Twelve ways to have a healthy holiday season

US CDC offers 12 simple tips for staying health this holiday season and all year long:

1. Wash hands often to help prevent the spread of germs. It's flu season. Wash your hands with soap and clean running water for at least 20 seconds.
2. Manage stress. Give yourself a break if you feel stressed out, overwhelmed, and out of control. Some of the best ways to manage stress are to find support, connect socially and get plenty of sleep.
3. Don't drink and drive or let others drink and drive. Whenever anyone drives drunk, they put everyone on the road in danger. Choose not to drink and drive and help others do the same.
4. Bundle up to stay dry and warm. Wear appropriate outdoor clothing: light, warm layers, gloves, hats, scarves and waterproof boots.
5. Be smoke-free. Avoid smoking and secondhand smoke. Smokers have greater health risks because of their tobacco use, but nonsmokers also are at risk when exposed to tobacco smoke.
6. Fasten seat belts while driving or riding in a motor vehicle. Always buckle your children in the car using a child safety seat, booster seat or seat belt according to their height, weight, and age. Buckle up every time, no matter how short the trip and encourage passengers to do the same.
7. Get exams and screenings. Ask your health care provider what exams you need and when to get them. Update your personal and family history. Get insurance from the Health Insurance Marketplace if you are not insured.
8. Get your vaccinations. Vaccinations help prevent diseases and save lives. Everyone 6 months and older should get a flu vaccine each year.
9. Monitor children. Keep potentially dangerous toys, food, drinks, household items and other objects out of children's reach. Protect them from drowning, burns, falls and other potential accidents.
10. Practice fire safety. Most residential fires occur during the winter months, so don't leave fireplaces, space heaters, food cooking on stoves or candles unattended. Have an emergency plan and practice it regularly.
11. Prepare food safely. Remember these simple steps: Wash hands and surfaces often, avoid cross-contamination, cook foods to proper temperatures and refrigerate foods promptly.
12. Eat healthy, stay active. Eat fruits and vegetables which pack nutrients and help lower the risk for certain diseases. Limit your portion sizes and foods high in fat, salt and sugar. Also, be active for at least 2½ hours a week and help kids and teens be active for at least 1 hour a day.

For more information, go to: http://www.cdc.gov/features/healthytips/index.html

Youth fitness reduces middle age death risk

A recently-published study in the JAMA Internal Medicine shows that fitness in youth may reduce the risk of heart-related death in middle age.

The study included nearly 5,000 adults who were between 18 and 30 in the mid-1980s when they completed baseline treadmill tests. Over 26 years, data showed that higher levels of fitness and improvement in fitness early in adulthood are associated with lower risks for heart disease and mortality.

For more information, go to http://archinte.jamanetwork.com/article.aspx?articleid=2473630

Maine ranked 15th healthiest state

The United Health Foundation released America's Health Rankings last week. Maine ranked 15th overall, up five spots from last year. 

Highlights noted by the foundation include:

• In the past year, immunizations among children aged 19 to 35 months increased 25 percent from 68.0 percent to 84.7 percent.
• In the past year, physical inactivity decreased 15 percent from 23.3 percent to 19.7 percent of adults.
• In the past five years, low birthweight increased 13 percent from 6.3 percent to 7.1 percent of live births.
• In the past 20 years, infant mortality increased 13 percent from 6.2 to 7.0 deaths per 1,000 live births.
• Since 1990, cardiovascular deaths decreased 46 percent from 408.0 to 218.7 per 100,000 population.

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

Environmental health staff recognized

Maine law and rules require that before a Health Inspection license to operate can be issued, all restaurants, hotels, inns, B&Bs, campgrounds, youth camps and fairs and festivals must show that they have safe drinking water and proper wastewater disposal. Maine CDC’s Health Inspection, Drinking Water and Subsurface Wastewater programs are co-located within the Division of Environmental Health, which allows for fast turn-arounds for routine applications.  For complicated business proposals, technical teams representing all three programs can be assembled quickly to find solutions for difficult drinking water or wastewater challenges.

Governor LePage recently received a letter from a business owner opening a new restaurant in rural Maine.  This business person wrote that he expected that the process would be equivalent to “…pushing a boulder uphill.”  He went on to say that “… to the contrary, these people bent over backwards to help us get the forms complete, inspect the water source, wastewater system, and the building to get us open as quickly as possible.”

