May is Asthma Awareness Month

Maine continues to have some of the highest asthma rates in the nation. Emergency departments deal with almost 8,500 visits a year for asthma, and there are more than 1,100 hospitalizations annually. These visits can be avoided, and while asthma cannot be cured, it can be managed. Proper medication, avoiding triggers, and seeing a medical provider on a routine basis, are simple steps that anyone can take to avoid costly visits to the ER or hospital.

Here at the Maine CDC, the Asthma Prevention and Control Program works to raise awareness about the dangers and costs associated with asthma, and also to provide resources that can help Maine people manage their condition and live happy and productive lives.

For more information on asthma and the Maine CDC Asthma Prevention and Control Program click here.

Hepatitis B

May is Hepatitis Awareness Month. One in in 12 Asian Americans and Pacific Islanders has Hepatitis B.

Hepatitis B is common worldwide, especially in many parts of Asia and the Pacific Islands. In the US, Hepatitis B disproportionately affects Asian Americans and Pacific Islanders (AAPIs). While AAPIs make up less than 5% of the U.S. population, they account for more than 50% of Americans living with Hepatitis B. 

Hepatitis B is serious, but treatments are available.

Left untreated, nearly 1 in 4 people living with hepatitis B develop serious liver problems, even liver cancer. In fact, Hepatitis B-related liver cancer is a leading cause of cancer deaths among Asian Americans. Getting tested for Hepatitis B can help many people access lifesaving treatments that can prevent serious liver damage.

Two in three Asian Americans with Hepatitis B don't know they are infected.

People can live with Hepatitis B for decades without having any symptoms or feeling sick. Hepatitis B is spread when blood or other body fluid infected with the Hepatitis B virus enters the body of a person who is not infected. This can happen through multiple ways, including getting Hepatitis B from an infected mother at birth or from a family member as a young child. Many AAPIs living with Hepatitis B got infected as infants or young children. Testing is the only way to know if someone has Hepatitis B.

Who should get tested for Hepatitis B?

• Anyone born in Asia or the Pacific Islands (except New Zealand and Australia)
• Anyone born in the United States, who was not vaccinated at birth, and has at least one parent born in East or Southeast Asia (except Japan) or the Pacific Islands (except New Zealand and Australia).

Hepatitis B testing identifies people living with Hepatitis B so they can get medical care to help prevent serious liver damage. Talk to a health care provider about getting tested for Hepatitis B. 

For more information, see:http://www.cdc.gov/knowhepatitisb/FAQs.htm or 

http://www.cdc.gov/knowhepatitisb/ProResources.htm

or  www.mainepublichealth.gov/hep

American Stroke Month

A stroke happens when part of the brain cannot get the blood and oxygen it needs and starts to die.  This is due to a blocked or ruptured blood vessel leading to or in the brain.  Stroke is the 4th leading cause of death in Maine and is the leading cause of serious, long-term disability in Maine and the U.S. 

What can you do to prevent a stroke?

You cannot control risk factors like age and family history.  Here are steps you can take for the risk factors you can control:

• Know Your ABCS:
  • Ask your doctor if you should take Aspirin every day.
  • Find out if you have high Blood Pressure or Cholesterol.  If you do, work with your doctor to treat it.
  • If you Smoke, get help to quit.  Call the Maine Tobacco Help Line at 1-800-207-1230.
• Be physically active at least 30 minutes on most days
• Eat more fruits and vegetables
• Be sure other foods are low in sodium and trans fat
• Take medication as prescribed by your doctor

What are the warning signs of stroke?

F.A.S.T. is an easy way to remember the sudden signs of stroke:

Face Drooping: Does one side of the face droop or is numb?  Ask the person to smile.  Is the smile uneven?

Arm Weakness: Is one arm weak or numb?  Ask the person to raise both arms.  Does one arm drift downward?

Speech Difficulty: Is speech slurred?  Is the person unable to speak or hard to understand?  Ask the person to repeat a simple sentence.  Is it repeated correctly?

Time to Call 9-1-1: If someone shows any of these signs, even if the signs go away, call 9-1-1.  Check the time so you will know when the first signs appeared.

