In this issue - December 2025

Program Updates
• Preventing Cold Chain Issues
• Cannabis and Psychosis - Early Identification and Support
• New Parenting Program!
• Supporting Parents with Mastitis-Like Symptoms

Announcements
•Respiratory Surveillance
• Niagara Cough, Cold and Flu Clinics

Educational Opportunities
•Niagara Region Public Health Rounds: Focus on the Immunization of School Pupils Act (ISPA) CME

As we close out another year, we want to extend our deepest gratitude to each of you. Your commitment to compassionate care continues to strengthen the health and resilience of our community.

As respiratory season progresses, your leadership in promoting and delivering immunizations remains one of the most powerful tools we have to protect our community - especially the very young, the elderly, and those with chronic conditions. Your efforts to educate, encourage, and immunize help prevent severe illness and reduce hospital burden.

Thank you for all you do to keep our community healthier. We look forward to supporting your work in the year ahead and celebrating the impact you continue to make every day.

Dr. Azim Kasmani
Medical Officer of Health
Niagara Region Public Health and Emergency Services

Preventing Cold Chain Issues

Busy clinic schedules, interruptions, uncertainty about when and how to respond, equipment challenges – things happen when systems break down and people are stretched.

Public Health tracks human error excursions in health care provider offices, pharmacies, long-term care homes and retirement homes. Approximately 60 excursions occur annually due to these common errors:

Cleared readings prior to or in between recordings
Improper storage (e.g. vaccine left out at room temperature, vaccine stored improperly inside the fridge - storing in drawers or the door shelves; or vaccine pressed against the walls or sitting on the floor of the fridge)
Storing vaccine in an unmonitored fridge
Recording alarm limits instead of vaccine fridge temperatures
Damaged product/equipment (accidentally dropping vaccine/fridge thermometer)
Missed recordings and/or missing temperature logs
Adjusting fridge settings incorrectly

Health care providers can reduce the risk of human errors by:

Following the Ministry's Vaccine Storage and Handling Guidelines
Never clearing the temperature readings without first recording them on the temperature log; cleared recordings results in a loss of minimum and maximum temperatures
Never moving vaccine to an unmonitored fridge or transport cooler
Never ordering more vaccine than what your vaccine fridge can safely store
Investing in a purpose-built vaccine fridge and/or data logger
Retaining temperature logs for 12 months

More Information

Following the instructions at Cold Chain Requirements
Call 905-688-8248 or 1-888-505-6074 ext. 7396 if you have questions or new staff that need to be trained

Cannabis and Psychosis – Early Identification and Support

Niagara Region Public Health has launched the Know the Link: Cannabis and Psychosis campaign which aims to increase awareness among youth and young adults of the risk factors and symptoms of cannabis-induced psychosis, ways to lower risk, and treatment intervention for those experiencing a first episode of psychosis. The campaign also seeks to support health care professionals with providing timely assessment and comprehensive support to individuals experiencing the first signs of psychosis, including referral to the Early Psychosis Intervention (EPI) service.

Eligibility Criteria for EPI Service:

To qualify for this service, an individual must meet the following criteria:

Be 14 to 35 years of age
Suspected of experiencing symptoms of psychosis or diagnosed with a first episode of psychosis

If your patient does not meet the criteria for this service, please refer them to the Access Line by calling 1-866-550-5205 or visiting the website.

Referrals

For patients who qualify, you can submit a referral online or call 905-688-2854 ext. 7356, Monday to Friday from 8:30 a.m. to 4:30 p.m.

Resources and More Information

Order Know the Link posters and post cards for your practice
Visit the Know the Link website for more information and videos on EPI

New Parenting Program!

Niagara Region Public Health is excited to introduce a new, free interactive parenting program, Positive Discipline in Everyday Parenting, to support parents and caregivers with children aged 0-18 years. This series is designed to help with:

Understanding children’s needs
Implementing effective and loving discipline strategies
Building confidence in managing everyday challenges
Improving communication with children

This program will be replacing the Triple P program that has previously been offered. Sessions are in-person, two hours per week, for nine weeks.

For more information or to refer patients to this support, please visit www.niagararegion.ca/parents/courses.

