Distributed by e-mail on October 9, 2014
This update provides information on the following:
1) Live Attenuated Influenza Vaccine (FluMist)
2) Employment posting – Contract Physician
3) Reminder - The Hajj 2014 – influenza, meningitis and MERS-CoV
4) Ebola Virus Disease (EVD) - update
5) Enterovirus D68 (EV-D68) - update
6) Acute Flaccid Paralysis (AFP)
1. Live Attenuated Influenza Vaccine (FluMist)
The National Immunization Advisory Committee on Immunization (NACI) is recommending the use of the Live Attenuated Influenza Vaccine (FluMist) for use in healthy children and adolescents based on greater effectiveness than trivalent inactivated vaccines (TIV). If FluMist is not available, TIV should be used as it is safe, efficacious and effective in this group.
FluMist is not recommended for children with immune compromising conditions, nor is it publicly funded. It is available by prescription at select pharmacies at a cost of approximately $30 per dose and is covered by some health care insurance plans. As the Ministry of Health funds only TIV, the Health Unit will be unable to offer FluMist at our clinics this year.
Additional information is contained in the Public Health Agency of Canada’s Statement on Seasonal Influenza Vaccine for 2014-2015.
2. Employment posting - Contract Physician
The Middlesex-London Health Unit is currently seeking a Contract Physician with availability Tuesday, Wednesday and Thursday evenings to work casual hours in our Sexual Health Clinics in London and/or Strathroy. This Physician will serve primarily female clients at these scheduled clinics. Full details, including responsibilities and qualifications can be found on the Health Unit’s job posting webpage. The deadline to apply is October 17th, 2014.
3. Middle East Respiratory Syndrome Coronavirus (MERS-CoV) and the Hajj
The conclusion of the Hajj 2014 means that many Ontarians who travelled to Saudi Arabia are returning home. Mass gathering events increase the risk of exposure and potential transmission of illnesses like influenza and meningococcal disease. While malaria remains the number one cause of fever in the returning traveller, Middle East Respiratory Syndrome Coronavirus, or MERS-CoV, is an additional risk for travellers to Saudi Arabia. Health care workers should be vigilant for patients who present with acute respiratory illness and relevant travel history. Information, including specimen requirements, and guidelines for the health sector, is available through Public Health Ontario’s MERS-CoV webpage.
4. Ebola Virus Disease (EVD) - Vigilance
No cases of Ebola have been identified in Canada and the risk of the disease in Ontario continues to be low. Federal and provincial public health officials continue to monitor the situation and have taken measures to ensure Ontario’s health sector is prepared should a traveler returning from a country where Ebola is circulating, is suspected of having the disease.
All healthcare providers should be aware of affected areas and be vigilant for people presenting with fever and a relevant travel history. Additional information, is available through Public Health Ontario’s Ebola Virus Disease webpage including sample collection guidance, and a list of frequently asked questions.
5. Enterovirus D68 (EV-D68)
Enteroviruses are very common and it is not unusual to see an increase in the number of infections each fall. Since September 17, 2014, there have been 30 laboratory-confirmed cases of EV-D68 in Ontario. Among these, several cases of Acute Flaccid Paralysis (AFP) are being investigated.
Public Health Ontario (PHO) has developed a website outlining Enterovirus D68 guidance for health workers and health sector employers. The website includes information on laboratory testing as well as infection prevention and control measures.
6. Acute Flaccid Paralysis (AFP)
While enteroviruses themselves are not reportable to public health, AFP – a syndrome related to polio and other enteroviruses – is reportable. This is a clinical diagnosis, so it is incumbent on clinicians to be aware of their duty to report, as the lab will often not be able to identify this syndrome. In Ontario, Acute Flaccid Paralysis was added as a reportable disease in December of 2013. Cases are reportable regardless of age. If reporting a case of AFP to the Health Unit, please complete a AFP Case Reporting Form.