Study Shows Effects of Heat on Health, Prompts Changes to Local Advisories

A new study of heat and health shows that hospital emergency department visits and deaths from all causes in Maine, New Hampshire, and Rhode Island increased significantly, by 7.5 and 5.1 percent respectively, on days when the heat index reached 95 degrees as compared to days with a maximum heat index of 75 degrees.

Based on the study findings, the National Weather Service (NWS) Northeast Region forecast offices will now issue heat advisories when the heat index is forecast to reach 95 degrees on two or more consecutive days or 100 degrees for any amount of time. The previous NWS regional threshold was a maximum daily heat index of 100.

In Maine, the results of the study and the NWS policy change are driving public health officials to develop local heat response plans. In 2015, Cumberland County was the first area in Maine to develop a comprehensive plan to identify what state and local officials will do during different hot weather scenarios. In addition, Maine CDC will begin issuing health warnings for the public at the lower threshold adopted by the NWS.

The study, “Heat-related morbidity and mortality in New England: Evidence for local policy,” was published in the journal Environmental Research and led by Gregory Wellenius of the Brown University School of Public Health, and co-authored by Andrew Smith and Rebecca Lincoln of the Maine CDC, along with colleagues from the state public health agencies in New Hampshire and Rhode Island.

For More Information:

• Information about preventing and recognizing heat illness: http://www.maine.gov/dhhs/mecdc/environmental-health/heat/index.html
• Data about heat illness in Maine: http://data.mainepublichealth.gov/tracking 

Keep Cool, Drink Fluids and Reduce Activity to Prevent Heat-Related Illness

During these hot summer days we can all use a reminder to keep cool, drink fluids and lie low to prevent heat-related illness.

Older adults, infants, pregnant women, people who have chronic diseases and those who work outside or in hot environments are most at risk for heat-related illnesses. On hot days, people need access to air conditioning or shade and those who are working outside should be sure to drink more fluids to stay hydrated. 

It is also a good idea to check on the elderly and relatives who live alone to make sure they are able to stay cool.

For more on how to recognize and prevent heat illness: http://www.maine.gov/dhhs/mecdc/environmental-health/heat/index.html

Use the Maine Tracking Network to find data about heat illness in Maine: https://data.mainepublichealth.gov/tracking

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: More information on tickborne diseases is available at http://go.usa.gov/kGYV For Lyme disease testing and treatment information, see the health alert at http://go.usa.gov/kscC  Lyme disease data are available on Maine CDC's website at http://go.usa.gov/kGYx 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

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.   For more information, see: http://www.healthit.gov/buzz-blog/health-innovation/pilot-helps-battle-hepatitis-c-health-telemedicine/

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

Stay cool the next couple of days

Maine CDC issued a heat advisory yesterday due to high temperatures forecast for today and tomorrow.

High temperatures are more common toward the end of July and into August in Maine. Everyone should take some simple measures to prevent heat-related illness. Some people are more likely to experience illness from heat and should take extra precautions to keep cool. These people include:

• Older adults (age 65 and older)
• Infants and young children
• People with a mental illness or who are under the influence of drugs or alcohol
• People who work outside
• People with heart conditions, kidney disease, diabetes, obesity, and high blood pressure
• People with mobility restrictions
• People living in poverty and who are homeless

More information on heat-related illness and ways to prevent it can be found at: http://www.maine.gov/dhhs/boh/heat/index.shtml

Tips for enjoying this weekend and the rest of the summer

Watch out for heat-related illness


Over the past 30 years more people have died in this country from heat than from hurricanes, lightning, tornadoes, floods, and earthquakes combined. This Maine CDC web site has a variety of resources describing the signs of heat-related illness, what you can do if you suspect someone has a heat-related illness, and ways to prevent these illnesses.


Water Safety

· This web site has some basic tips for keeping children safe around open waters.

· This Maine CDC web site has tips for avoiding recreational water illnesses.


Food Safety

· This USDA fact sheet gives information on how to safely defrost frozen foods before cooking them.

· This food safety blog discusses food safety at farmer’s markets.

· US CDC describes food safety at fairs and festivals.


Other Precautions

· Playing outdoors this summer can mean getting cuts that may become infected with bacteria commonly found in soil, including the ones that cause tetanus. Tetanus vaccine can help prevent tetanus disease.

· A single mosquito bite can give you West Nile Virus. Why take a chance? Use repellant.