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Children’s Health

Children’s Health

There are many excellent resources available for information about Children’s Health.

Check out these sites:

 

Child Development Resource Connection Peel
Information on child care, resources, training and services for children with special needs

Pep Start Clinics 
PEP-Start Clinic is a drop-in, no-fee clinic designed for families with children newborn up to 5 years of age who live in Peel. PEP-Start offers parents the opportunity to consult with professionals from community agencies in any or all the following:

  • Speech and Language
  • Parenting & Behaviour
  • Preschool Development
  • Infant/Toddler Development
  • Health & Nutrition

Erin Oak Kids
Erin Oak Kids provides a comprehensive range of family-centred treatment, rehabilitation and support services to children with disabilities and their families who reside in Dufferin, Halton, Peel, Waterloo and Wellington in areas such as:

  • Autism
  • Speech and Language
  • Hearing
  • Vision Services
  • Developmental Paediatrics
  • Occupational Therapy
  • Physiotherapy

Peel Children’s Centre
Peel Children’s Centre offers many excellent treatment services for children, teenagers, and families who are having serious issues with relationships, feelings, or behaviour.

Tangerine
Tangerine Walk-In Counselling is a free service for children, youth and families who live in the Peel Region.

Infant and Child Development Services Peel
This program specializes in providing services and resources for families with children 0-6 years old who are at risk of, or have a delay in his or her development.

Canadian Paediatric Society
This great resource from the National Association of Paediatricians  in Canada contains lots of information about children’s health, patient information, diet information, immunizations, guidelines, and resources for children.

Caring for Kids
This is an excellent site published by the Canadian Pediatric Society.  It contains information about Pregnancy and Babies (including feeding your baby in the first year, developmental milestones), Healthy Bodies, Keeping Kids Safe, Growing and Learning, Infections and Illnesses, Behaviour and Parenting, Teen Health, and Tips and Checklists.

 

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Immunizations

Immunizations

Immunization if a safe and proven way to protect us from many preventable diseases.  It reduces death and disability, medical costs, and hospital admissions.  Side effects are very rare and minor, and are much less than the diseases they prevent.  Vaccination is simply a process of giving us a small exposure to a disease without getting sick, so that our body can build up protection to the disease.  It’s like exercise for our immune system, so it can be ready to fight the disease if we are really exposed to the illness.

You may hear or read about many different opinions regarding immunization.  You may also have questions about the need for immunization, its safety or side effects.  Please chose credible information that is evidence based when making your decision about immunization.  Here are some references for evidence-based information about vaccination:

 

Evidence-Based Information About Vaccination

 

*Track all your Vaccinations with the new app from Health Canada – ImmunizeCA

Peel Health

Public Health Canada

A Parent’s Guide to Immunization, Wesbite, Health Canada

A Parent’s Guide To Immunization, Handout, Health Canada

Canadian Immunization Schedule

Immunize Canada

Centre For Disease Control, USA

 

Vaccines are safe

(*from Health Canada Website)

Vaccines are safe, with huge benefits to children’s health – all through their lives. Severe reactions from vaccines are extremely rare and are reported immediately to the Public Health Agency of Canada so that any problems can be dealt with quickly.

Safer than diseases they prevent

Vaccines in Canada are effective and safe–much safer than the 13 diseases they prevent. These diseases can lead to pneumonia, deafness, brain damage, heart problems, blindness, paralysis and carry a risk of life-long disability or death.

Rigorous research is ongoing

Vaccines are continuously monitored and tested around the world and in Canada before they are approved for use. Canada has several systems in place to keep a watchful eye on any reports of unusual, adverse side effects following immunizations.

False fears about harmful effects

All parents have questions about the risks associated with immunization. Some people worry that vaccines can cause health problems, such as autism or sudden infant death syndrome (SIDS). Expert research committees in Canada and around the world have investigated reports of serious effects over many years. They have found no evidence of a link between vaccines and autism or any other illnesses.

Should you experience an adverse event following immunization, please ask your doctor, nurse, or pharmacist to complete the Adverse Events following Immunization (AEFI) Form.

