Health Care Professionals

• Updated PHO IPAC recommendations for use of PPE for COVID-19
• Visit durham.ca/CovidInfoHub for the latest information from Durham Region Health Department.

Health Department communications and fact sheets

Fact sheets

• Measles
• Measles Exposure
• Measles, Mumps, and Rubella (MMR) Vaccine
• Measles, Mumps, Rubella and Varicella (MMRV) Vaccine
• Self-Isolation

FAX abouts

• Measles Preparedness
  February 23, 2024
• Measles Preparedness - Update #2
  March 28, 2024

News releases

Health Department investigating confirmed case of measles in Durham Region
April 3, 2024

Clinical presentation

Clinical signs and symptoms of measles are:

• Fever greater than or equal to 38.3 degrees Celsius oral and
• Generalized maculopapular, erythematous rash for at least three days, and
• At least one of the following:
  • Cough
  • Runny nose (coryza)
  • Red eyes (conjunctivitis)

Measles is characterized by a prodrome of fever (greater than or equal to 38.3 degrees Celsius oral), cough, coryza (runny nose) and conjunctivitis which usually begin 10 to 12 days after exposure (range seven to 21 days).

Koplik spots (tiny blue-white spots on the buccal mucosa) may also be present during the prodromal period.

Three to seven days after the onset of prodromal symptoms, a red maculopapular, non-itchy rash appears on the face and then spreads downward to the neck, trunk, arms, legs and feet. The rash usually appears about 14 days after exposure (range seven to 21 days).

Individuals who have received one or two doses of measles-containing vaccine may develop an infection with milder symptoms.

Unvaccinated or individuals who have not had two doses of measles-containing vaccine are at increased risk of measles.

The following individuals are at increased risk of more severe measles disease:

• Immunocompromised individuals, especially those who have severely impaired cell-mediated immunity, such as individuals who have recently undergone bone marrow transplantation, individuals with primary T-cell dysfunction, individuals with acute lymphoblastic leukemia, and individuals living with AIDS in whom measles can be severe, atypical and prolonged.
• Individuals with other forms of immunosuppression (e.g., other forms of malignancy), and those receiving high dose steroids or other types of immunosuppressive drugs.
• Children younger than five years of age and adults 20 years of age and older.
• Malnourished children, particularly those with vitamin A deficiency.
• Susceptible pregnant women in who infection is associated with risk of fetal loss and prematurity; there is no evidence that infection leads to congenital defects.

Measles diagnostic testing

Promptly isolate any suspect or confirmed measles patients in a single room with negative air flow (airborne infection isolation room) if available and order the following diagnostic tests, including PCR and serology.

Measles PCR testing Measles serology testing

Contact the Public Health Ontario (PHO) Laboratory and Durham Region Health Department prior to collecting specimens. Courier service will be arranged to facilitate timely shipping and testing of specimens.

• Collection of a nasopharyngeal (NP) or throat PCR AND a urine PCR is strongly recommended and should be attempted on all patients suspected of having measles so that genotyping can be conducted.
• Diagnostic serology (acute and convalescent whole blood or serum specimens) are also important to collect for detection of measles.
• Clearly mark "STAT – Suspect case of measles" (preferable in large bold bright colour) on each laboratory requisition and the outside of the specimen package. Complete a PHO Laboratory requisition form and ensure to include the following: patient’s symptoms, date of illness onset, exposure history, travel history (if any) and vaccination history.
  • Note: Failure to provide clinical information may result in only IgG testing being performed for serology testing.
• STAT measles specimens must be shipped separate from routine specimens. Ship the package directly to PHO Lab, preferably the Toronto site, in order to expedite testing. Durham Region Health Department will assist with sending samples to the lab for measles testing.Health care providers must report patients with suspected measles infection directly to Durham Region Health Department by calling 905-668-4113, ext. 2996 or after hours at 905-576-9991.
  • Note: Specimens should be stored at 2 to 8 degrees Celsius following collection and shipped to PHO Lab on ice packs.
• Please instruct your patient to isolate at home after leaving your clinical facility and that Durham Region Health Department will contact them for further direction and support. See Facts about... Self-Isolation.

Diagnostic laboratory tests for detection of measles

MMR vaccine OR immune globulin (Ig) may be used for measles post-exposure prophylaxis in susceptible individuals.

MMR vaccine

Susceptible immunocompetent contacts six months of age and older who have no contraindications should be given MMR vaccine within 72 hours of the exposure.

Immune Globulin (IMIg and IVIg)

IMIg/IVIg, if administered within six days of exposure, may provide some protection or modify the clinical course of disease among susceptible contacts. As the efficacy of Ig prophylaxis decreases with time from exposure, prompt administration of Ig is encouraged, if needed. Ig should be reserved for susceptible contacts at higher risk of disease severity.

