HIV/STD Update

World AIDS Day

December 1 is World AIDS Day. There are approximately 1,462 people estimated to be living in Maine with diagnosed HIV infection. In addition, Maine CDC estimates that about 388 people in Maine may be infected but unaware of their HIV status. Worldwide, more than 33 million people are estimated to be living with HIV. For more information on World AIDS Day: http://www.aids.gov/world-aids-day/ For more information on HIV/AIDS in Maine: www.mainepublichealth.gov/hivstdhep

Syphilis

Since mid-July, health care providers in Maine have diagnosed 19 cases of early syphilis, ages 19-56, in Cumberland, Penobscot, Waldo and York Counties. Eleven cases were primary syphilis, 5 cases were secondary syphilis, and 3 cases were early latent syphilis. All 19 cases were among men who have sex with men (MSM). Eight of the 19 individuals (42%) are known to be HIV positive. A total of 33 cases of early syphilis have been reported since the beginning of the calendar year. For more information, see this Health Alert: http://www.maine.gov/tools/whatsnew/index.php?topic=DHHS-HAN&id=152027&v=alert

PrEP

The National Institutes of Health (NIH) has announced the results of an international clinical trial, co-sponsored by the Bill and Melinda Gates Foundation, that examined whether a pill containing two drugs used to treat HIV can also help prevent HIV infection – an approach called pre-exposure prophylaxis, or PrEP. The trial found that daily oral use of Truvada ® provided an average of 44 percent additional protection to trial participants that included gay, bisexual, and other men who have sex with men (MSM), as well as transgendered women who have sex with men. These participants also received a comprehensive package of prevention services that included monthly HIV testing, condom provision, counseling, and management of other sexually transmitted infections.

US CDC will fully review the trial data and publish interim guidance in the coming weeks in the Morbidity and Mortality Weekly Report, to be followed in several months by formal U.S. Public Health Service guidelines. The agency urges individuals and their doctors to await those guidelines before use. For more information, please refer to the PrEP fact sheet: http://www.cdc.gov/nchhstp/newsroom/PrEPforHIVFactSheet.html

This blog has additional information from the White House.

Sixth Annual Comprehensive Sexuality Education Conference

Save the date for the sixth annual Comprehensive Sexuality Education Conference, which will be held April 7 at the Augusta Civic Center. It is sponsored by: Family Planning Association of Maine; Maine Department of Education, Maine CDC; New Beginnings; University of Maine at Farmington; and the Maine Association for Health, Physical Education, Recreation, and Dance.

Update on Smart Meters

In October, the Office of the Public Advocate (OPA) requested that Maine CDC comment on health concerns related to the wireless communication technology, also known as smart meters, being installed by Central Maine Power (CMP). As a result, Maine CDC submitted a report on November 8 to OPA and the Public Utilities Commission (PUC) of our review of national and international government-affiliated organizations’ analyses on this subject.

Subsequently, Maine CDC and others received several correspondences from people expressing concerns about the review. In order to make sure OPA, PUC, and the correspondents have our responses in a concise format, we have grouped the concerns into eight topic areas and compiled our responses into a Frequently Asked Questions document.

Health Reform Update

Health Reform News

CDC Vital Signs highlight recent data on important health topics. November’s health topic is Access to Care: http://www.cdc.gov/vitalsigns/HealthcareAccess/ New estimates show that the number of Americans without health insurance is growing, affecting middle-income Americans as well as those living in poverty. Adults without consistent health insurance are more likely to skip medical care because of cost concerns, which can lead to poorer health, higher long-term health care costs, and early death.

People with Medicare can review their current coverage or choose a new Medicare plan that works for them through the Open Enrollment period that ends Dec. 31: http://www.medicare.gov/navigation/medicare-basics/open-enrollment.aspx?AspxAutoDetectCookieSupport=1

The Affordable Care Act provides important new benefits to most people with Medicare starting in January 2011, including a 50% discount on brand name drugs for people who fall into the coverage gap, free annual wellness visits, and free mammograms, colonoscopies, and other screenings. For more information: http://www.healthcare.gov/foryou/seniors/strengthening/index.html

HHS Secretary Kathleen Sebelius has announced the launch of the new application cycle for the National Health Service Corps (NHSC) Loan Repayment Program. The NHSC offers primary care medical, dental and mental health clinicians up to $60,000 to repay student loans in exchange for two years of service at health care facilities in medically underserved areas. This year’s investment in the program, which includes $290 million from the Affordable Care Act, seeks to address shortages in the primary health care workforce and translates into greater access to healthcare for those who might otherwise go without.

The Affordable Care Act also provides more flexibility in how the Corps administers the loan repayment program. In addition to monetary awards that are higher than previous years, the Corps will give members the option of working half-time to fulfill their service obligation and provide credit for some teaching hours.

