Please review this helpful information about domestic acquisition of malaria in the U.S. in recent months, risks of acquisition of malaria in the U.S. with increased international travel, and the need to plan for testing and treatment of patients with malaria.

Particle pollution concentrations are expected to reach Unhealthy for Sensitive Groups level Sunday according to the Maine Department of Environmental Protection (DEP). A cold front is dropping down out of Canada bringing smoke from the fires in Quebec with it. Smoke will begin to move into the northern region after midnight Saturday night. It is expected to move south and west during the day on Sunday. The likelihood is that areas of Maine away from the coast will have some degree of smoke and it may be heavy at times.

Maine is seeing early signs of an active animal rabies season this year. In the first five months of 2023, 30 animals tested positive for rabies in Maine compared to 11 animals in the first five months of 2022. Some regions in Cumberland County are already seeing elevated animal rabies activity compared to this same time last year, including 11 confirmed cases of rabies in raccoons and skunks tested after encounters with humans or domestic animals. The purpose of this health advisory is to alert clinicians to the increased risk of rabies exposures and provide recommendations.

The United States Centers for Disease Control and Prevention (U.S. CDC) is issuing this Health Alert Network (HAN) Health Update to supplement the U.S. CDC HAN Health Advisory issued on May 17, 2023. This Health Update provides updates on the status of the ongoing fungal meningitis outbreak and highlights interim recommendations for diagnosis and treatment.

24-hour particle pollution concentrations are expected to reach Moderate levels Tuesday late afternoon into Wednesday according to the Maine Department of Environmental Protection (DEP). Several fires have been burning for more than a day in Nova Scotia. The smoke has moved into the Gulf of Maine where winds from a small High-Pressure system combined with an afternoon sea breeze are expected to bring the smoke ashore in Maine during the afternoon to evening hours. The plume of smoke is expected to move inland overnight.

COVID-19 infections, hospitalizations, and deaths have decreased substantially in recent months. SARS-CoV-2, the virus that causes COVID-19, continues to circulate worldwide and new variants are expected to continue to appear. Vaccines continue to provide the best protection against infection and severe illness. Medications that reduce progression to severe disease are widely available for people at highest risk for severe disease. The U.S.

The U.S. Centers for Disease Control and Prevention (U.S. CDC) is issuing this Health Alert Network Health Advisory about an outbreak of suspected fungal meningitis among U.S. patients hospitalized in Texas after undergoing cosmetic procedures under epidural anesthesia in the city of Matamoros, state of Tamaulipas, Mexico. It is currently unknown which organism(s) is causing the outbreak. A fungal etiology is suspected based on elevated cerebrospinal fluid (CSF) levels of the fungal biomarker (1,3)-beta-D-glucan in at least one patient.

Please review this important information from U.S. CDC regarding ongoing risks for mpox in the United States and recommendations for clinicians.

Ticks are already active this year. As the weather continues to get warmer into the spring and summer months, Maine expects the number of Lyme and other tickborne disease case reports to increase. The purpose of this advisory is to provide healthcare providers with useful information on how to assess and care for patients with possible tickborne disease infections. May is Lyme Disease Awareness Month in Maine and Maine CDC encourages all Mainers to stay "Tick Free ME."

Maine's Health and Environmental Testing Laboratory has notified Maine CDC of a positive PCR test for measles in a child. The individual is now isolated at home. Potentially exposed individuals should check their immunization status and monitor for symptoms. The best protection against measles is vaccination. Maine CDC is asking clinicians to increase surveillance for rash illness suggestive of measles to identify early potential cases and prevent the spread of disease and to promptly see any patients seeking post-exposure prophylaxis.