For Your Information News for Healthcare Providers
Serving the residents of Curve Lake and Hiawatha First Nations, and the County and City of Peterborough
UPDATE: Respiratory Viral Testing Algorithm and Enhanced Surveillance Effective November 7, 2016, Public Health Ontario (PHO) will be updating its respiratory viral testing algorithm to provide the highest quality testing for clinical management and treatment decisions for high risk patients in Ontario. This algorithm is available at: www.publichealthontario.ca search Respiratory Viral Testing Algorithm. PHO monitors and analyzes the spread and intensity of respiratory pathogen activity and influenza in Ontario to support local, provincial, federal and global surveillance efforts. The Ontario Respiratory Pathogen Bulletin is a comprehensive, weekly summary of provincial respiratory pathogen activity. As well, in the bulletin, you will find information on the onset, duration, conclusion, geographic patterns, severity and progression of seasonal influenza activity. Healthcare worker influenza immunization coverage rate data for the 2015-2016 season can be found in the Week 16 ORPB. Visit www.publichealthontario.ca to access the Ontario Respiratory Pathogen Bulletin. For more information, contact Vaccine Preventable Disease program nurses at 705-743-1000, ext. 131.
Volume 21 ∙ Number 11 ∙ December 2016
Advisory: Antiviral Medications For Influenza Treatment and Prophylaxis Antiviral medications are recommended to treat and prevent influenza. Influenza antiviral medications are recommended for: • Treatment of moderate, progressive, severe or complicated influenza, such as individuals who are hospitalized with influenza-like illness; • Treatment of those at high risk for complications of influenza, such as children less than 5 years of age, adults 65 years of age and over, and those with underlying medical conditions (see Appendix A for additional details); • Treatment and prevention in influenza outbreaks in institutional settings Amantadine is an older antiviral medication that is no longer used. Drugs currently used in Canada are oseltamivir (Tamiflu®) which is an oral medication, and zanamavir (Relenza®) which is an inhaled medication. Oseltamivir and zanamivir are neuraminidase inhibitors which work by blocking the exit of the influenza virus from respiratory cells and therefore prevent further replication of the virus. Because antiviral medications prevent further replication of the virus, when used for treatment, they should be taken as soon as possible, ideally within 48 hours of symptom onset. When influenza is circulating, laboratory confirmation of influenza is not needed before initiating treatment, as waiting until influenza is confirmed will delay initiation of therapy. Although treatment is generally more beneficial if given early, it can still be considered in those at high risk for influenza complications, even if more than 48 hours has passed from symptom onset. Use of antiviral medication is also recommended, regardless of time from symptom onset, in individuals with moderate, progressive, severe or complicated influenza-like illness, such as individuals who are hospitalized with influenza-like illness. Public Health Ontario has created an information sheet for health care providers, visit: www.publichealthontario.ca search Antiviral Medications for influenza: Information for health care providers. This sheet contains details on: • How the medications are used • Antiviral resistance concerns • How the medications are used in institutional outbreaks • What evidence that they are effective • Which organizations recommend influenza antiviral medications If you have questions, please call Vaccine Preventable Disease Program Nurses at 705-743-1000, ext. 131.
In this issue... View the FYI Newsletter online at www.peterboroughpublichealth.ca under For ProfessionalsHealth Professionals FYI Newsletter
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Pharmacists Administering Travel Vaccines Questions about this year's flu vaccine recommendations? Prepare for Increase in Requests for Immunizations to Prevent Suspensions Would U Rather Choose to be... Smoke Free
705-743-1000 ∙ www.peterboroughpublichealth.ca Jackson Square - 185 King Street, Peterborough, ON K9J 2R8
Volume 21 ∙ Number 11 ∙ December 2016
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Pharmacists Administering Travel Vaccines
Prepare for Increase in Requests for Immunizations to Prevent Suspensions
Ontario is making it easier and more convenient for people to protect themselves before travelling, by expanding the number of vaccines available in pharmacies across the province.
