. About one-third of HIV-infected women state that they want to have a child in the future [2]. A great deal of stigma still exists toward HIV-infected women and couples who want to get pregnant, especially from their healthcare providers. Women with HIV, particularly perinatally infected women now of reproductive age, come to motherhood with significant psychosocial as well as medical challenges. The small body of existing data tells us that that both HIV discordant and concordant couples have complex experiences, including making decisions about unprotected sex with the intention to conceive, shifting responsibility for condom use as relationships progress, and insufficient knowledge about how to reduce partner transmission risk in relation to childbearing [3].