The Importance of Influenza Vaccination Among Health Care Workers in Maine

Preventing transmission of influenza in healthcare settings requires a multifaceted approach that includes rapid identification of patients with influenza and institution of precautions, using masks where appropriate, keeping ill visitors away, emphasizing hand hygiene to prevent the spread of influenza, and using respiratory etiquette. In addition, all health care workers should be vaccinated against influenza virus.

Who is a Health Care Worker?

Health Care Workers (HCW) are personnel who work in acute care hospitals, nursing homes, skilled nursing facilities, physician offices, urgent care centers, outpatient clinics, and home health care agencies. Those working in clinical settings within non-health care institutions, such as school nurses or those staffing clinics in correctional facilities are also considered HCW.

HCW include all people whose occupational activities involve contact with patients or contaminated material in health care settings, including home health care or clinical laboratory settings. This includes those who do not provide direct patient care, but have patient contact, such as personnel involved in dietary and housekeeping services. HCW include all contractors, clinicians, volunteers, students, trainees, clergy, and others who come in contact with patients.

Why should Health Care Workers get vaccinated against the flu?

HCW have a special role in the fight against influenza.

1. By getting vaccinated themselves, HCW can protect their health, their families’ health, and the health of their patients.
2. Encouraging vaccination of vulnerable patients can protect them from the flu.
3. High rates of vaccination among HCW have been linked to improved patient outcomes and reduced absenteeism and flu infection among staff.

US CDC, Maine CDC, and other professional groups recommend that all HCW get annual influenza vaccine. However, fewer than half of HCW nationwide get the flu vaccine. With the emergence of the pandemic H1N1 flu in 2009, Maine CDC required health care facilities to report the rate of their workers vaccinated against H1N1. The rates for hospitals, home health, long-term care facilities, and other providers are listed in the following tables.

Hospital Vaccination 2009 H1N1 Influenza Vaccination Rates
Rate	Facility
Vaccination rate between 75% and 100%	Calais Regional Hospital (76%)
	Cary Medical Center (80%)
	MaineGeneral - Augusta Campus (76%)
	MaineGeneral - Waterville Campus (81%)
	Northern Maine Medical Center (75%)
	Penobscot Valley Hospital (97%)
	Sebasticook Valley Hospital (93%)
Vaccination rate between 50% and 74%	Blue Hill Memorial Hospital (55%)
	Bridgton Hospital (69%)
	Down East Community Hospital (58%)
	Eastern Maine Medical Center (65%)
	Houlton Regional Hospital (70%)
	Inland Hospital (50%)
	Maine Coast Memorial Hospital (63%)
	Maine Medical Center (66%)
	Mayo Regional Hospital (60%)
	Mercy Hospital (59%)
	Mid Coast Hospital (69%)
	Millinocket Regional Hospital (73%)
	Parkview Adventist Medical Center (63%)
	Redington Fairview General Hospital (60%)
	Rumford Hospital (72%)
	Southern Maine Medical Center (64%)
	St. Joseph Health Care (70%)
	St. Mary's Health System (52%)
	The Aroostook Medical Center (50%)
	Waldo County General Hospital (57%)
	York Hospital (54%)
Vaccination rate less than 50% or no reported rate	Central Maine Medical Center (NR)
	Charles A. Dean (25%)
	Franklin Memorial Hospital (NR)
	Goodall Hospital (0%)
	Miles Memorial Hospital (NR)
	Penobscot Bay Medical Center (NR)
	Spring Harbor Hospital (48%)
	St. Andrews Hospital (NR)

