All Health Advisories

AlertDateFile(s)

Booster Doses of Pfizer-BioNTech COVID-19 Vaccine

September 24, 2021 Advisory (PDF) 
This week, the U.S. Food and Drug Administration authorized, and the U.S. Centers for Disease Control and Prevention (CDC) recommended, administration of a booster dose of the Pfizer-BioNTech COVID-19 vaccine for certain individuals.

US CDC: Rapid Increase in Ivermectin Prescriptions and Reports of Severe Illness Associated with Use of Products Containing Ivermectin to Prevent or Treat COVID-19

August 27, 2021 Advisory (PDF) 
This Health Advisory from the US Centers for Disease Control and Prevention is being posted by Maine CDC to ensure widest visibility.

Increased Respiratory Syncytial Virus (RSV) Activity in Maine

August 16, 2021 Advisory (PDF) 
Respiratory syncytial virus (RSV) is circulating in Maine at a higher rate than usual for this time of year. Health care providers should consider testing patients with acute respiratory illness for RSV. To prevent transmission of RSV and other respiratory viruses, people with respiratory symptoms should refrain from in-person work, school, or daycare while acutely ill. This recommendation applies even if they have tested negative for SARS-CoV-2, the virus that causes COVID-19.

Use of an additional mRNA COVID-19 vaccine dose after an initial 2-dose primary mRNA COVID-19 vaccine series for immunocompromised people

August 14, 2021 Advisory (PDF) 
On August 12, 2021, the U.S. Food and Drug Administration modified the Emergency Use Authorizations (EUAs) for the Pfizer-BioNTech and Moderna COVID-19 vaccines to allow for administration of an additional dose (i.e., a third dose) of an mRNA COVID-19 vaccine after an initial 2-dose primary mRNA COVID-19 vaccine series for certain immunocompromised people. On August 13, 2021, the U.S. CDC's Advisory Committee on Immunization Practices ("ACIP") reviewed the data for use of an additional dose of mRNA COVID-19 vaccine for immunocompromised people. ACIP made an interim recommendation for use of an additional dose of Pfizer-BioNTech COVID-19 vaccine (for persons aged 12 years) or Moderna COVID-19 vaccine (for persons aged 18 years) after an initial 2-dose primary mRNA COVID-19 vaccine series for moderately to severely immunocompromised people.

Maine DEP Issues Air Quality Alert for Thursday, August 12th

August 12, 2021 Advisory (PDF) 
This message from the Maine Department of Environmental Protection is being forwarded by the Maine Center for Disease Control and Prevention to ensure widest visibility. Ground-level ozone concentrations will be climbing in Maine on Thursday and are expected to reach unhealthy levels for the Southwest Coast and the high elevations of Acadia NP according to the Maine Department of Environmental Protection (DEP). Ozone levels in southern New England began ramping up on Wednesday with transport of ozone and its precursors toward Maine later today and tomorrow. Meanwhile, some smoke is expected to combine with regional particle pollution to push particle pollution to moderate levels statewide tomorrow.

Health Risks from Extreme Heat this Week

August 11, 2021 Advisory (PDF) 
Maine will experience extremely hot and humid weather this week. The Maine CDC would like to remind health care providers, caregivers, and public health professionals to identify those in their care at increased risk and advise them to take precautions to prevent heat illness. Health care providers should remind patients and their caregivers about the importance of seeking medical attention for heat-related illnesses and discuss prevention methods. Residential care facilities should monitor their residents carefully for signs of heat illness, especially if the facility is not air conditioned.

Cluster of Legionellosis Cases - Greater Bangor Area

August 5, 2021 Advisory (PDF) 
In the greater Bangor area, Penobscot County, Maine, physicians have reported 4 confirmed cases of legionellosis from July 1, 2021 to July 31, 2021, 3 of which required intubation. Cases range in age from 38 to 67 years old. Maine CDC has not identified a common exposure among cases.

Varicella Testing and Reporting Recommendations

August 3, 2021 Advisory (PDF) 
Maine CDC is seeing a rise in the number of reported cases of varicella (chickenpox). Varicella is a notifiable condition in Maine, and all confirmed or suspect cases of varicella should be reported to Maine CDC. The number of reported cases of varicella decreased in 2020, likely due to reduced person-to-person transmission because of COVID-19 restrictions. Since January 1, 2021, Maine has identified 46 cases of varicella from all 16 counties (data as of 07/29/2021), including two outbreaks in child care facilities.

Standing Order for COVID-19 Testing

July 1, 2021 Advisory (PDF) 
On July 1, 2021, Maine CDC issued a revised Standing Order ("Order") that authorizes health care providers or other trained personnel at a health care facility or medically supervised COVID collection site (collection site) in the state to collect and submit specimens of SARS-CoV-2 for molecular or antigen-based testing. The Order is a physician's order that authorizes lab testing for COVID-19 for any individual in Maine at least 12 months of age or older. The Order is not meant to replace existing patient-provider relationships or provider-laboratory relationships. It can assist people who believe that they have been exposed or have an elevated risk of exposure and who do not have a primary care provider, cannot discuss this exposure in a timely way with their health care provider, or are visiting Maine from another state, as examples. The Order also authorizes the collection site that submitted the specimen for SARS-CoV-2 molecular or antigen testing under this Order to receive the results of the test directly from the testing laboratory. The Order further authorizes the laboratory that performed the test for SARS-CoV-2 to provide test results directly to the individual who was tested, with the individuals consent.

Human Powassan Case and Arbovirus Update for Healthcare Providers in Maine

June 29, 2021 Advisory (PDF) 
The purpose of this health advisory is to alert clinicians to the potential for human arboviral disease activity in Maine and to consider testing for arboviruses in patients presenting with unexplained encephalitis, meningitis or high fever (100.4F or 38C) during the summer and fall. Maine CDC identified a human case of Powassan encephalitis in a Maine resident who resides in midcoastal Maine. The individual was symptomatic in late June and hospitalized. CDC Fort Collins confirmed the Powassan result in this individual by neutralization testing. This individual likely acquired this Powassan encephalitis infection in the state of Maine. There are two types of Powassan virus in the United States. The first type, often called lineage 1 Powassan virus is associated with Ixodes cookei or the woodchuck tick. Lineage 2 POW, sometimes called Deer tick virus, is associated with Ixodes scapularis or the deer tick. Both can cause human disease. Powassan encephalitis is a member of the flavivirus genus which includes arboviruses like Dengue virus, West Nile virus (WNV), Yellow Fever virus, and Zika virus. Arboviral diseases, including Eastern equine encephalitis (EEE), Jamestown Canyon virus (JCV), and WNV, are serious infections that are transmitted by the bite of an infected mosquito. Maine reported one human case of WNV in 2020. Additionally, Powassan virus is an arboviral disease transmitted by the bite of an infected tick. Maine identified one case of Powassan virus disease in residents during 2020. Although rare, these diseases have potentially severe and even fatal consequences for those who contract them.

Changes to HETL COVID-19 Testing Operational Schedule

June 21, 2021 Advisory (PDF) 
On Monday, June 28, 2021, the hours of operation for the clinical microbiology section at the Maine CDC Health and Environmental Testing Laboratory (HETL) will shift to 7 a.m. to 5 p.m., Monday through Friday. As a result, HETL will not conduct COVID-19 PCR testing on Saturday or Sunday. Submitters should be aware that samples are only viable for testing within 72 hours after collection. Samples beyond that 72-hour window cannot be tested. Before 5 p.m. on Friday, HETL staff will freeze any sample that would expire because it is more than 72 hours post collection. HETL staff will then test that sample during the next business period. If HETL is not able to verify that an unfrozen sample was collected within 72 hours, the sample will not be tested. Facilities should plan to deliver COVID-19 samples before 5 p.m. on Friday. Samples delivered after 5 p.m. on Friday may exceed the 72-hour period of viability prior to Monday. Samples received on Saturday or Sunday will be processed during the next business period, provided that the sample has not exceeded the 72-hour period of viability.

Maine DEP Issues Air Quality Alert for Monday, June 7, 2021

June 7, 2021 Advisory (PDF) 
[This message from the Maine Department of Environmental Protection is being forwarded by the Maine Center for Disease Control and Prevention to ensure widest visibility.] Ground-level ozone concentrations will be climbing in Maine on Monday June 7th and are expected to reach unhealthy levels according to the Maine Department of Environmental Protection (DEP). Ozone levels have been high upwind since June 2nd. High levels began around Lake Michigan and have been slowly migrating eastward. By Saturday June 5th southern New England had very high levels of ozone even reaching into the Unhealthy (red) category. Transport winds are expected to direct the higher values to Maine on Monday. The unhealthy levels of ozone are possible along the entire coastline and the Eastern Interior. Meanwhile Particle Pollution levels are expected to be in the Moderate range. At elevated ozone levels, children, healthy adults who exert themselves, and individuals suffering from a respiratory disease such as asthma, bronchitis or COPD can experience reduced lung function and irritation. When this happens, individuals may notice a shortness of breath, coughing, throat irritation, and/or experience an uncomfortable sensation in their chest.