 

Vaccine Preventable Diseases

(*from Peel Health Website)

For more information on Vaccine Preventable Diseases:
Public Health Agency of Canada: Vaccine Preventable Diseases

Diphtheria

Diphtheria is a serious bacterial disease of the nose, throat and skin. It causes sore throat, fever and chills. Diphtheria can also cause breathing problems, heart failure, nerve damage and death.

Pertussis (Whooping Cough)

Pertussis (whooping cough) is a bacterial infection that causes severe spells of coughing. It is also known as whopping cough due to the sound children make when trying to catch their breath between coughing spells. The disease is spread from person to person through coughing and sneezing. It could cause pneumonia (lung infection), convulsions, brain damage or death, especially in young babies.

Tetanus (Lockjaw)

Tetanus is a disease caused by a bacterial spore that lives in soil and can infect wounds. It causes muscles of the body to go into painful spasms, and can be fatal when muscles in the chest wall or throat are involved. It is also referred to as Lockjaw because the painful muscle contractions begin in the neck.

Polio

Polio is caused by a virus that destroys nerve cells. Initial symptoms are fever, fatigue, headache, nausea, vomiting, flu-like symptoms, stiffness in the neck and pain in the limbs. This virus can lead to paralysis, inflammation of the brain and death.

Haemophilus Influenzae Type B (Hib)

Hib is a bacteria that can infect any part of the body. It can cause serious infections including meningitis, pneumonia, ear, bone and joint infections.

Measles (Red Measles)

Measles is a virus that causes a generalized rash, high fever, cough, runny nose, red eyes and white spots inside of the mouth. It can cause diarrhea, ear infections, pneumonia and inflammation of the brain.

Mumps

Mumps is a virus that causes fever, headache and painful swelling of one or more of the salivary glands (located in your cheek, near your jaw line, below your ears). Sometimes mumps can be more serious and cause swelling of the brain or its protective surface (encephalitis or meningitis). It can also cause temporary or permanent deafness or swelling of the testes or ovaries, resulting in infertility.

Rubella (German Measles)

Rubella (German Measles) is a virus that causes low-grade fever, sore throat, mild rash and swelling of the glands, as well as painful and swollen joints. When a woman gets rubella during pregnancy, it can cause miscarriage or severe disability for the baby.

Influenza (Flu)

Influenza is a serious respiratory infection that is caused by the influenza virus. It may cause headache, muscle pain, high fever, cough and chills. It may also cause pneumonia, middle ear infections, heart failure or death.

Colds, “stomach flu” and other viral infections are often confused with the flu but they are caused by viruses different from the flu virus. The flu is spread easily through coughing, sneezing or touching contaminated surfaces or objects. Flu strains change from year to year, so annual flu shots are recommended.

Varicella (Chickenpox)

Chickenpox is caused by a virus that causes fluid filled blisters and low-grade fever. Complications of chickenpox can include skin infections, pneumonia, ear infections, arthritis, inflammation of the brain and in some cases, death. Chickenpox is highly contagious and is easily spread through the air or by direct contact with the chickenpox blisters and the fluid from the blisters.

Pneumococcal Disease

Pneumococcal Disease is caused by bacteria that invade the lungs causing pneumonia and infections of the ears, lining of the brain and spinal cord. It can be fatal in people with certain chronic medical conditions and in the elderly.

Rotavirus

Rotavirus is a common infection in infants and children that causes fever, vomiting and diarrhea. It usually affects children between the ages of 6 months and 2 years. Most children will develop this infection at least once by the age of 5. The infection may cause severe dehydration.

Hepatitis B

Hepatitis B is a viral infection of the liver that can cause liver failure, liver cancer and death. Some people who develop hepatitis B have no symptoms, but can carry the virus and transmit the virus to others, while others develop flu-like symptoms such as nausea and fatigue.

Meningococcal Disease

Meningococcal disease is caused by bacteria that can lead to serious diseases, including meningitis (infection of the lining of the brain and spinal cord) and meningococcemia (infection of the blood). It can also cause deafness, seizures, brain damage and death. The bacteria, commonly found in the nose and throat of healthy people (carriers), is spread by activities where saliva can be shared, such as kissing or sharing a drink.