Non-Hospital Health Care Facility 2009 H1N1 Influenza Vaccination Rates
Rate	Facility
Vaccination rate between 75% and 100%	Bridgton Health Care Center (89%)
	Calais Regional Hospital Home Health (83%)
	HealthReach Network (79%)
	KVCAP Family Planning (80%)
	MaineGeneral – Glenridge (75%)
	MaineGeneral - Gray Birch (76%)
	MaineGeneral - Inn @ City Hall (90%)
	MaineGeneral Rehab & Nursing Care (77%)
	Professional Home Nursing (89%)
Vaccination rate between 50% and 74%	Acadia Hospital (50%)
	Ash Street (73%)
	Clover Manor Inc (55%)
	Downeast Health Services (58%)
	Family Planning Association of Maine (55%)
	Fryeburg Health Care & Residential Center (61%)
	Home Health Visiting Nurses (62%)
	Jackman Region Health Center (67%)
	Katherine Brown Home (56%)
	Klearview Manor (59%)
	Lincoln County Health Care (59%)
	Madigan Estates N.H. (53%)
	Madigan Home Health Care (67%)
	Maine Veteran's Home- Caribou (56%)
	Mount Desert Nursing Association (67%)
	Pine Point Center (51%)
	Riverview Psychiatric Center (61%)
	Sanfield Rehab & Living Center (73%)
	South Portland Nursing (72%)
	Stephen's Memorial Hospital (74%)
Vaccination rate less than 50%	Accent HealthCare Services (0%)
	Accomplished Professionals (0%)
	Anytime Servies for Seniors Inc. (0%)
	Apria Healthcare (18%)
	Aroostook Home Health Services – Caribou (23%)
	Aroostook Home Health Services - Fort Kent (10%)
	Aroostook Home Health Services Houlton (22%)
	Ask for Home Care (12%)
	Assistance Plus (0%)
	Atlantic Home Health Inc. (0%)
	Atlantic Rehab Nursing Center (0%)
	Augusta Rehab Center (20%)
	Bangor Nursing Rehab Center (16%)
	Beacon Hospice (0%)
	Borderview Rehab & Living Center (16%)
	Brewer Rehab & Living Center (0%)
	Caribou Rehab and Nursing (45%)
	Caring Way Inc. (0%)
	Casa ICF (35%)
	Coastal Manor (2%)
	Community Health & Counseling Services (8%)
	Courtland Rehab & Living Center (15%)
	Cummings Health Care Facility (0%)
	Danforth Habilitation Association (9%)
	Dorothea Dix Psychiatric Center (45%)
	Durgin Pines (0%)
	Eastern Maine Home Care (3%)
	Eastern Maine Home Care/ VNA (3%)
	Eastside Rehab & Living Center (0%)
	Falmouth By The Sea (15%)
	Forest Springs (0%)
	Forest Springs Community Living Assoc. (9%)
	Freeport Nursing & Rehab Center (7%)
	Genesis Healthcare- Marshwood Center (43%)
	Gentiva Health Services (22%)
	Gentiva Home Health (29%)
	Gorham House (0%)
	Granite Hill Estates (49%)
	Greenwood Center (0%)
	Harmony (0%)
	Harmony Community Living Association (13%)
	Harris House (24%)
	Hibbard Nursing Home Inc. (2%)
	Highview Rehab & Living Center (0%)
	Home, Hope, and Healing Inc. (0%)
	Independent Health Care Services (0%)
	Katahdin Nursing Home (0%)
	Kennebec Nursing & Rehab Center (0%)
	Ledgeview Living Center (5%)
	Maine Medical Partners (34%)
	Maine Veteran’s Home – Augusta (36%)
	Maine Veteran’s Home – Bangor (0%)
	Maine Veteran’s Home – Machias (0%)
	Maine Veteran’s Home – Scarborough (0%)
	Maine Veteran's Home - South Paris (33%)
	Market Square Nursing Facility (44%)
	Marsh River Group Home (0%)
	Marshall HealthCare (0%)
	Maxim Healthcare Services (15%)
	Mount Desert Island Hospital (46%)
	Mount St. Joseph (35%)
	MSMF (39%)
	Narraguagus Bay Health Care (0%)
	New England Rehab Hospital (46%)
Oak Grove Center (0%)
Oceanview Nursing Home & Res Care (0%)
Odd Fellows HCC (27%)
Orchard Park Rehab & Living Center (33%)
Orono Commons (41%)
Piper Shores (0%)
Presque Isle Rehab & Nursing Center (33%)
Professional Relief Nurses (0%)
River Ridge (0%)
Rumford Community Home (2%)
Schooner Retirement Community Inc. (21%)
Sedgewood Commons (0%)
SMMC Visiting Nurses (28%)
Somerset Rehab & Living Center (0%)
Sonogee Rehab & Living Center (0%)
Springbrook Center (0%)
St. Andre Health Care (47%)
St. Joseph Nursing Home (0%)
St. Jospeh's Manor (26%)
Sunrise Care Facility (25%)
Tall Pines Rehab & Living Center (0%)
Teakwood (29%)
Tebolt & Bolduc Inc. (0%)
The Cedars (0%)
Treat Falls House (2%)
Valley Home Health Services – Caribou (31%)
Valley Home Health Services – Fort Kent (10%)
Valley Home Health Services – Houlton (10%)
Varney Crossing Nursing Care Center (0%)
Westgate Manor (36%)
Windward Gardens (32%)
Winthrop Manor Inc. (0%)
No reported rate	Amenity Manor
	Barron Center
	Brentwood Rehab & Nursing Center
	Cedar Ridge Center
	Cedars Nursing Care Center
	Collier's Rehab & Nursing Center
	Colonial Health Care
	Country Manor Nursing Home
	Cove's Edge
	Dexter Health Care
	Eastport Memorial Nursing Home
	Edgewood Rehab & Living Center
	Evergreen Manor
	Forest Hill Manor
	Gardiner Health Care Facility
	Gregory Wing of St. Andrews Village
	Harbor Hill Center
	Hawthorne House
	Heritage Rehab & Living Center
	Island Nursing Home
	Knox Center for Long Term Care
	Lakewood
	Ledgewood Manor
	Maplecrest Rehab & Living Center
	Marshwood Center
	Mercy Home
	Mid Coast Senior Health Center
	Montello Manor
	Mountain Heights Health Care Facility
	Norway Rehab & Living Center
	Penobscot Nursing Home
	Ross Manor
	Russell Park Rehab & Living Center
	Sandy River Center
	Seal Rock Health Care
	Seaside Rehab & Health Care
	Sebasticook Valley Health Care
	St. Mary's D'Youville Pavilion
	Stillwater Health Care
	The Commons at Tall Pines
	The Gardens
	The Newton Center for Rehab & Nursing Care
	Victorian Villa
	Winship Green Nursing Center
	Woodlawn Rehab & Nursing Center