Acute Hepatitis A Case in a Food Service Worker in Eastport, Maine

May 27, 2021 Advisory (PDF) 
The Maine Center for Disease Control and Prevention (Maine CDC) has identified a case of acute hepatitis A virus infection in an Eastport, Maine, food service worker. The individual handled food in the deli at the R&M IGA at 88 Washington Street in Eastport, Maine, while infectious on the following dates in 2021: May 3-6, May 8, May 10-13, May 15, and May 18-20. Deli food items purchased on May 3-22 should be discarded or cooked thoroughly. Epidemiological assessment of the employee's illness determined that patrons of the establishment may be at risk for hepatitis A infection. Maine CDC recommends that anyone who ate food prepared in the R&M IGA deli from May 13-22, 2021, receive hepatitis A vaccine within 14 days of their potential exposure. There is a 14-day window during which prophylaxis is effective after exposure. Anyone who ate food prepared at or who worked at this establishment from May 3-12, 2021, is outside the window for which prophylaxis is recommended. Those individuals are advised to watch for symptoms and seek medical attention should they develop symptoms (see below). Health care providers are encouraged to remain vigilant for hepatitis A infection in persons with consistent symptoms and should ask individuals with such symptoms about consumption of prepared food from this establishment or who worked at this establishment during this period.

Cases of Myocarditis/Pericarditis Following COVID-19 Vaccination

May 26, 2021 Advisory (PDF) 
The U.S. Centers for Disease Control and Prevention is aware of reports of myocarditis and pericarditis after receipt of a COVID-19 vaccine. The reports appear to be rare, given the number of vaccine doses administered to date. U.S. CDC is investigating whether there is any causal association or an increase of such events relative to the background rates. Myocarditis is an inflammation of the heart muscle and pericarditis is the inflammation of the lining outside the heart. In both cases, the body's immune system causes an inflammation in response to an infection or some other trigger. While myocarditis can be serious, it is frequently mild and self-limited. Symptoms can include abnormal heart rhythms, shortness of breath, or chest pain. Myocarditis is often caused by a viral infection, but it can result from a reaction to a drug or as part of a more general inflammatory condition. Myocarditis itself not a notifiable condition in Maine. Maine CDC has received reports of cases of myocarditis occurring in Maine residents after receipt of an mRNA COVID-19 vaccine. Since there is usually an increase in myocarditis at this time of year, it is not known if these cases are associated with receipt of the vaccine. Vaccination for COVID-19 remains strongly recommended. U.S. CDC will continue to evaluate reports of myocarditis/pericarditis occurring after COVID-19 vaccination and will share more information as it becomes available.

2021 Lyme and Other Tickborne Disease Information

May 3, 2021 Advisory (PDF) 
Lyme disease is the most common vectorborne disease in Maine. Ticks are already active, and we expect the number of Lyme disease cases to increase as the weather continues to get warmer. May is Lyme Disease Awareness Month in Maine and we want to encourage Mainers to stay tick free using "Stop. Check. Prevent."

Health Risks from Browntail Moths

April 28, 2021 Advisory (PDF) 
The browntail moth is an invasive species of both forest and human health concern. Maine and Massachusetts are the only states in the U.S. experiencing problems with this moth. The microscopic hairs found on browntail moth caterpillars, shed skins, and cocoons can cause skin reactions and breathing problems.

Cases of Cerebral Venous Sinus Thrombosis with Thrombocytopenia after Receipt of the Johnson & Johnson COVID-19 Vaccine

April 13, 2021 Alert (PDF) 
Maine CDC is forwarding this HAN message from US CDC to ensure widest visibility. Maine CDC is not aware of any reports of these cases in Maine residents. The State of Maine is advising that providers pause administration of the Johnson & Johnson vaccine until the US CDC's scientific advisory committee has further reviewed the safety data. Maine CDC is working with administration partners to provide an alternative supply of the mRNA vaccines to clinics already scheduled so they can continue operations. As of April 12, 2021, approximately 6.85 million doses of the Johnson & Johnson (J&J) COVID-19 vaccine (Janssen) have been administered in the United States. The Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA) are reviewing data involving six U.S. cases of a rare type of blood clot in individuals after receiving the J&J COVID-19 vaccine that were reported to the Vaccine Adverse Events Reporting System (VAERS). In these cases, a type of blood clot called cerebral venous sinus thrombosis (CVST) was seen in combination with low levels of blood platelets (thrombocytopenia). All six cases occurred among women aged 18-48 years. The interval from vaccine receipt to symptom onset ranged from 613 days. One patient died. Providers should maintain a high index of suspension for symptoms that might represent serious thrombotic events or thrombocytopenia in patients who have recently received the J&J COVID-19 vaccine. When these specific type of blood clots are observed following J&J COVID-19 vaccination, treatment is different from the treatment that might typically be administered for blood clots. Based on studies conducted among the patients diagnosed with immune thrombotic thrombocytopenia after the AstraZeneca COVID-19 vaccine in Europe, the pathogenesis of these rare and unusual adverse events after vaccination may be associated with platelet-activating antibodies against platelet factor-4 (PF4), a type of protein. Usually, the anticoagulant drug called heparin is used to treat blood clots. In this setting, the use of heparin may be harmful, and alternative treatments need to be given. CDC will convene an emergency meeting of the Advisory Committee on Immunization Practices (ACIP) on Wednesday, April 14, 2021, to further review these cases and assess potential implications on vaccine policy. FDA will review that analysis as it also investigates these cases. Until that process is complete, CDC and FDA are recommending a pause in the use of the J&J COVID-19 vaccine out of an abundance of caution. The purpose of this Health Alert is, in part, to ensure that the healthcare provider community is aware of the potential for these adverse events and can provide proper management due to the unique treatment required with this type of blood clot.

Acute Hepatitis A Case in a Food Service Worker in Orono, Maine

March 24, 2021 Advisory (PDF) 
The Maine Center for Disease Control and Prevention (Maine CDC) has identified a case of acute hepatitis A virus infection in an Orono, Maine, food service worker. The individual handled food while infectious on the following dates: March 6-9, March 13-16, and March 20-21, 2021. Epidemiological assessment of the employee's illness determined that patrons of the establishment may be at risk for hepatitis A infection. Maine CDC recommends that anyone who ate food prepared at or who worked at the Circle K at 2 Stillwater Avenue in Orono, Maine, from March 13 through 16 and March 20 through 21 receive hepatitis A vaccine within 14 days of their potential exposure. There is a 14-day window during which prophylaxis is effective after exposure. Anyone who ate food prepared at or who worked at this establishment from March 6 through 9, 2021, is outside the window for which prophylaxis is recommended. Such individuals are advised to watch for symptoms and seek medical attention should they develop symptoms (see below). Health care providers are encouraged to remain vigilant for hepatitis A infection in persons with consistent symptoms and should ask individuals with such symptoms about consumption of food from or working at this establishment during this period.

Notifiable Diseases and Conditions Rule Update, Re-Instatement of Requirement to Submit SARS-CoV-2 Samples

February 17, 2021 Advisory (PDF) 
The Maine Center for Disease Control and Prevention (Maine CDC) has updated its Rules for the Control of Notifiable Diseases and Conditions. The new rule goes into effect today, February 17, 2021. One of the most significant parts of the rule is the Notifiable Diseases and Conditions List, which states the diseases and conditions required to be reported to the state. The Rules for the Control of Notifiable Diseases and Conditions were first drafted in 1976 by the Department of Health and Human Services. The last revision to the rules occurred in 2015.Maine CDC has updated the Rules for the Control of Notifiable Diseases and Conditions to better align with new and emerging diseases and more efficient methods of reporting that are being adopted nationally. The updated rules reinforce the requirements for electronic laboratory reporting of notifiable diseases as well as compliance with provider reporting.

Campylobacteriosis Outbreak Associated with Raw Milk from New Hampshire Farm

February 12, 2021 Advisory (PDF) 
The New Hampshire Department of Health and Human Services (DHHS) has notified the Maine Center for Disease Control and Prevention (Maine CDC) of multiple individuals with gastrointestinal illness associated with recent purchases of unpasteurized/raw milk from Brandmoore Farms in Rollinsford, NH. In subsequent investigations, Maine and New Hampshire public health officials have identified multiple cases of campylobacteriosis in residents of both states. Maine has identified at least 30 cases of campylobacteriosis among Maine residents associated with this outbreak. At least two Maine residents have been hospitalized. Maine CDC and New Hampshire DHHS are warning consumers that they should not consume Brandmoore Farm retail raw milk with best-by dates through February 5, 2021. Anyone who consumed this raw milk has an elevated risk of enteric diseases, including campylobacteriosis. Brandmoore Farm distributes raw milk from its retail store located in Rollinsford, NH, as well as at Heron Pond Farm in South Hampton, NH and Dog Rose Farm in Lee, NH. Customers who still have Brandmoore Farms raw milk are advised not to drink it and to dispose of the product. Anyone symptomatic should be evaluated by a medical provider, tested, and treated as appropriate.

