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PHO in Action is Public Health Ontario’s blog. Here we tell stories of the work we do day in and day out, with our partners, to keep Ontarians safe and create a healthier tomorrow.

May 25
​Recent flooding in Ontario sparks concerns over water contamination
Photo credit: Kevin McDermott, Research Technician, Public Health Ontario Laboratory, Kingston.

Flooding and a private drinking water system
Every year as snow melts, the run-off (often called spring run-off) results in contaminants entering groundwater. This year, in addition to spring runoff, Ontario and Quebec endured a record amount of rainfall, which resulted in flooding in many areas. Flooding combined with annual spring runoff has resulted in a higher-than-usual risk of contaminants, particularly in private well water.
It’s important to take flooding seriously, understand the risks and know what steps to take to protect you and your family.
What are the risks?
Flooding can affect water quality, and this is a particular concern for rural residents in Ontario on private drinking water systems. Be aware that flooding may cause contamination of private water sources, such as wells.
 "Private drinking water systems serve many Ontarians, particularly in rural and remote areas. These systems are vulnerable to contamination with fecal pathogens, particularly during flooding, and should be tested frequently." 
 - Dr. Anna Majury, Clinical and Environmental Microbiologist, PHO
What should I do?
  •  If you use a private well for your water supply, ensure that you reach out to your local public health unit or your local Public Health Ontario laboratory to have your water tested. Don’t drink, use the water in food preparation, or for brushing your teeth, until it has been determined that there are no indicators of bacterial contamination in the water source.
  • It is important to test frequently throughout the year. However, in times of flooding, heavy rainfall, snow melt or spring run-off, it is recommended that private well owners test more often (minimum of once per month).
Flooding and a private sewage system
If your property is at risk of a flood, or flooded, consider the effect on your private sewage system. A flooded sewage system will not function properly and can cause problems such as:
  • sewage backup in your home, and;
  • contamination of your water supply. 
In the event of a flood, contact your local public health unit for guidance regarding how to manage your private sewage system during the flood period.
If you have any questions, or would like to have your water tested, please reach out to your local public health unit.
May 24
​​Check out what you missed at TOPHC 2017!


For three days in March, TOPHC 2017: Global challenges. Local solutions. transformed Toronto’s Beanfield Centre into a hub of public health discovery, innovation and research. PHO partners with the Ontario Public Health Association and the Association of Local Public Health Agencies to put on this event. Now in its seventh year, TOPHC saw its largest attendance to date and featured over 180 sessions, workshops and poster presentations.

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Most of the presentations and posters from this year’s event are now available at Also, be sure to check out the TOPHC blog, which covers sessions, workshops, and highlights of social media activity.

Some notable highlights and videos: 

Plenary sessions: 

The Hot TOPHC panel sessions: 

May 19
Our People: Philip Banh, Biocomputing Systems Administrator, Biocomputing Centre


Phil Banh EN.png


May 10
Measuring the policy-making process — new resource!


As public health professionals, we know that developing policy is complex and evaluating the policy-making process can be even more complicated. So what questions do you ask yourself when planning for policy development?

Sticky notes on a white boardOur new Focus On: Measuring the policy-making process outlines guiding questions that could help to demonstrate the progress through developing a healthy public policy. These questions were identified through an academic literature review that examined four well cited theories: 

  • Stages Heuristic Model
  • Multiple Streams Framework
  • Advocacy Coalition Framework 
  • Punctuated Equilibrium Theory. 

Although no specific evaluation indicators were identified in the literature, these guiding questions offer a good starting point for measuring progress of policy-making efforts.

Making it all fit – PHO’s eight step model for developing health public policies

In 2016, we updated our eight step model for developing healthy public policies. These eight steps are organized into three phases to help drive the policy-making process: 1) planning, 2) implementation and 3) evaluation. The questions outlined in the Focus On align directly with the planning phase and the first four stages of PHO’s eight step model.

