Maine CDC Health Alert Network System (HAN)

Archived Alerts

Alert	Date	File(s)
Maine School-Located Influenza Vaccine Funding for K-12 Schools	October 25, 2009	Word PDF
In collaboration with the Maine Center for Disease Control and Prevention (Maine CDC) in the Maine Department of Health and Human Services we enter into this agreement to offer seasonal influenza and H1N1 influenza vaccines in K-12 schools. This partnership sets the foundation not only to protect the health of school children and the school community, but also to protect the health of the entire community, including siblings, parents, and the elderly. Since children are major transmitters of influenza, vaccinating them provides protection throughout the community. Additionally, offering vaccines in schools will help reduce the impact of large scale vaccination clinics on the health care system, which may be overstretched by a surge in H1N1 and/or seasonal influenza during the time in which many people will need and be seeking vaccination.	October 25, 2009	Word PDF
Widespread Influenza Activity in Maine	October 23, 2009	Word PDF
Influenza activity in Maine has increased during the past week. Additionally, this week laboratory confirmed seasonal influenza H3 and influenza B were reported, indicating seasonal variants of influenza are also present in Maine. The purpose of this health advisory is to request that health care partners report cases of laboratory-confirmed 2009 H1N1 influenza and any cases of influenza (seasonal or 2009 H1N1) among patients who are hospitalized, have died, and/or are associated with an outbreak.	October 23, 2009	Word PDF
Maine CDC/DHHS Update on Novel Influenza A (H1N1) Virus	October 22, 2009	Word PDF
The 2009 novel H1N1 influenza virus is the predominant influenza virus in circulation in most countries worldwide. The vast majority of the U.S. is seeing widespread influenza, with nearly all of it being the 2009 novel H1N1 influenza strain. Outpatient visits for influenza-like illness (ILI) increased in much of New England. Maine continues to see overall increases in outpatient visits for ILI.. Much of this is most likely due to novel H1N1. The vast majority of people with ILI are not being tested, and do not need to be. People with confirmed H1N1 are primarily children and young adults. The first confirmed person with H1N1 in Aroostook County was reported in the northern part of that county this week. Gould Academy has had 3 students confirmed with H1N1 as well as 2 other students and 2 staff with the symptoms. Two cases of seasonal influenza have been confirmed this last week in Maine, in individuals in Cumberland and Androscoggin counties. The vast majority of cases in Maine – as well as across the country – are novel H1N1.	October 22, 2009	Word PDF
Maine Animal Rabies 3rd Quarter Update	October 9, 2009	Word PDF
The Maine Center for Disease Control and Prevention (Maine CDC) provides a quarterly update on animal rabies to veterinarians and other animal health professionals. This update may be used as an educational tool to increase the understanding of pet owners and other members of the public regarding the risk of rabies in Maine and in their communities. This update is for rabid animals for the third quarter of 2009 or January 1 – September 30, 2009 (Table). Visit the Maine CDC rabies prevention website for more information, including rabies testing data updated regularly: http://www.maine.gov/dhhs/boh/ddc/epi/zoonotic/rabies.shtml The count of positive animals statewide may not be representative of the true incidence of animal rabies. Results are based on only those animals submitted for testing due to contact with a human or domestic animal.	October 9, 2009	Word PDF
Updated Clinical Testing and Management Guidance for ILI	October 9, 2009	Word PDF
This advisory provides an updated algorithm for health care providers in Maine for testing and management of influenza-like illness (ILI). Health care providers and other public health partners are asked to report to Maine CDC influenza infection among patients who: • Are hospitalized; • Have died; and/or • Are associated with a suspected outbreak. Health care providers with questions on influenza can contact the Maine CDC at 1-800-821-5821 24 hours a day, 7 days a week.	October 9, 2009	Word PDF
Update on H1N1 and Seasonal Influenza Vaccine	October 7, 2009	Word PDF
There is a lot of new information contained in the health advisory below, especially: new information on the anticipated distribution of H1N1 vaccine; resulting guidance on the administration of the H1N1 vaccine; ongoing delays in seasonal flu vaccine distribution; and emergency rules related to health care and some other facilities offering H1N1 vaccine to direct patient staff similar to what they are now required to do for seasonal influenza vaccine. We anticipate information to continue to change rapidly, so please stay informed. We at Maine CDC are greatly appreciative to all Maine health care providers, schools, emergency management, public health, and many other stakeholders for being patient and flexible and for your continued dedication to effectively addressing this pandemic.Approximately 14,800 doses of H1N1 nasal spray (LAIV=live attenuated influenza vaccine) is arriving in Maine this week. We are ordering about another 20,000 doses of H1N1 vaccine this week, both injectable and nasal spray. This additional supply should arrive in Maine next week, for a total of about 35,000 doses in the state. While this may seem like a lot of vaccine, it is not, when one considers there are 1.3 million people in Maine.	October 7, 2009	Word PDF
Update on H1N1 and Seasonal Influenza Vaccine	October 7, 2009	Word PDF
There is a lot of new information contained in the health advisory below, especially: new information on the anticipated distribution of H1N1 vaccine; resulting guidance on the administration of the H1N1 vaccine; ongoing delays in seasonal flu vaccine distribution; and emergency rules related to health care and some other facilities offering H1N1 vaccine to direct patient staff similar to what they are now required to do for seasonal influenza vaccine. We anticipate information to continue to change rapidly, so please stay informed. We at Maine CDC are greatly appreciative to all Maine health care providers, schools, emergency management, public health, and many other stakeholders for being patient and flexible and for your continued dedication to effectively addressing this pandemic. Approximately 14,800 doses of H1N1 nasal spray (LAIV=live attenuated influenza vaccine) is arriving in Maine this week. We are ordering about another 20,000 doses of H1N1 vaccine this week, both injectable and nasal spray. This additional supply should arrive in Maine next week, for a total of about 35,000 doses in the state. While this may seem like a lot of vaccine, it is not, when one considers there are 1.3 million people in Maine.	October 7, 2009	Word PDF
First Orders of H1N1 Vaccine to Be Submitted This Week	September 30, 2009	Word PDF
Maine CDC is placing orders with U.S. CDC for the first shipments of H1N1 vaccine this week, starting Wednesday, September 30th. The first shipments are not expected to arrive until later next week (the week of October 5th) and will consist of only a limited number of one type of H1N1 vaccine, the H1N1 LAIV (Live Attenuated Intranasal Vaccine). This nasal formulation is limited to healthy non-pregnant 2 – 49 year olds. In terms of the high-risk populations for H1N1, this vaccine is most appropriate for young healthy children and household contacts of young infants. Maine CDC urges pediatric and obstetrical health care providers to register and submit orders for H1N1 vaccine as soon as possible.	September 30, 2009	Word PDF
Updated Pediatric Antiviral Dosing Information for Seasonal and H1N1 Vaccine	September 25, 2009	Word PDF
As of September 25, 2009 influenza activity is increasing in the United States with 26 states reporting widespread influenza activity. So far, ninety-nine percent of all subtyped influenza viruses being submitted to CDC are 2009 influenza A (H1N1) viruses. The current situation will likely affect pharmacies as a greater number of people than usual seek to fill prescriptions for influenza antiviral drugs or antibiotics to treat secondary bacterial infections, in addition to seeking advice on over-the-counter flu medications. This may affect supplies and availability of antiviral medications and other materials that may be needed to fill prescriptions. Pharmacists and physicians who care for pediatric patients should be aware of two issues: (1) the possible need to compound Tamiflu® on site if commercially manufactured pediatric oral suspension formulation is not available, and (2) the need to ensure that the units of measure on the dosing dispenser and the dosing instructions match.	September 25, 2009	Word PDF
Varicella (Chickenpox) Outbreak in Penobscot County	September 24, 2009	Word PDF
The Maine Center for Disease Control and Prevention has received notification of four cases of clinically confirmed varicella (chickenpox) among young adults in a residential post-secondary institution in Penobscot County. The vaccination status of all four individuals is unknown. The purpose of this advisory is to alert providers in the area to an active varicella outbreak, recommend varicella vaccination, and to report new cases of varicella to Maine CDC at 1-800-821-5821.	September 24, 2009	Word PDF
Seasonal Influenza Vaccine Supply Delay	September 21, 2009	Word PDF
Based on national guidance from the Centers for Disease Control and Prevention (CDC) and in preparation for H1N1 flu vaccine arriving in October, the Maine CDC/DHHS asked health care providers to begin vaccinating with seasonal influenza vaccine as soon as it became available in August and September. We asked schools receiving state-supplied vaccine to schedule the majority of their seasonal flu clinics in September and early October. Unfortunately, we have recently learned from both the CDC and the vaccine manufacturers that the scheduled delivery for the remaining doses of seasonal flu vaccine will not be as accelerated as originally anticipated, due to prioritization of H1N1 vaccine and other challenges. This delay is being felt across the country, and other states are in the process of postponing large scale seasonal flu vaccine clinics.	September 21, 2009	Word PDF
Register to be a H1N1 Flu Vaccine Distribution Site	September 17, 2009	Word PDF
This health alert is to update health care providers on the availability of the ability to order H1N1 vaccine. As you may know, pregnant women, children and young adults are being disproportionately affected by novel H1N1 influenza virus (“swine flu”). We expect to start receiving H1N1 vaccine in Maine by mid-October. If you are a health care provider licensed to administer vaccine, we ask that you consider registering to receive the H1N1 vaccine. We also encourage you to become involved with the initiative to offer all children seasonal and H1N1 vaccines in Maine schools. This will assure all Maine children are offered vaccine as quickly and as efficiently as possible while also not overburdening the health care system. If you are interested in becoming involved, please contact your local schools, or call the Maine CDC at 1-888-257-0990, or check the school-located vaccine website at www.maineflu.gov. Thank you ahead of time for your consideration in this important public health effort to keep our communities and schools healthy!	September 17, 2009	Word PDF
Human Risk for Eastern Equine Encephalitis (EEE)	September 15, 2009	Word PDF
Eastern equine encephalitis (EEE) is a very serious viral infection that is transmitted by the bite of an infected mosquito. Although rare, this disease has potentially severe consequences for those who contract it. All people in Maine need to be aware of the health risk and protect themselves from mosquito bites.In recent days and weeks EEE has killed horses in York, Cumberland, Kennebec, Waldo, and Penobscot Counties. These horses mean infected mosquitoes posing a risk to people are present. Although the risk of contracting the disease from one particular mosquito bite is very small, since any one mosquito is unlikely to be infected, the risk is much more widespread geographically than previously thought. This risk for contracting EEE virus is highest at dusk to dawn and when temperatures are above 50 degrees (and especially above 60 degrees), since these are the conditions when mosquitoes are most actively biting. The risk is also likely to continue through next year. As a result, all Mainers, schools, and communities should take action.	September 15, 2009	Word PDF
Eastern Equine Encephalitis (EEE)	September 4, 2009	Word PDF
The Maine CDC and the Maine Department of Agriculture’s Animal Health and Industry Division announced today that a total of five horses in Maine have died of confirmed Eastern Equine Encephalitis (EEE) and three more are suspicious, awaiting test results. These horses are from the counties of York, Cumberland, Waldo, and Penobscot. Although the risk of contracting EEE from one mosquito bite is very small, these recent cases indicate that the risk for contracting EEE is much more widespread geographically in Maine than previously thought. Information contained in this health advisory is on the human and equine health issues related to EEE, testing information for EEE, as well as resources related to mosquito control.	September 4, 2009	Word PDF
Update: Hepatitis A Cluster, Swans Island, ME	September 4, 2009	Word PDF
The Maine Center for Disease Control and Prevention (Maine CDC) is continuing to investigate a cluster of acute hepatitis A associated with one household on Swans Island in Hancock County. Currently, nine cases have been identified. There has been one death; one other individual was hospitalized. All cases are among out-of-state residents. The cases are residents of Nebraska, Maryland, Virginia and West Virginia. The age range is 13 years to 69 years of age. The onset date of the first case was July 7. The most recent case became ill on September 2. This case prepared food at a potluck dinner on August 22 at a church on the island. Because of the time interval since the potluck, prophylaxis with vaccine or immune globulin is not recommended at this time for persons who attended the dinner.	September 4, 2009	Word PDF
Hepatitis A Cluster, Swans Island, Maine	August 27, 2009	Word PDF
The Maine Center for Disease Control and Prevention (Maine CDC) is investigating a cluster of acute hepatitis A associated with one household on Swans Island, Hancock County, Maine. Currently, six cases have been identified; 4 confirmed and 2 probable cases. There has been one death and one other individual is hospitalized. All cases identified are among out of state residents. All cases of suspected viral hepatitis should be reported immediately by phone to the Maine CDC at 1-800-821-5821. Epidemiologists are available to provide guidance on post-exposure prophylaxis with either hepatitis A vaccine or immune globulin. To be effective, post exposure prophylaxis needs to be given as soon as possible, but not later than 14 days after last exposure.	August 27, 2009	Word PDF
Air Quality Advisory for Monday and Tuesday	August 17, 2009	Word PDF
(AUGUSTA)-- Ground-level ozone concentrations are expected to reach unhealthy levels in the Southwest Coastal Region and the High Elevations of Acadia on Monday according to the Maine Department of Environmental Protection (DEP). Unhealthy levels of ozone are expected to continue and include more of the coast on Tuesday. Meanwhile, particle pollution levels are expected to be in the Moderate Range for both days. The combination of multiple pollutants in addition to the heat and humidity will likely cause health problems for children, the elderly and anyone with a heart or lung disease. Everyone is encouraged to limit outdoor exertion.	August 17, 2009	Word PDF
