Showing posts with label TB. Show all posts
Showing posts with label TB. Show all posts

Thursday, July 24, 2014

Public Health Update 7/24/14

Mosquito-borne diseases

EEE and WNV
 
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 potentially severe and even fatal consequences for those who contract them.  Other New England states have already detected both EEE and WNV this summer.   
 
Clinicians should be aware 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.
 
For more information, see the Health Alert from July 2: http://go.usa.gov/X9MV 
 
Weekly arboviral surveillance reports will be posted to the following website through October: http://go.usa.gov/55u3 


Chikungunya

Chikungunya virus is also transmitted to people by mosquitoes. Outbreaks have occurred in countries in Africa, Asia, Europe, and the Indian and Pacific Oceans. In late 2013, chikungunya virus was found for the first time in the Americas on islands in the Caribbean. The first locally acquired case of chikungunya in the US was reported July 17 in Florida. For case information on chikungunya in the US, seehttp://go.usa.gov/55uA.

The most common symptoms of chikungunya virus infection are fever and joint pain. Other symptoms may include headache, muscle pain, joint swelling, or rash. There is no vaccine to prevent or medicine to treat chikungunya virus infection.

Although US CDC does not expect widespread cases of chikungunya in the United States this summer, American travelers infected overseas may continue to return and bring the virus with them. Travelers can protect themselves by preventing mosquito bites. When traveling to countries with chikungunya virus, use insect repellent, wear long sleeves and pants, and stay in places with air conditioning or that use window and door screens.

For more information, visit
http://go.usa.gov/55hP or http://www.cdc.gov/chikungunya/ 
 
Tick-borne diseases

Ticks are generally found in brushy or wooded areas, near the ground; they cannot jump or fly. Ticks are attracted to a variety of host factors, including body heat and carbon dioxide. They will transfer to a potential host when one brushes directly against them and then seek a site for attachment.
Ticks cause a variety of diseases in Maine, including Lyme disease, Anaplasmosis, Babesiosis, Ehrlichiosis, and Powassan.

More than 1,375 cases of Lyme disease were reported statewide in 2013, a record high for Maine. So far in 2014, there have been 246 reported cases of Lyme disease. 

Other case counts for tickborne diseases reported in Maine so far in 2014 include:
  • 80 cases of Anaplasmosis, compared to 94 for all of 2013
  • 9 cases of Babesiosis, compared to 36 cases for all of 2013
  • 5 cases of Ehrlichiosis, compared to 3 for all of 2013
  • No cases of Powassan, compared to 1 in 2013 
 
 For more information:
Cyclosporiasis
  
Cyclosporiasis is an intestinal infection caused by a microscopic parasite. Cases are usually reported from May to August. Five cases have been reported in Maine between June 24 and July 21.

Maine CDC issued a Health Alert on July 8 to increase awareness among clinicians about cyclosporiasis and the need to specifically request testing for Cyclospora in patients with prolonged diarrheal illness. The Health Alert is available at http://go.usa.gov/XXDR 

Cyclosporiasis is not a reportable condition in Maine due to the low number of cases in previous years (last known case in Maine resident in 2010). However, due to large numbers of cases in the United States in 2013, Maine CDC is requesting providers report cyclosporiasis cases as an unusual condition, 
since it is not commonly seen in Maine residents.  
  
For more information, visit http://go.usa.gov/X9tF
  
  
Pertussis (whooping cough)
  
Pertussis (whooping cough) is a cyclical disease that continues to affect a significant number of Maine residents.  

There have been 230 reported cases of pertussis so far in 2014, an increase of 43 cases from two weeks ago. 

Maine CDC encourages providers continue to test and treat patients. DTaP vaccine is recommended for all infants and children. Tdap vaccine is recommended for all preteens, teens, and adults.

For more guidance and information, visit http://go.usa.gov/dCO 


TB Hero

Dr. Shulamith Bonham, former medical director for Health Care for the Homeless in Portland, has been named 2014 TB Hero by the New England Tuberculosis Consortium. 

