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Dr. Sheila Pinette Director, Maine CDC Osteopathic physician Public Health Update September 20, 2012 In this update: Falls Prevention Awareness Day Cancer Universal childhood immunizations Upcoming summit meeting Pertussis (whooping cough) Infectious disease conference World Rabies Day Flu EEE FDA consumer updates Follow us Falls Prevention Awareness Day September 22 is Falls Prevention Awareness Day in Maine. In 2010, 64 Maine citizens ages 65 and older died from injuries related to unintentional falls. Maine is home to the nation’s oldest citizens per capita in the U.S. Falls among older Maine people are the leading cause of outpatient emergency department visits and hospital discharges. Many falls are preventable and evidence-based programs show promise in reducing falls and facilitating cost- effective interventions. Some examples of prevention techniques include conducting comprehensive clinical assessments, exercise programs to improve balance and strength, management of medications, correction of vision, and reduction of home hazards. It is important to raise awareness for some preventable ways to help keep older citizens safe. Cancer Cancer is the leading cause of death in the state: Maine’s death rate due to cancer (any cause) is significantly higher than the U.S. White rate. According to the 2012 Maine Annual Cancer Report, Maine’s age–adjusted cancer mortality rate for All Malignant Cancer was 186.3 compared the U.S. Whites rate of 174.9. The 2012 Report identifies the top four cancers in Maine to be female breast, prostate, lung, and colorectal cancers. ---PAGE BREAK--- Age-Adjusted Cancer Mortality Rate by Site, 2008 Cancer site Maine U.S. Whites All Malignant Cancer 186.3 174.9 Colon and Rectum 16.3 15.8 Prostate (male population) 23.5 21.2 Breast (female population) 21.8 21.9 Source: Maine Annual Cancer Report 2012: Rates are calculated per 100,000 population and age-adjusted to the year 2000 U.S. standard population. The Maine Cancer Registry has recently been honored with two national recognitions. In August, the Maine CDC Cancer Registry was recognized by U.S. CDC National Program of Cancer Registries (NPCR) for achieving highest Standards for Data Completeness, Timeliness, and Quality. The Maine Registry achieved recognition for achieving both the Advanced and National Data Quality and Completeness Program as well as the standards for U.S. Cancer Statistics Publication. In June, the Maine Cancer Registry received Gold Level Certification Status from the North American Association of Central Cancer Registries (NAACCR). The 2012 Gold Certification is for 2009 cancer incidence data. NAACCR recognizes states that achieve reporting with complete, accurate, and timely data. Maine has achieved and maintained the Gold Level Certification Status since 2004. 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 to improve detection and follow up at an earlier stage, improving outcomes. Maine hospitals are partners in this effort, providing up to date local information to the Maine CDC Cancer Registry. ---PAGE BREAK--- Universal childhood immunizations Public Law 2009-595 went into effect on January 1. This law reinstated the universal status of childhood immunizations in Maine. As part of this legislation the Maine Vaccine Board (MVB) was formed to help the State of Maine reinstate its universal purchase of vaccines for children under age 19. The MVB assures the necessary flow of vaccine purchase funds by collecting payments from health plans, insurance companies, and other payers and remitting the funds to the state. Through the Maine CDC's Childhood Vaccine Program, the State purchases vaccines at favorable rates and distributes them to providers at no charge. This means that all Advisory Committee on Immunization Practices (ACIP) recommended vaccines are now available to all Maine children under age 19 at no cost to the child’s family or to providers in the State of Maine. This program has many benefits for Maine citizens: • reduces out-of-pocket vaccine costs for parents • improves vaccination rates in Maine children • lowers costs of vaccines through a public-private partnerships • lowers vaccine costs in provider offices • improves vaccine access by creating a single- tier system in provider offices • most importantly, will improve vaccine rates by offering combination vaccines to reduce missed opportunities. For more information: http://www.mevaccine.org/ 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. This summit is convened to: • Highlight recent efforts on the local, state, and national levels to integrate mental health into public health planning, policy, programming, and surveillance activities; • Provide mental health professionals with information on the benefits of self-management behaviors that can improve mental health status and quality of life (physical activity, stress reduction, tobacco cessation) as well as public health resources available to them in their work; • Provide public health professionals with information on the impact that mental health has on chronic disease, health risk behaviors, and self-management as well as mental health resources available to them in their work; and • Promote collaboration/action planning between mental health and public health professionals on mental health promotion and mental illness prevention activities. 