Healthcare Providers | Hastings Prince Edward Public Health

Healthcare Providers

Alcohol

Brief interventions have become increasingly recommended in the management of individuals with alcohol-related problems, because they are low-cost and have been proven to be effective for addressing harmful drinking. Research has shown that many screened patients cut down on their drinking simply because they were asked about their alcohol use—and effective screening for problem drinking can be completed in as little as five minutes.

In Hastings & Prince Edward Counties, 21% of adults over the age of 18 years reported hazardous or harmful drinking and 31% reported binge drinking (five or more drinks on any occasion per month). This is a concern considering excessive alcohol consumption significantly increases the risks of chronic disease, certain cancers, injury, violence, or death. Canada’s Low-Risk Alcohol Drinking Guidelines indicate that men should not exceed three standard alcoholic drinks most days and 15 drinks per week.  For women, the recommendation is no more than two standard alcoholic drinks most days and 10 drinks per week.

Resources for Physicians and Health Care Professionals

The following are resources and tools available for health care professionals in the primary care setting:

Patient Resources

To support your brief intervention, the following patient resources are also available:

  • The Check Your Drinking Survey can be used by your patients to conduct a self-assessment. They can then print or e-mail the results to you for follow-up at their next appointment.

Canada’s Low-Risk Alcohol Drinking Guidelines Brochure is available to download and print.

Child Health

Hastings Prince Edward Public Health Programs and Services

Hastings Prince Edward Public Health has a number of programs and services that can support the families you work with.

Child Health CARELine
Public Health Nurses from our Child and Reproductive Health Program are available to speak with clients by phone to answer their questions about infant feeding, parenting, growth and development, and more. Our nurses can also connect clients with other programs and services to help support them as a parent.

The CARELine is also available for professionals seeking information or wishing to make referrals to our programs and services.
Call 613-966-5500 or 1-800-267-2803, ext. 223

Infant Feeding Programs and Services

For information on our Breastfeeding Consultations, Baby Feeding Drop-Ins and Infant Feeding Classes, visit our Infant Feeding page.

Healthy Babies Healthy Children
Ontario's Healthy Babies Healthy Children (HBHC) program provides home visits by a public health nurse to families with children up to six years of age that may benefit from additional prenatal, postpartum or parenting support. HBHC is a free, confidential and voluntary service for families that qualify for the program.

The following are possible indicators for a referral to HBHC:

  • prenatal health conditions or medical complications during pregnancy
  • prenatal smoking, alcohol or drug use
  • preterm or multiple birth
  • mother is less than 18 years of age
  • mother has not completed high school
  • parental history of depression, anxiety or mental illness
  • single parent, relationship stressors or lack of support
  • parenting concerns
  • concerns regarding the child’s health or growth and development
  • financial stressors
  • family does not have a primary care provider
  • family is new to Canada
  • family has involvement with the Children’s Aid Society (CAS)

Making a Referral

Referrals can be made with the family’s consent by calling the Child Health CARE Line at 613-966-5500, ext. 223 or by completing the HBHC screening tool and faxing it to 613-966-4363.

Ontario’s Enhanced 18-Month Well-Baby Visit

Eighteen months is a pivotal age in a child’s growth and may be the last regular check-up before a child starts school. This is a crucial opportunity to determine whether a child is meeting important developmental milestones using standardized tools such as the Rourke Baby Record and the Nipissing District Developmental Screen.

The enhanced visit allows health professionals to engage in a broader discussion with parents on topics that include their child’s speech and language, growth and development as well as feeding and behavioural issues. The visit is an opportunity to monitor growth and development for early identification of risk, and for referral to necessary early intervention and treatment.

Electronic Nipissing District Developmental Screen

It is important for parents to learn about their child’s development and use activities to promote healthy growth and development. eNDDS™ is a developmental checklist that follows a child from one month of age to six years. It provides a snapshot in time of a child's development, and a starting point for discussion with a health/child care professional.

Encourage your clients to sign up for the eNDDS. It's quick, easy and it's free.

Nutri-eSTEP Screening Tool

The Nutri-eSTEP Screening Tool is a useful nutrition screening tool to assess a child’s eating habits and identify nutrition problems. Encourage your clients to visit www.nutritionscreen.ca for screening tools and helpful information for toddlers and preschoolers.

Resources

Drug Use and Opioids

Rates of opioid prescribing and use are on the rise. Ontario has the highest rate of narcotic use in Canada and over 300 people dies every year from opioid overdose. Opioid overdose deaths now equal the number of people killed in motor vehicle collisions.

Physician Resources for Opioid Management

Education and Resources


Self-Management Programs

Belleville and Quinte West Community Health Centre - Living well with a chronic condition. This is a 6 week self-management  workshop that helps people living with a chronic condition to better manage sysmptomsfor an improved quality of life.

Dr. Adam Stewart

Dr. Melissa Holowaty


Pain Clinics

  • Kingston Orthopaedic Pain Institute (KOPI) promoted wellness and optimizes functional abilities of individual with muscoloskeletal disorders by providing timely, comprehensive, and multidisciplinary evaluation and treatment. Patients must be referred by a physician. Please call 613-507-7246 or visit http://www.kopi.ca/


Harm Reduction Services

Methadone Maintenance therapy is available at:

  • OATC - Belleville: 257 Front Street 613-969-7862
  • OATC Bancroft : 89 Hastings Street N 613-332-0660
  • Change Health Care - Picton 266 Main Street 613-476-3636
  • Sunrise - Belleville 450 Dundas Street East 613-771-0004


Lifesaver Program

The Lifesaver Program is a new component of our ongoing harm reduction efforts at HPEPH. 

Naloxone is a medication that temporarily reverses the potentially fatal effects caused by an overdose, but only works on opioids. Some examples of opioids are morphine, hydromorph, percocet, and heroin. Those eligible for the kits are individuals who are presently taking opioids or have taken them in the past. We are also able to dispense to family and friends of those individuals.

Naloxone Kits and training are available at all health unit offices and paticipating pharmacies throughout the area. At the Health Unit, nurses are available for training clients at the following times and locations.

  • 179 North Park Street Belleville, Monday 8:30am-12:00pm and Thursday 9:00am-12:00pm, 1:00pm-4:00pm
  • 499 Dundas Stret Trenton, Tuesday 9:00am-12:00pm, 1:00pm-3:30pm and the 1st and 3rd Wednesday monthly 9:00am-12:00pm, 1:00pm-4:00pm

Environmental Health

It is important to be aware of the latest Environmental Health information, both for yourself and your patients.
 