Dr. Bonham was recognized for creating a low-barrier system for screening and treatment of latent TB infection (LTBI) within the Health Care for the Homeless clinic. 
  
Hepatitis
  
Health IT and telemedicine are important tools to help early diagnosis and treatment of the growing problem of hepatitis C (HCV) infection in the United States. 

US CDC has launched a new pilot program to help use telemedicine to fight HCV, develop new treatment tools, and get them in the hands of providers to try to stem the tide of HCV infections.  

  


Heat-related illness

Here in Maine, we don't have very hot weather too often. So when it does get really hot, we are more likely to become sick from heat. This is because our bodies are not used to high heat, and many of our homes and buildings do not have air conditioning.  

Certain people like older adults, infants, pregnant women, and people who have chronic diseases or who are sick already may feel much worse or have serious problems in extreme heat.
Heat-related illnesses happen when your body cannot cool itself. Some heat illnesses are mild, like heat rash, sunburn, and heat cramps. Others like heat exhaustion, dehydration, and heat stroke can be severe or even life-threatening.

To find out how to keep cool and healthy as the weather gets hotter this summer, go to http://go.usa.gov/X9uw 
  

Friday, March 26, 2010

Maine CDC/DHHS Public Health Update 03/26/10

MAINE H1N1 FEEDBACK SURVEY

Maine CDC is conducting numerous in-person debriefings across the state with stakeholders on our H1N1 efforts. In addition, this Maine CDC H1N1 Feedback Survey is being distributed widely. If you have not done so already, please complete the survey and share the link with others.

INFECTIOUS DISEASE SURVEILLANCE REPORTS

Maine CDC’s Infectious Epidemiology Program has issued several disease surveillance reports for distribution.

A graph of selected reportable diseases that displays preliminary Year-To-Date (through February, 2010) totals with median Year-To-Date totals for the previous five-year period is available at: http://www.maine.gov/dhhs/boh/ddc/epi/publications/reportable-diseases-0210.pdf. This graph shows higher reported cases of Lyme Disease and Gonorrhea through February than the 5-year median.

The annual surveillance report on Group A Strep can be found here: http://www.maine.gov/dhhs/boh/ddc/epi/airborne/gas_survreport2009.pdf

The annual surveillance report on Group B strep is available here: http://www.maine.gov/dhhs/boh/ddc/epi/airborne/gbs_survreport2009.pdf


INFLUENZA UPDATE

What’s New With Flu?

Flu Activity. Virtually all detected influenza activity seen across the country is with the pandemic strain of H1N1. Most states are reporting sporadic, local, or no flu activity. The full national report can be found at: http://www.cdc.gov/flu/weekly/index.htm.

Maine’s influenza activity was coded “sporadic” this week, mainly because of continued reports of influenza-like-illness. Maine’s weekly influenza surveillance report can be found at: http://www.maine.gov/dhhs/boh/influenza_surveillance_weekly_updates.shtml. Maine and the U.S. continue to see virtually no seasonal influenza virus strains except for some very occasional type B. Almost all the detectable influenza viruses remain the pandemic strain of H1N1 influenza.

For the 2010-2011 season, flu vaccine will be recommended for all people. Although Maine CDC does not and never has provided the majority of seasonal flu vaccine in Maine, we are able to purchase sufficient seasonal flu vaccine for the 2010-2011 season for:
· all Maine children ages 6 months to 18 years-old;
· employees of schools that are providing onsite vaccine clinics on school days;
· pregnant women and their partners;
· nursing home employees and residents;
· high risk adults in limited public health settings, the scope and number of such settings determined by our vaccine supply.

The 2010-2011 seasonal flu vaccine will contain the pandemic Type A H1N1 component as well as a strain of Type B and Type A H3N2. Those who received the pandemic H1N1 vaccine will need to also receive the seasonal flu vaccine this coming season. More details about ordering will be coming soon.