For more information: http://www.hhs.gov/newss/press/2010pres/11/20101122b.html

Health Reform in Maine

Maine Primary Care Association has been awarded $86,434 in additional technical assistance and training funds through the Affordable Care Act. For more information: http://www.hhs.gov/news/press/2010pres/11/20101119b.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/

Alcohol and Public Health

US CDC has released two new reviews from The Guide to Community Preventive Services that assess the effectiveness of limiting the days and hours of alcohol sales for preventing excessive alcohol consumption and related harms. Excessive alcohol use, including binge and underage drinking, is the third-leading preventable cause of death in the United States; responsible for, on average, more than 79,000 deaths per year and 2.3 million years of potential life lost. For more information, review CDC’s October Vital Signs report on binge drinking.

The U.S. Food and Drug Administration (FDA) issued warning letters to four companies that had caffeine added to their malt alcoholic beverages. FDA's action follows a scientific review that examined the published peer-reviewed literature on the co-consumption of caffeine and alcohol, consultation with experts in the fields of toxicology, neuropharmacology, emergency medicine, and epidemiology, and a review of information provided by product manufacturers. FDA also performed its own independent laboratory analysis of these products. Experts have raised concerns that caffeine can mask some of the sensory cues individuals might normally rely on to determine their level of intoxication. The FDA said peer-reviewed studies suggest that the consumption of beverages containing added caffeine and alcohol is associated with risky behaviors that may lead to hazardous and life-threatening situations. All four Maine distributors of Joose alcoholic energy drink have agreed to stop selling it, in response to FDA’s findings.

For More Information:

• Maine distributors voluntarily stop selling alcoholic energy drinks
• Caffeinated Alcoholic Beverages
• Caffeinated Alcoholic Beverages -- Consumer Update
• Caffeinated Alcoholic Beverages – Warning Letters
• Qs & As on Caffeine in Alcoholic Beverages:

• Caffeinated Alcoholic Beverages -- CDC Fact Sheet

Influenza Update

Surveillance

There was no flu activity reported in Maine for the week ending Nov. 20. Weekly updates on flu activity in Maine are available at http://www.maine.gov/dhhs/boh/influenza_surveillance_weekly_updates.shtml

Weekly updates for the US are available at http://www.cdc.gov/flu/weekly/summary.htm and international updates are available at http://www.cdc.gov/flu/international/activity.htm.

Update on state-supplied vaccine distribution

Most influenza vaccine arrives in Maine through private sector channels, but Maine CDC will be distributing a total of about 290,000 doses of flu vaccine this year; 92% of doses have already been shipped out to providers in the state. Almost 350 schools have received a total of more than 80,000 doses of state-supplied vaccine for school-based clinics.

Prevent Carbon Monoxide Poisoning

Recent severe weather has caused power outages, which raises concern about carbon monoxide poisoning. To prevent carbon monoxide poisoning:

• Have your heating system, water heater and any other gas, oil, or coal burning appliances serviced by a qualified technician every year.
• Don't use a gas-powered generator, charcoal grill, camp stove, or other gas or charcoal-burning device inside your home, basement, or garage or near a window or door. Generators should be more than 15 feet from your home when running.
• Don't run a car, truck or any other motor inside a garage or other enclosed space, even if you leave the door open.
• Don't try to heat your house with a gas oven.
• Make sure you have a CO detector with a battery back-up in your home near where people sleep. Check or replace the battery when you change the time on your clocks each spring and fall. You can buy an alarm at most hardware stores or stores that sell smoke detectors. By law, all rental units must have a CO alarm—talk to your landlord if you don’t have one in your apartment or rental house.
• If your CO alarm goes off, get out of the house right away and call 911. Get prompt medical attention if you suspect CO poisoning and are feeling dizzy, light-headed, or nauseous.

For more information, see this Maine CDC press release: http://www.maine.gov/tools/whatsnew/index.php?topic=DHS+Press+Releases&id=151572&v=cdc_article

Worried about wind turbines?

In recent months, several government agencies such as Australia, Minnesota, Ontario, and the Wisconsin PUC have conducted reviews of the science on wind turbine noise and health. They all have made similar conclusions — that there is no evidence of a direct health or disease impact from wind turbines, especially if properly placed. Maine’s noise regulations are within or comparable to the World Health Organization’s recommendations for noise.

Summaries of recent research and reviews are available at http://www.maine.gov/dhhs/boh/documents/community-involvement-critica.doc, which can also be found on Maine CDC’s wind turbine site: http://www.maine.gov/dhhs/boh/wind-turbines.shtml.