Click here for information about Rabies.
 
Click here for information about Vector-Borne Diseases, including Lyme Disease and West Nile Virus.

Health Updates

Hastings Prince Edward Public Health provides regular, time-sensitive public health updates to community health care providers. Listed below are the most recent public health updates:

Mumps (March 2017)

Mumps virus continues to circulate in Ontario in individuals 14-38 years of age.  As of March 8th, 42 cases of mumps (40 confirmed, 2 probable) have been reported in Ontario. Cases have been reported in 13 different public health units.  No cases have been reported in HPEPH at this point, however, cases have been reported in neighbouring health units.  Click here for Dr. Kieran Moore's memo and here to see diagnostic testing recommendations.

Seoul Virus (March 2017)

The Ministry of Health and Long-Term Care, in collaboration with public and animal health partners at a variety of government levels, are investigating three human cases of Seoul virus infection in Ontario. All three individuals had prolonged contact with rats. No serious health outcomes have been reported for the cases.  Click here to see the CMOH memo.

Influenza (November 2016)

Hastings Prince Edward Public Health reports their first two lab confirmed influenza cases.  Click here to see the memo.

PHO has recently released two influenza fact sheets for health care providers:

Information on 2016-2017 recommendations for influenza vaccines for children and adolescents
Antiviral medications for influenza: Information for health care providers

These fact sheets will help to support health care providers to support decision-making and answer patient questions about influenza vaccination and treatment.

Pertussis Advisory - North Hastings (May 2016)

5 confirmed cases of pertissus have been identified in Bancroft.  Click here to see the advisory to Health care providers.

FOOD RECALL WARNING (April 22nd)

New post-exposure prophylaxis guidelines associated with this food recall have been issued to reflect the newly released recommendations from National Advisory Committee on Immunization (NACI).

Please click here for a revised Hep A Post-Exposure Prophylaxis for Management of of Hepatitis A Outbreak Associated with Recalled Costco Frozen Berries.

FOOD RECALL WARNING (April 2016)

An investigation has led to a recall of Nature’s Touch Organic Berry Cherry Blend of frozen berries sold at Costco, due to concerns of Hepatitis A.

Hastings Prince Edward Public Health will be offering publicly funded Hepatitis A vaccination to those who consumed the recalled product within the last 14 days. Costco is currently contacting customers who purchased the recalled product.

To book an appointment to receive the Hepatitis A vaccine, please call Hastings Prince Edward Public Health at (613) 966-5500 ext. 313.

To view the Statement from Chief Medical Officer of Health on Hepatitis A, click here.

FAST FACTS:  2015 Reportable Diseases in Hastings & Prince Edward Counties (March 2016)

To see 2015 case counts of reportable diseases in Hastings & Prince Edward Counties, along with a 5-year average, click here.

Zika Virus Update - March 2016

Public Health Ontario has updated their testing protocols. PCR testing for Zika virus and serological testing for viral antibodies are available via the Public Health Ontario Laboratory (PHOL) and the National Microbiology Laboratory. Patients with symptom onset while in endemic areas or within 2 weeks of departure from an endemic area may be considered for testing. Asymptomatic pregnant women with potential Zika virus exposure during their pregnancy may be tested using serology. Testing is not indicated in non-pregnant patients after recovery from a self-limiting illness. PHOL specimen requirements can be found here.

Public Health Agency of Canada recommends that all pregnant women and those who are considering attempting to get pregnant discuss their travel plans with their health care provider and consider postponing travel to areas in the Americas affected by the ZIKA outbreak.

The risk to Ontarians remains low as mosquitoes known to transmit the virus are not established in Canada.

To access Hastings Prince Edward Public Health (HPEPH) fact sheet, click here.

Syrian Refugees Update - March 2016

CFB Trenton is no longer a designated Interim Lodging site for Syrian Refugees. We will continue to see privately sponsored refugees arriving over the next year. It is recommended that all children and adults lacking written documentation of immunization should be started on a primary immunization schedule as appropriate for their age. Refer to the Publicly Funded Immunization Schedule for Ontario – “Catch-up Schedule”. Additional copies of the Publicly Funded Immunization Schedule are available when picking up vaccine and can be found here.

The Ministry of Health and Long-Term Care (MOHLTC) has developed the temporary, multi-lingual, Refugee HealthLine (1-866-286-4770 (toll-free) to connect refugees to health care providers for transitional health care and services. Providers who have come forward to provide care to refugees should be encouraged to contact the Refugee HealthLine as soon as possible to register their availability.

The MOHTLC has also developed a support tool for primary care providers to be used in their early assessments and care of Syrian refugees (vaccination information and routine testing information can be found within this document).

Food Recall Warning - Dole Fresh Vegetables (January 2016)

The Canadian Food Inspection Agency (CFIA) issued a warning that Dole Fresh Vegetables Inc. is recalling various pre-packaged chopped salads, salad blends and kits, and leafy green products from the marketplace due to possible Listeria monocytogenes contamination.

This recall applies to all products manufactured from the Dole facility located in Springfield, OH. Affected product can be identified with a product code beginning with the letter "A" in the upper right-hand corner of the package.  A complete listing of products is available here.  We are asking all facilities with food services to check for recalled products.  Recalled products should be thrown out or returned to the store where they were purchased.

Food contaminated with Listeria monocytogenes may not look or smell spoiled but can still cause illness. Listeria typically incubates from 2 to 3 weeks, however cases have occurred up to 70 days after a single exposure to a contaminated product.  Symptoms can include vomiting, nausea, persistent fever, muscle aches, severe headache and neck stiffness. Pregnant women, the elderly and people with weakened immune systems are particularly at risk. Although infected pregnant women may experience only mild, flu-like symptoms, the infection can lead to premature delivery, infection of the newborn or even stillbirth. In severe cases of illness, people may die.

