Distributed by e-mail October 16, 2015
In this update:
- Launch of 2015-16 Universal Influenza Immunization Program
- Changes to Treatment of Gonorrhea in Ontario
1. Universal Influenza immunization Program (UIIP)
The official launch of the UIIP program is scheduled for October 26. Until then, Health Care Providers should prioritize vaccine for their high risk population due to limited vaccine supplies. The Health Unit will be receiving vaccine for the universal program in the week of October 19 and will start shipping flu vaccine to Health Care Providers and Pharmacies in preparation for the October 26th launch.
Quadrivalent Live Attenuated influenza Vaccine (Q-LAIV) FluMist will be available for healthy children and youth, aged two to 17 years of age. This needle-free vaccination is anticipated to increase uptake of the vaccine in the population that is most likely to spread the virus. Flumist is available for children who do not have a contraindication for a live attenuated influenza vaccine, such as immune compromising conditions or severe asthma. Q-LAIV, which is sprayed into both nostrils, is the only needleless influenza vaccine available in Canada. Q-LAIV is the vaccine of choice for children 2-5 years old based on superior efficacy of LAIV compared to inactivated vaccines. However, if LAIV is not available, inactivated quadravalent or trivalent vaccines should be used.
Only about 1/3 of the Health Unit’s total allocation of FluMist will be available on October 26 with more becoming available later in October and early November. Health Care Providers should prioritize FluMist for the 2-5 year age group until additional supplies of the vaccine are available.
2. Treatment of Gonorrhea in Ontario
Multi-drug resistance in N. gonorrhoeae is rapidly evolving, threatening the effectiveness of all currently available single-dose antibiotics in common use, including the third-generation cephalosporins. Clinical failures associated with the use of cephalosporins have been identified worldwide, including Ontario
The recommended first-line treatment for uncomplicated gonorrhea in Ontario is Ceftriaxone 250 mg intramuscularly plus azithromycin 1 g orally. Oral cephalosporins are no longer recommended as first line therapy for the treatment of gonorrhea in Ontario.
Test of cure is recommended if there are clinical features associated with a risk of treatment failure, such as pharyngeal or rectal infection, pregnancy, or persistent symptoms suggestive of treatment failure. Test of cure is also recommended if second-line treatment is used.
More information about gonorrhea treatment guidelines is available at http://www.publichealthontario.ca/en/eRepository/Guidelines_Gonorrhea_Ontario_2013.pdf
The Middlesex London Health Unit supplies free Ceftriaxone and Azithromycin to the community physicians for treatment of STIs. Please call 519-663-5317 to place your order.