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Dr. Gemmill's Blog

Dr. Gemmill
Dr. Ian Gemmill
Medical Officer of Health
An important message on pandemic H1N1 influenza
November 5, 2009

We have all felt the effects of pandemic H1N1 influenza. While many of you know someone who has been sick lately with influenza-like symptoms, some of you have been sick yourself. Perhaps you are one of the thousands who waited patiently in line to get your pandemic H1N1 influenza vaccine or stayed back and waited while your more vulnerable neighbours and family members got their vaccine. Because of your patience and understanding, we’ve been able to provide over 45,000 doses of the pandemic H1N1 influenza vaccine to KFL&A area residents—through our community vaccine clinics, family doctors, healthcare teams, partners, and hospitals. To you all, thank you for your patience.

While our surveillance shows us that the infection rates are starting to go down, we are still very much in a race against the pandemic H1N1 influenza virus.

For reasons beyond the control of any local public health agency, we have temporarily run out of pandemic H1N1 influenza vaccine. Until we get more, we will have to suspend our community immunization clinics. We don’t expect that wait to be long—perhaps only a matter of days. At KFL&A Public Health we have redeployed our staff and made every resource available to get the vaccine into arms. Once we have more vaccine we will work continually to provide pandemic H1N1 influenza vaccine to every resident who wants it.

Keep listening to local radio stations, check your daily or weekly newspapers, or visit our website, www.kflapublichealth.ca, for information on more clinic dates when the vaccine is once again available.

Thank you.



PH1N1 Influenza A
October 27, 2009

The new variant of PH1N1 influenza A is already circulating widely in Kingston, Frontenac and Lennox & Addington. It is essential for all members of our community to learn the risks of this illness, and how to minimize them.

Our observations from the spring of 2009, and from the influenza season in the southern hemisphere that has just ended, have helped us to understand how PH1N1 will affect our population. First, there is potential for a lot of illness; we expect the disease to be widespread, because a large number of people are susceptible. The infection spreads quickly, and as it continues to do so, there will be a high chance of being exposed.

Like most new strains of influenza, PH1N1 influenza A will mostly affect younger people. The preponderance of cases is in school-aged children, adolescents, and young to middle-aged adults in their 20s-50s. There is no reason to think that this epidemiology will change during the influenza season in the northern hemisphere.

The illness tends to be no worse than regular influenza, but it is still a highly unpleasant disease. Most people will feel very ill for a week, and fatigued for several more. Although the number of particularly severe cases seems to be fewer than with regular influenza, such severe cases will still occur. In fact, because we expect lots of cases, there will be a small number of deaths amongst otherwise healthy people, and it is impossible to predict who these people will be. Although the absolute risk is small, as it is with regular influenza, people who already have chronic medical conditions and pregnant women are at a higher risk for complications than the general population.

There are a number of things that people can do to stem the spread of PH1N1 influenza A and keep themselves from becoming ill:
  • Always follow the rules of good hygiene: wash hands or use hand sanitizer regularly, especially after touching objects in public places (buttons on elevators, shopping carts at the market, etc.);
  • Follow good cough etiquette: never cough into the hands, but rather into the sleeve;
  • If you do become ill, you should stay home to prevent spreading the infection to others.
That said, the best way to avoid becoming ill with PH1N1 is to get the vaccine that protects against this illness. Although everyone will be offered the vaccine, those who are at higher risk will be offered it first. The vaccine is now licensed and is deemed safe by Health Canada; early trials show extremely good responses in healthy adults and young children. It is certainly the most effective and long-lasting way to prevent influenza.



Chlamydia
October 13, 2009

Chlamydia is epidemic among older adolescents and young adults. As the new school year is underway in universities, high schools and colleges, it is important that they understand the risks associated with this infection, and how to protect themselves. Chlamydia is the most common reportable sexually transmitted infection (STI). Most cases in women and some in men are asymptomatic (i.e. there are no symptoms indicating that infection has occurred). Moreover, the risk of infection is directly proportional to the number of sexual partners that a person has. That fact is compounded further because there are now many more people in the highest risk ages: older adolescents and young adults. For all of these reasons, the incidence of this infection has risen to epidemic levels.

If a case of asymptomatic Chlamydia goes undiagnosed and untreated, it may have serious consequences, especially for women. Moreover, women are at greater risk of contracting the infection than men, because the transmission rate to women is higher. It is thus essential for women to know what kind of complications Chlamydia can cause, and to learn how to prevent that from happening.

If untreated in women, Chlamydia can lead to Pelvic Inflammatory Disease (PID), an infection of the ovaries and fallopian tubes. PID can cause tubal pregnancies, as well as infertility. Chlamydia poses a major risk to health and future reproduction in women, but knowing about prevention can greatly reduce that risk.

