Hepatitis B Vaccination for Adults with Diabetes

In recognition of Hepatitis Awareness Month, Maine CDC is featuring a three-part series on viral hepatitis in public health updates released in May.

Part 2: Hepatitis B Vaccination for Adults with Diabetes Mellitus

CDC's Advisory Committee on Immunization Practices (ACIP) now recommends hepatitis B vaccination for all unvaccinated adults with diabetes who are younger than 60 years of age. Vaccination should occur as soon as possible after diagnosis of diabetes, and vaccination should also be given to adults diagnosed with diabetes in the past.

Vaccination requires 3 doses at 0, 1, and 6 months, although other schedules are available. Longer intervals between doses are possible so that it is not necessary for patients to make extra medical visits for vaccination. However, longer intervals will leave adults with diabetes at risk for hepatitis B infection until the vaccination series is completed.

On the basis of available information about hepatitis B virus (HBV) risk, morbidity and mortality, available vaccines, age at diagnosis of diabetes, and cost-effectiveness, ACIP recommends the following:

• Hepatitis B vaccination should be administered to unvaccinated adults with diabetes mellitus who are aged 19 through 59 years (recommendation category A; evidence type 2).
• Hepatitis B vaccination may be administered at the discretion of the treating clinician to unvaccinated adults with diabetes mellitus who are aged ≥60 years (recommendation category B; evidence type 2).

For more information:

• CDC Expert Commentary on Hepatitis B Vaccine for Adults with Diabetes
• Use of Hepatitis B Vaccination for Adults with Diabetes Mellitus: Recommendations of the Advisory Committee on Immunization Practices (ACIP) 
• www.mainepublichealth.gov/hep

Celebrate Drinking Water Week: May 5-11, 2013

This week is National Drinking Water Week– a time to highlight the importance of a safe, reliable drinking water supply to our overall quality of life – from public health protection and fire suppression to the critical role it plays in supporting the economy.


Maine CDC works together with water utilities and water system owners and operators to protect and conserve our precious drinking water sources. Nearly 850,000 Maine residents and visitors are provided safe and secure drinking water each day by more than 1,900 public drinking water systems, ranging in size from a drinking fountain at a roadside rest area to a large metropolitan drinking water system.

If your drinking water is supplied by a public water system, you can be assured that the water you receive is regularly monitored and tested to ensure that it meets federal and state drinking water standards and is safe to drink.

If you rely on your own private well for drinking water, the Maine CDC recommends that well owners test their water annually for bacteria, nitrate, and nitrite and every three to five years for arsenic, radon, uranium, lead, and fluoride.

For more information about private wells, visit http://wellwater.maine.gov. For information about public water systems, visit www.medwp.com.

Lyme disease

May is also Lyme Disease Awareness Month. Lyme disease is the most common vectorborne disease in Maine. Ticks are already out, and we expect the number of Lyme disease cases to increase as the weather continues to get warmer. Anaplasma, Babesia, and other tickborne diseases are also increasing in Maine.


Maine CDC has issued a health alert (available at http://go.usa.gov/Tmkd) to provide general information regarding ticks and Lyme disease; remind providers to report cases of Lyme disease; provide resources on diagnosis and treatment of Lyme disease; and remind providers about other tickborne diseases in Maine.

Information about Lyme Disease Awareness Month is available at http://go.usa.gov/yTS

For general information about Lyme disease, visit http://go.usa.gov/yTh

Vaccinating MSM against Hepatitis A and B

In recognition of Hepatitis Awareness Month, Maine CDC is featuring a three-part series on viral hepatitis in public health updates released in May.


Part 1: Vaccinating MSM against Hepatitis A and B

Men who have sex with men (MSM) are at elevated risk for certain sexually transmitted diseases (STDs), including Hepatitis A, Hepatitis B, HIV/AIDS, syphilis, gonorrhea, and chlamydia. Despite the availability of safe and effective vaccines, many MSM have not been adequately vaccinated against viral hepatitis. Approximately 15%–25% of all new Hepatitis B virus (HBV) infections in the United States are among MSM. The Advisory Committee on Immunization Practices recommends Hepatitis A and Hepatitis B vaccination for MSM. Because of higher rates of infection among this population, CDC also recommends testing MSM for chronic HBV infection. For free adult hepatitis vaccine sites: http://go.usa.gov/TmWA

For more information: http://go.usa.gov/TmWJ

Dense breast tissue

As directed by LD 1886 Resolve Directing Review of Strategies to Improve Communication between Patients and Physicians, a work group met in the Summer of 2012 to address the issue of breast cancer screening in women with dense breast tissue.


