The Maine Center for Disease Control and Prevention (Maine CDC) has identified three additional new HIV diagnoses among people who inject drugs (PWID) in Penobscot County. There are now a total of six confirmed cases associated with this cluster; five of the newly diagnosed individuals were unhoused at the time of their diagnosis. Some of the individuals recently diagnosed with HIV had previous contact with the health care system, including missed opportunities for HIV testing.

Please take a moment to review this information on measles circulation in the U.S. and globally and consider what you can do to prepare for the possibility of measles cases in Maine in the near future.

Many Maine residents travel to warmer climates with heightened risk of mosquito-borne or other types of illness particularly during colder months and especially during school and other spring vacations occurring this time of year. In 2024, the Maine Center for Disease Control and Prevention (Maine CDC) has investigated multiple cases of travel-related illness in persons who have recently traveled within or outside the United States. At the same time, many jurisdictions both within and outside the U.S.

U.S. CDC is reporting an increase in invasive meningococcal disease in the U.S. in 2024, mainly attributable to Neisseria meningitidis serogroup Y. Most cases involve a single sequence type, ST-1466. Most of the patients are between 30-60 years old, are Black or African American, or are living with HIV. In addition, most cases caused by this strain had a clinical presentation other than meningitis, such as bacteremia and septic arthritis.

Influenza, COVID-19, and RSV continue to be significant health burdens in the U.S., especially to people at higher risk for severe disease, including older adults, young children, people with compromised immune systems, people with disabilities, and pregnant people. The health impacts of COVID-19 are now increasingly similar to those of other respiratory viruses, like influenza. Reported deaths involving COVID-19 are several-fold greater than those reported to involve influenza and RSV. However, influenza and likely RSV are often underreported as causes of death.

Measles activity in the United States is now the highest it has been since 2019. Between January 1 and February 29, 2024, 16 U.S. jurisdictions reported a total of 41 cases. Most of these cases were among children and adolescents who had not received a measles-containing vaccine (measles-mumps-rubella [MMR] or measles-mumps-rubella-varicella [MMRV]), even if age-eligible. Health care facilities should have plans and processes in place to rapidly identify, isolate, and inform Maine CDC of any suspected measles cases.

From October 2023 through February 23, 2024, Maine Center for Disease Control and Prevention (Maine CDC) has identified three new HIV diagnoses among people who inject drugs (PWID) in Penobscot County. Two of the individuals were unhoused and reported sharing or reusing injection drug equipment. All three individuals were coinfected with hepatitis C virus (HCV). Over the past five years, there have been an average of two new HIV diagnoses per year in Penobscot County residents and one new case per year among PWID in Penobscot County.

Respiratory Syncytial Virus (RSV) is a major cause of hospitalization in older adults and infants/young children. Several vaccines are newly available this fall/winter respiratory virus season for older adults, pregnant persons, and young children. This Health Advisory provides updates for the use of nirsevimab for young children, information on vaccine administration errors in young children and pregnant people, recommendations for this year's end of maternal RSV vaccine season, and vaccine availability in Maine.

Respiratory virus transmission in the United States has increased in recent weeks and is expected to peak in coming weeks, leading to more infections, serious illness, hospitalizations, and deaths as well as more health care workers out of work due to illness. When there is higher respiratory virus transmission, health care facilities should implement policies requiring staff to wear appropriate masks or respirators for source control and infection control either during patient interactions or at all times inside facilities.

COVID-19 continues to circulate in our communities and continues to cause hospitalizations and deaths. Access to timely testing and outpatient treatment is crucial to reducing severe disease. Two oral antiviral drugs, Paxlovid and Lagevrio, previously freely available, are now commercially available. Most people will still be able to access treatment in a timely manner at pharmacies or health care facilities. Uninsured or underinsured people may face new barriers to treatment access, and new patient assistance programs are now available to support these populations.