Hastings Prince Edward Public Health
Online Bulletin for Health Care Providers

October 28, 2020

From:
Dr. Piotr Oglaza
Medical Officer of Health
Hastings Prince Edward Public Health

In this Issue:

1. Gonorrhea outbreak continues in HPEC
2. Flu vaccinations during the pandemic
3. Influenza vaccine orders

Gonorrhea outbreak continues in HPEC, other STIs are on the rise 

Hastings Prince Edward Public Health (HPEPH) has continued to respond to cases and contacts of sexually transmitted infections throughout the COVID-19 pandemic. In June 2020, HPEPH declared a local outbreak of gonorrhea (GC). A steady increase in the number of cases and a higher rate of cases compared to same time last year was evident. Local GC cases continue to be above the expected number from January to September 2020:

• 48 lab confirmed cases
• 60% male – 40% female
• 31% of cases between 30-39
• 27% of cases between 15-24

Although HIV and syphilis cases remain relatively low in our area, we have seen a recent increase of newly reported HIV and syphilis cases locally. HPEPH is working closely with newly diagnosed individuals to ensure they receive appropriate follow-up including education and treatment and to ensure contact notification is completed.

In response to the GC outbreak and the recent rise in HIV and syphilis cases, HPEPH is encouraging health care providers to:

• Lower your threshold for suspicion of STIs in ALL sexually active individuals, regardless of age, sex and relationship status
• Complete full risk assessments for your patients when considering STI testing as recent increases in local cases of syphilis and HIV are being noticed
• In GC symptomatic persons, test using BOTH culture and NAAT methods
• Consider GC testing rectal and pharyngeal sites, especially for men who have sex with men (MSM), sex workers and their sexual contacts
• Treat GC with first-line dual therapy due to compelling evidence of efficacy and current antimicrobial susceptibility patterns in Ontario:
  • Ceftriaxone 250 mg IM with Azithromycin 1 gm po given at the same visit
• Ensure test of cure by culture (preferred) for all GC positive patients who are pregnant, treated with second line or alternative therapy or if there are concerns about compliance with treatment, potential re-exposure or concern about antimicrobial resistance
• Order publicly funded STI medications, including first line GC treatment, from Public Health using the HPEPH Vaccine/STI form available online at hpePublicHealth.ca
• Refer to HPEPH Sexual Health webpage for current and evidence-based resources, reporting forms and sexual health resources

Please note HPEPH has reduced in-person services to respond to the COVID-19 pandemic. We have recently discontinued universal self serve urine testing kits for individuals with a health care provider or who can access a local walk-in clinic. HPEPH currently focuses on continuing essential services to meet the needs of select priority populations and controlling communicable and reportable diseases.

At this time, HPEPH Sexual Health Program will continue:

• responding to sexual health inquiries
• offering sexual health services on site at local high schools
• managing local outbreaks and individual cases and contacts of reportable sexually transmitted infections
• offering birth control renewals to our current clients
• dispensing low cost (or no cost) birth control to those in need
• working with high risk clients to ensure best health outcomes

We appreciate the assistance of our local health care providers during this time to ensure the sexual health needs of our communities continue to be met. For more information please visit hpePublicHealth.ca or call the Sexual Health Program at 613-966-5500 x 243.

Flu vaccinations during the pandemic

Health care providers are encouraged to immunize their own patient roster for influenza this year. HPEPH has a limited supply of vaccine available and vaccination clinics offered through HPEPH are intended for individuals without a primary health care provider, as well as those under 5 years of age. If you would like guidance to run immunization clinics safely during the pandemic, please contact HPEPH for guidance and support.

As we are all reliant on the provincial distribution protocol to ensure we have adequate vaccine to meet community needs, we are encouraging health care providers, long term care homes, retirement homes, and hospitals to be mindful of the number of doses of influenza vaccine they are ordering from HPEPH. We are working diligently to distribute vaccine appropriately over the influenza season. Over ordering may lead to longer wait times for stock replenishment, and ultimately wastage if not used.

Flu Vaccination Roles and Responsibilities

As we all work together to provide the flu vaccine to our community, please review the following chart of roles and responsibilities (adapted from Toronto Public Health).

Influenza vaccine orders

Please continue to submit your Influenza Vaccine Orders to HPEPH. A link to the order form is available at Ministry of Health website or go to www.forms.ssb.gov.on.ca and search for flu vaccine order form. All orders must be faxed to 613-966-1813, along with four weeks of fridge temperature logs. HCP flu orders are received and processed by HPEPH’s Vaccine Inventory team as quickly as possible. Please note flu vaccine orders will be filled based on current inventory levels and you will not necessarily receive all the doses you have requested. Please be cautious of over ordering to decrease potential wastage. Please note pharmacies get their flu vaccines from Ministry-contracted distributors (not HPEPH).

Services at HPEPH

HPEPH is currently offering services by appointment only. We remain dedicated to protecting our community by providing local HCPs and community members with new information as it becomes available. Current information on COVID-19 specifically for health care providers can be found at hpePublicHealth.ca, Ontario Ministry of Health and at publichealthontario.ca.

Back to Summary

Contact Information: 

To give us your comments: etubbs@hpeph.ca

To report communicable diseases:613-966-5500 x349

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

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