In Northwestern Ontario, the incidence of invasive Hia disease exceeds that of H. influenzae type b (Hib) in the pre-Hib vaccine era. This provides strong support for the development of a new Hia vaccine. Improved pneumococcal vaccination of high-risk adults in the region is warranted.

Our findings support the effect of immunosuppressors/steroids on the risk of SSIs and add evidence to the previously reported association between the use of anti-hypertensive medications and subsequent development of infection/sepsis.

Introduction:Neisseria meningitidis serogroup B is an important infectious agent in developed countries, including Canada. Infants are particularly susceptible to infection with serogroup B because of immature immune systems, pathogen virulence factors and changing serogroup dynamics in the post-vaccination era. Currently, the Ontario provincial government does not include serogroup B in its routine publicly funded meningococcal vaccination program.Case Presentation:A formerly well 14-month-old male presented to a tertiary hospital emergency department with fever, minor respiratory problems, diffuse purpuric rash, distended abdomen, tachycardia, and history of one episode of vomiting and melena each. Meningococcaemia was immediately suspected, and he was treated with ceftriaxone, cefotaxime and vancomycin before transfer to a different acute care facility within 12 h. N. meningitidis serogroup B, sensitive to ceftriaxone and penicillin, was identified in his blood. The patient developed gangrene of the lower legs and underwent bilateral below-knee amputation 8 days post-admission.Conclusion:This instance of meningococcaemia with extensive sequelae is an example of the various serious outcomes of meningococcal infection. It provides persuasive reason for routine publicly funded vaccination against N. meningitidis serogroup B in Ontario.

Streptococcus pneumoniae is an encapsulated bacterium capable of causing invasive disease in susceptible individuals, including immunocompromised and asplenic patients. Wiskott-Aldrich syndrome (WAS) is a primary immunodeficiency disease with myriad manifestations; it can cause thrombocytopenia, platelet dysfunction, selective antibody deficiency, and predisposition to bacterial infections. A 24-year-old Métis man presented to a Northern Ontario emergency department with several days’ history of malaise, headache, and nuchal rigidity. Within 5 months, he presented again with similar symptoms. In both instances, S. pneumoniae serotype 15C was isolated from his cerebrospinal fluid. He was successfully treated with cefotaxime both times. The patient’s past medical history included WAS, splenectomy, Epstein-Barr virus-associated lymphoma treated with bone marrow transplant, and prior cases of pneumococcal meningitis and pneumonia. He was restarted on indefinite penicillin V prophylaxis. This is the first described case of WAS in a man of mixed European and Indigenous North American descent. We report recurrent invasive pneumococcal disease in an asplenic individual caused by an emerging invasive serotype.

Background: Compass North is a student-led health outreach initiative in Thunder Bay, Ontario, Canada. A current unmet need in Thunder Bay identified in a previously published community needs assessment is mental health services. Women, youth, senior, Indigenous, and LGBT2-SQ populations were disproportionately affected. In response to these perceived gaps in services, a subcommittee of Compass North developed, delivered, and evaluated mental health workshops.Methods: Affiliations with Shelter House Thunder Bay (SH) and Anishnawbe Mushkiki Thunder Bay Aboriginal Health Access Centre (AM) were established. Six interactive workshops were developed and delivered over eight months. Likert scale-based evaluation surveys gauging workshop participant and presenter satisfaction with content were used. Attendance and return attendance were additional markers of success.  Results: A total of 36 participant surveys were completed between both sites. Response rates were 74% and 84% at SH and AM, respectively. Workshop content was well-received by participants and helped address some unmet health education needs. Attendance increased with time at SH.Conclusions: These interactive workshops are one way of addressing unmet community needs in Thunder Bay while maintaining a community presence prior to establishing a fully functional student-run clinic (SRC). They comprise a potentially valuable stage in development of a SRC.