Thursday, July 24, 2014

Public Health Update 7/24/14

Mosquito-borne diseases

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: 
Weekly arboviral surveillance reports will be posted to the following website through October: 


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, see

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 or 
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 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 

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
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 

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. 
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 

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