Breast cancer

During 2014, it is estimated that more than 1,200 women will be diagnosed with breast cancer and 190 women will die from the disease. As National Breast Cancer Awareness month winds down, the Maine Center for Disease Control and Prevention reminds women that regular screening mammograms are critical in diagnosing and beginning treatment of the disease.

 Not all breast cancer is accompanied by a lump that is discovered during a breast exam, which is why a regular mammogram is so important.  Women should enter into a personal discussion regarding their screening with their primary care physicians and decisions should be individualized.

 A screening mammogram can detect breast cancer early, even before symptoms arise.  Women between ages 50 to 74 should have a screening mammogram every two years, while women age 40 to 49 should talk to their doctor about when and how often to have this screening.

The Maine CDC Breast and Cervical Health and Colorectal Cancer Control Programs can provide information about cancer screening tests and has some resources available for free cancer screenings.

Women must be age 40 or older and meet financial and other program criteria.  Interested women are encouraged to call 1-800-350-5180 or 1-207-287-8068; TTY users call Maine Relay 711.

More details can also be found at: http://go.usa.gov/GF8R 

Flu update 10/29/14

The flu has officially arrived in Maine for the 2014-2015 season. For more information, see the Oct. 17 health alert at: http://go.usa.gov/G6Vk 

Maine CDC reminds everyone to take everyday preventive measures against the flu:

• Wash your hands frequently;
• Cough and sneeze into your elbow or shoulder;
• Stay home when you feel sick;
• Get vaccinated. 

If you have the flu:

• Stay home if you are sick, until you are fever-free for a full 24 hours without taking fever-reducing medicine.
• Cough and sneeze into your elbow or into a tissue. Throw the tissue away.
• Although most people can stay home to recover without seeing a health care provider, it is possible for healthy people to develop severe illness from the flu. Anyone with the flu should seek medical attention for:
• Dehydration
• Trouble breathing
• Getting better, then suddenly getting a lot worse
• Any major change in condition 

Flu Activity

 Maine CDC reported sporadic flu activity for the week ending Oct. 25. Weekly updates are available online:

• for Maine: http://go.usa.gov/NoK
• for the US: http://go.usa.gov/ITB
• for the world: http://go.usa.gov/ITK

Flu Vaccination

US CDC recommends yearly flu vaccine for everyone 6 months of age and older. It takes about two weeks after vaccination to develop full immunity. To find a flu vaccine in your area, call 211, search www.211maine.org or http://flushot.healthmap.org/, or contact your health care provider.

For more information about flu vaccine: 

• Key facts about flu vaccine: http://go.usa.gov/yksA 
• How flu vaccines are made: http://go.usa.gov/ykHB 
• Vaccine recommendations: http://go.usa.gov/ykHw 
• Vaccine information statements (VIS): http://go.usa.gov/jdAC

For more information, go towww.maineflu.gov or http://www.cdc.gov/flu/ 

New pneumococcal recommendations

In August 2014, the Advisory Committee on Immunization Practices (ACIP) voted to recommend pneumococcal conjugate vaccine (PCV13, Prevnar-13®) for all adults 65 years or older. This dose is in addition to the existing recommendation of one dose of pneumococcal polysaccharide vaccine (PPSV23, Pneumovax®23).

• PCV13 was licensed by the FDA (Food and Drug Administration) for use in adults 50 years or older in 2011.
• Both PCV13 and PPSV23 should be routinely administered in series to all adults 65 years or older.
• The two pneumococcal vaccines should not be administered at the same visit.
• PCV13 should be given before PPSV23 because the optimal immune response is achieved when PCV13 is given first followed by PPSV23 for patients who have NEVER received PPSV23.

Both PCV13 and PPSV23 provide good protection against invasive forms of infection caused by vaccine-type pneumococci. 

 

For adults previously vaccinated with PPSV23:

• Adults 65 years of age or older who have previously received one or more doses of PPSV23 should also receive a dose of PCV13 if they have not yet received it.

• A dose of PCV13 should be given at least 1 year after the receipt of the most recent PPSV23 dose.

For those for whom an additional dose of PPSV23 is indicated, this subsequent PPSV23 dose should be given 6 to 12 months after PCV13 and at least 5 years since the most recent dose of PPSV23.