There are several actions that young people can take to decrease the risk of infection, such as consistent use of condoms, and limiting one’s number of sexual partners. If these preventive measures don’t work, testing is available to detect both symptomatic and asymptomatic infections. If an infection is detected before it spreads, it can be treated with a course of antibiotics, and the complications of Chlamydia can be prevented. All sexually active women who have more than one partner, or whose partner does, should be tested for Chlamydia regularly: at least once per year, or more often if the number of partners is higher. Men who have symptoms should be checked and treated before they have any further sexual contact.

Women (and men) can stay sexually healthy by being smart: use condoms, limit the number of sexual partners that you have, know your partners’ sexual histories, and have regular testing.



Lyme Disease
August 31, 2009

The incidence of Lyme disease, an infection carried by ticks, is on the rise in eastern Ontario. Read on to learn about how it is transmitted and what its symptoms are, so that you can protect yourself and your family.

In 1975 there were 50 cases of what appeared to be arthritis in children in the town of Lyme, Connecticut, prompting an initial diagnosis of “Lyme Arthritis.” It later became clear that this joint pain was in fact only one symptom of Lyme disease, caused by bacteria that can be transmitted to a person when he or she is bitten by an infected tick.

Lyme disease has become established in eastern Ontario, but at this point, it is still a very small risk. Although infected ticks are now found more commonly, there have still been only a handful of infections in humans. When infection occurs, however, it can be serious. An important part of prevention is to avoid ticks in the first place. Ticks cling to plants and grass in wooded areas, particularly in cottage or camping country, and can attach themselves to the skin or clothes of humans. After the tick begins to bite, it takes 18 hours or longer to transmit the bacteria that cause Lyme disease. Although it is not possible for pets to spread Lyme disease, they can bring infected ticks into your home. Knowing this information, it is easy to minimize one’s risk of contracting the disease by taking a few simple protective measures while enjoying the outdoors:
  • Wear protective, light-coloured clothing so that ticks can be easily seen and kept off the skin (long sleeved shirts, long pants, and socks).
  • Wear insect repellent. Insect repellents containing DEET should not be used on children under 6 months of age, and should be used only sparingly on children younger than 2.
  • After spending time outside, check for ticks on any exposed areas: thighs, arms, underarms and legs; check your pets too.
  • Learn to recognize a feeding tick. They are very small and can appear like a freckle. If you find one, use tweezers to pull it straight out, put it in a clean container and contact KFL&A Public Health during business hours.

Most people who have been bitten by an infected tick will develop a rash at the site of the bite that looks like a bull’s eye. The rash may grow bigger and then disappear, after which other symptoms may develop, including fever, headache, stiff neck, sore aching muscles and joints, fatigue, and sore throat. If detected at this early stage, it can be easily cured with antibiotics. If Lyme disease goes undiagnosed and untreated, however, it may cause potentially serious and rare complications for the heart and nervous system. Early recognition of symptoms and avoiding ticks in the first place, therefore, are essential.



H1N1 influenza A (new variant)
June 16, 2009

Over the past eight weeks, the media have focused significant attention on the new variant of influenza A, elsewhere referred to as H1N1 or swine flu, presenting the public with conflicting messages.  Read on to learn the facts about this illness.

Many people wonder why the new variant of influenza A is causing more public concern than seasonal influenza, the virus commonly called 'the flu.'  The difference between these two viruses is that many people will have little protection against this new variant of influenza, having neither been immunized against it nor exposed to it in the past.  Because this is the first time that many people have been exposed to the new variant of influenza A, it has the potential to cause a lot of illness.  In fact, the World Health Organization (W.H.O.) has announced that this virus has reached a level 6 pandemic, meaning simply that it is now active in many parts of the world.  We also know that when there is a lot of influenza around, even seasonal influenza, elderly and chronically sick people may die from it.  That said, it remains to be seen just how many people will get sick; there is some early evidence that people who are over 50 years old may have been exposed to a similar virus years ago, and may therefore have some immunity.

To date, H1N1 influenza A (new variant) has NOT caused a great number of deaths, and seems to be NO MORE SERIOUS than seasonal influenza.  In fact, the W.H.O. designation of a level 6 pandemic DOES NOT imply that the infection is severe, only that it is widespread.  Because influenza is such an unpredictable virus, however, anything is possible.  Although it is NOT expected that this new variant will turn nasty, public health agencies need to be prepared for any scenario, even the unlikely one that the virus will cause severe disease in the autumn.  Therefore, we are monitoring its severity and spread to see how it behaves, preparing ourselves for the unexpected.  The system is gearing up to provide vaccine for those people who need it, should it be available in the autumn.  Doing so involves production of the vaccine, testing it for safety and effectiveness, and co-ordinating the logistics of a mass immunization program.

Finally, since the emergence of this new strain, the public health system has had a chance to test out its pandemic response plan.  We can now refine it for use if a severe pandemic should occur—that is, if a particularly virulent strain of influenza should become widespread throughout the world.


Last updated: 11/09/2009

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