UPDATED: COVID-19 Updates: Quarantine and Testing

February 2, 2021 Advisory (PDF)  | Updates and Clarifications to “COVID-19 Updates: Quarantine and Testing” Advisory from 1/27/21
With Maine's increased COVID-19 infection rates and rollout of COVID-19 vaccinations, Maine CDC is updating its guidance regarding: - quarantine of individuals who are identified as close contacts of a COVID-19 case, and - use of antigen testing. 1/27/21: Original Advisory Posted 2/2/21: PLEASE SEE "UPDATES AND CLARIFICATIONS" DOCUMENT FOR ADDITIONAL INFORMATION.

Influenza Arrives in Maine

February 1, 2021 Advisory (PDF) 
Maine CDC's Health and Environmental Testing Laboratory (HETL) recently confirmed the first case of influenza B by PCR in Maine this season. Although multiple Maine health care facilities have reported influenza-positive antigen results in recent weeks, this is the first PCR-confirmed case. The individual is an adult who was not hospitalized, was unvaccinated, and had no recent travel history. It is not too late to vaccinate patients against influenza. Influenza vaccination can flatten the curve of influenza illnesses, and it also can help save medical resources for care of patients with COVID-19. Though influenza activity is currently lower than usual for this time of year, it may increase in the coming months. The 2020-2021 quadrivalent influenza vaccine contains components of both A subtypes (H1 and H3) as well as two B lineages (Yamagata and Victoria).

Adverse Event Related to Vaccination with Pfizer-BioNTech COVID-19 Vaccine

December 24, 2020 Advisory (PDF) 
Nationwide distribution of the first COVID-19 vaccine started December 14, 2020. U.S. CDC has since received reports that some people have experienced severe allergic reactions -- also known as anaphylaxis -- after receiving a COVID-19 vaccine. An allergic reaction is considered severe when a person needs to be treated with epinephrine or an EpiPen or if they must go to a hospital for emergent care. On Tuesday, December 22, 2020, Maine Medical Center reported an instance of a severe allergic reaction in an individual who had just received the Pfizer-BioNTech COVID-19 vaccine. The individual's past medical history was significant for severe allergic reactions and eosinophilic asthma. The individual experienced nausea, diaphoresis, and a dry cough that progressed to shortness of breath. The individual received epinephrine, was transported to the Maine Medical Center ED for monitoring, and is doing well.

Influenza Testing Reminder

December 23, 2020 Advisory (PDF) 
Maine CDC has recently received an increase in reported positive influenza antigen tests. Some specimens have been sent to Maine's Health and Environmental Testing Laboratory (HETL) for further analysis, but none have been confirmed. This is a reminder that providers are asked to send their first ten positive influenza specimens to HETL for confirmation and subtyping. This helps to determine where and which type of influenza is circulating in Maine. Instructions on submitting specimens for influenza testing can be found at: https://www.maine.gov/dhhs/mecdc/public-health-systems/health-and-environmental-testing/micro/submitting-samples.shtml. Influenza-related hospitalizations, influenza-like illness outbreaks, and influenza-associated pediatric deaths are required to be reported to Maine CDC. Though all other cases of influenza are not required to be reported, Maine CDC does appreciate reports of these as well. The best way to prevent influenza is by getting vaccinated. Maine CDC and national authorities recommend all individuals older than 6 months be immunized, even if they were vaccinated for influenza last season. It is not too late to get vaccinated.

COVID-19 Vaccination Training and Education

December 14, 2020 Advisory (PDF) 
As part of the State's response to COVID-19, Maine DHHS is offering a series of educational sessions for Maine clinicians on the COVID-19 vaccine(s) and to support efforts to build the knowledge and trust needed to ensure a successful vaccination effort statewide. Given busy clinician schedules, Maine DHHS is offering a series of short (30min) "COVID-19 Vaccine Info Sessions" that will be hosted twice a week starting Tuesday, Dec 15, 2020. The sessions will occur twice a week for the next several months at the following times: - Tuesdays at 7:30AM - 8:00AM - Fridays at 12:00PM - 12:30PM The sessions will offer brief didactic overviews on the vaccine development and approval process, followed by time for questions & discussions. Clinicians are welcome to attend one or multiple sessions.

Changes to Maine CDC's Quarantine Policy

December 4, 2020 Advisory (PDF) 
On December 2, 2020, the U.S. Centers for Disease Control and Prevention ("CDC") released a Scientific Brief on Options to Reduce Quarantine for Contacts of Persons with SARS-CoV-2 Infection Using Symptom Monitoring and Diagnostic Testing, based on a review of new epidemiological and modeling data. As noted in this Scientific Brief, local public health authorities determine and establish the quarantine options for their jurisdictions. Based on recent modeling and local circumstances and resources, U.S. CDC has provided data on options to shorten the previous 14-day quarantine period. Considering these data, Maine CDC is changing the quarantine period for individuals known to be close contacts of cases of COVID-19 to 10 days. It is important to note that a shorter quarantine period carries a risk that an exposed individual could become positive and potentially transmit COVID-19 to others after quarantine.

Acute Hepatitis A Case in a Food Service Worker in Dover-Foxcroft

November 19, 2020 Advisory (PDF) 
The Maine Center for Disease Control and Prevention (Maine CDC) has identified a case of acute hepatitis A virus infection in a Dover-Foxcroft, Maine, food service worker. The case handled food while infectious on November 11, 2020. Epidemiological assessment of the employee's illness determined that restaurant patrons may be at risk for hepatitis A infection. Maine CDC is recommending that anyone who may have eaten food prepared at or who worked at Pats Pizza in Dover-Foxcroft on November 11, 2020 receive hepatitis A vaccine by November 25, 2020 as there is a 14-day window during which prophylaxis is effective. This recommendation includes anyone who may have had dine-in, take-out, delivery, or curbside pickup of food from the restaurant. These recommendations are based on the best information available at this time. Health care providers are encouraged to remain vigilant for hepatitis A infection in persons with consistent symptoms and should ask individuals with such symptoms about consumption of food from this establishment during this period.

Acute Hepatitis A Case in a Food Service Worker in Bangor, Maine

November 3, 2020 Advisory (PDF) 
The Maine Center for Disease Control and Prevention (Maine CDC) has identified a case of acute hepatitis A virus infection in a Bangor, Maine, food service worker. The case handled food while infectious on October 16-18, 20, 22-25, 27 and 29. Epidemiological assessment of the employee's illness determined that restaurant patrons may be at risk for hepatitis A infection. Maine CDC is recommending that anyone who may have eaten food prepared at or who worked at the Texas Roadhouse in Bangor on the dates listed above between October 20th through October 29th receive hepatitis A vaccine within 14 days of their last exposure as there is a 14-day window during which prophylaxis is effective. This recommendation includes anyone who may have had dine-in, take-out, delivery, or curbside pickup of food from the restaurant. Anyone who visited the restaurant from October 16th through October 19th, 2020, is outside the window for which prophylaxis is recommended, but is advised to watch for symptoms and seek medical attention should they develop symptoms. These recommendations are based on the best information available at this time. Health care providers are encouraged to remain vigilant for hepatitis A infection in persons with consistent symptoms and should ask individuals with such symptoms about consumption of food from this establishment during this period.

Cryptosporidiosis Outbreak Linked to Raw Milk from Maine Farm

October 22, 2020 Advisory (PDF) 
Maine Center for Disease Control and Prevention (Maine CDC) has identified an outbreak of cryptosporidiosis in individuals who consumed unpasteurized/raw milk from Roux Farm in Shapleigh, Maine, within the last two months. Epidemiologists identified at least four individuals who became ill and tested positive for cryptosporidiosis. Anyone who consumed raw milk (regular or any flavor) from Roux Farm produced before October 18, 2020, may be at elevated risk of cryptosporidiosis. Raw milk from the farm was sold through a variety of stores in the state.

Flavivirus Case in a Maine Resident

October 21, 2020 Advisory (PDF) 
Maine CDC identified a human case of neuroinvasive Flavivirus infection in an adult who resides in Cumberland County. The individual became ill in early September and is currently hospitalized. Serum samples collected September 5th and September 13th tested positive for West Nile virus (WNV) antibodies at a commercial laboratory. Per established protocols, Maine's Health and Environmental Testing Laboratory (HETL) sent the samples to the U.S. CDC for further confirmation. Plaque reduction neutralization test (PRNT) testing results from the U.S. CDC indicated evidence of cross-reactive Saint Louis Encephalitis virus (SLEV) and WNV flavivirus neutralization antibodies, although the specific virus could not be identified. This is the first identification of a flavivirus in a Maine resident since 2018.