 For pneumococcal vaccine-naïve adults: 

• Adults 65 years of age or older who have not previously received pneumococcal vaccine or whose previous vaccination history is unknown should receive a dose of PCV13 first, followed 6 to 12 months later by a dose of PPSV23.
• If PPSV23 cannot be given during the 6 to 12 month time window, the dose of PPSV23 should be given during the next visit after 12 months. PPSV23 should not be given less than 8 weeks after the PCV13 dose.

Recommendations for routine use of PCV13 in adults at increased risk for pneumococcal disease remain unchanged: 

• Adults 19 years of age or older with immunocompromising conditions, functional or anatomic asplenia, CSF leaks, or cochlear implants, and who have not previously received PCV13 or PPSV23, should receive a dose of PCV13 first followed by a dose of PPSV23 at least 8 weeks later.
• Adults at increased risk for pneumococcal disease who received PCV13 at 64 years or younger should not receive another dose of PCV13 at 65 years or older. 

For more information visit http://www.cdc.gov/pneumococcal/clinicians/ or http://www.cdc.gov/mmwr/pdf/wk/mm6337.pdf

If you have any questions, please call the Maine Immunization Program at 287-3746 or 1- 800-867-4775

Enterovirus D68

US CDC has notified Maine CDC of a single confirmed case of Enterovirus D68 (EV-D68) in a school-aged child from York county. The child was hospitalized for four days with cough, wheezing, shortness of breath, difficulty breathing, retractions, cyanosis, vomiting, and chest pain. The child was not in intensive care and was released from the hospital and is recovering.

Enteroviruses are associated with various clinical symptoms from mild to severe. EV-D68 causes primarily respiratory illness, although the full spectrum of disease remains unclear. EV-D68 was originally isolated in 1962 and, since then, has been reported rarely in the United States. Small clusters of EV-D68 associated with respiratory illness were reported in the United States during 2009-2010. There are no available vaccines or specific treatments for EV-D68 and clinical care is supportive. All but one confirmed case have been in children. EV-D68 has now been confirmed in more than 40 states; this is the first confirmed case in Maine.

To prevent the spread of EV-D68, wash hands frequently and cough or sneeze into your elbow or shoulder. If you feel sick, stay home and avoid close contact with others. Disinfect commonly used areas, like tables, counters, and doorknobs.

For more information, see the health alert at http://www.maine.gov/tools/whatsnew/attach.php?id=628931&an=2 or visit our website at http://www.maine.gov/dhhs/mecdc/infectious-disease/epi/airborne/enterovirus.shtml 

Ebola

A Texas hospital patient has tested positive for ebola, making the patient the first case diagnosed in the United States. The patient is an adult with a recent history of travel to West Africa who developed symptoms days after returning to Texas and was admitted into isolation on Sunday at a hospital in Dallas. Texas health officials and US CDC are working to investigate the case and prevent transmission of the disease.

There have been no reported cases of ebola in Maine. 

The current outbreak of ebola virus disease (EVD) in West Africa is the largest outbreak of EVD ever documented and the first recorded in West Africa. For ongoing information about the outbreak in West Africa, go to http://go.usa.gov/Eu9B
  

US CDC advises US residents to avoid all non-essential travel to the West African countries of Liberia, Sierra Leone, and Guinea and to practice enhanced precautions when traveling to Nigeria. For more details on enhanced precautions, please see http://go.usa.gov/Eu9e.

For travelers who have recently been to affected countries in West Africa, Maine CDC advises that you self-monitor general health for 21 days after departing West Africa. Travelers should be especially vigilant for symptoms of fever (>101.5°F or 38.6°C), severe headache, muscle pain, weakness, diarrhea, vomiting, stomach pain, and unexplained bleeding. Should you develop any of these signs of symptoms, please seek medical attention immediately and inform your provider of your recent travel history.

Maine CDC issued an update for health care providers Aug. 1. The health alert is available at http://go.usa.gov/NEHH 

While the possibility of infected people entering the US remains low, Maine CDC advises health care providers in Maine to consider EVD in the differential diagnosis of febrile illness with compatible symptoms in any person with recent (within 21 days) travel history in the affected countries, and consider isolation of those patients meeting these criteria, pending diagnostic testing. If a provider suspects EVD, the patient should be placed in isolation and the provider should call Maine CDC (1-800-821-5821) for guidance on possible testing. Other infectious diseases, such as Malaria, Yellow fever, dengue fever, and chikungunya should be ruled out.