If you have any questions about this Focus On or any other of PHO’s policy-related resources, please contact​

May 06
Emergency Preparedness Week May 7-13

PHO is celebrating Emergency Preparedness Week (EP Week) May 7 – 13, 2017.   This awareness week promotes the importance of planning and preparing for emergencies.  There are actions we can all take to protect ourselves and our families during emergencies.  Check out the resources available from Public Safety Canada  at 

PHO also supports emergency preparedness in Ontario with resources and services specifically designed for public health.
Check out:
·         Public Health Emergency Preparedness: Online course.   This series of three interactive modules introduces the foundations of public health emergency preparedness. Definitions, concepts, strategies and more are covered in this self-directed course. A certificate of completion is available after completion of all three modules.
·        Public Health Emergency Preparedness: An IMS-based workshop. This is a workshop in emergency preparedness specifically developed by public health professionals for public health professionals.
 For more information contact us at
May 05
Tobacco control — a changing landscape in Ontario. New report!


With progressive action and new legislation including stricter policies around the use of water pipes, and the banning of flavoured tobacco products, rates of tobacco use in Ontario are at an all-time low. Despite the progress that Ontario has made, tobacco continues to be a leading cause of preventable death in Ontario. Approximately two million Ontarians still smoke and tobacco use is responsible for 13,000 deaths per year. That’s 36 deaths per day.

What does this mean for tobacco control in Ontario?

Map of Ontario with a cigarette

It is more important than ever to understand what tobacco control measures have the potential to reduce tobacco use and associated burden in Ontario. That’s why PHO at the request of the Ministry of Health and Long-Term Care convened the Smoke-Free Ontario Scientific Advisory Committee (SFO-SAC 2016) to undertake the massive task of updating and rigorously assessing the evidence published on tobacco control between 2009 and 2016. The result: the release of the Evidence to Guide Action Comprehensive Tobacco Control in Ontario (2016), a report of SFO-SAC 2016.

“We’re really excited about releasing this new report,” says Dr. Joanna Cohen, chair of the SFO-SAC 2016 committee. “A lot has changed in the field of tobacco control.”

The Report provides a comprehensive assessment of 56 tobacco control interventions and highlights their impact on reducing tobacco use and associated burden in Ontario. The report is organized into four main chapters which align with the four pillars of tobacco control: industry, prevention, protection and cessation. 

“We are excited for public health professionals, researchers, and many more to use their best interpretation of the new evidence and interventions and turn it into action,” says Dr. Cohen. “We hope to see a reduction of tobacco rates in Ontario, enabling us to become leaders in tobacco control in Canada.”

Quick facts about Evidence to Guide Action: Comprehensive Tobacco Control in Ontario (2016) 

  • The report answers the research question: Which interventions or set of interventions will have the greatest impact on reducing tobacco use in Ontario?
  • Each of the 56 interventions was assessed for effectiveness based on the evidence and assessed for potential contribution to reducing tobacco use in Ontario.
  • The report provides an assessment of the applicability of each intervention to the Ontario context and highlights equity, implementation and priority population considerations.
  • The SFO-SAC 2016 is a committee made up of 15 top tobacco control scientists and experts in Ontario.
  • The report updates the evidence from the Evidence to Guide Action: Comprehensive Tobacco Control in Ontario (2010) report, taking a rigorous approach to assessing and synthesizing the evidence.

Want to learn more about the Report?

no smoking signStay tuned to the PHO in Action blog in the coming weeks for more posts highlighting the importance and application of the different chapters of the report (industry, prevention, protection, and cessation) as well as insights from leading tobacco experts.

We have also created additional resources to accompany the report including: an introductory video, one page visual summary and downloadable Executive Summary

For more information on PHO and our tobacco-related resources, please contact us at

May 05
Top five things that impact effective hand hygiene


Hands counting to five 
Today is World Hand Hygiene Day! To celebrate, we asked one of our hand hygiene content leads to provide some insight into the top five things that impact effective hand hygiene.

Guest post by Debbie Valickis, Regional Infection Control Consultant, Public Health Ontario

One can have the best technique and the best product but there other things that need to be considered to ensure hand hygiene is effective.

​1. Jewellery is difficult to clean and will harbor microorganisms. Rings and bracelets should not be worn by healthcare providers in direct contact with a client, patient or resident.  Share our fun video Ask Yourself: Is the glam worth the grime with your staff or colleagues to increase their awareness.

