In This Issue - May 2023

UPDATE:
- Missed Newborn Hearing Screen
- Pneumococcal Vaccine Guidance
- Ontario HIV Testing Guidelines
- Updated Lyme Disease Risk Areas Map
REVIEW:
- Returning Seasonal Influenza Vaccine
- Be Safe - Mental Health Service Navigation App
- Nurse Family Partnership
EDUCATIONAL OPPORTUNITIES
- SURVEY: Innovations in Preventive Primary Care for Young Children during COVID-19

UPDATE: Missed Newborn Hearing Screen

Hearing screens are completed on newborns delivered at the St. Catharines Hospital weekdays from 8 a.m. to noon. Some newborns do miss this screening. This could possibly be due to an early discharge or if the baby does not yet meet the requirement for screening (vaginal births >15hrs of age and caesarean sections >22 hours of age). Unfortunately, newborn hearing screens are not available at the West Lincoln Memorial Hospital.

Parents with a newborn three months of age or younger who have missed screening are encouraged to make an appointment to get their baby’s hearing tested. Parents can book an appointment to get their baby's hearing tested online or can call the Central South Infant Hearing Program at 1-866-826-4327, ext. 221. Appointments are available in St. Catharine’s and Niagara Falls.

Contact the Central South Infant Hearing Program with questions at 905-385-7927, ext. 227.

UPDATE: Pneumococcal Vaccine Guidance

Recently, the National Advisory Committee on Immunization (NACI) released guidance statements on the use of pneumococcal vaccines for:

Eligibility for pneumococcal conjugate

While Health Canada authorized 15-valent and 20-valent conjugate vaccines for adults, they are not currently included in the publicly funded immunization program in Ontario. However, Prevnar®13 is indicated for individuals 50 years of age and older who meet the high-risk criteria as per the Publicly Funded Immunization Schedule for Ontario June 2022 (the schedule). Please refer to the schedule for dosing information.

Eligibility for pneumococcal polysaccharide

Pneu-P-23 is publicly funded for adults 65 years of age and older as part of the routine vaccine program.

To access the high-risk eligibility criteria for individuals 2 to 64 years of age, refer to Table 3 (page 9) of the schedule.

Questions about intervals?

Please be mindful of the minimum intervals between doses. Refer to Tables 18, 19 and 20 in the schedule for details, or call the Vaccine Preventable Disease program at 905-688-8248 ext. 7396 for consultation.

UPDATE: Ontario HIV Testing Guidelines

The Ministry of Health recently updated the HIV testing guidelines. These updates illustrate some exciting changes, however, 11% of persons with HIV remain undiagnosed in Ontario.

Select significant changes from the previous guidelines include:

Reduced window period, from three months to six weeks
Promotion of routine testing for members of groups with high HIV prevalence
Testing persons with suggestive or compatible symptoms to rule out HIV

Further support is included about what to do if a person with a high risk for HIV acquisition receives a negative result. Healthcare providers are encouraged to offer Post-exposure Prophylaxis (PEP) or Pre-exposure prophylaxis (PrEP) to all individuals who are considered high risk for HIV infection. Please see these links for more information on PrEP and PEP.

If you are interested in a free CME-accredited course you can find one here in the list of resources under "CME Accredited E-Learning Module".

Please continue to counsel your patients on HIV risk, and test as indicated.

UPDATE: Updated Lyme Disease Risk Areas Map

Public Health Ontario (PHO) has recently published its annual Lyme Disease Risk Areas Map. For 2023:

Niagara region remains a risk area
There are six newly identified areas: two in Grey Bruce, and one each in Haliburton-Kawartha-Pine Ridge District, Halton, Middlesex-London and Simcoe Muskoka

Patients with a single erythema migrans skin lesion can be seronegative at the time of initial presentation. A lesion greater than five centimetres in diameter consistent in appearance to erythema migrans in individuals exposed to black-legged ticks in risk areas, such as Niagara, is considered confirmation of early localized Lyme disease and should be treated without laboratory confirmation.

As a reminder, pharmacists can now prescribe post-exposure prophylaxis to prevent Lyme disease following a tick bite. PHO has recently published a new Assessment and Prescribing Algorithm to support community pharmacists in prescribing appropriate antibiotic prophylaxis.

Visit our Lyme disease webpage for more information and resources.

REVIEW: Returning Seasonal Influenza Vaccine

Unused seasonal influenza vaccines need to be returned to Public Health by the end of each flu season. Return all expired/wasted publicly funded vaccines through the Public Health delivery service. All publicly funded vaccine returns must be accompanied by a vaccine return form.

REVIEW: Be Safe - Mental Health Service Navigation App

Be Safe by mindyourmind is a free mobile app specific to Niagara that is designed to support people in reaching out for local mental health support. It includes a digital safety plan that patients can complete directly on their phones, and take with them following an appointment.

Physicians can use and help their patients use this app to

Crisis and safety plan
Navigate Mental Health resources in Niagara
Discuss what to expect when accessing services

Be Safe does not replace professional clinical advice or emergency services, but looks to support users in navigating and selecting the most appropriate services.

REVIEW: Nurse Family Partnership

The Nurse-Family Partnership (NFP) is a free, evidence-based home visiting program offered by nurses at Niagara Region Public Health. Public Health nurses conduct home visits, which occur consistently throughout pregnancy and the child’s first two years of life.

Through research trials, this program has been shown to improve

pregnancy outcomes,
child health and development, and
the economic self-sufficiency of the family.

Throughout 2022, NFP nurses in Niagara provided 1,068 visits to families, with 86% of these visits occurring in person.

Patients may benefit from in-home nursing support during their pregnancy if they live in Niagara and are

24 years of age or younger
less than 28 weeks pregnant, and
preparing to parent for the first time

To refer patients to the NFP, please complete our Family Health Referral Form.

For more information

Visit In-home Support for Expectant Mothers and Parents
Email Rose Burns, Nurse-Family Partnership Team Lead
Call 289-407-3600

If you have a pregnant patient or a patient with a young child who may benefit from home visits but does not meet the eligibility criteria for NFP, Niagara Parents also offers Healthy Babies Healthy Children, a more generalized home visiting program

SURVEY: Innovations in Preventive Primary Care for Young Children during COVID-19

Researchers at Queen’s and McGill Universities are looking for primary health care practitioners and administrators to complete a brief online survey called: Innovations in Preventive Primary Care for Young Children during COVID-19.

The aim of this survey is to discover programs or services that facilitated the delivery of primary health care to children 0-5 years old during the COVID-19 pandemic (March 2020 – present). 

The survey should take no more than 10 minutes to complete and includes a draw for a $100 gift card.

If you need more information or have any questions, please contact Kimberly McFadden (RA)

MEDICAL ADVISORIES AND MEMOS

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