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Dr. Sheila Pinette Director, Maine CDC Osteopathic physician Public Health Update October 17, 2013 In this update: Hepatitis A outbreak and response Acute hepatitis health alert Flu Tick-borne diseases Pertussis (whooping cough) Dental bond assists dental school and community-based clinics Upcoming events Follow us Hepatitis A outbreak and response Maine CDC’s Infectious Disease Epidemiology Program recently investigated a case of hepatitis A virus (HAV) infection that was traced to a community event in Durham. A person infected with HAV prepared and served food at a church supper attended by about 100 people. When administered within two weeks of exposure to hepatitis A, vaccination is very effective in preventing illness. Representatives from Maine CDC’s Public Health Nursing (PHN) Program, Infectious Disease Epidemiology Program, and Maine Immunization Program collaborated to plan and execute a free, public hepatitis A vaccine clinic. The Maine Immunization Program procured the vaccine and assisted in the clinic logistics, including answering questions about the vaccine and other doses needed. Five public health nurses and the PHN supervisor participated in the clinic, administering vaccine to 52 adults and six children. For more information about the initial investigation and response, see the press release at http://go.usa.gov/Dz4F For more information about prophylaxis and treatment, see the health alert at http://go.usa.gov/Dz23 Acute hepatitis health alert US CDC has issued a health alert about acute hepatitis and liver failure following the use of a dietary supplement intended for weight loss or muscle building. In September, the Hawaii Department of Health was notified of seven patients with severe acute hepatitis and sudden liver failure of unknown cause. The patients were previously healthy and sought medical care from May through September 2013. Clinicians reported that the seven patients had all used OxyELITE Pro, a dietary supplement marketed for weight loss and muscle gain, prior to illness onset. Following a health alert issued by the Hawaii Department of Health, an additional 22 people were confirmed to have acute hepatitis after using a nutritional supplement for weight loss or muscle building. Of the total 29 identified patients, 24 (83%) reported using OxyELITE Pro during the 60 days prior to illness onset. There was no other dietary supplement or medication use reported in common by more than two patients. National case finding efforts have identified several individuals from states outside Hawaii with reported OxyELITE Pro or other weight loss or muscle building dietary supplement use prior to the development of acute hepatitis of unknown cause. US CDC, in collaboration with state health departments, is collecting additional clinical and epidemiologic information from these individuals to determine if this outbreak is national in scope. For more information, see the health alert at http://emergency.cdc.gov/HAN/han00356.asp ---PAGE BREAK--- Flu Maine CDC has updated its flu website for the 2013-2014 season at www.maineflu.gov. Maine reported sporadic flu activity for the week ending Oct. 5 and no flu activity for the week ending Oct. 12. Weekly updates on flu activity are available at http://go.usa.gov/DHM6. 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 US CDC has published a summary of the recommendations of the Advisory Committee on Immunization Practices (ACIP) for the 2013-2014 flu season at http://go.usa.gov/jdfB The Vaccine Information Statements (VIS) for this coming season’s vaccines are available at http://go.usa.gov/jdAC Tick-borne diseases Babesiosis, a parasitic infection transmitted the same tick that carries Lyme disease, is an emerging infection in Maine. A total of 32 cases of babesiosis have been reported since January, compared to a total of 10 cases in all of 2012. Other diseases are also carried by ticks in Maine, including anaplasmosis and Lyme disease. There have been 59 cases of anaplasmosis in Maine to date this year, compared to 52 in all of 2012. There have been 1,073 cases of Lyme so far this year, compared to 1,111 in all of 2012. For more information: • Info on tick-borne diseases: http://go.usa.gov/jtFJ • To order tick educational materials: http://go.usa.gov/jtMY • Aug. 15 health alert on babesiosis: http://go.usa.gov/jtMB • May 30 health alert on Lyme disease: http://go.usa.gov/bnhR Pertussis (whooping cough) Pertussis (whooping cough) is a cyclical disease that continues to affect a significant number of Maine residents. There have been 292 reported cases of pertussis so far this year in Maine. This is less than the 585 reported cases for the same period last year, but is more than the five-year median. Oxford county has the highest rate of pertussis in the state, and the majority of cases have occurred in people ages 7-19. Maine CDC encourages providers continue to test and treat patients. DTaP vaccine is recommended for all infants and children. Tdap vaccine is recommended for all preteens, teens, and adults. For more guidance and information, visit http://go.usa.gov/dCO or see the update on statewide pertussis from July 30 at http://go.usa.gov/jdfe. ---PAGE BREAK--- Dental bond assists dental school and community-based clinics The University of New England’s new College of Dental Medicine held its formal ribbon-cutting ceremony on October 2. Gov. Paul LePage spoke and helped cut the ribbon, as one of the supporters of this program. The inaugural class of 64 students includes 24 from Maine. As they proceed through their professional training, the students will spend up to a year as externs in community-based dental clinics throughout Northern New England, including a number in Maine. Funds from a bond approved by Maine voters in November 2010 contributed to UNE’s state-of –the-art Oral Health Center and teaching clinic in Portland. Bond-related grants will now assist nine organizations in 11 locations throughout the state, from Sanford to Presque Isle, to upgrade their dental clinics to meet standards for hosting students, with the more immediate impact of improving access to dental services by allowing more efficient and cost-effective care. Contracts are in process for those projects, most of which will be completed within three to six months. All will be completed by the end of 2014. Upcoming events • Maine Public Health Association, American Lung Association of the Northeast, American Heart Association, American Cancer Society Cancer Action Network, Maine Medical Association, and Maine Osteopathic Association are co-hosting Public Health Policy & Advocacy: What You Really Want to Know but are Afraid to Ask from 12-4:30 p.m. Oct. 21 at the State House. For more information and to register: http://events.constantcontact.com/register/event?oeidk=a07e861d87l3db63a42 • Maine Public Health Association’s Fall Conference will be held from 8 a.m. to 4:30 p.m. Oct. 22 at the Augusta Civic Center. The theme of the conference is Health in All Policy: The Value of Public Health in Maine. For more information and to register: • Maine Medical Center will be holding a conference, Safe Patient & Family-Centered Care: Transdisciplinary Approaches to Caring for Drug Affected Mother/Baby Dyads from 7:30 a.m. to 4:30 p.m. Oct. 29 at MaineHealth, 110 Free Street, Portland. For more information and to register: http://www.cvent.com/d/x4q7pd?RefID=OTH • Maine CDC’s 2013 Division of Infectious Disease Conference will be held from 8:15 a.m. to 4:15 p.m. Nov. 13 at the Augusta Civic Center. The conference website is available at http://www.cvent.com/d/pcqy5p The website includes a summary, agenda, conference brochure, information about fees, and the link to register. • The State of Maine Acquired Brain Injury Advisory Council and Goodwill Industries of Northern New England are sponsoring a conference from 7:30 a.m. to 4:30 p.m. Nov. 15 at the University of Southern Maine in Portland. Dr. Jeffrey S. Kreutzer will present on Practical Approaches to Family Intervention After Brain Injury and Other Neurological Disorders. The cost is $65 to attend. Registration must be received by Nov. 8. For more information, contact Danielle Tapley at 795-6110 or [EMAIL REDACTED] ---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]