​2. Artificial nails, nail enhancements and long nails are also difficult to clean.  Long and artificial nails are connected to transmitting microorganisms such as Pseudomonas1, Klebseilla pneumonia2 and yeast in health care settings and are not appropriate for direct client, patient or resident care. Nails should be natural and short. 

3. Finger tips, between fingers, back of hands and base of thumbs are the most commonly missed areas in hand hygiene.  Spread product over all surfaces of hands and watch these PHO videos for proper hand hygiene technique: How to Hand Rub and  How to Hand Wash.

4. There is a common misconception that antimicrobial soaps are more effective than alcohol-based hand rub (ABHR).  Comparisons of ABHR and antimicrobial soap have shown that they are equal in reducing microorganisms.  ABHR is recommended as antimicrobial soaps are harsher on skin and may result in skin breakdown.  Frequent use may also lead to antimicrobial resistance. The PIDAC Best Practices for Hand Hygiene document can be referred to for best evidence and expert opinion on hand hygiene practice

5. The condition of our hands can influence effective hand hygiene.  The presence of dermatitis, cracks or abrasions can trap bacteria and impede hand hygiene.  Dermatitis is reported in approximately 30 per cent of health care workers (HCWs). 

It is important that HCWs:

  • moisturize with an approved product compatible with the hand hygiene products
  • monitor the skin on their hands
  • take action early if their hands become irritated.

More hand care guidance can be found through our JCYH Hand Care Program​ 

For more information and resources on hand hygiene, please go to Public Health Ontario’s Hand Hygiene webpage


1. Moolenaar RL, Crutcher JM, San Joaquin VH, Sewell LV, Hutwagner LC, Carson LA, et al. A prolonged outbreak of Pseudomonas aeruginosa in a neonatal intensive care unit: did staff fingernails play a role in disease transmission? Infect Control Hosp Epidemiol. 2000 Feb;21(2):80-5.

2. Gupta A, Della-Latta P, Todd B, San Gabriel P, Haas J, Wu F, et al. Outbreak of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in a neonatal intensive care unit linked to artificial nails. Infect Control Hosp Epidemiol. 2004 Mar;25(3):210-5.

May 03
May 5 is World Hand Hygiene Day — Join the Conversation!


World Hand Hygiene Day is an annual global advocacy day dedicated to increasing awareness of the importance of good hand hygiene. This Day was declared by the World Health Organization as a global call to action for health workers to “progress the goal of maintaining a global profile on the importance of hand hygiene in health care and to bring people together in support of hand hygiene improvement globally.” 

PHO has been having fun preparing for World Hand Hygiene Day

World Hand Hygiene Day Video screen capture 
This year, we decided to participate in Canadian Patient Safety Institute’s STOP! Clean Your Hands Day Video Competition. With the theme Ask Yourself, we created our own video that encourages people to have a conversation with themselves about hand hygiene. Ask Yourself: Is the glam work the grime is our playful way of helping health care providers remember good hand hygiene practices around jewelry and nail care. 

There are many ways that you can get involved this year

You can do your part in promoting good hand hygiene. Here’s a list of ways to get involved: 

  • ​Plan your own activities
    • ​CPSI offers a great set of innovative tools and resources like crossword puzzles, posters, videos and certificates to help plan your own set of activities.
    • WHO’s SAVE LIVES: Clean Your Hands 2017 Campaign has a great set of resources including advocacy posters, slide sets, activity toolkits and much more!

  • Join the conversation: Take the conversation online using the hashtags #handhygiene and #antibioticresistance

May 02
NIAW 2017: Learning about the history of vaccine preventable disease at the Quarantine Tent


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It’s hard to picture a time before vaccines existed, but infectious diseases used to routinely claim countless lives every day.

In celebration of National Immunization Awareness Week 2017, PHO held an interactive Quarantine Tent exhibit to remind people what it was like before vaccines. Set-up at the MaRS Centre in Toronto, actors donned period-correct costumes and life-like make-up to show visitors what these now-rare diseases are like.