Testing Specimen Collection for Foodborne Illness

Individuals who have eaten suspect food only require laboratory testing if they have symptoms of meningitis and invasive disease.  Specimens for Listeria monocytogenes should not be collected on asymptomatic patients.                                                                                                                                                                                

If the patient has invasive disease symptoms such as fever or meningitis:  

Specimens to be submitted to a local diagnostic laboratory:

  • Blood cultures
    • Two sets of blood cultures should be taken from different sites. A third set of blood cultures should be drawn if and only if endocarditis is suspected. Collect another set of blood cultures after 48hrs if the previous cultures are negative and there is ongoing concern of invasive infection with Listeria monocytogenes.
  • Cerebrospinal fluid (CSF)
  • Sterile site fluids and tissues such as joint fluid, cord blood and placental tissue

Specimens to be sent to the Public Health Laboratories (PHL):

  • All Listeria monocytogenes isolates from diagnostic laboratories
  • Stool specimens for culture of Listeria monocytogenes
    • Acceptance of stools specimens for culture for Listeria monocytogenes testing requires the presence of all three of the following criteria:  

1) symptomatic;

2) high risk - including immunocompromised, pregnant, neonate;

3) with ingestion of implicated food.

Stool cultures will not be accepted without the prior approval of a PHL Medical Microbiologist (please contact 416‐526‐5441). If approved, these samples will be forwarded to the Listeriosis Reference Service, Bureau of Microbial Hazards, Health Canada in Ottawa.

  • Food samples
    • Must be forwarded through public health units. Acceptable foods are those that have been ingested and are suspected of containing Listeria monocytogenes.  

For further testing information:

• Contact the PHL Customer Service Centre at 416‐235‐6556 or toll free at 1‐877‐ 604‐4567, or via email at customerservicecentre@oahpp.ca  

• For the PHL Specimen Collection Guide and previous Labstracts, click here.

 For further information on Listeria contact Hastings Prince Edward Public Health, Communicable Disease Program at 613-966-5500 x349.

Travel Health Notice - Zika Virus (January 2016)

In 2015, Zika virus was reported for the first time in a number of countries in Central and South America, as well as in Mexico. Past outbreaks of Zika virus infection have been reported in Africa, Asia and the Oceanic Pacific region.  There have been travel-related cases of Zika virus reported in Canada in returned travellers from countries where the virus is known to circulate.  There have been no reported cases of locally acquired Zika virus in Canada.

For the latest updates on countries affected by Zika virus, please visit the  World Health Organization’s website. For the latest map of confirmed cases in the Americas visit the Pan American Health Organization’s website.

Zika virus infection is caused by a virus which is spread by the bite of an infected mosquito. Symptoms can include fever, headache, conjunctivitis (pink eye) and rash, along with joint and muscle pain. The illness is typically mild and lasts only a few days.

In Brazil, there has recently been a significant increase in number of babies born with birth defects (congenital malformations), such as infants born with an abnormally small head and microcephaly (an underdeveloped brain). The Ministry of Health of Brazil recently identified a possible relationship between Zika virus infection and the increase in the number of microcephaly cases. An investigation to better understand the relationship between Zika virus infection and increased risk for microcephaly is ongoing.

It is recommended that pregnant women and those considering becoming pregnant discuss their travel plans with their health care provider to assess their risk and consider postponing travel to areas where the Zika virus is circulating in the Americas.  If travel cannot be postponed then strict mosquito bite prevention measures should be followed to protect themselves against bites.

The Public Health Agency of Canada recommends that all travellers protect themselves from mosquito bites when travelling to areas where Zika virus is circulating. There is no vaccine or medication that protects against Zika virus infection.

Please visit Public Health Ontario's website for more information.

Surveillance of Enterovirus 68 (EV-D68) (September 2015)

In early fall 2014, there was an increase of EV-D68 infections in North America, with some patients presenting with severe respiratory symptoms. Rare cases of acute flaccid paralysis (AFP) were also reported that were likely related to EV-D68 infection. In Ontario, the total number of respiratory specimens tested for EV-D68 at Public Health Ontario (PHO) in 2014 was 1,121, and of these, 100 (8.9%) tested positive for the virus. Of cases where AFP was documented and entered into the integrated Public Health Information System (iPHIS), two were confirmed positive for EV-D68, both in children less than 15 years of age.

As you are aware, EV-D68 is not a reportable disease in Ontario. In 2014, to ensure that any potential cases of AFP associated with EV-D68 were captured, the Ministry of Health and Long-Term Care (the ministry) temporarily removed the upper age limit of 15 years on the case definition for AFP. The age limit for reporting of AFP was subsequently returned to less than 15 years of age in April 2015.

As the 2015-2016 respiratory season approaches, we want to share with you some proactive planning that has been done to monitor transmission and potential severity of infection associated with EV-D68, in any age group, should the virus circulate this season:

  • PHO has established linkages with a key hospitals, such as the Hamilton Regional Laboratory and has requested to be notified when EV-D68 is diagnosed;
  • PHO Laboratories started testing for EV-D68 on August 3, 2015. Health care providers (HCPs) ordering enterovirus/EV-D68 testing are required to complete a Clinical Summary Form and a General Test Requisition Form;
  • PHO has also updated their EV-D68 webpage with general information on the virus and how to contact the laboratories when submitting specimens for EV-D68 testing.

For more information, please contact the Communicable Disease Intake line at 613-966-5500, ext. 349.

First Confirmed Case of MERS-CoV in Thailand (June 2015)

The first case of MERS-CoV was reported in Thailand in a 75-year old man who travelled from Oman to Thailand to seek medical care.

Globally, there has been 1,333 laboratory confirmed cases of MERS-CoV, including at least 471 associated deaths since 2012.  At least 217 of these confirmed cases have been Health Care Workers.

As of June 9th, 2015, the International Health Regulation (IHR) WHO Emergency Committee have concluded that the conditions for a Public Health Emergency of International Concern (PHEIC) have not been met.  Based on the current information available, there is no public health justification for implementing any measures to prevent the spread of this disease by restricting travel or trade.

Increased vigilance and heightened awareness should take place in the event of severe acute respiratory illness in a person with links to affected areas in the two weeks prior to symptom onset.  In the event of a SUSPECT or CONFIRMED case of MERS-CoV, Health Care Practitioners should notify the Communicable Disease Team at the Public Health Unit by calling 613-966-5500 ext. 349.

The Public Health Agency of Canada has posted guidance documents that can be found here.