Susceptible high-risk contacts include:

• Immunocompromised individuals;
• Susceptible pregnant individuals;
• Susceptible infants less than six months of age
• Susceptible immunocompetent infants six to 12 months of age who are identified after 72 hours and within six days of a measles exposure.

Canadian Immunization Guide Measles PEP Table

Individuals who receive an Ig as PEP should continue to monitor for signs and symptoms of measles for 28 days after the last exposure.

• Measles vaccines: Canadian immunization guide
• Updated NACI recommendations for measles post-exposure prophylaxis
• Blood products, human immunoglobulin and timing of immunization: Canadian immunization guide

Vaccine

• Ontario's routine immunization schedule
• Measles vaccines: Canadian immunization guide

If MMR vaccine is given prior to 12 months of age as PEP, two additional doses of measles-containing vaccine must be administered after the child is 12 months of age to provide long lasting immunity to measles.

When MMR vaccine is offered 72 hours after exposure, it will not be as effective for PEP, however it provides an opportunity to update immunizations, starting and completing a two-dose series that will provide long-term protection from any subsequent measles exposures.

MMR vaccine: Other considerations

• If a dose given for travel is administered on or after the first birthday and is separated from any previous live attenuated vaccine by at least 28 days, the dose is valid and will meet school-entry immunization requirements in Ontario.
• If a patient’s immunization records are unavailable, immunization with measles-containing vaccine is preferable to ordering serological testing to determine immune status. This avoids the potential for false positive and/or false negative results, reduces the risk of missed opportunities for immunization.
• It is safe to give additional dose of MMR vaccine to those who are already immune.
• Routine serological testing to determine immunity in healthy individuals is not routinely recommended.

• All health care workers (HCWs) should have documented immunity to measles.
• Only HCWs (regardless of age) with presumptive immunity to measles should provide care to patients with suspect/confirmed measles, including:
  • At least two doses of measles-containing vaccine received on or after their first birthday.
    or
  • Laboratory evidence of immunity.
• All HCWs should wear a fit-tested, seal-checked N95 respirator when enter the room and/or caring for a patient with suspect/confirmed measles.
• All patients with suspect or confirmed measles must be isolated in a single room with negative air flow (airborne infection isolation room) with the door closed, if available.
• In addition to the use of Routine Practices, additional personal protective equipment (PPE) such as gloves, gowns and eye protection and facial protection may be added as required based on risk assessment as per Acute Respiratory Infection Precautions (previously known as Droplet and Contact Precautions) practices.
• Where possible, all procedures should be conducted in the separate patient room with the patient wearing a medical mask, if tolerated.
• Schedule the patient visit to minimize exposure of others (e.g., at the end of the day), and ensure the patient arrives wearing a medical mask and an appropriate room (airborne infection isolation room, if available) is available to place the patient in immediately upon arrival.
• After the patient leaves, the door to the room where the patient was examined must remain closed with signage to indicates that the room is not to be used. Allow sufficient time for the air to change in the room and be free of respiratory particles before using the room for non-immune individuals (two hours is a conservative estimate if air changes are not known). For institutional settings, this time period can be reduced depending on the number of room air changes per hour.
• Conduct routine cleaning of the room and equipment once sufficient time has elapsed to ensure adequate air exchange has occurred in the room.

Interim IPAC recommendations and use of PPE for care of individuals with suspect or confirmed measles

Provincial Infectious Diseases Advisory Committee, Routine Practices and Additional Precautions in All Health Care Settings, 3rd Edition

