Thursday, September 3, 2015

Maine CDC seeks feedback

According to the Institute of Medicine, one of the core functions of public health is assessment: the systematic collection, assembly, analysis and sharing of information on the health of the community. As such, Maine CDC provides a great deal of data on its website. We are working to improve the organization, accessibility and usability of that data and seek your feedback. Please follow this link to access an outline survey by September 15 to assist us: https://www.surveymonkey.com/r/6TQMDMB

Wednesday, September 2, 2015

Shared health needs assessment & planning

The Maine Shared Health Needs Assessment & Planning Process (SHNAPP) Project - a collaborative of Central Maine Healthcare, Eastern Maine Healthcare System, MaineGeneral Health, MaineHealth and the Maine Center for Disease Control and Prevention - works to improve the health status of Maine residents and track results.
The goal is to create a framework and approach for a Shared Community Health Needs Assessment (CHNA) that can:
  • Address community benefit reporting needs of hospitals,
  • Support state and local public health accreditation efforts, and
  • Provide valuable population health assessment data for various organizations concerned with the health of Maine’s communities and citizens.

SHNAPP has DRAFT Shared CHNA reports that are available now for review and input.  Drafts of the State report and the Kennebec County report can be downloaded and comments submitted to us from this site.  We appreciate all of your feedback.

Monday, August 31, 2015

Flu

Although most influenza activity occurs from October to May in the U.S., flu viruses are detected year round.  Providers in Maine have reported positive rapid influenza and serology tests in the last month.  Summer and early fall are also the prime time for agricultural fairs, which provides an increased risk for flu associated with swine contact. 
Maine CDC requests that all rapid positive influenza samples during the summer months be forwarded to Maine’s Health and Environmental Testing Laboratory (HETL) for confirmation and typing.  This will allow us to monitor the circulating strains, and identify any variants if present.
If a provider sees a patient with flu-like symptoms who has swine or bird exposures; samples should be sent to HETL for testing.  Rapid tests may not pick up variant strains, and only the state lab is capable of determining if a strain is a variant.
Reporting requirements
  • Suspected novel or variant cases should be reported immediately by phone to 800-821-5821.
  • Outbreaks and pediatric deaths are required to be reported
  • We appreciate all positive lab tests, reported by fax (207-287-6865 or 800-293-7534) or by phone (800-821-5821) but this is not required
Additional Information

Friday, August 28, 2015

Child immunization rates

A recent U.S. CDC report shows that Maine’s vaccination rates for 19-35-month-olds are the best in the nation. 

These results are a cause for celebration and reflect an effective partnership that has been built across the state to address this important health issue. Our success can be attributed to the hard work of clinicians, partners, educators and funders who have collectively made the vaccination of Maine’s children a public health priority.

Maine CDC is proud of this accomplishment and looks forward to working with our partners to build upon this success in the coming year.

Additional information is available in these PowerPoint slides.

Tuesday, August 25, 2015

PHEP supports State Police search

Delorme InReach In its role of managing various vaccines and antidotes in the event of a public health emergency, Maine CDC’s Public Health Emergency Preparedness (PHEP) program identified the need to keep drivers of these types of supplies safe and secure.
Delorme InReach was ultimately chosen to meet this goal, as it allows for real-time GPS tracking. The technology also features text-based communication from the device to a web-interface that can be monitored at a central location.
Recently, this technology was used by the Maine State Police in their manhunt for suspect Robert Burton in Piscataquis County, which ended after 68 days on August 11.  The State Police appreciated the use of these units:
“What the units have enabled us to do is to track personnel in real time as we deploy tactical assets in the field.  By equipping each team with a device, we are able to visually demonstrate to the planners and managers of the incident where each team is tracking.  Not only is that demonstration valuable for progress display, it also allows for the ongoing consideration of reactionary forces should the team encounter a threat.
“The devices have also afforded us a communication alternative in an environment where radio communication is poor.  By utilizing the satellite capabilities to communicate, we are more assured that we are able to relay relevant information to the field as well receive urgent data from any team.”
This real-life application of the technology also served as on-the-job training for the State Police who were active in this search. They are now ready to assist in any public health emergency without additional training.

