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Dr. Sheila Pinette Director, Maine CDC Osteopathic physician Public Health Update January 10, 2013 In this update: Flu Pertussis (whooping cough) Norovirus Cervical Cancer Awareness Birth Defects Prevention Month 2012 Maine State Health Assessment Follow us Flu Maine CDC issued a health alert Jan. 9 with an update on flu. Flu activity in Maine is widespread with all three strains of influenza circulating. Flu activity is significantly higher than the 2011-2012 season, and flu levels are expected to remain high for the next several weeks. Vaccination is still strongly encouraged and is widely available, especially to protect people at risk of more severe disease. For recommendations related to treatment, testing, and management, as well as reporting requirements, see the Jan. 9 health alert at http://go.usa.gov/43kH US CDC has released an influenza app for clinicians and health care providers to make it easy to access the latest guidelines and information. For more information about the app, go to http://go.usa.gov/43nR Take everyday preventive measures against the flu: • Wash your hands frequently with soap and water, but especially after coughing and sneezing. Alcohol-based hand gels can also be used. • Avoid touching your nose, mouth, and eyes. Germs can spread this way. • Get vaccinated against the flu. • Consult your health care provider about getting a pneumococcal vaccine for anyone who is younger than 5, between ages 5 and 64 with high risk conditions, or age 65 and older. • Avoid contact with sick people. If you are at very high risk for complications, you may want to avoid large crowds. If you have the flu: • Stay home if you are sick, until you are fever-free for a full 24 hours without taking fever-reducing medicine. • Cough and sneeze into your elbow or into a tissue. Throw the tissue away. • Although most people can stay home to recover without seeing a health care provider, it is possible for healthy people to develop severe illness from the flu. Anyone with the flu should seek medical attention for: o Dehydration o Trouble breathing o Getting better, then suddenly getting a lot worse o Any major change in condition Flu activity Maine CDC reported widespread flu activity for the week ending Jan. 5. 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 ---PAGE BREAK--- Flu vaccination This year’s flu vaccine appears to be a good match to the circulating strains, and it is not too late to get vaccinated. To find locations where vaccine is available, call 211 or visit www.211maine.org or www.flu.gov Flu vaccine is still available through health care providers and local pharmacies. Maine CDC has again partnered with the Maine Department of Education to hold school-located vaccine clinics (SLVC), providing vaccine at no cost to the student or school. There is still time and vaccine available for schools that wish to hold SLVC. Resources are available to assist. School nurses may contact Ruth Lawson-Stopps at the Maine Department of Education at [EMAIL REDACTED] or [PHONE REDACTED] for more information. Pertussis (whooping cough) More than 700 cases of pertussis were reported in Maine in 2012, with the majority in children ages 7 to 19. Reported cases appear to be on a downward trend, but cases do continue to be reported. 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 Norovirus Since November, Maine CDC has investigated a number of gastroenteritis outbreaks statewide. Norovirus has been identified as the cause in many of the outbreaks. Norovirus infections typically increase during the winter months. Public health partners are encouraged to consider norovirus when assessing clusters of gastroenteritis and to act to prevent the spread of illness. Norovirus infections are characterized by the abrupt onset of gastrointestinal including nausea, vomiting, diarrhea, and stomach cramping. It is highly contagious and is transmitted in stool and vomitus. Exposure can result through direct contact with a person who is ill, by consuming food or liquids that are prepared or handled by an ill person, and through contact with contaminated surfaces or objects. The virus can persist on surfaces for prolonged periods at a wide range of temperatures. Follow US EPA guidance for proper cleaning agents effective against norovirus, available at http://go.usa.gov/435e. For more information and recommendations, see the health alert issued Jan. 3 at http://go.usa.gov/43Xm Cervical Cancer Awareness January is Cervical Cancer Awareness Month. Each year, approximately 50 Maine women are diagnosed with cervical cancer and an average of 16 Maine women die due to cervical cancer, but cervical cancer is preventable and highly curable if found and treated early. The Pap test can detect cervical cancer precursors as well as cervical cancer. Maine CDC’s Breast and Cervical Health Program provides free breast and cervical cancer screening to women that qualify. Eligibility is based on age, income, and health insurance status (uninsured or underinsured). For more information or to enroll, women should call 1-[PHONE REDACTED], press 1. Birth Defects Prevention Month January is National Birth Defects Prevention Month and this week is Folic Acid Awareness Week. Birth defects affect 1 in every 33 babies born in the United States and are a leading cause of infant mortality - 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. 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. For more information, visit Maine CDC’s birth defects program at http://go.usa.gov/43QA ---PAGE BREAK--- 2012 Maine State Health Assessment The 2012 Maine State Health Assessment is now posted on the Maine CDC website: http://go.usa.gov/43Nh Context & Purpose: Essential Public Health Service #1 calls for public health agencies to monitor the health of the population. Maine CDC collects health related data, analyzes this data and data from secondary sources, and shares these data as well as data analyzed by other parties. Much of this work is done by subject matter experts within the Divisions of the Maine CDC. The purpose of the 2012 State Health Assessment is to provide a broad overview of the health of Mainers, as well as to be a resource for state and local organizations and individuals looking for population health data. Included Data: The 167 State health Assessment indicators selected fall into 22 topic areas. Two are demographics and socioeconomic status, capturing many social determinants of health. The other 20 are public health topics related to general health status, infectious disease, environmental health, chronic disease, injury, maternal and child health, emergency preparedness, and some health behaviors. Limited substance use and mental health indicators were also included. For each indicator, Maine CDC analyzed: • state-level trends, • data by public health district and county, • data by gender, • data by race, ethnicity, • data by sexual orientation, • data by age, and • data by educational status and income. Limitations: Due to resource limitations, the assessment does not include in-depth descriptions of all health issues, or measures of policies and interventions designed to improve health. Further data on specific health issues may be found within specific “Burden of Disease” or “Burden of Injury “ reports, annual infectious disease reports, and other program specific data resources. Likewise, measures of policies and interventions can be found in evaluation documents produced by a variety of Maine CDC programs, and by other public health partners. Not all indicators were available by each of the categories. Some limitations include: • No new data were collected for this Assessment, and therefore data are limited to existing data sources. o In some cases, the most recent available data at the time of the data analysis were two or three years old. o Changes in data collection or methodology limited available trend data. o Some data sources do not include all of the demographic or social determinant elements that we used for other analyses. • For some indicators, data are limited by small numbers, requiring suppression for privacy and data reliability, and/or aggregation over several years. Resource limitations as well as small numbers limited the amount sub-state analysis done by additional factors that lead to health inequity. Feedback: Your feedback on the site and the data is welcome, and can be submitted via the website: http://go.usa.gov/43Nh ---PAGE BREAK--- 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://go.usa.gov/G6u. 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] For questions and potential exposure to poison, call the Poison Center’s 24-hour phone line: 1-[PHONE REDACTED]