Acute Hepatitis A Case in a Food Service Worker in Rockwood, Maine

September 30, 2020 Advisory (PDF) 
The Maine Center for Disease Control and Prevention (Maine CDC) has identified a case of acute hepatitis A virus infection in a Rockwood, Maine, food service worker. The case handled food while infectious from September 2, 2020, through September 22, 2020. Epidemiological assessment of the employee's illness determined that restaurant patrons may be at risk for hepatitis A infection. Maine CDC is recommending that anyone who may have eaten food prepared at or worked at The Birches Resort Restaurant in Rockwood on September 16, 2020, through September 22, 2020, receive hepatitis A vaccine within 14 days of their potential exposure as there is a 14-day window during which prophylaxis is effective after exposure. This recommendation includes anyone who may have had dine-in, take-out, delivery, or curbside pickup of food from the restaurant. Anyone who visited the restaurant from September 2, 2020 through September 15, 2020, is outside the window for which prophylaxis is recommended, but are advised to watch for symptoms and seek medical attention should they develop symptoms. Health care providers are encouraged to remain vigilant for hepatitis A infection in persons with consistent symptoms and should ask individuals with such symptoms about consumption of food from this establishment during this period.

COVID-19 Testing Updates - September 2020

September 8, 2020 Advisory (PDF) 
- Persons who test positive for SARS-CoV-2, the virus that causes COVID-19, using a molecular amplification test and have not had a previous positive test, should be considered infected at the time of testing, regardless of any subsequent negative test results. Molecular amplification tests include Polymerase Chain Reaction (PCR) and Nucleic Acid Amplification Tests (NAAT). - Maine Center for Disease Control and Prevention (Maine CDC) continues to recommend that ALL persons who were in close contact with a person infected with COVID-19 (defined as being within 6 feet for at least 15 minutes) should be tested, regardless of symptoms. - Maine's Health and Environmental Testing Laboratory (HETL) is working with all submitting facilities to convert to the Lab Web Portal for electronic test ordering and reporting.

Acute Hepatitis A Case in a Food Service Worker in Saco, Maine

September 1, 2020 Advisory (PDF) 
The Maine Center for Disease Control and Prevention (Maine CDC) has identified a case of acute hepatitis A virus infection in a Saco, Maine food service worker. The case handled food while infectious from August 5, 2020 through August 21, 2020. While this employee was not in charge of preparing food, this employee had access to food in the kitchen. Maine CDC is making these recommendations out of an abundance of caution.

Changes to U.S. CDC COVID-19 Guidance

July 24, 2020 Advisory (PDF) 
Accumulating evidence supports ending isolation and precautions for persons with COVID-19 using a Symptom-Based Strategy. Except for rare situations, a test-based strategy is no longer recommended to determine when to discontinue isolation and precautions. See https://www.cdc.gov/coronavirus/2019-ncov/hcp/duration-isolation.html

Human Arbovirus Update for Healthcare Providers in Maine

July 20, 2020 Advisory (PDF) 
The purpose of this health advisory is to alert clinicians to the potential for human arboviral disease activity in Maine as summer progresses and to consider testing for arboviral disease in patients presenting with unexplained encephalitis, meningitis or high fever (100.4F or 38C) during the summer and fall when mosquitoes are most active. Arboviral diseases, including Eastern equine encephalitis (EEE), Jamestown Canyon virus (JCV), and West Nile virus (WNV), are serious infections that are transmitted by the bite of an infected mosquito. Maine reported no cases of locally acquired mosquito-borne infection in residents in 2019. Additionally, Powassan virus is an arboviral disease transmitted by the bite of an infected tick. Maine identified two cases of Powassan virus disease in residents during 2019. Although rare, these diseases have potentially severe and even fatal consequences for those who contract them.

Serious Adverse Health Events Associated with Methanol-based Hand Sanitizers

July 7, 2020 Advisory (PDF) 
Most commercially available alcohol-based hand sanitizers or rubs (ABHSR) contain either ethanol or isopropanol as active ingredients. On June 19, 2020, the U.S. Food and Drug Administration (FDA) advised consumers not to use any hand sanitizer manufactured by "Eskbiochem SA de CV" in Mexico, due to the potential presence of methanol, a toxic alcohol, as an active ingredient, which can cause blindness and/or death when absorbed through the skin or when swallowed. Since then, FDA has identified additional ABHSR products that contain methanol and is working with manufacturers and distributors on a voluntary recall of these products (https://www.fda.gov/drugs/drug-safety-and-availability/fda-updates-hand-sanitzers-methanol).

COVID-19 Testing at HETL

June 30, 2020 Advisory (PDF) 
The Maine CDC Health and Environmental Testing Laboratory ("HETL") has received several specimens for COVID-19 testing that do not have the appropriate paperwork attached. Federal rules under CLIA require HETL to only run tests that are accompanied by complete paperwork.

Hepatitis A Increase in Maine

June 19, 2020 Advisory (PDF) 
Maine has seen an increase in hepatitis A cases in Penobscot, Somerset, and York counties over the past four months, with the number of reported cases climbing from zero in January and February to 13 in Penobscot, 7 in Somerset, and 6 in York counties in March through today. Twenty-one of the 26 cases had risk factors of injection drug use or housing insecurity. Historically Maine had 7 to 10 cases of hepatitis A per year over the past decade. In 2019, Maine CDC identified 45 cases. This increase was driven by a restaurant-associated outbreak and cases related to injection drug use or homelessness. Since January 1, 2020, Maine CDC has identified 39 cases of hepatitis A. Recent case investigations, however, have not identified a source of the infections. The increase of hepatitis A in Maine mirrors an increase of cases seen across the country.

Acute Hepatitis A Case in a Food Service Worker in Saco, Maine

June 5, 2020 Advisory (PDF) 
The Maine Center for Disease Control and Prevention (Maine CDC) has identified a case of acute hepatitis A virus infection in a Saco, Maine, food service worker. The case handled food while infectious from May 12, 2020, thru May 23, 2020. Epidemiological assessment of the employee's illness determined that restaurant patrons may be at risk for hepatitis A infection. Maine CDC is recommending that anyone who may have eaten food prepared at or worked at the Sea Salt Lobster Restaurant in Saco on May 22, 2020, and May 23, 2020, receive hepatitis A vaccine by Saturday, June 6, 2020, as there is a 14-day window during which prophylaxis is effective after exposure. This recommendation includes anyone who may have had take-out, delivery, or curbside pickup of food from the restaurant. Anyone who visited the restaurant from May 12, 2020, thru May 21, 2020, is outside the window for which prophylaxis is recommended, but are advised to watch for symptoms and seek medical attention should they develop symptoms. Health care providers are encouraged to remain vigilant for hepatitis A infection in persons with consistent symptoms and should ask individuals with such symptoms about consumption of food from this establishment during this period.

Universal Testing in Congregate Living Settings

May 23, 2020 Advisory (PDF) 
Maine CDC has adopted the attached recommendations regarding universal testing in congregate living settings. This policy may be updated as scientific understanding of COVID-19 evolves.

Increased COVID-19 Testing Capacity at Maine CDC Laboratory

May 18, 2020 Advisory (PDF) 
On March 25, 2020, Maine met U.S. CDC's criteria for a Moderate level of community transmission for coronavirus disease 2019 (COVID-19). Since then Maine's testing capacity has been inhibited by the limited national supply of laboratory materials and testing equipment. To preserve specimen collection and testing supplies for patients who may develop severe COVID-19 illness, Maine CDCs Health and Environmental Testing Laboratory (HETL) has, until now, had to prioritize testing for individuals in high-risk categories. Maine CDC has expanded its capacity for COVID-19 testing. This expansion results largely from a partnership with IDEXX (Westbrook, Maine) to use the OPTI SARS-CoV-2 RNA PCR Test Kit, which recently received US FDA Emergency Use Authorization. The test kit is based on real-time reverse transcription polymerase chain reaction (RT-PCR), which provides detection of the viral RNA in the sample.

2020 Lyme and Other Tickborne Disease Information

May 13, 2020 Advisory (PDF) 
Lyme disease is the most common vectorborne disease in Maine. Ticks are already active, and we expect the number of Lyme disease cases to increase as the weather continues to get warmer. May is Lyme Disease Awareness Month in Maine and we want to encourage Mainers to use the "Tick Tock" strategies to stay tick free.

