Tuesday, September 28, 2010

World Rabies Day

Today Maine CDC recognizes the third annual World Rabies Day. US CDC and the Alliance for Rabies Control, a UK charity, established this day in 2007 to raise awareness about rabies, which kills more than 50,000 people worldwide each year.

Rabies is a deadly disease caused by a virus. Rabies is 100% preventable by avoiding wild animals and any animal that you do not know, or by getting rabies shots if an exposure already occurred. A rabies exposure happens when a person or animal comes into contact with the saliva or tissue from the nervous system (brain or spinal cord) of a rabid animal. This contact can be from a bite or scratch, or if the animal’s saliva gets into a cut in the skin or in the eyes, nose, or mouth.

Rabies in people is very rare in the United States, with only one to two cases each year. The last human case of rabies in Maine was in 1937, but this does not mean that rabies is not a problem. Rabies in animals, especially wildlife, is common in most parts of the country, including Maine. The most commonly infected animals in Maine are raccoons, skunks, bats, and foxes. To date this year, 52 animals have tested positive for rabies.

If you think that you have been exposed to rabies, wash the wound right away with soap and water. Then, call your doctor and the Maine CDC at 1-800-821-5821 to evaluate the need for animal testing and rabies shots. In addition, if you or your pet is exposed to a suspected rabid animal, call your veterinarian and local Animal Control Officer. If you or your pet is exposed to a wild animal, call your local Game Warden.

Follow these steps to prevent rabies:

  • Vaccinate your pet cats and dogs against rabies; it is the law.
  • Avoid contact with wild animals or other animals that you do not know.
  • Bat-proof your home. Wildlife biologists can provide tips on how to bat-proof your home without harming bats.

For more information about rabies, visit the Maine CDC website at www.mainepublichealth.gov/rabies.

Monday, September 27, 2010

Health Reform Update

Health Reform and Public Health

Health reform has many implications for public health. Learn more by viewing or using the Power Point titled “Health Reform and Public Health” on this website: http://www.maine.gov/dhhs/boh/mills_presentations.shtml.

Maine CDC Awarded Public Health Infrastructure Grant

Maine CDC has received an award of $1.76 million per year for five years from the U.S. Department of Health and Human Services for improvements to Maine’s public health system.

The goal of these funds includes improving health departments’ performance management capacity and the ability to meet national public health standards to make programs and people in the public health system more efficient and effective. In Maine, these funds will: complete an electronic death certificate system; make necessary updates to an electronic birth certificate system; build systems to allow health care providers to more easily transfer information on immunizations to Maine CDC; apply public health performance management principles in Maine CDC and its work; improve capacity for health planning at the state and district level; and make public health data more accessible.

The grant is funded by the Affordable Care Act of 2010 and will be administered by US CDC.

For more information: http://www.maine.gov/tools/whatsnew/index.php?topic=DHS+Press+Releases&id=133134&v=article

Other Health Reform Updates

This web chat (http://www.healthcare.gov/news/blog/webchat_behavioralhealth.html) has information on how the Affordable Care Act will help improve behavioral health.

HealthCare.gov has posted updated information (http://www.healthcare.gov/foryou/youngadults/soon/index.html) for young adults about improvements to health care that are coming soon.

The Kaiser Family Foundation has launched an online resource on the health reform law, which provides explanations of the basics of the law, in-depth analysis of policy issues in implementation, and quick and easy access to relevant data, studies and developments. The Health Reform Source is accessible at: http://healthreform.kff.org

For more information about Health Reform in Maine, visit the Governor’s Office of Health Policy and Finance’s web site: http://www.maine.gov/healthreform/

Wednesday, September 22, 2010

Flu update

Flu information for the general public

US CDC recommends that everyone 6 months of age and older be vaccinated against the flu this year. Getting a flu vaccine is easy, and it is the single best way to protect yourself and your loved ones from flu. Vaccine is already available in many places, and it will provide protection through the entire flu season.

The 2010-2011 flu vaccine will protect against:

· an influenza A H3N2 virus,

· an influenza B virus, and

· the 2009 H1N1 virus that caused so much illness last season.

You need to get the 2010-11 seasonal flu vaccine even if you got the 2009 H1N1 flu vaccine last season.