Maine CDC Update on Novel H1N1	August 12, 2009	Word PDF
The purpose of this health advisory is to provide information on four important novel H1N1 updates recently issued by U.S. CDC. They are: changes to the recommended isolation period for people recovering from an influenza-like-illness; updated guidance for K-12 schools to respond to H1N1 influenza; H1N1 vaccine recommendations; and informational resources for those planning vaccination clinics. Additionally, this health advisory provides a list of strategies to keep informed about H1N1, which is especially important given the likelihood of pandemic escalation over the fall and winter.	August 12, 2009	Word PDF
Human Arbovirus Update for Healthcare Providers in Maine	August 11, 2009	Word PDF
This health advisory provides a brief update on the epidemiology and natural history of West Nile virus (WNV) and Eastern Equine Encephalitis (EEE) infections, a summary of surveillance findings in Maine, and guidance for obtaining and submitting clinical diagnostic specimens to the Maine Center for Disease Control (Maine CDC), where tests will be performed free of charge. Testing for mosquito-borne infections should be performed routinely for every person diagnosed with aseptic meningitis or encephalitis during the summer and fall months. Maine CDC will also test physician-submitted serum specimens for persons with other severe and/or persistent unexplained febrile illnesses.	August 11, 2009	Word PDF
H1N1 Preparations for Residential Schools	August 4, 2009	Word PDF
The purpose of this health advisory is to provide some guidance for residential schools on how to prepare for H1N1, based on preliminary lessons we have learned from the recent outbreaks in summer residential camps.	August 4, 2009	Word PDF
Salmonella Outbreak Identified in 3 Maine Counties	July 31, 2009	Word PDF
Six cases of an unusual type of Salmonella have been identified in Androscoggin, Cumberland and Sagadahoc Counties since the end of June. Four of the individuals were adults and two were children. The adults were associated with an outbreak involving 10 other individuals in a center for developmentally disabled persons. The source of the infection has not yet been identified. The epidemiologic investigation is ongoing.	July 31, 2009	Word PDF
Conference Call on Testing and Management of Novel Influenza A Virus (H1N1)	July 29, 2009	Word PDF
A conference call by the Maine CDC on testing and management of H1N1 for health care providers is scheduled from noon to 1 pm on Monday, August 3. The call in number is 1-800-914-3396. The participant code is 473623. Health care providers with questions on H1N1 can contact the Maine CDC at 1-800-821-5821 24 hours a day, 7 days a week.	July 29, 2009	Word PDF
Testing and Management of Novel Influenza A (H1N1)	July 28, 2009	Word PDF
This advisory provides an updated algorithm for health care providers in Maine for testing and management of novel influenza A (H1N1). Testing and treatment for influenza-like illness is indicated for persons who are hospitalized or at high-risk for severe disease.	July 28, 2009	Word PDF
Maine H1N1 Influenza Preparedness Summit	July 17, 2009	Word PDF
Maine CDC/DHHS, Maine Emergency Management Agency, and Maine Department of Education are co-sponsoring an H1N1 Influenza Preparedness Summit to promote vigilance, preparation, and a sharing of responsibility to mitigate the effects of H1N1 and to offer H1N1 immunization to all people in Maine later this year. A registration of $15 is required with scholarships by request. For more information contact MCD Meeting Services at conferences@mcd.org or 207-622-7566, ext 232.	July 17, 2009	Word PDF
Ten Action Steps for Novel H1N1 Influenza Planning	July 16, 2009	Word PDF
It is critical to assure that medical offices and other outpatient facilities (e.g., outpatient/ambulatory clinics, outpatient surgery centers, urgent care centers, physical therapy/rehabilitation offices or clinics) that provide routine, episodic, and/or chronic healthcare services can manage an increased demand for services in the midst of a novel H1N1 influenza outbreak. Ensuring a sustainable community healthcare response will be important for a likely recurrence of novel H1N1 flu in the fall.	July 16, 2009	Word PDF
Paralytic Shellfish Poisoning (Red Tide) Reminder	July 15, 2009	Word PDF
With elevated levels of paralytic shellfish poisoning (PSP, also known as red tide poisoning), causing much of the coastline to be closed to commercial harvesting for some shellfish, Maine CDC in the Department of Health and Human Services and the Maine Department of Marine Resources are reminding Mainers and tourists of recommendations for the safe consumption of shellfish.	July 15, 2009	Word PDF
Clinicians Advised to Halt Use of Propofol from Tainted Lots	July 14, 2009	Word PDF
The Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) have been investigating recent cases of febrile reactions among patients undergoing endoscopy in the United States. This investigation has revealed that all of the case-patients received the anesthetic propofol from 100 ml vials manufactured by Teva Pharmaceuticals. Testing done by the FDA has found that two lots of this product that were in use in facilities reporting febrile reactions were positive for elevated levels of endotoxin. The lots are 31305429B and 31305430B. Teva Pharmaceuticals is initiating a voluntary recall for these lots, and clinicians are advised to immediately stop using these lots of Teva Pharmaceuticals propofol. CDC, FDA and Teva Pharmaceuticals are continuing to investigate this issue. To date, all case-patients have recovered. As additional information about the recall becomes available, an updated Health Alert Notice will be provided.	July 14, 2009	Word PDF
Maine CDC/DHHS Update on Novel Influenza A (H1N1) Virus	July 11, 2009	Word PDF
Although very few people in Maine with H1N1 need to be or are being tested, Maine CDC has tested and confirmed a total of 203 cases as of July 10th. 114 are Maine residents, and 89 are out of state residents, mostly either summer residents or residential youth campers. Maine residents with confirmed H1N1 are concentrated in the southern half of the state, where there appears to be widespread transmission in many areas. A total of 10 have been hospitalized, including 2 out of state residents. About 60% of Maine resident cases are under the age of 24. Weekly updates with demographic data, including county breakdowns, can be found at: http://www.maine.gov/dhhs/boh/swine-flu-2009.shtml. H1N1 is widespread in much of the rest of New England, has been detected in all 50 states and 122 countries. 24 states have had deaths due to H1N1 (a total of 211 on July 10).	July 11, 2009	Word PDF
Maine CDC Operations during State Closure Days	July 3, 2009	Word PDF
Maine CDC will operate in very limited capacity during state government closure days. The state budget legislation for the current biennium has a provision which requires most executive branch departments, agencies, and offices to be closed for 10 days in fiscal year 2009-2010. Please note that several state closure days are situated near state holidays and will result in 4-day weekends. This will affect both handling of telephone inquiries to Maine CDC Division of Infectious Disease and testing availability and turn-around-time at the Maine CDC Health and Environmental Testing Laboratory (HETL).	July 3, 2009	Word PDF
Guidance for Camps to Address Novel H1N1 Virus	June 25, 2009	Word PDF
This health advisory provides guidance on suggested means to reduce the spread of the novel influenza A (H1N1) virus in day, residential, or overnight camp settings based on current knowledge of the H1N1 pandemic. Summary of Current Situation: At least 12 states have seen camp-associated outbreaks among staff and/or campers, and some camps, such as those sponsored by the Muscular Dystrophy Association, have been cancelled because of the very high risk for complications of those specific campers. Maine has seen outbreaks in 5 residential camps in 5 counties (Androscoggin, Cumberland, Lincoln, Oxford, and York) involving 10 confirmed cases in counselors. Other possible outbreaks involving camps are currently being investigated. No campers so far have been reported with H1N1.	June 25, 2009	Word PDF
Pregnant Women and Novel Influenza A H1N1	June 24, 2009	Word PDF
This advisory is intended to provide guidance for the diagnosis and management of pregnant women with influenza like illness (ILI) during the current outbreak of novel influenza A H1N1 in Maine. Pregnant women are known to be at higher risk for complications from infection with seasonal influenza viruses, and severe disease among pregnant women was reported during past pandemics. An excess of influenza-associated deaths among pregnant women was reported during the pandemics of 1918–1919 and 1957–1958. Adverse pregnancy outcomes have been reported following previous influenza pandemics, with increased rates of spontaneous abortion and preterm birth reported, especially among women with pneumonia. Case reports and several epidemiologic studies conducted during inter-pandemic periods also indicate that pregnancy increases the risk for influenza complications for the mother and might increase the risk for adverse perinatal outcomes or delivery complications.	June 24, 2009	Word PDF
Maine CDC Update on Novel Influenza A Virus (H1N1)	June 21, 2009	Word PDF
The purpose of this health advisory is to provide an update on H1N1 in Maine in the areas of surveillance, mitigation, vaccination, and communication. H1N1 continues to spread in Maine, especially in the southern half of the state, and Maine is one of 11 states reporting widespread influenza activity. Although we have an overall total of 61 cases identified by testing in Maine (50 among Maine residents and 11 among those visiting or staying in Maine) it is important to note that individual case data are useful only in that they are markers of the presence of H1N1 and community transmission in a given county or geographical area. Most people with H1N1 do not need testing (such as symptomatic close contacts of confirmed cases or people with mild illness), and their illness is not reflected in the case counts. Counties or regions with no reported cases may still be affected.	June 21, 2009	Word PDF
Rabies Vaccine Available for Pre-exposure Rabies Prophylaxis	June 19, 2009	Word PDF
Novartis announces sufficient RabAvert® rabies vaccine to resume pre-exposure prophylaxis for groups at risk for rabies virus exposure. Since early 2008, rabies vaccine has been in decreased supply in the United States. Previously, due to the limited supply, pre-exposure vaccination was suspended for groups at risk for rabies exposure. Please see archived HAN’s from October 23, 2008 and September 15, 2008 at http://www.maine.gov/tools/whatsnew/index.php	June 19, 2009	Word PDF
Maine CDC Update on Novel Influenza A (H1N1)	June 13, 2009	Word PDF
The purpose of this health advisory is to provide an update on H1N1 as well as links to new or focused planning and clinical resources. H1N1 continues to spread in Maine, especially in the southern and Mid Coast areas. Although we have an overall total of 44 cases confirmed by testing in Maine (35 among Maine residents and 9 among those visiting or staying in Maine) it is important to note that individual case data are useful only in that they are markers of the presence of H1N1 in a given county or geographical area. Many people with H1N1 are not tested (such as symptomatic close contacts of confirmed cases or people with mild illness), and their illness is not reflected in the case counts. Counties or regions with no reported cases may still be affected.	June 13, 2009	Word PDF
WHO Declares Pandemic Phase 6 for H1N1	June 11, 2009	Word PDF
World Health Organization (WHO) Declaration of Pandemic Phase 6 for Novel H1N1 Influenza.The WHO phases are based on the geographical spread of a novel influenza virus. As “pandemic” means worldwide epidemic, a WHO Phase 6 means that the virus is spreading across the globe. What the WHO phases do not do is predict the severity of the virus. The move to Phase 6 is really an alert that the spread of the H1N1 virus is now expected to traverse the globe and those nations where the virus has yet to arrive should expect to eventually see cases and be prepared to respond.	June 11, 2009	Word PDF
Seasonal Influenza Vaccine Opportunities for Schools and Communities	June 11, 2009	Word PDF
Maine CDC is working with the Maine Department of Education (Maine DOE) to provide communities an opportunity for their schools to offer seasonal influenza vaccine this fall for their students and possibly other children. Below is a slightly abridged version of the communication that was sent to all schools earlier this week. We are now sending it through the Health Alert Network so that interested community members, especially those working in health care, public health, emergency management, and other related fields can contact their local schools or school districts to partner on this effort. Doing so may not only help protect the health of the entire community but also ready the community for large scale vaccine clinics for H1N1.	June 11, 2009	Word PDF
Novel Influenza A (H1N1) in Maine	June 3, 2009	Word PDF
Maine CDC has identified a total of 17 cases of H1N1 (14 confirmed and 3 probable) among Maine residents, along with an additional 4 out of state residents who were ill and tested while staying in Maine, for an overall total of 21. This total includes 7 additional cases this week, 5 in Cumberland County and 2 in York County. One of the two new York County residents is hospitalized. One of the new Cumberland County residents is a Brunswick High School student. Four recent cases are residents of the Brunswick area, indicating possible clustering in that area, and include 3 children or youth.	June 3, 2009	Word PDF
Pertussis Outbreak in Penobscot County, Maine	June 2, 2009	Word PDF
In the past month seven cases of pertussis has been reported in individuals ranging from 9 months to 42 years of age in the Brewer, Hampden and Holden areas of Penobscot County. Ill individuals are associated with three different schools. A number of symptomatic contacts have been identified in Penobscot County and are undergoing diagnostic testing. 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. Symptoms include cough, paroxysms, whoop, and post-tussive vomiting.	June 2, 2009	Word PDF
Shiga-toxin positive E. coli O157:H7 (STEC) cluster	May 28, 2009	Word PDF
Maine CDC is investigating a cluster of 7 shiga toxin positive E.coli O157:H7 (STEC) cases in Cumberland and York counties that occurred among residents over the past month (case onset dates of April 17 to May 17). This is double the usual number of STEC cases reported this time of year (n=3). The median age of cases was 26 years (age range 14 years to 65 years). As of May 28, 6 of the 7 cases have been confirmed shiga positive E. coli O157:H7 by the Health and Environmental Testing Laboratory (HETL). Of these, 4 cases match by Pulse-Field Gel Electrophoresis (PFGE) and are considered part of a national cluster. At this time, the investigation is ongoing although we have not identified any common venues, events or foods based on case interviews.	May 28, 2009	Word PDF
Maine CDC H1N1 Update	May 28, 2009	Word PDF
This Maine CDC Health Advisory is providing an update on the H1N1 situation in Maine as well as some important updates from U.S. CDC. Although Maine CDC has identified and conducted case investigations on 10 people with either confirmed or probable H1N1, other nearby states are seeing much more of the infection, resulting in some school closures and hospitalizations. For instance, Massachusetts has over 400 confirmed cases of H1N1, mostly in the Greater Boston area, with 90% of them in people under 40 years of age. There are currently 27 people hospitalized with the infection, and about a dozen schools have closed due to H1N1 in Massachusetts. (http://publichealth.blog.state.ma.us/h1n1-swine-flu/). New York has also seen several hundred confirmed cases, mostly among young people, and has had several dozen schools closed. New Hampshire has 31 confirmed cases, with all but two under age 50 (http://www.dhhs.state.nh.us/DHHS/DHHS_SITE/swineflu.htm).	May 28, 2009	Word PDF
