Toronto Public Health

The goal of the Health Professionals website is to provide you with timely, accurate, and relevant local public health information. Resources are primarily targeted at physicians and infection control practitioners practising in Toronto.

News and Announcements

Hepatitis A Investigation in Toronto

Toronto Public Health is investigating a symptomatic food handler with confirmed hepatitis A infection. Physicians should be alert for patients presenting with signs and symptoms consistent with hepatitis A.


  • The source of the infection is travel related
  • The food handler prepared fresh fruit and vegetable juices at the Big Carrot Organic Juice Bar located at 348 Danforth Avenue in Toronto between March 17 and April 2, 2015
  • The case's onset of symptoms was April 1, 2015. Patrons and food handling staff who attended the juice bar March 17 to April 2, 2015 were offered vaccine against Hepatitis A

Vaccination, Transmission and Symptoms:

  • The hepatitis A vaccine is most effective when received within 14 days of exposure
  • This virus is usually transmitted from person-to-person by the fecal-oral route
  • Symptoms can begin 15-50 days after becoming infected. It is also possible to be infected and not have any symptoms. For symptomatic individuals, the severity of symptoms can range from mild to severe
  • Common symptoms of hepatitis A include:
    • Fever
    • Tiredness
    • Loss of appetite
    • Nausea/vomiting
    • Dark urine
    • Stomach pains
    • Jaundice (yellowing of the skin)

Immediately report to Public Health any suspect or confirmed cases of Hepatitis A to TPH's surveillance unit at 416-392-7411 during work hours (8:30am to 4:30pm, Monday to Friday) or at 3-1-1 after hours.

Increasing Incidence of Gonorrhea Infections in Toronto

Rising gonorrhea infection rates, in addition to increasing antimicrobial resistance, continue to be of great concern; treatment failures have been reported in several jurisdictions across Ontario, associated with the use of oral cefixime.

Site specific testing of all sexually active individuals is critical in diagnosing gonorrhea infection.

Health care providers in Ontario are encouraged to follow Public Health Ontario's Guidelines for Testing and Treatment of Gonorrhea in Ontario (2013).

More Information

Influenza Update – December 19, 2014

Toronto is currently experiencing a high number of influenza A(H3N2) cases. In addition, a mismatch to the vaccine influenza A/Texas/50/2012 strain has been identified by the United States Centres for Disease Control and Prevention (CDC). To date in Canada, strain characterization suggests a drift.

Recommendations for Health Care Providers:

  1. Continue to offer the influenza vaccine.
  2. Be prepared for an increased demand for health care services and outbreaks.
  3. Follow the AMMI Canada treatment guidelines: The use of antiviral drugs for influenza: A foundation document for practitioners.
  4. Offer antiviral prophylaxis to all staff on outbreak-affected units, regardless of their influenza immunization status, during influenza A outbreaks in long-term care homes and hospitals.
  5. Monitor influenza activity in Toronto.
  6. When caring for people with influenza or influenza-like illness, follow Provincial Infectious Diseases Advisory Committee's Routine Practices and Additional Precautions in all Health Care Settings
  7. Advise patients of infection prevention and control measures.

More information:

Ontario MOHLTC memo: preparing for a busy influenza season

TPH Influenza Information for Health Professionals page

Ebola Information for Health Care Professionals

Clinicians should be reminded that although the risk is extremely low Ebola virus disease (EVD) should be considered in the differential diagnosis of febrile persons who have returned from endemic regions or specific local areas of Ebola-affected countries as identified by the  Public Health Agency of Canada.

For the most up to date information on infection prevention and control, lab testing and initial assessment and management of the returning traveller visit the PHO EVD webpage.

Provincial directives, including the Directive for Primary Care, as well as an EVD Screening Tool for Primary Care Settingscan be found at Ministry of Health and Long Term Care EVD page

Toronto Public Health (TPH) has set up an Ebola Information Line for Health Care Professionals at 416-392-5311. The line is staffed during regular business hours Monday - Friday, 8:30 am to 4:30 pm. After hours, please call 311 and your call will be redirected to the After-hours Manager.