Pediatric Multi-System Inflammatory Syndrome Potentially Associated with COVID-19

May 11, 2020 Advisory (PDF) 
A pediatric multi-system inflammatory syndrome, recently reported by authorities in the United Kingdom, is also being observed among children and young adults in New York and elsewhere in the United States. Clinical features vary, depending on the affected organ system, but have been noted to include features of Kawasaki disease or features of shock; however, the full spectrum of disease is not yet known. Only severe cases may have been recognized at this time. This inflammatory syndrome may occur days to weeks after acute COVID-19 illness. This syndrome has features which overlap with Kawasaki Disease and Toxic Shock Syndrome. Inflammatory markers may be elevated (CRP, troponin etc.), and fever and abdominal symptoms may be prominent. Rash also may be present. Myocarditis and other cardiovascular changes may be seen. Some patients have developed cardiogenic or vasogenic shock and required intensive care. Patients with this syndrome who have been admitted to pediatric intensive care units have required cardiac and/or respiratory support.

Health Risks from Browntail Moths

May 5, 2020 Advisory (PDF) 
The browntail moth is an invasive species of both forest and human health concern. Maine and Massachusetts are the only states in the U.S. experiencing problems with this moth. The tiny, microscopic hairs found on browntail moth caterpillars, shed skins, and cocoons can cause skin reactions.

Testing for COVID-19 - Antibody Testing

May 1, 2020 Advisory (PDF) 
Antibody-based tests for the detection of antibodies against coronaviruses are now available through commercial laboratories. Only a select few of these tests are specific for SARS-CoV-2, the virus that causes COVID-19. Providers should review the COVID-19 Antibody Testing Primer from the Infectious Disease Society of America (IDSA) about serology-based tests for COVID-19.

Temporary Updates to the Notifiable Diseases and Conditions List - SARS CoV-2 and COVID-19 Deaths

April 22, 2020 Advisory (PDF) 
Reporting of notifiable diseases and conditions is required under 22 M.R.S., Chapter 250, 802 and 822. Failure to report could result in preventable morbidity or mortality. Maine CDC is authorized to advise through publicly noticed Health Alerts the public health need for the temporary reporting of any disease or condition in the state of Maine in order to study and control any apparent outbreak or unusual occurrence of communicable diseases. This Health Alert serves as notice for two temporary changes to the Notifiable Diseases and Conditions List.

Updated Guidance for COVID-19: Prioritization of Testing and Discontinuation of Home Isolation

March 19, 2020 Advisory (PDF) 
US CDC's guidelines on Implementation of Mitigation Strategies for Communities with Local COVID-19 Transmission define Moderate community transmission as, "Widespread and/or sustained transmission with high likelihood or confirmed exposure within communal settings with potential for rapid increase in suspected cases." According to US CDC, at that level and when testing capacity is limited, public health control activities may require prioritization of testing to high-risk individuals. Maine now meets US CDCs criteria for a Moderate level of community transmission. At present, a limited national supply of laboratory materials inhibits Maines testing capacity. Maine may also need to limit testing if such shortages continue. Therefore, consistent with US CDC guidelines, Maine is now creating a prioritization system to test to individuals in high-risk categories.

Updated Guidance for COVID-19 Testing

March 16, 2020 Advisory (PDF) 
On March 15, 2020, the U.S. Centers for Disease Control and Prevention (U.S. CDC) and the U.S. Food and Drug Administration (FDA) issued new guidance for collection, handling, and testing clinical specimens from persons for Coronavirus Disease 2019 (COVID-19). These new guidance can be found at https://www.cdc.gov/coronavirus/2019-ncov/lab/guidelines-clinical-specimens.htm and https://www.fda.gov/medical-devices/emergency-situations-medical-devices/faqs-diagnostic-testing-sars-cov-2. Key Messages: - U.S. CDC is now recommending collecting a single nasopharyngeal (NP) swab in viral transport media. Throat (OP) swabs are no longer required. If both swabs are used, they should be combined at collection in to a single vial. - FDA has expanded options for specimen transport media. - The Maine Health and Environmental Testing Laboratory (HETL) will no longer be running a respiratory viral panel with all submitted COVID-19 specimens.

Actions to Take Now for Community Transmission of COVID-19

March 15, 2020 Advisory (PDF) 
As of March 15, 2020, there are 7 confirmed and 5 presumptive positive COVID-19 cases in Maine. Community transmission is occurring in Cumberland County. The Maine Center for Disease Control and Prevention (Maine CDC) expects to see community transmission in other areas of Maine, possibly in the coming days. Such transmission will likely mean large numbers of patients needing medical care at the same time, stressing health care providers, hospitals, and other health care facilities. Critical systems, including emergency medical services, are likely to be affected, and should plan accordingly. Social distancing strategies should be implemented, even though they may impact daily activities and disrupt scheduled events.

First Presumptive COVID-19 Case in Maine

March 12, 2020 Advisory (PDF) 
On Thursday, March 12, 2020, Maine's Health and Environmental Testing Laboratory (HETL) reported out the first presumptive positive COVID-19 test result on a Maine resident. Currently, all positive COVID-19 results from state public health laboratories are considered presumptive until they are confirmed at the U.S. Center for Disease Control and Prevention (U.S. CDC). Health care providers should immediately notify infection control personnel at their health care facility if they suspect a patient of having COVID-19. Providers and health care facilities do not need to notify Maine CDC if they suspect their patient of having COVID-19, and do not need authorization to send samples to HETL. Providers should work with their health care facilities to determine the best location and method for specimen collection.

COVID-19 Updated U.S. CDC Guidance

March 12, 2020 Advisory (PDF) 
On March 10, 2020 the U.S. Centers for Disease Control and Prevention (U.S. CDC) released the following new or revised guidance in response to concerns around national and local shortages in Personal Protective Equipment (PPE) supplies, particularly N95 respirators: - Infection Prevention and Control - Emergency Medical Services (EMS) - Long-Term Care Facilities Other guidance issued includes - Guidance for Based Precautions and Disposition of Hospitalized Patients - People at risk for serious illness from COVID-19. Maine CDC is also providing additional guidance to providers seeking COVD-19 testing at Maine's Health and Environmental Testing Laboratory (HETL): - Providers no longer need to call Maine CDC for authorization prior to submitting a sample for testing - Nasopharyngeal (NP) and throat (oropharyngeal) swabs no longer need to be sent in separate viral transport media. NP and OP swabs can be submitted in a single container of viral transport media

Preparing for Community Transmission of COVID-19 in Maine

March 9, 2020 Advisory (PDF) 
As of March 9, 2020, U.S. states have reported over 500 cases of the novel coronavirus disease (COVID-19). Widespread sustained transmission has also been reported in China, Iran, Italy, and South Korea. Community spread has been reported in several other countries, including parts of the U.S. (California, Oregon, Washington). Community spread in Washington state led to the first death in the U.S. from COVID-19, the first reported case of COVID-19 in a health care worker, and the first outbreak in a long-term care facility. Widespread transmission of COVID-19 in the U.S. may occur, including within Maine. Such transmission could mean large numbers of patients needing medical care at the same time, stressing health care providers and hospitals/other health care facilities. Critical systems, including emergency medical services, are likely to be affected, and should plan accordingly. Various degrees of social distancing may be required, which could impact daily activities and disrupt scheduled events. There are no confirmed cases of COVID-19 in Maine at this time. Testing for COVID-19 is available at Maine's Health and Environmental Testing Laboratory. Health care workers caring for patients with COVID-19, close contacts of persons with COVID-19, and travelers returning from affected locations where community spread is occurring are at higher risk. The situation is rapidly evolving. For updates on the situation in Maine, visit https://www.maine.gov/dhhs/mecdc/infectious-disease/epi/airborne/coronavirus.shtml The clinical spectrum of COVID-19 disease is not fully known, but reported illnesses have ranged from mild to severe. Available information suggests most patients with COVID-19 have mild illness, with severe illness occurring in only 15-20% of patients. Most patients with confirmed COVID-19 have developed fever and/or symptoms of acute respiratory illness (e.g., cough, dyspnea). Risk factors for serious disease associated with COVID-19 include older age and co-morbidities (e.g., heart disease, lung disease, and diabetes). No vaccine to prevent COVID-19 is currently available, nor are there FDA-approved medications for treatment of COVID-19.

Updated COVID-19 Testing Criteria

March 5, 2020 Advisory (PDF) 
On Wednesday, March 4, 2020, the U.S. Centers for Disease Control and Prevention (U.S. CDC) expanded the Coronavirus Disease 2019 (COVID-19) testing criteria to a wider group of symptomatic patients. A patient who is suspected of having COVID-19 must wear a surgical mask as soon as they are identified and be evaluated in a private room with the door closed, ideally an airborne infection isolation room if available. Health care personnel entering the room should use standard precautions, contact precautions, airborne precautions, and use eye protection (e.g., goggles or a face shield). If providers suspect their patient of having COVID-19, they should immediately notify their health care facility's infection control personnel and Maine CDC at 1-800-821-5821. In the case of a patient suspected of having COVID-19, specimens must be sent to Maine Health and Environmental Testing Laboratory (HETL). Health care providers should remind all patients being tested for COVID-19 to remain isolated until test results are back and are negative.