World Rabies Day

Today Maine CDC recognizes the third annual World Rabies Day. US CDC and the Alliance for Rabies Control, a UK charity, established this day in 2007 to raise awareness about rabies, which kills more than 50,000 people worldwide each year.

Rabies is a deadly disease caused by a virus. Rabies is 100% preventable by avoiding wild animals and any animal that you do not know, or by getting rabies shots if an exposure already occurred. A rabies exposure happens when a person or animal comes into contact with the saliva or tissue from the nervous system (brain or spinal cord) of a rabid animal. This contact can be from a bite or scratch, or if the animal’s saliva gets into a cut in the skin or in the eyes, nose, or mouth.

Rabies in people is very rare in the United States, with only one to two cases each year. The last human case of rabies in Maine was in 1937, but this does not mean that rabies is not a problem. Rabies in animals, especially wildlife, is common in most parts of the country, including Maine. The most commonly infected animals in Maine are raccoons, skunks, bats, and foxes. To date this year, 52 animals have tested positive for rabies.

If you think that you have been exposed to rabies, wash the wound right away with soap and water. Then, call your doctor and the Maine CDC at 1-800-821-5821 to evaluate the need for animal testing and rabies shots. In addition, if you or your pet is exposed to a suspected rabid animal, call your veterinarian and local Animal Control Officer. If you or your pet is exposed to a wild animal, call your local Game Warden.

Follow these steps to prevent rabies:

• Vaccinate your pet cats and dogs against rabies; it is the law.
• Avoid contact with wild animals or other animals that you do not know.
• Bat-proof your home. Wildlife biologists can provide tips on how to bat-proof your home without harming bats.

For more information about rabies, visit the Maine CDC website at www.mainepublichealth.gov/rabies.

Health Reform Update

Health Reform and Public Health

Health reform has many implications for public health. Learn more by viewing or using the Power Point titled “Health Reform and Public Health” on this website: http://www.maine.gov/dhhs/boh/mills_presentations.shtml.

Maine CDC Awarded Public Health Infrastructure Grant

Maine CDC has received an award of $1.76 million per year for five years from the U.S. Department of Health and Human Services for improvements to Maine’s public health system.

The goal of these funds includes improving health departments’ performance management capacity and the ability to meet national public health standards to make programs and people in the public health system more efficient and effective. In Maine, these funds will: complete an electronic death certificate system; make necessary updates to an electronic birth certificate system; build systems to allow health care providers to more easily transfer information on immunizations to Maine CDC; apply public health performance management principles in Maine CDC and its work; improve capacity for health planning at the state and district level; and make public health data more accessible.

The grant is funded by the Affordable Care Act of 2010 and will be administered by US CDC.

For more information: http://www.maine.gov/tools/whatsnew/index.php?topic=DHS+Press+Releases&id=133134&v=article

Other Health Reform Updates

This web chat (http://www.healthcare.gov/news/blog/webchat_behavioralhealth.html) has information on how the Affordable Care Act will help improve behavioral health.

HealthCare.gov has posted updated information (http://www.healthcare.gov/foryou/youngadults/soon/index.html) for young adults about improvements to health care that are coming soon.

