Healthy Maine Works

Healthy Maine Works (HMW) is the Maine CDC’s initiative to support and provide employers of all sizes with tools and resources to develop an evidence-based worksite wellness program.  Many employees spend most of their waking hours at work. Worksite wellness programs give employers a unique opportunity to support the health of their employees.

What is Worksite Wellness?

Worksite wellness programs help to improve the health of employees, leading to a decrease in health-care costs for employees and their employer.  They offer many benefits such as:

• Lower health care costs
• Less absenteeism from work
• Reduced staff turnover
• More productive employees
• Healthier employees

Worksite wellness also offers a good return on investment.  According to the 2010 Harvard study Workplace Wellness Programs Can Generate Savings, for every dollar that an employer spends on worksite wellness, an average return of $3.27 will be seen.

How HMW Can Help

HMW can provide the tools to help any employer create a worksite wellness program or help improve an already existing program.  When you sign up, you can get access to:

• Employee health surveys to determine what health topics your employees would find interesting
• A newsletter that provides information, ideas and resources to help create healthier worksites
• Healthy Us Score card – an easy to use online assessment and planning tool that helps promote healthy living

Employers interested in developing a worksite wellness program can contact their local Healthy Maine Partnership by visiting www.healthymainepartnerships.org. They can help you get your worksite wellness program started today.

To learn more about Healthy Maine Works, visit www.healthymaineworks.com

Group A strep

Maine CDC is investigating an increase in the number and severity of invasive group A Streptococcal (GAS) infections in the first half of 2015 compared to a similar time frame in previous years.  Maine CDC received reports of 15 cases of invasive GAS in April and the first week of May alone, almost half of the 33 cases reported to date this year.  Of those 15 cases, six resulted in streptococcal toxic shock syndrome (STSS), a more serious presentation in which the disease affects multiple organs.  At this time in 2014, Maine had reports of 23 cases of invasive GAS and nine cases of STSS. 

Most GAS infections are relatively mild such as “strep throat,” scarlet fever or impetigo.  Invasive GAS disease is more severe and includes pneumonia, cellulitis and the least common forms but most severe forms -- necrotizing fasciitis and STSS. 

Invasive GAS infections are seasonal, peaking December through April. The spread of GAS can be prevented by good hand washing, especially after coughing and sneezing.  People with sore throats diagnosed as strep throat should stay home from work, school or day care until 24 hours after taking antibiotics.

Recommendations: 

Health care providers should consider invasive GAS in any patient who presents with early signs of STSS and should collect culture specimens and consider prompt antibiotic treatment. Because invasive GAS infections can progress rapidly, providers are encouraged to be familiar with early signs of STSS:

• Fever
• Abrupt onset of generalized or localized severe pain, often in an arm or leg
• Dizziness
• Influenza-like syndrome
• Confusion
• A flat red rash over large areas of the body (occurs in 10% of cases)

Reporting requirements:

All cases of suspected invasive GAS and STSS should be reported by phone to the Maine CDC at 1-800-821-5821, or by fax to 1-800-293-7534.

For more information:

• Maine CDC’s Group A Strep webpage: http://www.maine.gov/dhhs/mecdc/infectious-disease/epi/airborne/group-a.shtml

 US CDC’s Group A Strep webpage:  http://www.cdc.gov/groupastrep/

Varicella update

Maine has had four outbreaks of varicella (three or more cases in a single setting) reported in schools or daycares during the 2014-2015 school year, more than any previous year. 

Varicella is a highly contagious, acute viral illness that causes both chickenpox and shingles.  Varicella can be serious, especially in babies, adults and those with weakened immune systems.  It spreads in the air through coughing or sneezing, or by touching or breathing in the virus particles that come from the blisters. Infected people are contagious from two days before their rash starts until all blisters have scabbed over.  Vaccination is the best method of protection.

From September 2014 through mid-May 2015, 84 cases of varicella have been reported in children 18 years or younger, compared to 44 cases during the same time period of the 2013-2014 school year. Cases have been reported in all Maine counties except Washington County during the 2014-2015 school year. Of these cases, 57 (68 percent) were non- or under-immunized, including four children who were too young to receive vaccine. 

Key points for health care providers:

• Report all cases of varicella, including clinically diagnosed cases with no laboratory testing.
• Providers should ensure all patients are up to date with varicella vaccine and other vaccines. Two doses of varicella vaccine are recommended.
• Pregnant women exposed to varicella should contact their obstetrician for follow up.
• Varicella cases should be excluded from school or work until lesions are crusted over.
• Laboratory testing is available for varicella through Maine CDC’s Health and Environmental Testing Laboratory (HETL) as well as other reference laboratories.