Starting in late January/early February 2017, Peterborough Public Health will begin mailing Immunization Information Notice/ Questionnaires to parents/guardians of students born in 2003-2012 who do not have adequate immunization information on file. Public Health collects specific immunization and demographic information to maintain an electronic record under the Immunization of School Pupils Act (ISPA). This Act requires students to be immunized for measles, mumps, rubella, diphtheria, pertussis (whooping cough), polio, tetanus, meningococcal disease and chickenpox (for students born in 2010 or later), or have a valid exemption. Parents will receive two notices, 21 days apart followed by an Order for Suspension if we have not received the requested information. Parents/Guardians of students who receive these letters may contact you to arrange for immunization.
Starting December 15, Ontario pharmacists will be able to administer additional vaccines to protect against 13 preventable diseases. This includes common travel vaccines for diseases such as Hepatitis A and B, Typhoid, and Rabies. In addition, the flu vaccine will continue to be administered by pharmacists, free of charge. For many patients, pharmacies are a convenient alternative to doctors' offices, travel clinics or other clinics. Pharmacies are located throughout the province, offering extended hours of operation at night and on weekends. The vaccines help protect against the following 13 diseases: • Bacille Calmette-Guérin (BCG) • Haemophilus Influenzae Type B (Hib) • Hepatitis A • Hepatitis B • Herpes Zoster (Shingles) • Human Papillomavirus (HPV) • Japanese Encephalitis • Meningococcal disease • Pneumococcal disease • Rabies • Typhoid • Varicella • Yellow Fever
Be Prepared: 1. Have extra stock of vaccines required for school-aged students available. 2. Ask parents/guardians to bring the letter with them. The letters will specify which vaccines Public Health requires information on for the student, as well as a record of the ISPA vaccines that Public Health currently has on file. 3. Be aware of additional requirements. The suspension process includes vaccines for meningococcal disease, pertussis and varicella (for those born in 2010 or later). 4. Choose the right meningococcal disease vaccine. This would be clarified on the form the parent/guardian received. 5. Medical exemptions for varicella. Remember that this requires either a diagnosis or verification of a history of varicella by a healthcare provider or laboratory confirmation of immunity or infection that has occurred over the age of 1 year. If you have any questions regarding this process, please contact the Vaccine Preventable Disease Program at 705-743-1000, ext. 139
Questions about this year’s flu vaccine recommendations? Public Health Ontario has developed a fact sheet for healthcare providers to help understand recommendations for live attenuated influenza vaccine (LAIV) and the inactivated influenza vaccine (IIV) for children and adolescents in the 2016-2017 influenza season. This fact sheet is available on www.peterboroughpublichealth.ca by clicking on For Professionals | Health Professionals | Influenza.
705-743-1000 ∙ www.peterboroughpublichealth.ca Jackson Square - 185 King Street, Peterborough, ON K9J 2R8
Volume 21 ∙ Number 11 ∙ December 2016
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Dear Health Care Provider Leave The Pack Behind, the best practice program for young adult smoking cessation and prevention funded by the Ministry of Health and Long Term Care, is currently promoting its effective and successful wouldurather... contest (www.wouldurather.ca). This contest motivates Ontario young adults to make positive changes to their tobacco use behaviour – whether that is quitting, cutting back, cutting out smoking while partying, or renewing a decision to stay smoke-free for their chance to win cash prizes of up to $5,000. This intervention has been rigorously evaluated and is effective in helping smokers to quit. Additionally, Leave The Pack Behind occasionally makes available free, full-course 8-week treatment of nicotine-replacement therapy. Since you may be regularly seeing young adults, we are asking if you will assist us in promoting the contest during the registration period of November 15, 2016 – January 22, 2017. Print and digital promotional resources are available (in English and French). The contest is open to Ontario young adults between the ages of 18-29. Hard copy posters are available by directly contacting the following Peterborough Public Health staff: Mary Pat Cannon, Public Health Nurse Email:
[email protected] Phone: 705-743-1000, ext. 217 Keith Beecroft, Health Promoter Email:
[email protected] Phone: 705-743-1000, ext. 238
Choose to be… Smoke Free, is a FREE
tobacco cessation support program that combines behavioural counselling and access to free nicotine replacement therapy (NRT), made possible with funding from the Ministry of Health and Long-Term Care. More information and handouts for your patients will be mailed to you directly.