• Influenza Vaccine now Available for High-Risk Groups Only
  October 4, 2024
• COVID-19 Vaccine Fall Recommendations
  October 2, 2024
• Health Equity Series – Improve Health Through Financial Empowerment #3
  September 23, 2024
• Expanded RSV Program Eligibility
  September 11, 2024
• Rabies: Reminder to Assess, Treat, and Report
  September 6, 2024
• Mpox Update
  August 21, 2024
• Recognizing Tick-Borne Diseases
  August 12, 2024
• Recognizing Lyme Disease
  August 9, 2024
• Infection Prevention and Control (IPAC) in Clinicial Settings
  July 29, 2024
• "What’s Up Doc?" Series - Volume 17, Number 2, July 2024
  July 29, 2024
• World Hepatitis Day - July 28, 2024
  July 25, 2024
• Ontario Listeriosis Outbreak Linked to Plant-based Milk Recall (Silk and Great Value Brands)
  July 12, 2024
• Pneumococcal Vaccine Program Transition
  July 12, 2024
• Pertussis (Whooping Cough)
  June 24, 2024
• Recommendations for Children Previously Immunized with Oral Polio Vaccine (OPV)
  June 10, 2024
• Vision 2030 - Primary Care Dinner Event
  May 22, 2024
• Rabies: Exposures to Humans and Post-Exposure Prophylaxis
  May 13, 2024
• Public Health After-Hours Phone Number Back Online
  May 9, 2024
• Notification of Temporary Change to After Hours Contact Phone Number
  May 8, 2024
• Fridge Check: Have you Changed your Batteries?
  May 1, 2024
• Potassium Iodide (KI) Tablets in Durham
  May 1, 2024
• Influenza Vaccine Return
  April 23, 2024
• Opioid Use in Primary Care 2024 Virtual Conference - CAMH
  April 23, 2024
• "What’s Up Doc?" Series - Volume 17, Number 1, April 2024
  April 17, 2024
• Health Department Launches New Interactive Dashboard for Local Opioid Statistics
  April 17, 2024
• COVID-19 Vaccine Spring Recommendations
  April 12, 2024
• Measles Preparedness - Update #2
  March 28, 2024
• World TB Day
  March 22, 2024
• Transition to Boostrix® & Pentacel® Vaccines
  March 20, 2024
• Measles Preparedness
  February 23, 2024
• Invasive Group A Streptococcal (iGAS) Disease – Close Contact Management
  February 21, 2024
• Extended Shingrix® Eligibility and GSK Packaging Updates 
  February 5, 2024
• "What’s Up Doc?" Series - Volume 16, Number 4, January 2024
  January 19, 2024
• ISPA Enforcement for the 2023-2024 School Year
  January 15, 2024

• Tuberculosis Medication Access: New Pickering Location
  December 6, 2023
• Drug Reporting Tool
  December 5, 2023
• Durham.ca/HCP Website Updated
  December 4, 2023
• World AIDS Day - December 1st, 2023 "Let Communities Lead"
  December 1, 2023
• Increased Invasive Group A Streptococcal Disease (iGAS) in Ontario
  November 20, 2023
• Health Equity Series - Improve Health Through Financial Empowerment #2
  November 6, 2023
• Influenza and COVID-19 XBB Vaccines Now Available for Everyone
  October 31, 2023
• "What’s Up Doc?" Series - Volume 16, Number 3, October 2023
  October 31, 2023
• Respiratory Preparedness Checklist for Primary Care Providers
  October 25, 2023
• STI Online Medication Ordering 
  October 25, 2023
• CAMH Continue Education - Methadone and Buprenorphine
  October 23, 2023
• Echinococcus multilocularis in Durham Region
  October 20, 2023
• COVID-19 Antiviral Prescribing
  October 10, 2023
• Influenza Vaccine Available for High-Risk Groups Only
  October 2, 2023
• School-Based Vaccine Orders
  September 26, 2023
• Sports Related Concussions: Impact for Health Care Providers
  September 25, 2023
• New PHO General Test Requisition Form
  September 22, 2023
• Ordering Rapid Antigen Tests (RATs) for COVID-19
  September 19, 2023
• Rabies: Bat Exposures and Post-Exposure Prophylaxis
  August 15, 2023
• ISPA Enforcement for the 2023-2024 School Year
  August 3, 2023
• World Hepatitis Day - July 28, 2023
  July 28, 2023
• "What’s Up Doc?" Series - Volume 16, Number 2, July 2023
  July 24, 2023
• Health Equity Series - Improve Health Through Financial Empowerment
  July 24, 2023
• Rabies: Serology Testing, Reporting Human Exposures and Post-Exposure Prophylaxis
  July 17, 2023
• COVID-19 Vaccine Updates
  July 17, 2023
• Amendments to the Mandatory Blood Testing Act, 2006
  July 6, 2023
• Diseases of Public Health Significance - Tick-Borne Diseases added
  June 29, 2023
• Increased Invasive Group A Streptococcal Disease (iGAS) in Ontario
  May 26, 2023
• Early Diagnosis and Treatment of Lyme Disease
  May 23, 2023
• An Invitation: Connecting the Durham OHT with Primary Care in Durham Region - June 6, 2023
  May 19, 2023
• Reporting Diseases of Public Health Significance
  May 17, 2023
• Opioid Use in Primary Care Virtual Conference - CAMH
  May 10, 2023
• Potassium iodide tablets in Durham
  May 1, 2023
• Immunization Reminder Letter to Elementary Students sent in May 2023
  May 1, 2023
• Durham OHT Virtual Grand Rounds: Indigenous Cultural Safety in Primary Care - April 27, 2023
  April 25, 2023
• "What’s Up Doc?" Series - Volume 16, Number 1, April 2023
  April 24, 2023
• Influenza Vaccine Return
  April 24, 2023
• COVID-19 Vaccine Updates
  April 11, 2023
• New HIV Testing Guidelines
  April 4, 2023
• Multidrug-Resistant Gonorrhea
  April 3, 2023
• Reporting Requirements for Veterinarians
  April 3, 2023
• Lakeridge Health Electronic Referrals via Ocean Platform
  April 3, 2023
• Testing Changes for Lyme Disease
  March 29, 2023
• World TB Day
  March 24, 2023
• Scabies
  March 17, 2023
• XDR Shigella - Possible Sexual Transmission
  March 15, 2023
• It's Time to Spring Forward and Change Your Batteries
  March 13, 2023
• Durham OHT and Primary Care Network Durham Grand Rounds: Preventative Care - February 23, 2023
  February 17, 2023
• Measles Preparedness
  February 15, 2023
• "What's Up Doc?" Series - Volume 15, Number 4, January 2023
  January 30, 2023
• Canada's New Guidance on Alcohol and Health
  January 24, 2023
• Immunization Reminder Letter to Students sent in December 2022
  January 6, 2023

