Stay healthy when traveling abroad

Travel-Related Disease Conditions – 2014

Background: Maine Center for Disease Control and Prevention (Maine CDC) investigated multiple cases of travel-related illness in 2013. Cases of chikungunya, dengue fever, and malaria have been reported to Maine CDC in persons who have recently traveled or have moved to Maine from another country. Maine residents frequently travel outside of the United States during school vacation weeks in February and April, often to warmer climates, putting them at risk for vector- and food-borne diseases.

Recommendations: Many travel-related illnesses can be prevented by vaccinations, good hand hygiene, and knowledge of high-risk conditions in other countries. Maine CDC recommends that clinicians counsel patients who plan to travel, on precautions they can take to prevent travel-related illness. The federal CDC recommends vaccines based on travel destination, available at www.cdc.gov/travel. Clinicians are reminded to obtain recent travel history, especially travel outside of the US, for symptomatic patients.

Table 1: Regions for Increased Attention, Select Diseases	Caribbean	Latin America	Africa	Indian Sub-Cont.	SE Asia	W Pacific
Chikungunya is a mosquito-borne viral disease. In December 2013, local transmission was found for the first time in the Caribbean/ Americas. The best prevention is to avoid being bitten by infected mosquitoes, including wearing repellant while indoors or out.	✓		✓	✓	✓
Dengue Fever is a mosquito-borne viral illness occurring in many tropical and subtropical countries world-wide.  The best prevention for dengue is to avoid being bitten by infected mosquitoes, including wearing repellant while indoors or out.	✓	✓		✓	✓	✓
Malaria is a mosquito-borne parasitic disease, preventable by taking medication before and during travel (chemoprophylaxis). It occurs in more than 100 tropical and subtropical countries.	*Haiti	✓	✓	✓	✓
Hepatitis A is one of the most common vaccine-preventable infections acquired during travel. Transmitted through the fecal-oral route by ingesting contaminated food or water, and close personal contact, it is best prevented by vaccination and good hand hygiene.		✓	✓		✓
Shigellosis is a bacterial infection of the intestine transmitted through the fecal-oral route by ingesting contaminated food or water, and close personal contact. Like other enteric diseases, including salmonella and campylobacter, good hand hygiene is the best prevention.		✓	✓		✓

All suspected cases of travel-related illnesses that are notifiable conditions should be reported to the Maine CDC at 1-800-821-5821. If patients present with unusual symptoms, providers are encouraged to call Maine CDC for a consultation. A list of notifiable conditions is available at www.maine.gov/idepi.  

For More Information: Please contact the Maine CDC by calling the disease reporting and consultation line at 1-800-821-5821, e-mailing disease.reporting@maine.gov, or visiting the Maine CDC website at www.maine.gov/idepi. A list of travel medicine clinics in Maine can be found at www.maine.gov/dhhs/mecdc/infectious-disease/immunization/international-travel.shtml.

American Heart Month

Heart disease is the second leading cause of death in Maine and describes a variety of conditions that affect your heart and/or blood vessels including coronary artery disease, heart attack, and congestive heart failure.

You can help protect yourself and your loved ones from heart disease by understanding associated risks and taking these steps:

• Know Your ABCS:
  • Do you take Aspirin?  If your healthcare provider has said you are at risk for a heart attack, ask them about taking aspirin.
  • Do you know your Blood Pressure?  A normal blood pressure level is below 120/80.  Talk with your healthcare provider to find out your blood pressure numbers and get in control.
  • Do you know your Cholesterol Level?  A normal cholesterol level is below 200.  Talk with your healthcare provider to find out your cholesterol number and get in control.
  • Do you Smoke?  If you do, get help to quit. Smoking can raise your chances of having a heart attack or stroke.  To help you quit call the Maine Tobacco Help Line at 1-800-207-1230.
• Be physically active at least 30 minutes on most days
• Eat more fruits, vegetables, and other foods low in sodium and trans fat
• Take medication as prescribed by your doctor

Million Hearts Initiative

Million Hearts® is a national effort to prevent 1 million heart attacks and strokes by 2017. Million Hearts® brings together communities, health systems, nonprofit organizations, federal agencies, and private-sector partners from across the country to fight heart disease and stroke. 

To learn more about the initiative or to make the commitment visit: www.millionhearts.hhs.gov.

For more information about heart disease visit: http://mainehearthealth.org/.

CVS Tobacco Announcement

Maine CDC and the US Department of Health and Human Services applaud CVS Caremark Corp. for their leadership in helping to make the next generation tobacco-free.

The company's announcement that CVS/pharmacy stores will no longer sell cigarettes and other tobacco products is an unprecedented step in the retail industry. We look forward to seeing other stores and chains follow suit.

  

To see the related article in the Journal of the American Medical Association, visit http://jama.jamanetwork.com/article.aspx?articleid=1828530 

To see the statement by HHS Secretary Sebelius, visit: http://go.usa.gov/BkDH 

  

For support and resources related to tobacco cessation, visit http://tobaccofreemaine.org/ or call 1-800-207-1230

Pump Handle Awards

Maine CDC recently recognized four organizations by presenting them with the Pump Handle Award for their contributions to help reduce the impact of infectious diseases in Maine.

Camp Sunshine was honored for its quick response to an outbreak viral gastroenteritis outbreak, which led to the containment of a highly contagious virus. The camp also worked closely with the Maine CDC epidemiology and health inspections programs, providing information that allowed for surveying, follow-up on test results, and strengthened outbreak response in the community.

Mercy Hospital was recognized for its response to a highly publicized case of a rabid fox in Portland and for its decision to immediately make medication for treatment for exposure available to other healthcare systems, which were seeing a high volume of people with symptoms. The hospital also cared for five people who were exposed to rabies.

The Bangor Sexually Transmitted Disease Clinic, one of two clinics in the State, has been instrumental in Maine's ability to provide STD screening, treatment and disease surveillance in the Northern part of the state. The commitment and dedication of Clinic staff have helped many people living with HIV/AIDS know their status, get connected to important medical care and support services, and identify and test potential partners who may have been exposed to HIV.

The Maine School Nurses Association was chosen for the hard work and dedication of Maine's school nurses, particularly for their dedication to organizing and operating Maine's school located vaccine clinics. School Nurses responded to the need during H1N1 and have continued to assure availability of influenza immunization to students in the school setting because that is where children are and because as they have said, "it is the right thing to do."

The Pump-Handle Award has been given for more than a decade in Maine. The award's name is a tribute to Dr. John Snow, who is considered by many to be the father of epidemiological science. Snow identified that a public water pump was the source of a cholera outbreak in London in 1854. He convinced authorities to remove the handle of the pump, preventing any more of the infected water from being collected. The spring that fed the pump was later found to be contaminated.