In This Issue - May 2024

Updates and Review:

Nicotine Pouch Risks: Insights for Healthcare Providers
2024 Blacklegged Tick Established Risk Areas Map and Lyme Disease Clinical Guidance Resources
Mental Health Week 2024: The Importance of Compassion and Self-Compassion
Immunization Record Review for 2023-2024 is Over
Respiratory Surveillance Update

Nicotine Pouch Risks: Insights for Healthcare Providers

Nicotine pouches, small packets containing nicotine, are placed between the gum and cheek and used as a smoking cessation aid.

Health Canada has approved one type of nicotine pouch as a nicotine replacement therapy to help adults (18 and older) quit smoking. However, unauthorized nicotine pouches are being sold at convenience stores, gas stations, and other retailers. These products are increasingly available and appealing to youth under 18, especially because they come in enticing flavors like berry frost and tropical.

Nicotine exposure poses significant risks to the developing brain, including:

Attention deficits
Cognitive changes
Mood disorders
Heightened susceptibility to addiction

Additionally, nicotine exposure may lead to future tobacco use.

Healthcare professionals are encouraged to discuss the dangers of nicotine pouches and other nicotine products with youth and their parents. Open, honest, and ongoing conversations about the risks of addiction are essential.

Short-term adverse effects may include:

Nausea
Hiccups
Mouth soreness or irritation

The long-term effects of nicotine pouch use are still unknown.

For more information, please visit: Dangers of Nicotine Pouches - Canada.ca.

2024 Blacklegged Tick Established Risk Areas Map and Lyme Disease Clinical Guidance Resources

Public Health Ontario has published its annual Blacklegged Tick Established Risk Areas Map (formerly the Ontario Lyme Disease Map: Estimated Risk Areas). Blacklegged ticks are the primary vector of four reportable tick-borne diseases - Anaplasmosis, Babesiosis, Lyme disease and Powassan virus. For 2024:

Niagara remains a risk area
There are four newly identified risk areas, one each in Chatham-Kent, Grey Bruce, Hamilton and Windsor-Essex

Lyme diseases clinical guidance resources

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 blacklegged ticks in risk areas, such as Niagara, is considered confirmation of early localized Lyme disease and should be treated without laboratory confirmation.

For guidance on the management of tick bites and investigation of early localized Lyme disease refer to Ontario Health's clinical guidance resource .

PHO and Ontario Health have also developed an assessment and prescribing algorithm for community pharmacists when prescribing antibiotic prophylaxis to prevent Lyme diseases following a tick bite.

For more information, visit our Lyme disease webpage.

Mental Health Week 2024: The Importance of Compassion and Self-Compassion

Mental Health Week in Canada took place from May 6 to 12, highlighting the healing power of compassion as this year’s theme.

For healthcare providers, cultivating compassion for others starts with practicing self-compassion. According to Dr. Kristin Neff, self-compassion is about directing kindness inward, treating yourself with the same care and understanding that you would offer to others.

The Canadian Society of Physician Leaders has outlined several self-compassion practices based on Dr. Neff’s work:

Self-kindness: Treat yourself with the same support and encouragement you would give to others. Understand and embrace your failures instead of condemning them.
Common humanity: Recognize that pain and failure are part of the shared human experience. Normalizing these experiences fosters a sense of connection with others.
Mindfulness: Maintain awareness of your moment-to-moment experiences in a clear and balanced manner. When stressed, avoid getting caught up solely in problem-solving. Acknowledge your struggles and suffering, which can help you adopt a more constructive and objective perspective.

For further information, visit:

For more details on self-compassion, see Physician Wellness Hub: Self-Compassion 101 .

Immunization Record Review for 2023-2024 is Over

At the start of the immunization record review last fall, 12,744 students in the Niagara region were non-compliant. In November 2023, Public Health issued reminder notices to their families.

By January 2024, suspension orders were sent to 8,555 students, set to take effect on March 19, 2024.

Thanks to the combined efforts of primary care providers and Public Health, who held clinics in schools and offices across the region, significant progress was made in helping families update their records. As a result, only 1,281 students remained non-compliant and were suspended on March 19. By the end of that day, the number was reduced to 768, and by the end of the week, it dropped to 278 students.

For more information, contact the Vaccine Preventable Disease program at 905-688-8248 or 1-888-505-6074 ext. 7396.

Respiratory Surveillance

Surveillance Update: Influenza Activity is Lower

Public Health Ontario's most recent respiratory laboratory surveillance data indicates activity for influenza is low
In Niagara, there are 1,226 cases of influenza this season; 28,843 across Ontario

2023 - 2024 Respiratory Season

Please note: Seasonal human coronavirus refers to non-pandemic human coronaviruses.

Data source: Public Health Ontario’s Ontario Respiratory Virus Tool, data as of May 4, 2024

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