Morbid Obesity and Flu: Increasingly the national data are showing that minority populations have been harder-hit by the 2009 H1N1 pandemic than non-minority groups, and there is growing evidence to support early concerns that people who are morbidly obese are at greater risk of serious 2009 H1N1 complications.

Don’t Forget Spring Break: With spring break coming up and large numbers of students expected to travel both domestically and internationally, vaccination of college-age students, who have been hard-hit by illness during this pandemic, continues to be recommended. Vaccine clinics can be located by calling 211 or by visiting www.maineflu.gov. The free clinics are in bold font.

Ongoing Flu Issues:

Flu activity, caused by either 2009 H1N1 or seasonal flu viruses, may rise and fall, but is expected to continue, especially in areas that did not see large surges in disease and/or did not have high vaccine rates. Testing for and reporting of cases and outbreaks to Maine CDC continue to be important strategies to track the virus’s spread.

It is still important to continue to offer the H1N1 vaccine to those at high risk for severe disease or those who are in a high priority category and who may have been missed earlier. If someone is vaccinated now, they can still receive the seasonal flu vaccine in the fall, which will contain the 2009 H1N1 strain. Those who should be focused on for ongoing H1N1 flu vaccination include:
women who are now pregnant;
infants who are now 6 months of old or older;
caregivers and household contacts of newborns and other young infants;
people 65 and older who may have been waiting for others to be vaccinated;
those with chronic diseases;
all young people ages 6 months to 25 years of age; and
all health care workers and EMS, including caregivers of people with developmental and/or physical disabilities.

Disposing of and Reporting Unused/Expired Vaccine
Unused or expired H1N1 vaccines may not be returned to the distributor. If vaccine cannot be redistributed prior to expiration, the health care provider is responsible for disposing of the vaccine appropriately, in compliance with Maine’s biomedical and/or hazardous waste rules. However, US CDC is working on a possible centralized national system for disposal of vaccine, and we will know more about this later this month.

Discarded vaccine needs to be reported to Maine CDC. Providers should report the doses discarded on the same weekly reporting form used for vaccine administration (http://www.maine.gov/dhhs/boh/maineflu/schools/documents/Aggregate-H1N1-weekly-reporting_V3.pdf) – please note any discarded doses in the space between the two “Total” cells at the lower right corner of the form with a mark of “Expired (and discarded) doses.”


WORLD TUBERCULOSIS DAY

TB Elimination: Together We Can! was the U.S. theme for World TB Day on March 24. World TB Day is observed each year to commemorate the date in 1882 when Robert Koch announced the discovery of Mycobacterium tuberculosis, the bacterium that causes tuberculosis (TB).

Tuberculosis is a disease caused by bacteria that usually infects the lungs but can affect any part of the body. TB is spread through the air when a person with active TB disease of the lungs or throat coughs, speaks, sneezes or sings. Signs and symptoms include a cough lasting 3 weeks or more, night sweats, fatigue, weight loss, coughing up blood, fever, and chills.

Worldwide, TB remains one of the leading causes of death from infectious disease. Each year, approximately 9 million persons around the world become ill with TB, and nearly 2 million TB-related deaths occur worldwide. In the United States, however, the number of reported TB cases is at an all-time low with 17 consecutive years of decline.

Although both the nation and the state of Maine have successfully achieved decreased numbers of tuberculosis cases, there is still much to be done in the elimination of TB in at-risk populations, including minorities, foreign-born persons, substance abusers and those associated with homelessness who account for a disproportionate percentage of TB cases.

In 2009, Maine had 9 cases of TB, the same number of cases that were reported in 2008. Males accounted for 6 of the cases (67%). The median age of cases was 48 years (range 5-86 years). Risk factors included substance abuse (33%), homelessness (11%), and foreign-born status (44%).