Air Quality Advisory for Ozone in Southwest Coast, Mid-Coast, and Western Interior of Maine	May 21, 2009	Word PDF
Ground-level ozone concentrations are expected to reach the unhealthy for sensitive groups level today for the Southwest Coast, Mid-Coast and Western Interior according to the Maine Department of Environmental Protection (DEP). The U.S. Environmental Protection Agency (EPA) recently revised the national ozone standard from 84 parts per billion (ppb) to 75 ppb. At the same time, the Air Quality Index (AQI) for ozone was revised to reflect the new more protective standard. If Maine has a typical summer this year, the DEP will likely be encouraging you to take precautions to protect your health more often than usual because of this revised standard. For more information call DEP's toll free ozone hotline at 1-800-223-1196 or visit DEP’s air quality web site by going to MaineDEP.com and select ‘Maine Air Quality Forecast.	May 21, 2009	Word PDF
Maine H1N1 Update	May 8, 2009	Word PDF
As of the morning of May 8th, Maine has identified 12 people with H1N1 through testing, including 7 adults, 1 young adult, and 4 children or youth. They reside in York (5), Cumberland (3), Kennebec (3), and Penobscot (1) Counties. Three of the identified patients are students – one at the Lunt Elementary School in Falmouth, one at Bridgton Academy, and one early identified patient at the Kennebunk Elementary School. A recently identified patient is a young adult (with chronic underlying illness) who is hospitalized. 4 of the 12 test results have been confirmed by U.S. CDC; all 4 are in York County. 6 out of the 12 patients traveled to an area with confirmed H1N1. Of the 6 who did not travel out of state, 5 have no known contact with an identified case. Out of the over 1,000 influenza tests that have been conducted by the Maine CDC’s laboratory since April 27th, 12 have been positive for un-subtypeable H1N1, and 24 have been positive for seasonal influenza, mostly type A Influenza viruses (and mostly known subtypes of H1 or H3).	May 8, 2009	Word PDF
Updated Guidance on Laboratory Testing of Persons with Suspected Novel Influenza A (H1N1) Virus	May 6, 2009	Word PDF
Maine CDC issues the following updated guidance on laboratory testing of persons with suspected novel influenza A (H1N1) virus. These guidelines are current as of May 6, 2009. Maine is now considered an affected area. On 5/4/09, one case patient was confirmed as novel influenza A (H1N1) by Federal CDC. At this time, Maine CDC is maintaining case finding activities to better understand the spread of this virus across the state.	May 6, 2009	Word PDF
Maine Update and New School Closure Guidelines	May 5, 2009	Word PDF
Based on revised guidance on school closings from the U.S. Centers for Disease Control and Prevention and in consultation with the Maine Center for Disease Control, Maine Education Commissioner Susan Gendron advised Kennebunk Elementary School to reopen on Wednesday, a day earlier than previously recommended. In the new guidelines issued Tuesday afternoon, the U.S. CDC no longer recommends that schools with probable cases of H1N1 influenza be closed. Instead, it recommends a focus on “keeping all student, faculty and staff with symptoms of influenza out of schools and childcare facilities during their period of illness and recuperation, when they are potentially infectious to others.” The Kennebunk Elementary School was closed starting last Thursday for an expected seven days after a student was found to have a probable case of H1N1. The Maine CDC continues to test possible cases of H1N1. No new cases were identified on Monday or Tuesday. Totals as of Tuesday, May 5 include: two adults in Kennebec County, three adults and one youth in York County, and one youth in Penobscot County. U.S. CDC has confirmed one of the adults in York County as testing positive for H1N1. All are recovering. Four of the cases had an out of state travel history, though no travel to Mexico. One was a contact of the original four. The epidemiological investigation continues for the other two.	May 5, 2009	Word PDF
Update on H1N1 in Maine	May 2, 2009	Word PDF
In light of H1N1’s arrival in Maine with cases in 3 counties (Kennebec, Penobscot, and York) as of early morning of May 2nd, and the resulting closure of a school, this health advisory provides a brief review of informational resources and strategies as well as the most recently updated guidance for schools and child care facilities in affected areas from U.S. CDC.	May 2, 2009	Word PDF
Updated Guidance for Communities with Confirmed H1N1 Influenza A Virus	April 30, 2009	Word PDF
In light of H1N1’s arrival in Maine and the resulting closure of at least one school and day care, this health advisory is to review the major steps we ask that people and organizations in Maine take. The most important strategies to minimize swine flu’s impact in Maine are those of vigilant respiratory hygiene: covering coughs and sneezes with sleeves or a tissue; washing hands frequently; and staying home if ill, especially with a fever. Additionally, everyone should stay informed since this event is rapidly changing and resulting guidance is as well. The U.S. CDC’s website has updated national information and guidance, and can be found at: http://www.cdc.gov/swineflu/. Maine CDC’s website has updated Maine-specific information, including daily updates starting later today, as well as links to federal information. It can be located at: http://www.maine.gov/dhhs/boh/swine-flu-2009.shtml or found on the Maine CDC’s homepage: www.mainepublichealth.gov. Importantly, everyone should also make preparations. These preparations include activating a pandemic influenza plan. Every hospital, other health care institution, emergency management agency, school business, agency or organization should activate their pandemic influenza plan. Every individual and family should also activate their plan. If one does not exist, then preparation check lists for a variety of settings including individuals, homes, businesses, and schools can be found at: http://www.pandemicflu.gov/plan/checklists.html. These plans generally call for such measures as ensuring adequate critical supplies are on hand and preparing for higher than normal absenteeism. Health care providers should call Maine CDC’s 24-hour clinical consultation line (1-800-821-5821) to report a suspected case and obtain testing information including expediting the transportation of samples for testing. Maine CDC’s Health and Environmental Testing Laboratory (HETL) will perform influenza RT-PCR tests and subtyping for influenza A positive specimens. Instructions on collecting and submitting laboratory diagnostic specimens for H1N1 influenza testing are available at http://www.maine.gov/dhhs/etl/micro/submitting_samples.htm.	April 30, 2009	Word PDF
Three Probable H1N1 Influenza ("Swine Flu") Cases Identified in Maine	April 29, 2009	Word PDF
As of 12:30 PM April 29, 2009, 3 probable cases of H1N1 Influenza (“Swine Flu”) were identified in Maine. Two of the individuals are residents of Kennebec County and the third is a resident of York County. All are non-elderly adults. Samples from the three were tested this morning at Maine CDC’s Health and Environmental Testing Laboratory (HETL). The samples will be submitted to the US Centers for Disease Control and Prevention for final confirmation, which is highly likely. The cases are currently being investigated by Maine CDC infectious disease epidemiologists. The most important strategies to minimize swine flu’s impact in Maine are those of vigilant respiratory hygiene: covering coughs and sneezes with sleeves or elbows; washing hands frequently; and staying home if ill, especially with a fever. Additionally, everyone should stay informed since this event is rapidly changing and resulting guidance is as well. The U.S. CDC’s website has updated national information and guidance, and can be found at: http://www.cdc.gov/swineflu/. Maine CDC’s website has updated Maine-specific information, including daily updates starting later today, as well as links to federal information. It can be located at: http://www.maine.gov/dhhs/boh/swine-flu-2009.shtml or found on the Maine CDC’s homepage: www.mainepublichealth.gov.	April 29, 2009	Word PDF
H1N1 Influenza (“Swine Flu”) and New Clinical Guidance on Treatment of Children and Pregnant Women	April 29, 2009	Word PDF
It is announced on the news wires this morning the death of a 23-month old in Texas from H1N1 (“swine flu”). Maine does not have any confirmed cases yet of H1N1 influenza. The Maine CDC’s Health and Environmental Testing Laboratory (HETL) tested about three dozen samples on Tuesday April 28th. A number of tests are being conducted today. The most important strategies to minimize swine flu’s impact in Maine are those of vigilant respiratory hygiene: covering coughs and sneezes with sleeves or elbows; washing hands frequently; and staying home if ill, especially with a fever. Additionally, everyone should stay informed since this event is rapidly changing and resulting guidance is as well. The U.S. CDC’s website has updated national information and guidance, and can be found at: http://www.cdc.gov/swineflu/. Maine CDC’s website has updated Maine-specific information, including daily updates starting later today, as well as links to federal information. It can be located at: http://www.maine.gov/dhhs/boh/swine-flu-2009.shtml or found on the Maine CDC’s homepage: www.mainepublichealth.gov. Importantly, everyone should also make preparations. These preparations include activating a pandemic influenza plan. Every hospital, other health care institution, emergency management agency, school business, agency or organization should activate their pandemic influenza plan. If one does not exist, then preparation check lists for a variety of settings including homes, businesses, and schools can be found at: http://www.pandemicflu.gov/plan/checklists.html. Health care providers should call Maine CDC’s 24-hour clinical consultation line (1-800-821-5821) to report a suspected case and obtain testing information including expediting the transportation of samples for testing. Maine CDC’s Health and Environmental Testing Laboratory (HETL) will perform influenza RT-PCR tests and subtyping for influenza A positive specimens. Instructions on collecting and submitting laboratory diagnostic specimens for H1N1 influenza testing are available at http://www.maine.gov/dhhs/etl/micro/submitting_samples.htm.	April 29, 2009	Word PDF
Interim CDC Guidance for Nonpharmaceutical Community Mitigation	April 28, 2009	Word PDF
While Maine has not yet identified any people confirmed with swine influenza A (H1N1), there are several people being tested, and a large number of Mainers who have recently returned from traveling in areas where swine influenza is found. The most important strategies to minimize swine flu’s impact in Maine are those of respiratory hygiene: covering coughs and sneezes with sleeves or elbows; washing hands frequently; and staying home if ill, especially with a fever. Additionally, everyone should stay informed since this event is rapidly changing and resulting guidance is as well. The U.S. CDC’s website has updated national information and guidance, and can be found at: www.cdc.gov/swineflu . Maine CDC’s website has updated Maine-specific information, including daily updates starting later today, as well as links to federal information. It can be located at: www.maine.gov/dhhs/boh/swine-flu-2009.shtml or found on the Maine CDC’s homepage: www.mainepublichealth.gov . Importantly, everyone should also make preparations. These preparations include activating a pandemic influenza plan. If one does not exist, then preparation check lists for a variety of settings including homes, businesses, and schools can be found at: www.pandemicflu.gov/plan/checklists.html . This health advisory contains an update from U.S. CDC including new interim guidance on community mitigation strategies, such as isolation, quarantine, school and day care closures, and the social distancing strategies of cancelling mass gatherings. People and organizations in Maine need to prepare now for those possible strategies to be implemented.	April 28, 2009	Word PDF
Updated Guidance from Maine CDC for Laboratory Testing of Persons with Suspected Swine Influenza A (H1N1) Virus	April 27, 2009	Word PDF
Situation Update: No cases of swine influenza (H1N1), known as swine flu, have been detected in Maine as of April 26, 2009. Maine CDC urges health care providers to increase surveillance for acute febrile respiratory illness to identify early any cases of swine influenza (H1N1) in Maine. As part of their ongoing investigation into the outbreak, CDC yesterday announced confirmation of an additional 13 human cases of infection with swine flu in the U.S, bringing the total number of cases to 21 so far. At this time, cases of swine influenza have been confirmed in California, Kansas, New York City, Ohio and Texas. Based on the rapid spread of the virus thus far, public health officials believe that more cases will be identified over the next several weeks. Case counts are updated daily and available at http://www.cdc.gov/swineflu/investigation.htm. Yesterday the Acting Secretary of the U.S. Department of Health and Human Services declared a public health emergency in the United States. U.S. CDC and Maine CDC’s goals are to reduce transmission and illness severity, and provide information to assist health care providers and the public in addressing the challenges posed by this newly identified influenza virus. To this end, U.S. CDC has issued a number of guidance documents in the past 24 hours. In addition, U.S. CDC’s Division of the Strategic National Stockpile (SNS) is releasing one-quarter of its antiviral drugs, personal protective equipment, and respiratory protection devices to help states respond to the outbreak. Maine CDC is working closely with U.S. CDC to arrange for these materials to be delivered to and distributed in Maine, primarily for the care of hospitalized patients seriously ill with swine flu. Additionally, Maine CDC’s laboratory, the Health and Environmental Testing Laboratory, has increased its capacity to test for swine influenza. Maine CDC senior and epidemiology staff have been in close and frequent contact with U.S. CDC and other New England states, making preparations to address this expanding outbreak.	April 27, 2009	Word PDF
Surveillance for Swine Influenza A (H1N1) Virus in School and Childcare Settings	April 27, 2009	Word PDF
Guidance for School and Childcare Settings At this time, Maine CDC recommends that schools and childcare settings increase education on respiratory hygiene and monitor attendees for acute febrile respiratory illness. Staff and children (as developmentally appropriate) should all be taught and asked to follow these steps that prevent the transmission of infections such as influenza: 1.Cover your coughs and sneezes. 2.Avoid touching your eyes, nose and mouth. 3.Wash hands frequently, especially after coughing or sneezing. 4.Stay home if you’re sick, especially with a fever. School or childcare participants with acute febrile respiratory illness, regardless of travel history, should be sent home according to facilities-established procedures with instructions to stay at home until 24-48 hours after their symptoms resolve. Instructions should be given to seek medical care with worsening of symptoms. At this time, exclusion is not recommended for school or childcare participants who have recently traveled to an affected area and who do not have symptoms. Disease Reporting and Consultation To contact Maine CDC to report suspected cases of swine influenza, outbreaks of influenza like illness, or to request other clinical consultation please call the 24/7 Disease Reporting and Consultation Line at 1-800-821-5821.	April 27, 2009	Word PDF
