Maine CDC: Drug use, unprotected sex fuel rise in infectious diseases

By Jackie Farwell, BDN Staff
Posted June 21, 2012, at 6:24 p.m.

Along with widely publicized cases of Lyme disease and whooping cough, Maine has seen a rise in illnesses associated with drug use and unprotected sex, according to a new report.

Rates of hepatitis C, a liver disease that recently broke out at a New Hampshire hospital, are ticking up, though many carriers don’t even know they have it, according to the Maine Center for Disease Control and Prevention’s 2011 report on infectious disease.

The infection, transmitted by blood, is the leading reason for liver transplants in the United States. It’s typically spread by drug users sharing intravenous needles and equipment.

Before a blood test for hepatitis C became widely available in 1992, it also was spread by transfusions. Rarely, it’s transmitted through sexual contact.

Hepatitis C ranges in severity from hardly any symptoms at all over a few weeks to a lifelong illness that can kill. In 2011, Maine recorded 12 cases of acute, short-term hepatitis C, compared to two cases in 2010, according to the report.

In most people, acute hepatitis C leads to chronic illness. The number of newly reported cases of chronic infection in Maine rose from 1,142 in 2010 to 1,184 in 2011. That count, which includes people who have ever had the infection, exceeds reported cases of Lyme disease last year.

Rates of hepatitis C nationally are highest among baby boomers, leading the federal CDC to recommend in May that everyone born between 1945 and 1965 get screened for the infection.

But Maine is also seeing hepatitis C crop up among younger people, which could indicate an emerging trend of IV drug use, according to state epidemiologist Dr. Stephen Sears.

“We’re looking at it very carefully,” he said.

Vaccines are available for hepatitis A and B, two other types of the disease, but not for hepatitis C.

Maine also is seeing more cases of gonorrhea, especially in Androscoggin and Cumberland counties, according to the report. The state recorded 272 cases of the sexually transmitted disease last year, compared to 162 cases in 2010.

The highest incidence was among those aged 15 to 24.

Rates of gonorrhea tend to be cyclical, but have edged up in Maine overall during the last several years, Sears said.

Chlamydia, another STD, remained the most commonly reported infectious disease in Maine in 2011, with 3,094 cases. Widespread screening for chlamydia, which often doesn’t cause symptoms and can lead to infertility, means it shows up on health officials’ radar more than some other diseases, Sears said.

Maine had the lowest rate of tuberculosis in the country for a second year in a row.

The state recorded twice the national rate of giardiasis, an infection sometimes known as “beaver fever” caused by a parasite that can contaminate water through animal feces.

Many states don’t report giardiasis cases, so Maine’s rate appears unusually high, Sears said. Still, he warns nature lovers not to sip from streams, even when the water is crystal clear.

“No matter where you are in that stream, there’s always something upstream, whether it’s a moose, a caribou, a beaver or a person,” he said.

Last year also brought Maine’s first-ever reported case of hantavirus pulmonary syndrome, a potentially fatal respiratory condition spread by the common mouse. Diagnosed in Somerset County at the end of April 2011, the virus has no vaccine or cure. It’s more often found in dry, western states.

No other cases of hantavirus have been reported in the state since, but health officials warn Mainers to wear masks as they clean out camps and other rodent-friendly spaces to avoid breathing in the virus through the animals’ urine and feces.

Hantavirus can cause muscle aches, fever and fatigue in the early stages, and progress to coughing and shortness of breath as the lungs fill with fluid. The mortality rate is nearly 40 percent, according to the U.S. CDC.

Far more common in 2011 were cases of whooping cough, or pertussis, which rose fourfold to 205. The highly contagious respiratory disease continues to spread this year, especially among middle school-aged children.

Lyme and other tick-borne diseases also carried over from 2011 as a serious public health threat. Lyme sickened more than 1,000 people in Maine last year and has been found in nearly 200 so far in 2012.

Many cases of Lyme go unreported because even patients exhibiting the telltale rash may not test positive for the disease, Sears said.

Health officials have a good grasp on infectious diseases that show up in lab tests and are required by law to be reported, but often count on health care providers to notify them of illnesses diagnosed by symptoms alone.

“We are totally dependent on other people to report diseases to us,” Sears said.

http://bangordailynews.com/2012/06/21/health/maine-cdc-drug-use-unprotected-sex-fuel-rise-in-hepatitis-c-other-diseases/ printed on April 23, 2014