Updated COVID-19 Patients Under Investigation (PUI) Criteria

February 28, 2020 Advisory (PDF) 
U.S Centers for Disease Control and Prevention (U.S. CDC) updated the Coronavirus Disease 2019 (COVID-19) criteria for Patients Under Investigation (PUI) on Thursday, February 27, 2020. A person who meets the PUI criteria must wear a surgical mask as soon as they are identified and be evaluated in a private room with the door closed, ideally an airborne infection isolation room if available. Health care personnel entering the room should use standard precautions, contact precautions, airborne precautions, and use eye protection (e.g., goggles or a face shield). If providers suspect a patient meets the PUI criteria, they should immediately notify their healthcare facility's infection control personnel and Maine CDC at 1-800-821-5821. Currently, testing for COVID-19 is not yet available in Maine. In the case of a PUI, specimens must be sent to HETL who will facilitate sending them to U.S. CDC for COVID-19 testing. There are no confirmed cases of COVID-19 in Maine at this time; therefore, the risk of community spread remains low.

Influenza-Associated Pediatric Death

February 19, 2020 Advisory (PDF) 
Maine CDC received notification of an influenza-associated pediatric death on Tuesday, February 18, 2020. The child, a southern Maine resident under 5 years old, was unvaccinated and tested positive for influenza B. This is the first influenza-associated pediatric death in Maine during the 2019-20 influenza season. Influenza activity in Maine remains elevated. Influenza vaccination is strongly encouraged, and vaccine is still widely available. Vaccination can reduce illness and prevent hospitalization and death.

Maine CDC Encourages Providers to Obtain Vaccine and Vaccinate At-Risk Populations for Hepatitis A

February 13, 2020 Advisory (PDF) 
In 2019, Maine saw a nearly five-fold increase in hepatitis A cases over the five-year average number of cases, increasing from 9 in 2018 to 45 in 2019. A quarter of the cases in 2019 had risk factors such as injection drug use or homelessness. Maine CDC recommends that healthcare providers and facilities that provide services to at-risk populations obtain hepatitis A vaccine and offer vaccination to their clients to prevent further spread of hepatitis A. - Screen patients for risk factors (e.g., drug use, homelessness, incarceration, MSM, and chronic liver disease). - Recommend and administer hepatitis A vaccine to at-risk patients, regardless of the original presenting complaint or the type of clinical facility. In particular, the emergency department may be an individual's only interaction with the healthcare system and is an important opportunity for prevention. - Record immunizations in the state immunization information system (registry). - Consider hepatitis A as a diagnosis in anyone with jaundice, elevated liver enzymes, or clinically compatible symptoms. Order an acute hepatitis panel to include hepatitis A IgM on these patients. Rapidly report all persons diagnosed with hepatitis A to the health department to ensure timely case investigation and follow-up of contacts.

Update and Interim Guidance on Outbreak of 2019 Novel Coronavirus (2019-nCoV)

February 4, 2020 Advisory (PDF) 
The Centers for Disease Control and Prevention (federal CDC) continues to closely monitor an outbreak of respiratory illness caused by a novel coronavirus (2019-nCoV) that was initially detected in Wuhan City, Hubei Province, China in December 2019. This federal CDC Health Alert Network (HAN) Update provides a situational update and interim guidance to state and local health departments that supersedes guidance in federal CDC's HAN 426 distributed on January 17, 2020. - As of February 4, 2020, no cases of 2019-nCoV have been identified in Maine. - If a patient meets the PUI criteria, the provider should contact Maine CDC immediately, by calling 1-800-821-5821, to determine if this patient needs to be considered a PUI for 2019-nCoV and be tested for infection.

Increase in Suspected Unintentional Overdoses in Cumberland County

February 1, 2020 Advisory (PDF) 
On Saturday, February 1st, the Northern New England Poison Control Center notified Maine CDC of ten individuals who potentially overdosed unintentionally over the weekend. All ten individuals received emergency assistance in Cumberland County. Cases were reported from multiple facilities. Some of these individuals may have thought that they were using cocaine, but the cocaine may have been contaminated with opioids. At least one individual indicated they purchased the cocaine from a new dealer. Several individuals were seriously impaired and required naloxone to recover, some needing multiple doses. The intent of this HAN is to alert Emergency Medical Services, health care facilities and providers, and law enforcement to a potentially contaminated product that is leading to severe adverse outcomes.

Updated Definition for Patients Under Investigation (PUI) for 2019 Novel Coronavirus (2019-nCoV)

January 31, 2020 Advisory (PDF) 
Imported cases of 2019-nCoV infection in people have been detected in the U.S. While person-to-person spread among close contacts has been detected with this virus, this virus is NOT currently spreading in the community in the United States. At this time, Maine does not have any confirmed cases and has no patients under investigation (PUI). U.S Centers for Disease Control and Prevention (U.S. CDC) updated the 2019 Novel Coronavirus (2019-nCoV) definition for patients under investigation (PUI) on Friday, January 31, 2020.

Update and Guidance on Outbreak of 2019 Novel Coronavirus (2019-nCoV)

January 21, 2020 Advisory (PDF) 
The Centers for Disease Control and Prevention (CDC) continues to closely monitor an outbreak of a 2019 novel coronavirus (2019-nCoV) in Wuhan City, Hubei Province, China that began in December 2019. CDC has established an Incident Management System to coordinate a domestic and international public health response. Coronaviruses are a large family of viruses. Some cause illness in people; numerous other coronaviruses circulate among animals, including camels, cats, and bats. Rarely, animal coronaviruses can evolve and infect people and then spread between people such as has been seen with Middle Eastern Respiratory Syndrome Coronavirus (MERS-CoV) (https://www.cdc.gov/coronavirus/mers/index.html) and Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) (https://www.cdc.gov/sars/index.html).

Lead Poisonings Requiring Medical Chelation Treatment

January 16, 2020 Advisory (PDF) 
Between July and December 2019, four children ages 12 to 24 months were identified with blood lead levels ranging from 45 to 57 mcg/dL. Blood lead levels of 45 mcg/dL or higher are typically treated with medical chelation therapy to reduce blood lead levels. These are the first chelation cases identified in Maine since 2016. The children resided in Androscoggin, Cumberland, and York counties.

Widespread Influenza Activity in Maine

January 7, 2020 Advisory (PDF) 
Influenza activity in Maine is now widespread with providers reporting laboratory-confirmed influenza in all sixteen counties. Maine's Health and Environmental Testing Laboratory (HETL) confirmed influenza A/pH1N1, influenza A/H3, influenza B/Victoria, and influenza B/Yamagata are all circulating in Maine. Maine CDC has followed up on nine (9) outbreaks of influenza as of Tuesday, January 7, 2020. With increased influenza activity, it is not too late to get vaccinated. Influenza vaccination is the best way to prevent illness. Vaccination is strongly encouraged throughout the season and is still widely available.

Vaping-associated Pulmonary Illness - Reporting Now Required

October 3, 2019 Advisory (PDF)  | Disease Reporting Form
The purpose of this health advisory is to inform clinicians that, effective immediately, and pursuant to 22 M.R.S. 802(1)(B), pulmonary disease associated with e-cigarette use is now temporarily added to the list of Notifiable Conditions that are required to be reported to Maine CDC. Summary: There has been an increase in the number of cases of significant lung illness related to e-cigarette use in Maine. As of Wednesday, October 2, four additional cases of lung illness related to e-cigarette use have been confirmed, bringing Maine's total to five cases. No deaths from this illness have been reported in Maine. Recommendations: Consider e-cigarette-associated illness with patients who present with respiratory illness of unclear etiology and who have vaped or dabbed within the past 90 days. Clinicians should ask about and document extent of use, type of instrument used, type of vaping liquid used (i.e. nicotine, THC), place of purchase, and if the patient still has the vaping liquid they used. Clinicians should also complete a respiratory viral panel and test for influenza to rule out a possible viral cause of illness. Reporting: Clinicians should report cases with onset on or after May 1, 2019, that meet the criteria of (1) significant respiratory illness of unclear etiology and (2) a history of vaping. All suspect cases should be reported by phone to Maine CDCs 24/7 disease reporting and consultation line at 1-800-821-5821 or by fax to 1-800-293-7534 using the Disease Reporting Form (attached). Attention: On October 9, 2019, Maine CDC will be hosting a live webinar to discuss pulmonary illness associated with e-cigarette use. More information to follow.

Influenza Arrives in Maine

September 27, 2019 Advisory (PDF) 
Influenza has officially arrived in Maine. Multiple Maine facilities reported influenza positive lab results in the last week, including a PCR confirmed case, which tested positive for influenza A and was typed at Maine's Health and Environmental Testing Lab (HETL) as influenza A/H3. This individual is an adult who was not hospitalized, was unvaccinated, and had recent travel history. The 2019-2020 influenza season officially begins on September 29, 2019. Individuals should NOT wait to get vaccinated as influenza is already present in the state. Both Influenza A and B strains are currently circulating nationally. The 2019-2020 quadrivalent influenza vaccine contains components of both A strains (H1 and H3) as well as two B strains (Yamagata and Victoria). Quadrivalent vaccine is recommended for optimal protection, however if only trivalent vaccine is available the recommendation is not to wait and obtain the vaccine as soon as possible.