Swine Influenza Screening and Laboratory Testing Guidance for Health Care Providers	April 25, 2009	Word PDF
The US CDC has identified eight new cases of a novel swine influenza A (H1N1) virus first identified on April 17 in two children in southern California. The six additional cases were reported in San Diego County (three cases) and Imperial County, California (one case), and in Guadalupe County, Texas (two cases). The average age of these confirmed cases is 16, and all have fully recovered. In addition, US CDC has confirmed that the same unique strain of swine influenza A (H1N1) virus has been isolated among specimens from patients in Central Mexico, where there appears to be an emerging outbreak. No cases of swine flu have been reported in Maine or New England. Although seasonal influenza continues to be detected in Maine, influenza activity has been declining and is currently sporadic. Maine CDC health officials have been in close contact with officials at U.S. CDC the past few days as well as increasing capacity to further address the situation, including increasing influenza tracking and public health laboratory capacity (Maine CDC’s Health and Environmental Testing Laboratory=HETL) to perform rapid typing of influenza.	April 25, 2009	Word PDF
Invasive Haemophilus Influenzae, tybe b in an under-vaccinated 3 year old	March 9, 2009	Word PDF
The Maine Department of Health and Human Services’ Maine Center for Disease Control and Prevention, (Maine CDC) is issuing an advisory regarding meningitis and bacteremia from Haemophilus influenzae type b (Hib) in a 3 year old under-vaccinated child. In late February 2009, a 3 year old child from midcoast Maine developed Hib bacteremia and meningitis. The child received the 2 and 4 month immunizations, though did not complete the Hib vaccine series with the 6 month and 12-15 month vaccines. The child was hospitalized in intensive care, and is currently recovering. The child’s household members, including an unvaccinated infant, have been given prophylaxis with Rifampin antibiotic to prevent additional cases of invasive Hib.	March 9, 2009	Word PDF
Questions and Answers about Bisphenol-A and Formula	March 3, 2009	Word PDF
In response to a number of questions on BPA (Bisphenol-A), especially from local WIC agencies and clients, the Maine CDC has developed a fact sheet on this subject that we hope will help provide some guidance for parents of young children. The Maine CDC is not promoting either the liquid concentrate or powder formula (we formerly preferentially promoted the liquid concentrate) provided by WIC. We are asking that clients make the choice of the feeding method that is best for them using this additional information and talking with their baby’s doctor if questions remain.	March 3, 2009	Word PDF
Update on Norovirus Gastroenteritis Outbreaks in Maine	February 28, 2009	Word PDF
During December 1, 2008 – February 20, 2009, Maine CDC has investigated 28 confirmed or suspected norovirus gastroenteritis outbreaks from counties across the state. The majority of outbreaks reported occurred in long term care facilities or assisted living centers (23); however outbreaks have also occurred at acute care facilities (3), schools (1), and office settings (1). Norovirus infections typically increase during the winter months, and Maine CDC routinely receives reports of suspected norovirus outbreaks each year. Surveillance data suggests that norovirus circulation is more widespread this year. Public health partners are encouraged to consider norovirus when assessing clusters of gastroenteritis and to act promptly to prevent the spread of illness.	February 28, 2009	Word PDF
Carbon Monoxide (CO) Poisoning Warning	February 23, 2009	Word PDF
A number of Maine communities are experiencing power outages due to the recent storm. It is estimated that over 80,000 households are without power. Outbreaks of carbon monoxide (CO) poisonings have been associated with storm-related power outages due to improper placement and operation of gas-powered generators and other alternative heating and power sources. A study of a CO poisoning outbreak in the aftermath of the January 1998 Ice Storm found that improper placement of a gasoline generator, such as in a basement or garage, could increase the risk of CO poisoning by 20 to 300-fold. Using a kerosene heater in a room without any doors to other rooms opened, or failing to crack a window, also put people at increased risk for CO poisoning. CO is an odorless colorless gas emitted when burning most fuels. Improper operation or placement of alternative heating or power sources can result in poisoning when CO gas builds-up in enclosed spaces.	February 23, 2009	Word PDF
Information for Veterinarians regarding Pets and the Peanut Butter Recall	February 18, 2009	Word PDF
CDC has been investigating the current Salmonella Typhimurium outbreak in humans in coordination with the Food and Drug Administration (FDA) and state and local health departments. In addition to human illness, animals may also have been affected. One laboratory-confirmed case of Salmonella in a dog from an Oregon household was reported, and further characterization of this Salmonella isolate is pending. Salmonella resembling the outbreak strain was isolated by a private laboratory from recalled peanut butter flavored dog biscuits from this dog’s household. At least three states have reported incidents of dogs that have shown gastrointestinal signs consistent with Salmonella infection, and those animals have been known to have consumed peanut butter products on the FDA recall list.	February 18, 2009	Word PDF
REVISED Widespread Influenza Activity in Maine	February 17, 2009	Word PDF
In February, influenza activity has become widespread in Maine, with all three of the major seasonal influenza variants circulating. Outbreaks of influenza are occurring in schools and in long term care facilities across the state. The influenza vaccine is a good match for both influenza A strains, and matches approximately 30% of the influenza B strains currently circulating. Influenza vaccination is still strongly encouraged, especially to protect those persons at risk of more severe disease. Interim recommendations for chemoprophylaxis and treatment of influenza have been issued in response to the high resistance of influenza A H1N1 strains to oseltamivir (Tamiflu) in national studies.	February 17, 2009	Word PDF
Maine Animal Rabies 4th Quarter Update	February 11, 2009	Word PDF
The Maine Center for Disease Control and Prevention (Maine CDC) provides a quarterly update on animal rabies to veterinarians and other animal health professionals. This update may be used as an educational tool to increase the understanding of pet owners and other members of the public regarding the risk of rabies in Maine and in their communities. This update is for the forth quarter of 2008 or January 1 – December 31, 2008 (Table). Visit the Maine CDC rabies prevention website for more information, including rabies testing data updated regularly: www.maine.gov/dhhs/boh/ddc/rabies_surveillance.htm	February 11, 2009	Word PDF
Pertussis Outbreak Reported in Hancock County	January 29, 2009	Word PDF
Since January 9, 2009, eight cases of pertussis have been reported in individuals ranging from 9 to 50 years of age in the Blue Hill and Brooklin areas of Hancock County. The outbreak involves an elementary school, a middle school, and a worksite. A number of symptomatic contacts have been identified in Hancock County and are undergoing diagnostic testing. There is no evidence that this outbreak is directly related to the recent outbreak of pertussis reported in York County.	January 29, 2009	Word PDF
Outbreak of Salmonella Typhimurium Infections - United States	January 18, 2009	Word PDF
CDC, in collaboration with public health officials in many states and the U.S. Food and Drug Administration (FDA), is investigating a multistate outbreak of human infections caused by Salmonella serotype Typhimurium. As of January 16, 2009, 9PM EST, 474 persons infected with the outbreak strain of Salmonella Typhimurium have been reported from 43 states. Infection may have contributed to 6 deaths. Of persons for whom data was available, 107 (23%) were hospitalized.	January 18, 2009	Word PDF
Pertussis Outbreak in York County	January 16, 2009	Word PDF
A cluster of four cases of pertussis has been reported in girls 8 to 10 years of age in the Biddeford –Saco area. The ill children attend three different schools, but have common exposures at an after school program and an athletic facility. A number of symptomatic contacts have been identified in York, Cumberland and Aroostook counties and are undergoing diagnostic testing. 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. Symptoms include cough, paroxysms, whoop, and post-tussive vomiting.	January 16, 2009	Word PDF
Outbreaks of Norovirus Gastroenteritis in Maine	January 13, 2009	Word PDF
During December 1, 2008 – January 13, 2009, Maine CDC has investigated 14 reports of confirmed or suspected norovirus gastroenteritis outbreaks from six counties. Seven of these reports have been laboratory-confirmed. Eleven outbreaks occurred in long term care facilities or assisted living centers, two were associated with acute care facilities, and one occurred at an office holiday party. Noroviruses are the principal cause of viral gastroenteritis in the United States. Circulation of norovirus infections typically increases during the winter months, and outbreaks are currently being reported also in other areas of the nation. The Federal CDC estimates that 23 million cases of acute gastroenteritis per year are due to norovirus infection.	January 13, 2009	Word PDF
December 22, 2008-CDC Issues Interim Recommendations for the Use of Influenza Antiviral Medications	December 22, 2008	Word PDF
Although influenza activity is low in the United States to date, preliminary data from a limited number of states indicate that the prevalence of influenza A (H1N1) virus strains resistant to the antiviral medication oseltamivir is high. Therefore, CDC is issuing interim recommendations for antiviral treatment and chemoprophylaxis of influenza during the 2008-09 influenza season. When influenza A (H1N1) virus infection or exposure is suspected, zanamivir or a combination of oseltamivir and rimantadine are more appropriate options than oseltamivir alone. Local influenza surveillance data and laboratory testing can help with physician decision-making regarding the choice of antiviral agents for their patients. The 2008-09 influenza vaccine is expected to be effective in preventing or reducing the severity of illness with currently circulating influenza viruses, including oseltamivir-resistant influenza A (H1N1) virus strains. Since influenza activity remains low and is expected to increase in the weeks and months to come, CDC recommends that influenza vaccination efforts continue.	December 22, 2008	Word PDF
Influenza arrives in Maine	December 18, 2008	Word PDF
Influenza has officially arrived in Maine. The first laboratory confirmed cases of influenza were reported this week. A young adult from Androscoggin County tested positive for influenza A (H1). This young adult was unimmunized and has no record of recent travel. A youth from Cumberland County also tested positive for influenza A (H1). No medical history was available for this patient. Now that we know influenza is officially in Maine, it is important that we make every effort to try to limit its spread. The best way to prevent getting influenza is getting vaccinated. Influenza vaccine has been widely distributed in Maine and appears to be still available in most places. New recommendations advise all children aged 6 months to 18 years be immunized this influenza season. All high risk individuals should be vaccinated as soon as possible.	December 18, 2008	Word PDF
Carbon Monoxide Poisoning Advisory	December 13, 2008	Word
A number of Maine communities are experiencing power outages due to the recent storm. It is estimated that over 200,000 households are without power. Outbreaks of carbon monoxide (CO) poisonings have been associated with storm-related power outages due to improper placement and operation of gas-powered generators and other alternative heating and power sources. A study of a CO poisoning outbreak in the aftermath of the January 1998 Ice Storm found that improper placement of a gasoline generator, such as in a basement or garage, could increase the risk of CO poisoning by 20 to 300-fold. Using a kerosene heater in a room without any doors to other rooms opened, or failing to crack a window, also put people at increased risk for CO poisoning. CO is an odorless colorless gas emitted when burning most fuels. Improper operation or placement of alternative heating or power sources can result in poisoning when CO gas builds-up in enclosed spaces. We are receiving reports of CO poisoning in the aftermath of Friday’s storm.	December 13, 2008	Word
Domestic Violence and Sexual Assault Health Advisory for the General Public	December 9, 2008	Word PDF
Driven by recent domestic violence-related homicides, the Maine CDC is issuing a public health advisory. Domestic violence and sexual assault are public health problems that are unacceptable in any form. All Mainers can play a role in preventing further violence, especially since important resources exist for everyone.	December 9, 2008	Word PDF
Domestic Violence and Sexual Assault Health Advisory for Health Care Providers	December 9, 2008	Word Pdf
Driven by recent domestic violence-related homicides, the Maine CDC is issuing a public health advisory. Domestic violence and sexual assault are public health problems that are unacceptable in any form. All Mainers, including health care providers, can play an important role in preventing further violence.	December 9, 2008	Word Pdf
2008-2009 Winter Heating Advisory	December 2, 2008	Word PDF
The heating and economic crises can have a significant impact on Mainers’ health. A recent survey found that 10% of Maine households report not having sufficient funds to heat their homes this winter. About 2/3 of Maine households use oil as a primary source for heating their homes, with Mainers having one of the highest dependencies on oil heat in the nation. Mainers report a number of planned energy and monetary conservation strategies such as supplementing with wood heat and electric space heaters, turning down the thermostat and water heater, buying fewer groceries and other necessities such as medicines.	December 2, 2008	Word PDF
Revised - Maine Animal Rabies Third Quarter Report Jan.1 - Sept. 30, 2008	November 25, 2008	Word PDF
The Maine Center for Disease Control and Prevention (Maine CDC) provides a quarterly update on animal rabies to veterinarians and other animal health professionals. This update may be used as an educational tool to increase the understanding of pet owners and other members of the public regarding the risk of rabies in Maine and in their communities.	November 25, 2008	Word PDF
November 19, 2008 - Update on Hepatitis A in the Kennebunk Area	November 19, 2008	Word PDF
Five cases of hepatitis A have been reported among students at Consolidated School in Kennebunkport. The first two cases were part of a family cluster identified in September. The other three cases were reported in late October/early November and were unrelated to the family cluster. For the last three cases, it is believed that transmission occurred in the school setting after exposure to the first two ill students.	November 19, 2008	Word PDF
Update: Hepatitis A in the Kennebunk Area	November 7, 2008	Word PDF