Other warning signs of stroke include blurred vision, dizziness or loss of balance, and severe headache.

Million Hearts Initiative

Million Hearts® is a national effort to prevent 1 million heart attacks and strokes by 2017. Million Hearts® brings together communities, health systems, nonprofit organizations, federal agencies, and private-sector partners from across the country to fight heart disease and stroke.  To learn more about the initiative or to make the commitment visit:www.millionhearts.hhs.gov

  

For more information about heart disease visit:http://mainehearthealth.org/

Lyme Disease Awareness Month

May is Lyme Disease Awareness Month. Lyme disease is the most common vectorborne disease in Maine. Cases have already been reported in 2014, and the number will rise as the weather continues to get warmer.

Lyme disease is a bacterial infection carried by the deer tick. Cases have been increasing each year in Maine, and occur in all 16 counties. More than 1,375 cases of Lyme disease were reported statewide in 2013, a record high for Maine. Lyme disease is most common among school age children and adults older than 65. Most infections occur during the summer months.

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.

What to do after a tick bite:

• Remove the tick properly, ideally using tweezers or a tick spoon. 
• Clean the area around the bite, and watch for signs and symptoms for 30 days. 
• Testing of the tick is not routinely recommended. 
• Prophylactic treatment after a tick bite is not routinely recommended, but can be considered under specific circumstances including. 
• If you suspect Lyme disease, contact your health care provider for laboratory testing. The IDSA guidelines for assessment, treatment, and prevention of Lyme disease are available at http://cid.oxfordjournals.org/content/43/9/1089.full

Other tickborne diseases:
Other diseases that are carried by ticks in Maine include Anaplasmosis, Babesiosis and Powassan. Symptoms of Anaplasma include: fever, headache, malaise, and body aches. Symptoms of Babesia include: extreme fatigue, aches, fever, chills, sweating, dark urine, and possibly anemia. Symptoms of Powassan include: fever, headache, vomiting, weakness, confusion, loss of coordination, speech difficulties, seizures, and encephalitis and meningitis.

In 2013, providers reported 94 cases of Anaplasmosis, 36 cases of Babesiosis, and 1 case of Powassan. Five anaplasmosis cases and two babesiosis cases have already been reported in 2014.

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

State Health Improvement Plan (SHIP)

The 2013-2017 State Health Improvement Plan (SHIP) has been finalized, and implementation will begin soon.

Implementation teams for each of the six priorities will be recruited in the next two months. Partners who were identified in the planning process will receive an invitation to join the implementation teams, but we are also welcoming other interested parties.

The six priorities in the 2013-2017 SHIP are:

• Immunization 
• Obesity 
• Substance Abuse and Mental Health 
• Tobacco Use 
• Educate, Inform and Empower the Public 
• Mobilize Community Partnerships 

The implementation teams will be asked to focus on one or more of the objectives, and strategies in the plan, and may choose to work on all or part of those strategies.

Team members will help develop a work plan, identify commitments that they or their organization can make towards implementation, and then meet quarterly to provide progress updates and suggest new partnerships and or revisions to the work plan.

The plan can be found at: http://www.maine.gov/dhhs/mecdc/ship/index.shtml. If you are interested in participating in an implementation team, please contact Nancy Birkhimer at nancy.birkhimer@maine.govor 287-5716.

Viral hepatitis plan

On April 3, the U.S. Departments of Health and Human Services (HHS), Housing and Urban Development (HUD), Justice (DOJ), and Veterans Affairs (VA) released a 3-year update of Combating the Silent Epidemic of Viral Hepatitis: Action Plan for the Prevention, Care, & Treatment of Viral Hepatitis, which builds on the success of the nation's first comprehensive cross-agency action plan, released in 2011.   The updated Viral Hepatitis Action Plan builds on the foundation of and momentum generated by the original action plan and seeks to harness:

• New recommendations for health care providers regarding screening for hepatitis C;
• Promising new developments in treatments for hepatitis C;
• Mounting public awareness of and concern about hepatitis B and hepatitis C; and
• The expansion of access to viral hepatitis prevention, diagnosis, care, and treatment offered by the Affordable Care Act.

