In this issue - April 2026

Program Updates
• Lyme Disease Clinical Guidance Resources
• Child Care and School-Aged Immunization Record Reviews
• Helping Children Thrive: The Impact of Early Vision Detection
• Updated CT & MRI Requisition Forms – NH Implementation
• Celebrating Doctors and Nurses

Announcement
• Respiratory Surveillance

Educational Opportunities

Public Health Alerts
• Infant and High-Risk Children RSV Prevention Program Season End and COVID-19 Vaccine Eligibility Clarification
• Specimen Collection Material Ordering Update #2
• Spring Direction for COVID-19 Vaccine and RSV Prevention Programs

With spring in full swing, we’re pleased to share timely updates and practical resources to support you in your practice.

In this issue, you’ll find updated clinical guidance on Lyme disease to support early recognition and effective management. We’ve also included important reminders about immunization record reviews, along with insights into the vital role early vision detection plays in helping children thrive. In addition, our partners at Niagara Health share updated requisition forms to help keep your workflows running smoothly.

As we approach Doctor’s Day and Nurse’s Week, we also take a moment to honour the dedication, compassion, and expertise that health care professionals bring to patients every day.

Dr. Azim Kasmani
Medical Officer of Health
Niagara Region Public Health and Emergency Services

Lyme Disease Clinical Guidance Resources

Public Health Ontario’s Vector-Borne Disease Tool identifies Niagara as an established risk area for black-legged ticks. As tick activity increases with warmer weather, clinicians should be on heightened surveillance for patients presenting with signs and symptoms of Lyme disease. A total of 47 cases of Lyme disease were reported in Niagara in 2025.

Erythema migrans is a distinct characteristic of Lyme disease and may vary in appearance based on skin colour. In individuals exposed to black-legged ticks in risk areas such as Niagara, a lesion consistent with erythema migrans that is greater than five centimetres in diameter is considered confirmation of early localized Lyme disease and should be treated without laboratory confirmation.

Resources for Health Care Professionals:

Ontario Health created a clinical guidance document to support clinicians with the management of tick bites and investigation of early localized Lyme disease
An assessment and prescribing algorithm is also available to support pharmacists when prescribing antibiotic prophylaxis to prevent Lyme disease following a tick bite

For more information visit our Lyme disease webpage.

Child Care and School-Aged Immunization Record Reviews

Child Care and Early Years Act (CCEYA):

Starting in May, Public Health will be conducting the annual immunization record review for children attending licensed child care settings in Niagara
Approximately 2,000 reminder notices will be mailed to parents or guardians in batches
These children should receive vaccines according to their age as per the Publicly Funded Immunization Schedules for Ontario

Health Care Provider Actions:

Accommodate increased demand for childhood immunization appointments
Ensure sufficient vaccine supply
Remind parents/guardians to report vaccines received to Public Health

Immunization of School Pupils Act (the ISPA):

The 2025-2026 immunization record review concluded April 22, 2026.

Through the combined efforts of primary care providers, schools and Public Health, the majority of students were able to remain in school
ISPA compliance among Niagara students aged 4 to 17 years increased from 84% in October 2025 to 92% by April 2026. Your role in assessing immunization status, providing vaccinations, and encouraging reporting to Public Health continues to play a key part in improving compliance.

While the 2026–2027 record review will begin in the fall, Public Health will connect with some families over the summer to update records early and reduce the need for official notices during the school year.

For more information, contact the Vaccine Preventable Disease Program at 905-688-8248 or 1-888-505-6074 ext. 7396.

Helping Children Thrive: The Impact of Early Vision Detection

May is Vision Health Month, making it an ideal time to reinforce the importance of early eye care for children. As a health care provider, you play an important role in identifying factors that influence a child’s learning and development, including vision. Many young children are unaware they are not seeing clearly, which can delay detection.

The Canadian Association of Optometrists recommends eye exams in infancy, during the preschool years, and annually once children reach school age.

Recommendations for Health Care Providers:

Please remind families, especially those with young children, that their child is eligible for a yearly OHIP covered eye exam and may also qualify for a free pair of eyeglasses if the child is in Kindergarten
Learn about the program and participating optometrists, visit the Eye See Eye Learn program

For more information about vision health, visit the Niagara Region website.

Updated CT & MRI Requisition Forms – NH Implementation

Ontario Health is moving toward digital‑first processes by reducing reliance on paper‑based workflows. The standardized referral form is part of the broader Patients Before Paperwork strategy and will enable future electronic referrals (eReferral) and centralized intake.

Ontario Health West (OHW) has released new standardized CT and MRI requisition forms and will stop accepting older requisition forms after the end of May 2026. Full details can be found on our Resources for Primary Care Providers webpage.

To align with this change, Niagara Health has made recent updates to its Medical Imaging requisition forms to ensure all required patient information is captured and processed efficiently. This includes the addition of non-invasive cardio diagnostics.

Important dates:

Cutoff for regional OHW and NH legacy forms is end of May 2026
Beginning April 20, 2026, all NH legacy forms submitted will receive an auto‑fax reminder advising that legacy forms will not be accepted beyond the May 2026 cutoff

Health Care Provider Actions:

Begin using the updated forms immediately:
- Niagara Health requisition forms
- OHW standardized CT and MRI forms
Complete all required fields to avoid delays or fax‑backs
Ocean e‑referral processes remain unchanged

If you have any questions, please contact the Medical Imaging Booking Office at 905-378-4647 x46350.

Celebrating Doctors and Nurses

As we approach Doctors’ Day (May 1) and Nurses' Week (May 11-17), we take the time to recognize the dedicated professionals who form the backbone of our health care system. Across hospitals, clinics, community practices, long‑term care, home care, and every setting where care is delivered, nurses and physicians work side by side to provide safe, compassionate, and reliable support that strengthens our communities and touches the lives of every person they serve.

Their commitment shows in countless ways: in the clinical expertise that guides treatment, in the calm presence offered during difficult moments, and in the teamwork that ensures patients receive the highest standard of care. Whether responding to urgent needs, managing complex conditions, or promoting long‑term wellness, these professionals play an essential role in keeping our community healthy and safe.

This month, we extend our sincere gratitude to all nurses and doctors. Thank you for your resilience, your skill, and your unwavering dedication to the Niagara community.

Respiratory Surveillance

Public Health Ontario’s most recent respiratory laboratory surveillance data indicates activity for influenza is low
Provincially, Entero/Rhinovirus is the most commonly circulating virus (based on percent positivity); regionally, Entero/Rhinovirus is the most commonly circulating virus.
In Niagara, there have been 1,695 cases of influenza this season; 37,330 across Ontario

Niagara reports flu activity surveillance information weekly on Fridays during the respiratory season.

For more details on the 2025 to 2026 respiratory season, please visit Public Health Ontario’s page for the Ontario Respiratory Virus Tool.

Visit the Professional Development Opportunities page for in-person and online opportunities available to health care professionals in Niagara.

Medical Advisories and Memos

Don't miss important communications from Public Health! Sign up to receive health care professional alerts and urgent notices

MEMO: April 28 - Discontinuation of the Niagara Region Tobacco Hotline – April 30, 2026
MEMO: April 13 - Infant and High-Risk Children RSV Prevention Program Season End and COVID-19 Vaccine Eligibility Clarification
MEMO: April 9 - Specimen Collection Material Ordering Update #2
MEMO: April 8 - Spring Direction for COVID-19 Vaccine and RSV Prevention Programs

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