An Update from Public Health's Secual Health Clinic: Gonorrhea...A growing Concern (June 2015)

The number of cases of gonorrhea among residents of Hastings & Prince Edward Counties is on the rise.  In order to support local health care providers to effectively identify and manage cases and contact of gonorrhea, please refer to our Quick Guides. Health care providers can now order a supply of publicly-funded STI medications through the recently update Vaccine/STI Medication Order Form.

New Ebola Directive Released and Changes Made to CMOH Directive for Paramedic Services (December, 2014)

The Ministry of Health and Long - Term Care released Directive #3: Precautions and Procedures for Primary care Settings.

The Ministry of Health and Long - Term Care also released a revised version of Directive #2: Paramedic Services Land and Air Ambulances and First Responder Practices and Procedures.

First Influenza Cases Reported for 2014/2015 Season (December, 2014)

This year’s first two local cases of Influenza (“flu”) were confirmed in December, both involving unimmunized residents of the Bancroft area. These individuals were seen and released from the hospital Emergency Department. Click here for our influenza fact sheet.

Influenza Surveillance

The predominant influenza virus circulating to date in Ontario is the influenza A/H3N2. This strain is associated with moderate to severe disease, higher morbidity and mortality, as well as increased numbers of institutional outbreaks. Early data is suggesting the 2014/2015 influenza vaccine may be mismatched to this predominant circulating strain.

Recommendations for Health Care Providers

  1. Continue to offer the influenza vaccine. Despite the potential vaccine mismatch, it is still important to offer immunization as it may provide cross protection that can lead to milder illness and fewer influenza related complications. The current vaccine will provide protection against the two non-drifted influenza strains.
  2. Prepare for an increased demand for health care services and outbreaks.
  3. Offer early antiviral treatment to recommended recipients presenting with influenza symptoms, regardless of immunization status as per the AMMI Canada Treatment Guidelines. (link to Guidelines - http://www.ammi.ca/guidelines)

Antivirals are recommended for:

  • Those with influenza-like illness severe enough to require hospitalization; and
  • Individuals with influenza-like illness at higher risk of complications from influenza infection as follows:
    - children aged 1 to 5 years;
    - adults 65 years of age and older;
    - persons with chronic pulmonary (including asthma), cardiovascular (except hypertension      alone), renal, hepatic, hematological (including sickle cell disease), or metabolic disorders (including diabetes mellitus), or neurologic and neurodevelopment conditions;
    - persons with immunosuppression, including that caused by medications or by HIV infection;
    - women who are pregnant or postpartum (within 4 weeks after delivery);
    - aboriginal people;
    - persons aged younger than 18 years of age who are receiving long-term aspirin therapy; and
    - persons who are morbidly obese (e.g., body-mass index is equal to or greater than 40).

Be aware of current antiviral recommendations for staff of long-term homes, retirement homes, and hospitals. In light of the potential vaccine mismatch, it is currently recommended that during outbreaks of Influenza A, antivirals be offered to all staff, regardless of immunization status, until the outbreak is declared over.

It is important to be prepared ahead of time for the rapid provision of antivirals to all residents and all staff in the event of an Influenza A outbreak.

The Ministry of Health and Long-Term Care will reimburse long-term care homes and retirement homes for the cost of antiviral drugs for vaccinated staff providing the following conditions have been met:

- Hastings Prince Edward Public Health has confirmed an Influenza A outbreak;
- The number of staff requiring the antiviral for prophylaxis has been determined by Public Health;
- The staff member recommended to receive the antiviral does not have health insurance to cover the expense; and
- The process for reimbursement at this time is through the High Intensity Needs Fund.

Healthy Eating

Hastings Prince Edward Public Health recommends the use of Canada’s Food Guide as a guide for healthy eating for everyone 2 years of age and older. The Food Guide provides information on the amount and type of food people need to eat on a daily basis.

In the Workplace

Creating a Healthy Workplace Nutrition Environment

Healthy Nutrition Environment (video)

Nutrition Directory

The Nutrition Directory is a comprehensive source of reliable and credible nutrition programs and services available to residents of Hastings and Prince Edward counties. A listing of services provided by local registered dietitians is available, as well as information on other agencies/professionals dealing with nutrition-related medical concerns, such as, diabetes and eating disorders.

EatRight Ontario

Registered dietitians at EatRight Ontario provide feature articles on food and nutrition, meal planning advice, healthy eating tips, and recipes. You can also ask nutrition-related questions and receive feedback by phone or email from a registered dietitian. Nutrition tools and links offer many additional resources to support individuals to develop healthy eating habits.

To speak with a registered dietitian call toll-free at 1-877-510-5102.

Healthy Life Line

Residents of Hastings and Prince Edward Counties with questions about physical activity or local healthy eating programs and services can call Hastings Prince Edward Public Health’s Healthy Life Line. Registered dietitians and physical activity professionals will respond to questions.

Call (613) 966-5500 or 1-800-267-2803, ext. 610.

TTY: Dial 711 + (613) 966-5500 + GA (Monday to Friday from 8:30 a.m. to 4:30 p.m.)

Related Links:

Dietitians of Canada

EatRight Ontario

Health Canada – Food and Nutrition

Healthy Weights

Using Common Messages to Support Healthy Eating and Active Living

The emphasis on obesity in health care today often leads to a strong focus on body weight. While excess weight is a risk factor for some chronic diseases, it is important to remember that weight is only one indicator of health. Other factors, including genetics, age, activity levels, and eating habits, affect health risk as well. In fact, people who are overweight can improve their health status and reduce their risk of chronic diseases by engaging in healthier behaviours, independent of weight loss.

It is important for children and adults to learn that their personal worth is not related to their body size. Words and actions intended to target obesity can sometimes cause unintended harm, resulting in lowered self-esteem and negative body image. People who feel good about themselves and their bodies are more likely to adopt lifestyle behaviours that lead to improved health. Therefore, we encourage health professionals and the community to suspend any negative biases or judgments associated with weight and to focus on promoting healthy lifestyle behaviours instead.

Healthy Bodies: Eat Well, Be Active, and Feel Good About Yourself is a document created for health professionals that contains consistent, evidence-based key messages for the public on the issues of weight, healthy eating, physical activity, body image, and self-esteem.  Each key message is accompanied by background evidence and rationale. Several case study scenarios are also included which demonstrate how the key messages can be incorporated into practice.

For more information, call our Healthy Life Line at (613) 966-5500 or 1-800-267-2803, ext. 610.

