Tickborne diseases

Anaplasmosis, a bacterial infection carried by deer ticks, is an emerging infection in Maine. As of Aug. 8, 38 cases have been reported to Maine CDC from 8 counties (Androscoggin, Cumberland, Hancock, Kennebec, Knox, Lincoln, Somerset and York). During 2011, a total of 26 cases were reported. Most infections occur during the summer and fall months, so the number of cases is expected to rise. For more information about anaplasmosis, see the health alert issued Aug. 9.
Other diseases that are carried by ticks in Maine include babesiosis and Lyme disease. In 2011, providers reported 9 cases of babesiosis; 3 cases have been reported to date in 2012. In 2011, providers reported 1,006 cases of Lyme disease; 483 cases have been reported to date in 2012.

Lyme disease is the most common vectorborne disease in Maine. Ticks are out and we expect the number of Lyme disease cases to increase in the warm weather.

For general information about Lyme disease see the May 1 health alert issued by Maine CDC.

Flu update

The Advisory Committee on Immunization Practices (ACIP) recommendations for the 2012-2013 flu season are now available. The Vaccine Information Statements (VIS) for influenza for the 2012-2013 season are also online. 

Influenza A H3N2v is a variant virus recently detected in the United States. The first case of H3N2v was detected in summer of 2011, with 12 total cases being detected in all of 2011. The virus has already been found in over 200 individuals to date in 2012. Maine has not identified any cases in 2012. Influenza A H3N2v is associated with exposures to pigs, and most cases had either direct contact with pigs, or indirect contact such as visiting a fair.

Maine identified 2 cases of influenza A H3N2v in the fall of 2011. Both of Maine’s cases had fair exposures, and one had direct pig contact.

Symptoms of influenza A H3N2v are similar to regular influenza including fever, cough, sore throat, and body aches. This virus can spread between humans and pigs, so sick humans should avoid animal contact, and the general public should avoid contact with ill animals.

Maine CDC and the Maine Department of Agriculture remind everyone to exercise good judgment while attending agricultural fairs. For recommendations and more information, see the health alert Maine CDC issued on Aug. 7.

Know how to protect yourself from West Nile and EEE

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. Although rare, these diseases have the potential to be severe and even fatal.


On Aug. 17, a mosquito pool (a collection which contains between 1-50 mosquitoes) tested positive for WNV at Maine’s Health and Environmental Testing Laboratory. The pool of mosquitoes was collected Aug. 1 in the town of Lebanon, as described in this health alert. Since then, a second mosquito pool from Cumberland County tested positive.

This is the earliest WNV has been identified in mosquitoes in Maine. The last time WNV was identified in Maine was from a mosquito pool in 2010. There has been a significant increase in arboviral activity in the last month.

Maine CDC recommends the following preventative measures to protect against mosquitoborne illnesses:

Control what you can. Improve your odds of avoiding mosquito spread viruses by using a repellent on exposed skin and clothes while outdoors. Wear protective clothing when outdoors, including long-sleeved shirts, pants, and socks. Use screens on your windows and doors to keep mosquitoes out of your home, and remove standing water from artificial water-holding containers in and around the house.


Insect Repellent: It keeps you from being what’s for dinner.

There are always excuses for not using repellent— forgot it, didn't want to go back and get it, it doesn't smell good, it's not in the budget, or "mosquitoes don't bite me"…

Think of repellent as you would an important article of clothing, and increase your chances of avoiding weeks (or even months) of aches and fatigue that come with West Nile fever, dengue fever, or any number of other mosquito borne diseases. More severe problems are possible. Being hospitalized with swelling of the brain, or even worse, are possibilities from many of these diseases.


What repellent should I use?

US CDC recommends a variety of effective repellents. The most important step is to pick one and use it. There are those that can protect you for a short while in the backyard or a long while in the woods. DEET, picaridin, IR3535 and the plant-based oil of lemon eucalyptus are all repellents recommended by US CDC. All contain an EPA-registered active ingredient and have been studied to make sure they are effective and safe. EPA has a long listing of repellent brands in the United States. Check out US CDC’s traveler’s health page on repellents here.


When should you wear repellent?