• COVID-19 Vaccine Update
  December 22, 2022
• Update - Compounding Pharmacies, Operational Direction, COVID-19 Assessment and Treatment Centres, and Call for Pediatric Support
  November 30, 2022
• Compounding Pharmacies, Operational Direction, COVID-19 Assessment and Treatment Centres, and Call for Pediatric Support
  November 21, 2022
• Multidrug-Resistant (MDR) Salmonella associated with travel to Mexico
  November 16, 2022
• Free Online Prenatal Classes
  November 9, 2022
• Lyme Disease cases are rising in Durham Region
  November 8, 2022
• Influenza Vaccine Supply Update
  November 7, 2022
• Influenza Vaccines are Now Available for Everyone
  November 1, 2022
• North Durham Breastfeeding Services
  October 31, 2022
• "What's Up Doc?" Series - Volume 15, Number 3, October 2022
  October 26, 2022
• It’s Time to Fall Back - Change your Batteries for the Fall!
  October 24, 2022
• Bivalent COVID-19 Vaccine Booster Update
  October 21, 2022
• Viral Haemorrhagic Fever Including Ebola Virus
  October 14, 2022
• Influenza Vaccine Available for High-Risk Individuals & Healthcare Workers
  October 6, 2022
• Pfizer COVID-19 Vaccine Available for Children 6 months - 4 years of age
  September 29, 2022
• Port Perry Office Reopening for Vaccine Order Pick Up
  September 23, 2022
• Potassium iodide tablets in Durham
  September 22, 2022
• Enterovirus D68
  September 21, 2022
• Moderna Bivalent COVID-19 Vaccine Available
  September 13, 2022
• Product Safety Update: Opening Ampoules for MMR(V) Diluent
  September 8, 2022
• COVID-19 Vaccine - Expanded First Booster Eligibility for 5-11
  September 6, 2022
• Aconite Poisoning Cases in Ontario
  September 6, 2022
• Updated Pandemic Stockpile Guidelines
  August 30, 2022
• School-Based Vaccines: Extended Eligibility Update
  August 24, 2022
• Routine & High-Risk Immunizations: Extended Eligibility Update
  August 24, 2022
• Product Update: Recombivax HB (Adult) for School Program
  August 15, 2022
• COVID-19 Vaccination - It's a Great Time to Get on Board
  August 2, 2022
• "What's Up Doc?" Series - Volume 15, Number 2, July 2022
  July 28, 2022
• COVID-19 Vaccine Approved for Children 6 months - 5 years of age
  July 28, 2022
• Monkeypox Educational Webinar for Health Care Providers - July 19, 2022
  July 14, 2022
• COVID-19 Vaccine - Expanded Second Booster Eligibility for 18+
  July 14, 2022
• Update: Revised Publicly Funded Immunization Schedules for Ontario is Now Available
July 11, 2022
• Monkeypox Pre-Exposure Prophylaxis (PrEP) Clinics
  July 5, 2022
• Durham OHT and Primary Care Network Durham Town Hall - June 23, 2022
  June 21, 2022
• Monkeypox Educational Webinar for Health Care Providers - June 23, 2022
  June 21, 2022
• Monkeypox Now Reportable as a Disease of Public Health Significance
  June 21, 2022
• Monitoring for Monkeypox - Update #2
  May 26, 2022
• Monitoring for Monkeypox
  May 20, 2022
• Community of Practice Series: Infection Prevention and Control in Primary Care Settings
  May 19, 2022
• COVID-19 Assessment Centre Closures – By May 31, 2022
  May 13, 2022
• Ministry of Health Refugee HealthLine
  May 11, 2022
• COVID-19 Vaccine: Fifth Dose Eligibility
  May 5, 2022
• "What’s Up Doc?" Series - Volume 15, Number 1, April 2022
  April 29, 2022
• Sexual Health Clinic Reopening
  April 28, 2022
• Webinar - Prescribing Paxlovid in the Community
  April 26, 2022
• COVID-19 Vaccine: Novavax Nuvaxovid availability in Ontario
  April 21, 2022
• Influenza Season is Done and the Vaccine Return Has Begun
  April 20, 2022
• Botulism - Updated Guidance
  April 14, 2022
• Tdap Maternal Program
  April 13, 2022
• COVID-19 Vaccine Expanded Fourth Dose Eligibility
  April 7, 2022
• Durham OHT and Primary Care Network Durham Town Hall - April 7, 2022
  April 6, 2022
• COVID-19 Vaccine for 5 - 11-year-olds: Vaccine Hesitancy
  March 31, 2022
• It’s Time to Spring Forward and Change Your Batteries
  March 25, 2022
• Should I give DTaP-IPV-Hib or Tdap-IPV to my school aged patient?
  March 22, 2022
• Update on School-Based Immunizations
  March 16, 2022
• COVID-19 Therapeutic Clinic Update
  March 16, 2022
• COVID-19 Vaccine Interval Post SARS-CoV-2 Infection
  March 3, 2022
• Immunization Reminder Letter to Students sent in March 2022
  March 2, 2022
• COVID-19 Vaccine Eligibility and Interval Updates
  February 18, 2022
• Healthy Babies Healthy Children Program Restoration
  February 15, 2022
• COVID-19 Therapeutic Clinic
  February 3, 2022
• COVID-19 Vaccine Eligibility and Interval Updates
  January 21, 2022
• Medical Exemptions to COVID-19 Vaccination
  January 4, 2022