Supporting Parents with Mastitis-Like Symptoms

Mastitis describes a range of conditions that involve inflammation within the breast. Mastitis-like symptoms are a common concern among parents who are breast/chest feeding and may develop as a result of nipple trauma and inflammation caused by improper feeding methods.

Current best practice evidence highlights the critical role of addressing the underlying cause of certain conditions through ongoing breast/chest feeding support. This approach can help to prevent or mitigate symptoms and improve recovery better than traditional treatments alone.

Health Care Provider Actions

Refer patients to Niagara Parents for additional feeding support via Family Health Referral
Refer patients to Niagara Parents webpage to book a one-on-one infant feeding appointment

References/Resources

Respiratory Surveillance

Public Health Ontario’s most recent respiratory laboratory surveillance data indicates activity for influenza is high
Provincially, Influenza is the most commonly circulating virus (based on percent positivity)
In Niagara, there have been 232 cases of influenza this season; 3,943 across Ontario
Niagara reports flu activity surveillance information weekly on Fridays
For more details on the 2025 to 2026 respiratory season, please visit Public Health Ontario’s page for the Ontario Respiratory Virus Tool.

Cough, Cold and Flu Clinics

Cough, Cold and Flu clinics are being held out of Niagara North Family Health Team locations with support from the NOHT-ÉSON. These clinics are for people of all ages and all Niagara residents who have non-emergency cough, cold or flu symptoms and need care in the evening. They are open to all Niagara residents.

Clinics run from Monday, December 8, 2025 to Monday, March 30, 2026 at the following locations from 4:30 p.m. to 8:00 p.m.:

Mondays and Wednesdays - 101 Garrison Village Drive, Niagara-on-the-Lake
Thursdays – 145 Carlton Street, Unit 7, St. Catharines
Fridays – 1338 Fourth Avenue, Suite S100, St. Catharines

How patients can book appointments

Patients can call 289-267-2879 to book an appointment on clinic days with phone lines opening at 1:00 p.m.
Appointments are first-come, first served until spots are filled

For more information, please visit Niagara Cough, Cold and Flu Care Clinics - Niagara Ontario Health Team - Équipe Santé Ontario Niagara.

Visit the Professional Development Opportunities page for in-person and online opportunities available to health care professionals in Niagara.

Recap - NRPH Rounds: Focus on The Immunization of School Pupils Act (ISPA)

How confident are you in your ability to assess your patients’ immunization records and identifying compliance with the ISPA?

The Dec. 10 virtual education reviewed sample immunization records. Did you know that:

Oral polio vaccine (OPV) given on or after April 1, 2016 are invalid, as they are a bivalent product – this also affects polio vaccine where the route was unknown. IPV given on the same day as OPV after this date is also invalid, as it could be a fractional dose which would not provide adequate protection
If a child less than 7 years of age has not received at least 3 doses of DTaP-IPV-Hib, they should still be provided with this high antigen pediatric product to ensure adequate protection against pertussis and diphtheria. (E.g. a 6 year old who has received 2 doses of DTaP-IPV-Hib needs another DTaP-IPV-Hib; if they got a Tdap-IPV, the diphtheria and pertussis components would not be valid)
If measles, mumps, and rubella (MMR) vaccine was given under the age of 1, that dose will not count towards ISPA as it is not expected to confer long-lasting protection
Live vaccines (such as MMR and varicella vaccine) must be given either on the same day, or a minimum number of days apart in order to ensure adequate immune response
Students in Grade 7 (or older if they missed their grade 7 dose) should be provided the Men-C-ACYW-135 vaccine, which will protect them against the serogroup present in the Men-C-C vaccine along with the A, Y, and W serogroups

Order the new quick reference guide for health care providers to help patients and their families meet the ISPA requirements and prevent school suspension.

More Information

Call 905-688-8248 or 1-888-505-6074 ext. 7396

Medical advisories and memos

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Your monthly update from Niagara Region Public Health

Welcome to Public Health Pulse! Formerly known as the Physicians’ Newsletter, the publication was given a fresh name in January 2025 to better reflect our commitment to supporting Niagara’s physicians, primary care providers, and allied health professionals with essential public health updates.

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