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Communicable Diseases Information for Physicians

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About Halton Region's efforts to prevent, monitor, investigate and report communicable diseases.


Diseases of Public Health Significance

Reporting Requirements

Under the authority of the Health Protection and Promotion Act (HPPA) (external link) and Regulation 569 (external link), suspect and confirmed cases or death caused by or contributing to diseases of public health significance are to be reported to the local Medical Officer of Health.

Provide the following details in your report as per Regulation 569 (external link):

  • Case’s Name and Address in full
  • Date of Birth
  • Disease (specify if confirmed or suspected)
  • Telephone number
  • Specimens taken, if any
  • Physician’s name
  • Name of person reporting, designation, and contact information
Learn more about Diseases
of Public Health Significance

Diagnostic Testing Recommendations

All suspected cases of pertussis should be reported immediately to Halton Region Public Health at 905-825-6000 (or toll-free at 1-866-442-5866) or dial 311 if calling within Halton Region.

Whenever possible, suspect pertussis patients should be placed in a separate room upon arrival.

Isolation

Advise the patient to self-isolate for five days from the start of antibiotic treatment or for 21 days from the onset of cough, if not treated. Also advise the patient to expect a call from Halton Region Public Health.

Testing to confirm pertussis infection

Recommended specimens for acute pertussis infection are:

  • Bordetella pertussis Nasopharyngeal swab

Note: these swabs are different from other NPS swabs

Refer to Public Health Ontario Laboratory (PHOL) Test Information Index:

All suspected cases of mumps should be reported immediately to Halton Region Public Health at 905-825-6000 (or toll-free at 1-866-442-5866) or dial 311 if calling within Halton Region.

Whenever possible, suspect mumps patients should be placed in a separate room upon arrival. Only health care workers with documented immunity to mumps should assess the patient.

Isolation

Advise the patient to self-isolate at home for five days from the onset of symptoms and to expect a call from Halton Region Public Health.

A mask should be worn if the person requires being in public (e.g. lab or clinic appointments)

Testing to confirm mumps infection

Recommended specimens for acute mumps infection are:

  • Buccal swab *preferred* (within nine days from symptom onset) or Throat swab (within nine days from symptom onset)
    AND
  • Urine (within 14 days following symptom onset)
  • Serology (IgG and IgM)

Refer to Public Health Ontario Laboratory (PHOL) Test Information Index:

All suspected cases of measles should be reported immediately to Halton Region Public Health at 905-825-6000 (or toll-free at 1-866-442-5866) or dial 311 if calling within Halton Region.

Important: Whenever possible, suspect measles patients should promptly be isolated in a single room with negative air flow (airborne isolation room). Suspect measles patients should be assessed at the end of day and placed in a separate room upon arrival to minimize contact with other patients. Only health care workers with documented immunity to measles should assess the patient (scroll below for more IPAC Measures).

Signs and symptoms

Symptoms can appear 7 to 21 days after contact with someone who has the measles virus.

Measles symptoms include:

  • fever
  • cough
  • runny nose
  • red eyes
  • sleepiness
  • irritability
  • small, white spots on the inside of the mouth (Koplik Spots)
  • a red blotchy rash that first starts on the face and spreads down the body, arms, and legs (this rash can last 4 to 7 days)

Isolation

Advise the patient to self-isolate and to expect a call from Halton Region Public Health.

Testing to confirm measles infection

Recommended specimens for acute measles infection are:

  • Nasopharyngeal or throat swab PCR using Viral Transport Media (within seven days of rash onset)
    AND
  • Urine PCR (within 14 days of rash onset)

Refer to Public Health Ontario Laboratory (PHOL) Test Information Index:

Note: serology testing is not recommended for diagnosing acute infection but can be done to determine immune status. Refer to PHOL Measles – Serology for details (external link).

Infection prevention and control

In addition to routine practices, airborne precautions should be used for patients with aknown or suspected case of having measles.

In a clinical office setting, follow the Provincial Infectious Diseases Advisory Committee’s (PIDAC) Infection Prevention and Control for the Clinical Office Practice (external PDF):

  • Make an effort to see the patient at the end of the day, if possible.
  • Suspect measles patients should be assessed at the end of day and placed in a separate room upon arrival.
  • Only health care workers with documented immunity to measles should assess the patient.
  • Triage the patient out of the waiting area as quickly as possible. The patient should enter and exit through a separate access point and go directly into and out of the examination room.
  • Provide a surgical mask for the patient to wear at all times while in all areas of the office.
  • Keep the examination room door closed and open a window in the room if possible.
  • After patient assessment, do not use the exam room until at least 2 hours have elapsed.

In an acute care setting, isolate the suspected measles case in a single room with negative air flow and keep the door closed.


How Halton Region Health Department Supports Physician Offices

The Health Department provides support for:

  • investigating all reports of confirmed and suspected cases of diseases of public health significance (formerly reportable diseases) in the community and within institutions (i.e., schools, licensed daycares, hospitals, long-term care homes, retirement homes)
  • reporting cases to the Ministry of Health and Long-Term Care and/or Pubic Health Ontario for ongoing surveillance and identification of outbreaks
  • inspecting institutions, premises or facilities where cases and/or disease transmission is suspected

We:

  • issue Physician Advisories and Outbreak Bulletins
  • manage cases and contacts, including:
    • recommendations to physicians about treatment and chemoprophylaxis
    • advice on required testing and/or specimen sample submission
    • recommendations about infection prevention and control measures
    • advice on immunization or immune-globulin to cases and contacts
    • counselling for cases and contacts about disease prevention
  • provide Health Care Providers with publically funded medication for the treatment of Sexually Transmitted Infections (STI) and tuberculosis

Infection Prevention and Control (IPAC) for Health Professionals

We have assembled information and resources for health professionals about Infection Prevention and Control.

  • Manuals, guides and reports
  • Physician/dental office resources
  • Reprocessing of medical devices
  • Clinic/ambulatory care resources
  • Related associations and networks

Tuberculosis: Screening and Treatment Resources

We have assembled information and resources for physicians about Tuberculosis.

  • Halton Region Health Department Tuberculosis Program
  • TB screening and treatment resources

Topics Library

Lyme disease and other tick-borne diseases

Rabies

As per Health Protection and Promotion Act (external link), report information concerning any animal bite or other animal contact that may result in rabies in one of your patients to the Halton Region Health Department as soon as possible by calling 311. After calling, please also complete our Rabies Exposure Reporting Form and fax it to 905-825-8797.

Seasonal Influenza

West Nile Virus (WNV)

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