Thursday, August 20, 2015

DHHS appoints Pezzullo Chief Health Officer

Dr. Christopher PezulloChristopher Pezzullo, D.O., has accepted the position of Chief Health Officer of the Maine Department of Health and Human Services.  Dr. Pezzullo has been serving in this role in an acting capacity since March.
The Chief Health Officer’s (CHO) role is to develop and coordinate an integrated, results-oriented approach throughout DHHS to address significant health issues that span many of the programs within the Department  The CHO will work to implement innovative public health strategies that partner community health promotion efforts with health care clinicians and leaders as well as to construct a more integrated, effective health system through collaboration between clinical care and public health.  All of these efforts are designed to provide strong clinical leadership within the Department to positively improve the health of Maine people.
“I have been impressed with Dr. Pezzullo’s knowledge of and commitment to the public health issues that are impacting Mainers,” wrote DHHS Commissioner Mary Mayhew when announcing the appointment. “His experiences in clinical practice will be helpful as we focus on critical issues like drug-affected babies, fragmented care delivery, chronic disease management, eldercare and effective primary care screenings for tobacco, alcohol and drug use.”
Dr. Pezzullo has been practicing medicine for nearly 20 years in Maine as a pediatrician.  He’s a graduate of the University of New England College of Osteopathic Medicine and has been recognized as a Diplomate of the American Board of Pediatrics and the National Board of Osteopathic Medical Examiners.  Dr. Pezzullo previously served as the Medical Director of the Division of Population Health at Maine CDC, beginning in 2012.  Prior to joining State government, he was the Chief Medical Officer for University Health Care from 2008 to 2012. 

Wednesday, August 19, 2015

Ryan White HIV/AIDS Program anniversary

On August 18, 1990, the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act was signed into law, creating what is now the largest Federal program exclusively providing care and treatment services to people living with HIV – the Ryan White HIV/AIDS Program.
Twenty-five years later, the Health Resources and Services Administration’s (HRSA) HIV/AIDS Bureau commemorates this historic anniversary and honors the Ryan White HIV/AIDS Program, which has played a critical role in the United States’ public health response to the HIV/AIDS epidemic.   The theme:  Moving Forward with CARE: Building on 25 Years of Passion, Purpose, and Excellence”  reflects the passion that inspired the legislation, purpose that continues to drive the Ryan White HIV/AIDS Program and excellence in health outcomes for people living with HIV receiving Ryan White HIV/AIDS Program-funded care.  

HRSA has also produced a new video to highlight the work of the program: http://hab.hrsa.gov/ryanwhite25/

Friday, July 24, 2015

World Hepatitis Day

July 28 is World Hepatitis Day, which aims to increase awareness about viral hepatitis on a global level.  The World Health Organization (WHO) estimates that 400 million people worldwide have chronic viral hepatitis. A approximately 1 million individuals die  each year from viral hepatitis-related causes. 
Hepatitis A is a liver disease spread by ingestion of contaminated food or water or by direct contact with an infected individual. The hepatitis A virus (HAV) can cause mild to severe illness with symptoms ranging from nausea and fever to jaundice. HAV cannot become chronic. Once a person is infected, he or she cannot become infected again.  There is a vaccine available for HAV, which is recommended for all children at age 1 and any adults at risk of infection.
Hepatitis B is caused by the hepatitis B virus (HBV) and can be both acute and chronic. HBV is spread though contact with blood or other bodily fluids of an infected individual.  HBV infection may be symptomatic, but infected individuals may also go years before symptoms or complications occur.  If left undiagnosed and untreated, HBV may result in serious liver disease, cirrhosis, end-stage liver disease or death in 25 percent of people.  There is an effective vaccine available for HBV prevention, which is recommended for all babies at birth and adults at risk of infection.
Hepatitis C is a serious liver disease caused by the hepatitis C virus (HCV), which can be both acute and chronic. HCV is spread by blood-to-blood contact with an infected individual. It is estimated that only 20 percent of people with acute cases experience symptoms of HCV. It’s  possible that patients may live with HCV infection for years without experiencing symptoms until serious liver damage occurs.  Hepatitis C is the leading cause of liver transplant in the United States. The U.S. CDC estimates that there are 3.2 million people living with chronic hepatitis C nationwide, and most individuals are  unaware of their infection. 
Symptoms of hepatitis C include fever, fatigue and loss of appetite, nausea, vomiting, abdominal pain, darkened urine, clay-colored stools, joint paint and jaundice.  People who have ever injected drugs, shared needles and equipment or who were born to a hepatitis C-positive mother join Baby Boomers in the highest risk category.
Recent advancement in therapies for treatment of hepatitis C can cure up to 95 percent of infections. Maine CDC recommends that people talk to their health care provider about their risk for hepatitis C testing. There is no vaccine available for hepatitis C.
For more information about viral hepatitis resources in Maine, visit: www.mainepublichealth.gov/hepatitis
For more information about hepatitis, visit: http://www.cdc.gov/knowmorehepatitis 

