Hastings Prince Edward Public Health
Online Bulletin for Health Care Providers

February 17, 2023

From:
Dr. Ethan Toumishey
Medical Officer of Health and CEO
Hastings Prince Edward Public Health

In this Issue:

1. Measles Preparedness
2. Mpox
3. Tuberculosis Updates  
4. COVID-19 Updates

News & Updates

Measles preparedness

On Feb. 8, 2023, the Pan American Health Association issued a statement concerning the potential increase in measles cases worldwide, including Canada. This concern is due to decreased vaccine coverage during the COVID-19 pandemic and an anticipated increase in travel during student’s school breaks.

Dr. Keiran Moore, CMOH is requesting all health system partners be on alert and be prepared for suspected measles cases and to support their patients to ensure they have up-to-date routine immunizations, especially if they have travel planned.

For additional information on Measles vaccine, diagnosis, testing, reporting requirements and infection prevention and control precautions:

• CMOH Measles Memo Feb 14, 2023
• Public Health Ontario - Measles

Monkeypox Updates (MPOX)

Toronto Public Health has reported a recent increase in MPOX cases, with four cases reported in a single week in early February. Hastings Prince Edward Public Health has completed contact management for MPOX, but have had no lab confirmed cases in our area.

Public Health is requesting health care partners remind eligible patients to receive a full two-dose vaccine series for protection against MPOX infection. Many eligible persons have received only one dose of the two-dose series.

Individuals residing in HPEPH who are being investigated as a case or contact of MPOX will be contacted by the Infectious and Communicable Diseases team. Otherwise, MPOX vaccines are available for eligible persons through Public Health in Kingston and Toronto.

For additional information:

• UPDATED: The Ontario Ministry of Health’s Recommendations for the management of cases and contacts of MPOX in Ontario February 2023

Tuberculosis Updates

Screening in Long Term Care (LTC) and Retirement Homes (RH)

Hastings Prince Edward Public Health has recently changed their recommendations for tuberculosis screening in LTC and RH to align with updates in the Canadian Tuberculosis (TB) Standards, 8^th edition.

Current recommendations for TB screening of residents entering LTC/RH include:

• History and physical exam by physician or nurse practitioner within 90 days prior to admission or 14 days following admission. This assessment should include a symptom review for respiratory TB.
• If symptoms suggest possible active TB disease, the resident should not be admitted and should complete:
  • A posteroanterior and lateral chest X-ray
  • Three sputum samples taken at least one hour apart submitted to Public Health Laboratory for testing (Acid Fast Bacilli and Culture) and receive negative results. Note: It can take up to 8 weeks for final culture report.
• Routine and mandatory chest X-ray is no longer required. CXR is dependant on symptoms as per above.

Additional Tuberculosis information, including detailed screening recommendations for LTC/RH residents and staff can be found online at Hastings Prince Edward Public Health.

REMINDER: Under the Health Protection and Promotion Act, diagnoses of Tuberculosis (TB) infection and/or disease must be reported to Public Health. This includes:

• All patients with clinical, suspected and lab confirmed cases of TB disease (pulmonary and extra-pulmonary) – these cases must be reported immediately by phone to Public Health.
• All patients with suspected latent TB infection (LTBI), indicated by a positive tuberculin skin test (TST) or positive TB Quantiferon Gold/IGRA blood test, regardless of plans for prophylaxis. (Refer to the Canadian Tuberculosis Standards, 8th edition for guidelines on reading a TST and follow-up of a positive skin test).
  • Please fax Positive TST Report Form to Infectious and Communicable Diseases Program who are able to facilitate referral to our TB clinic for assessment with a respirologist.

COVID-19 Updates

• UPDATED: Ministry of Health’s COVID-19 Guidance LTC Homes, Retirement Homes & Other Congregate Living Settings Jan 2023
  • Includes revised outbreak definition and when to declare outbreak over and revised language on conducting risk assessments for close contacts
• UPDATED: Ministry of Health’s COVID-19 Guidance: Acute Care Jan 2023

Back to Summary

Contact Information: 

To report communicable diseases:613-966-5500 x349

To report AEFI or DOPHS: Online / Fax: 613-966-1813 or CDCFAX1@hpeph.ca

Hastings Prince Edward Public Health is situated and provides services on the traditional territory of the Anishinaabe, Huron-Wendat and Haudenosaunee people.

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