Healthcare Provider Outreach Webinar

Healthcare Provider Outreach
Webinar
November 19, 2024
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Presenter:
 
D
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J
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Associate Medical Officer of Health 
Middlesex-London Health Unit
November 19, 2024
 
Respiratory Surveillance Report
Vaccine Updates
o
COVID-19 Reminders
o
Beyfortus / Nirsevimab RSV Product for Infants
o
Influenza Vaccine
Syphilis
o
Congenital Syphilis
Mycoplasma Pneumoniae - Increased Activity in Ontario 
 
Public Health Ordering System (PHOS)
eNewsletter and Webinars
Questions
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You can co-administer any other vaccine on the same day as the COVID-
19 vaccine.
There is no pediatric Pfizer product this year.
o
Individuals 11 years of age and younger need to receive Moderna,
which is from the same vial as adults (0.25ml for 6 months to 11 years
and 0.5ml for 12 years and older). 
When drawing up doses, a new needle tip should be used each time.
o
A needle tip should not be left in the stopper on an ongoing basis.
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Punctured vials must be wasted when doses are not withdrawn and
administered within the acceptable time
.
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The use of COVaxON is a requirement. All doses must be documented in
the system within 24 hours of vaccine administration and prior to your
Tuesday hand count survey.
Hand count surveys are mandatory, as all COVID-19 vaccine inventory
must be balanced and reported to the Ministry by the health unit. Vaccine
orders may be held if weekly surveys are not completed or reconciled.
Please reach out to 
COVIDVaccine.Informatics@mlhu.on.ca
 if you require
assistance or support.
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Stock is being replenished.
If your office placed an order and received a limited quantity, please
order again.
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50mg dose for infants under 5 kg
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100mg dose for infants and children > 5 kg who qualify
For more information on eligibility and dosing:
October 16, 2024,
 HCP eNewsletter
Ministry of Health 
Infant RSV Guidance for Health Care Providers –
Beyfortus
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High dose Influenza Vaccine - Individuals 65 years of Age and Older
This product is still available to order
.
MLHU thanks everyone for ordering and administering vaccines to help
protect our community.
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Between 2013 and 2022, there were 779 syphilis (all types)
infections reported among Middlesex-London residents.
Most of the syphilis cases were considered infectious syphilis
(76%, n=592).
The rate of syphilis (all types) and infectious syphilis both
increased six-fold during that time, from 6 to 33 reported
cases per 100,000 population for syphilis (all types) and from
4 to 23 per 100,000 for infectious syphilis.
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Given the rising syphilis rates and the challenge with case
detection, it is critical to maintain a high index of suspicion
across all demographics.
You are encouraged to screen for syphilis as part of routine
medical care for sexually active individuals.
The MLHU Syphilis web page includes all the resources for
testing and treatment.
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The number of cases of congenital syphilis has been rising sharply in
recent years.
A
 Public Health Ontario
 surveillance report states that “between 2013 and
2018, a total of six cases of early congenital syphilis were reported
provincially (i.e., an average of one case per year) however,
    
from 2019 to 2022 a total of 41 cases were reported.” 
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As healthcare providers, we need to continue to: 
Normalize 
sexual health conversations
 with patients
Screen for syphilis - 
o
In pregnancy, universal screening is recommended in the first
trimester or at the first prenatal visit 
o
Repeat screening at 28-32 weeks and again at delivery for pregnant
women at ongoing risk of infection or reinfection, and in areas
experiencing outbreaks 
o
Consider screening pregnant individuals more frequently who are at
ongoing risk of infection 
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All individuals who deliver a stillborn infant after 20 weeks of gestation. 
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Public Health Ontario shared the following information regarding an
observed increase in Mycoplasma (M.) pneumoniae.
M. pneumoniae tends to occur in late summer and early fall and there are
cyclical increases every 3 – 7 years.
Ontario is experiencing a marked increase in disease activity this year.
Total specimens tested, total positive specimens, and percent positivity
are all increased compared to the same period last year.
Activity has remained high since August. 
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Based on preliminary data from PHO:
 