Human Papillomavirus (HPV)

HPV is a viral infection spread by skin-to-skin contact. Certain types of HPV can cause warts on the skin, genital warts, cell changes to the cervix or cervical cancer. Four strains of the virus are responsible for 70 per cent of cervical cancers and 90 per cent of genital warts.

 

What To Expect After Immunization

(*From Peel Health Website)

Vaccines are safe and effective. For most people, there are no side effects after immunization.

  • Minor local side effects may occur, but usually last only a few days.
  • Local reactions may include redness, soreness, swelling or itchiness at the injection site.
  • Occasionally, tiredness and/or muscle aches, headache and/or slight fever may result.
  • Severe reactions are very rare and may include trouble breathing, swelling or the face or mouth, hives or a fever over 39oC.

You should always discuss the benefits and risks of any vaccine with your health care professional.

Report severe reactions to your doctor and Peel Public Health at
905-799-7700.

 

Immunization Schedule

(*From Peel Health Website)

Routine immunization typically begins in infancy at two months of age; but remember, it’s never too late to begin or complete an immunization series. Ask your doctor or call Peel Public Health at 905-799-7700, to discuss immunization needs.

Learn more information about vaccine preventable diseases.

 

Immunizations for Infants, Toddlers and Preschoolers

Required immunizations for daycare or preschool:

Diphtheria, Tetanus, Pertussis, Polio and Haemophilus Influenzae B vaccine (DTaP-IPV-Hib)
The DTaP-IPV-Hib vaccine is given at 2, 4, 6 and 18 months of age. Hib vaccine is not recommended for children 5 years of age or older.

Note: Polio vaccine can be IPV (injectable) or OPV (oral). Children with immunization records from other countries may have OPV recorded.

Measles/Mumps/Rubella (MMR)
The first dose of MMR must be given on or after the first birthday. Children are required to have two doses of MMR vaccine given at least 28 days apart. The second dose of MMR is routinely given in combination with the second recommended dose of varicella* (chicken pox). This vaccine is called MMRV and is given at 4 to 6 years of age (preferably prior to school entry) – see immunizations for school-aged children.

Children may be immunized with MMR and varicella as separate vaccines if there are existing medical reasons or if the child will be travelling outside Canada prior to his/her fourth birthday. Please consult your physician or contact Peel Public Health for more information.

*Please note that the varicella component of the MMRV falls under the recommended vaccines list below.

Recommended immunizations:

Influenza
All individuals, starting at 6 months of age, are eligible to receive this vaccine. Previously unvaccinated children 6 months to less than 9 years of age require two doses of influenza vaccine, given four weeks apart. Children under 9 years of age who have already received one or more doses of influenza vaccine in the past are recommended to receive one dose per season thereafter.

Meningococcal C (Men C)
Children 1 year of age should receive a single dose. Unimmunized persons remain eligible for a single dose of Men C if they were 1 year of age on or after September 2004; or born between 1986 and 1996.

Pneumococcal
The pneumococcal conjugate vaccine is available for infants and children and protects against 13 strains of pneumococcal bacteria. It is routinely given at 2 and 4 months with a booster dose at 12 months of age.

Rotavirus
Rotavirus ORAL vaccine is offered for infants 6-24 weeks of age. It is routinely given at 2 and 4 months of age. The first dose can be given as early as 6 weeks and as late as 20 weeks of age. Both doses must be completed by 24 weeks of age. A minimum of 4 weeks is required between doses.

Varicella (Chickenpox)
Varicella vaccine can be given as early as 12 months. Children born on or after January 1, 2000 can receive the recommended two doses for free. The second dose of varicella is routinely given as the combined MMRV vaccine at 4 to 6 years of age (preferably prior to school entry) – see immunizations for school-aged children.

 

Immunizations for School-Aged Children

Required immunizations:

Diptheria, Tetanus, Pertussis and Polio (DTaP-IPV)
The DTaP-IPV vaccine is routinely given at 4 to 6 years of age (4 to 6 year booster).

Note: Polio vaccine can be IPV (injectable) or OPV (oral). Children with immunization records from other countries may have OPV recorded.

Measles/Mumps/Rubella and Varicella (MMRV) Vaccine
Children are required to have two doses of MMR given at least 28 days apart. The second dose of MMR is routinely given in combination with the second recommended dose of varicella* (chicken pox). This combined vaccine is called MMRV and is given at 4 to 6 years of age (preferably prior to school entry).