As a result, Governor LePage invited the three staff named in the letter, Haig Brochu from the Drinking Water Program, Sandi Clark from the Health Inspection Program and Jim Jacobsen from the Subsurface Wastewater Unit, to his office to personally thank them for their work. They were joined by DHHS Commissioner Mary Mayhew, Maine CDC Director and Chief Operating Officer Kenneth Albert and Health Inspection Supervisor Rebecca Walsh. Governor LePage presented each staff member with a Governor’s coin and thanked them for their assistance.

HETL chemist presents paper at national meeting

Jamie Foss, Chemist II with the Forensic Chemistry Section at Maine CDC's Health and Environmental Testing Lab (HETL), recently presented a paper  at the Northeastern Association of Forensic Scientist’s Annual Meeting on his research related to the analysis of drugs by Time of Flight (TOF) Mass Spectroscopy.

Maine has seen an increase in heroin use and overdose over the past three years, resulting in an increase in heroin samples submitted to the lab for identification. To meet this challenge, HETL has been working with Perkin Elmer Health Sciences to beta-test their direct sample analysis. The sensitivity and quality of the data generated by this instrument, allows HETL to rapidly identify drugs and help its partners gain a better understanding of the types of drugs encountered on the streets as well as improve analysis turn-around time needed to meet the demands of the judicial system.

Maine CDC receives prematurity campaign award

Maine CDC has been awarded the March of Dimes Virginia Apgar Prematurity Campaign Leadership award in recognition of a more than 8% reduction in pre-term births based on 2014 data compared to 2009 baseline data. 

People with pre-diabetes can stop type 2 diabetes

Pre-diabetes is when blood sugar levels are higher than normal and puts a person at risk for developing type 2 diabetes.  According to the U.S. CDC and the American Diabetes Association an estimated:

• 86 million adults in the U.S. have pre-diabetes
• 386,000 adults in Maine have pre-diabetes
• $243 million in medical costs contributes to Maine’s economic burden

If pre-diabetes is left undiagnosed and untreated it can progress to type 2 diabetes.  This can lead to serious health problems like heart disease, stroke, blindness, kidney disease, amputation or death if steps are not taken to self-manage this disease.  There are steps people can take to prevent developing type 2 diabetes.  Lifestyle and behavior changes related to eating and physical activity can decrease a person’s chance of developing type 2 diabetes.

Maine has the National Diabetes Prevention Program (NDPP) available in many communities across Maine.  NDPP classes typically last for one hour, once a week for 16 weeks then meets monthly for six months.  It helps participants make real lifestyle changes such as healthy eating, daily physical activity and improving problem-solving and coping skills to help prevent type 2 diabetes.  Many people who complete the program stay in touch with their group for support.  In 2014 alone, over 800 adults in Maine completed the NDPP curriculum.  To find a program and class near you visit RethinkDiabetes.org.  

For more information:

• Maine CDC Diabetes Prevention and Control Program (DPCP)
• Rethink Diabetes
• National Diabetes Prevention Program (NDPP)
  

Breastfeeding support improves in Maine hospitals

Hospital support for breastfeeding has improved since 2007, according to the latest U.S. CDC Vital Signs report released early October. The percentage of U.S. hospitals using a majority of the Ten Steps to Successful Breastfeeding, the global standard for hospital care to support breastfeeding, increased from approximately 29 percent in 2007 to 54 percent in 2013, a nearly two-fold increase over six years. Hospitals in Maine that have implemented the majority of the Ten Steps increased from 72 percent in 2007 to 83 percent in 2013. 

Improved hospital care could increase rates of breastfeeding both in Maine and nationally, contributing to healthier children. According to U.S. CDC’s 2014 Breastfeeding Report Card, approximately 28 percent of babies in Maine were born in baby-friendly hospitals, a rate topped only by New Hampshire and Connecticut.  The Baby-Friendly Hospital Initiative (BFHI) was established by the World Health Organization and UNICEF and endorsed by the American Academy of Pediatrics. The core of the BFHI is the Ten Steps to Successful Breastfeeding, which include:

• Educating all pregnant women about the benefits and management of breastfeeding.
• Helping mothers initiate breastfeeding within one hour of birth.
• Keeping mothers and babies together throughout the entire hospital stay.
• Providing mothers with information about breastfeeding support groups and refer mothers to these groups upon discharge from the hospital.

Maine has implemented “6 for ME,” a health care and quality improvement initiative focused on providing assistance and support to health care professionals, focusing on six of the Ten Steps to Successful Breastfeeding.  Maine CDC, Let's Go!, MaineHealth and the Maine State Breastfeeding Coalition all link resources to offer technical assistance and educational opportunities to health care professionals caring for mothers and babies.