Are you at risk for viral hepatitis?  Find out if you should get tested:  www.cdc.gov/hepatitis/riskassessment/index.htm 

Thursday, July 9, 2015

Cancer registry awards

Cancer Registry staff pose with awards
L-R: Dr. Molly Schwenn and Katherine Boris of the Maine Cancer Registry and Debra Wigand, Director of Maine CDC's Division of Population Health,  pictured with the two honors from US CDC.

The Maine Cancer Registry has been recognized with two national honors from the US CDC National Program of Cancer Registries (NPCR)
Maine was recognized as one of 19 states to receive the Registry of Excellence designation. In addition, the registry was recognized for achieving the highest standards for data completeness, timeliness and quality. According to the NPCR, Maine’s data are so thorough and accurate that they will be included in this year's United States Cancer Statistics report and other analytic data sets. 
Achievement of these standards and certification is important to ensure accurate information is available about cancer in Maine and to monitor trends in cancer diagnosis. Detecting cancer at an earlier stage can improve outcomes. Maine hospitals are partners in this effort, providing up-to-date local information to the Maine Cancer Registry.

Thursday, July 2, 2015

Arboviral diseases

Summer is here, which means mosquitoes are here as well.  Arboviral diseases, including eastern equine encephalitis (EEE) and West Nile virus (WNV), are very serious infections that are transmitted by the bite of an infected mosquito.  Additionally, Powassan virus is an arboviral disease transmitted by the bite of an infected tick.  Although rare, these diseases have potentially severe and even fatal consequences for those who contract them.  Maine CDC reminds clinicians of the potential for human disease activity in Maine and to consider testing for arboviral disease in patients presenting with unexplained encephalitis, meningitis or fever (≥100.4°F or 38°C) during the summer and early fall.
EEE and WNV were first detected in Maine in 2001 in birds.  In 2009, Maine experienced unprecedented EEE activity with 19 animals and two mosquito pools testing positive.  In 2012, Maine reported its first human case of locally-acquired WNV neuroinvasive illness.  In 2014, Maine reported its first human case of locally-acquired EEE neuroinvasive illness. Powassan was first identified in Maine in 2000 but is rarely reported; a confirmed case in 2013 was the first reported case in nearly a decade.  In 2014, Maine reported EEE in an emu from Cumberland County, 22 mosquito pools from York County and one human from York County.
Many people infected with arboviral illness remain asymptomatic. The following groups of people are at higher risk for clinically significant arboviral infection:
  • Residents of and visitors to areas with mosquito or tick activity
  • People who engage in outdoor work and recreational activities
  • People older than 50 and younger than 15 

Additional Information
  • Disease consultation and reporting available through Maine CDC at 1-800-821-5821

Friday, June 12, 2015

New State epidemiologist

Maine CDC is pleased to announce that Siiri Bennett, MD, has accepted the position of State epidemiologist. 
Dr. Bennett received her medical degree from the University of Washington School of Medicine and completed her residency in internal medicine at Mt. Auburn Hospital in Massachusetts. 
Dr. Bennett is currently a senior research scientist and medical data consultant in the Department of Biostatistics at the University of Washington in Seattle, where she is co-principal investigator for an NIH-funded Data Coordinating Center for a multi-study collaboration looking at tuberculosis latency and reactivation and also serves as a project director for a multi-study consortium looking at cardiovascular disease in patients with HIV.

She will begin her new role at Maine CDC on July 20.

