Diseases of public health significance | Diseases of public health significance notification form
Mpox
Visit durham.ca/mpox for the latest information from Durham Region Health Department.
Mpox testing
Approval for mpox testing is not required. Health care providers can submit mpox specimens to Public Health Ontario Lab (PHOL) for testing. Health care providers may consult with a PHOL microbiologist for testing eligibility and instructions for collection, submission, and shipment of mpox samples.
For more information on mpox testing, please visit Public Health Ontario Laboratory.
Mpox has been designated a Disease of Public Health Significance (DOPHS) as “Smallpox and other Orthopoxviruses including mpox” under the Health Protection and Promotion Act (HPPA).
Health care providers with patients suspecting mpox infection must report directly to their local Medical Officer of Health (Ontario Reg 135/18) under the Health Protection and Promotion Act.
For more information:
Mpox vaccine
Infection prevention and control (IPAC) recommendations for mpox in health care settings
Public Health Ontario infection prevention and control (IPAC) recommendations for mpox in health care settings.
Additional mpox information
Pertussis
Clinical presentation
Symptoms of pertussis often develop within five to ten days after contact with the bacteria. In the early stages, pertussis appears to be nothing more than a common cold. Pertussis most often starts with a runny nose, sneezing and coughing. The cough gradually gets worse over the next one to two weeks until there are episodes of repeated, violent coughing. These coughing “fits” may end in either a high pitched “whoop” sound, loss of breath or vomiting. The coughing decreases over time but can take weeks to months to go away completely. Infants under six months of age and people who have been vaccinated often do not have the “whoop” or the coughing fits. Vaccinated people who become ill with pertussis usually have only mild illness.
Pertussis diagnostic testing
- Recommendations for testing if pertussis is suspected
- It will be important to keep a stock of the viral swabs in the office or clinic.
|
Test requested
|
Required requisitions
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Specimen type
|
Minimum volume
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Collection kit
|
|
Bordetella pertussis
|
General test requisition |
Nasopharyngeal (NP) swab or NP aspirate, preferred. Sputum (including induced), or Tracheal aspirates are acceptable. |
None |
Bordetella pertussis BP collection kit: Kit order# 390052 |
Public Heath Ontario: Bordetella - Respiratory - PCR
Pertussis post-exposure prophylaxis
Chemoprophylaxis is only recommended for contacts of confirmed cases. Chemoprophylaxis should be offered as soon as possible after exposure. It is not likely beneficial after 21 days following exposure to pertussis. This includes:
- Household contacts (including attendees at family child care centres) where there is a vulnerable person defined as an infant less than one year of age (regardless of immunization status) and/or a pregnant individual in the third trimester of pregnancy.
- Out of household exposures, vulnerable persons, defined as infants less than one year of age (regardless of immunization status) and pregnant individuals in their third trimester who have had face-to-face exposure and/or have shared confined air for more than one hour.
- Note: If the case is an infant less than one year of age (immunized or not) or a pregnant woman in the third trimester, household contacts are recommended to have chemoprophylaxis.
Laboratory diagnostic testing of contacts should not be done to guide decisions around who should receive chemoprophylaxis.
The following antimicrobials are indicated for chemoprophylaxis among people without contraindications
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Age
|
Drug
|
Dosage
|
|
Infants (<1 month)
|
Azithromycin |
10 mg/kg once daily in a single dose for 5 days |
| Erythromycin |
Not preferred |
| Clarithromycin |
Not recommended |
| Infants (1 to 5 months) |
Azithromycin |
As per <1 month |
| Erythromycin |
40 mg/kg po (maximum 1 gram/day) in 3 doses for 7 days |
| Clarithromycin |
15 mg/kg/day po (maximum 1 gm/day) in 2 divided doses for 7 days |
| Infants (6 months and over and children) |
Azithromycin |
10 mg/kg po maximum 500 mg) once for 1 day, the 5 mg/kg po (maximum 250 mg) once daily for 4 days |
| Erythromycin |
As per 1 to 5 months |
| Clarithromycin |
As per 1 to 5 months |
| Adults |
Azithromycin |
500 mg po once for 1 day then 250 mg po once for 4 days |
| Erythromycin |
As per 1 to 5 months |
| Clarithromycin |
1 gm/day in 2 divided doses for 7 days (not recommended in pregnancy) |
Reporting
Pertussis is a reportable infection. Suspect and confirmed pertussis infections should be reported using our online reporting form at durham.ca/DophsReport.
