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Dr. Sheila Pinette Director, Maine CDC Public Health Update November 10, 2011 In this update: National Diabetes Month Pertussis Prescription painkiller overdoses Safe disposal of sharps Premature Birth Report Card Influenza update Great American Smokeout AAP policy statement on routine HIV testing American Indian/Alaska Native Heritage Month World Pneumonia Day Follow us National Diabetes Month Diabetes is a chronic endocrine disease that effects both microvascular and macrovascular organ systems. More than 87,000 Mainers (8.3% of population in Maine) have been diagnosed with diabetes and it is estimated that an additional 32,000 people have diabetes that have not been diagnosed (total of 119,000 Mainers with diabetes). Another 63,000 have pre-diabetes. Diabetes can cause diabetic neuropathy, sexual dysfunction, and macular degeneration. It is a leading cause of kidney failure, non-traumatic lower-limb amputations, new cases of blindness, is a major cause of heart disease and stroke, and is the seventh-leading cause of death in Maine. Diabetes can lead to serious complications and premature death, but individuals with diabetes can take steps to control the disease and lower the risk of complications. Research has shown that modest lifestyle changes – such as exercising at least 30 minutes daily, dietary modification with healthy foods and snacks and decreased portions sizes – can prevent or delay the onset of type 2 diabetes among high-risk adults. Many complications from diabetes can be avoided or reduced through self-management and regularly scheduled medical consultations that focus on diabetes care, including primary care visits at least every three months; consultation with a nutritionist for counseling on diabetic diet and possibly carbohydrate counting for motivated individuals; and visiting an ophthalmologist once per year to check for retinopathy. Visits with a diabetologist are suggested in some cases, especially if the person is starting insulin. Closed, protective, flat footwear is suggested to help with footing and to prevent trauma and infections and often a podiatrist is seen every 6 months for nail trimming. People with diabetes should receive diabetes self-management education, check feet daily for sores or irritation, and check blood glucose levels daily. Find out if you are at risk for diabetes by taking this quiz: For more information, visit the Maine Diabetes Prevention and Control Program at http://go.usa.gov/IT5 ---PAGE BREAK--- Pertussis There have been about 150 cases of pertussis (whooping cough) reported in Maine so far in 2011, compared with 53 for all of 2010 and 80 in 2009. About 64% of 2011 cases have been in residents of Penobscot County. Clusters of pertussis have been reported in schools, camps, sport teams, and workplaces. Pertussis is a highly communicable, vaccine-preventable respiratory disease that can last for many weeks. It is spread from person to person through the air. The first signs of pertussis are similar to a cold (sneezing, runny nose, low-grade fever, and a cough). After one or two weeks, the cough gets worse. For example: • The cough occurs in sudden, uncontrollable bursts where one cough follows the next without a break for breath. • Many children will make a high-pitched whooping sound when breathing in after a coughing episode. Whooping is less common in infants and adults. • After a coughing spell, the person may throw up. • The person may look blue in the face and have a hard time breathing. • The cough is often worse at night. • Between coughing spells, the person seems well, but the illness is exhausting over time. • Over time, coughing spells become less frequent, but may continue for several weeks or months. Pertussis can be very serious, especially in infants. The most common complication of pertussis is bacterial pneumonia. Rare complications include seizures, inflammation of the brain, and death. Pertussis can be treated with antibiotics, but treatment may not cure the coughing right away. The most effective way to prevent pertussis is through vaccination with DTaP for infants and children and with Tdap for pre-teens, teens, and adults. Clinicians should check the vaccine status of their patients to make sure they are up to date for their age. A summary of pertussis vaccine recommendations broken down by age and other life factors is available at http://go.usa.gov/ITj For More Information: • General information on pertussis can be found on the Maine CDC website or US CDC website http://www.cdc.gov/pertussis/ • For information about pertussis vaccine or vaccine schedules, please contact the Maine Immunization program at www.immunizeme.org or by calling 1-[PHONE REDACTED] • Disease reporting or consultation is available by calling Maine CDC at 1-[PHONE REDACTED] Prescription painkiller overdoses Overdose deaths from prescription painkillers have skyrocketed in the past decade. Every year, nearly 15,000 people die from overdoses involving these drugs—more than those who die from heroin and cocaine combined. This month’s US CDC Vital Signs feature (http://go.usa.gov/ITb) and