• National Pfizer-BioNTech Comirnaty Shortage
  December 24, 2021
• COVID-19 Vaccine: Expanded Eligibility, Revised Intervals, and Referral Requirements
  December 17, 2021
• Service Reduction and Closures
  December 15, 2021
• COVID-19 Vaccine: Janssen (Johnson & Johnson) Availability in Ontario
  December 10, 2021
• COVID-19 Vaccine: Expanded Third Dose Eligibility and Referrals for Special Populations
  December 6, 2021
• COVID-19 Vaccine Approved for Children 5 – 11 years of age
  November 24, 2021
• COVID-19 Vaccine Update Recommended Second Dose Interval
  November 19, 2021
• COVID-19 Vaccine Allergy Clinic Referral Process
  November 9, 2021
• COVID-19 Vaccine Third Dose Eligibility Expanded
  November 4, 2021
• "What's Up Doc?" Series - Volume 14, Number 3, October 2021
  November 3, 2021
• Influenza Vaccine is Now Available for Everyone
  November 1, 2021
• COVID-19 Vaccine Third Dose Referrals Expanded: Immunosuppressant Medications Updated
  October 20, 2021
• COVID-19 Vaccine Third Dose Referrals Expanded: List of Immunosuppressant Medications
  October 19, 2021
• COVID-19 Vaccine and Co-Administration with other Vaccines
  October 5, 2021
• Influenza Vaccine Now Available for High-Risk Individuals
  October 1, 2021
• COVID-19 Vaccine Administration in Primary Care Settings
  September 22, 2021
• COVID-19 Vaccine Third Dose Referrals for Immunocompromised Update
  September 16, 2021
• Program Restoration
  September 1, 2021
• COVID-19 Vaccine Third Doses Referrals for Immunocompromised
  August 30, 2021
• COVID-19 Vaccine Third doses and Expanded Youth Eligibility
  August 20, 2021
• COVID-19 Vaccine Reminders and Moderna Transfer Update
  August 19, 2021
• Clinic Reopening
  August 9, 2021
• COVID-19 Mass Immunization Clinics Wind Down
  August 6, 2021
• Hepatitis A Outbreak Linked to Frozen Mangoes
  August 6, 2021
• Lyme Disease is rising in Durham Region
  August 4, 2021
• COVID-19 Vaccine Walk-in Appointments Available
  July 28, 2021
• RotaTeq® to Rotarix®
  July 23, 2021
• "What's Up Doc?" Series - Volume 14, Number 2, July 2021
  July 20, 2021
• Mobile COVID-19 Vaccine for Clients who are Housebound
  June 21, 2021
• COVID-19 Vaccine at Local Pharmacies
  May 28, 2021
• COVID-19 Vaccine Booking Open for Individuals 12+
  May 26, 2021
• Lyme Disease is still here!
  May 19, 2021
• AstraZeneca Vaccine - On Pause
  May 12, 2021
• COVID-19 Vaccination for Special Populations: High-Risk Children 12 to 15 Years of Age
  April 27, 2021
• AstraZeneca Vaccine at Local Pharmacies
  April 23, 2021
• Batch Order Available for School-based Immunizations
  April 16, 2021
• COVID-19 Vaccine Eligibility Update & Physician Reminders
  April 14, 2021
• Tick Identification and Testing
  April 13, 2021
• COVID-19 Vaccine Eligibility Update
  April 8, 2021
• COVID-19 Vaccine Eligibility Update
  April 1, 2021
• COVID-19 Vaccine Eligibility Update
  March 31, 2021
• Spring School-based Immunization Clinics Update
  March 26, 2021
• Mobile COVID-19 Vaccine for Clients who are Housebound
  March 25, 2021
  • Client Load Template (COVax)(xlsx)
• COVID-19 Vaccine Eligibility Update
  March 23, 2021
• COVID-19 Vaccine Eligibility Update
  March 15, 2021
• COVID-19 Vaccine Resource for Healthcare Providers
  March 15, 2021
• Service Closures
  March 11, 2021
• COVID-19 Vaccine Booking for Adult Recipients of Chronic Home Care
  March 6, 2021
• COVID-19 Vaccine Booking for Adults 80 Years and Older
  March 3, 2021
• Book your COVID-19 Vaccine Appointment Now!
  March 3, 2021
• Book your COVID-19 Vaccine Appointment Now!
  March 1, 2021
• Book your COVID-19 Vaccine Appointment Now!
  February 22, 2021
• COVID-19 Vaccine Update #1
  February 12, 2021
• New eConsult for COVID-19 Vaccine Allergies Available to Health Care Providers
  February 9, 2021
• Immunization Reminder Letter to Students will be sent in late February
  February 5, 2021
• Update: Revised Ontario’s Publicly Funded Immunization Schedule is Now Available
  January 26, 2021
• "What’s Up Doc?" Series - Volume 13, Number 4, January 2021
  January 22, 2021
• Report of Adverse Event Following COVID-19 Vaccine
  January 5, 2021