Over the years, hundreds of millions of people in the U.S. have safely received seasonal flu vaccines. Last flu season, about 80 million people in the U.S. also received the vaccine made to protect against the 2009 H1N1 virus, and the vaccine’s safety was similar to that of seasonal flu vaccines. Over the last 50 years, flu vaccines have been shown to be safe. Every year, CDC works closely with FDA, health care providers, state and local health departments, and other partners to ensure the highest safety standards for flu vaccines. CDC also works closely with FDA to ensure systems are in place to promptly detect unexpected health problems following vaccination.

Update on distribution

Most influenza vaccine arrives in Maine through private sector channels, but some federal and state funds allow Maine CDC to purchase flu vaccine for some populations in Maine such as pregnant women, those in nursing homes, K-12 school children and their teachers and other staff, all other children, homeless, and people served by municipal and tribal health departments. Maine CDC will be distributing a total this year of about 290,000 doses of influenza vaccine, most of it over the coming weeks.

Doses Approved for Shipment as of Sept. 22:



Children ages 6 months to 18 years




Nursing homes and long-term care facilities




* This includes doses shipped to both schools and private health care providers.

Number of schools that have received flu vaccine so far: 81

Number of doses distributed to schools so far: 20,590

All health care providers who have fulfilled the requirements in their provider agreements have received some vaccine toward their orders. If you are a provider who has not yet received vaccine, ensure that you have submitted all the appropriate paperwork and temperature logs.

Flu resources

Maine CDC has posted materials – including registration forms, consent forms, and sample protocols – for those participating in school-based flu vaccine clinics at: http://www.maine.gov/dhhs/boh/maineflu/h1n1/educators.shtml#schoolclinics

A zip code searchable flu clinic locator will be available at www.flu.gov shortly.

A conference call for those participating in school-based vaccine clinics will be held at 3 p.m. Wednesday, Oct. 6. The phone number is 1-800-914-3396 with the pass code 473623#. During calls, please press *6 to mute your line un-mute when you are actively participating.

Federal guidance and updates

Tuesday, September 14, 2010

Protect Your Groundwater

It's National Protect Your Groundwater Day. Nearly 2/3 of Maine people get their drinking water from groundwater, so we have a large stake in protecting our groundwater quality and quantity in Maine. We can all use this day to begin doing our part for protecting one of our most important natural resources — our groundwater!

Some things you can do to help protect our groundwater:

  • Properly maintain your septic system: make sure to have your septic tank pumped every 3 to 5 years and check for signs that your septic system is not working
  • Handle gasoline, motor oil, fertilizers, pesticides and other hazardous chemicals with care, making sure not to dump them on the ground or pour them down the sink. When you’re done with them, dispose of them properly at a recycling center
  • Inspect your heating oil tank and its piping to make sure it’s not leaking, starting to corrode or rust, or in danger of tipping over
  • Don’t throw away or flush unused or unwanted medications down the drain. Instead, properly and safely dispose of them by using Maine’s Safe Medicine Disposal for ME free medication mailback program

For more information on Protect Your Groundwater Day, or to learn more ways you can protect groundwater, visit http://www.ngwa.org/public/PYGD/pygd.aspx. For information on public water systems visit the Maine CDC Drinking Water Program website at www.medwp.com. For more information on private wells, visit http://wellwater.maine.gov.

Friday, September 10, 2010

World Suicide Prevention Day

Today is World Suicide Prevention Day. Suicide claims 1 million lives worldwide every year, resulting in one suicide every 40 seconds. Suicide is a preventable cause of premature death on a global level. In 2007, the latest year for which national data are available, suicide accounted for 57% of violent deaths in the U.S.

Suicide is a significant problem in Maine. Maine’s suicide rate among people of all ages ranked 14th highest in the U.S. in 2007. Of 218 violent deaths in Maine that year, 26 (12%) were homicides and 191 (88%) were suicides.

Suicide is the second leading cause of death for Maine’s young people aged 15-24. Maine lost a total of 104 young lives from 2004-2008, an average of more than 20 per year. In 2007, the rate of suicide by people aged 15-24 in Maine ranked 6th highest in the nation.

Experts believe that most suicidal individuals do not want to die and that suicidal crises tend to be brief. Suicidal individuals want to end the pain that they are experiencing. When suicidal risk is detected early, lives can be saved.