In mid to late September 2008 a cluster of six cases of hepatitis A was reported in a family in the Kennebunk area. Two of the children in the family attended Consolidated School in Kennebunkport. Since late October four additional cases of illness have been identified. Two of these cases were in members of the extended family diagnosed in September. The other two cases were in students at Consolidated School; these two students were unrelated to the extended family with hepatitis A. The average incubation period of hepatitis A is 30 days with a range from 15 to 50 days. Given the time interval since the initial family cluster, these newly identified cases most likely represent a second generation of infection. With the two new ill students, it is likely that transmission occurred in the school setting.	November 7, 2008	Word PDF
Hepatitis A in the Kennebunk Area	October 30, 2008	Word PDF
In mid to late September 2008 a cluster of six cases of hepatitis A was reported in a family in the Kennebunk area. This week three additional cases have tentatively been identified. Two of the cases are in members of the extended family. The third case is in an unrelated child. The average incubation period of hepatitis A is 30 days with a range from 15 to 50 days. Given the time interval since the initial family cluster, these newly identified cases most likely represent a second generation of infection. An investigation of the most recent cases is underway.	October 30, 2008	Word PDF
Rubella on a Ship	October 28, 2008	Word PDF
On October 18, 2008 a crew member of a cruise ship had onset of fever and rash. The crew member worked in the kitchen and reportedly did not have direct contact with passengers. The illness was subsequently confirmed to be rubella. The ship visited Bar Harbor on October 15 and October 19.	October 28, 2008	Word PDF
Eastern Equine Encephalitis in Massachusetts Resident	October 27, 2008	Word
On October 22, 2008, Maine Center for Disease Control and Prevention (Maine CDC) was notified of a Massachusetts resident that tested positive for Eastern Equine Encephalitis (EEE). The 73 year old man from northeast Massachusetts developed symptoms of illness on September 21, 2008 while vacationing in Maine. After several weeks of hospitalization, he was transferred to a facility in Massachusetts where his prognosis remains guarded.	October 27, 2008	Word
Human Rabies Vaccine Supply Update	October 24, 2008	Word PDF
There is currently a rabies vaccine supply shortage in the United States. Novartis (produces RabAvert®) now has adequate supply to deliver post-exposure prophylaxis (PEP) vaccine upon request and without restriction. Sanofi Pasteur (IMOVAX®) has PEP vaccine available on a limited basis with a password requirement. It is anticipated that a vaccine supply shortage will continue through 2009.	October 24, 2008	Word PDF
Eastern Equine Encephalitis: Update for Maine Clinicians	October 9, 2008	Word PDF
The Maine Center for Disease Control and Prevention (Maine CDC) within the Maine DHHS is reporting that a pool of mosquitoes, collected on September 30, 2008 from the town of Arundel in York County, has tested positive for Eastern Equine Encephalitis (EEE). Test results for additional pools from this location are currently pending. Numerous other mosquito pools previously collected this year from Arundel and York County have come back negative for both EEE and West Nile virus (WNV).	October 9, 2008	Word PDF
Eastern Equine Encephalitis: Update for Maine Clinicians, September, 2008	September 19, 2008	Word PDF
A horse has recently died and tested positive for Eastern Equine Encephalitis (EEE) in Lebanon, in York County, Maine. An emu also recently tested positive in nearby Barnstead, NH. Because there is a risk of human transmission of EEE from infected mosquitoes to people in the area of positive animals, Maine CDC within the Maine Department of Health and Human Services and the Maine Department of Agriculture are alerting physicians, veterinarians, and other health care providers of this EEE activity, and providing laboratory testing criteria and guidelines. For further questions or concerns, please contact Maine CDC for the medical epidemiologist on call at: 1-800-821-5821.	September 19, 2008	Word PDF
Continued Decrease in Human Rabies Vaccine	September 15, 2008	Word PDF
Rabies vaccine for humans in the United States is provided by two manufacturers: Sanofi Pasteur produces IMOVAX® and Novartis produces RabAvert®. It is anticipated that a vaccine supply shortage will continue through mid-to-late 2009.	September 15, 2008	Word PDF
Temporary Decrease in Human Rabies Vaccine Supplies	August 27, 2008	Word PDF
Because of limited existing supplies, CDC strongly recommends that health-care providers, state and local public health authorities, animal control officials, and the public take immediate steps to ensure appropriate use of human rabies biologics.	August 27, 2008	Word PDF
Human Arbovirus Update for Healthcare Providers in Maine, August 2008	August 6, 2008	Word PDF
This health advisory provides a brief update on the epidemiology and natural history of West Nile virus (WNV) and Eastern Equine Encephalitis (EEE) infections, a summary of surveillance findings in Maine, and guidance for obtaining and submitting clinical diagnostic specimens to the Maine Center for Disease Control (Maine CDC), where tests will be performed free of charge. Testing for mosquito-borne infections should be performed routinely for every person diagnosed with aseptic meningitis or encephalitis during the summer and fall months. Maine CDC will also test physician-submitted serum specimens for persons with other severe and/or persistent unexplained febrile illnesses	August 6, 2008	Word PDF
Temporary Decrease in Human Rabies Vaccine Supplies	July 30, 2008	Word PDF
Rabies vaccine for humans in the United States is provided by two manufacturers. Sanofi Pasteur produces IMOVAX and Novartis produces RabAvert. Both manufacturers are currently having problems meeting the demand for their products.	July 30, 2008	Word PDF
Paralytic Shellfish Poisoning (Red Tide) Advisory Update	July 30, 2008	Word PDF
With an incident of paralytic shellfish poisoning (PSP, also known as red tide poisoning) being reported earlier this month and recent test results showing high levels of PSP in the tomalley of some lobster, the Maine CDC/DHHS is updating its recommendations on safe shellfish consumption to include a reminder about not eating tomalley.	July 30, 2008	Word PDF
Red Tide Press Release for LHOs	July 8, 2008	Word PDF
Over the weekend of July 5th three people from Washington County were hospitalized with symptoms of paralytic shellfish poisoning, also known as red tide poisoning. This occurred several hours after they shared a meal of mussels. Samples of the mussels were highly contaminated with the toxin that causes paralytic shellfish poisoning. All three people were discharged the day after admission, and are expected to fully recover.	July 8, 2008	Word PDF
Paralytic Shellfish Poisoning in Washington County (medical provider version)	July 8, 2008	Word PDF
Over the weekend of July 5, 2008 three people from Washington County were hospitalized with symptoms of paralytic shellfish poisoning, also known as red tide poisoning. This occurred several hours after they shared a meal of mussels. Samples of the mussels were highly contaminated with the toxin that causes paralytic shellfish poisoning. All three people were discharged the day after admission, and are expected to fully recover.	July 8, 2008	Word PDF
Air Quality Alert for the Southwest Coast, Mid-Coast, Western Interior, and Eastern Interior regions of Maine	July 7, 2008	Word PDF
On Tuesday, ground-level ozone concentrations are expected to reach the “unhealthy for sensitive groups” level for the Southwest Coast, Mid-Coast, Western Interior and Eastern Interior regions while “unhealthy” levels are expected for the high elevations of Acadia National Park, according to the Maine Department of Environmental Protection (DEP). The coastal regions are likely to record higher levels of ozone than interior regions so everyone, not just sensitive groups, should take precautions.	July 7, 2008	Word PDF
Syphilis in Maine 2008	June 30, 2008	Word PDF
Since March 5, 2008 health care providers in Maine have diagnosed syphilis in nine individuals, ages 25-59, in Cumberland, Kennebec, and York Counties. Three individuals had primary syphilis, three had secondary syphilis, and three had early latent syphilis. Eight of the nine individuals with syphilis were men who have sex with men (MSM); the remaining person with syphilis was a male to female transgendered (MTF) individual. Three of the nine individuals are known to be HIV positive.	June 30, 2008	Word PDF
Air Quality Alert for Mid-Coast Region of Maine	June 26, 2008	Word PDF
Ground-level ozone concentrations are expected to reach unhealthy levels for sensitive groups for the mid-coast region and high elevations of Acadia (Port Clyde through Mt. Desert) according to the Maine Department of Environmental Protection (DEP).	June 26, 2008	Word PDF
June 9, 2008 – Maine CDC Advises Caution in Heat	June 9, 2008	Word PDF
With Maine heading into summer, it is important for all of us to prevent heat-related problems and to recognize the signs of heat illness early. Heat-related illnesses and deaths are preventable, yet over the past 30 years more people have died in this country from heat than from hurricanes, lightning, tornadoes, floods, and earthquakes combined.	June 9, 2008	Word PDF
Hepatitis B Screening and Vaccination of the Foreign-Born	May 27, 2008	Word PDF
May is Viral Hepatitis Awareness Month. Maine has an estimated 5,000 chronic hepatitis B virus (HBV) carriers; many of whom are foreign-born from regions with high endemicity of HBV infection. The Maine Center for Disease Control and Prevention (Maine CDC) is reminding health care providers about the need for screening of all foreign-born persons from high risk countries for hepatitis B virus infection. Hepatitis B vaccination should be offered to all susceptible patients. Chronic hepatitis B carriers require counseling and medical management to reduce their risk for developing chronic liver disease; their household, sex, and needle-sharing contacts also should also be tested, and if susceptible, vaccinated against hepatitis B.	May 27, 2008	Word PDF
Measles in the United States Jan.1 to April 25, 2008	May 16, 2008	Word PDF
From January 1 through April 25, 2008, CDC received a total of 64 reports of confirmed measles cases in the U.S. This is the highest number reported for the same time period since 2001.	May 16, 2008	Word PDF
Multi-Dose Medication and Reuse of Syringes	April 25, 2008	Word PDF
The purpose of this advisory is to notify you of a potential threat to patient safety if your facility uses parenteral medications for multiple patients with unsafe injection practices.	April 25, 2008	Word PDF
Animal Rabies 1st Quarterly Update January 1 – March 31, 2008	April 22, 2008	Word PDF
The Maine Center for Disease Control and Prevention (Maine CDC) provides a quarterly update on animal rabies to veterinarians and other animal health professionals. This update may be used as an educational tool to increase the understanding of pet owners and other members of the public regarding the risk of rabies in Maine and in their communities.	April 22, 2008	Word PDF
Cereal recalled due to contamination with Salmonella	April 10, 2008	Word PDF
On April 5, 2008 the Malt-O-Meal Company of Minnesota announced a recall of unsweetened puffed rice and unsweetened puffed wheat cereals. In addition to Malt-O-Meal’s own brand, these cereals are sold under multiple labels including the store brands for Hannaford and Shaw’s Supermarkets. The other brands being recalled are Acme, America’s Choice, Food Club, Giant, Jewel, Laura Lynn, Pathmark, ShopRite, Tops, and Weis Quality. The products recalled include “Best if used by” codes between April 8, 2008 (APR0808) and March 18, 2009 (MAR1809). The entire list of products included in the recall is available at: http://www.malt-o-meal.com/recallinfo/. The reason for the recall was contamination with Salmonella.	April 10, 2008	Word PDF
Influenza Activity in Maine	February 26, 2008	Word PDF
In February, influenza activity has become widespread in Maine, with all 3 of the major seasonal influenza variants circulating. Outbreaks of influenza are occurring in schools and in long term care facilities across the state. Although there is a decrease in the relative efficacy of this year’s vaccine against two of the three circulating strains, influenza vaccination is still strongly encouraged, especially to protect those persons at risk of more severe disease. Chemoprophylaxis and treatment of influenza with osteltamivir (Tamiflu) or zanamivir (Relenza) continues to be recommended in spite of low levels of oseltamivir resistance noted among influenza A (H1N1) in national studies. Influenza-related deaths in persons aged less than 18 years and outbreaks of influenzalike illnesses in long term care facilities should be immediately reported to Maine CDC at 1-800-821-5821.	February 26, 2008	Word PDF
Hepatitis B	February 6, 2008	Word PDF
An increase in acute Hepatitis B Virus (HBV) was noted in 2006 when 26 cases of infection were identified in Maine. This was a substantial increase from the annual average of 10 cases per year for the preceding six years (2000-2005) (range 5-14 cases per year). Preliminary data from 2007 indicate that the number of cases of acute HBV infection remains elevated (n=18).	February 6, 2008	Word PDF
Norovirus Gastroenteritis	February 6, 2008	Word PDF
Since December 1, 2007, the Maine CDC has investigated seven reports of confirmed or suspected norovirus gastroenteritis outbreaks from six counties. Four of these reports have been laboratory-confirmed. Five outbreaks occurred in long term care facilities and two in elementary schools. Noroviruses are the principal cause of viral gastroenteritis in the United States. Circulation of norovirus infections typically increases during the winter months, and outbreaks are currently being reported also in other areas of the nation. The Federal CDC estimates that 23 million cases of acute gastroenteritis per year are due to norovirus infection.	February 6, 2008	Word PDF
Rabies 4th Quarter Update	January 29, 2008	Word PDF
The Maine Center for Disease Control and Prevention provides a quarterly update on animal rabies to veterinarians and other animal health professionals. This update may be used as an educational tool to increase the understanding of pet owners and other members of the public regarding the risk of rabies in Maine and in their communities.	January 29, 2008	Word PDF
Erratum Mumps Outbreak in Maine	November 21, 2007	Word PDF
In the November 19, 2007 Health Alert Network Advisory "Mumps Outbreak in Maine" errors occurred. On page 2, under laboratory diagnosis, the second sentence of the second paragraph should read, " The diagnosis of mumps in persons with suggestive clinical presentation can be confirmed through viral culture of urine or saliva, by identifying mumps IgM antibody in serum, or through polymerase chain reaction (PCR) testing of saliva to amplify mumps nucleic acid early in the acute illness." In addition, updates were made to the text under laboratory diagnosis, third paragraph, number 2. See below for the corrected text.	November 21, 2007	Word PDF
Mumps Outbreak in Maine	November 19, 2007	Word PDF
Since late September, Maine CDC has confirmed seven people with mumps in central and southern Maine, and is awaiting the results of laboratory testing on other patients with clinicallysuspected illnesses. Confirmed patients reside in Cumberland, Androscoggin, Oxford, and Somerset Counties and range in age from late teens to late fifties. Mumps exposures at two acute care hospitals have resulted in serological testing for immunity and/or expedited vaccine boosting of a significant number of health care workers. Although no formal epidemiological link has been made, it is likely that these infections may be associated with an ongoing outbreak of mumps in New Brunswick and Nova Scotia. The epidemiology of recent outbreaks in North America, including the current situation in Canada, suggests that college and university students and health care workers should be priority populations for vaccination initiatives.	November 19, 2007	Word PDF