For more information: http://www.aids.gov/news-and-events/hepatitis/

Water Fluoridation Map

US CDC has recognized community water fluoridation as one of the 10 public health achievements of the 20th century.  Fluoridation is a cost effective community heath measure for all regardless of education, socioeconomic status, or access to dental care.

The Pew Charitable Trust Foundation has developed an interactive map to show the percentage of residents served by public water systems in each state who are receiving fluoridated water.  

The map can be accessed at:http://www.pewstates.org/research/data-visualizations/fluoridation-by-the-numbers-85899538636

National Nutrition Month

The Nutrition Month 2014 theme is Enjoy the Taste of Eating Right. Consumer research suggests that people tend to purchase and eat more of the foods that taste great to them. The trick lies in convincing people that foods low in saturated fats, sodium, and added sugars and rich in color, fiber, and poly- and monounsaturated fats are tasty.

The 2012 Behavioral Risk Factor Surveillance System data and the 2011 Maine Integrated Youth Health Survey data tell us that 28% of Maine's adult and 13% of Maine's youth population are obese. These data also show that only one third of Maine's adult and youth population meet the fruit and vegetable recommendations.  Many of the most common chronic diseases that cut Maine residents' lives short are influenced by food intake, activity level, and weight status, so it's important that Maine focuses on strategies to aid people in enjoying the taste of eating right.

Here are a few suggestions from the US CDC Division of Physical Activity, Nutrition, and Obesity Prevention:

• Increase access to healthy foods
  • o   Consider which foods are readily available at work, school, and the childcare center. Aim to make the environment support the words "making the easy choice the healthy choice."
  • o   Is there a grocery store with affordable and varied produce within 10 miles of residents in rural areas? Or 1 mile in urban areas? If not, what could be done?
  • o   Is there a farmers' market in those areas that live greater than the 10 or 1 mile from a grocery store? If not what can be done about it?
  • Support farm to school and farm to institution.
    • o   Farm to School programs introduce youth to healthy foods in their natural state and often include taste testing. This has been shown to increase youth's likelihood of eating foods like fruits and vegetables.
    • o   Does your child's school have a garden? Growing a vegetable garden is another great way to create interest in eating fruits and vegetables.

For more information, visithttp://www.cdc.gov/nccdphp/dnpao/index.html

Colorectal Cancer Awareness Month

March is Colorectal Cancer Awareness Month, and Maine CDC encourages Mainers to talk with a health care provider about when and how to be tested for colorectal cancer.

The number of deaths from colorectal cancer and the number of new colorectal cancer cases diagnosed in Maine has been decreasing over the last decade due to screening and improvements in treatment. However, colorectal cancer still remains the third-leading cause of Maine cancer cases and deaths.

While many people know that early detection of cancer is important to a positive long-term outcome, some cancers such as colorectal cancer (also referred to as colon cancer) can be prevented. Colorectal cancer starts as a polyp, which is a small collection of abnormal cells in the colon or rectum. Polyps tend to grow slowly and can take many years before they become cancerous.

The recommended age to start screening is 50. There are three types of tests recommended for colorectal screening: the high-sensitivity fecal occult blood test (FOBT) or fecal immunochemical test (FIT) (annually); flexible sigmoidoscopy (every five years); and colonoscopy (every 10 years). For those younger than age 50 who have a family history of colorectal cancer, screening may start earlier.

It is important for people to talk with their health care provider about their risk for all cancers.  For additional information and resources: www.screenmaine.org/colon-cancer

Stay healthy when traveling abroad

Travel-Related Disease Conditions – 2014

Background: Maine Center for Disease Control and Prevention (Maine CDC) investigated multiple cases of travel-related illness in 2013. Cases of chikungunya, dengue fever, and malaria have been reported to Maine CDC in persons who have recently traveled or have moved to Maine from another country. Maine residents frequently travel outside of the United States during school vacation weeks in February and April, often to warmer climates, putting them at risk for vector- and food-borne diseases.

Recommendations: Many travel-related illnesses can be prevented by vaccinations, good hand hygiene, and knowledge of high-risk conditions in other countries. Maine CDC recommends that clinicians counsel patients who plan to travel, on precautions they can take to prevent travel-related illness. The federal CDC recommends vaccines based on travel destination, available at www.cdc.gov/travel. Clinicians are reminded to obtain recent travel history, especially travel outside of the US, for symptomatic patients.