Assessment

Edinburgh Postnatal Depression Scale Assessment tool
Instructions

Apply for Health Department approval to manage a corpse with a specific communicable disease

Learn more about managing corpses with specific communicable diseases

• Canada Dental Benefit
• Healthy Smiles Ontario general application
• Healthy Smiles Ontario Emergency and Essential Services Stream (HSO-EESS) application form
• Ontario Seniors Dental Care Program application

Ontario Naloxone Program (ONP)

Eligible community agencies are now able to order naloxone kits from the Health Department to distribute to:

• Individuals who are at risk of opioid overdose;
• Friends and family members of individuals at risk of opioid overdose;
• Newly released inmates at risk of opioid overdose

Publicly funded sexually transmitted infection (STI) medications

STI medications order form

Vaccines

Order influenza vaccine

Order RSV vaccine for eligible 60+ high risk adults

Order RSV vaccine for pregnant individuals

The forms below are for print purposes only.

• Act-Hib Vaccine: High-Risk Client Order Form
• Hepatitis A Vaccine: High-Risk Client Order Form
• Hepatitis B Vaccine: High-Risk Client Order Form
• HPV9 Vaccine: High-Risk Client Order Form
• Meningococcal Vaccine: High-Risk Order Form
• Monthly Vaccine Order Form
• School Based Vaccines: Individual Client Grade 7-12
  (Hepatitis B, Men-C-ACYW-135 and Human Papillomavirus-9 Vaccines)
• School-Based Vaccines: Batch Order Form
  (Men-C-ACYW-135 Vaccine)

Annual fridge inspections

Annual fridge inspections typically occur between the summer months of June to August. You will be contacted by a Durham Region Health Department (DRHD) nurse to schedule an inspection time. If you have obtained a new fridge, contact us at 905-668-7711 extension 3063 to arrange fridge inspection prior to storing publicly funded vaccines. If you have questions or concerns about your upcoming fridge inspection, please call 905-668-7711 extension 3063.

Order print resources

Our online resource order form provides a range of print materials regarding a variety of relevant health topics. Our resources can be distributed to your patients, and are intended to assist you in your daily practice while supporting the health of your patients.

