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Dr. Sheila Pinette Director, Maine CDC Osteopathic physician Public Health Update May 17, 2012 In this update: National High Blood Pressure Education Month Pertussis Hepatitis Awareness Month and Testing Day Weight of the nation Women’s health week Lyme disease Childhood lead poisoning prevention Health equity Breast cancer plate Influenza Community transformation New reports Rural health IT toolkit Active Community Conference Follow us National High Blood Pressure Education Month May is National High Blood Pressure Education Month. About 1 in 3 Mainers is diagnosed with high blood pressure, which is also called hypertension. High blood pressure usually has no but it can cause serious problems such as stroke, heart attack, kidney failure and blindness. Since there are usually no many people have high blood pressure and do not know it. You are more likely to have high blood pressure if you… Are over 55 years old Have a family history of high blood pressure Are overweight Eat foods high in salt/sodium Do not exercise regularly Smoke Drink alcohol regularly You can prevent and control high blood pressure Get your blood pressure checked at least every year and encourage friends and family to do the same If you have medicine for high blood pressure, use it as directed Talk with your doctor to learn more about your blood pressure and staying healthy If you have any of the risks mentioned above, make changes to reduce the risks you can o Stop smoking: Get free help to quit at the Maine Tobacco Helpline 1-[PHONE REDACTED] o Limit your intake of sodium (salt) o Maintain a healthy weight: Eat healthy, limit portion sizes, eat more fruits and vegetables, and be physically active o Be physically active: Try to get at least 30 minutes of activity every day. Find a walking route near you at Remember anyone can develop high blood pressure and there usually are no Get your blood pressure checked regularly and do what you can to live a healthy life. For more information visit the Maine CDC Cardiovascular Health Program Website www.mainehearthealth.org or contact David Pied, Public Health Educator at [EMAIL REDACTED] Help us prevent one million heart attacks and strokes nationally over five years, visit http://millionhearts.hhs.gov/ ---PAGE BREAK--- Pertussis Maine, like many other states, has been experiencing an increasing number of pertussis cases over the past year. Between January 1 and May 11 of this year, 55 pertussis cases have been reported to Maine CDC from nine Maine counties. More than 200 cases of pertussis were reported to Maine CDC in 2011, far exceeding the 53 reported cases in 2010 and the 10-year average of 82 cases per year. Clusters of pertussis have occurred in schools, child care centers, camps, sport teams, and workplaces. Pertussis is a highly communicable, vaccine-preventable disease that can last for many weeks. It is transmitted through direct contact with respiratory secretions of infected persons. Classic pertussis include paroxysmal cough, whoop, and posttussive vomiting. Pertussis can cause serious illness and can even be life-threatening, especially in infants. More than half of infants less than 1 year of age who get pertussis must be hospitalized. For more information, see Maine CDC’s May 15 Health Alert (http://go.usa.gov/pa9) or visit http://www.cdc.gov/Features/Pertussis/ Hepatitis Awareness Month and Testing Day May is Viral Hepatitis Awareness Month. Maine CDC issued a Health Alert on May 14 (http://go.usa.gov/pa8) urging clinicians to understand the burden of viral hepatitis in Maine and to follow key recommendations for testing and prevention. Viral hepatitis is a leading cause of liver cancer and the most common reason for liver transplantation among adults in the U.S. May 19 will be recognized as the first ever Hepatitis Testing Day in the United States (http://www.cdc.gov/hepatitis/TestingDay/). The “Know More Hepatitis” campaign encourages Americans to talk to their doctor and get tested. Viral hepatitis is a silent epidemic in the United States, because more than 4 million Americans are living with chronic hepatitis B or chronic hepatitis C, and up to 75% don’t know they are infected. Visit www.cdc.gov/knowmorehepatitis for more information. An online Hepatitis Risk Assessment has been developed to determine a person’s hepatitis testing and vaccination recommendations. The tool allows individuals to answer questions privately, either in their home or a health care setting, and then print tailored recommendations based on US CDC’s guidelines to discuss with their doctor. It is available at: http://www.cdc.gov/HEPATITIS/riskassessment/ For information about where to get tested and/or vaccinated in Maine, visit www.mainepublichealth.gov/hep Weight of the nation Obesity is common, serious, and costly. Behavior and environment play a large role causing people to be overweight and obese. These are the greatest areas for prevention and treatment actions. Weight of the Nation brings together public health researchers and practitioners, policy makers, and national partners devoted to obesity prevention and control to raise awareness across the country as well as share approaches