Table 1: Regions for Increased Attention, Select Diseases	Caribbean	Latin America	Africa	Indian Sub-Cont.	SE Asia	W Pacific
Chikungunya is a mosquito-borne viral disease. In December 2013, local transmission was found for the first time in the Caribbean/ Americas. The best prevention is to avoid being bitten by infected mosquitoes, including wearing repellant while indoors or out.	✓		✓	✓	✓
Dengue Fever is a mosquito-borne viral illness occurring in many tropical and subtropical countries world-wide.  The best prevention for dengue is to avoid being bitten by infected mosquitoes, including wearing repellant while indoors or out.	✓	✓		✓	✓	✓
Malaria is a mosquito-borne parasitic disease, preventable by taking medication before and during travel (chemoprophylaxis). It occurs in more than 100 tropical and subtropical countries.	*Haiti	✓	✓	✓	✓
Hepatitis A is one of the most common vaccine-preventable infections acquired during travel. Transmitted through the fecal-oral route by ingesting contaminated food or water, and close personal contact, it is best prevented by vaccination and good hand hygiene.		✓	✓		✓
Shigellosis is a bacterial infection of the intestine transmitted through the fecal-oral route by ingesting contaminated food or water, and close personal contact. Like other enteric diseases, including salmonella and campylobacter, good hand hygiene is the best prevention.		✓	✓		✓

All suspected cases of travel-related illnesses that are notifiable conditions should be reported to the Maine CDC at 1-800-821-5821. If patients present with unusual symptoms, providers are encouraged to call Maine CDC for a consultation. A list of notifiable conditions is available at www.maine.gov/idepi.  

For More Information: Please contact the Maine CDC by calling the disease reporting and consultation line at 1-800-821-5821, e-mailing disease.reporting@maine.gov, or visiting the Maine CDC website at www.maine.gov/idepi. A list of travel medicine clinics in Maine can be found at www.maine.gov/dhhs/mecdc/infectious-disease/immunization/international-travel.shtml.

American Heart Month

Heart disease is the second leading cause of death in Maine and describes a variety of conditions that affect your heart and/or blood vessels including coronary artery disease, heart attack, and congestive heart failure.

You can help protect yourself and your loved ones from heart disease by understanding associated risks and taking these steps:

• Know Your ABCS:
  • Do you take Aspirin?  If your healthcare provider has said you are at risk for a heart attack, ask them about taking aspirin.
  • Do you know your Blood Pressure?  A normal blood pressure level is below 120/80.  Talk with your healthcare provider to find out your blood pressure numbers and get in control.
  • Do you know your Cholesterol Level?  A normal cholesterol level is below 200.  Talk with your healthcare provider to find out your cholesterol number and get in control.
  • Do you Smoke?  If you do, get help to quit. Smoking can raise your chances of having a heart attack or stroke.  To help you quit call the Maine Tobacco Help Line at 1-800-207-1230.
• Be physically active at least 30 minutes on most days
• Eat more fruits, vegetables, and other foods low in sodium and trans fat
• Take medication as prescribed by your doctor

Million Hearts Initiative

Million Hearts® is a national effort to prevent 1 million heart attacks and strokes by 2017. Million Hearts® brings together communities, health systems, nonprofit organizations, federal agencies, and private-sector partners from across the country to fight heart disease and stroke. 

To learn more about the initiative or to make the commitment visit: www.millionhearts.hhs.gov.

For more information about heart disease visit: http://mainehearthealth.org/.

CVS Tobacco Announcement

Maine CDC and the US Department of Health and Human Services applaud CVS Caremark Corp. for their leadership in helping to make the next generation tobacco-free.

The company's announcement that CVS/pharmacy stores will no longer sell cigarettes and other tobacco products is an unprecedented step in the retail industry. We look forward to seeing other stores and chains follow suit.