The work group reviewed breast imaging standards, the federal Mammography Quality Standards Act, and breast imaging reporting requirements and their impact on reporting of screening mammography results when dense breast tissue is noted by the interpreting physician.

The work group had a full discussion of issues associated with early detection breast cancer screening options for women with dense breast tissue, including input from both the patient and health care provider perspective.

The work group developed recommended strategies for improving communication between patients and health care providers when a screening mammogram demonstrates dense breast tissue. A copy of the LD 1886 Resolve Work Group Final Report and recommended strategies is available on the Maine CDC website.

National Public Health Week

It’s National Public Health Week. This year’s theme is “Public Heath is ROI: Save Lives, Save Money.”


The American Public Health Association released a new video supporting the theme:



Daily themes for the week include health and safety in the home (Monday), school (Tuesday), workplace (Wednesday), while traveling (Thursday), and in your community (Friday).

For more information, visit http://www.nphw.org/

Salmonella

Salmonella infections don’t just come from contaminated food—they can come from contact with animals, too. Many Salmonella infections occur in people who have contact with certain types of animals. In 2012, there were two records involving outbreaks of human Salmonella infections linked to live poultry: 

1. Eight outbreaks were reported which was more than any year in history and these outbreaks resulted in more than 450 illnesses –and-
2. The largest outbreak of human Salmonella infections linked to backyard flocks in a single year occurred.

Chicks, ducklings, and other poultry can carry Salmonella. Live poultry may have Salmonella germs in their droppings and on their bodies (feathers, feet, and beaks) even when they appear healthy and clean.

 

While it usually doesn't make the birds sick, Salmonella can cause serious illness when it is passed to people. Salmonella germs can cause a diarrheal illness in people that can be mild, severe, or even life threatening. Infants, seniors, and those with weakened immune systems are more likely than others to develop severe illness. These simple steps will help protect yourself and others from getting sick:

• Wash hands thoroughly with soap and water right after touching live poultry or anything in the area where they live and roam. Adults should supervise hand washing for young children.
• Clean any equipment or materials associated with raising or caring for live poultry outside the house, such as cages or feed or water containers.
• Never bring live poultry inside the house, in bathrooms, or especially in areas where food or drink is prepared, served, or stored, such as kitchens, or outdoor patios.

 

Learn more about the risk of human Salmonella Infections from live poultry here.

 

 

Groundwater: Out of sight, but not out of mind

National Groundwater Awareness Week, March 10-16, 2013, is a good time for the owners of household drinking water wells to test their water as managers of their own, personal drinking water system. 

 

The Maine CDC recommends that private well owners test their water annually for bacteria, nitrate, and nitrite and every three to five years for arsenic, radon, uranium, lead, and fluoride.  

 

Well owners should check their water more often than annually if:

• There is a change in the taste, odor, or appearance of the water
• A problem occurs such as a broken well cap or a new contamination source
• Family members or houseguests have recurrent incidents of gastrointestinal illness
• An infant is living in the home
• There is a need to monitor the efficiency and performance of home water treatment equipment.

 

For a list of certified drinking water testing laboratories in Maine, see: Maine Certified Commercial Laboratories.  

 

If your drinking water is supplied by a public water system, you can be assured that the water you receive is regularly monitored and tested to ensure that it meets federal and state drinking water standards and is safe to drink.   

 

Whether you have your own private well or are supplied by a public water system, there are several things you can do to protect 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. There are several law enforcement agencies throughout the state that will accept unused prescription drugs for proper and safe disposal. For more information, visit: Maine State Map of Law Enforcement Agencies Accepting Unused, Unwanted Consumer Prescription Drugs for Disposal. 

For more information about private wells, visit http://wellwater.maine.gov. For information about public water systems, visit www.medwp.com. 