Disease activity is highest in children and adolescents.
Activity is highest in those aged 10 – 19 years, then 5 – 9 years, followed
by 1 – 4 years.
This is notable because historically those under 4 years of age have very
low disease activity.
This information should be interpreted in the context of potential testing bias,
where some age groups may have been and continue to be tested at
different frequency than others
.
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he MLHU will not conduct case and contact management for cases of
Mycoplasma pneumoniae.
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M. pneumoniae testing is conducted by PHO and many community and
hospital laboratories in the province.  
Information on PHO testing here:  
Mycoplasma pneumoniae –
Respiratory PCR | Public Health Ontario
.
Laboratory testing protocols, including testing criteria and the type and
number of specimens, may differ between PHO laboratories and other
community or hospital laboratories. 
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:
HCPs should be aware of increasing M. pneumoniae activity in Ontario,
including infections in young and school aged children, and be familiar
with how to test for M. pneumoniae. 
HCPs could consider M. pneumoniae infection among patients with
community-acquired pneumonia who are not clinically improving on
antibiotics that are known to be ineffective against M. pneumoniae, such
as beta-lactams. 
Since PHO has identified molecular markers that are associated with
macrolide resistance in a subset of samples tested, consider using a
second-line antibiotic regimen to treat patients with suspected or
confirmed M. pneumoniae infection who aren't improving on macrolides. 
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.
Those who order vaccines from
MLHU will already be familiar
with this platform. 
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Step by Step Instructions on
how to get started are
included in both the
November 5
th
 and November
19
th
 eNewsletter.
PHOS provides the familiarity
of the previous resource
binder, while introducing new
features designed to increase
the ease of resource access
and ordering
.
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The next newsletter is scheduled
for December 3, 2024.
Join us on
 December 3, 2024, an
exclusive webinar on how to use
the Public Health Ordering
System for ordering resources
starts at 12:15 p.m. 
If you have a suggestion for an
email update, please share your
ideas with us!
We appreciate hearing from you.
You can contact us @
healthcareproviders@mlhu.on.ca
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Ask using chat function now, or after the
webinar at: 
healthcareproviders@mlhu.on.ca
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This summary provides an overview of a recent healthcare provider outreach webinar conducted on November 19, 2024. The webinar covered topics such as respiratory surveillance reports, vaccine updates including COVID-19 reminders, Beyfortus/Nirsevimab RSV product for infants, influenza vaccine updates, syphilis concerns, and more. Data was sourced from the Middlesex-London Health Unit's respiratory surveillance report as of November 19, 2024, with insights on COVID-19, influenza, and other respiratory viruses. The presentation was led by Dr. Joanne Kearon, Associate Medical Officer of Health at Middlesex-London Health Unit.

  • Healthcare
  • Webinar
  • Provider Outreach
  • Respiratory Surveillance
  • Vaccine Updates

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  1. Healthcare Provider Outreach Webinar November 19, 2024

  2. Welcome Presenter: Dr. Joanne Kearon Associate Medical Officer of Health Middlesex-London Health Unit November 19, 2024

  3. Outline Respiratory Surveillance Report Vaccine Updates o COVID-19 Reminders o Beyfortus / Nirsevimab RSV Product for Infants o Influenza Vaccine Syphilis o Congenital Syphilis Mycoplasma Pneumoniae - Increased Activity in Ontario Public Health Ordering System (PHOS) eNewsletter and Webinars Questions

  4. Respiratory Surveillance Report

  5. Data source: Middlesex-London Health Unit Middlesex-London Respiratory Surveillance Report, extracted 2024-11-19. Data current as of the end of day 2024- 11-19 . https://app.powerbi.com/view?r=eyJrIjoiODg3ZDIwOTctNzFmOS00MDczLWEwMDAtMDU1ZDk4OGZlMzgzIiwidCI6ImRjNTYxMjk1LTdjYTktNDFhOS04M2JmLTUw ODM0ZDZhOWQwZiJ9