Governor John Baldacci has proclaimed September 14 as Maine Suicide Prevention Awareness Day. An event marking youth suicide prevention efforts in Maine will be held from 2-4 p.m. September 14 in the Hall of Flags on the second floor of the State Capitol Building in Augusta. First Lady Karen Baldacci will read the Governor’s proclamation and Muriel Littlefield, Director of the Department of Health and Human Services Project, will recognize individuals who have made outstanding contributions to suicide prevention. Other state and local leaders will speak and urge others to get involved in suicide prevention. Nancy Thompson, a mother whose son Timmy died by suicide in 2004 and a “Maine Connect speaker,” is a featured speaker. Anyone is welcome to attend.

Several Maine businesses are helping to raise awareness of suicide prevention by distributing information to their customers, including: Fashion Bug, Lithgow Library, Marden’s, Bangor Mall Pizza Hut, and Reny’s.

For more information on youth suicide prevention efforts in Maine, visit www.maine.gov/suicide

Thursday, September 9, 2010

Bi-weekly Public Health Update 9/9/10


Maine CDC has already distributed more than 36,000 doses of flu vaccine. The vaccine distributed so far is earmarked for pre-schoolers as well as residents and employees of nursing homes and long-term care facilities. It is the first time in many years that state-supplied vaccine has been distributed this early.

Most influenza vaccine arrives in Maine through private sector channels, but some federal and state (Tobacco Settlement - Fund for a Healthy Maine) funds allow Maine CDC to purchase flu vaccine for some populations in Maine such as pregnant women, those in nursing homes, K-12 school children and their teachers and other staff, all other children, homeless, and people served by municipal and tribal health departments. Maine CDC will be distributing a total this year of about 290,000 doses of influenza vaccine, most of it over the coming weeks.

Maine CDC has posted materials – including registration forms, consent forms, and sample protocols – for those participating in school-based flu vaccine clinics at: http://www.maine.gov/dhhs/boh/maineflu/h1n1/educators.shtml#schoolclinics

Updates from the US CDC can be found on its Influenza Site.


Pertussis is still an important concern in Maine and throughout the U.S., with outbreaks being seen in several states, including significant ones among un and under-vaccinated in California, resulting in 8 infant deaths there. To date in 2010, Maine has seen 32 confirmed cases of pertussis with 11 of those reported in the past month. The majority of people identified are younger than 13 years of age. Half are not up to date on their vaccines or their vaccine status is not known. With school reconvening and with so many children under-vaccinated, we are concerned about increasing outbreaks here in Maine. For more information, see this Health Alert: http://www.maine.gov/tools/whatsnew/index.php?topic=DHHS-HAN&id=128206&v=alert


This report (http://www.rwjf.org/coverage/product.jsp?id=68128&cid=xtw_rwjf) examines the demographics and health characteristics of the new population nationally now eligible for Medicaid under health reform.

Although health coverage is currently available to children in families with incomes up to about $45,000 per year in nearly every state, an estimated five million uninsured children are eligible for Medicaid or CHIP but not enrolled. The Centers for Medicare & Medicaid Services (CMS) have built an unprecedented coalition of partners, ranging from state governors to national advocacy organizations, to enroll children in Medicaid and CHIP and educate families. For more information: http://www.hhs.gov/news/press/2010pres/09/20100903a.html

As part of the health reform’s step-by-step efforts to close the Medicare Part D prescription drug coverage gap, more than 1 million eligible Medicare beneficiaries who fall in this “donut hole” this year are mailed a one-time, tax-free $250 rebate check. For more information: http://www.hhs.gov/news/press/2010pres/08/20100830b.html

Through the Affordable Care Act’s Early Retiree Reinsurance Program, employers are going to receive help to maintain health coverage for retirees not yet eligible for Medicare. Nearly 2,000 employers, representing large and small businesses, State and local governments, educational institutions, non-profits, and unions have been accepted into the program and will begin to receive reimbursements for employee claims this fall. For more information: http://www.hhs.gov/news/press/2010pres/08/20100831a.html

