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U.S. CDC: Increased Chikungunya Virus Activity in Paraguay and Associated Risk to Travelers

Please review this advisory on the potential for chikungunya infection after travel to Paraguay. Consider testing for chikungunya in patients with unexplained encephalitis, meningitis, fever, or polyarthralgia. Chikungunya is a serious arboviral infection transmitted from the bite of an infected mosquito. Maine does not have mosquitoes that transmit this virus and there is no risk of local transmission. Most people are infected while travelling abroad to an area with known chikungunya activity. This disease has potentially severe and even fatal consequences for those who contract it.

U.S. CDC: Measles Exposure at a Large Gathering in Kentucky (February 2023) and Global Measles Outbreaks

Please review this information regarding a large group event in Kentucky last month leading to measles cases across the country. Measles is a reportable condition: cases should be reported immediately to Maine CDC at 800-821-5821 on recognition or strong suspicion of disease. Labs should submit isolates and clinical specimens to Maine CDC for confirmation. Antibody and PCR testing can be performed at some commercial laboratories.PCR testing can be performed at Maine's Health and Environmental Testing Laboratory (HETL).

Increase in Extensively Drug-Resistant Shigellosis in the United States

Please take a moment to review this information from U.S. CDC that includes key recommendations for health providers, laboratories, and the general public. The United States has seen a rise in extensively drug-resistant shigellosis. In 2022, Maine CDC identified 11 cases of shigellosis (preliminary data as of February 28, 2023). Shigellosis is a reportable disease in the State of Maine. All Shigella isolates and specimens are required to be sent to the Maine Health and Environmental Testing Laboratory.

Updates on Mpox Surveillance, Testing, Treatment, and Vaccination in Maine

As of February 15, 2023, a total of 30,193 cases of mpox and 32 deaths have been reported nationwide as part of the 2022 mpox outbreak. Mpox case counts have fallen in recent months, from an average of over 400 cases a day in August 2022 to less than five per day in February 2023. Thirteen mpox cases were reported in Maine residents in 2022 (preliminary data as of February 28, 2023) and no cases have been reported so far in 2023.

Gonorrhea with Resistance or Reduced Susceptibility to Multiple Antibiotics Identified in Massachusetts

Massachusetts recently identified a novel strain of multidrug-non-susceptible Neisseria gonorrhoeae (N. gonorrhoeae) with resistance or reduced susceptibility to all drugs that are recommended for treatment in the U.S. The novel strain, identified in Massachusetts, showed reduced susceptibility to ceftriaxone, cefixime, and azithromycin and showed resistance to ciprofloxacin, penicillin, and tetracycline. This is the first isolate identified in the U.S. showing resistance or reduced susceptibility to all drugs that are recommended for treatment.

Outbreak of Extensively Drug-resistant Pseudomonas aeruginosa Associated with Artificial Tears

Please review this national alert regarding a healthcare product contaminated with extensively drug-resistant Pseudomonas aeruginosa. Maine has not identified any cases linked to this outbreak. Removing contaminated artificial tears from healthcare facilities and homes will avoid actual tears caused by infections. Carbapenemase-producing organisms, like the organism identified in this investigation, are a reportable condition in Maine.

Evusheld No Longer Authorized for Emergency Use in the U.S.

The U.S. Food and Drug Administration (FDA) announced on January 26, 2023, that the Emergency Use Authorization (EUA) for Evusheld (tixagevimab co-packaged with cilgavimab) has been revised and based on this revision, Evusheld is not currently authorized for use in the U.S. This is because it is unlikely to be active against more than 90% of the SARS-CoV-2 variants currently circulating in the U.S. based on the latest CDC data.

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