Infectious Diseases

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Report one of the Diseases of Public Health Significance to the Medical Officer of Health (in accordance with the Health Protection and Promotion Act):

  • During regular business hours (Monday – Friday, 8:30 a.m. to 4:30 p.m.)
  • After hours
    • Phone only: 519-753-4937 (stay on the line to speak to an operator)

Health-care professionals may also consult with the Health Unit regarding infectious diseases and infection prevention and control. The infectious diseases team also assists with outbreak management (e.g. respiratory and gastrointestinal) in institutional and community settings.

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Clinical Entry Signage for Measles

Measles Prevention Poster

Measles Exposure Contact Reporting Form

Measles Prevention Urged at all Health Care Settings – January 31, 2025

Expanded Eligibility for Measles Vaccines – February 10, 2025

Health care providers should promptly isolate any patient with suspect or confirmed measles in a single room with negative air flow (airborne isolation room), if available, and order the following tests:

Measles PCR (nasopharyngeal (NP)/throat swab and urine specimen)

Measles Serology 

Both measles cases and contacts should be reported to Public Health as soon as possible. During regular office hours, suspected cases and contacts can be reported to the Infectious Diseases Team at Grand Erie Public Health Brantford-Brant 519-753-4937 ext. 454. For after hours and weekends, please contact on-call at 519-753-4937.

Clinical Information:

Measles symptoms include fever, a maculopapular rash lasting at least three days, and at least one of the following: cough, coryza, or conjunctivitis. The incubation period ranges from 7-21 days, with symptoms typically appearing 10-14 days after exposure. Individuals are infectious from one day before the prodromal period begins until four days after the rash appears. Exclusion for measles exposure begins five days after the first exposure, as transmission may occur before symptoms develop.

Vaccination:

Measles continues to spread globally, often travel-related. The MMR vaccine provides about 85% protection with one dose and over 95% protection with two doses. Publicly funded MMR vaccine is recommended based on the following guidelines:

Infants aged 6 to 11 months

  • Eligible to receive one dose of MMR vaccine before travel to an area where the disease is of concern outside of Canada
  • Child would still be required to receive two doses after the first birthday, based on the routine immunization schedule (12 months of age and again at 4-6 years of age)

Children aged 12 months to 17 years

  • The first dose of measles-containing vaccine is given at 12 months of age (on or after the first birthday). A second dose is routinely given between four to six years of age.
  • Children who have not received the measles-containing vaccine are recommended to receive two doses.

Adults aged 18 to 25 years

  • Adults aged 18 to 25 years who have not had a measles-containing vaccine should receive two doses of MMR. If only one dose was previously received, individuals in this age group are recommended to receive a second dose.

Adults aged 26 years and older and born in or after 1970

  • Adults who have not had a measles-containing vaccine can be immunized by receiving one dose of measles-containing vaccine.
  • A second dose of measles-containing vaccine is also recommended for adults who meet the following criteria:
    • Health care workers
    • Post-secondary students
    • Military personnel
    • Anyone travelling outside of Canada
    • Anyone based on their health care provider’s clinical judgement

Those born prior to 1970

  • Considered to be immune and do not require a vaccine.
  • Eligible for 1 dose if travelling to an area where disease is of concern outside of Canada.
  • Eligible for two doses if a health care worker or military personnel.

Post Exposure Prophylaxis (PEP) and Immunoglobulin (Ig):

Reference: Measles: Post-exposure Prophylaxis for Contacts

For more information on susceptibility criteria refer to the “Host Susceptibility and Resistance” section of the  Infectious Diseases Protocol Pg 21-23.

Treatment

  • There is no specific treatment for measles.
  • Medical care is supportive to help relieve symptoms and address complications such as bacterial infections.

Infection Control

In a clinical office setting, follow provincial guidance:

  • See the patient at the end of the day after the final patients have left the office.
  • Isolate the patient in a separate examination room and keep the door closed.
  • Provide a surgical face mask for the patient and keep the room ventilated.
  • Health care workers should wear a fit-tested N95 respirator.
  • Post alert signage for staff on the closed room door.
  • Allow at least two hours for air clearance before reusing the room.

Preventative Actions to Take

  • Place signage at the entrances of all clinical settings (e.g., waiting rooms or emergency triage areas) advising individuals not to enter if they have been exposed to, are showing symptoms of, or suspect they may have measles. Include a contact number for them to call, so that infection prevention and control (IPAC) measures can be prepared for their arrival. GEPH has created a template you can use, print, and post.
  • Inform patients about the importance of calling ahead to healthcare facilities if they have been exposed to, show symptoms of, or suspect they may have measles. By calling in advance, staff can implement infection prevention and control (IPAC) measures to prepare for the arrival of a potential measles case.
  • Consider implementing symptom screening before patients enter your healthcare setting (e.g., through self-assessment signage, pre-appointment calls, or staff-led screening of patients, visitors, and support persons at entrances).
  • Re-educate clinical and support staff on specimen collection (PCR and serology) and IPAC precautions for measles, including conducting an assessment of PPE supplies and PPE fit-testing
  • Immunize patients in your roster who are not up-to-date and eligible for a dose of measles[1]containing vaccine. Ensure your staff are also up-to-date and have ready access to their immunization records.

