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Dr. Sheila Pinette Director, Maine CDC Osteopathic physician Public Health Update October 18, 2012 In this update: Meningitis outbreak Pertussis (whooping cough) ACIP recommendations for pneumococcal vaccine National Food Day Updated recommendations: special foreign–born populations Bladder Health Week Influenza Rabies Lead dust Upcoming events Follow us Meningitis outbreak There has been national news about a multistate outbreak of fungal meningitis and joint infections associated with contaminated steroid medications. Maine CDC issued a health alert related to this topic on Oct. 5: http://go.usa.gov/YRGe Since then, US CDC and the Food and Drug Administration (FDA) continue to work closely with state public health departments on a multistate investigation of fungal meningitis and joint infections among patients who received a acetate injection prepared by the New England Compounding Center (NECC) in Framingham, MA. Three lots of this medication were recalled by NECC, and are suspected in 233 cases and 15 deaths (as of October 16). Maine did not receive any of the recalled lots of this medication. On October 15, FDA released a MedWatch Safety Alert recalling all NECC products: http://go.usa.gov/YR7H. FDA is requesting the clinicians contact any patient who may have received any NECC product since May 21, 2012. US CDC has not confirmed any infections from medications other than the 3 recalled lots, but they are encouraging awareness out of an abundance of caution. For more information: http://go.usa.gov/YRA4 Pertussis (whooping cough) More than 570 cases of pertussis (whooping cough) have been reported in Maine this year, and cases continue to be reported. Most reported cases have been in children ages 7 to 19. Close to 30 cases have been reported in children younger than 1 year old. 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 ---PAGE BREAK--- ACIP recommendations for pneumococcal vaccine The Advisory Committee on Immunization Practices (ACIP) recommended routine use of 13-valent pneumococcal conjugate vaccine (PCV13) for adults age 19 and older with immunocompromising conditions, functional or anatomic asplenia, cerebrospinal fluid leaks, or cochlear implants in June. PCV13 should be administered to eligible adults in addition to the 23-valent pneumococcal polysaccharide vaccine (PPSV23), the vaccine currently recommended for these groups of adults. The evidence for the benefits and risk of PCV13 vaccination of adults with immunocompromising conditions was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework and designated as a Category A recommendation. US CDC has issued an MMWR (http://go.usa.gov/YRpY) which outlines the new ACIP recommendations for PCV13 use; explains the recommendations for the use of PCV13 and PPSV23 among adults with immunocompromising conditions, functional or anatomic asplenia, CSF leaks, or cochlear implants; and summarizes the evidence considered by ACIP to make its recommendations. National Food Day National Food Day is next Wednesday. Setting aside one day to focus on food reminds us of: • the connection between health and great tasting food, like Maine apples; • what we can do to end hunger; and • the importance of having Maine farms and farmers that produce some of the best tasting fruit, vegetables, meats, chicken, fish, and grains in the nation. Take the Food Day Challenge: 1. Take a small step to eat like your life depends on it - it does. • Add one more veggie to your meals. • Switch to lower fat dairy, whole grains, and grilled, baked, or broiled foods. • Eat a little less. 2. Look for local produce in season. Farmers markets go all year long now. Check: http://www.getrealmaine.com/ 3. Savor your food with a family member or a friend. 4. When you donate foods to the food bank, think about health. For healthy recipes, check http://recipefinder.nal.usda.gov/, which allows you to search for healthy and affordable recipes. Each recipe includes nutritional information, ingredients, instructions, and cost per recipe and per serving. Updated recommendations: special foreign–born populations Maine CDC has issued an updated guidance document for health care providers titled Initial Health Assessment and Management for Special Foreign- Born Populations in Maine. This guidance was developed by a workgroup of public health and medical professionals to provide recommendations for a standardized approach to the initial health assessment and health management of all recently arrived foreign-born people. Recommendations pertain to three categories of foreign-born people: • Refugees (primarily resettled in Maine by a Maine-based refugee resettlement program) • Secondary migrants (refugees who have moved to Maine from another state) • People seeking asylum and asylees This document is an updated and revised version of a similar set of recommendations originally developed in 2008. Maine CDC plans to review and update these recommendations every two years, unless immigration or disease patterns warrant consideration on a more frequent basis. Recommendations include specific tests and procedures as well as guidance for appropriate patient management. The document is available online at http://go.usa.gov/YNtY Bladder Health Week National Bladder Health Week will be recognized Nov. 12-16. The campaign is inspired by the 25 million people in the U.S. and the 200 million people worldwide who suffer from bladder control loss. The goal of this campaign is for people to get control of their bladder and get talking about the topic of bladder health. For more information: www.bladderhealthawareness.org ---PAGE BREAK--- Influenza Surveillance Maine CDC has not yet reported any flu activity for the 2012-2013 season. 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 Prevention 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 Vaccination School-Located Vaccine Clinics (SLVC) are being conducted in many schools again this year and provide a chance for more children to be vaccinated against the flu. Approximately 27,000 children were vaccinated in a school setting last year, and the Maine Immunization Program anticipates many schools participating again this year. SLVC offer many benefits, such as: • the ability to provide flu vaccination to a large number of children in a central location; • no copayments or fees; • allowing schools and physician offices an opportunity to collaborate to immunize Maine children; • providing easier access to children’s flu immunization for working parents; and • helping to minimize illness in school. The Department of Education and Maine CDC are pleased to be partnering to support SLVC and to provide the necessary tools to host and maintain clinics. To get more information on please contact Ruth Lawson- Stopps at [EMAIL REDACTED] Rabies Maine CDC provides quarterly updates on animal rabies to veterinarians and other animal health professionals. This update may be used as an educational tool to inform pet owners and other members of the public about the risk of rabies in Maine and in their communities. The 2012 third quarter report is now available at http://go.usa.gov/YRU3 Lead dust Maine CDC has produced a video which shows how to do the free home lead dust test offered by its Environmental & Occupational Health Programs. The video is posted at www.youtube.com/mainepublichealth The quick and easy test is a great way to find out if you have dust from lead paint in your home. Knowing if your home has dust from lead paint helps you protect your children from lead poisoning. For more information and to order a free lead dust test kit, visit: ---PAGE BREAK--- Upcoming events • Infectious Disease Conference. Maine CDC’s Infectious Disease Conference will be held from 7:45 a.m. to 4 p.m. November 13 at the Augusta Civic Center. This year’s meeting is dedicated to a review of emerging issues in the field of infectious diseases, particularly as they impact the Maine medical community. Issues presented will include challenges in controlling infectious diseases, information on responding to new disease threats, and clinical updates and approaches. The cost is $35 if registration is received on or before Oct. 24; $50 if registration is received Oct. 25 or later. For more information and to register: http://adcarecdc.neias.org/infectiousdisease/ • Upcoming Summit Meeting. Bridging Mental Health and Public Health Summit Meeting: A Focus on Local, State, and National Efforts will be held from 8 a.m. to 12:30 p.m. November 14 at Governor Hill Mansion, 136 State St., Augusta. The Summit Meeting is presented by the Maine Health Access Foundation; the Maine Department of Health and Human Services Chronic Disease Division; and the USM Muskie School of Public Service. For more information and to register: http://www.surveymonkey.com/s/QZ55T63 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]