705-743-1000 ∙ www.peterboroughpublichealth.ca Jackson Square - 185 King Street, Peterborough, ON K9J 2R8
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Volume 21 ∙ Number 11 ∙ December 2016
Resources For HCPs 2015 Annual Report This seven-minute video celebrates the many public health accomplishments made in 2015. As you know, 2015 was a year of major milestones. We are pleased to share these along with how we empower others to live healthier lives in this new video. In addition to our daily work in the community, this video captures the exciting transition to our new home at Jackson Square, 185 King St. and how this location is quickly becoming a community hub where people come together to improve the quality of life for all. Public Health staff welcome opportunities to present this video to community groups and organizations to discuss how we can advance the public health priorities of our area. To book a presentation, please call Alida Gorizzan, Executive Assistant to the Medical Officer of Health at 705-743-1000, ext. 264 or email
[email protected].
Speech and Language Brochures Click on each brochure above to preview. Learning to Talk is about children ages birth to 2 ½, while Learning to Talk 2 is about children ages 2 ½ to 5 years of age. Both brochures provide concrete suggestions and examples of activities to stimulate growth and development, especially speech and language. These new and free brochures are available for order through the Peterborough Public Health Family Health Resource Order Form at www.peterboroughpublichealth.caFor ProfessionalsHealth Professionals under Resources. Also remember to refer families to our local speech and language website www.kidtalk.on.ca as well as our Family HEALTHline at 705-743-1000. Public Health Nurses are ready to talk to parents about ways to encourage speech and language, as well as refer to appropriate agencies for further support. The website has recently been updated to include an FAQ section, downloadable audio rhymes and finger-plays, videos and age appropriate tips about sharing books together.
Health Events For Patients We would like to inform you of an upcoming opportunity for your clients, brought to you by Peterborough Public Health. Choose to be… Smoke Free, is a FREE tobacco cessation support program that combines behavioural counselling and access to free nicotine replacement therapy (NRT), made possible with funding from the Ministry of Health and LongTerm Care. Appointments are available until March 31, 2017 on: • Mondays from 9:00 a.m. – 12:00 p.m.; and • Thursdays from 1:00 p.m. – 4:30 p.m. The Choose to be… Smoke Free support group is also available for women. The next group starts Tuesday, January 17, 2017 from 10:30 a.m. – 12:00 p.m. at Partners in Pregnancy Clinic. Help with transportation and childcare, and a $10 gift card will be provided for each session, as well as cost-free NRT for women who find it difficult to quit smoking using nonpharmacological methods. For more information or to book an appointment please call Peterborough Public Health at 705-743-1000, ext. 330
Breastfeeding Support Appointments Peterborough Public Health is excited to announce that we are expanding our breastfeeding support services. We are now providing face-to-face breastfeeding assessment, consultation and support at our new location at 185 King Street, Peterborough. This new service will complement our existing breastfeeding supports which include prenatal education, postpartum follow up, in-home support for Healthy Babies Healthy Children clients, and telephone consultations on our Family HEALTHline. A breastfeeding assessment will consist of a mother/baby breastfeeding history, observation of a feed, and guidance to overcome common breastfeeding challenges such as: engorgement, concerns about milk supply, and pain or discomfort during position and latch. This service will be provided by Public Health Nurses with additional training and education in breastfeeding. *Please note that we do not have weigh scales on site and will not be providing check-up or pre-post feed weights. Face-to-face appointments for breastfeeding clients available Monday and Wednesday mornings from 9:00 a.m. to 12:00 p.m. Please book appointments by calling Family HEALTHline at 705-743-1000. A complete list of local breastfeeding supports can be found at peterboroughpublichealth.caMy Life & HealthParents & CaregiversBreastfeedingBreastfeeding Help Peterborough.
705-743-1000 ∙ www.peterboroughpublichealth.ca Jackson Square - 185 King Street, Peterborough, ON K9J 2R8
