In this issue - June 2026

Program Updates
• Reporting Diseases of Public Health Significance (DOPHS): Role of Health Care Providers
• Suspected Rabies Exposure Management
• Ebola Virus Resources
• Serology Testing for Guiding Decisions to Vaccinate
• Return Influenza Vaccine in July
• Expanding Oral Health Support to Older Adults in Niagara

Announcements
• Dr. Angela Ma joins Niagara Region Public Health as AMOH
• SeamlessMD Launches Digital Maternity Support for Niagara

Educational Opportunities
• Preparing Families for Feeding Success: Infant Feeding Education Sessions

Public Health Alerts
• Memo: Candida auris Colonization - Enhanced Surveillance Directive
• Medical Advisory: Legionellosis - Heightened Awareness

This month’s newsletter delivers timely resources and information to support your practice. Inside, you’ll find key reminders on reporting diseases of public health significance, guidance for suspected rabies exposure, and Ebola virus preparedness resources. We also highlight information about serology testing and instructions for returning influenza vaccine in July.

Beyond communicable disease, this issue features initiatives expanding preventive care such as oral‑health supports for older adults and the launch of SeamlessMD maternity support. We are also thrilled to share the introduction of our new Associate Medical Officer of Health, Dr. Angela Ma, who will help guide ongoing public‑health priorities.

Thank you for all you do to keep our Niagara community healthy.

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

Reporting Diseases of Public Health Significance (DOPHS): Role of Health Care Providers

Under the Health Protection and Promotion Act (HPPA), Ontario Regulation 135/18, regulated health care providers must report suspected or confirmed cases of designated diseases to their local public health unit.

Timely reporting of these and other diseases of public health significance is essential to enable rapid public health action. Early notification allows for prompt case investigation, contact tracing, and implementation of control measures that help prevent further transmission. This is especially important for highly communicable, vaccine-preventable, or emerging infections, where delays can lead to outbreaks and increased morbidity. In addition, reporting supports surveillance systems that monitor disease trends, guide resource allocation, and inform provincial health policy.

Recommendations for Health Care Providers

Order a printed copy of current list of DOPHS through our Health Care Professional Resource Ordering page
Familiarize yourself with Ontario’s current list of DOPHS and learn more about how to report and reporting timelines to NRPH

More Information:

Call 905-980-6000, (Mon-Fri, 8:30 a.m. to 4:30 p.m.), Toll free: 1-888-505-6074, After hours: 905-984-3690

Suspected Rabies Exposure Management

Niagara Region Public Health (NRPH) has identified the first rabies-positive bat in the region this year but the risk to the community remains low.

Key Highlights

Direct contact with a bat is necessary for increased risk of rabies exposure, according to provincial guidance
Rabies post-exposure prophylaxis (rPEP) following bat contact is recommended when both the following conditions apply:
- There has been direct contact with a bat; AND
- A bite, scratch, or saliva exposure into a wound or mucous membrane cannot be ruled out
When there is no direct contact with a bat, the risk of rabies is extremely rare, and rPEP is not recommended
- Evidence of direct contact includes: bite/scratch marks on the skin, or an individual crying/upset while a bat was in the room
Local public health is available to provide risk assessment support following a potential rabies exposure

Health Care Provider Action

Health care providers must immediately report any suspected rabies exposures to NRPH in one of three ways:
- Complete the Animal Bite or Scratch Report Form online
- Print and fax the form at 905-641-4994
- Call 905-688-8248 or 1-888-505-6074 ext. 7590
  - Mon-Fri (8:30 a.m. - 4:30 p.m.), After hours and weekends, call 905-984-3690 or 1-877-552-5579
Refer to PHO’s Management of Patients with Suspected Rabies Exposure, Guidance for Health Care Providers Working with Your Local Public Health Unit for animal specific post-exposure management algorithms
Following consultation to support risk assessment, rabies post-exposure prophylaxis can be requested and delivered to primary care providers by Public Health

More Information

Rabies vaccine information, please refer to the Canadian Immunization Guide
Bat exposures and rPEP administration, please refer to Figure 1: Algorithm for Bat Exposures and PEP administration*

Ebola Virus Resources

With the ongoing Ebola virus disease (EVD) outbreak affecting parts of the Democratic Republic of Congo (DRC) and Uganda, NRPH is sharing reminders and resources to support health care providers.

From May 30 to August 29, 2026, federal temporary border measures are in place, including a mandatory 21-day quarantine for returning travellers from the DRC, Uganda, or South Sudan
The risk of Ebola importation to Ontario is low

Recommendations and Reporting

If a clinician suspects a patient may have EVD:

Immediately isolate the patient in a single room or an airborne infection isolation room and implement droplet and contact precautions with the appropriate personal protective equipment (PPE). Refer to PHO resources below
Notify the IPAC department, occupational health and safety team, and infectious diseases physician
Defer drawing blood or any other testing until after discussion with NRPH
Assess symptoms, travel history, and exposure risk using PHO’s VHF Clinical Risk Assessment Tool
If suspicion remains, immediately notify NRPH, Infectious Disease program:
- Mon-Fri (8:30 a.m. to 4:30 p.m.): 905-688-8248 ext.7330, (toll-free: 1-888-505-6074), After hours: 905-984-3690

Resources

Additional resources can be found on the Public Health Ontario (PHO) Viral Hemorrhagic Fever (VHF) landing page, including:

New and updated resources will continue to be posted to this page as they become available.

