Your monthly update from Niagara Region Public Health

Welcome to Public Health Pulse! Formerly known as the Physicians’ Newsletter, the publication was given a fresh name in January 2025 to better reflect our commitment to supporting Niagara’s physicians, primary care providers, and allied health professionals with essential public health updates.

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In connecting with many of you, I continue to appreciate the dedication and expertise you bring to improving the health of the Niagara community. With that in mind, I’m please to share a few key updates and resources to support your clinical practice and public health efforts.

In this issue of PH Pulse, you’ll find important information on rabies risk assessment and reporting, updates on gonorrhea treatment guidelines, antenatal care pathway resources and updated evidence regarding alcohol screening, brief interventions and referral services in health settings.

Additionally, our partners at Niagara Health share details on the new centralized booking process for nuclear medicine services.

Thank you, as always, for your commitment and dedication to improving the health of our communities.

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

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In this issue - July 2025

Program Updates
• Rabies Risk Assessment and Reporting
• Updated Gonorrhea Treatment Guidelines
• Updated Antenatal Care Pathway
• Alcohol Screening, Brief Intervention and Referral (SBIR)
• Niagara Health Update - new centralized booking process for nuclear medicine

Medical Advisories and Memos
• MEMO - July 3 - Vaccine Ordering Reminders
• MEMO - July 10 - Vaccine Eligibility Updates
• MEMO - July 16 - Summer Vaccination Catch up for Students
• MEDICAL ADVISORY - July 29 - Heightened Surveillance for West Nile Virus (WNV)

Rabies Risk Assessment and Reporting

This time of year, many more patients may present following interactions with animals. Management of a suspected rabies exposure requires an appropriate risk assessment, which will aid the decision on whether rabies post-exposure prophylaxis (rPEP) is required. Public Health is well positioned to assist with the risk assessment and reduce unnecessary rPEP administration.

Under the Health Protection and Promotion Act, Ontario Regulation 557 - Communicable Diseases-General, Health care professionals are required to report animal bites or scratches immediately to Public Health, whether the animal is suspected to be rabid or not.

To report an animal exposure to Public Health:

Step 1: Complete the report online, or print the form and fax the completed form back to Public Health at 905-641-4994.

Step 2: Call Public Health to ensure a risk assessment is completed and documented.

Monday to Friday (8:30 a.m. to 4:30 p.m.), call 905-688-8248 or 1-888-505-6074 Ext. 7590
After hours and weekends, call 905-984-3690 or 1-877-552-5579

Ensuring a thorough risk assessment is completed remains critical to ensure rPEP is administered in the appropriate scenarios and to reduce wastage.

Public Health investigates all animal exposures and will follow up with the patient to assess the appropriate response. A Niagara Region Public Health Inspector may also contact health care professionals during an exposure investigation.

If the animal can be located: A Public Health Inspector will confine the animal to check for symptoms. Healthy animals will not be removed from their owner.
If the animal cannot be located: A Public Health Inspector may recommend the patient schedule another visit with a health care provider to discuss their initial exposure considering the inability to monitor the animal

Questions regarding rabies risk assessments or follow up

Niagara Region Public Health Inspectors are available to assist with rabies risk assessments, inquiries regarding rabies investigations, or recommended follow up.

Call 905-688-8248 or 1-888-505-6074 Monday to Friday, 8:30 a.m. to 4:30 p.m.
Call 905-984-3690 or 1-877-552-5579 after hours or on weekends
For more information, visit our rabies webpage
A rabies post-exposure prophylaxis algorithm is also available on our webpage

Updated Gonorrhea Treatment Guidelines

In December 2024, the Public Health Agency of Canada (PHAC) updated the recommendations for treating uncomplicated gonorrhea (NG) infections. Preferred treatment for uncomplicated NG infections in adults and adolescents 10 years of age and older is Ceftriaxone 500mg IM as a single dose (monotherapy). Ceftriaxone comes in vials of 250 mg dose. Please ensure your patient receives the full dose of 500 mg.

To order STI medications or if you have any questions, please contact the Sexual Health Centre at 905-688-3817 ext. 7223.

If you would like these copies of the guide for your office, you can order from this webpage.

Complete guidelines, including alternative treatments are available through PHAC.

Updated Antenatal Care Pathway: Supporting informed and timely referrals

Niagara Region Public Health (NRPH) has updated the Antenatal Care Pathway to ensure it reflects the most current information and supports available for new and expectant parents. The purpose of the tool is to provide guidance and support to health care providers in determining appropriate next steps for patients during antenatal care.

Health care providers are encouraged to use the Family Health referral form to directly refer patients to NRPH for further assessment and referral to evidence-based programs, including the Cognitive Behavioural Therapy (CBT) and home-visiting programs. To order a copy of the updated antenatal pathway tool or to submit a Family Health referral form, click the links below:

Alcohol Screening, Brief Intervention and Referral Services - Updated Evidence

Public Health Ontario has released an updated evidence brief outlining alcohol screening, brief intervention and referral services (SBIR) as an effective tool in health care settings.

SBIR is intended to motivate adults and youth engaging in high-risk alcohol consumption to reduce their use and be connected to supportive care. By identifying high-risk individuals through universal screening, a brief intervention is delivered followed by referral to treatment, where appropriate.

SBIR can be conducted in a range of healthcare settings, including emergency departments, primary care clinics and electronically through web-based interventions.

The Canadian Clinical Guidelines for High-Risk Drinking and Alcohol Use Disorder recommends screening all adult and youth patients for alcohol use above low risk.

More Information

Review the updated Alcohol Screening, Brief Intervention and Referral Services evidence brief to learn more.

New Centralized Booking Process for Nuclear Medicine at Niagara Health

To help streamline the booking process for Nuclear Medicine exams, Medical Imaging at Niagara Health is transitioning to a regional booking solution.

Effective immediately, please fax all new Nuclear Medicine requisitions to the Marotta Family Hospital Central Booking Office at 905-323-7560. Only one requisition should be submitted per patient.

The team will schedule the next available appointment at the most appropriate Niagara Health site, based on clinical need and availability.

To support timely communication with patients, please ensure their updated phone number is clearly included on the requisition.

Thank you for your cooperation with this important change, which will help reduce booking turnaround times and improve the patient experience across Niagara Health.

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

Medical advisories and memos

MEMO: July 3 - Vaccine Ordering Reminders
MEMO: July 10 - Vaccine Eligibility Updates: Pediatric Pneumococcal and COVID-19
MEMO: July 16 - Summer Vaccination Catch Up for Students
MEDICAL ADVISORY - July 29 - Heightened Surveillance for West Nile Virus (WNV)