March is Colorectal Cancer Awareness Month

We know that colorectal cancer is one of the few cancers that can be prevented as well as detected early with screening. Colon cancer starts as a polyp, or small collection of abnormal cells. Colon polyps become more common as we age. The recommendation for screening at age 50 is based upon this science. Don’t delay your screening appointment if you are turning 50 – and consult your doctor about screening if you are younger than 50 but have a family history of colon cancer or precancerous polyps.

 

Colon cancer is most treatable when found in the earliest stages. Often, people have few symptoms until polyps have progressed to cancer.

 

Screening saves lives, so get screened and encourage others to be screened as well.

 

The United States Preventive Services Task Force and the American Cancer Society recommend three types of tests as options for people without a family history of colon cancer:

 

• High-sensitivity fecal occult blood testing or fecal immunochemical testing (FIT) every year: This can be obtained from your doctor’s office and can be done in the privacy of your home.
• Flexible sigmoidoscopy every 5 years combined with a high-sensitivity stool test or FIT every 3 years
• Colonoscopy every 10 years

For more information about colon cancer prevention visit the Maine CDC Colorectal Cancer Control Program.
 

Gonorrhea

US CDC has issued an MMWR describing the growing threat of multidrug-resistant gonorrhea and what public health agencies and partners can do to delay the emergence of cephalosporin-resistant strains, mitigate the public health consequences of expanded resistance, and prevent a return to the era of untreatable gonorrhea. For these strategies and more information, see the MMWR at: http://go.usa.gov/4JY3


A total of 40 confirmed gonorrhea cases have been reported in Maine through Feb. 16, compared to 54 reported cases in 2012 and 19 reported cases in 2011 during the same period. Some cases are reported more than once and may represent reinfection, recurrent infection, or persistent infection.

The majority of cases have been reported in Androscoggin County, followed by Cumberland County. Maine CDC is issuing biweekly gonorrhea surveillance updates. The most recent report is available at: http://go.usa.gov/4JrF

Current treatment guidelines and reporting requirements are included in this Health Alert from Dec. 4: http://go.usa.gov/4JY9

Important public health data now online

Maine CDC is pleased to release the Maine Behavioral Risk Factor Surveillance System (BRFSS) 2000-2010 Interactive web-query that should make most popular BRFSS public health data easily available. BRFSS non-institutional adult data is available at the State, District, and County levels in a variety of public health categories including General Health, Chronic Disease, Risk Factors, Prevention Activities, and Environmental Health. Since 1987, Maine BRFSS data has been an important surveillance data source for Maine CDC programs, other DHHS programs, and public health entities. A new version with additional data and a new weighting methodology will be available soon. Subsequent yearly updates will be available.

The BRFSS web-query should be intuitive in its use. It has both basic and advanced query functions and there is a "Quick Guide" reference for more information. The web-query, a link to the National BRFSS homepage with additional BRFSS data, and related BRFSS information are available at http://go.usa.gov/4yhm


Any questions regarding this Maine web-query system can be directed to Kip Neale, Maine BRFSS Coordinator at Kip.Neale@Maine.gov or 287-1420.

Immunization recommendations

Each year, the Advisory Committee on Immunization Practices (ACIP) develops recommendations for routine use of vaccines in children, adolescents, and adults in the US. This year, for the first time, recommended immunization schedules for children and adolescents up to age 18 and adults age 19 and older are being published together. Updated schedules are available at http://www.cdc.gov/vaccines/schedules/


The MMWR for children and adolescent immunization schedules is available at http://go.usa.gov/4yJk


The MMWR for adult immunization schedules is available at http://go.usa.gov/4yJP


Adult vaccination is critical to public health. Far too few adults are fully vaccinated, leaving themselves and others at risk of vaccine preventable diseases, including pneumococcal disease, whooping cough, and shingles.


US CDC has issued an MMWR describing the status of vaccination of US adults in 2011. For more information, read the MMWR at http://go.usa.gov/4yzB

American Heart Month

February is American Heart Month. Most of us know someone who has had a heart attack or stroke. In Maine, more than 1 of every 4 deaths is from heart disease or stroke.

 

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

• Know your ABCS
• Ask your doctor if you should take an 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 ~ Maine Tobacco Helpline 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 transfat
• Take medicine as prescribed by your doctor

What else can you do?