Mosquitoes can bite anytime. Most of the mosquitoes that carry West Nile virus bite from around sundown to around sun-up (throughout the night). Put a few bottles or packets of repellent around—in the car, by the door, in a purse or backpack.

Health tips to keep in mind as summer winds down

Maine CDC reminds people to stay healthy while enjoying outdoor activities this summer.

 

Make sure you know what steps to take to protect your skin from the sun.
 
Use good judgment for good health when attending Maine agricultural fairs:

• Do not attend a fair if you are ill.
• Always ask the owner for permission before you touch an animal.
• Before and after touching animals, wash your hands with soap and water or use alcohol hand gel.
• Before eating, wash your hands with soap and water or use alcohol hand gel.

 

 If you’ll be grilling outdoors, check out this video from the Grill Sergeants with safety guidelines for safe grilling. 

 

 One in six Americans will get sick from food poisoning this year alone. FoodSafety.gov has a number of helpful at-a-glance food safety charts available and other food safety information. 

 

 Get information about recreational water illnesses and how to avoid them.

 

Be prepared to stay healthy in extremely high temperatures.
 

Avoid carbon monoxide poisoning.

 

 Stay safe in lightning.

Six in 10 adults now get physically active by walking

Sixty-two percent of adults say they walked for at least once for 10 minutes or more in the previous week in 2010, compared to 56 percent in 2005, according to a new Vital Signs report from US CDC.
However, less than half (48 percent) of all adults get enough physical activity to improve their health, according to data from the National Health Interview Survey. For substantial health benefits, the 2008 Physical Activity Guidelines for Americans recommends at least two and a half hours per week of moderate-intensity aerobic physical activity, such as brisk walking. This activity should be done for at least 10 minutes at a time.

To learn more about Physical Activity Guidelines for Americans and ways to get active, visit www.cdc.gov/physicalactivity

Third-hand smoke

Ever take a whiff of a smoker's hair and feel faint from the pungent scent of cigarette smoke? Or perhaps you have stepped into an elevator and wondered why it smells like someone has lit up when there is not a smoker in sight. Welcome to the world of third-hand smoke.

 

“Third-hand smoke is tobacco smoke contamination that remains after a cigarette has been extinguished," says Jonathan Winickoff, a pediatrician at the Dana–Farber/Harvard Cancer Center in Boston and author of a study on the new phenomenon published in the journal Pediatrics. “Third-hand smoke," a term coined by Winickoff's research team, is a relatively new concept, but one that has worried researchers and nonsmokers for several years.

 

Third-hand smoke refers to the tobacco toxins that build up over time—one cigarette will coat the surface of a certain room, a second cigarette will add another coat, and so on. The third-hand smoke is what remains after visible or "second-hand smoke" has dissipated from the air.

 

The 2006 surgeon general's report says there is no risk-free level of tobacco exposure. There are more than 250 poisonous toxins found in cigarette smoke.

 

For more information:

• http://www.cdc.gov/tobacco/data_statistics/sgr/2006/index.htm
• http://pediatrics.aappublications.org/content/123/1/e74.abstract
• http://www.portlandmaine.gov/hhs/phbreatheeasy.asp
• http://www.smokefreeforme.org

Influenza

The Vaccine Information Statements (VIS) for influenza for the 2012-2013 season are now available.

Multiple infections with variant influenza A (H3N2v) viruses have been identified in three states in recent weeks. From July 12 through August 3, 2012, 16 cases of H3N2v were reported and confirmed by US CDC. This virus was first detected in humans in July 2011. It has also been isolated in U.S. swine in many states.

 

Since July 12, 2011, there have been 29 cases of H3N2v virus infection, including the 16 cases occurring in the last three weeks. Maine confirmed two cases of H3N2v influenza in 2011, but no new cases have been detected to date in 2012.

 

Each of the 16 recent cases reported contact with swine prior to illness onset; in 15 cases, contact occurred while attending or exhibiting swine at an agricultural fair. While the viruses identified in these cases are genetically nearly identical, separate swine exposure events in each state were associated with human infections. Maine CDC and the Maine Department of Agriculture remind everyone to exercise good judgment while attending agricultural fairs.

