Obesity

During the past 20 years, there has been a dramatic increase in obesity in the United States and rates remain high. In 2010, no state had a prevalence of obesity less than 20%. Maine is one of 36 states with a prevalence of 25% or more.

There are a variety of online tools to help you stay active and eat healthier:

• My Fitness Pal lets you track your calories on their website or with free mobile apps: www.myfitnesspal.com
• Find safe environments in Maine to walk: www.healthymainewalks.org
• Learn more about portion size, balanced meals, and get healthy eating tips at www.choosemyplate.gov
• Search for low-cost health care resources in your area – including nutrition and wellness services – at www.keepmewell.org

For more information:

• Maine Physical Activity and Nutrition Program: http://www.maine.gov/dhhs/boh/hmp/panp/

• US CDC: http://www.cdc.gov/obesity/

Bath salts

Unregulated psychoactive substances marketed as “bath salts” are among the latest in a series of legal synthetic substances that, when used improperly, offer alternatives to illegal drugs. “Bath salts” are powerful stimulant drugs that are suspected to have been designed to avoid legal prosecution, and are commonly available on the Internet and in specialty smoke shops.

“Bath salt” products are known to produce certain side effects, some of which are quite severe. This MMWR describes emergency department visits in Michigan over the last year after use of “bath salts.”

In July, Maine enacted legislation to make it illegal to possess or sell any of the 21 different hallucinogenic drugs or stimulants that are sold and marketed as “bath salts.”

For more information, see this Fact Sheet from the state Office of Substance Abuse.

School-based flu vaccine clinics

Maine CDC has received a two-year, $1.25 million cooperative agreement award from US CDC to enhance the sustainability of school-located vaccination. School-located vaccination clinics (SLVC) were first broadly implemented in Maine in response to the 2009 H1N1 flu pandemic. Since then, schools and health care providers in many communities around the state have worked together to continue to offer influenza vaccine to students and staff members in the school setting. SLVC can provide low-cost and convenient opportunities for families to have their children vaccinated each year. In addition, achieving high immunization rates in schools can reduce the number of days that students and staff are absent during the flu season and improve the learning environment.

CDC now recommends that all people over six months of age receive an annual flu vaccine as the best way to prevent influenza. Unlike adults, children have few opportunities to get a flu shot, and primary care doctors may not be able to accommodate the high demand for vaccine in their offices. Maine’s influenza immunization rates among children for the 2010-11 season were well above the national average, but too many Maine children still go without an annual flu shot. Providing vaccines to children in the school setting is a strategy that can improve access and decrease financial barriers that some children may face in getting the flu vaccine.

Among the strengths that were noted in the review of this application were the success of previous years’ SLVC; the use of Maine’s immunization registry system, ImmPact2; and the strengths of the partnerships that have been developed at the local level.

In the 2010-11 school year, more than 350 SLVC were held statewide. Clinics were run by school nurses, hospitals, health centers, visiting nurses’ associations, and primary care practices. Maine CDC recognizes the many organizations and individuals who have worked hard at implementing school vaccination. Funds from this cooperative agreement will be used to further these efforts by:

1.) increasing and supporting SLVC over the next two years;

2.) improving mechanisms of insurance reimbursement to schools and health care providers who provide flu shots in the school setting; and

3.) evaluating the impact of school clinics and developing plans for long-term sustainability beyond the funding period.

More information on specific funding initiatives and opportunities related to this cooperative agreement will be forthcoming. General information on influenza in Maine is accessible at www.maineflu.gov.

An online toolkit for SLVC with registration forms, guidance documents, and sample materials has been posted at http://www.maine.gov/dhhs/boh/maineflu/h1n1/educators.shtml#schoolclinics

Hepatitis A Virus Cluster

Maine CDC is investigating a cluster of acute hepatitis A virus infections in Northern Lincoln County. Currently, 2 suspect and 3 confirmed cases have been identified. The first identified infected person had a history of recent international travel. The other four ill individuals were close contacts of the first case-patient.

Hepatitis A is an uncommon disease in Maine, with an average of 10 cases reported each year.

Illness caused by hepatitis A virus typically has an abrupt onset and can include fever, malaise, anorexia, nausea, abdominal discomfort, dark urine, and jaundice.

The average incubation period for hepatitis A is 28 days (range: 15-50 days). Individuals are considered infectious from 2 weeks before until 1 week after the onset of jaundice. The infectious periods for the persons in the Northern Lincoln County cluster range from early-July to mid-August. The virus is excreted in feces and is transmitted by the fecal-oral route or through the consumption of contaminated food or water. Good hand washing is key to limiting disease transmission.

For more information, see this Health Alert.

Infectious Disease Conference

Since 1983, Maine CDC’s Division of Infectious Disease has organized an annual infectious disease conference targeting public health issues of emerging concern to medical practitioners throughout the state. This year’s conference will be held from 8:30 a.m. – 4:00 p.m. Nov. 15 at the Augusta Civic Center. Issues presented will include challenges in controlling infectious diseases, information on responding to new disease threats, and clinical updates and approaches. Registration fees, including the program, lunch, breaks, & CEUs, are $35 on or before 10/24/11 and $50 on or after 10/25/11. Space is limited.

The event brochure and agenda are available at: http://www.neias.org/mecdc/pdf/IDconferencebrochure_Final(3).pdf

For more information and to register: http://adcarecdc.neias.org/idhome/

Breastfeeding and obesity

Childhood obesity is an epidemic. In the US, 1 preschooler in 5 is at least overweight, and half of these are obese. Breastfeeding helps protect against childhood obesity. A baby's risk of becoming an overweight child goes down with each month of breastfeeding. In the US, most babies start breastfeeding, but within the first week, half have already been given formula, and by 9 months, only 31% of babies are breastfeeding at all. Hospitals can either help or hinder mothers and babies as they begin to breastfeed.

This month’s Vital Signs feature and related MMWR from US CDC focus on hospital support for breastfeeding.

US CDC’s Breastfeeding Report Card shows that Maine ranked third in the nation for percent of live births occurring at baby-friendly facilities and tied for third in the nation for State Maternity Practices in Infant Nutrition and Care scores from birthing facilities.

Rabies update

US CDC and the Maryland Department of Health and Mental Hygiene, with assistance from Montgomery County Department of Health and Human Services and Suburban Hospital-Johns Hopkins Medicine, have developed an online course to educate healthcare providers and public health professionals about rabies, the approach used in evaluating patients for rabies virus exposure, and the administration of rabies postexposure prophylaxis (PEP). There is no cost to view the course or to receive continuing education credit.

As a reminder to clinicians, PEP for rabies is reportable in Maine.

The second quarter animal rabies update for Maine is now available at http://www.maine.gov/tools/whatsnew/attach.php?id=277584&an=1