TTY: Dial 711 + (613) 966-5500 (Monday to Friday from 8:30 a.m. to 4:30 p.m.)

Immunization

Updates on Specific Vaccines:

Pneumococcal Vaccine:

Effective September 2016, Ontario will offer publicly funded HPV vaccine to men who have sex with men (MSM). Eligible individuals include people who are 26 years of age or younger who identify as gay, bisexual, as well as other MSM including some trans people. A fact sheet is available with information for Patients from the MOHLTC

Zostavax: Herpes zoster vaccine (Zostavax®II) is now publicily funded for individuals aged 65 to 70 years (i.e., from the 65th birthday to the day prior to the 71st birthday). Catch-up Program: Until December 31, 2016, individuals born in 1945 (i.e. those who have turned or will be turning 71 years of age in 2016), will be eligible for publicily funded herpes zoster vaccine through a one-time catch-up program. For more information see HCP Q&A or Shingles Vaccine (Zostavax®II) Information for Patients

HUMAN PAPILLOMAVIRUS (HPV) VACCINE GARDASIL ® - Starting September 2016, All grade 7 students (male & female) will be able to receive Gardasil free of charge. Under the expanded school based program, Gardasil will be offered to all grade 7 students along with their Hepatitis B and Meningococcal (Men C-ACYW135) vaccinations. Females entering Grade 8 in the 2016-17 school year will also be offered the Gardasil vaccine. HCP's can order all 3 vacciness by placing an order with Hastings Prince Edward Public Health (Do not put any patient personal information on the order form). Once the order is received, a nurse will call to verify patient information and eligibility.

VARICELLA - It is recommended to have 2 doses of Varicella vaccine for those who have not had the disease. It is publicly funded for those born on or after 2000/Jan/01.

QUADRACEL® (Dtap-IPV)- is no longer available. It has been replaced by INFRANRIX-IPV. This vaccine is available by special order only for the few children aged 5-6 years who have never been immunized and require their primary series.

ADACEL-IPV® or BOOSTRIX-IPV® (Tdap-IPV) - is now given as the 5th booster dose to 4-6 year olds to complete their primary childhood series. It should also be given for those 7-17 years of age who have never been vaccinated and require a primary series.

ADACEL® or BOOSTRIX® (Tdap) - should still be given for the adolescent booster for 14-16 years of age. Tdap is now available publibly funded for a one time dose to all adults. This lifetime dose of Tdap will replace one of the Td booster doses given every 10 years.

Publicly Funded Vaccines

Publicly Funded Immunization Schedules for Ontario - December 2016

Publicly Funded Immunization Schedule for Ontario – Quick Reference Guide

Ordering and Returning Vaccines

To order high-risk Meningococcal, Hep A, Hep B or Pneumococcal vaccine, school Hepatitis B,  Menactra or HPV vaccines, and Infanrix IPV (formerly Quadracel vaccine), call our Vaccine Preventative Disease intake line at (613) 966-5500 or 1-800-267-2803, ext. 313.

TTY: Dial 711 + (613) 966-5500 + GA (Monday to Friday from 8:30 a.m. to 4:30 p.m.)

Vaccine/STI Medication Order Form

Non-Reusable Vaccine Return Record

Eligibility/Referrals

Pneumococcal Conjugate 13-Valent for Adults with High Risk Medical Conditions

Fact Sheets/FAQs

Immunization Fact Sheets and Patient Tools

Shingles vaccine (Zostavax®II) information for Patients

Publicly Funded Human Papillomavirus Vaccine

Forms - Reporting

Report of Adverse Event Following Immunization

Cover letter for exemption affidavits - school

Cover letter for exemption affidavits - day care

Statement of Conscience or Religious Belief Affidavit for Child Care Centres

Statement of Conscience or Religious Belief Affidavit for JK-grade 12

Statement of Medical Exemption –Immunization of School Pupils Act

Guidelines/Standards

Canadian Immunization Guide

National Advisory Committee on Immunization (NACI)

2016/2017 School Vaccine Schedule for Elementary and Secondary School Students

Immunization of School Pupils Act

Ontario Ministry of Health and Long-Term Care's Immunization Requirements for School Attendance

Related Links:

Your Child's Best Shot : A Parent's Guide to Vaccination

Immunize Canada

Working with vaccine-hesitant parents

Immunization Services in Hastings and Prince Edward Counties

Immunization Intake Line

Hastings Prince Edward Public Health’s Vaccine Preventable Disease Program provides regular immunization updates to local health care providers.

If you have questions, call the Vaccine Preventable Program's intake line at (613) 966-5500 or 1-800-267-2803, ext. 313.

TTY: (613) 966-3036 (Monday to Friday from 8:30 a.m. to 4:30 p.m.)

Adverse Event Following Immunization

Health care professionals who administer vaccines and/or care for patients who may have had an Adverse Event Following Immunization (AEFI) are required by law to report these events to local public health authorities within seven days. Click here for the AEFI form.

Seasonal Influenza Vaccine

The National Advisory Committee on Immunization (NACI) Statement Canadian Immunization Guide Chapter on Influenza and Statement on Seasonal Influenza Vaccine for 2016/17 is now available online.

The Ministry of Health and Long Term Care indicates that the influenza season for Ontario runs from October to April. When ordering influenza vaccine for the 2016/17 season from Hastings Prince Edward Public Health,  please use the correct order form along with 4 weeks of your fridge temperature log book, when placing your order. Please allow 3 business days before coming to pick up your order.

Please ensure that all your unused influenza vaccine (Fluviral, Fluad, Influvac, Fluzone and Flumist) is bagged and returned, along with a completed Vaccine Return Form, to a Hastings Prince Edward Public Health office in your area by May 1st, 2017. The returned influenza vaccine is not required to be kept under cold chain.

Influenza (Flu) Fact Sheet

Fluzone® Product Monograph

Reporting Cold Chain Failures

Vaccines are to be kept between +2 °C and +8 °C at all times. Administering improperly stored vaccines can result in a poor immune response and a lack of protection for clients. 

