Distributed by e-mail on February 14, 2014
In this update, please find information on the following:
- H7N9 influenza and MERS-CoV continue to occur
- Chikungunya virus
- MMRV vaccine
- Smoking cessation workshops
1. H7N9 influenza and MERS-CoV continue to occur
Cases of H7N9 influenza continue to occur in China. There has been a notable increase in cases in recent months, with January being the worst month of the outbreak so far. In the first wave of the outbreak (from March to July 2013) there were 136 reported cases, with approximately 213 cases reported in the second wave (from October 2013 to present). There have been approximately 72 deaths (21% of the cases). All cases have arisen from exposure in eastern and southeastern China and many have had direct contact with poultry or live poultry markets, with no evidence of sustained human to human transmission. Additional information is available on the World Health Organization web site and the Ministry of Health and Long-Term Care web site. Information for travelers is available on the Public Health Agency of Canada web site.
Cases of MERS-CoV also continue to arise from the Middle East. To–date, there have been 182 cases and 79 deaths (43% of the cases). All cases have been acquired in the Middle Eastern countries of
Jordan, Kuwait, Oman, Qatar, Saudi Arabia and the United Arab Emirates. Some cases have occurred from exposure to people with known infections, including infections in health care settings. Other cases have occurred from a yet unknown exposure, likely of animal origin; camels and bats have been implicated as possible carriers of the virus, but the source of transmission to humans remains uncertain. Additional information is available on the World Health Organization web site and the Ministry of Health and Long-Term Care web site.
Please ensure that patients with severe respiratory symptoms are asked about recent travel for themselves and their close contacts. Please contact the Health Unit should H7N9 influenza or MERS-CoV be suspected in a patient (519-663-5317 ext. 2330).
2. Chikungunya virus
Chikungunya is a virus spread by mosquitoes. It can be acquired in Africa, Asia, the Indian subcontinent and most recently from the Caribbean. Cases have been identified from Saint Martin/Saint Maarten, Dominica, Guadeloupe, Martinique, Saint-Barthélemy and the British Virgin Islands. These cases are the first time locally-acquired chikungunya has been detected in the Americas.
The incubation period for chikungunya is 1-12 days, with onset often between 3-7 days after the mosquito bite. Symptoms include the rapid onset of high fever, headache, myalgia and arthralgia, mainly of the limbs and large joints. A maculopapular rash is also common. Symptoms are similar to dengue which is spread by the same types of mosquitos, however chikungunya is less severe than dengue. Symptoms of chikungunya usually resolve in 7-10 days, although arthralgia and joint stiffness may persist intermittently for several months.
The Public Health Agency of Canada recommends a health care provider or travel health clinic consultation at least six weeks before travel. Travellers should use personal protective measures to avoid mosquito bites. Information for travelers is available on the Public Health Agency of Canada web site. Additional information on chikungunya is available from the Pan American Health Organization web site.
3. MMRV vaccine
The MMRV vaccine is recommended for children between 4 to 6 years of age who need their second doses of MMR and varicella vaccines. The cohort of children who only received one MMR at 12 months and one varicella at 15 months are now just turning 4 years of age and so would be eligible for MMRV. MMRV can also be used for older children up to 12 years of age who need both MMR and varicella vaccinations. For children less than 4 years of age, the MMR and varicella vaccines should generally be given separately.
4. Smoking cessation workshops
Prepared by Sarah Neil, Public Health Nurse
The attached poster and the information below may be of assistance for patients interested in quitting smoking.
The Middlesex-London Health Unit is hosting two smoking cessation workshops on February 20, 2014 from 9:30 -12:00 pm and on February 25, 2014 from 5:30-8:00 pm.
These workshops will provide participants with:
- Free nicotine replacement therapy (NRT)
- Educational material to help patients improve their overall health and well-being.
Call the Health Unit at 519-663-5317 ext. 2675 to determine eligibility and to register. Spaces are limited.