Children 7 to 11 years of age who have not received any doses of MMR or varicella may receive two doses of MMRV.

*Please note that the varicella component of MMRV falls under the recommended vaccines list below.

Tetanus, Diphtheria and Acellular Pertussis (Tdap)
Students are required to have their adolescent tetanus and diphtheria booster given 10 years after the 4 to 6 year booster. It is recommended that all adolescents 14 to 16 years of age receive their adolescent booster as a single dose of Tdap, which includes additional protection against acellular pertussis.

Children aged 7 years and older who missed their 4 to 6 year booster dose of DTaP-IPV can receive Tdap plus IPV vaccine either combined or given separately, depending on vaccine supply.

Recommended immunizations:

Hepatitis B (Hep B)
Hep B vaccine is offered in a two-dose schedule to students in grade 7 at school-based immunization clinics.

Human Papillomavirus (HPV)
HPV vaccine is offered in a three-dose schedule to female students in grade 8 at school-based immunization clinics.

Influenza
All individuals, starting at 6 months of age, are eligible to receive this vaccine. Previously unvaccinated children 6 months to less than 9 years of age require two doses of influenza vaccine, given four weeks apart. Children under 9 years of age who have already received one or more doses of influenza vaccine in the past are recommended to receive one dose per season thereafter.

Meningogcoccal ACYW-135 (Men ACYW-135)
Men ACYW-135 vaccine is offered to students in grade 7 at school-based immunization clinics. Only one dose is needed.

Varicella (Chickenpox)
Children born on or after January 1, 2000 can receive the recommended two doses for free. The second dose of varicella is routinely given as the combined MMRV vaccine at 4 to 6 years of age (preferably prior to school entry). Children who have already received two doses of the MMR vaccine and one dose of the varicella vaccine can receive a second dose of varicella.

 

Immunization Schedule for Adults

(*From Peel Health Website)

Immunization is one of the most effective public health interventions. Every year immunizations save many people from death or disability, and help reduce medical care costs and hospital admissions. Immunization is a lifelong process of preventing infection and disease.

We do our best to protect our children, but we also have to remember to protect ourselves. Adults should receive all doses of vaccines recommended to them. Immunizations are recommended based on your occupation, travel, underlying medical conditions, environment, lifestyle and age.

Some vaccines are free through your health care provider. Make sure you’re protected.

Vaccine Who should receive it?
Tetanus
Diphtheria
Everyone, every 10 years
Pertussis
(whooping cough)
Everyone, once in adulthood
Influenza Everyone 6 months of age and older, every year
Polio People who were previously unimmunized who may be exposed to wild polio cases, and health care workers
Pneumococcal Everyone 65 years of age and older
Hepatitis B People with medical, occupational or lifestyle risks and anyone who wants protection from Hepatitis B
Hepatitis A People with medical, occupational or lifestyle risks and anyone who wants protection from Hepatitis A
Meningococcal People with specific medical conditions and people living in residential accommodation including students and military personnel
Measles
Mumps
Rubella
(German measles)
People who have not had the vaccine or the disease
Varicella
(chickenpox)
People who have not had the vaccine or the disease
HPV All females 9 to 45 years of age
All males 9 to 26 years of age
Herpes Zoster
(shingles)
Everyone 60 years of age and older
Travel Vaccines Varies by destination – visit the Public Health Agency of Canada website or go to your local travel clinic

 

*Adapted from the Canadian Immunization Guide 2006, National Advisory Committee on Immunization and Immunize Canada

Learn more information about vaccine preventable diseases.

Recommended Adult Immunizations

Tetanus, Diphtheria (Td)
A booster for Td is recommended every 10 years after the 14 to 16 year old adolescent booster to ensure long-lasting protection against these diseases. This vaccine is publicly funded (free) for all adults.

Tetanus, Diphtheria and Pertussis (Tdap)
One lifetime dose of Tdap is recommended for adults 19 to 64 years of age who have not previously received a dose of acellular pertussis vaccine during adolescence. This lifetime dose is free and will replace one of the Td booster doses given every 10 years.