  6. COVID-19 Data source: Middlesex-London Health Unit Middlesex-London Respiratory Surveillance Report, extracted 2024-11-19. Data current as of the end of day 2024 11-19. https://app.powerbi.com/view?r=eyJrIjoiODg3ZDIwOTctNzFmOS00MDczLWEwMDAtMDU1ZDk4OGZlMzgzIiwidCI6ImRjNTYxMjk1LTdjYTktNDFhOS04M2JmLTUwODM0ZDZhOWQwZiJ9

  7. Influenza Data source: Middlesex-London Health Unit Middlesex-London Respiratory Surveillance Report, extracted 2024-11-19. Data current as of the end of day 2024 11-19. https://app.powerbi.com/view?r=eyJrIjoiODg3ZDIwOTctNzFmOS00MDczLWEwMDAtMDU1ZDk4OGZlMzgzIiwidCI6ImRjNTYxMjk1LTdjYTktNDFhOS04M2JmLTUwODM0ZDZhOWQwZiJ9

  8. Other Respiratory Viruses Data source: Middlesex-London Health Unit Middlesex-London Respiratory Surveillance Report, extracted 2024-11-19. Data current as of the end of day 2024-11-19. https://app.powerbi.com/view?r=eyJrIjoiODg3ZDIwOTctNzFmOS00MDczLWEwMDAtMDU1ZDk4OGZlMzgzIiwidCI6ImRjNTYxMjk1LTdjYTktNDFhOS04M2JmLTUwODM0ZDZhOWQwZiJ9

  9. Vaccine Updates

  10. COVID-19 Vaccine Reminders You can co-administer any other vaccine on the same day as the COVID- 19 vaccine. There is no pediatric Pfizer product this year. o Individuals 11 years of age and younger need to receive Moderna, which is from the same vial as adults (0.25ml for 6 months to 11 years and 0.5ml for 12 years and older). When drawing up doses, a new needle tip should be used each time. o A needle tip should not be left in the stopper on an ongoing basis. o Punctured vials must be wasted when doses are not withdrawn and administered within the acceptable time.

  11. COVID-19 Vaccine Reminders The use of COVaxON is a requirement. All doses must be documented in the system within 24 hours of vaccine administration and prior to your Tuesday hand count survey. Hand count surveys are mandatory, as all COVID-19 vaccine inventory must be balanced and reported to the Ministry by the health unit. Vaccine orders may be held if weekly surveys are not completed or reconciled. Please reach out to COVIDVaccine.Informatics@mlhu.on.ca if you require assistance or support.

  12. Beyfortus / Nirsevimab RSV Product for Infants Stock is being replenished. If your office placed an order and received a limited quantity, please order again. o 50mg dose for infants under 5 kg o 100mg dose for infants and children > 5 kg who qualify For more information on eligibility and dosing: October 16, 2024, HCP eNewsletter Ministry of Health Infant RSV Guidance for Health Care Providers Beyfortus

  13. Influenza Vaccine High dose Influenza Vaccine - Individuals 65 years of Age and Older This product is still available to order. MLHU thanks everyone for ordering and administering vaccines to help protect our community.

  14. Syphilis

  15. Syphilis Between 2013 and 2022, there were 779 syphilis (all types) infections reported among Middlesex-London residents. Most of the syphilis cases were considered infectious syphilis (76%, n=592). The rate of syphilis (all types) and infectious syphilis both increased six-fold during that time, from 6 to 33 reported cases per 100,000 population for syphilis (all types) and from 4 to 23 per 100,000 for infectious syphilis.

  16. Syphilis Given the rising syphilis rates and the challenge with case detection, it is critical to maintain a high index of suspicion across all demographics. You are encouraged to screen for syphilis as part of routine medical care for sexually active individuals. The MLHU Syphilis web page includes all the resources for testing and treatment.

  17. Congenital Syphilis The number of cases of congenital syphilis has been rising sharply in recent years. A Public Health Ontario surveillance report states that between 2013 and 2018, a total of six cases of early congenital syphilis were reported provincially (i.e., an average of one case per year) however, from 2019 to 2022 a total of 41 cases were reported.