 If your vaccine has been exposed to temperatures below +2 °C and/or above +8 °C you should:

  1. Call Hastings Prince Edward Public Health immediately at (613) 966-5500 or 1-800-267-2803, ext. 313 to report the exposure.  Public Health staff will conduct an assessment of the exposed vaccine.
  2. Segregate the exposed vaccines in the refrigerator by placing these vaccines in a labelled container (or bag), marked with the date, time, and “DO NOT USE”.
  3. Check to ensure your temperature monitoring device is working correctly. If in doubt, replace the battery.
  4. After checking the temperature monitoring device and the refrigerator, record the date, time and temperature in your temperature log book. Always remember to reset your maximum-minimum thermometer (if applicable) after each recorded temperature.
  5. If the current temperature is too low or too high, move these vaccines to a properly functioning, monitored refrigerator, or place the vaccines in an insulated container with icepacks and a temperature monitoring device inside the vaccine package. Insulated containers will only keep vaccines at the appropriate temperatures for a short period of time (approximately two hours).

For more information, call Hastings Prince Edward Public Health’s Vaccine Preventable Disease Cold Chain Specialist at (613) 966-5500 or 1-800-267-2803, ext. 222.

TTY: Dial 711 + (613) 966-5500 + GA (Monday to Friday from 8:30 a.m. to 4:30 p.m.)

Related Links:

Vaccine Storage and Handling Guidelines

Infant Feeding

Informed Decision Making

As a health care provider it is your job to provide individuals and families with information to help them make an informed decision on how to feed their baby, and support them with their choice.

Please visit the Informed Decision Making Tip Sheet from BFI Ontario to aid your discussions with clients about infant feeding.

Hastings Prince Edward Public Health Programs and Services

Hastings Prince Edward Public Health has a number of programs and services that can support the families you work with to feed their infants.

Child Health CARELine
Public Health Nurses from our Child and Reproductive Health Program are available to speak with clients by phone to answer their questions about infant feeding, parenting, growth and development, and more. Our nurses can also connect clients with other programs and services to help support them as a parent.
Call 613-966-5500 or 1-800-267-2803, ext. 223

Breastfeeding Consultations
Breastfeeding is natural, but it can take time to learn. Hastings Prince Edward Public Health offers one-to-one support for mothers experiencing breastfeeding challenges.
To arrange a breastfeeding consultation, call the Child Health CARELine.

Baby Feeding Drop-In
If clients have questions about feeding their baby, you can direct them to one of our Baby Feeding Drop-Ins for answers and reassurance. No appointment is necessary. Visit our Baby Feeding Drop-In page for information on times and locations.

Infant Feeding Classes
Free Infant Feeding Classes provide the latest information about when and how to start babies on solid foods. Visit our Infant Feeding Classes page for more information.

Breastmilk Substitute (Formula) Safety

If your clients have made an informed decision to feed their infant formula, they need information and support to prepare and store it safely.

Clients can contact the Child Health CARELine for resources and support on how to feed prepare and store formula safely.

Resources

Infection Control

Infection Prevention and Control Lapse Disclosures

The Ministry of Health and Long  Term Care has directed all public health units to publicly disclose more detailed information on non-routine infection prevention and control (IPAC) lapse investigations where they are identified. An IPAC lapse is a departure from infection prevention and control standards. The result could be infectious disease transmission to patients or staff through exposure to blood or body fluids.  An example would be medical equipment that is improperly cleaned and can spread infections from one patient to another. Information about IPAC investigations in HPEPH can be found on our Infection Prevention and Control Lapse Reporting Page. HPEPH encourages Health Care Providers to review IPAC best practices and resources listed below.

Resources and Best Practices

Best Practices for Infection Prevention and Control Program in Ontario in all Health Care Settings

CPSO's Guidelines for Infection Prevention and Control in Clinical Practice

Infection Prevention and Control Best Practices for Long Term Care, Home and Community Care including Health Care Offices and Ambulatory Clinics

Public Health Ontario's Just Clean Your Hands Campaign

Infection Control in Institutional Settings

In accordance with the Health Protection and Promotion Act and the Ontario Public Health Standards, Public Health inspectors and nurses work closely with long-term care homes, retirement homes, hospitals, and other institutional settings to prevent or reduce the burden of infectious diseases of public health importance. 

Outbreak Management

Outbreaks occur when the usual incidence of disease in a long-term care or retirement home is exceeded at any given time.  Early identification of an outbreak is essential since the implementation of precautions and therapeutic interventions can prevent the spread of infection and decrease the morbidity and mortality of a very frail, compromised population.

Outbreak Management Quick Reference Guide

For a list of open outbreaks in Hastings and Prince Edward Counties, click here

Related Links:

Admission, Transfer and Return Algorithm for use During Outbreaks

A Guide to the Control of Gastroenteritis Outbreaks in Long-Term Care Homes

A Guide to the Control of Respiratory Infection Outbreaks in Long-Term Care Homes

Best Practice Documents - Provincial Infectious Disease Advisory Committee (PIDAC)

Food Premises Regulation

Laboratory Services (Public Health Ontario Laboratory)                           

Labstracts (Public Health Ontario Laboratory)                           

Retirement Homes Regulatory Authority

TB Screening in Long-Term Care and Retirement Homes

The regulations in the Long-Term Care Homes Act, 2007 and the Retirement Homes Act, 2010 set out requirements with respect to screening for TB.  Each resident admitted to the home must be screened for tuberculosis within 14 days of admission unless the resident has already been screened at some time in the 90 days prior to admission and the documented results of the screening are available to the licensee.

The Canadian TB Standards (7th Edition), 2013 – Chapter 15 - provides a summary of recommendations for TB screening and infection prevention and control measures in non-hospital settings.

Note that a TB screening test is not recommended for residents who are over 65 years of age. As people age, the test may become increasingly unreliable and difficult to interpret. In addition, if an elderly individual does convert to a positive result following a TB exposure, prophylaxis is often not possible.

Related Links:

Active TB Screening Checklist for Clinicians

Canadian Tuberculosis Standards,  7th Edition 2013

Frequently Asked Questions

Positive Tuberculin Skin Test Report Form

Recommendations for Tuberculosis (TB) Screening in Long Term Care and Retirement Homes

Tuberculosis Fact Sheet

Tuberculosis Information for Health Care Providers 5th Edition

Tuberculosis (TB) Skin Test – Mantoux:  A Guide for Health-Care Providers

Mandatory Blood Testing Act

Hastings Prince Edward Public Health is required to follow the Mandatory Blood Testing Act (2006) of Ontario.