Serology Testing for Guiding Decisions to Vaccinate

Titres may become undetectable over time. This does not always indicate loss of immunity. If immunization records are unavailable to assess immune status, revaccination is generally preferred over serologic testing. Learn more about indications for serology.

Health care providers may encounter requests from employers, colleges or universities for serologic testing (titres) to assess immunity. These institutions set their own requirements, and may require both proof of immunization and serology.

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

Return Influenza Vaccine in July

Influenza vaccinations can be provided as needed until the product expires.

All unused influenza vaccine should be returned with delivery staff in July:

Place the expired influenza vaccine in an empty bag
Complete the appropriate boxes on the Vaccine Inventory and Return Form and attach the completed form to the bag
Ensure the facility's name is written on the outside of the bag

Other expired immunization products should also be returned to NRPH.

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

Expanding Oral Health Support to Older Adults in Niagara

Health care providers in the Niagara region play an important role in helping seniors access the Ontario Seniors Dental Care Program (OSDCP) available through NRPH and the Community Health Centres.

OSDCP provides free, essential dental services for eligible low-income adults aged 65 and older. It can reduce barriers to care and support the overall health and well-being of Niagara’s older adults.

Dental services are available at multiple locations across Niagara, helping ensure care is accessible for seniors seeking OSDCP. Starting June 24, 2026, NRPH will expand access further by bringing the Mobile Dental Clinic to the Peach King Centre in Grimsby.

How to Refer

For program information, application support or to book an appointment, direct patients to contact the Dental Health Line at 905-688-8248 or 1-888-505-6074 ext. 7399

More Information

Eligibility details and application information are available at Dental care for seniors | ontario.ca
More information about OSDCP can be found on the online

Dr. Angela Ma joins NRPH as AMOH

NRPH is pleased to share that Dr. Angela Ma will be joining our team as our new Associate Medical Officer of Health (AMOH).

Dr. Ma’s experience includes training rotations at public health units across Ontario (including senior residency positions here at NRPH), as well as Public Health Ontario and the Office of the Chief Medical Officer of Health. She completed her medical degree at McMaster University and a Master of Public Health at Harvard University.

With a passion for health equity and upstream public health approaches, Dr. Ma is looking forward to helping our team improve population health in Niagara. She will begin this role on July 6, 2026.

Please join us in congratulating her as she steps into this new role.

SeamlessMD Launches Digital Maternity Support for Niagara

Niagara Health and NRPH are excited to announce the launch of SeamlessMD, a free, interactive, step-by-step digital guide supporting maternity patients through pregnancy, birth, and postpartum. Funded by Niagara Health and Ontario Health, this initiative is available any smartphone, tablet, or computer, providing a secure way to access digital health information and services.

Content has been tailored specifically for Niagara patients by a clinical working group of obstetricians, midwives, nurses, and public health leads, ensuring locally relevant, evidence-based information. With this digital guide, patients receive:

Real-time reminders
Access to a comprehensive education library, labour tracking, and third-trimester health check-ins
Post delivery
- Daily physical and mental health check-ins with instant, personalized guidance
- Self-care tips and information about supportive public health and community resources

SeamlessMD acts as a safety net, helping patients manage non-urgent concerns, connect to public health resources, and know when to seek care.

Referrals and Resources:

Patients can self-enroll by visiting SeamlessMD, creating an account and following the instructions provided
Seamless MD printed brochures and posters will be delivered to your offices with your vaccine orders over the coming months

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

Preparing Families for Feeding Success: Infant Feeding Education Sessions

Early hand expression is a simple and effective way to support infant feeding from the start. Expressing milk soon after birth helps signal the body to begin and maintain milk production. The more often milk is removed, the more milk the body will produce.

To further support families, the Early Years team at NRPH is launching new online prenatal infant feeding education sessions to help parents and caregivers feel confident feeding their baby. Topics include early hand expression, skin-to-skin care, recognizing feeding cues, positioning and latching, and signs that feeding is going well.

Registration can be completed online or by contacting Niagara Parents.

Resources

Infant feeding, skin-to-skin and hand expression posters and/or postcards are available to order online

Referrals

If your patient requires family health supports, complete an online referral
Families can self-refer by contacting Niagara Parents online or by phone 905-684-7555 or 1-888-505-6074 ext. 7555, Monday to Friday

Medical Advisories and Memos

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

MEMO: June 24 - Candida auris Colonization: Enhanced Surveillance Directive
MEMO: June 11- Summer Student Immunization Catch-Up

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