The U.S. Department of Health and Human Services has unveiled CuidadodeSalud.gov, the first website in Spanish of its kind to help consumers take control of their health care by connecting them to new information and resources that will help them access quality, affordable health care coverage. This site is the partner of HealthCare.gov, which was launched in July 2010, and is the first website in Spanish to provide consumers with both public and private health coverage options tailored specifically for their needs in a single, easy-to-use tool. For more information: http://www.hhs.gov/news/press/2010pres/09/20100908a.html

For more information about Health Reform in Maine, visit the Governor’s Office of Health Policy and Finance’s web site: http://www.maine.gov/healthreform/


CDC Vital Signs is a new report that will appear on the first Tuesday of the month as part of the US CDC journal Morbidity and Mortality Weekly Report (MMWR). Vital Signs is designed to provide the latest data and information on key health indicators. This month’s Vital Signs focus on tobacco use:
Vital Signs: Current Cigarette Smoking Among Adults Aged ≥18 Years — United States, 2009
Vital Signs: Nonsmokers’ Exposure to Secondhand Smoke — United States, 1999–2008

Despite the known dangers of tobacco use, 1 in 5 American adults continues to smoke cigarettes, and 4 in 10 nonsmokers were exposed to cigarette smoke during 2007-2008. Among children between the ages of 3 and 11 years old, 54 percent were exposed to secondhand smoke. Nearly all (98%) of children who live with a smoker are exposed and have measureable levels of toxic chemicals from cigarette smoke.

In this report, US CDC commends California for their successful long term comprehensive tobacco control program that has been associated with adult smoking rate reductions. They then commend the successes seen in youth smoking in our state: “Maine, New York, and Washington have seen 45%--60% reductions in youth smoking with sustained comprehensive statewide programs.”

Additionally, the report notes that the 2009 Family Smoking Prevention and Tobacco Control Act gives the Food and Drug Administration authority to regulate the manufacturing, marketing, and distribution of tobacco products and has provided new opportunities to reduce tobacco use.

For more information visit the Partnership for a Tobacco-free Maine, Maine CDC’s tobacco prevention and control program.


Tattoo licensing has been in the local news recently. Licensed tattoo artists in Maine are required to have special training about bloodborne diseases and to utilize safety precautions before, during and after the application of the tattoo. In getting a tattoo, safety should always be vigilantly observed to avoid medical issues. These include preventing diseases such as HIV, AIDS, hepatitis and other diseases that can be acquired through sharing of needles, use of unsterile equipments and sloppy procedures. You can reduce the health risks by only going to tattoo shops and tattoo artists that are fully licensed. The following provides information on the health risks associated with tattoos and the safety precautions that should be used by all licensed tattoo artists in the State of Maine.

Health Risks Associated with Tattoos:
• Bloodborne diseases. If the equipment used to create your tattoo is contaminated with infected blood, you can contract various bloodborne diseases, including hepatitis B, hepatitis C, tetanus and HIV — the virus that causes AIDS.
• Skin infections. Tattoos can lead to local bacterial infections, characterized by redness, swelling, pain and a pus-like drainage.
• Allergic reactions. Tattoo dyes — especially red dye — can cause allergic skin reactions, resulting in an itchy rash at the tattoo site. This may occur even years after you get the tattoo.
• Other permanent skin problems. Sometimes bumps called granulomas form around tattoo ink, especially red ink. Tattooing can also lead to raised areas caused by an overgrowth of scar tissue (keloids).

Safety Precautions for Reducing Health Risk Associated with Tattoos:
• Go to a reputable tattooing studio that employs only licensed, properly trained employees.
• Make sure the tattoo artist washes his or her hands and wears a fresh pair of protective gloves for each procedure.
• Make sure the tattoo artist removes a needle and tubes from sealed packages before your procedure begins. Any pigments, trays and containers should be unused as well.
• Make sure the tattoo artist uses a heat sterilization machine (autoclave) to sterilize all nondisposable equipment after each customer. Instruments and supplies that can't be sterilized with an autoclave — including drawer handles, tables and sinks — should be cleaned with a commercial disinfectant or bleach solution after each use.

If you think your tattoo may be infected or you're concerned that your tattoo isn't healing properly, contact your doctor.


