Issue 34 October 2012 IMPACT is an active paediatrics-based surveillance system that collects information on hospitalizations and select outpatient hospital visits for events that occur within a specified time frame after an immunization and on vaccine-preventable or soon-to-be preventable illnesses. The IMPACT team invites you to share this newsletter. You can also subscribe at: http://www.cps.ca/en/impact Surveillance update Recent IMPACT publications: Rotavirus: Doug Coyle MA MSc PhD, Kathryn Coyle BSc Pharm MSc, Julie A Bettinger MPH PhD, Scott A Halperin MD FRCPC, Wendy Vaudry MD FRCPC, David W Scheifele MD FRCPC, Nicole Le Saux MD FRCPC. Cost effectiveness of infant vaccination for rotavirus in Canada. Canadian Journal of Infectious Diseases and Medical Microbiology 2012; 23(2):71-77 http://www.pulsus.com/journals/abstract.jsp?sCurrPg=journal&jnlKy= 3&atlKy=10634&isuKy=1027&spage=1&isArt=t Influenza: Dat Tran, Wendy Vaudry, Dorothy L. Moore, Julie A. Bettinger, Scott A. Halperin, David W. Scheifele and Samina Aziz for the IMPACT Investigators. Comparison of children hospitalized with seasonal versus pandemic influenza A, 2004-2009. Pediatrics 2012; 130(3); 397-406 http://pediatrics.aappublications.org/content/130/3/397.long In this issue Surveillance update 1 Welcome to IMPACT 2 Pertussis 2 Influenza 3 Case examples 3 Social media 3 Resources 4 Contacts 5 Varicella: Tan, Ben MD, Bettinger, Julie PhD, McConnell, Athena MD, MSc, Scheifele, David MD, Halperin, Scott MD, Vaudry, Wendy MD, Law, Barbara MD, for members of the Canadian Immunization Monitoring Program, Active (IMPACT). The effect of funded varicella immunization programs on varicella-related hospitalizations in IMPACT Centers, Canada, 2000-2008. Pediatric Infectious Disease Journal 2012; 31(9); 956-963 http://journals.lww.com/pidj/Abstract/2012/09000/The_Effect_of_Fun ded_Varicella_Immunization.23.aspx The current IMPACT publications and presentations list can be found at: www.cps.ca/en/impact 1 Welcome to IMPACT A warm welcome to the two new monitors and three co-investigators on our team. Sharon Penney replaced Cheryl Crummell at the St. John’s N.L. centre in April 2012. Annick Audet replaced Lorraine Piché for a one-year leave of absence in July 2012. Co-investigators Karina Top, at the Halifax centre, Otto Vanderkooi at the Calgary centre, and Athena McConnell at the Saskatoon centre joined our investigator team this year. Pertussis – These vaccines are not just for children! In Canada cases of pertussis usually peak every 2 to 5 years. Over the past few years outbreaks have been occurring at an alarming rate. Below are some of the recent news releases on outbreaks in specific areas in Canada and the United States. Complications from pertussis can be very serious for all ages but especially for infants, who are too young to be fully immunized yet are at highest risk for severe disease and even death. Pertussis is preventable. Getting the proper immunizations at the right time also protects those who cannot yet be immunized. Infants are being exposed to the disease by family members and caregivers who are not up-to-date with their immunizations or who, sadly, may not even be aware that they need to be immunized. Children require pertussis immunizations at 2, 4, and 6 months of age (called their primary series) and then a booster at 18 months and again prior to entering school at 4 to 6 years of age. Adolescents require a booster in their teen years (usually given as part of a school program) and adults should be reimmunized once in their adult years (usually along with tetanus and diphtheria vaccines, which are given every 10 years). Parents, child care providers and individuals who have regular contact with children should have a pertussis vaccination if they are not up-to-date (i.e., have not been immunized at least once as an adult). Studies are being conducted across Canada to determine whether vaccinating