Health care professionals resource order form

• Breastfeeding services referral form
• COVID-19 vaccine allergy and viral vector vaccine clinic patient referral form
• Healthy Babies Healthy Children Program referral form
• Infant & Child Development Program referral form
• Perinatal Mood Disorder (PMD) Care Pathway

• Adverse event following immunization (AEFI) report form
• (Right click the link above and select "Save link/target as" to download.)
• Animal bite/exposure reporting
  Fillable form | Printable form
• Animal disease reporting form for veterinarians
• Cold chain incident instructions
• Diseases of public health significance
  Diseases of public health significance notification form
• Immunization record update form for parents
• Immunization: Statement of medical exemption for child attending child care
• Immunization: Statement of medical exemption for child attending school
• Health care worker influenza immunization coverage reporting form (DOC)
  Questions and answers
• Naloxone reporting form
• Pharmacy temperature log submission form
• Vaccine cold chain inventory worksheet
• Vaccine return form

Alcohol

• Rapid Access Addictions Medicine
  Rapid Access Addiction Medicine (RAAM) clinics offer fast access to quality care for people living with alcohol and opioid-related addictions. Services include medical treatment and counselling services without a doctor’s referral.
• Breaking Free Online
  Free online confidential wellness and recovery support program for alcohol, cannabis, opioids, and over 70 drugs.
• Know your limits with alcohol

Canada's Guidance on Alcohol and Health

• Guidance to support people in Canada to make informed decisions about alcohol and consider reducing their alcohol use.
• Public summary: drinking less is better (infographic)
• Public summary: drinking less is better (poster)
• Drinking less is better English | French

Cannabis

• Breaking Free Online
  Free online confidential wellness and recovery support program for alcohol, cannabis, opioids, and over 70 drugs.
• Knowing your limits with cannabis: A practical guide to assessing your cannabis use
• Talking to youth about cannabis vaping: A guide for health care professionals
• 10 ways to reduce risks to your health when using cannabis: Canada’s Lower-Risk Cannabis Use Guidelines
• Drug Free Kids Canada
• Cannabis talk kit: Know how to talk with your teen
• Talking pot with youth: A cannabis communication guide for youth allies
• Durham Region Health Department: Cannabis

Opioids

• Breaking Free Online
  Free online confidential wellness and recovery support program for alcohol, cannabis, opioids, and over 70 drugs.
• Drug Reporting Tool
• How can I end stigma? Learn ways that you can help end stigma in Durham Region.
• Where to get a free naloxone kit
• Opioid Agonist Therapy: A synthesis of Canadian guidelines for treating opioid use disorder
• Abstinence and harm reduction
• Recovery-oriented care
• Rapid Access Addictions Medicine
  Rapid Access Addiction Medicine (RAAM) clinics offer fast access to quality care for people living with alcohol and opioid-related addictions. Services include medical treatment and counselling services without a doctor’s referral.
• Using motivational interviewing approaches with clients who have self-identified problematic substance uses
• Xylazine information
• Xylazine in the unregulated drug supply
• A harm reduction guide to wound care

Patch for Patch Program

• Return Policy FAQs for health professionals
• Return Policy FAQs for patients
• Patch Return Record Sheet
• Safeguarding our Communities Act (Patch for Patch Return Policy), 2015
• Patch-For-Patch Fentanyl Return Program: Fact Sheet

Smoking

• Breaking Free Online
  Free online confidential wellness and recovery support program for alcohol, cannabis, opioids, and over 70 drugs.
• Algorithm for Tailoring Pharmacotherapy in Primary Care Setting
• Physicians for a Smoke-Free Canada website
• Tobacco screening, Brief Contact Intervention, the 5A’s
• Tobacco Use Intervention 5A pocket card

Determining when its safe for someone diagnosed with a concussion to resume regular activities is particularly important, whether those activities are heavily sport-related or simply returning to school or work.

Rowan’s Law

Rowan’s Law provides a framework for concussion prevention, detection, and management within amateur competitive sport. The final phase of implementation of Rowan’s Law includes the requirements for removal-from-sport and return-to-sport protocols. In addition, the Ministry of Education have also made amendments to the Education Act, such that policies on concussions are consistent with Rowan’s Law.

What does this mean for health care providers?

Under Rowan’s Law, physicians and nurse practitioners are the only health care providers that can medically assess and provide medical clearance for an athlete to return to unrestricted athletic participation. Based on this requirement you may see an uptick in patients seeking concussion assessments.

Note: Students do not need medical clearance to return to school.

Resources to assist you

• Refresh your knowledge on concussions and earn CME Mainpro-M2 credits.
• Rowan’s Law: Information for health care providers.
• Know the Canadian Guideline on Concussion in Sport.
• Follow the return-to-sport strategy or return to school strategy for players who have had a concussion. Children are only safe to return after a doctor says so.
• Find other resources on concussions for health care professionals from Parachute Canada.
• Consensus Statement on Concussion in Sport.

