World Hepatitis Day

July 28 is World Hepatitis Day, which aims to increase awareness about viral hepatitis on a global level.  The World Health Organization (WHO) estimates that 400 million people worldwide have chronic viral hepatitis. A approximately 1 million individuals die  each year from viral hepatitis-related causes. 

Hepatitis A is a liver disease spread by ingestion of contaminated food or water or by direct contact with an infected individual. The hepatitis A virus (HAV) can cause mild to severe illness with symptoms ranging from nausea and fever to jaundice. HAV cannot become chronic. Once a person is infected, he or she cannot become infected again.  There is a vaccine available for HAV, which is recommended for all children at age 1 and any adults at risk of infection.

Hepatitis B is caused by the hepatitis B virus (HBV) and can be both acute and chronic. HBV is spread though contact with blood or other bodily fluids of an infected individual.  HBV infection may be symptomatic, but infected individuals may also go years before symptoms or complications occur.  If left undiagnosed and untreated, HBV may result in serious liver disease, cirrhosis, end-stage liver disease or death in 25 percent of people.  There is an effective vaccine available for HBV prevention, which is recommended for all babies at birth and adults at risk of infection.

Hepatitis C is a serious liver disease caused by the hepatitis C virus (HCV), which can be both acute and chronic. HCV is spread by blood-to-blood contact with an infected individual. It is estimated that only 20 percent of people with acute cases experience symptoms of HCV. It’s  possible that patients may live with HCV infection for years without experiencing symptoms until serious liver damage occurs.  Hepatitis C is the leading cause of liver transplant in the United States. The U.S. CDC estimates that there are 3.2 million people living with chronic hepatitis C nationwide, and most individuals are  unaware of their infection. 

Symptoms of hepatitis C include fever, fatigue and loss of appetite, nausea, vomiting, abdominal pain, darkened urine, clay-colored stools, joint paint and jaundice.  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. There is no vaccine available for hepatitis C.

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

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

Are you at risk for viral hepatitis?  Find out if you should get tested:  www.cdc.gov/hepatitis/riskassessment/index.htm 

Cancer registry awards

L-R: Dr. Molly Schwenn and Katherine Boris of the Maine Cancer Registry and Debra Wigand, Director of Maine CDC's Division of Population Health,  pictured with the two honors from US CDC.

The Maine Cancer Registry has been recognized with two national honors from the US CDC National Program of Cancer Registries (NPCR). 

Maine was recognized as one of 19 states to receive the Registry of Excellence designation. In addition, the registry was recognized for achieving the highest standards for data completeness, timeliness and quality. According to the NPCR, Maine’s data are so thorough and accurate that they will be included in this year's United States Cancer Statistics report and other analytic data sets. 

Achievement of these standards and certification is important to ensure accurate information is available about cancer in Maine and to monitor trends in cancer diagnosis. Detecting cancer at an earlier stage can improve outcomes. Maine hospitals are partners in this effort, providing up-to-date local information to the Maine Cancer Registry.

Arboviral diseases

Summer is here, which means mosquitoes are here as well.  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.  Additionally, Powassan virus is an arboviral disease transmitted by the bite of an infected tick.  Although rare, these diseases have potentially severe and even fatal consequences for those who contract them.  Maine CDC reminds clinicians of the potential for human disease activity in Maine and to consider testing for arboviral disease in patients presenting with unexplained encephalitis, meningitis or fever (≥100.4°F or 38°C) during the summer and early fall.

EEE and WNV were first detected in Maine in 2001 in birds.  In 2009, Maine experienced unprecedented EEE activity with 19 animals and two mosquito pools testing positive.  In 2012, Maine reported its first human case of locally-acquired WNV neuroinvasive illness.  In 2014, Maine reported its first human case of locally-acquired EEE neuroinvasive illness. Powassan was first identified in Maine in 2000 but is rarely reported; a confirmed case in 2013 was the first reported case in nearly a decade.  In 2014, Maine reported EEE in an emu from Cumberland County, 22 mosquito pools from York County and one human from York County.

Many people infected with arboviral illness remain asymptomatic. The following groups of people are at higher risk for clinically significant arboviral infection:

• Residents of and visitors to areas with mosquito or tick activity
• People who engage in outdoor work and recreational activities
• People older than 50 and younger than 15 

Additional Information

• For more information on arboviral disease: http://www.maine.gov/dhhs/mecdc/infectious-disease/epi/vector-borne/index.shtml

• HETL Laboratory Submission Sheet: http://www.maine.gov/dhhs/mecdc/public-health-systems/health-and-environmental-testing/micro/documents/wnv-sle-eee.pdf

• Weekly arboviral reports will be posted throughout the season at: http://www.maine.gov/dhhs/mecdc/infectious-disease/epi/vector-borne/arboviral-surveillance.shtml

• Disease consultation and reporting available through Maine CDC at 1-800-821-5821