Infectious Diseases and Reporting

• Specimen collection: Collect a nasopharyngeal swab using a colourless transport medium (can be obtained via London Public Health Lab). 

• Order kits online: For more information about these specimen kits or to order a specimen collection kit online 

• After-hours reporting: Call 1-800-922-0096, ext. 0. after-hours, weekend and holidays to report any disease that requires immediate reporting by phone. 

• Download the staff-facing poster to display in clinic staff areas

Reference:

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

• For guidelines for tick bite management and early Lyme Disease management:

  • 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

• To identify ticks:

  • Submitting a tick for identification

   

• PHO Respiratory Pathogen Surveillance Reports: Stay updated on the latest influenza and respiratory virus activity in Ontario through Public Health Ontario's weekly reports.

• FluWatch Canada: Access national influenza surveillance data to see how flu activity is trending across Canada.

• AMMI Guidelines on Antiviral Use: Review clinical guidelines on the appropriate use of antivirals for treating and preventing influenza.

• Influenza Vaccine Ordering: Order flu vaccines for your practice to ensure your patients are protected during flu season.

Mpox must be reported 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.

Mpox Information and Resources:

• From the Ministry of Health:

  • General Information: Mpox Overview and Updates

  • Healthcare Guidance: Resources for Healthcare Professionals

• From Public Health Ontario (PHO):

  • Find detailed information on Mpox, including prevention and testing guidelines

• From Government of Canada: 

  • Stay informed about mpox-related travel advisories and safety updates

Measles is a highly contagious respiratory virus that causes fever, a red blotchy rash, red watery eyes, and cough, and it has no specific treatment. It can lead to severe complications such as blindness, encephalitis, severe diarrhea, and dehydration, and when contracted during pregnancy, it increases the risk of hospitalization, pneumonia, miscarriage, stillbirth, low birth weight, and preterm delivery.

Measles is 99 per cent preventable with immunization 

• If you are born before 1970 you are considered immune due to circulating measles at that time
• If you have had two doses of MMR-containing vaccine, you are considered immune
• Children are routinely vaccinated against measles at 12 months and 4-6 years of age with the two doses
• Due to the outbreak, early vaccination for babies 6-11 months and early second doses for those under 4 are available

What to do if someone has suspected measles

• If you suspect measles, patients should isolate at home and call before visiting a health care setting for advice and to avoid exposing others
• If someone presents to the clinic with suspicion of measles, ask them to wait in their car, or to put on a mask and isolate them immediately in a room with the door closed, don N95 mask, gown, gloves before assessing them in person
• The room cannot be used for two hours after exposure
• If someone is attending the clinic and it is practical, obtain urine and NP swab for confirmation
• Write STAT on requisitions
  

Report all suspected measles cases to SWPH. Call 1-800-922-0096, weekdays 8:30 a.m. - 4:30 p.m.

Preventing exposure in clinical settings

• External signage: Post this sign on clinic or hospital doors to prevent individuals with a rash or possible measles exposure from entering.

SWPH resources

• Reporting forms: Reportable Disease Notification Form

• Patient information: Measles Fact Sheet for Patients

Health Canada

• Surveillance: Weekly Monitoring Report for Measles and Rubella

Measles testing and specimen collection

Tests to order for suspected measles

1. PCR Tests

• Nasopharyngeal (NP) or Throat Swab: Collect within 7 days of rash onset. Use Viral Transport Medium (VTM) (pink liquid medium) collection kit.

• Urine sample: Collect at least 50 mL within 14 days of rash onset.

2. Diagnostic Serology

• Blood sample: Collect 5 mL in serum tube for IgM and IgG antibodies (ideally within 7 days of rash onset).

• Note: PCR is required for symptomatic patients; IgM serology alone is not reliable for diagnosis.

Ordering specimen kits

Ensure your office has NP and throat swab kits:

• NP swab kit (#390082)
• Throat swab kit (#390081)
• Order from PHO
• Requisition Form for Supplies

Collection instructions

Nasopharyngeal swab:

• Step-by-Step Instructions (PDF)
• How-To Video (5 min)

Throat swab:

• Step-by-Step Instructions (PDF)

Submitting specimens

Prepare specimens:

• Ensure each specimen has a completed PHO Laboratory Requisition

  • Example requisition with fields required for submission 

  • Label biohazard bags clearly

Contact PHO Labs:

• 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

Customer Service: 416-235-6556 or 1-877-604-4567

• Learn about rabies: Understand the risks, symptoms, and how rabies is spread.

• Report animal bites: Report a possible rabies exposure to public health immediately.

• Learn about TB: Understand the symptoms, risks, and how TB spreads.

• TB Skin Testing: Find out how TB skin testing works and when you need it.

• Avian Influenza or Novel Influenza in Birds or Other Animals: Learn the management guideline for Avian Influenza or Novel Influenza in birds or other animals.

• Guidance for Health Care Providers: Access the latest COVID-19 guidance, protocols, and resources to support patient care.

• COVID-19 Testing Guidelines: Review current guidelines for COVID-19 testing, including eligibility and procedures.

• COVID-19 Surveillance Dashboard: Stay updated with real-time data on COVID-19 cases and trends in your community.

• Frequently Asked Questions: Find answers to common questions about COVID-19 symptoms, prevention, and care.