Key points for schools and daycares:         

• Report all cases of varicella.
• School nurses should review and update vaccine records.
• Exclusion of unvaccinated children may be warranted when a varicella case is identified. Exclusion laws can be found at http://www.maine.gov/dhhs/mecdc/infectious-disease/immunization/family/rules.html.
• Varicella cases should be excluded from school or work until lesions are crusted over.

Reporting requirements:

All laboratory and clinically diagnosed cases of varicella should be reported by phone to 1-800-821-5821, or by fax to 1-800-293-7534.

For more information:

• Maine CDC’s varicella webpage: http://www.maine.gov/dhhs/mecdc/infectious-disease/epi/vaccine/varicella.shtml
• US CDC’s varicella webpage: http://www.cdc.gov/varicella
• The Health and Environmental Testing Lab's webpage: www.mainepublichealth.gov/lab
• Maine Immunization Program webpage:  https://www1.maine.gov/dhhs/mecdc/infectious-disease/immunization/

Immunization Champion

Cassandra Grantham (L) was recently honored as US CDC's Childhood Immunization Champion for Maine. She is pictured with Tonya Philbrick, Director of the Maine Immunization Program at Maine CDC.

The Maine Immunization Program is proud to announce that Cassandra Cote Grantham, a health communication specialist at MaineHealth in Portland, has been selected as the US CDC Childhood Immunization Champion for Maine.

Cassandra was nominated and selected from a pool of health care professionals, community advocates and other immunization leaders for making a significant contribution to public health in Maine through her work in children’s immunization.

In 2010, Cassandra established MaineHealth’s childhood immunization program, with the goal of increasing Maine’s childhood immunization rates to the highest in New England by 2016. Under this program, she has launched several educational initiatives, such as the Vax Maine Kids website and Kohl’s Vax Kids—a program to increase immunization awareness among parents most likely to delay or skip their child’s vaccinations.

To read her profile on the CDC’s website and to learn more about CDC’s Childhood Immunization Champion Award program, please visit http://www.cdc.gov/vaccines/champions 

Lab workers recognized

Heather Dyer and Steve Pierce, chemists at Maine CDC’s Health and Environmental Testing Lab, recently presented on toxicology forensics at the Maine Impaired Driving Summit. They were recognized by AAA Northern New England and Maine Bureau of Highway Safety for their support in organizing the statewide summit. 

Hepatitis

May is National Hepatitis Awareness Month, and Maine CDC urges people to talk with their providers about testing for hepatitis. 

US CDC reports that people born from 1945 through 1965 are five times more likely to be infected with Hepatitis C than other adults.  There are approximately 3.2 million individuals living with hepatitis C in the country, and it is estimated that 75 percent of these individuals are Baby Boomer age (ages 50 to 70). 

Most people living with hepatitis C do not know they are infected and can live with the disease for decades without having symptoms or feeling sick. If left untreated, hepatitis C can lead to serious liver damage, including cirrhosis and liver cancer.  Hepatitis C is the leading cause of liver transplant in the United States. 

Symptoms of hepatitis C include fever, fatigue and loss of appetite, nausea, vomiting, abdominal pain, darkened urine, clay-colored stools, joint paint and jaundice.  It is estimated that only 20 to 30 percent of individuals who have Hepatitis C experience symptoms. People who have ever injected drugs, shared needles and equipment, or who were born to a Hepatitis C positive mother join Baby Boomers in the highest risk category. 

Recent advancement in therapies for treatment of hepatitis C can cure up to 95 percent of infections. Maine CDC recommends that people talk to their health care provider about their risk for hepatitis C. 

Testing days are scheduled in May for individuals who are uninsured and at high risk for hepatitis C. The dates and locations are:

• May 18: Waterville Family Planning  18 Silver Street Waterville 207-509-3267
• May 19: Florence House (women's shelter) via Portland Public Health. 103 India St Portland 207-874-8446

Those who are interested in being tested should call the test site prior to the testing day to find out if they qualify for the free test. 

For more information about hepatitis, visit: http://www.cdc.gov/knowmorehepatitis 

For more information about viral hepatitis resources in Maine, visit: www.mainepublichealth.gov/hepatitis

Lyme and other tickborne diseases

Lyme disease is the most common vector-borne disease in Maine. Cases have been increasing each year in Maine, and occur in all 16 counties. More than 1,395 cases of Lyme disease were reported statewide in 2014, a record high for Maine.  Lyme disease is most common among school age children and mature adults over the age of 65. Most infections occur during the summer months. A total of 71 cases have already been reported in 2015.