Outbreak of Atypical Pneumonia in College Students, Brunswick	November 6, 2007	Word PDF
The Maine Center for Disease Control and Prevention (Maine CDC) is working closely with the Bowdoin College Health Services to investigate and control an outbreak of 32 cases of atypical pneumonia that have occurred over a two month period at the college. Initial diagnostic testing has identified Mycoplasma pneumoniae (M. pneumoniae), the most common agent of pneumonia in adolescents and young adults, as the probable cause of this outbreak. Epidemiological and laboratory investigations are ongoing. Students at the college have been encouraged to practice cough hygiene measures, to minimize contact with others during acute illness, and to visit the infirmary for medical evaluation if they have fever or cough illnesses. There is no evidence that this outbreak is currently affecting college employees or residents of surrounding communities.	November 6, 2007	Word PDF
Information on MRSA for Maine Schools	October 31, 2007	Word PDF
The Maine Center for Disease Control and Prevention (Maine CDC) has received many recent inquiries related to Methicillin-resistant Staphylococcus aureus (MRSA). MRSA is a bacterial infection that is easily spread and can be prevented through increased personal hygiene and environmental cleaning.	October 31, 2007	Word PDF
Outbreak of Salmonella Infections in Cumberland County	October 25, 2007	Word PDF
The Maine CDC is currently investigating a cluster of Salmonella infections that have been reported among persons residing in Cumberland County in the last month. As of October 24, 2007, we have identified a total of 10 cases that are associated with this outbreak; eight (8) are culture-confirmed and two (2) are probable cases (i.e. epidemiologically-linked cases without culture confirmation). Symptom onset dates range from September 13 to October 2 and ages range from 23 to 64 years. The investigation of this outbreak is ongoing.	October 25, 2007	Word PDF
Mumps	October 18, 2007	Word PDF
Since September 27, Maine CDC has received reports of three people with laboratory-confirmed mumps in central and southern Maine. Three people of unknown vaccination status in their 30s-40s are infected in York and Cumberland Counties. Two were hospitalized and are now recovering at home. All are expected to fully recover. These are the first confirmed people infected with indigenous mumps in Maine in more than ten years. In addition, Maine CDC is currently investigating the possibility of two people infected in Kennebec County. We are also investigating any common exposures these individuals might have had to mumps.	October 18, 2007	Word PDF
Maine Animal Rabies 3rd Quarter Update	October 2, 2007	Word PDF
The Maine Center for Disease Control and Prevention provides a quarterly update on animal rabies to veterinarians and other animal health professionals. This update may be used as an educational tool to increase the understanding of pet owners and other members of the public regarding the risk of rabies in Maine and in their communities.	October 2, 2007	Word PDF
Shiga toxin positive E.coli 0157:H7 (STEC)	September 19, 2007	Word PDF
Maine CDC is investigating a cluster of six hemorrhagic shiga toxin positive E.coli O157:H7 (STEC) cases in mid-coast and central Maine that occurred among residents over the past 3 weeks (case onset dates of August 22 to September 13 and ages range 9 months to 75 years). As of September 19, four of the six have been confirmed shiga-positive E.coli O157:H7 by the Health and Environmental Testing Laboratory (HETL). Two other specimens are pending and one other suspect case is under investigation. All patients had bloody diarrhea and one (adult) was hospitalized. At this time, the investigation is ongoing although we have not identified any common venues, events or foods based on case interviews.	September 19, 2007	Word PDF
Lyme Disease in Maine: Answers to Frequently-Asked Questions from Health Professionals	September 12, 2007	Word PDF
Although the Maine Center for Disease Control and Prevention does not provide clinical consultation on the management of individual cases of Lyme disease, the Medical Epidemiology Section in the Division of Infectious Disease receives frequent requests from health professionals for Lyme disease-related information to assist in patient assessment and care. This Health Advisory includes answers to some of the more frequently asked questions that we receive, and is not intended in any way to be comprehensive.	September 12, 2007	Word PDF
Pertussis Cluster in Portland Area	September 7, 2007	Word PDF
Maine CDC is investigating a household cluster of pertussis cases in the Portland area, following the diagnosis of pertussis in an infant who was admitted to a hospital critical care unit over the weekend. Although there are no other persons currently hospitalized or seriously ill, this health advisory is being distributed because of the large number of children who were likely to have been exposed to pertussis during the past several weeks and for whom antibiotic prophylaxis and evaluation of respiratory illnesses is being recommended. Exposures occurred over the past 2-3 weeks in several settings including a childcare center and two children’s sports teams. Parents of children who have been identified as case contacts are being notified and will be likely to be calling their medical provider offices over the next few days. It should be noted that there is no evidence of a wider community outbreak of pertussis in southern Maine at this time.	September 7, 2007	Word PDF
Syphilis in Maine	August 30, 2007	Word PDF
Since January 1, 2007 health care providers in Maine have diagnosed 9 cases of syphilis all among males, ages 22-63, in Androscoggin, Cumberland, Oxford, and York Counties. Three cases were primary syphilis, two cases were secondary syphilis and four cases were early latent syphilis. Eight of the 9 cases were among men who have sex with men (MSM). Two of the 8 individuals are known to be HIV positive.	August 30, 2007	Word PDF
Outbreak of Botulism Associated with Canned Chili	August 28, 2007	Word PDF
Public health officials in Indiana, Texas, and at CDC are investigating an outbreak of botulism associated with canned hot dog chili sauce manufactured by Castleberry’s Food Company.	August 28, 2007	Word PDF
More Toys Recalled Because of Lead Paint	August 16, 2007	Word PDF
The Department of Health and Human Services’ Maine Center for Disease Control (Maine CDC) wants to remind Maine parents what they can do about common toys that have been recently recalled because they contain lead.	August 16, 2007	Word PDF
Human Arbovirus Update for Healthcare Providers in Maine	August 16, 2007	Word PDF
This health advisory provides a brief update on the epidemiology and natural history of West Nile virus (WNv) and Eastern Equine Encephalitis (EEE) infections, a summary of surveillance findings in Maine, and guidance for obtaining and submitting clinical diagnostic specimens to the Maine Center for Disease Control (Maine CDC), where tests will be performed free of charge. Testing for mosquito-borne infections should be performed routinely for every person diagnosed with aseptic meningitis or encephalitis during the summer and fall months. Maine CDC will also test physician-submitted serum specimens for persons with other severe and/or persistent unexplained febrile illnesses	August 16, 2007	Word PDF
Maine Paralytic Shellfish Poisoning (Red Tide) Illnesses - Washington County	August 1, 2007	Word PDF
Four persons from a Washington County fishing household were hospitalized with symptoms of paralytic shellfish poisoning (PSP) on the evening of July 31th within several hours of sharing a meal of mussels. Preliminary testing of mussels taken from the home were highly contaminated with the toxin that causes paralytic shellfish poisoning. These preliminary tests show toxin levels 200 times the threshold level used to close shellfish beds in Maine. Maine CDC is now assisting the Maine Department of Marine Resources (DMR) to determine the source of the implicated mussels and to assure that any harvested shellfish available to the public continue to be safe to eat. Early information indicates the probable source of the mussels was a drifting barrel found by the lobsterman off the Washington County coast; not from a mussel bed. This information also indicates the mussels taken off the barrel were for the lobsterman’s personal use.	August 1, 2007	Word PDF
Maine Animal Rabies 2nd Quarter Update - January 1 - June 30 2007	July 9, 2007	Word PDF
The Maine Center for Disease Control and Prevention provides a quarterly update on animal rabies to veterinarians and other animal health professionals. This update may be used as an educational tool to increase the understanding of pet owners and other members of the public regarding the risk of rabies in Maine and in their communities.	July 9, 2007	Word PDF
Toys Recalled Because of Lead Based Paint	June 15, 2007	Word PDF
The Department of Health and Human Services’ Maine Center for Disease Control (Maine CDC) wants Maine parents to know what to do about common toys that have been recently recalled because they contain lead.	June 15, 2007	Word PDF
Federal CDC Health Advisory: Early Report of Serious Eye Infections Associated with Soft Contact Lens Solution	May 29, 2007	Word PDF
The Centers for Disease Control and Prevention (CDC), collaborating with the Food and Drug Administration, state and other partners, has identified an outbreak of a serious but rare eye infection called Acanthamoeba keratitis (AK). This infection is caused by a free-living ameba (Acanthamoeba) a microscopic organism found everywhere in nature. Infections can result in permanent visual impairment or blindness. AK primarily affects otherwise healthy people, most of whom wear contact lenses. In the United States, an estimated 85% of cases of this infection occur in contact lens users. The incidence of the disease in the U.S. is approximately one to two cases per million contact lens users.	May 29, 2007	Word PDF
Mumps Outbreak in Eastern Canada - Alert for Maine Clinical Providers	May 18, 2007	Word PDF
Increased mumps activity is currently being reported in three Canadian provinces (Nova Scotia, New Brunswick, and Prince Edward Island), and has recently also spread to Ontario. As of May 11th, 2007, 271 confirmed cases of mumps had been reported from the four affected provinces. Approximately 90% and 25% of the mumps cases in Nova Scotia and New Brunswick respectively, are associated with university settings. The viral strain in these outbreaks is the same genotype (G) detected from the 2005-06 Nova Scotia outbreaks, the United States' multi-state outbreak in 2006, and the United Kingdom epidemic between 2004 and 2006	May 18, 2007	Word PDF
New Federal CDC Treatment Guidelines for Gonorrhea	May 4, 2007	Word PDF
As of April 13, the federal Centers for Disease Control and Prevention (CDC) no longer recommends the use of fluoroquinolones for the treatment of gonococcal infections and associated conditions such as pelvic inflammatory disease (PID). This is due to widespread fluoroquinolone resistance in Neisseria gonorrhoeae in the United States. CDC now recommends only one class of antibiotics, cephalosporins, for the treatment of gonorrhea. All providers in Maine are strongly encouraged to follow the updated guidelines.	May 4, 2007	Word PDF
Carbon Monoxide Poisoning Warning	April 19, 2007	Word PDF
A number of Maine communities continue to experience power outages due to the recent storm. Outbreaks of carbon monoxide (CO) poisonings have been associated with storm-related power outages due to improper placement and operation of gas-powered generators and other alternative heating and power sources. A study of a CO poisoning outbreak in the aftermath of the January 1998 Ice Storm found that improper placement of a gasoline generator, such as in a basement or garage, could increase the risk of CO poisoning by 20 to 300-fold. Using a kerosene heater in a room without any doors to other rooms opened, or failing to crack a window, also put people at increased risk for CO poisoning. CO is an odorless colorless gas emitted when burning most fuels. Improper operation or placement of alternative heating or power sources can result in poisoning when CO gas builds-up in enclosed spaces.	April 19, 2007	Word PDF
Maine Animal Rabies Quarterly Update - 1st Quarter, 2007	April 3, 2007	Word PDF
The Maine Center for Disease Control and Prevention provides a quarterly update on animal rabies to veterinarians and other animal health professionals. This update may be used as an educational tool to increase the understanding of pet owners and other members of the public regarding the risk of rabies in Maine and in their communities.	April 3, 2007	Word PDF
Salmonella Infections Associated with Peanut Butter	February 16, 2007	Word PDF
The Food and Drug Administration (FDA) is warning consumers not to eat certain jars of Peter Pan peanut butter or Great Value peanut butter due to risk of contamination with Salmonella Tennessee.	February 16, 2007	Word PDF
Outbreaks of Norovirus Gastroenteritis in Maine	January 12, 2007	Word
Since December 1, 2006, the Maine CDC has investigated eight reports of confirmed or suspected norovirus gastroenteritis outbreaks from seven counties. Four of these reports have been laboratory-confirmed. Six outbreaks occurred in long term care facilities and one in an elementary school. One outbreak associated with a gathering of families and friends was reported from a hospital emergency department.	January 12, 2007	Word
Influenza Arrives in Maine	January 3, 2007	Word
Cases of both influenza A and influenza B among Maine residents have now been confirmed by laboratory diagnostic testing in several communities, marking the beginning of our influenza season.	January 3, 2007	Word
Influenza B in Maine	December 16, 2006	Word
Laboratory-confirmed influenza B has been reported in Maine for the first time this season. Medical providers should continue to promote influenza immunization, especially for persons at risk of complications. Rapid influenza diagnostic tests may be useful as clinicians begin to see individuals with influenza-like illnesses in their practices. Providers should review updated guidelines for the use of antiviral drugs for prevention and chemoprophylaxis of influenza. Links to detailed CDC recommendations on vaccination, testing, and antivirals are provided below.	December 16, 2006	Word
Hepatitis B Outbreak	December 5, 2006	Word
An outbreak of acute Hepatitis B Virus (HBV) began in the Bangor area in June 2006. The Maine CDC has continued to receive reports of cases throughout the summer and fall. Currently, there are seven cases in Penobscot County and one case in Hancock County. (For comparison, only 12 cases of acute hepatitis B are reported statewide during an average year.) Each case has undergone one or more in-depth interviews. Sexual exposure has been identified as a major risk factor in this outbreak.	December 5, 2006	Word
Updated Treatment Guidelines for Lyme Disease	October 31, 2006	Word
The infectious Disease Society of America (IDSA) recently issued new guidelines for the diagnosis and treatment of Lyme disease, ehrlichiosis and babesiosis.	October 31, 2006	Word
Pertussis Outbreaks in Western and Southern Maine	October 13, 2006	Word