The Act permits anyone that may have come into contact with blood or body fluids of another person, as a result of being a victim of crime, an emergency service worker, or Good Samaritan (emergency first aid provider), to have the blood of the other person tested. The sample is tested for HIV, Hepatitis B and Hepatitis C.

Applicant Report Form

Consent & Capacity Review Board

Physician Report Form

Reportable Diseases

Hastings Prince Edward Public Health’s Reportable Disease List outlines the communicable diseases that must be reported by physicians, laboratories, administrators of hospitals, schools, and institutions to the local Medical Officer of Health (as stated in Ontario Regulation 559/91 under the Health Protection and Promotion Act and the timelines for reporting.

Reportable diseases can be reported to Hastings Prince Edward Public Health by filling out the Reportable Disease Notification Form and faxing it to (613) 966-1813. Patient consent is not required for reporting this information. The Personal Health Information Protection Act explicitly allows health care providers to disclose information to the local Medical Officer of Health for purposes outlined under the Health Protection and Promotion Act.

To see 2015 case counts of reportable diseases in Hastings & Prince Edward Counties, along with a 5-year average, click here.

Oral Health

Healthy Smiles Ontario

The Healthy Smiles Ontario program is a government-funded dental program that provides free preventive, routine, and emergency dental services for children and youth 17 years old and under from low-income households.

Hastings Prince Edward Public Health and ServiceOntario can assist with application and enrolment. Once clients have completed this process, they can seek treatment from dental health professionals in the community.

For more information call:

  • Hastings Prince Edward Public Health's Oral Health program: 613-966-5500 or 1-800-267-2803, ext. 680.
  • ServiceOntario INFOline: 1-844-296-6306. TTY: 1-800-387-5559

Oral Health Clinics

Hastings Prince Edward Public Health offers preventive dental services to children and teens aged 0 to 17 years who cannot afford dental care. Visit our Oral Health Clinic page for more information.

Oral Health Resources

HSO Information for Professionals

Oral Health Different Ages/Different Stages - Birth to 12 Years

Your All-Access Pass to a Healthy Mouth, Healthy You

Oral Health School Screening

Oral Health program staff visit all elementary schools in Hastings and Prince Edward Counties each school year, and screen students in certain grades.

Each child screened receives an Oral Health School Screening Report Card. Clients may bring their report card to their dental professional.

For more information about the Oral Health School Screening program, call our Oral Health program at 613-966-5500 or 1-800-267-2803, ext. 680.

Physical Activity

Healthy Life Line

Residents of Hastings and Prince Edward counties with questions about physical activity or local healthy eating programs and services can call Hastings and Prince Edward Public Health’s Healthy Life Line at (613) 966-5500 or 1-800-267-2803, ext. 610.

TTY: Dial 711 + (613) 966-5500 + GA (Monday to Friday from 8:30 a.m. to 4:30 p.m.)

Questions will be answered by registered dietitians and physical activity professionals. 

Healthy Bodies’ Messaging

Hastings Prince Edward Public Health has created a document for health professionals to provide consistent evidence-based messages and recommendations for the public on issues of weight, healthy eating, physical activity, body image, and self-esteem. Healthy Bodies: Eat Well, Be Active, and Feel Good About Yourselfcontains 18 key messages that are accompanied by background evidence and rationale. Several case study scenarios are also included which demonstrate how the key messages can be incorporated into practice.

Physical Activity Directory

Hastings Prince Edward Public Health has developed a directory containing physical activity opportunities offered throughout Hastings and Prince Edward Counties. This directory is divided by geographic area. Activities are listed alphabetically by area and include key contact information. Also included in the directory is information on financial assistance available to help families access these activities.

Belleville

Central Hastings

North Hastings

Prince Edward County

Quinte West

Tyendinaga and Deseronto area

Canadian Physical Activity Guidelines

The Canadian Society for Exercise Physiology (CSEP) has developed a set of physical activity guidelines for each age group from birth to older adult. Sedentary behaviours guidelines also exist for children in the early years (0-4 years of age), older children (5-11 years of age) and youth (12-17 years of age).

Access CSEP guidelines

Preconception / Pregnancy

Preconception

What is my role in promoting preconception health?
Healthcare Providers can:

  • Help their patients optimize their health and knowledge before conceiving.
  • Educate patients with chronic conditions on the impact and/or adverse effects the condition or treatment could have on their infant.
  • Discuss risks associated with delayed childbearing.

How can I integrate preconception health care into my practice?
Healthcare providers can use the Preconception Health Care Tool, created by The Centre for Effective Practice in partnership with the Ontario College of Family Physicians to assess and counsel patients on preconception health.
Visit www.effectivepractice.org/preconception to download the tool.

Health care providers can use the Ontario Health Insurance Plan (OHIP) billing code for individual care counselling (K013) to complete the Preconception Health Care Tool with their clients.

Additional resources

Pregnancy

Hastings Prince Edward Public Health provides a number of programs and services that support families throughout their pregnancy. Visit our Pregnancy page for more information.

Prenatal Education

Hastings Prince Edward Public Health, in partnership with the Ontario Early Years Centres, the Prince Edward Family Health Team, and Quinte Health Care, offers a free Prenatal Education Series.

Our Prenatal Education Series consists of an e-learning program and a set of three in person sessions. The series is designed to help clients and their families experience a healthy pregnancy, have the healthiest baby possible, and be prepared for parenthood.

Expectant parents and support persons are encouraged to start prenatal education as early as possible in their pregnancy. 

E-learning Program: The Gift of Motherhood

The Gift of Motherhood e-learning program provides clients with information and resources in an easy to use format that can be viewed in the comfort of their own home. Topics include: having a healthy pregnancy, breastfeeding, preparation for parenting, and labour and birth.

We encourage pregnant women and support persons to access the e-learning program before taking the in-person sessions. 

In-Person Sessions

The set of three in-person sessions cover preparation for parenting, breastfeeding, and labour and birth. Sessions include demonstrations, hands-on skills practice, and time for questions.

Visit our schedule of upcoming in-person sessions.

What is my role in promoting prenatal education?

  • To inform all pregnant women about prenatal education as early as possible in their pregnancy.
  • To display prenatal education information in your office or clinic.
  • To complete the Healthy Babies Healthy Children Prenatal Screen with prenatal clients.
  • To make a direct referral to the Reproductive Health Program, please use this referral form.