Influenza
All individuals aged 6 months and older who live, work or attend school in Ontario are eligible to receive seasonal influenza vaccine for free.

Polio
Publicly funded for eligible individuals.

Pneumococcal
Adults 65 years of age and older can receive one free dose of 23-valent pneumococcal polysaccharide vaccine, which protects against meningitis, septicemia (blood poisoning) and pneumonia caused by 23 strains of the Streptococcus pneumoniae bacteria.

A 13-valent pneumococcal conjugate vaccine is also available for adults 50 years of age and older. This vaccine provides protection against 13 strains of Streptococcus pneumoniae. Currently this vaccine is not publicly-funded in Ontario. It is available for purchase with a prescription. Consult your health care provider to discuss which vaccine meets your immunization needs.

Measles, Mumps, Rubella (MMR)
A second dose of MMR is recommended for young adults (18 to 25 years), post secondary students, persons who received killed measles vaccine (1967 to 1970), health care workers or those who plan to travel internationally. This is a live vaccine and should not be given during pregnancy. Talk to your health care provider if you plan on becoming pregnant. This vaccine is publicly funded.

Hepatitis B, Hepatitis A, Combined hepatitis A/B, and Meningococcal Vaccines
Publicly funded for adults in certain high-risk groups; for more information about high-risk groups, please contact Peel Public Health at 905-799-7700. May be required for certain occupations, travel or educational institutions, however, it is not publicly funded under these circumstances.

Varicella (Chickenpox)
Individuals who have never had the vaccine or chickenpox disease are recommended to receive a 2-dose series of varicella vaccine. This is a live vaccine and should not be given during pregnancy. Talk to your health care provider if you plan on becoming pregnant. This vaccine is only publicly funded for adults in certain high-risk groups.

Human Papillomavirus (HPV)
HPV is given in a 3-dose series and is currently not publicly funded for adults.

Herpes Zoster (Shingles)
Recommended for the prevention of herpes zoster and its complications in adults 60 years of age and older. This vaccine is given in one dose and is currently not publicly funded.

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Doc Mike Evans White Board Talks

Doc Mike Evans White Board Talks

Check out this new exciting method of delivering health information.

Dr. Mike Evans is an Associate Professor at the University of Toronto in Family Medicine.

He has published a series of educational videos on various health topics in Family Medicine.

He uses an innovative wipe board to tell a story about a topic, that is evidence based, informative and entertaining.

Visit his Youtube channel for topics ranging from healthy lifestyle treatment to specific disease information.

DocMikeEvans

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Cancer Screening

Cancer Screening

Cancer is the second leading cause of death in Canada, second only to cardiovascular diseases.  The most common causes of death from cancer are lung, breast, colon, and prostate cancer.

There are several ways your Doctor can help you screen for cancer.   Please review your specific situation with your Physician at your medical visit.

For more information on cancer, visit The Canadian Cancer Society.

 

Guidelines for Cancer Screening in Ontario

Cancer Care Ontario Guidelines for Breast, Cervical & Colorectal Cancer Screening

Guidelines_English_March2013

 

Breast Cancer Screening

  • Women
  • Age 50-74
  • Mammogram
  • Low Risk – Every 2 years
  • High Risk – Every year, starting at age 30

Breast Cancer Screening

 

Cervical Cancer Screening

  • Women
  • pap tests
  • every 3 years
  • age 21 to 70
  • who are or who have even been sexually active

Cervical Screening Guidelines

Cervical Screening Information

 

Colon Cancer Screening

  • Men and Women
  • Age 50 to 74
  • Low Risk – Stool check for blood (FOBT) every 2 years
  • High Risk – Colonoscopy every 10 years, starting 10 years earlier than relative with colon cancer

Colon Cancer Facts

 

Other Cancers

There is also screening tests available for other forms of cancer.  Please contact your Doctor to review what is available and whether this applies to your situation.

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Periodic Health Exams or “Physicals”

Periodic Health Exams or “Physicals”

Preventative Medicine is an important part of health care.  It is a way to screen for illnesses before they happen, identify risk factors for diseases, and make positive changes to our health to prevent illness.

An important part of Preventative Medicine is the Periodic Health Exam, or “Complete Physical.”  