pregnant women against pertussis provides protection for their newborn baby. Some topical news releases follow … British Colombia: immunizebc.ca/diseases-vaccinations/pertussis Alberta: www.albertahealthservices.ca/6977.asp Ontario: news.ontario.ca/mohltc/en/2012/07/ontarians-reminded-to-get-fully-immunized-against-whoopingcough.html Quebec: www.montrealgazette.com/health/Whooping+cough+outbreak+worst+decades/7137163/story.html New Brunswick: www2.gnb.ca/content/gnb/en/departments/ocmoh/cdc/content/whooping_cough.html United States: www.cdc.gov/mmwr/preview/mmwrhtml/mm6128a1.htm; www.cdc.gov/pertussis 2 Case examples Here is a ‘snapshot’ of pertussis cases reported by IMPACT centres: An infant spent 27 days in hospital care and developed rotavirus during treatment. An infant infected with both pertussis and influenza required nine days of hospital care (four in the intensive care unit [ICU]). An infant spent 33 days in the ICU but survived without complications. This child likely contracted pertussis from an unimmunized sibling. An infant with pertussis and a viral co-infection required 23 days of hospital care. A toddler with multiple pulmonary and neurologic complications from prematurity spent 34 days in hospital (including 29 in the ICU). This child had received primary immunizations but no booster was documented. IMPACT reported one infant death due to pertussis in 2011. Seasonal influenza IMPACT continues to report paediatric influenza hospitalizations and deaths to the Public Health Agency of Canada’s Flu Watch system: http://www.phac-aspc.gc.ca/fluwatch/. These were cases admitted to one of the 12 Canadian tertiary care hospitals where an IMPACT centre is located: http://www.cps.ca/en/impact Centres are on active lookout, screening admission sheets and lab testing results for positive influenza cases. Weekly tallies of such cases are sent to the PHAC and followed up by collecting data from the case medical history, including but not limited to the child’s general health, manifestations of illness, treatment, travel record and immunization history. The immunization history is a crucial piece of information that is often not well documented in case histories, requiring monitors to take a number of additional steps to determine a child’s immunization status. In provinces and territories with a number of different immunization providers (e.g., public health, walk-in clinics, family physicians and nurse practitioners) finding this information can be difficult. Immunization registries only exist in a few places in Canada, making this searching even more complex. Acute flaccid paralysis IMPACT nurse monitors continue to report cases of acute flaccid paralysis to the Canadian Paediatric Surveillance Program. To access the 2011 CPSP Annual Results, please visit: http://www.web.cps.ca/English/surveillance/CPSP/Studies/2011Res ults.pdf Social Media New ways to communicate and share health program-related information have exploded in recent years. The following recommended social media resources offer tools and strategies for health professionals: The Health Communicator’s Social Media Toolkit from the U.S. Center for Disease Control, at: www.cdc.gov/socialmedia/Tools/guidel ines/pdf/SocialMediaToolkit_BM.pdf helps health professionals provide credible, science-based health messaging and helps to empower individuals and communities toward positive health decision making. The government of Alberta uses social media to encourage immunization: http://www.660news.com/news/local/ article/395519--alberta-governmentusing-social-media-to-encouragevaccinations Immunize Canada (formerly the Canadian Coalition for Immunization Awareness and Promotion) has its own YouTube channel: Check it out! www.youtube.com/user/ImmunizeCan ada For IMPACT on YouTube, visit www.youtube.com/user/immunizebc. Vancouver IMPACT nurse monitor, Karen Kroeker, speaks about the program and vaccine safety in a video produced by Immunize B.C. Best thanks to them for highlighting IMPACT’s important work and the manifold benefits of immunization. 