For more information about U.S. CDC’s work to improve hospital practices to support breastfeeding, visit www.cdc.gov/breastfeeding or Maine’s 6 for ME: Maine takes 6 steps to improve breastfeeding.

State epidemiologist speaks at conference

On October 6, Maine State Epidemiologist Dr. Siiri Bennett participated in a four-person panel at the Maine Public Health Association’s annual fall conference in Augusta. The session served as an informal introduction to many public health partners, since Dr. Bennett has been in Maine for around five weeks.

The session was titled: Voices of Public Health: Sharing Visions for the Future. Each panelist was asked to share their vision for the future of public health. Dr. Bennett identified four areas that she believes are crucial to the success of Maine CDC’s mission to preserve, promote and protect the health, safety and well-being of all Maine people. Those four areas are disease surveillance, collaboration, education and communication.

Maine CDC seeks feedback

According to the Institute of Medicine, one of the core functions of public health is assessment: the systematic collection, assembly, analysis and sharing of information on the health of the community. As such, Maine CDC provides a great deal of data on its website. We are working to improve the organization, accessibility and usability of that data and seek your feedback. Please follow this link to access an outline survey by September 15 to assist us: https://www.surveymonkey.com/r/6TQMDMB

Shared health needs assessment & planning

The Maine Shared Health Needs Assessment & Planning Process (SHNAPP) Project - a collaborative of Central Maine Healthcare, Eastern Maine Healthcare System, MaineGeneral Health, MaineHealth and the Maine Center for Disease Control and Prevention - works to improve the health status of Maine residents and track results.

The goal is to create a framework and approach for a Shared Community Health Needs Assessment (CHNA) that can:

• Address community benefit reporting needs of hospitals,
• Support state and local public health accreditation efforts, and
• Provide valuable population health assessment data for various organizations concerned with the health of Maine’s communities and citizens.

SHNAPP has DRAFT Shared CHNA reports that are available now for review and input.  Drafts of the State report and the Kennebec County report can be downloaded and comments submitted to us from this site.  We appreciate all of your feedback.

Flu

Although most influenza activity occurs from October to May in the U.S., flu viruses are detected year round.  Providers in Maine have reported positive rapid influenza and serology tests in the last month.  Summer and early fall are also the prime time for agricultural fairs, which provides an increased risk for flu associated with swine contact. 

Maine CDC requests that all rapid positive influenza samples during the summer months be forwarded to Maine’s Health and Environmental Testing Laboratory (HETL) for confirmation and typing.  This will allow us to monitor the circulating strains, and identify any variants if present.

If a provider sees a patient with flu-like symptoms who has swine or bird exposures; samples should be sent to HETL for testing.  Rapid tests may not pick up variant strains, and only the state lab is capable of determining if a strain is a variant.

Reporting requirements

• Suspected novel or variant cases should be reported immediately by phone to 800-821-5821.
• Outbreaks and pediatric deaths are required to be reported
• We appreciate all positive lab tests, reported by fax (207-287-6865 or 800-293-7534) or by phone (800-821-5821) but this is not required

Additional Information

• Maine CDC’s influenza webpage:  www.maineflu.gov
• Federal CDC’s influenza webpage:  www.cdc.gov/flu
• HETL submission forms:  www.mainepublichealth.gov/lab

Child immunization rates

A recent U.S. CDC report shows that Maine’s vaccination rates for 19-35-month-olds are the best in the nation. 

These results are a cause for celebration and reflect an effective partnership that has been built across the state to address this important health issue. Our success can be attributed to the hard work of clinicians, partners, educators and funders who have collectively made the vaccination of Maine’s children a public health priority.

Maine CDC is proud of this accomplishment and looks forward to working with our partners to build upon this success in the coming year.

Additional information is available in these PowerPoint slides.

