No Images? Click here In This Issue - May 2018
IPAC REVIEW: Did you know?
UPDATE: Rabies Prevention and Control ProtocolThe Ontario Ministry of Health and Long-Term Care has updated the Rabies Prevention and Control Protocol. One of the changes will affect the distribution of rabies vaccine and RabIg. Publicly-funded rabies vaccine should be limited to the following groups: A) Residents of Ontario with a potential rabies exposure acquired in Ontario or while travelling; or B) Residents of Canada with a potential rabies exposure acquired while in Ontario, or requiring completion of vaccine initiated within their home province (appropriate documentation of initiation of treatment is required) Non-residents of Canada who request the rabies vaccine while in Ontario will need to obtain the vaccine from a healthcare provider at their own cost. Healthcare providers should order rabies vaccines for non-residents from a pharmacy, rather than from Niagara Region Public Health. Access to publicly-funded rabies vaccine should only be given to non-residents of Canada under extenuating circumstances. Niagara Region Public Health will assist in determining extenuating circumstances. Physicians are reminded to inform Niagara Region Public Health of all animal bites that are reported. Public Health staff are available 24 hours to assist your patients with a risk assessment if there is concern that they have been exposed to the rabies virus from an animal bite or scratch. For further information, please contact the Environmental Health program at 1-888-505-6074 or 905-688-8248 ext. 7590 Monday to Friday between 8:30a.m. and 4:30p.m. After hours, please call 905-984-3694. REVIEW: Lyme Disease and TicksLyme disease is caused in humans by a bite from a blacklegged tick carrying the bacterium Borrelia burgdorferi. Clinical Manifestations of Early Localized Disease (Less than 30 days)
Prophylaxis Routine use of antimicrobials or serologic testing is not recommended for clients exposed to a tick bite, nor should tick test results be used in making prophylaxis decisions as it causes considerable delay. The Infectious Disease Society of America Guidelines recommend that prophylaxis can be considered if all of the following criteria are met:
The recommended prophylaxis is a single dose of doxycycline for adult clients (200 mg) and children 8 years of age or older (4mg/kg up to a maximum dose of 200 mg). Doxycycline is not recommended for children less than 8 years of age. Submitting a Tick for Identification: If you are a health care provider and your patient will be submitting a tick to Niagara Region Public Health for identification, the online tick submission form can be completed electronically. Find detailed information on Lyme disease and for diagnostic testing refer to Lyme Disease testing information. UPDATE: New Guidelines for Tdap VaccineTdap Vaccine Now Recommended in Every Pregnancy:Although pertussis incidence varies by age group, infants who are unvaccinated or incompletely vaccinated are at greatest risk of infection and associated complications. Routine maternal vaccination will help to improve pertussis protection for infants by conferring additional maternal antibodies to neonates. Tdap vaccination in pregnancy has been shown to protect 90% of infants, younger than three months of age, against pertussis. The National Advisory Committee on Immunization (NACI)recommends vaccinating with Tdap in every pregnancy ideally between 27 and 32 weeks of gestation.
Many countries have already incorporated Tdap vaccination in pregnancy as part of routine adult immunization programs. No increased risk of serious adverse pregnancy, maternal or infant events have been reported in these countries. In addition, no serious adverse events to pertussis vaccination have been found in Canada through CAEFIS (Canadian Adverse Events Following Immunization Surveillance). View the full Advisory Committee Statement published by the Public Health Agency of Canada. For further information, please contact the Vaccine Preventable Disease program at 1-888-505-6074 or 905-688-8248 ext. 7425 Monday to Friday between 8:30 a.m. to 4:30 p.m. |