We had the great pleasure of sponsoring the 12th International Pediatric Intestinal Failure and Rehabilitation Symposium (PIFRS)this year, and what a great honour it was. We met so many amazing medical professionals and organizations, and had the honour of sharing the greatness and services that we offer. We hope to be a part of this excellent event again in the future!

Monkeypox is a viral zoonosis (a virus transmitted to humans from animals) with symptoms similar to smallpox patients, although it is clinically less severe.

Monkeypox primarily occurs in proximity to tropical rainforests, but has been increasingly appearing in urban areas. CDC reports that symptoms tend to start within 3 weeks of exposure. Individuals with monkeypox get a rash that may be located on or near the genitals or anus, but could also be on other areas like the hands, feet, chest, face, or mouth.The rash can initially look like pimples or blisters and may be painful or itchy.

How Is It Spread?

Monkeypox is spread through close skin to skin contact, this can include, but is not limited to:

• Direct contact with monkeypox rash, scabs, or body fluids from an infected person
• Touching objects, fabrics and surfaces that have been used by an infected person including objects used during sex
• Contact with respiratory secretions.
• Oral, anal, and vaginal sex or touching the genitals of a person with Monkeypox
• Prolonged face-to-face contact.

It is also possible for people to spread the virus to animals and vice versa, either by being scratched or bitten by the animal or by preparing or eating meat or using products from an infected animal.

QUICK FACT – Pregnant individuals can also spread the virus to their fetus through the placenta.

Symptoms

Indiviuals who have been exposed to Monkeypox may experience all, some or no symptoms, including, but not limited to:

• Fever
• Chills
• Fatigue
• Body aches
• Headache
• Swollen Lymph nodes
• Respiratory symptoms

Monekypox is contagious from the time symptoms start until the rash is healed, all scabs have fallen off and a fresh layer of skin has formed — typically last 2-4 weeks

Prevention & Infection

CDC highly recommends that you get the monekypox vaccine, if available, but due to limited supply CDC recommends practicing safe sex and other safe behaviours regarding monkeypox transmission – COMMUNICATION IS KEY

Monkeypox can contaminate the environment. Poxviruses can survive in linens, clothing and on surfaces, particularly when in dark low humidity environments – MAKE SURE TO DISINFECT YOUR HOME THOROUGHLY and take regular hygiene measures!

Final Notice

If you notice any new and concerning rashes coming up on you or a pet or if you are experiencing any new or worsening symptoms, contact your health care provider. If diagnosed with Monkeypox isolate immediately!

For More Information Check Out:

ENFit is a global innovative change in nutritional delivery products, with a mission to make all enteral (tube feeding) devices specific to tube feeding. In line with this change, every extension set, syringe, long tube/PEG, and NG-tube will be designed with a specific ENFit end so that you can only use products designed for enteral/tube feeding access. Button style G-tubes will not change at all — only the extension sets that connect to them.

Recently, the International Standards Organization created ISO CD 80369-3 to help reduce the frequency of medical tubing misconnections. ENFIT features a unique design to reduce the risk of enteral feeding tube misconnections and improve patient safety. 

Why The Change?

Way back in 2006, many in the enteral community expressed concern about the ability of medical devices to connect across systems. For example, so that syringes used for tube feeding would also fit into IV systems of TPN patients. Cases of misconnections are majorly under-reported and many may be assessed as medication errors. Several people have die from misconnections and many more are put at serious risk. In our pediatric community, there is also a very serious risk of disconnection. Current systems, particularly med ports, open easily, making it possible for our children to miss feeds for hours, particularly overnight. This is an inconvenience for most, but a serious problem for children who have issues maintaining their blood sugars.

It took several years to get all manufacturers of enteral products around the world together to move to a standard connection. A trade group was formed called GEDSA to work through the transition. The roll out is worldwide with staggered timing. There is a lengthy transition period during which both the old and the new enteral products will be available. 

Where We Are Now and Moving Forward

ENFit versions are available for all product lines in the United States. However, some durable medical equipment providers have not transitioned over. We estimate about 2/3 of families are receiving ENFit versions and 1/3 are receiving the older versions as of 2020. It will take time for supply companies to work through their stock of supplies with the old connectors before they start mass distribution of the new ENFit supplies.

Quick facts!

• AMT has released a series of adaptors so that you can continue to use your current supplies and stockpiles
• It will take time for supply companies to work through their stock of supplies with the old connectors before they start mass distribution of the new ENFit supplies.
• Low-dose ENFit syringes have been redesigned to prevent the medication errors that were a concern with preliminary designs. There are also adapter caps to ensure accurate dosing.
• There is ongoing testing on various commercial formulas and blenderized food products to ensure that tube feeders’ dietary choices will not be impacted by the move to ENFit.
• Multiple companies have created special cleaning brushes to allow for thorough cleaning of all ENFit connectors.

The novel drug shows breakthrough results in treating the rare but debilitating condition known as Short Bowel Syndrome (SBS).

It is there first long-term treatment advance for this condition in nearly 40 years. It promotes repair and normal growth of the intestine and increases the absorption of nutrients in patients with this condition.

It’s exciting to know REVESTIVE has significant impact on the quality of TPN patients’ lives.

Concord Specialty Pharmacy is full ready to coordinate with TPN patients and their healthcare teams to initiate REVESTIVE therapy when necessary.

SickKids Hospital is doing outstanding efforts to maintain their stock at adequate levels.

Concord Specialty Pharmacy reconciles with HSC supply team on a weekly basis to manage the situation on the patient level. The good news is the issue is about to resolve in just a few weeks.

Our patient kids’ safety is priceless, and we do every attempt to have them enjoy their health to the fullest.

This means that the existing stock of RANITIDINE products currently available in pharmacies may continue to be sold.

Health Canada will take further actions if a risk to Canadians is identified and will continue to inform the public of new safety information.

Oral forms are the most affected and recalled, while injections are still available to use but with restrictive supply until Health Canada completes its thorough assessment.

It is important to note that NOT all RANITIDINE products are affected and recalled. The supply of the only other alternative, Famotidine, is also affected by such a critical situation.

Concord Specialty Pharmacy pharmacists are working diligently with physicians to recommend alternative therapies when necessary, such as Pantoprazole, for their TPN patients to ensure no disruption in their most needed treatment.

KITELOCK

KITELOCK is a non-antibiotic antimicrobial solution that helps patients with central lines, fight off infections.

Since 2016, KITELOCK has been used in hospitals across Canada, especially with high-risk population of kids who rely on their central lines for long-term TPN.

Clinical results are showing that the product drastically reducing the rate of infections in Canadian hospitals, preventing catastrophic outcomes in these patients.