Many people recognize this as an “annual check-up” with their Family Doctor, and may include things like reviewing their medical history, family history, medications, and allergies, receiving a physical examination from their Doctor, doing blood work or other screening tests like pap tests, mammograms, colon cancer screening, or prostate screening.

There is some debate about the frequency and content of  Periodic Health Exams.   What age should these begin?  How often should they be done?  What should be done at the visit?  What tests should be performed?

Currently there is no consensus or rule available to answer these questions exactly.  You will find that Periodic Health Exams vary between Physicians.  The term “Periodic” is used now instead of “Annual” to suggest that certain tests are recommended at various intervals, and not necessarily every year.

There are however some guidelines for Periodic Health Exams that are evidence-based.  Please see the recommendations below.

**These guidelines are suggestions based on evidence for healthy individuals, taking no medications, and having no other illness, risk factors, or family history of diseases.  For individuals with any medical conditions, taking medications, having risk factors for diseases, or past history of illness, these recommendations are reviewed on a case by case basis.  Please talk to your Doctor to review your preventative health care needs.  These are only suggestions, and should be reviewed with your physician to determine if they are right for you or your children.

Periodic Health Exams

Download a copy

 

Children 0-6 years old

 

Visits are timed with newborn care and vaccinations, and follow a guideline called the Rourke Baby Record

  • within the 1st week of delivery
  • 1 month
  • 2 months (Tetanus, Diphtheria, Polio, Pertussis, H Influenza, Men C, Pneumococcus, Rotavirus)
  • 4 months (Tetanus, Diphtheria, Polio, Pertussis, H Influenza, Men C, Pneumococcus, Rotavirus)
  • 6 months (Tetanus, Diphtheria, Polio, Pertussis, H Influenza)
  • 12 months (Pneumococcus, Measles, Mumps, Rubella)
  • 15 months (Chicken Pox, Men C)
  • 18 months (Tetanus, Diphtheria, Polio, Pertussis)
  • 2-3 years old
  • 4-6 years old (Tetanus, Diphtheria, Polio, Pertussis, Measles, Mumps, Rubella)

 

Children 6 – 14 years old

 

Every 2 years:

  • height, weight
  • growth, development, nutrition, healthy lifestyle
  • social, family, school, peer issues
  • vaccinations done at school:
  1. Hepatitis B (Grade 7, 2 doses, for boys and girls to protect against Hepatitis B)
  2. Menomune (Grade 7, 1 dose, for boys and girls to protect against Meningitis ACYW-135)
  3. Gardasil (Grade 8, 2 doses, for girls to protect against HPV & cervical cancer)

 

Teen 14-16 years old

 

  • Adacel Vaccination (Tetanus, Diphtheria, Pertussis)

Teen Age 16-17

 

  • height, weight
  • growth, development, nutrition, healthy lifestyle
  • social, family, school, peer issues
  • teen health, puberty, healthy sexuality, substance issues
  • accident prevention

 

Age >21 year old females

 

 Every 3 years:

  • Cervical Cancer Screening for women (Pap tests; Low Risk – every 3 years, age 21 to 70 who are or who have ever been sexually active ; High Risk – Based on results)

 

Age >50

 

Men every 2-3 years:

  • Cholesterol
  • Glucose
  • BP
  • Prostate Cancer Screening (Examination, PSA every year – this is debated by Physicians)
  • Colon Cancer Screening (Low Risk – Stool Check for blood (FOBT) every 2 years; High Risk – Colonoscopy every 10 y, starting 10 years before relatives cancer age, until age 74)

Women every 2-3 years:

  • Cholesterol
  • Glucose
  • BP
  • Breast Screening (Mammograms; Low Risk – every 2 years, age 50 – 74; High Risk – every year, age 30-74)
  • Cervical Cancer Screening (Pap tests; Low Risk – every 3 years, age 21 to 70 who are or who have ever been sexually active; High Risk – Based on results)
  • Colon Cancer Screening (Low Risk – Stool Check for blood (FOBT) every 2 years; High Risk – Colonoscopy every 10 y, starting 10 years before relatives cancer age, until age 74)

 

Age >65

 

  • All of the above for men and women
  • Bone Density (every 3-5 years, depending on risk factors)

 

 

 

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