Dr. Sheila Pinette
Director, Maine CDC
Osteopathic physician / Public Health Update
August 22, 2013
In this update:
Air quality alert
Tick-borne diseases
Mosquito-borne diseases
Pertussis (whooping cough)
Summer health / Flu
GI illness
Recent health alerts
Upcoming events
Follow us

Air quality alert

Unhealthy levels of ozone are expected to continue into Thursday for the entire coastline. Ozone values for interior regions will likely reach the Moderate range possibly into Thursday. Particle pollution levels are expected to be Moderate statewide during this time.
For more information, see the air quality alert issued Aug. 20 at

Tick-borne diseases

Babesiosis, is a parasitic infection transmitted the same tick that carries Lyme disease, is an emerging infection in Maine. Seventeen cases of babesiosis have been reported between January and mid-August, compared to a total of 10 cases in 2012. Most infections occur in the summer and fall months, so the number of 2013 cases is expected to rise.
So far, cases have been reported this year in Cumberland, Knox, and York counties.
Common symptoms include: extreme fatigue, aches, fever, chills, sweating, dark urine, and possibly anemia. People with babesiosis may experience no symtpoms at all. Babesiosis is treatable, and people who are infected and do not have underlying conditions generally make a full recovery.
Other diseases are also carried by ticks in Maine, including anaplasmosis and Lyme disease.
Last year, health care providers reported 52 cases of anaplasmosis in Maine, compared to 45 cases so far this year. In 2012, providers reported 1,111 cases of Lyme disease in Maine, so far 489 cases have been reported in 2013.
Symptoms of anaplasmosis include: fever, headache, malaise, and body aches. The most common early symptom of Lyme disease is an expanding red rash that occurs at the site of the tick bite within 3-30 days after being bitten. Fever, joint and muscle pains may also occur. People can get infected with anaplasmosis, babesiosis, and/or Lyme disease at the same time.
For more information:
  • Info on tick-borne diseases:
  • To order tick educational materials:
  • Aug. 15 health alert on babesiosis:
  • May 30 health alert on Lyme disease:

Mosquito-borne diseases

Maine CDC has confirmed the presence of Eastern Equine Encephalitis (EEE) in two mosquito pools from York County.
EEE is a virus that is transmitted through the bite of an infected mosquito. It can cause serious illness in humans; large animals, like horses; and some species of birds. Maine confirmed EEE in a flock of pheasants during 2012 and experienced unprecedented EEE activity during 2009 with multiple animals and mosquito pools testing positive for the virus.
Regionally, all of our surrounding states have also identified EEE in 2013, including mosquito pools in New Hampshire, Vermont, and Massachusetts. In Massachusetts, two horses have tested positive for EEE and an elderly woman who recently died is the state’s first human case.
Maine CDC recommends the following preventative measures to protect against EEE and other mosquito-borne illnesses:
  • Use an Environmental Protection Agency-approved repellent when outdoors, especially around dawn and dusk. Always follow the instructions on the product’s label;
  • Wear protective clothing when outdoors, including long-sleeved shirts, pants and socks;
  • Keep window and door screens down to keep mosquitoes out of the home;
  • Limit time outdoors at dawn and dusk when many species of mosquitoes are most active;
  • Remove containers holding water in and around the home, as water can attract mosquitoes.
Maine's Health and Environmental Laboratory (HETL) routinely performs testing for EEE and West Nile virus (WNV) in mosquitoes, large animals and humans. Maine stopped testing individual dead birds for mosquito-borne illnesses in 2006 and no longer uses them as an indicator for disease.
Maine CDC will continue to update information on mosquito-borne disease surveillance in the state every Monday from May through September at
Information on pesticides and repellents is available at the Maine Board of Pesticides Control website at:

Pertussis (whooping cough)

Pertussis (whooping cough) is a cyclical disease that continues to affect a significant number of Maine residents. Maine CDC issued an update on statewide pertussis on July 30, which can be found at
There have been 227 reported cases of pertussis so far this year in Maine. This is less than the 430 reported cases for the same period last year, but is more than the five-year median. Oxford county has the highest rate of pertussis in the state, and the majority of cases have occurred in people ages 7-19.
Maine CDC encourages providers continue to test and treat patients. DTaP vaccine is recommended for all infants and children. Tdap vaccine is recommended for all preteens, teens, and adults.
For more guidance and information, visit

Summer health

Make sure you know how to keep your summer safe and healthy. Know how to avoid:
  • Carbon monoxide poisoning:
  • Recreational water illnesses:
  • Heat-related illnesses:
  • Contracting or spreading illness at agricultural fairs:
For more information, see this press release: /

Flu

US CDC has published a summary of the recommendations of the Advisory Committee on Immunization Practices (ACIP) for the 2013-2014 flu season.
The summary is available at
The full recommendations will be published in Morbidity and Mortality Weekly Report (MMWR).
The Vaccine Information Statements (VIS) for this coming season’s vaccines are available at

GI illness

Maine CDC issued a health alert on Aug. 8 about diagnosing and reporting gastrointestinal illness and outbreaks.
Many health care providers that evaluate patients with vomiting and/or diarrhea do not take diagnostic specimens. It is important for health care providers to consider collecting specimens to facilitate: 1) accurate diagnosis and treatment of the patient; 2) disease control recommendations for those patients with high risk for disease transmission (e.g., food service, healthcare, and childcare workers); and 3) recognition of emerging and unusual pathogens, disease clusters, and outbreaks.
Maine sees the majority of gastrointestinal illness in the summer months.
In 2012, 51% of enteric bacterial disease reports and 44% of waterborne pathogen reports occurred from June – September. Cases of vibriosis doubled in 2012, including multiple out-of-state residents who were ill after consuming seafood while traveling in Maine. Outbreaks of norovirus continue to occur in the summer time, especially at large events. In 2012, outbreaks of suspected or confirmed norovirus occurred at summer camps, campgrounds and private events. This trend continues in 2013. National and regional outbreak investigations this summer have included hepatitis A associated with pomegranate seeds, cyclosporiasis associated with lettuce mix, listeriosis associated with cheese, shigellosis associated with fresh water beach exposures and exposure to hepatitis A in food handlers.
The full health alert, which includes information about testing and reporting, is available at

Recent health alerts

  • Air Quality Alert:
  • Babesiosis:
  • EEE:
  • Diagnosing and Reporting Gastrointestinal Illness and Outbreaks:
/

Upcoming events

Maine CDC’s 2013 Division of Infectious Disease Conference will be held from 8:15 a.m. to 4:15 p.m. on Nov. 13 at the Augusta Civic Center. The conference website is now live at The website includes a summary, agenda, conference brochure, information about fees, and the link to register.

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For clinical consultation and outbreak management guidance, call Maine CDC’s toll-free 24-hour phone line:
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For questions and potential exposure to poison, call the Poison Center’s 24-hour phone line: 1-800-222-1222