Interim Recommendations for the Public

• Persons who are at high risk for influenza complications (e.g., underlying chronic medical conditions such as asthma, diabetes, heart disease, or neurological conditions, or who are pregnant or younger than 5 years, older than 65 years of age or have weakened immune systems) should consider avoiding exposure to pigs and swine barns this summer, especially if ill pigs have been identified.
• Persons engaging in activities that may involve swine contact, such as attending agricultural events or exhibiting swine, should wash their hands frequently with soap and running water before and after exposure to animals; avoid eating or drinking in animal areas; and avoid close contact with animals that look or act ill.
• Patients who experience influenza-like symptoms following direct or close contact with pigs and who seek medical care should inform their health care provider about the exposure.
• Patients with influenza-like illness who are at high risk for influenza complications (e.g., underlying chronic medical conditions such as asthma, diabetes, heart disease, or neurological conditions, or who are pregnant or younger than 5 years, older than 65 years of age or have weakened immune systems) should see their health care provider promptly to determine if treatment with antiviral medications is warranted.
• Influenza viruses have not been shown to be transmissible to people through eating properly handled and prepared pork or other products derived from pigs. For more information about the proper handling and preparation of pork, visit the USDA website fact sheet “Fresh Pork from Farm to Table.”

 

Interim Recommendations for Health Care Providers  

• Clinicians who suspect influenza in persons with recent exposure to swine should obtain a nasopharyngeal swab or aspirate from the patient, place the swab or aspirate in viral transport medium, and contact their state or local health department to arrange transport and request a timely diagnosis at a state public health laboratory.
• Reverse-transcription polymerase chain reaction (RT-PCR) testing for influenza should be considered for patients with influenza-like illness prior to the start of the traditional influenza season in October.
• RT-PCR testing for influenza should be considered throughout the year for patients with influenza-like illness reporting recent swine exposure and for those who can be epidemiologically linked to confirmed cases of variant influenza.
• Commercially available rapid influenza diagnostic tests (RIDTs) may not detect H3N2v virus in respiratory specimens. Therefore, a negative rapid influenza diagnostic test result does not exclude infection with H3N2v or any influenza virus. In addition, a positive test result for influenza A cannot confirm H3N2v virus infection because these tests cannot distinguish between influenza A virus subtypes (they do not differentiate between human influenza A viruses and H3N2v virus). Therefore, respiratory specimens should be collected and sent for RT-PCR testing at a state public health laboratory.
• Clinicians should consider antiviral treatment with oral oseltamivir or inhaled zanamivir in patients with suspected or confirmed H3N2v virus infection. Antiviral treatment is most effective when started as soon as possible after influenza illness onset.

 For more information, see the health alert Maine CDC issued on Aug. 7.

 

National Immunization Awareness Month

We all need immunizations (also called vaccines or shots) to help protect us from serious diseases. Shots can prevent infectious diseases like measles, diphtheria, and rubella. But people in the U.S. still die from these and other vaccine-preventable diseases. It’s important to know which shots you need and when to get them.

Everyone age 6 months and older needs a seasonal flu shot every year. Other shots work best when they are given at certain ages. Here are some general guidelines:

• Children need a series of shots from birth to age 6.
• Pre-teens need recommended shots at age 11 or 12.
• All adults need a booster shot every 10 years to help protect against tetanus and diphtheria.

We are seeing many cases of pertussis (whooping cough) in Maine right now. Pertussis is a highly communicable, vaccine-preventable disease that can last for many weeks. Immunity to pertussis following infection is not lifelong. Persons with a history of pertussis should continue to receive pertussis-containing vaccines according to the recommended schedule. Because vaccination is not 100% effective and immunity wanes over time, even fully vaccinated persons can become infected with pertussis. However, unvaccinated children have an 8 times higher risk of becoming infected with pertussis than fully vaccinated children. Furthermore, vaccinated children who do get infected with pertussis have milder symptoms, shorter duration of illness, fewer severe outcomes (including hospitalization) and are less infectious than their non-vaccinated counterparts. Therefore, vaccination remains the most effective way to prevent pertussis.

 

Talk to your doctor or nurse to find out which immunizations you need. For more information, visit
www.immunizeme.org 

 

If you choose not to vaccinate, understand the risks and responsibilities.