The Kaiser Family Foundation has launched an online resource on the health reform law, which provides explanations of the basics of the law, in-depth analysis of policy issues in implementation, and quick and easy access to relevant data, studies and developments. The Health Reform Source is accessible at: http://healthreform.kff.org

For more information about Health Reform in Maine, visit the Governor’s Office of Health Policy and Finance’s web site: http://www.maine.gov/healthreform/

Flu update

Flu information for the general public

US CDC recommends that everyone 6 months of age and older be vaccinated against the flu this year. Getting a flu vaccine is easy, and it is the single best way to protect yourself and your loved ones from flu. Vaccine is already available in many places, and it will provide protection through the entire flu season.

The 2010-2011 flu vaccine will protect against:

· an influenza A H3N2 virus,

· an influenza B virus, and

· the 2009 H1N1 virus that caused so much illness last season.

You need to get the 2010-11 seasonal flu vaccine even if you got the 2009 H1N1 flu vaccine last season.

Over the years, hundreds of millions of people in the U.S. have safely received seasonal flu vaccines. Last flu season, about 80 million people in the U.S. also received the vaccine made to protect against the 2009 H1N1 virus, and the vaccine’s safety was similar to that of seasonal flu vaccines. Over the last 50 years, flu vaccines have been shown to be safe. Every year, CDC works closely with FDA, health care providers, state and local health departments, and other partners to ensure the highest safety standards for flu vaccines. CDC also works closely with FDA to ensure systems are in place to promptly detect unexpected health problems following vaccination.

Update on distribution

Most influenza vaccine arrives in Maine through private sector channels, but some federal and state funds allow Maine CDC to purchase flu vaccine for some populations in Maine such as pregnant women, those in nursing homes, K-12 school children and their teachers and other staff, all other children, homeless, and people served by municipal and tribal health departments. Maine CDC will be distributing a total this year of about 290,000 doses of influenza vaccine, most of it over the coming weeks.

Doses Approved for Shipment as of Sept. 22:

Population	Doses
Children ages 6 months to 18 years	77,070*
Adults	27,100
Nursing homes and long-term care facilities	11,230
Total	115,400

* This includes doses shipped to both schools and private health care providers.

Number of schools that have received flu vaccine so far: 81

Number of doses distributed to schools so far: 20,590

All health care providers who have fulfilled the requirements in their provider agreements have received some vaccine toward their orders. If you are a provider who has not yet received vaccine, ensure that you have submitted all the appropriate paperwork and temperature logs.

Flu resources

Maine CDC has posted materials – including registration forms, consent forms, and sample protocols – for those participating in school-based flu vaccine clinics at: http://www.maine.gov/dhhs/boh/maineflu/h1n1/educators.shtml#schoolclinics

A zip code searchable flu clinic locator will be available at www.flu.gov shortly.

A conference call for those participating in school-based vaccine clinics will be held at 3 p.m. Wednesday, Oct. 6. The phone number is 1-800-914-3396 with the pass code 473623#. During calls, please press *6 to mute your line un-mute when you are actively participating.

Federal guidance and updates

• For health care workers: http://www.flu.gov/professional/hospital/hcworkers_vaccine.html
• For school administrators: http://www.flu.gov/professional/school/k12administrators.html and http://www.flu.gov/professional/school/cleaning.html
• This MMWR reviews parental attitudes and experiences during school dismissals related to 2009 H1N1 flu last year: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5935a2.htm?s_cid=tw_mmwr21
• This National Institutes of Health press release describes how NIH continues to study the spread of H1N1: http://www.nih.gov/news/health/sep2010/nigms-21.htm
• Other updates from the US CDC can be found on its Influenza Site: http://www.cdc.gov/flu/whatsnew.htm

Protect Your Groundwater

It's National Protect Your Groundwater Day. Nearly 2/3 of Maine people get their drinking water from groundwater, so we have a large stake in protecting our groundwater quality and quantity in Maine. We can all use this day to begin doing our part for protecting one of our most important natural resources — our groundwater!

Some things you can do to help protect our groundwater:

• Properly maintain your septic system: make sure to have your septic tank pumped every 3 to 5 years and check for signs that your septic system is not working
• Handle gasoline, motor oil, fertilizers, pesticides and other hazardous chemicals with care, making sure not to dump them on the ground or pour them down the sink. When you’re done with them, dispose of them properly at a recycling center
• Inspect your heating oil tank and its piping to make sure it’s not leaking, starting to corrode or rust, or in danger of tipping over
• Don’t throw away or flush unused or unwanted medications down the drain. Instead, properly and safely dispose of them by using Maine’s Safe Medicine Disposal for ME free medication mailback program

For more information on Protect Your Groundwater Day, or to learn more ways you can protect groundwater, visit http://www.ngwa.org/public/PYGD/pygd.aspx. For information on public water systems visit the Maine CDC Drinking Water Program website at www.medwp.com. For more information on private wells, visit http://wellwater.maine.gov.