"Start of Influenza Season" Conference Call Agenda

September 23, 2019 Agenda 
The agenda for the upcoming 2019 "Start of Influenza Season" conference call.

Maine Reports a Case of Lung Illness Related to E-Cigarette Use

September 20, 2019 Advisory (PDF) 
The purpose of this health advisory is to alert clinicians to the first case in Maine of severe pulmonary disease linked to e-cigarette product use, or "vaping". Clinicians should consider vaping-associated pulmonary illness in the evaluation of patients with significant respiratory illness and a history of vaping. Patients presenting with significant respiratory illness of unclear etiology should be asked about their use of vaping products. For patients who have used vaping products, clinicians should ask about the extent of use, the type of instrument used, the type of vaping liquid used, and the place of purchase. Patients should also be asked if they still have the vaping liquid they used. If so, Maine CDC can assist with arranging laboratory testing of the liquid. Reporting: Maine CDC asks that clinicians report cases that meet the criteria of (1) significant respiratory illness of unclear etiology and (2) a history of vaping. All suspect cases should be reported by phone to Maine CDC's 24/7 disease reporting and consultation line at 1-800-821-5821 or by fax to 1-800-293-7534 using the Disease Reporting Form.

Eastern Equine Encephalitis Positive Horse

September 3, 2019 Advisory (PDF) 
The purpose of this health advisory is to alert clinicians to the potential for human Eastern Equine Encephalitis (EEE) disease activity in Maine and to consider testing for EEE in patients presenting with unexplained encephalitis, meningitis or high fever (100.4F or 38C) during the summer and early fall. Maine Department of Agriculture, Conservation, and Forestry notified Maine CDC of a case of Eastern Equine Encephalitis (EEE) in a horse from York County late Friday August 30th. The Animal Health Diagnostic Center at Cornell University in New York confirmed the EEE result in this horse. Maine has not detected EEE to date in mosquito collections. However, public health officials in other Northeast states have seen significant increases in EEE activity this year. Massachusetts has reported four human cases and one human death, as well as four animal deaths from EEE. New Hampshire has reported one animal death from EEE. Maine has not identified a human case of EEE since 2015. EEE is a rare, but potentially fatal arboviral disease. It is the most severe arboviral infection found in the United States. EEE virus is transmitted to humans through the bite of an infected mosquito. Signs and symptoms can include fever, headache, myalgias, vomiting, weakness, confusion, seizures, and memory loss. In more serious cases, the illness may progress to encephalitis, coma, and death. The case-fatality rate for infected individuals is approximately 33% and up to 50% for those who show symptoms. Most survivors are left with significant and long-term brain damage. Symptoms can begin anytime from four to ten days after the mosquito bite, and usually last one to two weeks. It is possible some people will not show any signs of EEE illness. There is no specific treatment, but people with severe EEE illness often need to be hospitalized.

Severe Pulmonary Disease Associated with Using E-Cigarette Products

August 30, 2019 Advisory (PDF) 
In an ongoing effort to provide the most up-to-date information on respiratory illnesses related to e-cigarette use, the Maine Center for Disease Control and Prevention is sharing this advisory from the federal Centers for Disease Control and Prevention. There have been no confirmed cases of vaping-related respiratory illness in Maine as of Friday, August 30, 2019. Maine CDC continues to ask that clinicians report cases of severe pulmonary disease of unclear etiology and a history of e-cigarette product use within the past 90 days to Maine CDC's 24/7 disease reporting and consultation line at 1-800-821-5821 or by fax to 1-800-293-7534 using the Disease Reporting Form.

Vaping-associated Pulmonary Illness - Call for Cases

August 21, 2019 Advisory (PDF) 
The purpose of this health advisory is to alert clinicians to reports of severe pulmonary disease linked to e-cigarette product use, or "vaping". As of August 15, 2019, 94 possible cases of severe lung illness associated with vaping have been reported in 14 states since June 28, 2019. Clusters are occurring in multiple states, including Wisconsin, Illinois, California, Indiana and Minnesota, primarily among adolescents and young adults. Additional states have alerted federal CDC to possible (not confirmed) cases and investigations into these cases are ongoing. There is no conclusive evidence that an infectious disease is causing the illnesses. While some cases in each of the states are similar and appear to be linked to e-cigarette product use, more information is needed to determine the etiology. Clinicians should consider vaping-associated pulmonary illness in the evaluation of patients with significant respiratory illness and a history of vaping. Patients presenting with significant respiratory illness of unclear etiology should be asked about their use of vaping products. For patients who have used vaping products, clinicians should ask about the extent of use, the type of instrument used, the type of vaping liquid used, and the place of purchase. It is not yet known if similar cases are occurring in Maine.

Cases of Varicella (Chickenpox) Associated with the Portland Expo Center

August 3, 2019 Advisory (PDF) 
Maine CDC is aware of cases of varicella (chickenpox) in individuals who are staying at the Portland Expo Center. Varicella is a contagious viral disease that can spread easily to individuals who have not had varicella and have not gotten the varicella vaccine. There are several diseases that can cause a febrile rash in children, so Maine CDC encourages laboratory testing when assessing patients when possible. If diagnosed with varicella, patients may return to their congregate living setting if clinically stable and indicated by a provider. Individuals staying at the Portland Expo are already considered exposed. Providers should encourage patients to practice good hand and respiratory hygiene and stay away from non-immune individuals as much as possible.

Human Powassan Case

July 24, 2019 Advisory (PDF) 
The purpose of this health advisory is to alert clinicians to the potential for human Powassan encephalitis disease activity in Maine and to consider testing for Powassan in patients presenting with unexplained encephalitis, meningitis or high fever (100.4F or 38C) during the summer and early fall. Maine CDC was notified of a human case of Powassan encephalitis (POW) in a Maine resident who resides in southern Maine. The individual was symptomatic in late June and hospitalized. CDC Fort Collins confirmed the Powassan result in this individual. Powassan virus is transmitted to humans through the bite of an infected Ixodes tick. Signs and symptoms can include fever, headache, vomiting, weakness, confusion, seizures, and memory loss. Long-term neurologic problems may occur. Symptoms can begin anytime from one week to one month after the tick bite. There is no specific treatment, but people with severe Powassan virus illness often need to be hospitalized.

Increase in Legionellosis Cases - Greater Bangor Area, Penobscot County

July 12, 2019 Advisory (PDF) 
In the greater Bangor area, Penobscot County, Maine, physicians have reported 6 confirmed cases of legionellosis from November 2018 to the present. This is an increase from the 5-year median of 3.2 cases for Penobscot County. Cases range in age from over 50 to under 85 years old. Maine CDC is actively investigating the cases and has not identified a common exposure among cases. Health care providers should be aware of this increase in legionellosis cases and consider legionellosis in the differential diagnosis of any pneumonia case. Although urinary antigen assay is an adequate diagnostic test for Legionella, given the recent increase in number of cases, Maine CDC recommends respiratory specimen culture, particularly for patients who live in the greater Bangor area. Culture specimens can detect all species and serogroups of Legionella and may aide in exposure identification. Maine CDC requests Legionella isolates grown from respiratory specimens be sent to the Maine Health and Environmental Testing Laboratory (HETL) for further analysis.

Maine CDC Update on Portland Expo Operations

July 3, 2019  
Maine CDC continues to support the City of Portland in connection with asylum seekers residing at The Expo. The response has involved conducting health screenings, providing vaccinations, and offering assistance through the Women, Infants and Children (WIC) program.

Human Arbovirus Information for Healthcare Providers in Maine

July 2, 2019 Advisory (PDF) 
The purpose of this health advisory is to alert clinicians to the potential for human arboviral disease activity in Maine and to consider testing for arboviral disease in patients presenting with unexplained encephalitis, meningitis or high fever (100.4F or 38C) during the summer and early fall. Arboviral diseases, including Eastern equine encephalitis (EEE), Jamestown Canyon virus (JCV), and West Nile virus (WNV), are serious infections that are transmitted by the bite of an infected mosquito. Maine reported a fatal case of JCV infection, a relatively rare arboviral disease carried by mosquitoes, in a resident in 2018. Additionally, Powassan virus is an arboviral disease transmitted by the bite of an infected tick. Maine identified zero cases of Powassan virus disease in residents during 2018. Although rare, these diseases have potentially severe and even fatal consequences for those who contract them.

Maine CDC Hepatitis A Update

June 28, 2019 Update (Doc) 
Maine Center for Disease Control and Prevention (Maine CDC) is providing this update on hepatitis A cases in the state in 2019. Providers or labs reported 24 cases of acute hepatitis A to date this year in Maine. Of these cases, six occurred last week and one case is currently under investigation in an out-of-state resident tested in Maine. Nine cases are linked to exposures at a restaurant in Caribou, and five cases are linked to an ongoing outbreak in New Hampshire. The remaining cases are sporadic.

