Maine CDC/DHHS Public Health Update
February 12, 2010
Influenza Activity in Maine and the US
H1N1 activity continues in Maine as well as across the U.S. but in diminished levels than in November and December. There was one outbreak of influenza like illness in a Hancock County K-12 school last week. Nationally and in Maine, virtually all of the influenza viruses identified are the 2009 pandemic strain of influenza A. More information can be obtained at: http://www.cdc.gov/flu/weekly/index.htm#whomap.
Influenza Vaccine
Sanofi Pasteur has shortened the expiration period of all of its 2009 H1N1 influenza vaccine in pre-filled syringes; all lots should now be administered by February 15, 2010 regardless of the expiration imprinted on the package. There are no safety concerns with the recalled lots of 2009 H1N1 vaccine and no re-administration of the vaccine is required. For more information, see this US CDC Q&A: http://www.cdc.gov/h1n1flu/vaccination/qa_recall.htm?s_cid=tw_flu104. Maine health care providers who have received this vaccine have been contacted directly by Maine CDC’s Immunization Program staff.
With more than 900,000 doses of H1N1 vaccine distributed in Maine to about 500 health care providers and a variety of free flu clinic settings throughout the state, everyone should consider getting vaccinated against H1N1 flu. Clinics can be located by calling 211 or by visiting www.maineflu.gov. The free clinics are in bold font.
Parents are reminded to ensure that children younger than 10 years-old get both doses of 2009 H1N1 vaccine. The recommended interval between the first and second dose is 28 days.
Even those not at high-risk for complications from influenza should consider vaccine, because either they themselves can suffer complications or can infect those who are at higher risk for complications. Health care providers who treat people at high risk for complications from influenza (such as those with underlying conditions, pregnant women, young children, and those older than 64) are urged to vaccinate those patients and to treat with antiviral medicines at the onset of symptoms.
Disposing of and Reporting Unused/Expired Vaccine
Health care providers who have sufficient supplies and no longer need vaccine that is being shipped to them should contact their local vaccine coordinator to arrange for redistribution. Unused or expired H1N1 vaccines may not be returned to the distributor. If vaccine cannot be redistributed prior to expiration, the health care provider is responsible for disposing of the vaccine appropriately.
For information on hazardous waste disposal in Maine, see the Biomedical Waste Management Rules (06-096 CMR 900): http://www.maine.gov/sos/cec/rules/06/096/096c900.doc and 38 MRSA Chapter 13, Waste Management: http://www.mainelegislature.org/legis/statutes/38/title38ch13sec0.html
Discarded vaccine needs to be reported to Maine CDC. Providers Please discard the expired vaccine doses as providers do with their other expired medicines and ask them to report the doses discarded on the same weekly reporting form used for vaccine administration (http://www.maine.gov/dhhs/boh/maineflu/schools/documents/Aggregate-H1N1-weekly-reporting_V3.pdf) – please note any discarded doses in the space between the two “Total” cells at the lower right corner of the form with a mark of “Expired (and discarded) doses.”
Group A Strep Update
Maine CDC has now received 13 reports of cases of invasive Group A Streptococcal (GAS) infections since January in Maine. Cases have been confirmed in Androscoggin, Cumberland, Hancock, Kennebec, Oxford, Penobscot, and York counties in people ages 6 through 90. Seven of these have resulted in Streptococcal Toxic Shock Syndrome (STSS), of which three have died. Although GAS is a common bacteria in the throat and skin, often causing strep throat or impetigo, invasive GAS disease is rare, with the five-year median in Maine being 19 cases per year.
There is no reported increase in cases in nearby states, and these patients in Maine do not appear to be associated with a specific area of the state, or with influenza or with health care facilities. More information, including recommendations, can be found in this Maine CDC health advisory http://bit.ly/bswpU2 or this US CDC site: http://bit.ly/cP0vIl.
Earthquakes and Public Health
The American Public Health Association has developed a web page with links to information about relief efforts in Haiti, which includes resources for people who are interested in volunteering: http://www.apha.org/programs/globalhealth/issues/
There are many public health concerns as a result from earthquakes, including those related to victims of the disaster and those related to people traveling to post earthquake zones, such as Haiti, to assist in recovery efforts. These two US CDC sites provide advice for relief workers, including travel guidance specific to workers traveling to Haiti: http://wwwnc.cdc.gov/travel/content/relief-workers.aspx and http://emergency.cdc.gov/disasters/earthquakes/responders.asp
Updates from Federal Partners
US CDC issued an abbreviated Pandemic Influenza Plan template for primary care provider offices, which will allow providers to rapidly (within 1-5 days) develop a pandemic influenza plan: http://www2c.cdc.gov/podcasts/download.asp?af=h&f=761031
Maine Animal Rabies Fourth Quarter Update
Maine CDC provides a quarterly update on animal rabies to veterinarians and other animal health professionals, which may be used to increase the understanding of pet owners and other members of the public regarding the risk of rabies in Maine. Read the update here: http://www.maine.gov/tools/whatsnew/attach.php?id=91596&an=2
To read the full update, click here: http://bit.ly/bhbbuw