For example, one character was a 32-year old woman from 1918, with the Spanish flu in Toronto. She had debilitating pain in her legs, a major fever and was coughing so hard that she could barely breathe. Her husband, who was fighting in the war, had just died from the flu. Most of her family who cared for her were sick now too.

diphtheria.jpgSpanish Flu was an H1N1 influenza strain. It was unusual in that it was most lethal for otherwise healthy adults, many of whom suffocated from the swelling and buildup of liquid in their lungs. By the end of the pandemic, the Spanish Flu infected one in six Canadian, killing up to 50,000. Worldwide, the disease killed more people than World War I in just two short years.

Other actors told similar tales of tragedy, but from diseases such as diphtheria, smallpox, mumps, pertussis, polio and HPV.

The lessons from these actors are stark reminders of what life before vaccines was like, and what life could be like if immunizations were to stop. The work of public health and immunization are crucial to protecting the lives of Ontarians and National Immunization Awareness Week is a time to look back on our success. However we continue to fight these diseases today and must continue working together to protect the lives of Ontarians. 

The Quarantine Tent is a grassroots event created by Pippa Wysong, a medical writer, to teach the public about the risk of diseases, medical science, and vaccination.​ She has been conducting Quarantine Tents since 2013. 


Yvonne Whitfield, Senior Program Specialist, as Measles; Kelty Hillier, Epidemiologist, as Spanish Flu​; Shelly Bolotin, Scientist, as Smallpox.  Above: Lisa Grant, Project Coordinator, as Diphtheria

May 01
Antimicrobial resistance: A significant public health threat

Antimicrobial resistance (AMR) is a significant public health threat in Ontario and worldwide. The use of antimicrobials contributes to the growing rates of resistance. Antimicrobial resistance can occur naturally, through mutation or by picking up resistant genes (meaning the genes are “coding” for resistance) from other microbes. It is imperative to preserve the effectiveness of established antibiotics as antibiotic discovery is costly, slow, and ultimately uncertain.

With the ineffectiveness of antimicrobial drugs on the rise, action must be taken to ensure antimicrobials are used appropriately (also known as “antimicrobial stewardship”) to safeguard the availability of future treatments for both common and serious infections. However, addressing this threat requires a “One Health” approach; a shared and coordinated multi-disciplinary action to address AMR in humans, animals and the environment.  

At PHO, we aim to help advance antimicrobial stewardship in Ontario by providing scientific and technical guidance, resources, and expertise to support stakeholders in implementing antimicrobial stewardship in their practice. PHO is also involved in research and evaluation of antimicrobial use and stewardship practices in acute care, primary care and long-term care settings.

Antimicrobial use in long-term care homes

Antibiotics are the most commonly used type of antimicrobials, and are frequently prescribed in long-term care homes. In Ontario, 78% of residents of long-term care homes receive at least one antibiotic course each year and approximately 50% of these courses are unnecessary. Older residents are at a particularly elevated risk of harm from antibiotics such as AMR, Clostridium difficile infection, and side effects.

To help draw awareness to the high usage and variability of antibiotic prescribing in long-term care homes, PHO has developed an infographic that describes the scope of the issue as well as the importance of practicing antibiotic stewardship.

Sharing this information is a first step in working toward antibiotic stewardship practices to help improve care for these residents and mitigate AMR.

Steps you can take to practice antibiotic stewardship:

  • Reduce unnecessary antibiotic prescriptions  

  • Re-assess the need for antibiotics regularly

  • Use the shortest effective duration possible

April 28
​Building Bridges: The Art and Science of Immunization Symposium
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his April, PHO and the Jackman Humanities Institute at the University of Toronto hosted the Art and Science of Immunization Symposium. This event explored the breadth of perspectives on immunization issues and how those in arts and science fields can work together to address them. A major focus of the day was on vaccine hesitancy. There was significant discussion around how a humanities approach can inform how we communicate with the public and weave a narrative to help bridge the gap between science and the public. Attendees were a diverse mix, with backgrounds in fields such as immunology, epidemiology, history, English, anthropology and even theatre studies.  


Ève Dubé, a professor of anthropology at Université Laval and keynote speaker, talked about vaccine hesitancy from an anthropological perspective. She explained that vaccine hesitancy isn’t a simple issue, but rather a complex interplay of personal, cultural, societal and economic factors. She further explained that our behaviour isn’t always based on logic and reason, and that humans tend to look for information in the world that agrees with their decisions. The final takeaway was that public health and anthropology have contrasting yet complementary approaches that can be used to address vaccine hesitancy.