Maine CDC Hepatitis A Update

June 21, 2019 Update (Doc) 
The Maine Center for Disease Control and Prevention (Maine CDC) has identified three additional cases of hepatitis A virus infection in Aroostook County since the last update on June 18, 2019. There is now a total of nine confirmed hepatitis A cases in Aroostook County since May 17, 2019. All nine cases are linked to exposures at a restaurant in Caribou. There is no ongoing risk to the public from eating at this restaurant, nor is there any ongoing risk to the public as a result of the original case.

Maine CDC Hepatitis A Update

June 18, 2019 Update (Doc) 
The Maine Center for Disease Control and Prevention (Maine CDC) has identified three additional cases of hepatitis A virus infection in Aroostook County over the past week. There are now six confirmed hepatitis A cases in Aroostook County since May 17, 2019. All six cases are linked to exposures at a restaurant in Caribou. There is no ongoing risk of hepatitis A to the public from eating at this restaurant.

Acute Hepatitis A Case in a Food Service Worker in Presque Isle, Maine

June 14, 2019 Advisory (PDF) 
Maine Center for Disease Control and Prevention (Maine CDC) identified additional cases of acute hepatitis A virus infection in Aroostook County. Close contacts at risk are already being notified. The only risk to the public identified by Maine CDC at this time involves a Presque Isle food service worker. The Presque Isle case served food and drink while infectious on May 26, 2019 and June 2, 2019. Maine CDC recommends the hepatitis A vaccine as post-exposure prophylaxis to anyone who ate or worked at the Mai Tai Restaurant in Presque Isle, Maine between 11:00am and 4:30pm on June 2, 2019. Exposed persons can receive post-exposure prophylaxis up to 14 days from exposure, after which the treatment is no longer effective. Anyone who visited the restaurant between 11:00am and 4:30pm on May 26, 2019 is outside the window for which prophylaxis is recommended, but they should watch for symptoms and seek medical attention should they develop symptoms. Health care providers are encouraged to remain vigilant for hepatitis A infection in persons with consistent symptoms. All cases of hepatitis are reportable in Maine. Providers with suspected cases should report them to Maine CDC at 1-800-821-5821.

Meningococcal Disease Case at Wiscasset Middle High School

June 12, 2019 Advisory (PDF) 
The Maine Center for Disease Control and Prevention (Maine CDC) is reporting a case of meningococcal disease in a student who attends Wiscasset Middle High School. Lab tests confirmed the case on June 11, 2019. Maine CDC has informed Wiscasset Middle High School as well as local medical facilities of the case, and is working with them to notify exposed individuals. The student attended two public events during their infectious period: the Wiscasset Middle High School Alumni Banquet on Saturday, June 1st and the Wiscasset Middle High School Graduation on Thursday, June 6th. There are no specific recommendations for students, staff, or visitors to the school, alumni banquet, or graduation. Most cases of meningococcal disease are sporadic, with fewer than 5% associated with secondary cases. Maine CDC is asking clinicians to be aware of potential exposures and increase surveillance for illness suggestive of meningococcal disease.

Maine CDC Health Update

June 11, 2019  

No new cases of Measles or Hepatitis A

June 5, 2019 Advisory (DOC) 

Health Risks from Browntail Moths

May 29, 2019 Advisory (PDF) 
The browntail moth is an invasive species of both forest and human health concern. Maine and Massachusetts are the only states in the U.S. experiencing problems with this moth. The tiny, microscopic hairs found on browntail moth caterpillars, shed skins, and cocoons can cause skin reactions.

Confirmed Measles Case in Maine

May 21, 2019 Advisory (PDF) 
Maine Center for Disease Control and Prevention is reporting the first case of measles in Maine this year. Maine CDC confirmed the case on May 20th, 2019. The case involves a school aged child from Somerset County. The child was vaccinated, did not have any serious complications, and is fully recovered from the disease. Maine CDC is working with the family and clinicians to identify exposed contacts and to assess contacts for evidence of immunity. Measles is a highly contagious respiratory illness caused by a virus. Maine clinicians are asked to encourage vaccination and increase surveillance for rash illness suggestive of measles to identify early potential cases and prevent the spread of disease in Maine.

Hepatitis A in Caribou Update

May 21, 2019  
On Friday, May 17, the Maine Center for Disease Control and Prevention (Maine CDC) alerted Mainers to a confirmed case of acute hepatitis A in a food worker in Caribou. The case was infectious and handled food at Burger Boy restaurant from April 24 to May 13. In response to this case, Maine CDC issued guidance for those who visited the restaurant during the infectious period, and for health providers in this area.

Acute Hepatitis A Case in a Food Service Worker in Caribou, Maine

May 17, 2019 Advisory (PDF) 
Maine Center for Disease Control and Prevention (Maine CDC) identified a case of acute hepatitis A virus infection in a Caribou, Maine food service worker. The case prepped food while infectious from April 24, 2019 thru May 13, 2019. A public health assessment of the employee's illness determined that restaurant patrons may be at risk for hepatitis A infection.

2019 Lyme and other Tickborne Disease Information

May 7, 2019 Advisory (PDF) 
Lyme disease is the most common vectorborne disease in Maine. Ticks are already out and we expect the number of Lyme disease cases to increase as the weather continues to get warmer. May is Lyme Disease Awareness Month in Maine and we want to encourage Mainers to use the "Tick Aware and Tick Alert" strategies to stay tick free.

Viral Hepatitis Awareness Month: Information for Clinicians

May 7, 2019 Advisory (PDF) 
May is Viral Hepatitis Awareness Month. Maine CDC urges clinicians to understand the burden of hepatitis B and C in Maine and to follow key recommendations for testing and prevention. All persons at risk for hepatitis B and C should be tested and those who are susceptible should be vaccinated for hepatitis A and hepatitis B.

MMR Guidance

May 3, 2019 Advisory (PDF) 
Over the past few weeks, multiple news outlets have reported on the MMR vaccine, previous vaccine recommendations, and the potential for some adults to need additional doses of MMR vaccine. This HAN message contains the most current MMR vaccine recommendations from the federal Centers for Disease Control and Prevention (CDC).

Influenza-Associated Pediatric Death

April 9, 2019 Advisory (PDF) 
Maine CDC received notification of an influenza-associated pediatric death on Monday, April 8, 2019.

Influenza Season Continues with Widespread Activity in Maine

April 4, 2019 Advisory (PDF) 
Influenza activity remains elevated and widespread in Maine and throughout the United States.

Measles Exposure in Two Healthcare Offices in Maine

April 2, 2019 Advisory (PDF) 
On April 1, 2019 Maine CDC was notified of a confirmed case of measles in an out of state resident who visited two businesses in Maine while traveling in the state on Wednesday, March 27, 2019.

Rabies Positive Bat in Bangor Potentially Exposes Several Individuals

March 22, 2019 Advisory (PDF) 
Maine Center for Disease Control and Prevention is investigating the circumstances surrounding a rabid bat in the general area outside the Shaw House in Bangor on the weekend of March 16 and 17.

Confirmed Mumps Case in Maine

March 15, 2019 Advisory (PDF) 
Maine CDC is investigating a confirmed case of mumps in an unvaccinated student in York County.

Measles Recommendations and Current Situation in Maine

March 8, 2019 Advisory (PDF) 
The purpose of this advisory is to provide health care providers with the most current information on measles prevention and assessment of suspect cases, should they arise.

Widespread Influenza Activity in Maine

January 30, 2019 Advisory (PDF) 
Influenza activity in Maine is now widespread with providers reporting laboratory confirmed influenza in all sixteen counties.

Confirmed Hepatitis A Case in an Individual Who Stayed in Portland Shelters

October 29, 2018 Alert (PDF)  | Fact Sheet (PDF)
Maine CDC offers free vaccines to those at highest risk as a precaution following confirmed hepatitis A case in Portland shelter.

Maintaining Vigilance for Acute Flaccid Myelitis Cases

October 25, 2018 Advisory (PDF) 
Maine CDC advises clinicians to maintain vigilance for AFM and report patients who meet clinical criteria for AFM to the Maine CDC.

Pertussis Update in Maine

October 24, 2018 Advisory (PDF) 
Maine sees increase in pertussis cases in York and Waldo counties, and an increase in infant cases.

Early Start to Influenza Season in Maine

September 7, 2018 Advisory (PDF) 
Influenza has officially arrived early in Maine. Individuals should not wait to get vaccinated.

Dramatic Increases in Cases of Syphilis and Gonorrhea

September 5, 2018 Advisory (PDF) 
Maine CDC recommends screening for all at-risk people and appropriate treatment for infected individuals as cases continue to rise.