Maine CDC has been notified of a possible cluster of suspected Pertussis cases in a high school in Portland, Maine. In the past two months, Maine CDC was also notified of small clusters in some daycares in western and southern Maine.	October 13, 2006	Word
Multiple States Investigating a Large Outbreak of E. coli 0157:H7 Infections	September 15, 2006	Word
Public health officials in multiple states, with the assistance of the Centers for Disease Control and Prevention, are investigating a large outbreak of E. coli O157:H7 infections. Thus far, 50 cases with matching pulsed-field gel electrophoresis (PFGE) pattern have been reported from CT (1), ID (3), IN (4), MI (3), OR (5), NM (2), UT (11), WI (20). Eight patients developed the hemolytic uremic syndrome (HUS) and one patient died. Most cases are recent: for those with known illness onset, the range of onset is 08/25/2006 to 09/03/2006. The outbreak is likely ongoing.	September 15, 2006	Word
Hepatitis B Cluster, September 2006	September 14, 2006	Word
The Maine Center for Disease Control and Prevention (Maine CDC) has continued to receive reports of acute hepatitis B (HBV) from the Bangor area. During the summer a total of five cases were reported. Only 12 cases of acute hepatitis B are reported statewide during an average year. The cases in the Bangor area are males, 55 to 77 years of age, with no apparent risk factors or links to each other. An investigation for possible common exposures is ongoing.	September 14, 2006	Word
Guidance for Laboratory Testing of Persons with Suspected Infection with Avian Influenza A (H5N1) Virus in the United States	July 20, 2006	Word
This update provides revised interim guidance for testing of suspected human cases of avian influenza A (H5N1) in Maine and is based on the current state of knowledge regarding human infection with H5N1 viruses. The epidemiology of H5N1 human infections has not changed significantly since February 2004. Therefore, federal CDC recommends that H5N1 surveillance in the United States remain at the enhanced level first established at that time. However, this revised interim guidance provides an updated case definition of a suspected H5N1 human case for the purpose of determining when testing should be undertaken and also provides more detailed information on laboratory testing. Effective surveillance will continue to rely on health care providers obtaining information regarding international travel and other exposure risks from persons with specified respiratory symptoms as detailed in the recommendations below. This guidance will be updated as the epidemiology of H5N1 changes. Note: Federal CDC is revising its interim guidance for infection control precautions for avian influenza A (H5N1). These will be issued as soon as they are available.	July 20, 2006	Word
Hepatitis B Cluster, July 2006	July 14, 2006	Word
The Maine Center for Disease Control and Prevention (Maine CDC) has received 3 reports of acute hepatitis B (HBV) in the month of June from the Bangor area. Only 12 cases of acute hepatitis B are reported statewide during an average year. The cases are 56 to 77 years of age, diabetic, and have no apparent risk factors or links to each other. An investigation for possible common exposures is ongoing.	July 14, 2006	Word
Risk of Salmonella Infectious from Chicks and Other Poultry, June 2006	July 5, 2006	Word
The Maine Center for Disease Control and Prevention (Maine CDC) alerts healthcare providers to the risks of Salmonella infection associated with exposure to chicks. The Maine CDC further advises healthcare providers to educate patients and families about the risks of Salmonella and other enteric diseases from contact with chicks and other poultry.	July 5, 2006	Word
New Recommendations for Mumps Prevention in Maine	June 20, 2006	Word
Federal CDC, and state and local health departments across the nation are still coping with an outbreak of mumps that began in Iowa in December 2005 and involved at least 12 additional states. To date, Maine CDC has not received any reports of confirmed mumps in Maine. Nationally, the CDC reported 4,016 confirmed, probable, or suspect cases of mumps as of June 14, 2006.	June 20, 2006	Word
Human Arbovirus Update for Healthcare Providers in Maine, June 2006	June 13, 2006	Word
In 2005, two horses, one bird, and one mosquito pool tested positive for Eastern Equine Encephalitis (EEE) in Maine, all in York County. In the same year, eight birds tested positive for West Nile virus (WNV). These results are the latest indication that there is a real risk of EEE and WNV transmission from infected mosquitoes to Maine residents. As the warm season approaches, the Maine CDC is alerting physicians and other healthcare providers of the risk of acquired human EEE and WNV infections, and providing laboratory testing criteria and guidelines	June 13, 2006	Word
Community-associated MRSA and Tattoos	May 30, 2006	Word
The Division of Infectious Disease has received an increasing number of reports of skin and soft tissue infections (SSTI) among persons that recently received tattoos or piercing. Several patients were subsequently diagnosed with community-associated methicillin-resistant Staphylococcal aureus (CA MRSA). Additionally, secondary cases of CA MRSA have been identified among household members.	May 30, 2006	Word
Syphilis Increase in Maine	May 25, 2006	Word
Since January 1, 2006, health care providers in Maine have diagnosed 9 cases of syphilis among seven males and two females, ages 24-48, in Cumberland, Kennebec, Waldo and Somerset Counties. Two cases were primary syphilis, two cases were secondary syphilis and five cases were early latent syphilis. Three of the cases were among males with HIV infection.	May 25, 2006	Word
Avian and Pandemic Influenza: What Mainer's Need to Do	May 18, 2006	Word
The current circulating strain of H5N1 avian influenza, more commonly referred to as bird flu, could very likely appear in the United States in the near future, at least among birds. This virus also has the potential to mutate and start infecting a large number of humans, possibly even becoming a pandemic (global epidemic). However, the detection of H5N1 in the United States in birds does not signal the start of a human pandemic	May 18, 2006	Word
Potent substance probably sold as heroin is causing overdoses - may be or may contain methyl fentanyl	April 21, 2006	Word
Three states, New Jersey, Maryland and Illinois, are reporting an increase in opioid overdoses, supposedly heroin, requiring significant amounts of antidote	April 21, 2006	Word
Mumps Outbreak in Iowa - Air Travel Exposure	April 14, 2006	Word
The state of Iowa has been experiencing a large mumps outbreak that began in December 2005. As of April 10, 2006, a total of 515 possible mumps cases have been reported to the Iowa Department of Public Health (IDPH) during 2006. This outbreak has spread across Iowa, and mumps activity, possibly linked to the Iowa outbreak, is under investigation in six neighboring states, including Illinois (n = four), Kansas (n = 33), Minnesota (n = one), Missouri (n = four), Nebraska (n = 43), and Wisconsin (n = four) (CDC, unpublished data, April 10, 2006). The reasons for this outbreak are under investigation.	April 14, 2006	Word
Widespread Influenza Activity	April 6, 2006
After an initial peak in activity in late-December, Maine’s influenza sentinel surveillance providers reported an increasing number of outpatient visits for influenza-like illness during the past 3 weeks. Laboratory surveillance data from the state laboratory and two reference laboratories indicate an increasing number of specimens submitted for influenza testing and number of specimens positive for influenza A and B. During the past 3 weeks, over 20 outbreaks of influenza have been reported in long-term and acute care facilities and schools.	April 6, 2006
Pertussis in Maine	March 7, 2006	PDF
Maine has seen significant increases in the incidence of pertussis (whooping cough) in recent years. Ten cases were recently reported from Hancock County. This advisory provides recommendations for the evaluation and management of pertussis.	March 7, 2006	PDF
Meningococcal Chemoprophylaxis	March 7, 2006	PDF
Maine Center for Disease Control and Prevention (Maine CDC) recently received reports of meningococcal disease in which large numbers of persons were placed on chemoprophylaxis. The purpose of this health advisory is to make health care providers aware of national guidelines for chemoprophylaxis of meningococcal disease.	March 7, 2006	PDF
CDC Recommends against the use of Amantadine and Rimandatine for the treatment or prophylaxis of influenza in the United States during the 2005-06 influenza season.	January 18, 2006	Word
CDC Recommends against the Use of Amantadine and Rimandatine for the Treatment or Prophylaxis of Influenza in the United States during the 2005–06 Influenza Season Recent evidence indicates that a high proportion of currently circulating Influenza A viruses in this country are resistant to these medications	January 18, 2006	Word
Varicella Outbreak in a Brunswick Elementary School	January 10, 2006	Word
During the week of December 19th Maine CDC (formerly Bureau of Health) received a report of an outbreak of varicella (chickenpox) among 12 students at Longfellow School in Brunswick, Maine. The school also reported that during the holiday season 14 children developed chickenpox. This brought the number of chickenpox cases in the school since the end of October to more than 30. The school is a K-5th grade elementary school with a student population of 354.	January 10, 2006	Word
Public Health Update on Influenza in Maine	December 13, 2005	Word
The purpose of this Health Advisory is to provide recommendations on: Influenza in Maine Influenza vaccine availability Anti-viral medications Laboratory testing for influenza Influenza surveillance activities	December 13, 2005	Word
Maine Frequently Asked Questions on Avian and Pandemic Influenza	November 2, 2005	Word PDF
Bird flu is an infection caused by avian (bird) influenza (flu) viruses, normally a subtype of a type A influenza virus. Occurring naturally among birds, these viruses are often carried by wild birds in their intestines, causing few if any symptoms. However, they can cause some domestic birds, including chickens, to be very ill and even die. Although bird flu viruses do not usually infect humans, occasionally some strains can. Symptoms of bird flu in humans depend on the subtype and strain of bird flu, but can range from conjunctivitis to typical flu-like symptoms to severe respiratory disease and sometimes even death.	November 2, 2005	Word PDF
Eastern Equine Encephalitis: Update for Maine Clinicians	October 4, 2005	Word PDF
Two horses and one bird have recently tested positive for Eastern Equine Encephalitis (EEE) in Maine, all in York County. Because there is a risk of human transmission of EEE from infected mosquitoes to people in that area, Maine Health and Human Services’ Public Health is alerting physicians and other health care providers of this EEE activity, and providing laboratory testing criteria and guidelines. For further questions or concerns, please contact Public Health for the medical epidemiologist on call at: 1-800-821-5821.	October 4, 2005	Word PDF
Imported Mumps Cases in Maine Summer Camps, June-July 2005	July 15, 2005	Word
The Bureau of Health (Maine Center for Disease Control and Prevention) is currently investigating two confirmed cases of mumps among campers and staff members at two Maine youth summer camps. Both individuals are non-U.S. residents here for the camping season. The cases are not linked to each other. No secondary transmission has been identified as of July 14 th.	July 15, 2005	Word
Community-Associated MRSA Update	June 8, 2005	Word
Over the past 3 years, outbreaks of community-associated Methicillin-resistant Staphylococcus aureus (MRSA) have become a well-documented problem in correctional facilities across the United States. During the week of May 30th, officials at two Maine correctional facilities reported outbreaks of skin and soft tissue infections caused by CA-MRSA affecting a total of 11 inmates. None of the inmates were critically ill and there is no evidence that the two outbreaks were directly connected. No infections have been reported among correctional officers or other staff.	June 8, 2005	Word
Community-Associated MRSA Infections in a Correctional Facility	May 26, 2005	Word PDF
This week the Cumberland County Jail reported an outbreak among inmates of skin infections caused by community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA). This outbreak is currently limited to a very small number of inmates, and control measures have been initiated in collaboration with the DHHS Bureau of Health and Portland Public Health. The problem of CA-MRSA, however, is growing and becoming a bigger public health concern across Maine and the nation. Health professionals should be aware of some of the basic issues in recognition, management, and prevention of these infections.	May 26, 2005	Word PDF
Bureau of Health Update on Influenza	November 3, 2004	Word
Influenza vaccine supply in Maine continues to be extremely limited, and no outbreaks of flu are evident yet in the State. The Bureau of Health’s goal is to minimize influenza’s impact by: assuring influenza vaccine access for high-priority Mainers; promoting measures that will minimize transmission of influenza; and improving Maine’s health system preparedness for influenza. We expect to evolve our recommendations as this situation continues to change.	November 3, 2004	Word
Updated Guidance on Influenza	October 20, 2004	Word
The purpose of this Health Advisory is to provide: An update on influenza vaccine supplies in Maine; Vaccine guidelines for Maine; Revisions to the recommendations for vaccinating healthy health care workers; and Influenza-related infection control measures for health care settings that should be implemented as soon as possible.	October 20, 2004	Word
Maine Health Advisory on Influenza to Health Providers	October 13, 2004	Word
Due to recently announced loss of half the nation’s expected influenza vaccine supply for the 2004 – 2005 season, vaccine availability continues to be extremely limited. At this time the supply is insufficient to provide flu vaccine to all persons for whom it is recommended.	October 13, 2004	Word
Interim Influenza Vaccination Recommendations 2004-05 Influenza Season	October 6, 2004	Word
We are forwarding to you a Health Advisory from CDC on the sudden shortage of flu vaccine and their recommendations. Here in Maine, Maine Department of Health and Human Services, Bureau of Health is working to assess the influenza vaccine supply (both the supply ordered by the Bureau of Health as well as that ordered by health care providers privately). Maine typically does not experience influenza activity prior to late November/early December.	October 6, 2004	Word
Outbreak of Pertussis Cases at a Southern Maine High School	May 13, 2004	Word PDF
The Bureau of Health is currently investigating an outbreak of pertussis at Cheverus High School, an institution in Portland which enrolls students from across southern and midcoastal Maine. Bureau epidemiologists are working with the school administration and nursing staff to ensure that close contacts of cases are referred for appropriate antibiotic prophylaxis and that individuals with clinical illnesses compatible with pertussis are referred for diagnostic testing and antibiotic treatment. Student families and staff members have received advisories instructing them to contact their primary care medical providers if they are symptomatic or are close contacts of confirmed cases. This advisory is intended to alert area clinicians who may see such patients and to provide an update on current recommendations in evaluation and preventive management of pertussis. If you are involved in evaluation or treatment of suspect pertussis cases or their exposed contacts, please review this advisory and contact the Division of Disease Control at 1-800-821-5821.	May 13, 2004	Word PDF

