Group A strep

Maine CDC is investigating an increase in the number and severity of invasive group A Streptococcal (GAS) infections in the first half of 2015 compared to a similar time frame in previous years.  Maine CDC received reports of 15 cases of invasive GAS in April and the first week of May alone, almost half of the 33 cases reported to date this year.  Of those 15 cases, six resulted in streptococcal toxic shock syndrome (STSS), a more serious presentation in which the disease affects multiple organs.  At this time in 2014, Maine had reports of 23 cases of invasive GAS and nine cases of STSS. 

Most GAS infections are relatively mild such as “strep throat,” scarlet fever or impetigo.  Invasive GAS disease is more severe and includes pneumonia, cellulitis and the least common forms but most severe forms -- necrotizing fasciitis and STSS. 

Invasive GAS infections are seasonal, peaking December through April. The spread of GAS can be prevented by good hand washing, especially after coughing and sneezing.  People with sore throats diagnosed as strep throat should stay home from work, school or day care until 24 hours after taking antibiotics.

Recommendations: 

Health care providers should consider invasive GAS in any patient who presents with early signs of STSS and should collect culture specimens and consider prompt antibiotic treatment. Because invasive GAS infections can progress rapidly, providers are encouraged to be familiar with early signs of STSS:

• Fever
• Abrupt onset of generalized or localized severe pain, often in an arm or leg
• Dizziness
• Influenza-like syndrome
• Confusion
• A flat red rash over large areas of the body (occurs in 10% of cases)

Reporting requirements:

All cases of suspected invasive GAS and STSS should be reported by phone to the Maine CDC at 1-800-821-5821, or by fax to 1-800-293-7534.

For more information:

• Maine CDC’s Group A Strep webpage: http://www.maine.gov/dhhs/mecdc/infectious-disease/epi/airborne/group-a.shtml

 US CDC’s Group A Strep webpage:  http://www.cdc.gov/groupastrep/

Maine CDC Public Health Update 12/13/12

Pertussis (whooping cough)

Thirty cases of pertussis (whooping cough) have been reported in children younger than 1 year old in Maine so far this year. Maine CDC has issued new clinical guidance for providers treating infant pertussis. It is available on the Maine CDC website.

In total, more than 660 cases of pertussis have been reported in Maine this year, with the majority in children ages 7 to 19. Reported cases appear to be on a downward trend.

Weekly updates on pertussis in Maine are posted to www.mainepublichealth.gov on Thursdays.

DTaP vaccine is recommended for all infants and children. Tdap vaccine is recommended for all preteens, teens, and adults.

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


Recent health alerts

• Group A Strep: Maine CDC is investigating a cluster of invasive Group A Streptococcal (GAS) infections in patients who have reported a history of injecting bath salts. Four cases of invasive GAS have been reported among persons aged 23-37 years, two of which resulted in Streptococcal Toxic Shock Syndrome (STSS). All cases reported injecting bath salts, all required hospitalization, one required intensive care, and one had necrotizing fasciitis. All four cases are from Aroostook and Penobscot counties. The health alert is at: http://go.usa.gov/gPfj

• Gonorrhea: Gonorrhea is a sexually transmitted disease caused by the Neisseria gonorrhoeae bacterium. Gonococcal infection is reportable to Maine CDC within 48 hours of recognition or strong suspicion of disease. In men, common symptoms include burning sensation when urinating or a white, yellow or green penile discharge. In women, symptoms are uncommon, but may include painful or burning sensation when urinating or increased vaginal discharge. Gonorrhea is a major cause of serious reproductive complications in females. Case reports of gonorrhea in Maine have been increasing in recent years from 96 cases in 2008 to 272 cases in 2011. The health alert is available at: http://go.usa.gov/gPf5

Influenza

Maine CDC reported regional flu activity for the week ending Dec. 8. Weekly updates 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

Maine CDC reminds everyone to take everyday preventive measures against the flu: 

• Wash your hands frequently
• Cough and sneeze into your elbow or shoulder
• Stay home when you feel sick
• Get vaccinated – find locations at www.flu.gov

America's Health Rankings

Maine ranked ninth overall (up from tenth last year) in the recently released America’s Health Rankings by the United Health Foundation.

These rankings are used to stimulate action by individuals, elected officials, medical professionals, public health professionals, employers, educators and communities to improve the health of the population of the U.S.

For more information, visit http://www.americashealthrankings.org/ME


HIV and hepatitis screenings

Recently, the U.S. Preventive Services Task Force (USPSTF) issued draft recommendations pertaining to HIV and viral hepatitis screening and is inviting public comments on both.


The Task Force is an independent group of national experts in prevention and evidence-based medicine that works to improve the health of all Americans by making evidence-based recommendations about clinical preventive services.

The draft recommendation for HIV screening applies to all people aged 15 to 65 and all pregnant women. Public comments can be submitted online until December 17.

Public comments on the draft recommendations for screening adults for hepatitis C virus infection can be submitted online until December 24.

For more information and to submit comments, go to http://www.uspreventiveservicestaskforce.org/index.html