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In this update:
Reports of multiple tick-borne diseases to Maine CDC are
indicating an increase in all tick-borne diseases. Physicians
have already reported more anaplasmosis cases so far this year than all of last
year, and babesiosis and Lyme numbers are steadily increasing as well.
Providers should be aware of the risk and prevalence of these diseases and
consider them in their diagnoses.
Anaplasmosis:
- 228 cases reported to date in
2016, compared to 186 in all of 2015
- 116 cases reported from the Mid
Coast region (Knox 49, Lincoln 43, Sagadahoc 18 and Waldo six)
Babesiosis:
- 49 cases have been reported to date
in 2016, compared to 55 in all of 2015
- 13 cases reported from York
county, ten cases from Knox county
Lyme disease:
- Lyme disease cases take several
months to be entered and classified, so current numbers are not available
at this time
Powassan:
- No cases have been reported to
date in 2016, compared to one in all of 2015
Co-infections:
Because all of these diseases are carried by the same tick
(Ixodes scapularis), a person may be infected with more than one disease.
- To date, 11 co-infections have
been reported: four co-infections with anaplasmosis and Lyme disease, two
co-infections with babesiosis and Lyme disease and five co-infections with
anaplasmosis and babesiosis.
- In 2015, 22 co-infections were
reported: ten co-infections of Lyme disease and anaplasmosis; eight
co-infections of Lyme disease and babesiosis; one co-infection of
anaplasmosis and babesiosis; one co-infection of Lyme disease,
anaplasmosis and babesiosis; one co-infection of Lyme disease and ehrlichiosis;
and one co-infection of babesiosis and ehrlichiosis.
Recommendations for Providers:
- Consider tick-borne illnesses
in your differential, particularly for individuals with “summer flu”
symptoms
- Submit samples for testing
- Treat patients appropriately –
recommendations for treatment are available from http://www.idsociety.org/uploadedfiles/idsa/guidelines-patient_care/pdf_library/lyme%20disease.pdf
- Report cases. All tick-borne
illnesses are reportable in Maine, including the erythema migrans rash
which is confirmatory. All cases should be reported by phone to
1-800-821-5821 or by fax to 1-800-293-7534.
For more information:
During Lyme Disease Awareness Month, Maine CDC held many events
to raise awareness of the disease and increase knowledge about prevention. One
of the highlights is the annual poster design contest for students in
kindergarten through eighth grade.
This year’s theme was Tick Watch, with an emphasis on the
awareness of ticks and prevention of tick bites. Students were asked to
illustrate at least one of the prevention methods from the ‘No Ticks 4 ME’
educational campaign:
- Using EPA-approved repellant
- Wearing protective clothing
- Performing daily tick checks
- Using caution in tick infested
area
Maine CDC received many great submissions for the 2016 contest,
and one poster winner was selected from each of the three participating age
groups: K-3; 4-5; 6-8. They are:
- Reid Robishaw, Kindergarten,
Gilford Butler School
- Elizabeth Grondin, Grade 4, Jay
Elementary School
- Vanessa Luce, Grade 6, Warren
Community School
The winning posters are viewable at www.maine.gov/lyme. Each winner received a
Maine State Parks family day pass, a certificate and tick removal kits for
their entire classroom.
Gonorrhea is the second most commonly reported notifiable
disease in the United States. National concerns about increasing rates of
gonorrhea and increasing antimicrobial resistant strains of N. gonorrhoeae are
prompting increased efforts to ensure adherence to the revised 2015 Sexually
Transmitted Disease Treatment Guidelines.
U.S. CDC now recommends treating gonorrhea with ceftriaxone
250 mg as a single intramuscular dose and azithromycin 1 g orally.
Clinicians need to use dual therapy and stay up to date with
treatment recommendations:
- Data show that resistance
decreases when the correct dual therapy is used.
- Using azithromycin as a
monotherapy to treat gonorrhea might promote the emergence of azithromycin
resistance.
- Patients with cephalosporin
allergies should be treated with azithromycin 2 g plus either gentamicin
or gemifloxacin.
There has been a steady
increase in the number of reported gonorrhea cases in Maine. As of June 30,
2016, 251 cases of gonorrhea have been reported to the Maine CDC. The five-year
median for this time period is 116 cases. The increase in gonorrhea in Maine
mirrors a national trend reported by U.S. CDC.
Breastfeeding is one of the most effective steps a mother can
take to protect the health of her baby. All major medical authorities recommend
that mothers breastfeed exclusively for six months. In 2013, 87 percent of
Maine infants were ever breastfed, similar to the national average. More Maine
infants were exclusively breastfed for six months, 32 percent, than compared to
the U.S., 22 percent.
Maine’s efforts to protect, promote and support breastfeeding
include:
The Florida Department of Health has identified an area with
local mosquito-borne Zika virus transmission in Miami. U.S. CDC has issued
guidance which applies to women of reproductive age and their partners who
lived in or traveled to this area after June 15.
Current recommendations are:
- Pregnant women should avoid
non-essential travel to the Miami area with active Zika virus transmission
identified by the Florida Department of Health
- All pregnant women in the U.S.
should be assessed for possible Zika virus exposure during each prenatal
care visit
- Pregnant women with possible
exposure to Zika virus and signs or symptoms consistent with Zika virus
should be tested for infection
For more information:
Maine Public Health Association (MPHA) will be holding its
annual fall conference from 8:30 a.m. to 3:30 p.m. October 18 at
the Abromson Center at the University of Southern Maine, 88 Bedford St.,
Portland.
APHA President, Dr. Camara Jones will deliver the keynote
presentation. In addition to eight breakout sessions there will be
afternoon plenary sessions from the Brady Campaign to Prevent Gun Violence and
Info Inspired.
For more information and to register, visit https://mpha23.wildapricot.org/event-2146973
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