that show promise or demonstrated success for improving healthy eating and active living. Over 1,200 people gathered in Washington, D.C. on May 7-9 for the Weight of the Nation 2012 conference. The Weight of the Nation is also a documentary series and public health campaign. Three years in the making, the campaign is an unprecedented collaboration of HBO and the Institute of Medicine, is association with CDC, the National Institutes of Health, made in partnership with the Michael & Susan Dell Foundation and Kaiser Permanente. The core of The Weight of the Nation campaign are four feature films that take an unflinching look at the severity of the obesity epidemic and its crippling effects on our health care system. The films broadcast on May 14-15 on HBO, and will stream free of charge after the broadcast at theweightofthenation.hbo.com For more information, visit http://www.cdc.gov/Features/weightofthenation/ ---PAGE BREAK--- Women’s health week National Women’s Health Week is a nationwide observance that begins on Mother’s Day. During the week of May 13 through May 19, individuals, families, communities, and others work to help women learn how to achieve longer, healthier, and safer lives. This year’s theme is “It’s Your Time!” and encourages women to take simple steps to improve their physical and mental health and lower their risks of certain diseases. Some of these steps include: visiting a health care professional for regular checkups and preventive screenings; getting active; eating healthy; paying attention to mental health, including getting enough sleep and managing stress; and avoiding unhealthy behaviors, such as smoking or not wearing a seatbelt or bicycle helmet. For more information, visit www.womenshealth.gov Lyme disease 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. May is Lyme Disease Awareness Month. Maine CDC issued an advisory on May 1 to provide general information regarding ticks and Lyme disease; remind providers to report cases of Lyme disease, including those diagnosed by erythema migrans; provide resources on diagnosis and treatment of Lyme disease; and remind providers that Anaplasma, Babesia and other tickborne disease are also increasing in Maine. The full health alert is available at http://go.usa.gov/V4q The 2011 Lyme disease surveillance report is now available at http://go.usa.gov/VgS 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 Childhood lead poisoning prevention US CDC has issued its response to their Advisory Committee on Childhood Lead Poisoning Prevention’s recommendations presented in its report: Low Level Lead Exposure Harms Children: A Renewed Call of Primary Prevention (http://go.usa.gov/prD). The most notable response is that for the first time in 20 years, US CDC will revise the blood lead level considered to be elevated. The Advisory Committee recommended adopting a new reference value of 5 micrograms per deciliter (5 ug/dL) for identifying children with an elevated blood lead level, and US CDC has announced that it concurs with the use of this value. The new reference value replaces the value of 10 ug/dL, which has been used as the benchmark for identifying children having an elevated blood lead level since 1991. This change was motivated by a growing body of studies concluding that blood lead levels (BLLs) <10 μg/dL harm children, resulted in decreased IQ and other behavioral deficits such as attention-related behaviors and academic achievement. Since no safe blood level in children has been identified, the Advisory Committee recommended the reference level be set at a value that represents a high level of exposure in the U.S. population – a level present in no more than 2.5 percent of young children. Maine has tracked the number of children with a blood lead level of 10 ug/dL and higher for years, with the number of children above this benchmark dropping from over 200 in 2003 to about 100 children in 2010. Maine estimates that there about 400 children under age 6 years were identified as having a blood lead level above 5 ug/dL in 2010. Since no safe blood level in children has been identified, US CDC also concurred in principle with the Advisory Committee’s recommendation for an increased focus on primary prevention. Fortunately for Maine children, a shift to primary prevention has already occurred because of action by the Maine Legislature to establish the Lead Poisoning Prevention Fund to support primary prevention efforts. Maine CDC’s Childhood Lead Prevention Program already mails primary prevention information to all families in Maine with a 1- or 2-year-old. In addition, the program will soon be offering free lead dust test kits to all families with a child with a blood lead level of 5 ug/dL lead or more. US CDC also concurred with the Advisory Committee’s recommendation that clinicians should monitor children with a confirmed BLL ≥ 5 μg/dL for subsequent changes in blood lead levels until all recommended environmental investigations and mitigation strategies have been completed. US CDC plans to assist with provider training and develop guidance for implementing this recommendation. For more information about childhood lead poisoning, visit http://go.usa.gov/prK ---PAGE