Clinical Service

The Hepatitis Support Program (HSP) in Edmonton provides comprehensive care to Northern Albertans with hepatitis C and hepatitis B infections. Physicians from both Infectious Diseases and Gastroenterology & Hepatology participate in this program, with a Medical Lead representing each Division. There are six program nurses as well as a dedicated social worker and clerical staff for the program.

The Infectious Diseases Division accepts referrals from physicians, from other health care providers (e.g. nurse clinicians, public health professionals), and as self-referrals. The program has been operating since 2003, with an average of about 600 referrals yearly to the ID section.

Nurses triage referrals, coordinate baseline investigations prior to the physician visit, are trained in the non-invasive assessment of hepatic fibrosis using FibroScan®, and follow patients on antiviral therapy. Nurses and the social worker also provide education and counseling, including the need for vaccination against hepatitis A and B and as needed, harm reduction, and access to mental health and addiction services. After completion of baseline investigations, patients are seen by physicians at the University of Alberta and Royal Alexandra Hospitals as well as the Boyle McCauley Health Centre.

The ID Division is actively involved in clinical trials in viral hepatitis and potentially eligible patients are presented with the opportunity to participate as trials begin. The ID HSP also provides core training in viral hepatitis to our University of Alberta ID Subspecialty Residents and offers an elective rotation (generally 2-4 weeks) to other medical residents.

Medical Lead (ID):

Dr. Stephen Shafran
Division of Infectious Diseases
1-135 Clinical Sciences Building
Email: sshafran@ualberta.ca
Phone: 780-492-3319

Medical Lead (GI):

Dr. Winnie Wong
Division of Gastroenterology
1-24B Zeidler Ledcor
Email: winnie.wong@ualberta.ca
Phone: 780-492-8134

Program Secretary:

3A1.05, Kaye Edmonton Clinic
Edmonton, AB T6G 1Z1
Phone: 780-407-1650
Fax: 780-407-8659

Bohdan Savaryn, MD, FRCPC

Director, Northern Alberta HIV Program

Program Description

The Northern Alberta HIV Program and its affiliates are the main source of care to all HIV-infected individuals in northern Alberta, currently over 2,500. The clinic population is highly varied, and we aspire to provide a welcoming environment to indigenous patients, immigrants and refugees, men who have sex with men and people who are street involved or use drugs.

A broad range of care and support, including antiretroviral therapy, is provided by a multi-disciplinary team working from two primary sites: the University of Alberta and Royal Alexandra Hospitals. Support around housing, substance use, partners and families, and reduction of HIV transmission are part of the team's mandate, depending on the individual patient's needs. The team includes nurses, social workers, pharmacists, psychologists and dietitians working with Infectious Diseases physicians with a special interest and expertise in HIV care. The program has a particular emphasis on the prevention of mother-to-child transmission of HIV. Antiretroviral drugs are provided to all patients with Alberta Health Care at no cost to the patient.

There are strong links with relevant community organizations including HIV Edmonton (the local AIDS service organization) and Streetworks (needle exchange and street outreach program). Several program members have been involved in international work. The Edmonton Sexually Transmitted Infections Clinic and the inner-city Boyle McCauley Health Centre are closely affiliated with our program. We have links with northern communities such as Fort McMurray and Grande Prairie to facilitate care for patients who live far from Edmonton. Our staff also provides outreach services to local correctional facilities, and the local HIV patient residence, Kairos House.  The ACE team is a unique resource which provides intensive medication adherence and other supports to patients with particularly complex needs. Team members are involved in a broad range of research activities including trials of new drugs and epidemiologic studies.

Stephanie W. Smith, MD, MSc, FRCPC

Medical Director, University of Alberta Hospital and Stollery Children's Hospital Infection Control Unit

Uma Chandran, MD, MPH, FRCPC

Medical Director, Infection Prevention and Control, Royal Alexandra Hospital, Glenrose Rehabilitation Hospital & Suburban Hospitals Edmonton Zone

Alexandra McFarlane MD, FRCPC

Associate Medical Director, Infection Prevention and Control, Sturgeon Community Hospital

Other Key Participants in the Program:

Dr. Bonita Lee

Associate Medical Director (Stollery Children’s Hospital), Beth Wilke Administrative Director

PROGRAM DESCRIPTION

Infection Prevention Services provides expertise and support to meet the needs of all individuals associated with the Royal Alexandra Hospital, with regard to the prevention of healthcare-associated infections. The program also interacts with national and international Infection Prevention programs. The primary goal of Infection Prevention Services is to promote patient safety by minimizing healthcare-associated infections. Infection Prevention Services personnel provide expertise in epidemiological methods of investigation and current cost-effective interventions. Their scope of activities includes the following:

1. Policy & procedure formulation.
2. Education.
3. Consultation with medical staff, hospital staff and administration.
4. Surveillance (prospective-inpatient, and post-discharge).
5. Collaboration with Public Health Regional Infection Prevention & Control Program.
6. Investigation of outbreaks.
7. Reporting of notifiable diseases to appropriate authorities.
8. Research.
9. Product evaluation.
10. Collaborate with Occupational, Health Safety & Wellness.
11. Initial advice to/follow-up and risk management of potentially exposed patients.
12. Advice/Infection Control Expertise and participation with Hospital Redevelopment Projects.

PROGRAM DESCRIPTION

The Outpatient Parenteral Antimicrobial Therapy (OPAT) clinics provides intravenous antimicrobial therapy and follow up care to ambulatory patients, with consultative support and oversight from members of the Division of Infectious Diseases at multiple sites in the Edmonton Zone. Patients are referred from community physicians and hospital services and accepted based on referral criteria. The clinic not only provides patients with timely access to Infectious Diseases expertise and continuing care but also serves to alleviate congestion in the Emergency Departments and facilitate early discharge from Inpatient Units. The clinic facilitates medical education (both undergraduate and postgraduate), providing learners the opportunity to diagnose and manage common outpatient infectious disease syndromes.

Infectious Diseases Led OPAT Sites

• Royal Alexandra Hospital, Outpatient IV Clinic
  Medical Director, Dr. Isabelle Chiu
• University of Alberta Hospital, OPAT Clinic
  Medical Director, Dr. Karen Doucette
• Grey Nuns Hospital, IV Clinic
  Medical Director, Dr. David Waldner

OPATs Supported by On-Site ID Consultation

• Misericordia Community Hospital, IV Therapy Clinic
• Strathcona Community Hospital, IV Therapy Clinic
• Sturgeon Community Hospital, IV Clinic
• Northeast Community Health Centre, IV Therapy Clinic

CARLOS CERVERA, MD, PHD

Medical Director, Transplant Infectious Diseases

Other Key Participants in the Program

• Karen Doucette, MD, MSc, FRCPC
• Dima Kabbani, MD, Program Director
• Catherine Burton, MD
• Wendy Sligl, MD

Program Description

The Transplant Infectious Diseases program is the largest such program in Western Canada. It provides in-ward consultation to the Multi-Organ Transplant program and the Cross Cancer Institute. In addition, the program provides pre-transplant evaluation for complex cases and follow-up of infectious complications in the outpatient clinic. The Transplant ID program is actively involved in basic, translational, and clinical research as well as providing clinical and research training. This group is also actively involved in Master and PhD graduate studies. We offer a 1-2 year Transplant ID fellowship program as well as shorter (1 month) electives in Transplant ID for interested trainees.

The Tropical Medicine & Parasitic Infections clinic serves as an avenue for evaluation, diagnosis, and management of infections in returning travellers (especially from tropical areas), as well as evaluation and management of all parasitic infections.  Offered at the Kaye Edmonton Clinic (University of Alberta Hospital), this clinic is staffed by physicians of the Infectious Diseases Division with specialised training and certification in the area of Tropical Medicine and Travel Health.  The physicians that currently participate in the Tropical Medicine & Parasitic Infections Clinic include:

• David Waldner, MD, DTM&H, FRCPC
• William Stokes, MD

DENNIS KUNIMOTO, MD, FRCPC

Medical Director, Edmonton TB Clinic, Edmonton Tuberculosis Program
Director of the Program since July 1999

Aberhart Center
9232 - 11402 University Ave
Edmonton, Alberta, Canada  T6G 2J3
Phone: 780-407-4550
Fax: 780-407-7637

Other Key Participants in the Program:

Drs. Rabia Ahmed, Ryan Cooper, Vivek Dhawan, Giovanni Ferrara, Angela Lau, Richard Long, Anu Parhar, Alena Tse-Chang

Program Description

The Edmonton TB program comprises three components: outpatient clinics at the Aberhart Center; an inpatient isolation ward on 5C3 Walter Mackenzie Health Sciences Center, University Hospital; and a consultation service. More than ninety patients per year with active TB are managed by the program, and over three hundred patients per year are started on treatment for latent TB infection. The average census on the TB inpatient service is three. The TB physicians rotate for a week at a time for the inpatient service; one trainee at a time is accepted onto the service, and that individual participates in all three components of the program.