The most common early symptom of Lyme disease is an expanding red rash that occurs 3-30 days after being bitten. Fever, headache, joint and muscle pains and fatigue are also common during the first several weeks. Later features of Lyme disease can include arthritis in one or more joints (often the knee), Bell's palsy and other cranial nerve palsies, meningitis and carditis (AV block). Lyme disease is treatable, and the majority of patients recover after receiving appropriate therapy.

Lyme disease is a reportable condition in the State of Maine.  Providers should report all diagnosed erythema migrans rashes and all positive lab diagnoses.  Cases can be reported by fax at 1-800-293-7534 or by phone at 1-800-821-5821.

Other tickborne diseases: 

Other diseases that are carried by ticks in Maine include anaplasmosis, babesiosis, ehrlichiosis, Powassan and Rocky Mountain spotted fever. They are all reportable in Maine.

In 2014, providers reported 191 cases of anaplasmosis, more the twice the number of cases reported in 2013.  Providers reported 42 cases of babesiosis, a slight increase from 2013.  Four anaplasmosis cases and one babesiosis case have already been reported in 2015.  

For more information:

• Lyme disease data are available on Maine CDC's website at http://go.usa.gov/kGYx
•  For more information on tickborne diseases, including Lyme:  http://go.usa.gov/kGYV
• A Physician's Reference Guide is available and describes the most common tickborne diseases in Maine.  This guide can be found on our website at:http://go.usa.gov/kGrw 
• For IDSA Lyme disease treatment guidelines: http://cid.oxfordjournals.org/content/43/9/1089.full
• To order Lyme educational materials: http://go.usa.gov/kGYh

Six steps to control blood pressure

High blood pressure, often referred to as the “silent killer,” does not have any symptoms, but can cause serious damage to arteries, leading to heart disease and stroke. Nearly one in three adults in the United States has high blood pressure and many people remain unaware of this condition because there are no symptoms. 

A routine doctor’s appointment often involves a health professional checking your blood pressure. The results of this simple test may identify a condition that, when managed, could help reduce your chances for stroke or heart attack.

The national high blood pressure campaign, Measure Up/Pressure Down®, encourages adults to get in control by making simple lifestyle changes, including:

1. Know your numbers – Understanding what blood pressure is, and what your numbers are, is an important first step. Work with your health care provider to determine your individual blood pressure goals and treatment plan if your numbers are too high.

2. Eat right – A diet with excessive sodium (salt) can lead to higher blood pressure. Check food labels before you buy and choose foods with less than 400 mgs of sodium per serving.

3. Stay active – By being active at least 30 minutes a day at least 5 times a week, you can help reduce your blood pressure.  

4. Reduce stress – A stressful situation can increase blood pressure for a short period of time. Try to reduce the occurrence of these situations and look for healthy ways - like meditation or walking - to help you deal with stress.

5. Set alcohol limits and eliminate tobacco – Over time, consuming a high amount of alcohol can damage the heart. Tobacco use and secondhand smoke can immediately raise blood pressure levels and cause damage to the lining of arteries. If you’re interested in quitting tobacco, call the Maine Tobacco HelpLine 1-800-207-1230. 

6. Take medication – Your doctor may recommend taking a blood pressure medication to keep levels steady. Be sure to follow the directions provided for taking the medications to ensure you’re getting the most benefit from them.

Through Measure Up/Pressure Down®, you are encouraged to measure, monitor and maintain your blood pressure level to stay in control of this health condition. If you don’t know your blood pressure and want more information to determine if you might be at risk for high blood pressure, visit MaineHeartHealth.org.

Suicide Prevention Conference

From left to right-Ken Albert, Director and Chief Operating Officer, Maine CDC; Kyle Poissonnier, founder of Katalyst; MaKayla Reed, volunteer for The Trevor Project; Jodi Beck, Director of Clinical Integration and Physician Practice Improvement for Kennebec Regional Health Alliance, MaineGeneral Health; Anthony Ronzio, Director of news for the Bangor Daily News; Kristen McAuley, Team Lead, Healthy and Safe Living, Division of Population Health, Maine CDC; Brian Walsh, Principal of Hermon High School. CAL ME Award recipients not pictured- Ethel Jalbert and Tonya Bailey-Curry, community volunteers.

  

More than 200 people attended the Maine Suicide Prevention Program’s conferece, 2015 Beyond the Basics: Pathway to Suicide Prevention, last week. Ken Albert, Director and Chief Operating Officer of Maine CDC, presented the Caring About Lives in Maine Awards to seven Individuals and agencies for their leadership and dedication to suicide prevention.