May 6, 2019

In This Issue
MMA and Leading Medical Associations Hail Ruling in Maine Case Over Medication Assisted Treatment in Jail
Eat, Sleep, Console Update
Tick Aware and Tick Alert - May is Lyme Disease Awareness Month in Maine
Trump Administration Reveals New Refusal Options for Healthcare Personnel
Alfond Leaders Program Seeking More Applicants for Student Debt Relief - Applications Being Accepted Through May 15
Federal Judge Agrees with AMA, Strikes Down Gag Rule
This Week's Public Health Updates from the AMA
Experts Fear Rising Number of Unvaccinated Children Will Lead to More Measles Outbreaks
Free MAT Training at CMMC June 1
Lawrence B. Mutty, M.D., M.P.H., 1934-2019; MMA President 2004-2005
MMA Legislative Call Tuesday, May 7th
Vaccine Vote Drama and Other State House Highlights of the Week
Upcoming Specialty Society Meetings
Cumberland County Physicians: Join the MMA at the Foreside Tavern in Falmouth on Thursday, May 16
Treatment & Prevention of Medical & Mental Health Emergencies -Substances & Gun Violence -May 17 & 18
Quality Counts: Rapid Induction Starting in the ED (RISE) Training, Webinars, ECHO Program
"Trust Me, I’m a (Certified) Doctor: Innovations and Improvements in Maintenance of Certification” - Thursday, May 23
MICIS 2019 Clinical and Legal Opioid Update - May 29 in Brewer, June 5 in Augusta
MaineGeneral Xwaiver Training for Staff - June 3
The Maine Concussion Management Initiative Will Be Offering Training Programs – June 21 and October 29
Assessing and Managing Non-Suicidal Self-Injury and Suicide Risk in Healthcare Settings - 3 Hour CME Training for Healthcare Professionals at MMA on Friday, June 21, 2019
2019 Mary Cushman, MD Award for Exceptional Humanitarian Service as a Medical Volunteer
Maine Independent Clinical Information Service 2019 Presentations
BC/BE Family Medicine or Internal Medicine Physician
BC/BE Family Medicine Physician or Experienced Family Nurse Practitioner
Gastroenterology Lead Physician - Bangor, Maine
Physician for Maine Maritime Academy Summer Training Cruise
Internal Medicine Outpatient Physician
Mid Coast Maine - Adult Psychiatrist and/ Psychiatric NP/PA Opportunity
Family Medicine Opportunity in Beautiful Western Maine
PCHC in need of Pediatrician for Brand New Pediatric Center!
Outpatient Internal Medicine Physician – Bangor, Maine
Opportunities at the VA for Volunteer Physicians
Volunteer Opportunity with Partners for World Health

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Tick Aware and Tick Alert - May is Lyme Disease Awareness Month in Maine

Lyme disease remains the most common tickborne disease in Maine.  Providers reported over 1,400 cases in 2018 (preliminary data as of 3/25/19). While ticks can be active at any temperature above freezing, they are most active in warmer months. May is Lyme Disease Awareness Month in Maine, and the Maine Center for Disease Control and Prevention (Maine CDC) is asking health care providers to help stress the importance of tick education. Specifically, please encourage patients to be “Tick Aware and Tick Alert” when spending time outdoors.  This includes:
  1. Using caution in areas where ticks may be found;
  2. Wearing light-colored clothing that covers arms and legs;
  3. Using EPA approved repellents; and
  4. Performing daily tick checks after being outdoors on themselves and any pets.  Taking a shower after exposure to a tick habitat is an effective way to wash off any unattached ticks and provides a good opportunity to do a tick check.

Important to Remember

  • Lyme disease is preventable by avoiding contact with infected ticks and tick infested areas.
  • Lyme disease is caused by the bacteria Borrelia burgdorferi, which is transmitted through the bite of an infected deer tick (Ixodes scapularis). The tick must be attached to an individual for 24-48 hours before the bacteria that causes Lyme disease can be transmitted.
  • The most common early symptom of Lyme disease is an erythema migrans (EM), a “bull’s eye” rash that appears 3-30 days after transmission (seen in about 60 to 80 percent of cases nationwide). Other early symptoms include: fatigue, fever, headaches, arthralgia, and myalgia.
  • Disseminated symptoms include: arthritis including joint swelling, Bell’s palsy and other cranial neuritis, encephalitis, lymphocytic meningitis, radiculoneuropathy, and second- or third-degree atrioventricular block.
  • Antibiotic therapy is effective for the treatment of Lyme disease.  Clinical treatment guidelines are available at the Infectious Diseases Society of America (IDSA)’s website.

Lyme disease is not the only disease that can result from a bite by Ixodes scapularis. Anaplasmosis, babesiosis, Borrelia miyamotoi, and Powassan are other tickborne infections found in Maine. In 2018, the number of human anaplasmosis cases decreased to 477, the number of human babesiosis cases decreased to 101, the number of human cases of Borrelia miyamotoi increased to 8, and there were zero identified cases of Powassan (preliminary data as of 3/25/19).   The decrease in cases is likely the result of the hot and dry summer Maine experienced and should not be taken as an indication that the threat of tickborne diseases is diminishing.  The majority of tickborne illnesses occur during the summer months when ticks and humans are active outdoors. 

Thank you for your invaluable help in the prevention and early identification of tickborne diseases here in Maine.



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