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Maine CDC Information

District Public Health

Info for Health Providers

Maine CDC Health Alert Network System (HAN)

Archived Alerts

Maine School-Located Influenza Vaccine Funding for K-12 Schools

Widespread Influenza Activity in Maine

Maine CDC/DHHS Update on Novel Influenza A (H1N1) Virus

Maine Animal Rabies 3rd Quarter Update

Updated Clinical Testing and Management Guidance for ILI

Update on H1N1 and Seasonal Influenza Vaccine

Update on H1N1 and Seasonal Influenza Vaccine

First Orders of H1N1 Vaccine to Be Submitted This Week

Updated Pediatric Antiviral Dosing Information for Seasonal and H1N1 Vaccine

Varicella (Chickenpox) Outbreak in Penobscot County

Seasonal Influenza Vaccine Supply Delay

Register to be a H1N1 Flu Vaccine Distribution Site

Human Risk for Eastern Equine Encephalitis (EEE)

Eastern Equine Encephalitis (EEE)

Update: Hepatitis A Cluster, Swans Island, ME

Hepatitis A Cluster, Swans Island, Maine

Air Quality Advisory for Monday and Tuesday

Maine CDC Update on Novel H1N1

Human Arbovirus Update for Healthcare Providers in Maine

H1N1 Preparations for Residential Schools

Salmonella Outbreak Identified in 3 Maine Counties

Conference Call on Testing and Management of Novel Influenza A Virus (H1N1)

Testing and Management of Novel Influenza A (H1N1)

Maine H1N1 Influenza Preparedness Summit

Ten Action Steps for Novel H1N1 Influenza Planning

Paralytic Shellfish Poisoning (Red Tide) Reminder

Clinicians Advised to Halt Use of Propofol from Tainted Lots

Maine CDC/DHHS Update on Novel Influenza A (H1N1) Virus

Maine CDC Operations during State Closure Days

Guidance for Camps to Address Novel H1N1 Virus

Pregnant Women and Novel Influenza A H1N1

Maine CDC Update on Novel Influenza A Virus (H1N1)

Rabies Vaccine Available for Pre-exposure Rabies Prophylaxis

Maine CDC Update on Novel Influenza A (H1N1)

WHO Declares Pandemic Phase 6 for H1N1

Seasonal Influenza Vaccine Opportunities for Schools and Communities

Novel Influenza A (H1N1) in Maine

Pertussis Outbreak in Penobscot County, Maine

Shiga-toxin positive E. coli O157:H7 (STEC) cluster

Maine CDC H1N1 Update

Air Quality Advisory for Ozone in Southwest Coast, Mid-Coast, and Western Interior of Maine

Maine H1N1 Update

Updated Guidance on Laboratory Testing of Persons with Suspected Novel Influenza A (H1N1) Virus

Maine Update and New School Closure Guidelines

Update on H1N1 in Maine

Updated Guidance for Communities with Confirmed H1N1 Influenza A Virus

Three Probable H1N1 Influenza ("Swine Flu") Cases Identified in Maine

H1N1 Influenza (“Swine Flu”) and New Clinical Guidance on Treatment of Children and Pregnant Women

Interim CDC Guidance for Nonpharmaceutical Community Mitigation

Updated Guidance from Maine CDC for Laboratory Testing of Persons with Suspected Swine Influenza A (H1N1) Virus

Surveillance for Swine Influenza A (H1N1) Virus in School and Childcare Settings

Swine Influenza Screening and Laboratory Testing Guidance for Health Care Providers

Invasive Haemophilus Influenzae, tybe b in an under-vaccinated 3 year old

Questions and Answers about Bisphenol-A and Formula

Update on Norovirus Gastroenteritis Outbreaks in Maine

Carbon Monoxide (CO) Poisoning Warning

Information for Veterinarians regarding Pets and the Peanut Butter Recall

REVISED Widespread Influenza Activity in Maine

Maine Animal Rabies 4th Quarter Update

Pertussis Outbreak Reported in Hancock County

Outbreak of Salmonella Typhimurium Infections - United States

Pertussis Outbreak in York County

Outbreaks of Norovirus Gastroenteritis in Maine

December 22, 2008-CDC Issues Interim Recommendations for the Use of Influenza Antiviral Medications

Influenza arrives in Maine

Carbon Monoxide Poisoning Advisory

Domestic Violence and Sexual Assault Health Advisory for the General Public

Domestic Violence and Sexual Assault Health Advisory for Health Care Providers

2008-2009 Winter Heating Advisory

Revised - Maine Animal Rabies Third Quarter Report Jan.1 - Sept. 30, 2008

November 19, 2008 - Update on Hepatitis A in the Kennebunk Area

Update: Hepatitis A in the Kennebunk Area

Hepatitis A in the Kennebunk Area

Rubella on a Ship

Eastern Equine Encephalitis in Massachusetts Resident