Please take a moment to review this information from U.S. CDC regarding increased respiratory virus activity in the U.S., including in Maine. The information provided here also addresses current trends of respiratory syncytial virus (RSV), seasonal influenza, COVID-19, and enterovirus/rhinovirus (EV/RV).
Please see the attached HAN Health Advisory from U.S. CDC about an emerging outbreak of Ebola in Uganda. Further information is available on U.S. CDC's webpage on the September 2022 Uganda, Mubende District (https://www.cdc.gov/vhf/ebola/outbreaks/uganda/2022-sep.html) page.
The purpose of this U.S. Centers for Disease Control and Prevention (CDC) Health Alert Network (HAN) Health Advisory is to inform healthcare providers that
Healthcare providers and hospitals in several regions of the United States notified the Centers for Disease Control and Prevention (U.S. CDC) during August 2022 about increases in pediatric hospitalizations in patients with severe respiratory illness who also tested positive for rhinovirus (RV) and/or enterovirus (EV). RVs and EVs can have clinically similar presentations and are indistinguishable from one another on multiplex assays often used in clinical settings. Upon further typing, some specimens have been positive for enterovirus D68 (EV-D68).
The Maine Center for Disease Control and Prevention (Maine CDC) has received several reports of positive influenza laboratory results during recent weeks. Maine CDC is requesting that laboratories send respiratory specimens from influenza confirmed or suspect patients to Maine's Health and Environmental Testing Laboratory (HETL) for subtyping, especially in the beginning of influenza season. Subtyping allows Maine CDC to determine which influenza viruses are circulating this season and detect novel influenza virus infections.
The global outbreak of monkeypox continues to grow in Maine and across the United States. Most cases have been identified in urban areas in other states. More cases are expected in Maine. Nationwide, the outbreak remains largely confined to gay, bisexual, or other men who have sex with men and transgender, gender non-conforming, or non-binary individuals who have sex with men, although some infections have been identified in other people.
This health advisory provides updates on three key areas for clinicians: testing, vaccination, and treatment.
In 2021, providers reported 63 cases of varicella in Maine residents to Maine CDC, compared to just 33 cases reported in 2020. The decrease in widespread COVID-19 social distancing practices likely played a role in the increase in varicella cases. Varicella is a notifiable condition in Maine, and all confirmed or suspected cases should be reported to Maine CDC by telephone, fax, or electronic lab report within 48 hours of recognition or strong suspicion of disease.
In 2014, national surveillance began for Acute Flaccid Myelitis (AFM). Peaks of cases were observed across the United States in 2014, 2016, and 2018. Given the observed biennial pattern, it was anticipated that there would be an increase in AFM cases in 2020; however, cases plateaued from 2019 through 2021. It is likely that methods of prevention for COVID-19 contributed to the deviation from the previously observed biennial pattern. AFM is still observed across the country; it is unknown if the biennial pattern will resume.
As of July 29, 2022, the Centers for Disease Control and Prevention (CDC) and state and local public health partners are reporting 5,189 cases of Monkeypox virus infections in the United States across 47 states, Washington, D.C., and Puerto Rico. CDC is also reporting multiple outbreaks of monkeypox have also been reported globally in 72 countries that do not normally report monkeypox activity. On Friday, July 22, CDC reported the first two cases of monkeypox in children in the United States during the current outbreak.
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 mosquito-borne arboviruses in patients presenting with unexplained encephalitis, meningitis, or high fever (≤100.4°F or 38°C) during the summer and fall. Consider testing for Powassan virus year-round.