Responsive Actions to Take

  • Verify the vaccination status of patients who report a possible exposure to measles and ensure symptoms of measles are being monitored for up to 21 days after their last exposure.
  • Contact GEPH if an infant under 12 months of age or pregnant and/or immunocompromised patients reports an exposure to measles as they may be eligible for immunoglobulin;
  • Immunize patients who are not up-to-date and eligible for a dose of measles-containing vaccine;

Additional information and resources can be found below:

Measles Information for Health Care Providers – Public Health Ontario (September 2024)

  • Quick reference for information on diagnosis, testing, and patient counselling.
  • Please note that both PCR AND urine are recommended for diagnosis of measles.

Measles: Post-exposure Prophylaxis for Contacts – Public Health Ontario (September 2024)

  • Outlines considerations for measles PEP for contacts of cases.

Measles Infectious Disease Protocol – Public Health Ontario (March 2024)

  • Disease-specific information.

Measles Summary – Ontario Family Physicians (March 2024)

  • Prevention and Management of Suspect cases in family practice

Measles IPAC Checklist for Clinics and Specimen Collection Centres – Public Health Ontario (2024)

  • Assessing organizational readiness for preventing and managing measles exposures in clinics and specimen collection centres.

Key guidance documents

COVID-19 Data and Surveillance

COVID-19 Testing and Treatment

Publicly funded PCR testing for eligible individuals remains available at select locations in Brantford/Brant. If you are referring patients to one of these locations, advise them to wear a well-fitted mask in all indoor spaces and outdoors if physical distancing cannot be maintained.

Clinical Resources:

COVID-19 Infection prevention and control (IPAC)

Routine practices are required for all clinical interactions, independent of any concern for the possibility of COVID-19 or other infectious diseases, and therefore remain important regardless of the respiratory virus transmission risk.

For additional precautions and recommendations specific to COVID-19, see IPAC Recommendations for Use of Personal Protective Equipment for Care of Individuals with Suspect or Confirmed COVID-19.

See Public Health Ontario's technical brief for guidance on IPAC measures based on respiratory virus transmission in health care settings

MPOX (formerly known as monkeypox) virus is an Orthopoxvirus that causes symptoms similar to, but less severe than smallpox, and is endemic to parts of Central and West Africa.  As of May 2022, clusters of MPOX cases were identified in non-endemic countries, including Canada.

Clinical Information

Key Guidance Documents

Epidemiology

Laboratory Testing

Reporting to Public Health

Vaccination

The Health Unit investigates all animal bites and scratches reported in Brantford and Brant County. Any resident bitten or scratched by an animal is advised to get medical attention right away and report the bit to the Health Unit:

  • Brantford-Brant: 519-753-4937 ext. 6470 or Fax 519-753-2140
  • Haldimand-Norfolk: 519-900-9600 ext. 3477 or Fax 519-427-5907

If you are calling after hours or during the weekend, please stay on the line to be transferred to our on-call answering service.

Resources

Health-care providers must report all cases of latent Tuberculosis (TB) infection, active disease, and positive skin tests to the Health Unit by:

  • During regular business hours (Monday – Friday, 8:30 a.m. to 4:30 p.m.)
  • After hours
    • Phone only: 519-753-4937 (stay on the line to speak to an operator)

We provide:

  • Free TB medication
  • Follow-up of all causes of latent and active TB, and positive skin tests

Resources

What is a designated officer?

The Ontario Public Health Standards require that emergency services (ex: firefighters, ambulance, police) have designated officers (DO) identified within their workplace to respond to and investigate reported exposures to communicable diseases. DOs support emergency service workers (ESW) in taking appropriate action after being exposed to communicable diseases in the line of duty. The role of the DO is to act as a liaison between the ESW and the Brant County Health Unit (BCHU) 

Designated officers will: 

  • Respond to and document reported exposure to a communicable disease by an ESW 
  • Determine if an exposure could have occurred 
  • Notify BCHU for assistance as required and provide details of the exposure, including the demographic information of the ESW. 

The Public Services Health and Safety Association offers training for designated officers with both in-class and distance learning options. 

Distance learning: Public Services Health and Safety Association | Designated Officer Program Distance Learning (pshsa.ca) 

In-class: Public Services Health and Safety Association | Designated Officer Training (pshsa.ca) 

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