Infectious Diseases and Reporting

 Pertussis

• To test, collect a nasopharyngeal swab using a special colourless transport medium (can be obtained via London Public Health Lab). For more information about these specimen kits or to order a specimen collection kit online visit the Public Health Ontario website. 
• Call 1-800-922-0096 ext. 0 after-hours, weekend and holidays to report any disease that requires immediate reporting by phone.  Call 1-800-922-0096 EXT 3500, Monday - Friday 8:30 - 4:30 
• Download: Staff-facing poster to display in clinic staff areas
• Ontario Public Health Standards: Requirements for Programs, Services and Accountability Infectious Disease Protocol Appendix 1: Case Definitions and Disease - Pertussis (Whooping Cough) Effective: May 2022

Lyme Disease

• Clinical Guidance: Management of Tick Bites and Investigation of Early Localized Lyme Disease, Ontario Health

• Early Lyme Disease Management in Primary Care, CEP

• 2020 Guidelines for the Prevention, Diagnosis, and Treatment of Lyme Disease, IDSA 

• Lyme Disease Testing, PHO

• Lyme Disease Risk Area Map (Updated annually; shown is 2023)

• Submitting a tick for identification

Influenza

• PHO Respiratory Pathogen Surveillance Reports
• FluWatch Canada
• AMMI Guidelines on Antiviral Use
• Influenza Vaccine Ordering

Mpox

Monkeypox is reportable directly to public health as a disease of public health significance. 

REPORT BY PHONE ONLY

St. Thomas: 519-631-9900, ext 1232 (Monday to Friday, 8:30AM to 4:30PM); ext. 0 if after hours, holidays, or weekends. 
Woodstock: 519-421-9901, ext 3500 (Monday to Friday, 8:30AM to 4:30PM); ext. 0 if after hours, holidays, or weekends. 

Southwestern Public Health has a limited number of vaccine clinics available for those who are eligible for pre-exposure prophylaxis vaccine.

• Information from the Ministry of Health is located at www.ontario.ca/page/mpox-monkeypox. 
• Information from Public Health Ontario is located at www.publichealthontario.ca/en/Diseases-and-Conditions/Infectious-Diseases/Vector-Borne-Zoonotic-Diseases/Mpox. 
• Travel information from the Government of Canada is located at https://travel.gc.ca/travelling/health-safety/travel-health-notices/515 
• Healthcare professionals can find current guidance related to mpox from the Ministry of Health at www.ontario.ca/page/mpox-monkeypox-resources-health-care-professionals. 

 Measles

Post this signage on external doors to prevent individuals from entering clinical or hospital settings if they have a rash or have been exposed to measles.

• Public Health Ontario - Measles: Information Updates for Health Care Providers
• Public Health Ontario - Measles Testing Guidance-PCR
• Public Health Ontario- Measles Testing Guidance- Serology
• Public Health Ontario- Measles IPAC Checklist for Clinics and Specimen Collection Centres
• Public Health Ontario- Measles in Ontario Epidemiological Summary
• Public Health Ontario- Measles: Post-exposure Prophylaxis for Contacts
• Ministry of Health - Measles Case Definitions and Disease
• Ministry of Health - Measles Q&A for Public Health Units
• SWPH - Reportable Disease Notification Form
• SWPH – Measles Fact Sheet for Patients
• Health Canada - Weekly Monitoring Report for Measles and Rubella

Tests to order when measles is suspected:

• Virus detection by PCR (NP/throat swab AND urine) AND diagnostic serology (IgM and IgG)
• Measles Virus Detection by PCR
• Nasopharyngeal swab (NP) OR throat swab obtained 7 days of rash onset. Specimens should be collected using the Viral Transport Medium (VTM) (pink liquid medium) collection kit; AND 
• Urine: Minimum of 50 mL collected within 14 days of rash onset; AND 
• Diagnostic Serology:
• A blood specimen (5 mL collected in a serum tube) for measles antibodies (IgM and IgG) should be collected at the first visit (ideally within 7 days of rash onset)
• Diagnosis for a symptomatic patient requires testing by PCR
• IgM serology should not be the only diagnostic test relied upon for the diagnosis of measles.

Ordering Swabs for Measles Specimen Collection

• Ensure your office has testing specimen containers/ supplies available for testing. 
• Check the expiry dates on the specimen containers (e.g. swabs). 
• Kits can be ordered from PHOL (kit #390082 – NP swab & kit #390081 – throat swab)
• Link to Requisition for Specimen Containers and Supplies  

How to collect swabs

• How to collect a nasopharyngeal swab
• Nasopharyngeal Collection Instructions  (written with visuals)
• How to obtain a nasopharyngeal swab specimen (video) - Marty FM, Chen K, Verrill KA. Waltham, MA: N Engl J Med; 2020 [cited 2021 Feb 01]. 5 min.
• How to collect a throat swab
• Oropharyngeal (throat) specimen collection instructions (written with visuals)

Measles Requisitions

• Complete a Public Health Ontario Laboratory Requisition found HERE (a separate requisition is required for each specimen)
• Example requisition with fields required for submission 

 How to submit specimens to Public Health Lab

• Ensure proper specimens collected
• Ensure one Public Health Lab requisition per specimen
• Label specimen biohazard bag with PHOL so that the specimen goes to the correct lab
• Contact the Public Health Ontario (PHO) Laboratories customer service at 416-235-6556 or 1-877-604-4567 if you have any questions.

Refer to Alerts, Advisories and Information Updates for additional updates related to measles.

NOTE: Updated March 19, 2024

Rabies

Learn more about Rabies and report an animal bite. 

Tuberculosis

Learn more about Tuberculosis (TB) and TB Skin Testing.

Zoonotic Diseases

• Avian Chlamydiosis
• Avian Influenza or Novel Influenza in Birds or Other Animals
• Echinococcus Multilocularis

 COVID-19 (Novel Coronavirus nCoV)

• COVID-19 Guidance and Resources for Health Care Providers
• COVID-19 Testing Guidelines
• COVID-19 Surveillance Dashboard
• COVID-19 Information and Frequently Asked Questions