Ontario Works Dental Benefits - Adult Ontario Works recipients

Spore testing (biological monitoring)

Diseases of public health significance

Diseases of public health significance notification form

• Botulism - Guide for Health Care Professionals
• Ebola Virus Disease
• Enterovirus D68
• General Reprocessing Guidelines
• Hepatitis C: Recommendations for public health response in Ontario - PHO
• Hepatitis C: Infectious Diseases Protocol
• Hepatitis C: CATIE website information
• Infectious Disease Trends in Ontario Interactive Tool
• Influenza: Durham Region's Pandemic Plan
• Influenza: MOHLTC
• Legionellosis: PHO
• Lyme Disease: PHO
• Lyme Disease: CDC
• Managing corpses with specific communicable diseases
• MERS-CoV Guidance for Health Workers and Health Sector Employers,  MOHLTC
• Ontario Respiratory Virus Tool
• Outbreak management and infection control in institutions
• PIDAC Best Practices documents
• Rabies: Management of Potential Exposures Guideline, 2020
• Rabies Virus: PHO
• Scabies management
• Canadian TB Standards 8th Edition, 2022
• Tuberculosis screening recommendations for residents of long-term care and retirement homes
• Tuberculosis (TB) screening recommendations for health care workers (employees and volunteers)

• Health care provider Q&A and fact sheets: Pneumococcal Vaccine Program
• Immunization: Canadian Guide Evergreen Edition
• Immunization: Vaccine Storage and Handling Guidelines
• Publicly funded immunization schedules for Ontario (Updated June 2022)
• Public Health Ontario: Building confidence in vaccines
• Summary of immunization recommendations for children previously immunized with oral poliovirus vaccine
• Recommendations for children previously immunized with oral polio vaccine: Q&A for immunizers

COVID-19

• Ontario Ministry of Health
• Health care provider fact sheet: COVID-19 vaccine
• General COVID-19: Vaccine storage and handling guidance

Influenza (Flu)

• Ontario Ministry of Heath
• Health care provider fact sheet: Influenza immunization information for the 2024/2025 influenza season
• Health care provider fact sheet: Influenza immunization for individuals 6 months to 64 years of age
• Health care provider fact sheet: Influenza immunization for individuals ≥65 years of age

Adverse event following immunization (AEFI)

• Adverse event following immunization (AEFI) report form
  (Right click the link above and select "Save link/target as" to download.)
• Appendix 1: Provincial Case Definitions for Diseases of Public Health Significance Disease: Adverse Events Following Immunization
• Adverse Events of Special Interest (AESI) for COVID-19 Vaccines Surveillance
• Adverse Event Following Immunization for Health Care Providers in Ontario

Visit durham.ca/mpox for the latest information from Durham Region Health Department.

• Potassium Iodide (KI) guidelines
• Potassium Iodide Tablets (KI) fact sheet

• Child Health News 2019 Edition
  A Health Department publication for health and social service providers with up-to-date information related to child health.
• Enhanced 18-month well-baby visit pathway
• Healthy Babies Healthy Children Program
• Infant and Child Development Program
• Preconception Health Screening Tool
• Preconception health: Infographic
• Preconception Care Booklet
• Preconception Health: Optimizing Health fact sheet

• Post-exposure anti-rabies treatment recommendations
• Recommendations for administration of rabies post exposure prophylaxis (rabies PEP)
• Management of patients with suspected rabies exposure. Guidance for health care providers working with your local public health unit (Public Health Ontario)

• Chlamydia/gonorrhea treatment guidelines
• Sexually Transmitted Infections: Canadian Guidelines
• Simplified algorithm for clinical syphilis staging and treatment in adolescents and adults
• Staging a syphilis infection in adolescents and adults: Selected physical exam findings according to stage of disease
• Syphilis laboratory results/interpretation

If you are a care provider working with older adults, take our e-course to prevent falls and injuries for your clients or family members.

Positive Steps Work e-course

Technology FAQs

• PHO - IPAC Online Learning Modules
• Personal Protective Equipment Video
• Hand Hygiene: Just Clean Your Hands - PHO

Understanding Stigma – CAMH course
A course is designed to help health care providers and frontline clinicians develop strategies to improve patient–provider interactions and overall care for people with mental illness including addiction.

Trauma-Informed Care (TIC) e-Learning Series
Seven foundational self-study modules that can be completed in approximately 30 minutes or less. Designed for a broad audience, including those providing addiction and mental health treatment services.

Launch the Link 'n' Learn online learning module