The state of Maine is actively engaged in partnerships and collaborations with community-based organizations throughout the state to reach this population and succeed in the elimination of TB. For more information: http://www.cdc.gov/Features/WorldTBDay/

Maine CDC has recently identified TB among two people who are homeless in Cumberland County. More information on this can be found at:
http://www.maine.gov/tools/whatsnew/attach.php?id=94284&an=1

RABIES

US CDC has established a new rabies webpage, which includes updated ACIP recommendations on human rabies post-exposure prophylaxis and new content organization: http://www.cdc.gov/rabies/

Maine CDC provides a quarterly update on animal rabies to veterinarians and other animal health professionals, which may be used to increase the understanding of pet owners and other members of the public regarding the risk of rabies in Maine. The 4th quarter update is available here: http://www.maine.gov/tools/whatsnew/attach.php?id=91596&an=2

FDA RECOMMENDS TEMPORARY SUSPENSION OF ROTARIX VACCINE

The US Food and Drug Administration (FDA) has learned that DNA material from porcine circovirus type 1 (PCV1) is present in Rotarix, a vaccine used to prevent rotavirus disease. Although there is no evidence at this time that this DNA material poses a safety risk, finding the material was unexpected and FDA is assessing the situation. As a result, FDA is recommending that clinicians temporarily suspend the use of Rotarix. FDA will keep the public and clinical community updated through www.fda.gov.

Rotavirus vaccines are given by mouth to young infants to prevent rotavirus disease, which can cause severe diarrhea and dehydration. Rotavirus disease causes the deaths of more than 500,000 infants around the world each year, primarily in low- and middle-income countries. Before the introduction of vaccination, the disease caused more than 50,000 hospitalizations and several dozen deaths in the United States each year.

There are two licensed rotavirus vaccines in the United States: RotaTeq (Merck) and Rotarix (GlaxoSmithKline). Because RotaTeq was licensed in 2006 and Rotarix in 2008, most children vaccinated in the United States received RotaTeq.

RotaTeq is made using a different process from Rotarix. Preliminary studies on the RotaTeq vaccine, both by the academic research team and by FDA, have not shown the presence of PCV1 DNA. FDA is working with Merck to confirm these findings.

Within approximately four to six weeks, FDA will convene an advisory committee to review the available data and make recommendations on the licensed rotavirus vaccines. FDA will also seek input on the use of new techniques for identifying viruses or viral particles in vaccines.


MAINE AWARDED FEDERAL OBESITY PREVENTION FUNDS

First Lady Michelle Obama and US DHHS Secretary Kathleen Sebelius announced last week that Maine is one of 9 states to receive American Recovery & Reinvestment Act funds focused on preventing obesity. Maine’s award is $4.28 million over a 2-year period.

Maine CDC’s Division of Chronic Disease conducted a mini-RFP process prior to submitting the federal application, which resulted in the selection of two Healthy Maine Partnerships – Healthy Portland and Communities Promoting Health Coalition, which serves the Sebago Lakes region.

To view a complete listing of grant awardees, visit http://www.hhs.gov/recovery/programs/cppw/grantees.html

To view a fact sheet on Communities Putting Prevention to Work visit http://www.hhs.gov/recovery/programs/cppw/factsheet.html

To learn more about Communities Putting Prevention to Work, visit http://www.hhs.gov/recovery and http://www.cdc.gov/chronicdisease/recovery

STAY UPDATED

· Follow Maine CDC’s Social Media Updates:
o Facebook (search for “Maine CDC”) http://www.facebook.com/pages/Augusta-ME/Maine-CDC/135584761549
o Twitter (http://twitter.com/MEPublicHealth)
o MySpace (www.myspace.com/mainepublichealth)
o Maine CDC’s Blog (http://mainepublichealth.blogspot.com)
· For clinical consultation and outbreak management guidance, call Maine CDC’s toll free 24-hour phone line at: 1-800-821-5821.
· For general questions on flu, call 2-1-1 from 8 a.m. to 8 p.m. seven days per week