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
Things That Bite: Rabies, Lyme Disease, Zika etc.
Toronto health professionals are invited to attend TPH's upcoming CME accredited event "Things That Bite: Rabies, Lyme Disease, Zika etc." on Wednesday, June 8th, 2016 from 6:00 p.m. - 9:30 p.m.
Speakers include: Dr. Christine Navarro, Dr. Jay Keystone & Dr. Paul Bunce.
Toronto Public Health was notified by the Ministry of Health and Long Term Care (MOHLTC) on April 28, 2016 that due to production delays at Pfizer Canada, there will be a national shortage of Bicillin expected to last until July 2016.
In order to meet expected demand using Ontario's current supply of Bicillin, the MOHLTC has developed a document entitled Interim Guidance on the Management of Syphilis Cases in Ontario During Bicillin Production Delay. Health care providers managing patients with syphilis are requested to begin following the interim guidance document immediately.
Health care providers with questions about the treatment of syphilis or the interim guidance document can call the Sexually Transmitted Infections Case Management Program at 338-2373.
The Public Health Agency of Canada (PHAC) issued an updated travel notice recommending that pregnant women and those considering becoming pregnant avoid travel to areas where the Zika virus is circulating. More information about Zika virus, including testing indications.
On April 15, the Canadian Food Inspection Agency (CFIA) issued a food recall for Nature's Touch brand Organic Berry Cherry Blend sold at Costco due to possible hepatitis A contamination.
- Revised recommendations regarding hepatitis A post-exposure management in response to Nature’s Touch Organic Berry Cherry Blend products
NOTE: As this situation is evolving, please continue to monitor this webpage for the most up to date information and guidelines.
- The MOHLTC has revised the MERSCoV case definition for a Person Under Investigation to be more specific regarding travel history and exposure to health care settings and camels or camel products. More information.
- Physicians should continue to be alert for patients presenting with signs and symptoms consistent with acute respiratory infections (ARIs).
- Persons under investigation for respiratory infections of epidemiologic significance, such as travel-related acute respiratory infections like MERS-CoV, must be immediately referred to the emergency department (ED) of an acute care hospital for investigation. It is advisable to notify the ED prior to patient arrival.
For more information:
Several raccoons have recently tested positive for rabies in the City of Hamilton and Haldimand County. While the risk to the general public remains low, all patients with a bite or other exposure to raccoons, bats and other animals should be assessed for the need for rabies post-exposure prophylaxis (PEP). More information about rabies and animal bites/exposures.
The Ministry of Health and Long-Term Care is working with federal, provincial and health system partners to support Syrian refugee resettlement in Ontario
What Toronto health care providers need to know:
1. Clinics have been established in Toronto to provide comprehensive medical services to newly arrived Syrian refugees. More information, including clinic dates and locations.
2. There are a variety of services available to help connect Syrian refugees with the health care they need. More information including contact info for Medavie Blue Cross (Interim Federal Health Plan), and various helplines.
3. The multi-lingual Refugee HealthLine (1-866-286-4770 (toll-free)) has been established to connect refugees to health care providers for transitional health care and services.
4. Providers who have come forward to provide care to refugees should be encouraged to contact the Refugee HealthLine (1-866-286-4770 (toll-free)) as soon as possible to register their availability.
Resources for Health Care Providers:
• College of Family Physicians of Canada – Refugee Health Care Resource
• CMAJ guidelines "Caring for a Newly Arrived Syrian Refugee Family"
Health care practitioners are required to report any adverse events following immunization. A causal relationship does not need to be proven before reporting. Call Toronto Public Health Immunization Nursing Line at 416-338-2030 for more information or fax the completed Ministry AEFI form to 416-338-2028.
Note: If the form does not open in the browser, download it before completing.
A recent case of lead toxicity in Ontario has been linked to the use of an Ayurvedic medicinal product purchased online. Health Canada posted a related alert regarding Ayurvedic products with high levels of lead, arsenic, and mercury.
Toronto Public Health recently investigated elevated blood lead levels in a group of family members. Spices (turmeric, red chili powder, coriander) brought over from Bangladesh by the family (un-labelled bags ground and purchased at a market) were identified as the likely source of the elevated blood lead levels.
Although exposure to lead among Canadians has declined significantly over the past few decades, health professionals are reminded that imported consumer products may be a source of lead and other heavy metals.
Important information for health professionals:
- Health professionals should consider testing BLLs in patients who are symptomatic (e.g. abdominal pain, anemia, tremor), and screening in children at risk (see Rourke Baby Record).
- Blood lead levels (BLL) <10 ug/dL can have harmful effects on cognitive, cardiovascular, immunological and endocrine function.
- At BLLs >10 ug/dL, the exposure source (such as imported consumer products) should be identified and removed, and BLLs repeated within 3 months.
- Higher BLLs (>20 ug/dL) should prompt specialist referral for further assessment.
- For further assistance with investigating potential sources of lead exposure where BLLs are >10 ug/dL, contact TPH at 416-338-7600.
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.
Influenza activity generally occurs in the late fall and winter months.
As of October 20, 2015, Toronto Public Health (TPH) has received reports of nine laboratory-confirmed influenza cases since September 10, 2015.
For more information regarding the year's flu season, including vaccine details, visit the Influenza page for health professionals.
Toronto Public Health is encouraging the public to nominate individuals and organizations for the 2016 Public Health Champion Awards. Find out more about the award, who is eligible and how you can nominate.
- Publicly Funded Immunization Schedules for Ontario
- Bed Bugs
- Breastfeeding E-Learning Modules
- Cancer Prevention and Screening
- Enteric Outbreak Management
- Grade 7 & 8 Immunization and Vaccines
- Harm Reduction Services
- Rabies and Animal Bites/Exposures
- Respiratory Outbreak Management
- Vaccine Storage and Handling