 

Heart Month is a great time to learn about the Million Hearts Campaign.

 

Million Hearts is a national campaign with the goal of preventing 1 million heart attacks and strokes over five years.

For more about heart disease and stroke visit http://www.mainehearthealth.org/

Lyme disease data

The Maine Tracking Network now includes Lyme disease data.


As the third most commonly reported infectious disease in Maine, Lyme disease poses a significant health risk to people in all parts of Maine. The availability of Lyme disease data on the Maine Tracking Network will raise awareness of the disease and help promote primary prevention of the disease and recognition of the signs of early-stage Lyme disease.

The Maine Tracking Network is a web-based data portal that lets users explore some of Maine's public health data and create customized reports, by geographic area, time period, age group, etc., using analysis and visualization tools.

Maine Tracking Network now has data for 10 public health topics, including asthma, childhood lead poisoning, heart attack, carbon monoxide poisoning, and birth outcomes. Lyme disease data were made available on the network after many months of work and collaboration between members of Maine CDC’s Divisions of Environmental Health, Public Health Systems, and Infectious Disease.

These data can be accessed at: http://go.usa.gov/4Zgw For direct access to the Maine Tracking Network: https://tracking.publichealth.maine.gov

Folic Acid Awareness

January 6-12 is National Folic Acid Awareness Week. Adequate folic acid intake is important for the prevention of birth defects.


Facts About Folic Acid

Folic acid is a B vitamin. Our bodies use it to make new cells. Everyone needs folic acid.


US CDC urges women to take 400 mcg of folic acid every day, starting at least one month before getting pregnant, to help prevent major birth defects of the baby's brain and spine.

Why folic acid is so important

Folic acid is very important because it can help prevent some major birth defects of the baby's brain and spine (anencephaly and spina bifida).

When to start taking folic acid

For folic acid to help prevent some major birth defects, a woman needs to start taking it at least one month before she becomes pregnant and while she is pregnant.

Every woman needs folic acid every day, whether she’s planning to get pregnant or not, for the healthy new cells the body makes daily. Think about the skin, hair, and nails. These – and other parts of the body – make new cells each day.

How a woman can get enough folic acid

There are two easy ways to be sure to get enough folic acid each day:

1. Take a vitamin that has folic acid in it every day.

Most multivitamins sold in the United States have the amount of folic acid women need each day. Women can also choose to take a small pill (supplement) that has only folic acid in it each day.

Multivitamins and folic acid pills can be found at most local pharmacy, grocery, or discount stores. Check the label to be sure it contains 100% of the daily value (DV) of folic acid, which is 400 micrograms (mcg).


2. Eat a bowl of breakfast cereal that has 100% of the daily value of folic acid every day.

Not every cereal has this amount. Check the label on the side of the box, and look for one that has “100%” next to folic acid.

Birth Defects Prevention

January 2013 is National Birth Defects Prevention Month! The theme is "Birth defects are common, costly, and critical.”

Birth defects affect 1 in every 33 babies born in the United States and are a leading cause of infant mortality. Put another way, Every 4.5 minutes, a baby is born 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 The good news is awareness efforts offer hope for reducing the number of birth defects in the future:

• 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

Research and Tracking:

Accurately tracking birth defects is the first step in preventing them and reducing their effect. Birth defects tracking systems are vital to help us find out where and when birth defects occur and who they affect. This gives us important clues about preventing birth defects and allows us to evaluate our efforts. We base our research on what we learn from tracking. By analyzing the data collected, we can identify factors that increase or decrease the risk of birth defects and identify community or environmental concerns that need more study. In addition, research helps the Centers for Disease Control and Prevention (CDC) answer critical questions about the causes of many of these birth defects.

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

Partnering to Create Healthy Futures

Maine's statewide Community Transformation Grant (CTG) is facilitating partnerships among state and local organizations to implement an evidence-based approach to reduce childhood obesity. Working with state agencies and private programs that care for children, the Maine CTG effort has been able to leverage the expertise of the Let's Go! 5210 Goes to Childcare program and added resources to support healthy eating and active living in childcare programs. Already, more than 230 additional sites are benefiting from the collaborative approach.