  

To see the related article in the Journal of the American Medical Association, visit http://jama.jamanetwork.com/article.aspx?articleid=1828530 

To see the statement by HHS Secretary Sebelius, visit: http://go.usa.gov/BkDH 

  

For support and resources related to tobacco cessation, visit http://tobaccofreemaine.org/ or call 1-800-207-1230

Pump Handle Awards

Maine CDC recently recognized four organizations by presenting them with the Pump Handle Award for their contributions to help reduce the impact of infectious diseases in Maine.

Camp Sunshine was honored for its quick response to an outbreak viral gastroenteritis outbreak, which led to the containment of a highly contagious virus. The camp also worked closely with the Maine CDC epidemiology and health inspections programs, providing information that allowed for surveying, follow-up on test results, and strengthened outbreak response in the community.

Mercy Hospital was recognized for its response to a highly publicized case of a rabid fox in Portland and for its decision to immediately make medication for treatment for exposure available to other healthcare systems, which were seeing a high volume of people with symptoms. The hospital also cared for five people who were exposed to rabies.

The Bangor Sexually Transmitted Disease Clinic, one of two clinics in the State, has been instrumental in Maine's ability to provide STD screening, treatment and disease surveillance in the Northern part of the state. The commitment and dedication of Clinic staff have helped many people living with HIV/AIDS know their status, get connected to important medical care and support services, and identify and test potential partners who may have been exposed to HIV.

The Maine School Nurses Association was chosen for the hard work and dedication of Maine's school nurses, particularly for their dedication to organizing and operating Maine's school located vaccine clinics. School Nurses responded to the need during H1N1 and have continued to assure availability of influenza immunization to students in the school setting because that is where children are and because as they have said, "it is the right thing to do."

The Pump-Handle Award has been given for more than a decade in Maine. The award's name is a tribute to Dr. John Snow, who is considered by many to be the father of epidemiological science. Snow identified that a public water pump was the source of a cholera outbreak in London in 1854. He convinced authorities to remove the handle of the pump, preventing any more of the infected water from being collected. The spring that fed the pump was later found to be contaminated. 

The Health Consequences of Smoking-50 Years of Progress

The Health Consequences of Smoking-50 Years of Progress: A Report of the Surgeon General was released on Jan. 17, a half century after the historic 1964 Surgeon General's report that concluded that cigarette smoking causes lung cancer. Since that time, smoking has been identified as a cause of serious diseases of nearly all the body's organs. 

Today, scientists add diabetes, colorectal and liver cancer, rheumatoid arthritis, erectile dysfunction, age-related macular degeneration, and other conditions to the list of diseases that cigarette smoking causes. In addition, the report concludes that secondhand smoke exposure is now known to cause strokes in nonsmokers.

For the full report, executive summary, consumer guide and PSA, visit http://www.surgeongeneral.gov/library/reports/50-years-of-progress/index.html.

For free help quitting smoking, visit www.tobaccofreemaine.org or call 1-800-207-1230

Prevent adult-onset occupational asthma

Isocyanates (eye-so-sigh-a-nates) are chemicals that can cause asthma and cancer, irritate the skin, eyes, nose and throat, and even cause death.  It is important for medical providers to know the health risks associated with isocyanates and be aware that patients who work in certain industries are in danger of being exposed.  The risks are so well documented that the Occupational Safety and Health Administration (OSHA) has announced an emphasis program to protect workers from exposure to isocyanates.

  

Patients potentially exposed to isocyanates may have:

• Persistent or recurring eye irritation
• Nasal congestion
• Dry or sore throat
• Cold-like symptoms
• Cough
• Shortness of breath
• Wheezing
• Chest-tightness

Direct skin contact can cause:

• Sensitization
• Inflammation
• Rash
• Itching
• Hives
• Swelling

Isocyanates are found in the following compounds:

• Paints
• Varnishes
• Foams
• Sealants

They are used in the following industries:

• Residential/commercial construction to coat cement, wood, fiberglass, steel and aluminum
• Automotive painting and spray on bed-liners
• Commercial manufacturing of ridged and flexible foams
• Boatbuilding coatings to protect boats

  

When dealing with a patient, medical providers should consider that patient's occupation and work environment. Isocyanates are powerful irritants to the eyes, gastrointestinal, and respiratory tracts. Isocyanates can sensitize a patient through skin contact which means a patient could be subject to a severe asthma attack if they come into contact again (death from severe asthma in some sensitized subjects has been reported).  Isocyanates cannot easily be washed off skin or clothing because they are not water soluble.  OSHA is hoping that by focusing on this problem it will raise physician awareness of the risk, reduce employee exposure, and lessen the overall negative health effects associated with isocyanates. 