related MMWR (http://go.usa.gov/ITT) highlight this issue. Safe disposal of sharps U.S. Food and Drug Administration (FDA) has launched a new website for patients and caregivers on the safe disposal of needles and other sharps that are used at home, at work, and while traveling: http://go.usa.gov/IT2 After being used, many sharps end up in home and public trash cans or flushed down toilets. This kind of improper disposal puts people, such as sanitation workers, sewage treatment workers, janitors, housekeepers, family members, and children at risk for needle-stick injuries or infection with viruses such as Hepatitis B and C and HIV. This new website helps people understand the public health risks created by improperly disposing of used sharps and how users should safely dispose of them. ---PAGE BREAK--- Premature Birth Report Card The March of Dimes recently released its 2011 Premature Birth Report Card, giving Maine a grade of B, with a 9.9% preterm birth rate, compared to 12.2% for the US as a whole, and tied for third-lowest rate with New Hampshire. Influenza update Maine CDC reminds everyone to take everyday preventive measures against influenza by washing hands, covering coughs, and staying home when sick. No flu activity was reported in Maine for the week ending Nov. 5. Low flu activity nationwide means this is a great time to get vaccinated – you can search for flu clinics by county at http://www.211maine.org/flu-clinics/ or by zipcode at www.flu.gov Weekly updates on flu activity are available online: • for Maine: http://go.usa.gov/ITD • for the US: http://go.usa.gov/ITB • for the world: http://go.usa.gov/ITK Maine CDC has already distributed more than 193,000 doses of state-supplied influenza vaccine to registered providers for the 2011-2012 season. About 97 school districts are offering school-located flu vaccine clinics (SLVC) again this year. More than 320 clinics are registered. A list of participating schools is posted at http://go.usa.gov/ITk Great American Smokeout The 36th Great American Smokeout will be held Nov. 17, encouraging smokers to use the date to make a plan to quit, or to plan in advance and quit smoking that day. In addition, the Maine Tobacco HelpLine (1-800-207- 1230) celebrates its 10th anniversary this month. The HelpLine has served more than 75,000 customers in 10 years, reaching an average of 3% of smokers annually – a rate that is ranked fourth in the U.S. The HelpLine is one facet of the Partnership for a Tobacco-Free Maine (PTM). The adult smoking rate in Maine has dropped from 30% when PTM began in 1997 to 18% in 2010. One of the hardest things to do is to quit using tobacco. Quitting is a process and sometimes it takes more than one try. The HelpLine offers support that can help people stay tobacco-free for life. The Maine Tobacco HelpLine answers questions and offers friendly support to those who are thinking about quitting or who are ready to quit smoking, or those who want to help a friend or family member quit. For more information, visit http://www.tobaccofreemaine.org/ AAP policy statement on routine HIV testing The American Academy of Pediatrics has broadened its recommendations for HIV testing among adolescents in a new policy statement on the pediatrician's role in promoting routine testing: http://pediatrics.aappublications.org/content/early/2011/10/26/peds.2011-1761.abstract The statement includes the following recommendation: “routine screening be offered to all adolescents at least once by 16 to 18 years of age in health care settings when the prevalence of HIV in the patient population is more than 0.1%. In areas of lower community HIV prevalence, routine HIV testing is encouraged for all sexually active adolescents and those with other risk factors for HIV.” ---PAGE BREAK--- American Indian/Alaska Native Heritage Month November is National American Indian/Alaska Native Heritage Month, which is an opportunity to raise awareness of important health disparities experience by American Indians and Alaska Natives: http://www.cdc.gov/Features/AIANHeritageMonth/ For more information, visit Maine CDC’s Office of Minority Health at http://go.usa.gov/IT8 or the US Office of Minority Health at http://go.usa.gov/IT0 World Pneumonia Day This Saturday, Nov. 12, is World Pneumonia Day (http://www.cdc.gov/Features/Pneumonia/). Pneumonia is an infection of the lungs that is usually caused by bacteria or viruses. Globally, pneumonia causes more deaths than any other infectious disease. However, it can often be prevented with vaccines and can usually be treated with antibiotics or antiviral drugs. Follow us Follow Maine CDC’s Social Media Updates: • Facebook (www.facebook.com/MaineCDC) • Twitter (http://twitter.com/MEPublicHealth) • Blog (http://mainepublichealth.blogspot.com) You may subscribe to these updates for free through an RSS feed at http://www.maine.gov/tools/whatsnew/rss.php?tid=1049. In Internet Explorer and Firefox, you will be prompted to Subscribe to the Feed and then select the folder where feeds are stored. For clinical consultation and outbreak management guidance, call Maine CDC’s toll-free 24-hour phone line: 1-[PHONE REDACTED]