  18. Congenital Syphilis As healthcare providers, we need to continue to: Normalize sexual health conversations with patients Screen for syphilis - o In pregnancy, universal screening is recommended in the first trimester or at the first prenatal visit o Repeat screening at 28-32 weeks and again at delivery for pregnant women at ongoing risk of infection or reinfection, and in areas experiencing outbreaks o Consider screening pregnant individuals more frequently who are at ongoing risk of infection o All individuals who deliver a stillborn infant after 20 weeks of gestation.

  19. Mycoplasma Pneumoniae - Increased Activity in Ontario

  20. Mycoplasma Pneumoniae - Increased Activity in Ontario Public Health Ontario shared the following information regarding an observed increase in Mycoplasma (M.) pneumoniae. M. pneumoniae tends to occur in late summer and early fall and there are cyclical increases every 3 7 years. Ontario is experiencing a marked increase in disease activity this year. Total specimens tested, total positive specimens, and percent positivity are all increased compared to the same period last year. Activity has remained high since August.

  21. Mycoplasma Pneumoniae - Increased Activity Based on preliminary data from PHO: Disease activity is highest in children and adolescents. Activity is highest in those aged 10 19 years, then 5 9 years, followed by 1 4 years. This is notable because historically those under 4 years of age have very low disease activity. This information should be interpreted in the context of potential testing bias, where some age groups may have been and continue to be tested at different frequency than others.

  22. Mycoplasma Pneumoniae - Increased Activity Reminder: Mycoplasma pneumoniae is not a designated Disease of Public Health Significance and is not subject to mandatory reporting. The MLHU will not conduct case and contact management for cases of Mycoplasma pneumoniae.

  23. Mycoplasma Pneumoniae - Increased Activity Testing/Laboratory Information M. pneumoniae testing is conducted by PHO and many community and hospital laboratories in the province. Information on PHO testing here: Mycoplasma pneumoniae Respiratory PCR | Public Health Ontario. Laboratory testing protocols, including testing criteria and the type and number of specimens, may differ between PHO laboratories and other community or hospital laboratories.

  24. Mycoplasma Pneumoniae - Increased Activity Clinical Practice Considerations: HCPs should be aware of increasing M. pneumoniae activity in Ontario, including infections in young and school aged children, and be familiar with how to test for M. pneumoniae. HCPs could consider M. pneumoniae infection among patients with community-acquired pneumonia who are not clinically improving on antibiotics that are known to be ineffective against M. pneumoniae, such as beta-lactams. Since PHO has identified molecular markers that are associated with macrolide resistance in a subset of samples tested, consider using a second-line antibiotic regimen to treat patients with suspected or confirmed M. pneumoniae infection who aren't improving on macrolides.

  25. Public Health Ordering System (PHOS) for Resources

  26. Public Health Ordering System (PHOS) for Resources The MLHU Resource Binder is now online Sign up today! PHOS is a one-stop online platform for Healthcare Providers in Middlesex County and the City of London to access and order publicly funded vaccines, and now, public health resources. Those who order vaccines from MLHU will already be familiar with this platform.

  27. Public Health Ordering System (PHOS) for Resources Step by Step Instructions on how to get started are included in both the November 5th and November 19th eNewsletter. PHOS provides the familiarity of the previous resource binder, while introducing new features designed to increase the ease of resource access and ordering.

  28. eNewsletters and Webinars

  29. eNewsletters and Webinars The next newsletter is scheduled for December 3, 2024. Join us on December 3, 2024, an exclusive webinar on how to use the Public Health Ordering System for ordering resources starts at 12:15 p.m. If you have a suggestion for an email update, please share your ideas with us! We appreciate hearing from you. You can contact us @ healthcareproviders@mlhu.on.ca

  30. Thank you for joining us! Questions? Ask using chat function now, or after the webinar at: healthcareproviders@mlhu.on.ca For urgent matters please call the Health Unit s main line at 519-663-5317 For more information www.healthunit.com/healthcare-providers

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