Thursday, May 28, 2015

Healthy Maine Works

Healthy Maine Works (HMW) is the Maine CDC’s initiative to support and provide employers of all sizes with tools and resources to develop an evidence-based worksite wellness program.  Many employees spend most of their waking hours at work. Worksite wellness programs give employers a unique opportunity to support the health of their employees.
What is Worksite Wellness?
Worksite wellness programs help to improve the health of employees, leading to a decrease in health-care costs for employees and their employer.  They offer many benefits such as:
  • Lower health care costs
  • Less absenteeism from work
  • Reduced staff turnover
  • More productive employees
  • Healthier employees
Worksite wellness also offers a good return on investment.  According to the 2010 Harvard study Workplace Wellness Programs Can Generate Savings, for every dollar that an employer spends on worksite wellness, an average return of $3.27 will be seen.
How HMW Can Help
HMW can provide the tools to help any employer create a worksite wellness program or help improve an already existing program.  When you sign up, you can get access to:
  • Employee health surveys to determine what health topics your employees would find interesting
  • A newsletter that provides information, ideas and resources to help create healthier worksites
  • Healthy Us Score card – an easy to use online assessment and planning tool that helps promote healthy living
Employers interested in developing a worksite wellness program can contact their local Healthy Maine Partnership by visiting www.healthymainepartnerships.org. They can help you get your worksite wellness program started today.

To learn more about Healthy Maine Works, visit www.healthymaineworks.com

Tuesday, May 26, 2015

Group A strep

Maine CDC is investigating an increase in the number and severity of invasive group A Streptococcal (GAS) infections in the first half of 2015 compared to a similar time frame in previous years.  Maine CDC received reports of 15 cases of invasive GAS in April and the first week of May alone, almost half of the 33 cases reported to date this year.  Of those 15 cases, six resulted in streptococcal toxic shock syndrome (STSS), a more serious presentation in which the disease affects multiple organs.  At this time in 2014, Maine had reports of 23 cases of invasive GAS and nine cases of STSS. 
Most GAS infections are relatively mild such as “strep throat,” scarlet fever or impetigo.  Invasive GAS disease is more severe and includes pneumonia, cellulitis and the least common forms but most severe forms -- necrotizing fasciitis and STSS. 
Invasive GAS infections are seasonal, peaking December through April. The spread of GAS can be prevented by good hand washing, especially after coughing and sneezing.  People with sore throats diagnosed as strep throat should stay home from work, school or day care until 24 hours after taking antibiotics.
Recommendations: 
Health care providers should consider invasive GAS in any patient who presents with early signs of STSS and should collect culture specimens and consider prompt antibiotic treatment. Because invasive GAS infections can progress rapidly, providers are encouraged to be familiar with early signs of STSS:
  • Fever
  • Abrupt onset of generalized or localized severe pain, often in an arm or leg
  • Dizziness
  • Influenza-like syndrome
  • Confusion
  • A flat red rash over large areas of the body (occurs in 10% of cases)
Reporting requirements:
All cases of suspected invasive GAS and STSS should be reported by phone to the Maine CDC at 1-800-821-5821, or by fax to 1-800-293-7534.
For more information:
 US CDC’s Group A Strep webpage:  http://www.cdc.gov/groupastrep/

Monday, May 25, 2015

Varicella update

Maine has had four outbreaks of varicella (three or more cases in a single setting) reported in schools or daycares during the 2014-2015 school year, more than any previous year. 
Varicella is a highly contagious, acute viral illness that causes both chickenpox and shingles.  Varicella can be serious, especially in babies, adults and those with weakened immune systems.  It spreads in the air through coughing or sneezing, or by touching or breathing in the virus particles that come from the blisters. Infected people are contagious from two days before their rash starts until all blisters have scabbed over.  Vaccination is the best method of protection.
From September 2014 through mid-May 2015, 84 cases of varicella have been reported in children 18 years or younger, compared to 44 cases during the same time period of the 2013-2014 school year. Cases have been reported in all Maine counties except Washington County during the 2014-2015 school year. Of these cases, 57 (68 percent) were non- or under-immunized, including four children who were too young to receive vaccine. 
Key points for health care providers:
  • Report all cases of varicella, including clinically diagnosed cases with no laboratory testing.
  • Providers should ensure all patients are up to date with varicella vaccine and other vaccines. Two doses of varicella vaccine are recommended.
  • Pregnant women exposed to varicella should contact their obstetrician for follow up.
  • Varicella cases should be excluded from school or work until lesions are crusted over.
  • Laboratory testing is available for varicella through Maine CDC’s Health and Environmental Testing Laboratory (HETL) as well as other reference laboratories.
Key points for schools and daycares:         
Reporting requirements:
All laboratory and clinically diagnosed cases of varicella should be reported by phone to 1-800-821-5821, or by fax to 1-800-293-7534.
For more information:

Monday, May 18, 2015

Immunization Champion

Cassandra Cote Grantham and Tonya Philbrick
Cassandra Grantham (L) was recently honored as US CDC's Childhood Immunization Champion for Maine. She is pictured with Tonya Philbrick, Director of the Maine Immunization Program at Maine CDC.

The Maine Immunization Program is proud to announce that Cassandra Cote Grantham, a health communication specialist at MaineHealth in Portland, has been selected as the US CDC Childhood Immunization Champion for Maine.
Cassandra was nominated and selected from a pool of health care professionals, community advocates and other immunization leaders for making a significant contribution to public health in Maine through her work in children’s immunization.
In 2010, Cassandra established MaineHealth’s childhood immunization program, with the goal of increasing Maine’s childhood immunization rates to the highest in New England by 2016. Under this program, she has launched several educational initiatives, such as the Vax Maine Kids website and Kohl’s Vax Kids—a program to increase immunization awareness among parents most likely to delay or skip their child’s vaccinations.

To read her profile on the CDC’s website and to learn more about CDC’s Childhood Immunization Champion Award program, please visit http://www.cdc.gov/vaccines/champions 

Friday, May 15, 2015

Lab workers recognized

Heather Dyer and Steve Pierce, chemists at Maine CDC’s Health and Environmental Testing Lab, recently presented on toxicology forensics at the Maine Impaired Driving Summit. They were recognized by AAA Northern New England and Maine Bureau of Highway Safety for their support in organizing the statewide summit. 

Thursday, May 14, 2015

Hepatitis

May is National Hepatitis Awareness Month, and Maine CDC urges people to talk with their providers about testing for hepatitis. 
US CDC reports that people born from 1945 through 1965 are five times more likely to be infected with Hepatitis C than other adults.  There are approximately 3.2 million individuals living with hepatitis C in the country, and it is estimated that 75 percent of these individuals are Baby Boomer age (ages 50 to 70). 
Most people living with hepatitis C do not know they are infected and can live with the disease for decades without having symptoms or feeling sick. If left untreated, hepatitis C can lead to serious liver damage, including cirrhosis and liver cancer.  Hepatitis C is the leading cause of liver transplant in the United States. 
Symptoms of hepatitis C include fever, fatigue and loss of appetite, nausea, vomiting, abdominal pain, darkened urine, clay-colored stools, joint paint and jaundice.  It is estimated that only 20 to 30 percent of individuals who have Hepatitis C experience symptoms. People who have ever injected drugs, shared needles and equipment, or who were born to a Hepatitis C positive mother join Baby Boomers in the highest risk category. 
Recent advancement in therapies for treatment of hepatitis C can cure up to 95 percent of infections. Maine CDC recommends that people talk to their health care provider about their risk for hepatitis C. 
Testing days are scheduled in May for individuals who are uninsured and at high risk for hepatitis C. The dates and locations are:
  • May 18: Waterville Family Planning  18 Silver Street Waterville 207-509-3267
  • May 19: Florence House (women's shelter) via Portland Public Health. 103 India St Portland 207-874-8446
Those who are interested in being tested should call the test site prior to the testing day to find out if they qualify for the free test. 
For more information about hepatitis, visit: http://www.cdc.gov/knowmorehepatitis 

For more information about viral hepatitis resources in Maine, visit: www.mainepublichealth.gov/hepatitis