  

For more on the National Emphasis Program, visit: http://go.usa.gov/Zp7h (See appendix C for a patient questionnaire.)

 

Maine Youth and Suicide Prevention

Maine youth are making healthier choices, including smoking and drinking less, but are increasingly struggling with their emotional wellbeing.

Those findings and other insights directly from tens of thousands of Maine students about their health and habits are detailed in the newly released results of the 2013 Maine Integrated Youth Health Survey (MIYHS).

The survey, which has been given every odd year since 2009, is a collaboration of the Maine Department of Education and the Maine Center for Disease Control and Substance Abuse and Mental Health Services in the Department of Health and Human Services. The results inform prevention and program planning, as well as future funding proposals.

While students largely feel more supported by parents, teachers and their communities, they also admit they are increasingly struggling with feelings of sadness and hopelessness. At the high school level, 14.6 percent of students said they have seriously considered attempting suicide, and 16.8 percent of seventh and eighth graders said the same. 

In October, Maine was one of six states awarded a 3-year federal Substance Abuse Mental Health Services Administration grant, which will expand statewide education, training, and outreach services and offers new screening, assessment, treatment and follow-up services for youth to age 24 at risk for suicide.

The Maine Suicide Prevention Program is collaborative initiative among: the Departments of Health and Human Services, Education, Corrections, Labor, Public Safety, and Veteran's Affairs; advocacy organizations like American Foundation for Suicide Prevention, NAMI ME; crisis agencies; parents, survivors and young adults.

Although suicide is a rare event, we must encourage and support our youth and young adults who may be feeling overwhelmed and hopeless to reach out to a trusted adult who will provide support and connect them to helping resources, such as:

• Statewide Crisis Hotline: 1-888-568-1112 - connects callers to crisis service provider in area from which they are calling. This is for ALL individuals in crisis to provide immediate, local assistance in a crisis situation. The crisis worker will ask what is going on and ask about everyone's safety to help figure out what kind of help is need. If you believe a person might be in danger of suicide, call the statewide crisis hotline or the police (911) to keep the person safe if needed.

• Statewide Information Resource Center (IRC): 1-800-499-0027 Office of Substance Abuse and Mental Health Services IRC has suicide prevention informational materials for adults and teens including: print and audio/visual educational materials, Maine and national data, etc.

For more information:

• Maine Suicide Prevention Program: www.maine.gov/suicide

• Maine Integrated Youth Health Survey summary results and press release: at http://mainedoenews.net/category/news-views/press-releases/

• 2013 Maine Integrated Youth Health Survey result: https://data.mainepublichealth.gov/miyhs/

Update on tickborne diseases

The deer tick can remain active in its adult stage from fall to spring as long as the temperature is above freezing. The tick will remain alive, but inactive when temperatures are below 40 degrees Fahrenheit.

Maine CDC saw increased numbers of tickborne disease reports in 2013, including multiple cases with onset of symptoms as late as December and the first documented case of Powassan encephalitis in the state since 2004. Providers should continue to consider tick borne illnesses, even during the winter months.

For more information, see the update from Dec. 18 at http://go.usa.gov/ZpAG 

Cervical Cancer

January is Cervical Cancer Awareness Month.

Before the development of the Pap test, cervical cancer was one of the most common causes of cancer death for American women.  As an available, accepted, and cost-effective screening test, the Pap test can detect cervical cancer early when treatment is most effective. If women receive regular screenings, the Pap test can detect cervical cell changes before they become cancerous.

Help is available for qualifying women age 40 and older who are in need of breast or cervical screening tests. The Maine CDC Cancer Prevention and Control programs can provide information about cancer screening tests as well as resources for free cancer screenings.

Interested women are encouraged to call 1-800-350-5180 or 1-207-287-8068. TTY users should call Maine Relay at 711. 

