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.

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.

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.

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.

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.

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.

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.

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.

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.

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.