BREAK--- Health equity DHHS Commissioner Mary Mayhew and our legal counsel have approved the change in name of the Office of Minority Health to the Office of Health Equity. This is a national trend to recognize all groups that experience health disparities and the move toward the integration of health equity as a framework for the work we do. Our goal is to have equality for all. With that said, we also recognize the need to work on data integrity for populations that experience health disparities. Of particular importance for this name change is to better reflect the work that the Office is currently involved with. With the Maine CDC reorganization in the Fall of 2011 we brought the Women's Health Program under the jurisdiction of the Office, as we provide services to underserved women across the state. Additionally, we are well aware of disparities that impact women disproportionately. We will also be adding a child wellness liaison to the Office of Health Equity. We will have a more deliberate focus on our most vulnerable population. By working with Therese Cahill Lowe, the director of the Office of Child and Family Services, we developed a plan for Maine CDC’s Office of Health Equity to gain capacity to address issues related to children who are at risk. Breast cancer plate An effort is underway to create a Maine Breast Cancer specialty license plate for similar to the specialty plate for automobiles that was first released in 2008. In order to begin a formal legislative process to gain approval for the specialty plate, 500 reservations (along with payment of $25) must be obtained. These reservations guarantee a plate when they become available. Proceeds from these license plates will be evenly distributed among the Maine Cancer Foundation; the Maine Breast Cancer Coalition’s Support Service Fund; and Maine CDC’s Breast and Cervical Health Program, which will allocate funds directly to the cost of mammograms received by clients age 40-49. For more information or to reserve a plate, visit Influenza Maine CDC reported regional flu activity for the week ending May 12. 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 Community transformation On May 14 and 15, Maine CDC’s Division of Population Health hosted a statewide meeting of District grantees working on the Community Transformation Grant. The Community Transformation Grant is a competitive award received from US CDC to assist Maine’s communities in becoming places where healthier choices are easier to make. The three focuses of the Community Transformation Grant are: tobacco-free living, active living and healthy eating, and high blood pressure and cholesterol control. The statewide meeting provided local partners with essential information and tools to assist them in implementing their work within schools and child care settings within the Districts. Unhealthy weight and obesity contribute to many of the leading causes of death in the United States, including heart disease, stroke, diabetes, and some types of cancer. The increasing rate of childhood obesity is a public health crisis, in some Maine counties more than 15% of Maine’s low income children ages 2-4 are reported as obese. ---PAGE BREAK--- New reports Maine CDC has issued the report Gays, Lesbians and Bisexuals in Maine: A Behavioral and Health Profile: http://go.usa.gov/p1P US CDC has issued a report providing a decade of analysis of various foodborne illnesses: http://go.usa.gov/paX This new Institute of Medicine report identifies strategies with the greatest potential to accelerate success in obesity prevention by making healthy foods and beverages and opportunities for physical activity easy, routine, and appealing aspects of daily life: http://www.iom.edu/Reports/2012/Accelerating- Progress-in-Obesity-Prevention.aspx Rural health IT toolkit This Rural Health IT Toolkit (http://www.raconline.org/collaborate/pr_hittoolkit.php) is intended to serve as a resource on health IT for rural health care providers. It includes resources related to understanding health IT, the role of various Federal agencies, the legislation mandating meaningful use, and technical assistance resources to support meaningful use. Active Community Conference Maine's Active Community Conference will be held May 31 at University of Southern Maine's Abromson Conference Center in Portland. A full session will be held from 8:30 a.m. to 3:45 p.m., and is targeted primarily for professionals working in local policy, programs, and infrastructure that impact Active Community Environments. An evening session from 5:30 p.m. to 8:30 p.m. is designed for elected officials and citizen volunteers who are so critical to this effort but who may not be able to attend a full daytime conference. Public and private sector professionals in the fields of Public Health, Transportation, Parks & Recreation, Planning, Public Safety, Economic Development and Public Works, as well as Elected Officials, Citizens, City and Town Mangers, Business Owners and others interested in improving their communities should attend. The cost is $40 for the full day session and $10 for the evening session. For more information: To register: 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]