PHEP supports State Police search

In its role of managing various vaccines and antidotes in the event of a public health emergency, Maine CDC’s Public Health Emergency Preparedness (PHEP) program identified the need to keep drivers of these types of supplies safe and secure. Delorme InReach was ultimately chosen to meet this goal, as it allows for real-time GPS tracking. The technology also features text-based communication from the device to a web-interface that can be monitored at a central location. Recently, this technology was used by the Maine State Police in their manhunt for suspect Robert Burton in Piscataquis County, which ended after 68 days on August 11.  The State Police appreciated the use of these units: “What the units have enabled us to do is to track personnel in real time as we deploy tactical assets in the field.  By equipping each team with a device, we are able to visually demonstrate to the planners and managers of the incident where each team is tracking.  Not only is that demonstration valuable for progress display, it also allows for the ongoing consideration of reactionary forces should the team encounter a threat. “The devices have also afforded us a communication alternative in an environment where radio communication is poor.  By utilizing the satellite capabilities to communicate, we are more assured that we are able to relay relevant information to the field as well receive urgent data from any team.” This real-life application of the technology also served as on-the-job training for the State Police who were active in this search. They are now ready to assist in any public health emergency without additional training.

DHHS appoints Pezzullo Chief Health Officer

Christopher Pezzullo, D.O., has accepted the position of Chief Health Officer of the Maine Department of Health and Human Services.  Dr. Pezzullo has been serving in this role in an acting capacity since March. The Chief Health Officer’s (CHO) role is to develop and coordinate an integrated, results-oriented approach throughout DHHS to address significant health issues that span many of the programs within the Department  The CHO will work to implement innovative public health strategies that partner community health promotion efforts with health care clinicians and leaders as well as to construct a more integrated, effective health system through collaboration between clinical care and public health.  All of these efforts are designed to provide strong clinical leadership within the Department to positively improve the health of Maine people. “I have been impressed with Dr. Pezzullo’s knowledge of and commitment to the public health issues that are impacting Mainers,” wrote DHHS Commissioner Mary Mayhew when announcing the appointment. “His experiences in clinical practice will be helpful as we focus on critical issues like drug-affected babies, fragmented care delivery, chronic disease management, eldercare and effective primary care screenings for tobacco, alcohol and drug use.” Dr. Pezzullo has been practicing medicine for nearly 20 years in Maine as a pediatrician.  He’s a graduate of the University of New England College of Osteopathic Medicine and has been recognized as a Diplomate of the American Board of Pediatrics and the National Board of Osteopathic Medical Examiners.  Dr. Pezzullo previously served as the Medical Director of the Division of Population Health at Maine CDC, beginning in 2012.  Prior to joining State government, he was the Chief Medical Officer for University Health Care from 2008 to 2012.

Ryan White HIV/AIDS Program anniversary

On August 18, 1990, the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act was signed into law, creating what is now the largest Federal program exclusively providing care and treatment services to people living with HIV – the Ryan White HIV/AIDS Program.

Twenty-five years later, the Health Resources and Services Administration’s (HRSA) HIV/AIDS Bureau commemorates this historic anniversary and honors the Ryan White HIV/AIDS Program, which has played a critical role in the United States’ public health response to the HIV/AIDS epidemic.   The theme:  Moving Forward with CARE: Building on 25 Years of Passion, Purpose, and Excellence”  reflects the passion that inspired the legislation, purpose that continues to drive the Ryan White HIV/AIDS Program and excellence in health outcomes for people living with HIV receiving Ryan White HIV/AIDS Program-funded care.  

HRSA has also produced a new video to highlight the work of the program: http://hab.hrsa.gov/ryanwhite25/

World Hepatitis Day

July 28 is World Hepatitis Day, which aims to increase awareness about viral hepatitis on a global level.  The World Health Organization (WHO) estimates that 400 million people worldwide have chronic viral hepatitis. A approximately 1 million individuals die  each year from viral hepatitis-related causes. 

Hepatitis A is a liver disease spread by ingestion of contaminated food or water or by direct contact with an infected individual. The hepatitis A virus (HAV) can cause mild to severe illness with symptoms ranging from nausea and fever to jaundice. HAV cannot become chronic. Once a person is infected, he or she cannot become infected again.  There is a vaccine available for HAV, which is recommended for all children at age 1 and any adults at risk of infection.

Hepatitis B is caused by the hepatitis B virus (HBV) and can be both acute and chronic. HBV is spread though contact with blood or other bodily fluids of an infected individual.  HBV infection may be symptomatic, but infected individuals may also go years before symptoms or complications occur.  If left undiagnosed and untreated, HBV may result in serious liver disease, cirrhosis, end-stage liver disease or death in 25 percent of people.  There is an effective vaccine available for HBV prevention, which is recommended for all babies at birth and adults at risk of infection.