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. To register: http://www.surveymonkey.com/s/QZ55T63 Pertussis (whooping cough) Pertussis cases continue to be reported in Maine. Most reported cases have been in children ages 7 to 19. More than 20 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 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/ ---PAGE BREAK--- World Rabies Day On September 28, the State of Maine will celebrate the sixth annual World Rabies Day. Although Maine has not had a case of human rabies since 1937 due to reporting and effective control measures, the threat of rabies remains. Last month, Maine CDC was notified of a domestic dog that tested positive for rabies. This is the first case of rabies in a domestic dog in Maine since 2003. This case reminds us of the importance of keeping pets up-to-date on rabies vaccine and avoiding contact with wild animals to prevent the spread of rabies. The dog was infected with a variant of the rabies virus that circulates most commonly in raccoons and is predominant in the eastern United States. Rabies is a preventable viral disease of mammals. The virus is spread when infected animals bite or scratch a person or another animal. The virus can also be spread if saliva or tissue from the brain or spinal cord of a rabid animal touches broken skin or gets into the mouth, nose or eyes of a person or another animal. All mammals are susceptible to rabies infection, but only a few wildlife species are important reservoirs for the disease, including raccoons, skunks, bats, and foxes. While wildlife are more likely to be rabid than are domestic animals in the United States, domestic animals can be infected when they are bitten by wild animals. Rabies in humans is preventable through prompt appropriate medical care. If you or someone you know is bitten or scratched by an animal, wash the wound with soap and water right away, and contact your healthcare provider to find out if you need to be treated for a rabies exposure. Usually, medical care can be delayed if rabies can be ruled out in the biting animal either through a confinement period for domestic animals or rabies testing for wild animals. All Mainers are encouraged to consider ways in which they can prevent the spread of rabies including: • Vaccinate your pet cats and dogs against rabies; it is the law. • Avoid contact with wild animals or other animals that you do not know. • Bat proof your home. Wildlife biologists can provide tips on how to bat proof your home without harming bats but preventing them from entering your home. For more information, contact your local animal control officer or Maine CDC at 1-[PHONE REDACTED]. Stop by at our World Rabies Day Table in the lobby of KeyBank Plaza on Water Street in Augusta from 8 a.m. to 2 p.m. Thursday, September 27. Flu Weekly updates on flu activity will resume in October. 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 EEE On September 10, Maine’s Health and Environmental Testing Laboratory confirmed Eastern equine encephalitis (EEE) in a pheasant flock from York County. This is the first report of EEE activity in Maine in 2012; however, 4 pools of mosquitoes tested positive for West Nile virus (WNV) earlier this year. Like WNV, EEE is transmitted through the bite of an infected mosquito. EEE is the most severe arboviral illness in the United States. It can cause illness in humans, horses, llamas, alpacas, and game birds. While there is a vaccine for horses, there is no human vaccine to protect against EEE. Treatment is based on alleviating the of the infection. For more information, see the health alert issued Sept. 11: http://go.usa.gov/re9J ---PAGE BREAK--- FDA consumer updates The US Food and Drug Administration (FDA) has recently issued the following consumer updates: • Since May 2011, the agency has identified 22 infants who developed necrotizing enterocolitis (NEC), a condition in which tissue in the intestines becomes inflamed and dies, after being fed a thickening product called Seven of those infants died. Further study is needed to determine if there is an actual link between consumption of and the development of NEC. But, FDA wants everyone involved in the care of a baby to be aware of the potential risk before deciding whether to feed to infants of any age. For more information: http://go.usa.gov/reXQ • FDA Looks for Answers on Arsenic in Rice: FDA monitors hundreds of foods and beverages that make up the average American diet, including rice and rice products, foods that FDA has specifically tested for the presence of inorganic arsenic, a chemical that under some circumstances has been associated with long- term health effects. Based on data and scientific literature available now, FDA is not recommending that consumers change their consumption of rice and rice products at this time, but that people eat a balanced diet containing a wide variety of grains. For more information: http://go.usa.gov/reXw 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]