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Maine Center for Disease Control and Prevention (Maine CDC) MAINE PUBLIC HEALTH ALERT NETWORK SYSTEM Maine Department of Health and Human Services Maine Center for Disease Control and Prevention (Maine CDC) (Formerly Bureau of Health) 11 State House Station Augusta, Maine 04333-0011 Phone 1-[PHONE REDACTED] / Fax [PHONE REDACTED] **ADVISORY – Important Information** 2012PHADV015 TO: Academic, Animal Care, Epidemiologists, HETL, City and County Health Departments, All Healthcare, Lab Facilities, County EMA, Maine Medical Association, Public Health, EMS Regional Coordinators, Regional Resource Centers FROM: Dr. Sheila Pinette, Maine CDC Director Dr. Stephen Sears, State Epidemiologist SUBJECT: Eastern Equine Encephalitis Positive Pheasant DATE: Tuesday, September 11, 2012 TIME: 3:00PM PAGES: 2 PRIORITY: Medium Confidentiality Notice: This message is intended for the exclusive use of the individual or entity identified above. It may contain information, which is privileged and/or confidential under both state and federal law. If you are not notified otherwise, any further dissemination, copying, or disclosure of the communication is strictly prohibited. If you have received this transmittal in error, please immediately notify us at 287-6551 and return the original transmission to us by mail at Key Bank Plaza, 6th Floor-286 Water Street. Augusta, ME 04333, without making a copy. Your cooperation in protecting confidential information is greatly appreciated. ---PAGE BREAK--- Maine Center for Disease Control and Prevention (Maine CDC) Eastern Equine Encephalitis Positive Pheasant On September 10, 2012 Maine’s Health and Environmental Testing Laboratory (HETL) confirmed Eastern equine encephalitis (EEE) in a pheasant flock from Lebanon in York County. Maine CDC and the Maine Department of Agriculture were notified of multiple deaths in a pheasant flock in the first week of September. The bird that tested positive died on September 6th as a result of the infection. 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. In the fall of 2008, a Massachusetts resident vacationing in Cumberland County died of the disease; it is unclear where he contracted the infection. In 2009, Maine experienced unprecedented EEE activity with 19 animals and 2 mosquito pools testing positive. Regionally there has been EEE activity in Massachusetts, New Hampshire, and Vermont in 2012, including 5 human cases – 2 in Vermont and 3 in Massachusetts. Prevention: Maine CDC recommends the following preventative measures to protect against EEE and other mosquito-borne illnesses: • Use an EPA approved repellent when outdoors, especially around dawn and dusk – always follow the instructions on the product’s label • Wear protective clothing when outdoors, including long-sleeved shirts, pants, and socks • Use screens on your windows and doors to keep mosquitoes out of your home • Limit time outdoors at dawn and dusk when many species of mosquitoes are most active • Practice household mosquito-source reduction: standing water should be removed from artificial water-holding containers in and around the house • Vaccinate horses (there are effective vaccines to prevent EEE and WNV in horses; horses with arboviral illness do not pose a risk to human health) Testing: Maine CDC encourages providers to test for arboviral illness in patients presenting with unexplained encephalitis, meningitis or high fever (greater than 100.4°F or 38°C) during the late summer and early fall. If arboviral infection is suspected based on clinical evidence, serum samples and CSF (if available) should be submitted for arboviral testing. Arboviral testing for EEE and WNV can be performed at HETL. HETL requires the submitter to complete an arboviral submission form. All samples of CSF should be accompanied by a serum sample. Ideally an acute and a convalescent serum sample should be submitted for each patient. • Acute serum samples should be collected within 14 days of onset of • Convalescent serum samples should be collected 10 days to 4 weeks following the acute specimen Reporting: Arboviral illness is reportable in Maine. All suspect cases, and any positive laboratory reports should be reported by phone to the disease reporting and consultation line at 1-[PHONE REDACTED] or by fax to 1-[PHONE REDACTED]. More Information: More information on arboviral illness is available at Maine CDC’s Vector-Borne Disease website at Information on pesticides and repellents is available at the Maine Board of Pesticides Control website at http://www.maine.gov/agriculture/pesticides/public/index.htm#mosquito.