The U.S. CDC’s Advisory Committee on Immunization Practices (ACIP) has updated its recommendations for prevention of invasive pneumococcal disease through use of the 23-valent pneumococcal polysaccharide vaccine among all adults aged ≥65 years and those adults aged 19–64 years with underlying medical conditions that put them at higher risk for serious pneumococcal infection. The new recommendations include the following changes from previous ACIP recommendations: 1) indications for which PPSV23 vaccination is recommended now include cigarette smoking and asthma, and 2) routine use of PPSV23 is no longer recommended for Alaska Natives or American Indians aged ≤65 years unless they have medical or other indications for PPSV23. For more information, read this MMWR: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5934a3.htm?s_cid=mm5934a3_w

Monday, September 6, 2010

Pertussis Advisory for Parents and Clinicians

Pertussis is still an important concern in Maine and throughout the U.S. To date in 2010, Maine has seen 32 confirmed cases of pertussis with 11 of those reported in the past month. The majority of people identified are younger than 13 years of age. Half are not up to date on their vaccines or their vaccine status is not known. This advisory provides information on pertussis for the public and clinicians as well as a reminder about required vaccines for school attendance.

Pertussis Info for the Public:

The cyclical nature of pertussis, also known as whooping cough, historically causes it to peak every few years, especially when there are high rates of non or under immunization. This year appears to be one of those peak years, given the increase in new cases in many parts of the U.S. As of two weeks ago, almost 10,000 new cases of pertussis were reported nationally. This figure is close to surpassing the total number of cases reported in all of 2009. One in eight of the reported cases this year are from California, which has seen the highest number of cases in 52 years. Tragically, 8 young infants have died in California from pertussis. All were too young to be vaccinated except for one who had just received one dose. The vaccine protects not only those who are receiving it but also young infants who are too young to be fully vaccinated and are more vulnerable to the devastating effects of the disease.

Children need 5 doses of DTaP by kindergarten (ages 4 -6) and a TDaP booster by age 11. All teens and adults are recommended to receive TDaP boosters.

FMI for Consumers:

* Video stories of those affected by pertussis and being undervaccinated against various diseases: http://shotbyshot.org/story-gallery#Pertussis
* U.S. CDC’s info page on pertussis: http://www.cdc.gov/pertussis/about/index.html

Pertussis Info for Clinicians:

1. Consider pertussis when evaluating any patient with an acute illness characterized by cough >2 weeks in duration, or cough with paroxysms, whoop, or post-tussive vomiting. Infants may present with apnea and/or cyanosis.

2. Report known or suspected cases promptly to the Maine CDC at 1-800-821-5821.

3. Persons who exhibit symptoms consistent with pertussis should be tested with a nasopharyngeal swab. The Maine CDC’s Health and Environmental Testing Laboratory (HETL) tests specimens by culture and polymerase chain reaction (PCR) in addition to other reference labs in the state. Serologic testing through private laboratories has not been well standardized and should not be used.

4. Individuals with suspected pertussis should be treated after a nasopharyngeal specimen is collected for testing. Guidelines for antibiotic treatment for pertussis cases and contacts have been published by the federal CDC in the MMWR (December 9, 2005. RR-14) and are available at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5414a1.htm.

5. Individuals with symptoms of pertussis should be considered to be infectious and should not attend school, work, or daycare until they have completed 5 days of an appropriate antibiotic. This is especially important for persons working in medical settings or with infants and young children.

Reminder about School Immunizations:

As the school year begins, it is important to remind patients and their families to check that they are up to date on their immunizations. This is also an excellent opportunity for patients to catch up on any immunizations they may have missed. Maine’s school immunization law requires the following vaccines for children entering school:

* Diphtheria/Pertussis/Tetanus (DTaP)
* Measles/Mumps/Rubella (MMR)
* Poliomyelitis
* Varicella

The Maine Immunization Program supplies these required vaccines free to healthcare providers:

* DTaP: for any child under 7
* MMR/Polio/Varicella: for any child under 18

Additionally, federal CDC maintains a recommended immunization schedule, which includes schedules for children and adolescents up to age 18 as well as a recommended catch up schedule. This is listed here: http://www.cdc.gov/vaccines/recs/schedules/child-schedule.htm

Going back to school is a busy time of year for both families and health practitioners. By reminding and encouraging patients to stay up to date on their vaccines, we can create a healthy and safe learning environment for all Maine children.

For more information on pertussis control measures, please go to www.cdc.gov/nip/publications/pertussis/guide.htm or call 1-800-821-5821.