For more information, visit http://go.usa.gov/ZpFh 

Flu update 1/9/14

Influenza activity in Maine is widespread with laboratory confirmed influenza reported in all counties. Influenza A/pH1N1, Influenza A/H3, and influenza B have been confirmed in Maine indicating all three strains are circulating.  Maine CDC has followed up on six outbreaks of influenza as of Tuesday, January 7th. Influenza vaccination is still strongly encouraged and is widely available, especially to protect those persons at risk of severe disease.  The vaccine appears to be a good match to the circulating strains this year, and it is not too late to get vaccinated.  

For more information, see the Health Alert from Dec. 26 about Early Reports of pH1N1-Associated Illnesses for the 2013-14 Influenza Season at http://go.usa.gov/Zp6w and the Health Alert from Jan. 8 about Widespread Influenza Activity in Maine at http://go.usa.gov/ZdAj

Weekly updates on flu activity 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

In addition, people and clinicians may review or anonymously report flu at www.flunearyou.org  

Prevention 

Take everyday preventive measures against the flu:

• Wash your hands frequently with soap and water, but especially after coughing and sneezing. Alcohol-based hand gels can also be used.
• Avoid touching your nose, mouth, and eyes. Germs can spread this way.
• Consult your health care provider about getting a pneumococcal vaccine for anyone who is younger than 5, between ages 5 and 64 with high risk conditions, or age 65 and older.
• Avoid contact with sick people. If you are at very high risk for complications, you may want to avoid large crowds.

Vaccination

There is still time to get vaccinated against the flu for this season. Full immunity develops 7-10 days after the vaccine is administered. To find locations where vaccine is available, contact your health care provider or pharmacy, call 211, or visit www.211maine.org  or www.flu.gov 

Maine CDC recommends that Health Care Providers continue vaccinating to protect against influenza this year. To ensure that vaccine is available for all Maine people who are seeking it, please use the following as guidelines:

Health Care Providers should use state-supplied vaccine for patients in the following circumstances:

• The patient is a child ages 6 months through 18 years;
• The patient is pregnant or the partner of a pregnant patient;
• The patient's insurance does not cover vaccinations;
• The patient is uninsured.

Health Care Providers may use state-supplied vaccine for other patients only if:

• The Health Care Provider has already vaccinated all eligible patients listed above and has excess state-supplied vaccine; and
• Privately purchased vaccine is not available.

Please remember that providers may not charge for state-supplied vaccine. It is reasonable and allowable to charge an administration fee for administration of state-supplied vaccine in some circumstances provided that:

1. MaineCare-eligible children are not charged an out of pocket administration fee;
2. Administration fees do not exceed the regional Medicare maximum; and
3. No one is denied vaccine because of their inability to pay an administration fee.  

Treatment

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

For more information, visit www.maineflu.gov. 

Birth Defects

January is National Birth Defects Prevention Month and this year’s theme is “Birth defects are common, costly, and critical.”

Every 4.5 minutes, a baby is born in the U.S. with a birth defect. Major birth defects are conditions present at birth that cause structural changes in one or more parts of the body. They can have a serious adverse effect on health, development, or functional ability. Babies who survive and live with birth defects are at increased risk for developing many lifelong physical, cognitive, and social challenges. Medical care and support services only scrape the surface of the financial and emotional impact of living with birth defects.

Not all birth defects can be prevented, but a woman can increase her own chances of having a healthy baby by managing health conditions and adopting healthy behaviors before becoming pregnant. This is important because many birth defects happen very early during pregnancy, sometimes before a woman even knows she is pregnant. Here are some steps a woman can take to get ready for a healthy pregnancy:

• consume 400 micrograms of folic acid daily
• manage chronic maternal illnesses such as diabetes, seizure disorders, or phenylketonuria (PKU)
• reach and maintain a healthy weight
• talk to a health care provider about taking any medications, both prescription and over-the-counter
• avoid alcohol, smoking, and illicit drugs
• see a health care provider regularly
• avoid toxic substances at work or at home
• ensure protection against domestic violence
• know their family history and seek reproductive genetic counseling, if appropriate

For more information, visit http://go.usa.gov/Zd8w or http://go.usa.gov/Zd9x