Wednesday, May 13, 2015

Lyme and other tickborne diseases

Lyme disease is the most common vector-borne disease in Maine. Cases have been increasing each year in Maine, and occur in all 16 counties. More than 1,395 cases of Lyme disease were reported statewide in 2014, a record high for Maine.  Lyme disease is most common among school age children and mature adults over the age of 65. Most infections occur during the summer months. A total of 71 cases have already been reported in 2015.
The most common early symptom of Lyme disease is an expanding red rash that occurs 3-30 days after being bitten. Fever, headache, joint and muscle pains and fatigue are also common during the first several weeks. Later features of Lyme disease can include arthritis in one or more joints (often the knee), Bell's palsy and other cranial nerve palsies, meningitis and carditis (AV block). Lyme disease is treatable, and the majority of patients recover after receiving appropriate therapy.
Lyme disease is a reportable condition in the State of Maine.  Providers should report all diagnosed erythema migrans rashes and all positive lab diagnoses.  Cases can be reported by fax at 1-800-293-7534 or by phone at 1-800-821-5821.
Other tickborne diseases: 
Other diseases that are carried by ticks in Maine include anaplasmosis, babesiosis, ehrlichiosis, Powassan and Rocky Mountain spotted fever. They are all reportable in Maine.
In 2014, providers reported 191 cases of anaplasmosis, more the twice the number of cases reported in 2013.  Providers reported 42 cases of babesiosis, a slight increase from 2013.  Four anaplasmosis cases and one babesiosis case have already been reported in 2015.  
For more information:

Tuesday, May 12, 2015

Six steps to control blood pressure

High blood pressure, often referred to as the “silent killer,” does not have any symptoms, but can cause serious damage to arteries, leading to heart disease and stroke. Nearly one in three adults in the United States has high blood pressure and many people remain unaware of this condition because there are no symptoms. 
A routine doctor’s appointment often involves a health professional checking your blood pressure. The results of this simple test may identify a condition that, when managed, could help reduce your chances for stroke or heart attack.
The national high blood pressure campaign, Measure Up/Pressure Down®, encourages adults to get in control by making simple lifestyle changes, including:
1. Know your numbers – Understanding what blood pressure is, and what your numbers are, is an important first step. Work with your health care provider to determine your individual blood pressure goals and treatment plan if your numbers are too high.
2. Eat right – A diet with excessive sodium (salt) can lead to higher blood pressure. Check food labels before you buy and choose foods with less than 400 mgs of sodium per serving.
3. Stay active – By being active at least 30 minutes a day at least 5 times a week, you can help reduce your blood pressure.  
4. Reduce stress – A stressful situation can increase blood pressure for a short period of time. Try to reduce the occurrence of these situations and look for healthy ways - like meditation or walking - to help you deal with stress.
5. Set alcohol limits and eliminate tobacco – Over time, consuming a high amount of alcohol can damage the heart. Tobacco use and secondhand smoke can immediately raise blood pressure levels and cause damage to the lining of arteries. If you’re interested in quitting tobacco, call the Maine Tobacco HelpLine 1-800-207-1230. 
6. Take medication – Your doctor may recommend taking a blood pressure medication to keep levels steady. Be sure to follow the directions provided for taking the medications to ensure you’re getting the most benefit from them.
Through Measure Up/Pressure Down®, you are encouraged to measure, monitor and maintain your blood pressure level to stay in control of this health condition. If you don’t know your blood pressure and want more information to determine if you might be at risk for high blood pressure, visit MaineHeartHealth.org.


Monday, May 11, 2015

Suicide Prevention Conference

Maine Suicide Prevention Program’s CAL ME Award Presentation
From left to right-Ken Albert, Director and Chief Operating Officer, Maine CDC; Kyle Poissonnier, founder of Katalyst; MaKayla Reed, volunteer for The Trevor Project; Jodi Beck, Director of Clinical Integration and Physician Practice Improvement for Kennebec Regional Health Alliance, MaineGeneral Health; Anthony Ronzio, Director of news for the Bangor Daily News; Kristen McAuley, Team Lead, Healthy and Safe Living, Division of Population Health, Maine CDC; Brian Walsh, Principal of Hermon High School. CAL ME Award recipients not pictured- Ethel Jalbert and Tonya Bailey-Curry, community volunteers.
  

More than 200 people attended the Maine Suicide Prevention Program’s conferece, 2015 Beyond the Basics: Pathway to Suicide Prevention, last week. Ken Albert, Director and Chief Operating Officer of Maine CDC, presented the Caring About Lives in Maine Awards to seven Individuals and agencies for their leadership and dedication to suicide prevention.