In This Issue - October 2023

UPDATE:
- PCAL Recruitment is Open for 2024!
- 2023 / 2024 Influenza Immunization Program
- Respiratory Surveillance
- Health Canada Safety Review: Domperidone and Risk of Psychiatric Withdrawal Events
REVIEW:
- Antiviral Medication for the 2023 - 2024 Respiratory Season
- Centre de santé Communautaire: Caring for my COPD Welland Pulmonary Rehabilitation Program
- Opioid and Safer Supply Resources
- National Breastfeeding Week
EDUCATIONAL OPPORTUNITIES
- FREE TRAINING: Breastfeeding “Making a Difference” Level 2 - Last Chance to Register!
MEDICAL ADVISORIES AND MEMOS

UPDATE: PCAL Recruitment is Open for 2024!

The Niagara Region Public Health Primary Care Advisory and Liaison (PCAL) Group is made up of Public Health representatives, family physicians, and nurse practitioners.

This group is in place to support improved two-way communication between Niagara Region Public Health and Niagara’s primary care sector, including collaboration efforts, resource sharing, and knowledge exchange. It is an excellent opportunity to work collaboratively on addressing community-health related issues.

We are looking for new members to join PCAL in 2024!

Time Commitment & Responsibilities

PCAL Meetings: every-other month for 1.5 hours in the evening
Primary care connect: a shorter meeting on off-months to determine priorities for discussion
Primary care members are responsible for connecting with colleagues in their geographic catchment areas to relay information and collect feedback
Please note: members are compensated for their time

How to Join & More Information

If you are interested or would like to learn more about joining, please send an email to PCAL@niagararegion.ca
Check out the Primary Care Advisory and Liaison Group webpage
Reach out to your catchment area lead to speak to them about their experience as a PCAL member

UPDATE: 2023 / 2024 Influenza Immunization Program

The Ministry of Health has updated the Universal Influenza Immunization Program (UIIP) website with information on product availability, distribution and vaccine supply.

Health Care Provider Action

Influenza vaccination for the general public can begin Oct. 30
QIV-HD should, whenever available, be preferentially administered to the oldest and most vulnerable clients (65 years of age and older). However, please do not delay vaccination to wait for a particular product, especially since supply may be unpredictable. The QIV, QIV-HD and TIV-adj all protect against the flu, and the most important thing is for older adults to be vaccinated.
Co-administration information for influenza and other vaccines:
- Concurrent administration of COVID-19 and influenza vaccines are encouraged where possible
- It is recommended to wait at least two weeks before or after administration of Arexvy vaccine for RSV
- The Ministry guidance indicates that no studies have been conducted that assess the co-administration of Shingrix® with adjuvanted or high-dose influenza vaccines. With Fluad®, it is unknown how the adjuvants may interact when Shingrix® is co-administered.

More Information

Visit our website or call the Vaccine Preventable Disease program at 905-688-8248 or 1-888-505-6074 ext. 7396.

UPDATE: Respiratory Surveillance

Surveillance Update: Influenza Activity is Low

Public Health Ontario’s most recent respiratory laboratory surveillance data indicates activity for both influenza A and influenza B is low
Provincially, COVID-19 is the most commonly circulating virus
In Niagara, there are 6 cases of influenza so far this season; 205 across Ontario

2023-2024 Respiratory Season

Data source: Public Health Ontario’s Ontario Respiratory Virus Tool, data as of October 14^th, 2023. Please note: Coronavirus refers to non-pandemic human coronaviruses. Provincially, SARS-CoV-2 is the most commonly circulating virus amongst samples analyzed.

Niagara reports flu activity surveillance information weekly on Fridays.

For more detail on the 2023 to 2024 respiratory season, please visit Public Health Ontario’s page for the Ontario Respiratory virus Tool.

UPDATE: Health Canada Safety Review: Domperidone and Risk of Psychiatric Withdrawal Events

In October 2023, Health Canada issued a review of the research relating to psychiatric withdrawal events following sudden discontinuation or tapering (dose reduction) of domperidone used to stimulate lactation. Events may include, but are not limited to, depression, anxiety, and insomnia.

Health Canada’s review of the available information found a link between the sudden discontinuation or tapering of domperidone, used off-label for lactation stimulation, and the risk of psychiatric withdrawal events. This link was mostly observed in patients taking daily doses greater than the maximum recommended dose of 30 mg per day. Please note, the review was limited by the small number of cases.