3 Canadian Adverse Event Following Immunization information To report an AEFI in Canada, complete the form on the PHAC website, at www.phacaspc.gc.ca/im/aefi-essi-form-eng.php. For additional help, consult the user guide at www.phac-aspc.gc.ca/im/aefi-essi_guide/index-eng.php The 10th Canadian Immunization Conference will be held at the Vancouver Conference Centre in Vancouver, B.C. on December 3-5, 2012: http://www.phacaspc.gc.ca/cnic-ccni/index-eng.php Resources Canadian IMPACT Public Health Agency of Canada Canadian Paediatric Society Caring for Kids (resources to share with families) Immunize Canada (previously CCIAP) Aboriginal Peoples Immunization Information PHAC/Canadian Influenza Research Network Meningitis Research Foundation of Canada Immunization Education Initiative Flu Watch Canadian Healthcare Influenza Immunization Network www.cps.ca/en/impact www.phac-aspc.gc.ca www.cps.ca www.caringforkids.cps.ca www.immunize.ca www.getimmunizedinformation.ca www.pcirn.ca www.meningitis.ca www.immunizationeducation.ca www.phac-aspc.gc.ca/fluwatch www.chiin.ca/index.html Provincial and territorial websites and immunization schedules: www.phac-aspc.gc.ca/im/is-vc-eng.php www.phac-aspc.gc.ca/im/is-pi-eng.php International U.S. Centers for Disease Control Immunization Action Coalition Children’s Hospital of Philadelphia Parents of Kids with Infectious Diseases (PKIDs) PATH: A catalyst for global health www.cdc.gov/nip www.immunize.org www.chop.edu www.pkids.org www.path.org/index.php The following article from the Immunization Action Coalition gives some tips for locating old immunization records: www.immunize.org/catg.d/p3065.pdf 4 IMPACT contacts Centre Nurse Monitor Investigator IWK Health Centre Halifax, N.S. Andrea Hudgin Heather Samson (Nurse Monitor Liaison) Dr. Scott Halperin (Co-PI) Dr. Karina Top (Co-Investigator) Le Centre Mère-Enfant de Lynn Poirier Dr. Pierre Déry The Hospital for Sick Children Toronto, Ont. Suganya Lee (lead) Dr. Dat Tran Children’s Hospital Winnipeg, Man. Debbe Cote (lead) B.C. Children’s Hospital Vancouver, B.C. Karen Kroeker Dr. Laura Sauvé Children’s Hospital of Eastern Ontario, Ottawa, Ont. Chantal Bergeron Dr. Nicole Le Saux Alberta Children’s Hospital Calgary, Alta. Shannon Pyra Dr. Taj Jadavji Dr. Otto Vanderkooi (Co-investigator) The Montreal Children’s Hospital Montreal, Que. Annick Audet (lead) and Teena Marie Johns (additional) Dr. Dorothy Moore Eastern Health Janeway St. John’s, NL Sharon Penney Dr. Natalie Bridger CHU Sainte-Justine Montreal, Que. Sophie Bouchard Dr. Marc Lebel Stollery Children’s Hospital Edmonton, Alta. Barb Neufeld Dr. Wendy Vaudry (Co-PI) Royal University Hospital Saskatoon, Sask. Brenda Andreychuk Dr. Ben Tan Dr. Athena McConnell (Co-investigator) Québec City, Que. and Kim Simpson (additional) Dr. Joanne Embree and Michelle Breton (additional) Other contacts: Public Health Agency of Canada (PHAC), Centre for Immunization and Respiratory Infectious Diseases (CIRID): Monique St-Laurent (Director); Dr. Barbara Law (Chief Vaccine Safety); Heather Deehan (Chief Vaccine-Preventable Diseases); Dr. Holy Akwar (Chief influenza) Canadian Paediatric Society (CPS): Marie Adèle Davis (Executive Director); Melanie Laffin-Thibodeau (Manager, Surveillance); Dominique Paré (French translator) IMPACT Data Center: Dr. David Scheifele (Data Centre Chief); Kim Marty (Data manager); Dr. Julie Bettinger (Epidemiologist); Debbe Heayn (Data scrutineer) Canadian Center for Vaccinology (CCfV): Natalie Giorgis (newsletter formatting); Heather Samson (Nurse Monitor Liaison) For Media requests please contact Andrée Dion at the CPS office: (613) 526-9397 ext 247 To connect with an IMPACT centre please contact Heather Samson by email, at [email protected] 5
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