Challenge

In 2011, more than 38% of Maine's kindergarten students were overweight or obese. Carrying too much weight as a young child increases the risk of being an overweight or obese adult; increases the risk of having chronic diseases, such as Type 2 diabetes and heart disease; and leads to a poor quality of life. The good news is that with time and attention, the trend can be stopped and even reversed. Healthy eating and physical activity are two behaviors that are known to impact weight. These behaviors are influenced by family, and friends, and access to health options. For our youngest children who spend much of their days with childcare providers, the childcare setting presents an opportunity to set the stage for a lifetime of healthy habits. The challenge is in providing caregivers the assistance they need to foster healthy places and habits for our youngest residents.

Solution

Maine’s Community Transformation Grant is leveraging limited resources through public-private partnerships and multiple collaborations to address childhood obesity. The approach uses a structured, evidenced process, Let’s Go! 5210 Goes to Childcare or Let’s Move, to help licensed child care providers identify and implement more supports in their programs for healthy eating and active living. Through education and guidance, providers will adopt practices that foster healthy lifestyle choices for Maine’s most vulnerable, our children.

Results

Maine's CTG has built on the strengths and skills of the Statewide Childhood Obesity Taskforce partners to create and implement common approaches and tools to support healthier childcare environments. Maine's nine public health districts have created plans and started implementation of the structured process with their local licensed childcare providers and local Let's Go! 5210 Goes to Childcare partners. In the first year with the help of CTG, more than 230 additional licensed childcare sites have enrolled with Let's Go! 5210 Goes to Childcare to begin the change process.

Future Directions

This is an opportunity for licensed childcare providers and supporting agencies to benefit from technical assistance and resources to promote healthy eating and active living in your communities. The ultimate goal is to create a healthy start for our youngest residents by surrounding them with healthy environments and promoting habits that prevent obesity. By 2016, we expect to see one-third of Maine's licensed childcare sites make environmental changes to support healthy living. There will be continued strong collaboration across public and private agencies working to address childhood obesity in Maine.

Get Smart About Antibiotics

What do sinusitis, most sore throats, bronchitis, runny noses and the regular cold have in common? They are upper respiratory tract infections usually caused by viruses that can′t be cured with antibiotics. Yet, each year, health care providers in the U.S. prescribe tens of millions of antibiotics for viral infections.


To bring attention to this increasing problem, Maine CDC is observing Get Smart About Antibiotics Week this week, along with the Maine Medical Association, Maine Hospital Association, and Maine Public Health Association.

The campaign highlights the coordinated efforts of US CDC, states, and other partners to educate clinicians and the public about antibiotic resistance and the importance of appropriate antibiotic use.

Over-prescribing antibiotics, using a broad-spectrum therapy when a more specific drug would be better, starting and stopping medications, giving leftover medications to a friend who appears to have the same ailment you had, all contribute to the problem of antibiotic drug resistance, according to US CDC. As we enter this year′s cold and flu season, CDC asks parents to not insist on getting antibiotics when a health care provider says they are not needed.

Health care providers are asked to take the time to educate patients about antibiotic resistance and the possibility of having serious side effects. For example, allergic reactions to antibiotics, such as rash and anaphylaxis, send thousands of patients to the emergency room each year, according to a study published in the Clinical Infectious Diseases Journal.

Health care providers can also prevent antimicrobial resistance by ensuring prompt diagnosis and treatment of infections, prescribing antibiotics appropriately, and following infection prevention techniques to prevent the spread of drug-resistant infections in health care facilities. Doctors cite diagnostic uncertainty, time pressure, and patient demand as the primary reasons for their tendency to over-prescribe antibiotics. Appropriate use of existing antibiotics can limit the spread of antibiotic resistance, preserving antibiotics for the future.

For treatment guidelines for Upper Respiratory Tract Infections, see: http://go.usa.gov/YSb5

For more information about antimicrobial resistance, including background articles, patient materials, and continuing education programs, see http://go.usa.gov/YSbV

Influenza update 11/15/12

Maine CDC recently reported the first flu activity for the 2012-2013 season. For more information and clinical recommendations for this flu season, see the Nov. 5 health alert at http://go.usa.gov/YSTQ

 

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

 

 

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