For more information about prenatal education or other Public Health programs and services call 613-966-5500 or 1-800-267-2803, ext. 223 or e-mail rh@hpeph.ca.

Prenatal Education Key Messages for Ontario

The Prenatal Education Key Messages for Ontario is an evidence-based online tool that identifies universal key messages for service providers in Ontario to share with their clients related to preconception, prenatal, postpartum and newborn health, as well as the supporting evidence for each of these key messages. Visit www.ontarioprenataleducation.ca for more information.

Sexual Health

Hastings Prince Edward Public Health is mandated by the Ministry of Health and Long Term Care in the Ontario Public Health Standards to provide access to lower cost birth control methods. We do so through our Sexual Health Clinic.

Some young women are uncomfortable seeing their primary health care provider or do not have a health care provider to obtain a contraceptive prescription. Any woman under 25 years of age can visit our Sexual Health Clinic practitioner for a contraceptive prescription. 

Occasionally, in the best interest of the client, we will need to work with the health care provider to provide the safest contraceptive option. Our clinic practitioner will prescribe the contraceptive, which will either be dispensed at the Sexual Health Clinic or at a pharmacy.

For financial reasons, a woman of any age can bring a contraceptive prescription (pill, patch, ring) from her health care provider to our Sexual Health Clinic for dispensing at a lower cost. The health care provider can also fax the prescription to us at (613) 968-1482, indicating which Sexual Health Clinic the woman plans to attend. These are usually women without access to a drug plan.

Depo Provera prescriptions are dealt with on a case-by-case basis. If a woman needs financial help, this may be possible, but we prefer that the woman return to your office for her injections.

Only name-brand contraceptives are available at our Sexual Health Clinic. A prescription written for a generic prescription will be filled with the name-brand contraceptive unless otherwise stated on the prescription. We do not carry the extended brands of pills.

With each client contact to obtain contraceptives, a registered nurse assesses for side effects and any struggles to use the contraceptive method effectively.

Any opportunity to work with the individual’s health care provider (with consent) to support the person’s success with contraception is welcomed.

Free urine/blood pregnancy testing and subsequent option counselling or contraceptive counselling are provided on a walk-in basis at all of our Sexual Health Clinics.

Please call us with any questions or concerns at (613) 966-5500 or 1-800-267-2803, ext. 243.

TTY: Dial 711 + (613) 966-5500 + GA (Monday to Friday from 8:30 a.m. to 4:30 p.m.)

STI Treatment and Contacts

Hastings Prince Edward Public Health is mandated by the Ontario Public Health Standards (link to Standards - http://www.health.gov.on.ca/en/pro/programs/publichealth/oph_standards/d...) to provide Sexually Transmitted Infection (STI) testing, case management, and treatment of reportable bacterial STIs.

In order to meet these obligations, we work in partnership with community health care providers to provide the best coordinated care for infected individuals.

The following is the process that we follow when investigating a reportable STI:

  1. Public Health receives a copy of the lab report confirming a positive result for a reportable STI.
  2. Public Health contacts the health care provider who ordered the test to ensure that adequate treatment is taken by the client/patient. 
  3. Public Health recommends that health care providers utilize the Canadian Guidelines on Sexually Transmitted Infections on treatment options or download A Quick Guide to: Sexually Transmitted Infections (revised May 2015)
  4. With regard to Gonorrhoea treatment, Public Health advises health care providers to utilize the  recommendations contained in the Guidelines for Testing and Treatment of Gonorrhea in Ontario (May, 2013) or down load our Gonorrhea Testing, Screening and Treatment Quick Guide (revised May 2015)
  5. Syphilis is a complex infection which needs to be staged in order to provide adequate treatment.  If you need this type of support, our Sexual Health Clinic physician may be able to help. Contact our clinic directly.
  6. Public Health determines who will take responsibility for the contact tracing required. The contact tracing process significantly helps to notify exposed individuals regarding their need for testing and/or treatment.
  7. Public Health collects specific, detailed information from health care providers required by the provincial database. This database allows Public Health to maintain surveillance of all reportable communicable infections, including most STIs.

Any of your patients, who are unable to afford antibiotic treatment for chlamydia, including Lymphogranuloma venereum, Gonorrhoea and syphilis, can obtain free treatment at our Sexual Health Clinics. Your written prescription can be faxed to (613) 968-1482 or brought by the individual to a Sexual Health Clinic for dispensing.  Antibiotics can also be ordered from the clinic.

Hastings Prince Edward Public Health offers fact sheets about various STIs. Click here to access these.

If you have any questions regarding STIs and treatment, call our Sexual Health Intake Line at (613) 966-5500 or 1-800-267-2803, ext 243.

TTY: Dial 711 + (613) 966-5500 + GA (Monday to Friday from 8:30 a.m. to 4:30 p.m.)

Tobacco

Quit Smoking Programs

Smoke-Free Families

Most parents hope for a healthy baby and to give their child the best start in life. Hastings Prince Edward Public Health offers a number of programs that can assist families to become smoke-free. 

Benefits of being a smoke-free family:

  • Improvements in circulation, breathing, and general health;
  • Ability to be active with your kids and be a positive role model;
  • Decreases your child’s risk of breathing problems, asthma, pre-term birth, attention and behaviour problems;
  • Results in fewer coughs, colds; and ear infections; and
  • Saves times and money.

We Can Quit Prenatal/Postnatal Initiative

Hastings Prince Edward Public Health offers this program for women who are pregnant or who have a baby (up to 12 months of age) and want to quit smoking. Weekly visits in your home with Public Health staff will include:

  • Free nicotine replacement therapy (patch, gum, lozenges);
  • Free quit kit and resources;
  • Help to make a quit plan; and
  • Support for you and your partner. 

Click here for a client referral form related to this program.

For more information, email or call ourTobacco Talk Line at (613) 966-5500 or 1-800-267-2803, ext. 600.

TTY: Dial 711 + (613) 966-5500 + GA (Monday to Friday from 8:30 a.m. to 4:30 p.m.)

Provincial Resources:

Smoker’s Helpline - 1-877-513-5333

Motherisk Helpline - 1-877-327-4636  

Other Supports: 

Families Controlling and Eliminating Tobacco (FACET)

Pregnets

Smokefree Women

Smoker's Helpline