Health Reform Update

Health Reform News

An important provision of the Affordable Care Act requires insurance companies to meet new requirements concerning their “medical loss ratios” – the percentage of premium dollars that an insurance company spends on providing health care and improving the quality of care, versus how much is spent on administrative and overhead costs. To be sure that premium dollars are spent primarily on health care itself, the law requires that 80% to 85% of the money collected by insurance companies be spent on health care services and health care quality improvement. For more information on medical loss ratios, see http://www.healthcare.gov/news/blog/MLR.html

HealthCare.gov’s insurance finder (http://finder.healthcare.gov/) now features pricing and detailed benefit information for private insurance plans for individuals and families. The finder also provides enhanced information about public health resources.

Health Reform in Maine

Thirteen employers have enrolled in the Early Retiree Reinsurance Program, which provides financial relief to businesses, schools and other educational institutions, unions, State and local governments, and non-profits, in order to help retirees and their families continue to have quality, affordable health coverage. Find a list of organizations accepted into this program at http://www.healthcare.gov/law/provisions/retirement/states/me.html

Several grants to support biomedical research have been made through the Affordable Care Act. For more information, see this HHS press release: http://www.hhs.gov/news/press/2010pres/11/20101103b.html

HealthCare.gov has state-by-state summaries of Affordable Care Act grants. Summaries of funds awarded in Maine are available at: http://www.healthcare.gov/center/states/me.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/

Influenza Update, 11/12/10

Surveillance

The first case of laboratory-confirmed influenza in Maine this season was reported this week. It was a case of type B influenza in someone who recently returned from a visit out of state. Type B as well as type A 2009 H1N1 pandemic strain and type A H2N3 have all been detected circulating in the U.S. All three are also reflected in this year’s seasonal flu vaccine, which is now recommended for all ages 6 months and older. For more information, see this Health Alert: http://www.maine.gov/tools/whatsnew/attach.php?id=151569&an=2

Weekly updates on flu activity in Maine are available at http://www.maine.gov/dhhs/boh/influenza_surveillance_weekly_updates.shtml

Weekly updates for the US are available at http://www.cdc.gov/flu/weekly/summary.htm and international updates are available at http://www.cdc.gov/flu/international/activity.htm.

Update on state-supplied vaccine distribution

Most influenza vaccine arrives in Maine through private sector channels, but Maine CDC will be distributing a total of about 290,000 doses of flu vaccine this year.

Doses Approved for Shipment as of Nov. 10:

Population	Doses
Children ages 6 months to 18 years	174,650*
Adults	70,430
Nursing homes and long-term care facilities	20,360
Total	265,440

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

Number of schools that have received flu vaccine so far: 336

Number of doses distributed to schools so far: 82,688

Flu information for the general public

Now is the perfect time for most people to get vaccinated against the flu. Maine CDC strongly encourages everyone who is older than six months of age to get vaccinated against the flu this season – a new recommendation from the US CDC, which had previously focused on people at high risk of flu. There is already a significant amount of vaccine available in Maine, and many schools are offering vaccine to students during the school day.

Anyone can get sick from the flu, but certain people are at greater risk for serious complications from the flu, including:

· older people,

· young children,

· people with chronic lung disease (such as asthma and COPD), diabetes (type 1 and 2), heart disease, neurologic conditions, and certain other long-term health conditions,

· pregnant women, as well as

· American Indians and Alaska Natives, and

· people with a Body Mass Index (BMI) of 40 or more.

Vaccination is the most effective way to prevent the flu and its complications. Vaccine is already available in many places – you can check listings by zip code at www.flu.gov or www.211maine.org. 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.

The 2010-2011 flu vaccine will protect against three types of flu including the 2009 H1N1 virus. The 2010-2011 seasonal flu vaccine is recommended even if you got the 2009 H1N1 flu vaccine last season. People who were sick with the flu last season should also still get a flu shot this year.

Protect yourself and others from the flu

• Cover coughs and sneezes with a tissue or sleeve.
• Wash hands frequently.
• Stay home if ill with a fever.
• Get vaccinated against the flu.
• Ask your doctor if you should receive a pneumococcal vaccine.

Worried about smart meters?

A complaint was filed with the Maine Public Utilities Commission at the end of October, focusing on concerns related to the health, safety (malfunctioning, shorting out, and igniting), and security (vulnerability to hacking) of smart meters, also known as advanced metering infrastructure.

Maine CDC conducted a review focused on the health concerns expressed in the complaint. The review did not indicate any consistent or convincing evidence to support a concern for health effects related to the use of radio frequency in the range of frequencies and power used by smart meters. The review also did not indicate an association of EMF exposure and symptoms that have been described as electromagnetic sensitivity.

For more information, visit http://www.maine.gov/dhhs/boh/smart_meters.shtml. The full review is about 70 pages, but the executive summary is only 5 pages.