Hepatitis C is a serious liver disease caused by the hepatitis C virus (HCV), which can be both acute and chronic. HCV is spread by blood-to-blood contact with an infected individual. It is estimated that only 20 percent of people with acute cases experience symptoms of HCV. It’s  possible that patients may live with HCV infection for years without experiencing symptoms until serious liver damage occurs.  Hepatitis C is the leading cause of liver transplant in the United States. The U.S. CDC estimates that there are 3.2 million people living with chronic hepatitis C nationwide, and most individuals are  unaware of their infection. 

Symptoms of hepatitis C include fever, fatigue and loss of appetite, nausea, vomiting, abdominal pain, darkened urine, clay-colored stools, joint paint and jaundice.  People who have ever injected drugs, shared needles and equipment or who were born to a hepatitis C-positive mother join Baby Boomers in the highest risk category.

Recent advancement in therapies for treatment of hepatitis C can cure up to 95 percent of infections. Maine CDC recommends that people talk to their health care provider about their risk for hepatitis C testing. There is no vaccine available for hepatitis C.

For more information about viral hepatitis resources in Maine, visit: www.mainepublichealth.gov/hepatitis

For more information about hepatitis, visit: http://www.cdc.gov/knowmorehepatitis 

Are you at risk for viral hepatitis?  Find out if you should get tested:  www.cdc.gov/hepatitis/riskassessment/index.htm 

Cancer registry awards

L-R: Dr. Molly Schwenn and Katherine Boris of the Maine Cancer Registry and Debra Wigand, Director of Maine CDC's Division of Population Health,  pictured with the two honors from US CDC.

The Maine Cancer Registry has been recognized with two national honors from the US CDC National Program of Cancer Registries (NPCR). 

Maine was recognized as one of 19 states to receive the Registry of Excellence designation. In addition, the registry was recognized for achieving the highest standards for data completeness, timeliness and quality. According to the NPCR, Maine’s data are so thorough and accurate that they will be included in this year's United States Cancer Statistics report and other analytic data sets. 

Achievement of these standards and certification is important to ensure accurate information is available about cancer in Maine and to monitor trends in cancer diagnosis. Detecting cancer at an earlier stage can improve outcomes. Maine hospitals are partners in this effort, providing up-to-date local information to the Maine Cancer Registry.

Arboviral diseases

Summer is here, which means mosquitoes are here as well.  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.  Additionally, Powassan virus is an arboviral disease transmitted by the bite of an infected tick.  Although rare, these diseases have potentially severe and even fatal consequences for those who contract them.  Maine CDC reminds clinicians 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.

EEE and WNV were first detected in Maine in 2001 in birds.  In 2009, Maine experienced unprecedented EEE activity with 19 animals and two mosquito pools testing positive.  In 2012, Maine reported its first human case of locally-acquired WNV neuroinvasive illness.  In 2014, Maine reported its first human case of locally-acquired EEE neuroinvasive illness. Powassan was first identified in Maine in 2000 but is rarely reported; a confirmed case in 2013 was the first reported case in nearly a decade.  In 2014, Maine reported EEE in an emu from Cumberland County, 22 mosquito pools from York County and one human from York County.

Many people infected with arboviral illness remain asymptomatic. The following groups of people are at higher risk for clinically significant arboviral infection:

• Residents of and visitors to areas with mosquito or tick activity
• People who engage in outdoor work and recreational activities
• People older than 50 and younger than 15 

Additional Information

• For more information on arboviral disease: http://www.maine.gov/dhhs/mecdc/infectious-disease/epi/vector-borne/index.shtml

• HETL Laboratory Submission Sheet: http://www.maine.gov/dhhs/mecdc/public-health-systems/health-and-environmental-testing/micro/documents/wnv-sle-eee.pdf

• Weekly arboviral reports will be posted throughout the season at: http://www.maine.gov/dhhs/mecdc/infectious-disease/epi/vector-borne/arboviral-surveillance.shtml

• Disease consultation and reporting available through Maine CDC at 1-800-821-5821

New State epidemiologist

Maine CDC is pleased to announce that Siiri Bennett, MD, has accepted the position of State epidemiologist. 

Dr. Bennett received her medical degree from the University of Washington School of Medicine and completed her residency in internal medicine at Mt. Auburn Hospital in Massachusetts. 

Dr. Bennett is currently a senior research scientist and medical data consultant in the Department of Biostatistics at the University of Washington in Seattle, where she is co-principal investigator for an NIH-funded Data Coordinating Center for a multi-study collaboration looking at tuberculosis latency and reactivation and also serves as a project director for a multi-study consortium looking at cardiovascular disease in patients with HIV.

She will begin her new role at Maine CDC on July 20.