More Information

The full review may be found here

REVIEW: Antiviral Medication for the 2023-2024 Respiratory Season

Health care providers are encouraged to discuss treatment options with patients who are at a higher risk of severe illness from influenza, COVID-19 and Respiratory Syncytial Virus (RSV) before they get sick and create a plan to ensure patients receive the appropriate therapeutic within the treatment window.

Influenza

Antiviral medications (Tamiflu and Relenza) may be used for both the prevention and treatment of influenza and should be given as soon as possible and optimally within 48 hours of symptom onset. Laboratory confirmation is not required to initiate antiviral treatment and may be discontinued if testing identifies an alternate pathogen.

COVID-19

Treatment for COVID-19 must be administered early in the course of illness; Paxlovid must begin within five days of symptom onset, and Remdesivir within seven days of symptom onset. Learn how to access COVID-19 treatments for patients in the community.

RSV

RSV prophylaxis for high-risk infants (Palivizumab) works best if started as early as possible to prevent illness.

More Information

REVIEW: Centre de santé Communautaire - Caring for my COPD - Welland Pulmonary Rehabilitation Program

As winter approaches, so does the dreaded Cold and Influenza season. Health Care professionals may see an increased number of calls/visits from patients with COPD. The pulmonary rehabilitation program continues to offer services virtually as well as in person with reduced group sizes. The Canadian Thoracic Society recommends pulmonary rehab for the treatment of COPD.

Program Overview (Free)

Weekly education
Two exercise sessions/week (education only stream available)
CBT with a mental health counselor
1 on 1 access to dietician, counselor, smoking cessation (26 weeks Free NRT & support group)
Serving both French & English speaking patients

Who is Eligible?

Patients with a confirmed diagnosis of COPD (FEV1/FVC ratio of <70%) or confirmed diagnosis by a respirologist

How to Refer

To refer patients, please use the referral form or call 905-734-1141 Ext 2113
Or, visit the website for more information

REVIEW: Opioid and Safer Supply Resources

Did you know Public Health has an Opioid and Safer Supply Resources webpage?

Visit the Opioid and Safer Supply Resources webpage for:

Links to safer supply peer support, resources, and Niagara-specific opioid use statistics
Videos about the need for safer supply and prescribing
Information on how to join the National Safer Supply Community of Practice to receive prescriber mentoring, access to newsletters, webinars and discussion forums

The College of Physicians and Surgeons of Ontario recognizes that providing pharmaceutical-grade alternatives to the toxic street supply, both in the context of a comprehensive treatment plan or as a standalone harm reduction strategy, can enable physicians to support patients with opioid use disorder and reduce their risk of overdose and death. See their advice to the profession about prescribing drugs.

REVIEW: National Breastfeeding Week

This year, National Breastfeeding Week was celebrated from October 1 to 7, 2023.

Niagara Region Public Health is here to help you support patients in navigating breastfeeding support in the community. Niagara Region Public Health offers one-on-one infant feeding support from a public health nurse who can answer questions related to breastfeeding, bottle feeding, and transitioning to solids.

How to Refer

To refer a patient to infant feeding support, please fill out our Family Health Referral Form: Family Health Referral - Niagara Region, Ontario
Or, individuals can book an infant feeding appointment online by visiting this link: Clinics, Classes and Groups for Parents, Caregivers and Children

FREE TRAINING: Breastfeeding "Making a Difference" Level 2 - Last Chance to Register!

Niagara Region Public Health is hosting a 2-day virtual (LIVE) workshop series for community health care professionals and hospital staff practicing in Niagara who currently work with expectant or new parents and families.

When:

This series will take place over Zoom on November 7 and November 14, 2023 from 8:30 a.m. – 4:00 p.m.

Keynote Speaker:

Kathleen O’Grady is a registered nurse and an International Board Certified Lactation Consultant (IBCLC). Please see: Breastfeeding: Making a Difference Level 2 Workshop - Niagara Region, Ontario, for her additional credentials.

Key Topics

Effective assessment and management skills by applying current research, using complex case studies and group problem solving to formulate care plans to deal with challenging situations
Effective breastfeeding promotion in a multi-cultural society
Infant-parent attachment
Ethics
Evaluating research, training materials and research

Requirements:

Have completed the Breastfeeding Level 1 training (or an equivalent) within the past 3 years
Must be a health care practitioner practicing in the Niagara region

Note: Participants must attend both session dates and may be eligible to receive IBLCE CERPS (Continuing Education Recognition Points).

The event is live for registration on the Professional Development Opportunities Page .

Registration Deadline: October 31, 2023

MEDICAL ADVISORIES AND MEMOS