Natasha Crowcroft, Chief of Applied Immunization Research at PHO talked about the history of vaccine preventable disease, and its role in major historical events. She described how during the Battle of Quebec in 1775, immune British soldiers were victorious against the American invaders who were ravaged by smallpox.


Shelly Bolotin and Allison Crehore from PHO, and Avnee Paranjapa, a graduate student from U of T, performed a short skit on translating science from technical terms to plain language, and finally, how the public interprets this. This humorous presentation helped to show the major divide that exists between the way scientists speak, and what the public understands.

Kim Barnhardt, Strategic Communications Advisor with CANImmunize and the Canadian Medical Association Journal, discussed the creation of a “motion comic” called Immunity Warriors. This comic teaches children about vaccines and how they protect against disease. Kim explained that while many adults tend to be firm in their attitudes towards health behaviours, children are more flexible, and are important stakeholders in their own health decisions.


Allison Humphrey, a PhD student in Cinema and Media Arts from York University, introduced her interactive motion capture game, Poxémon. Players users use their arms and legs to fight off the “shadowpox” disease that attacks the individual, meanwhile trying to protect 100 other characters on the screen from infection. This game helps players to understand how infectious diseases can spread in a population, or be protected by vaccination. Attendees had the opportunity to demo the game during breaks.

Overall the day was enlightening and entertaining. As public health continues forward in addressing immunization issues, we may have unexpected allies from other fields, and perhaps a thing or two to learn from them as well.​ 

April 27
NIAW 2017: #VaccinesWork: Expertise to Guide Immunization Practice in Ontario

​#VaccinesWork has become a common hashtag for the advocacy for the safety and effectiveness of vaccines. Immunization is widely recognized as one of the greatest public health achievements of the twentieth century. Vaccines prevent diseases, save lives and reduce health care costs. Immunization programs are an important foundation of Ontario’s health system.

PHO is home to internationally recognized experts in immunization and vaccine preventable disease prevention and control. Our experts and knowledge resources help immunization professionals to better understand and communicate about vaccines. Our experts have contributed to successes such as the elimination of measles in the Americas and participation in groups like the National Advisory Committee on Immunization​

immunizeroverviewthumb.jpgCheck out some of our resources and expertise for immunization:  

Vaccine Safety

We support Ontario’s immunization stakeholders to better understand and communicate about vaccine safety. Public Health Ontario also leads the provincial surveillance of adverse events following immunization (AEFIs). 

The latest Annual Report and supporting resources can be found on our vaccine safety page​

Ontario Health Profiles

The Ontario Health Profile is a new way of describing the health status of Ontarians focusing on key public health issues that influence and shape Ontario’s population health status. Check out the infographic or interactive web reports for the Measles and respiratory viruses: 

Interactive Report
Interactive Report​​

PIDAC Immunization

PHO also hosts the Provincial Infectious Diseases Advisory Committee (PIDAC) for Immunization, which applies the best available evidence to provide recommendations on vaccine-related issues and vaccine program delivery.

Check out all of our other Immunization resources.

Stay tuned to our blog​ for more NIAW 2017 updates!

April 25
NIAW 2017: Impactful applied research to push forward immunization practices

​The better we understand how vaccines work and how they are being used, the better we can take impactful action to protect Ontarians. PHO experts are leading contributors to the body of evidence on immunization to help shape policy and practice provincially, nationally and internationally. 

Applied immunization research and evaluation is a cross-cutting Public Health Ontario scientific initiative to guide immunization programs, maximizing the synergies of inter-disciplinary research, in order to deliver innovative, policy-relevant, responsive and impactful evidence that leads to improved health for all Ontarians.


Check out some of these recent immunization publications from PHO: 

See more of PHO’s immunization research on PubMed​.

Meet some of our immunization researchers!

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April 20
Celebrate National Immunization Awareness Week 2017 with PHO!


PHO is celebrating National Immunization Awareness Week (NIAW)  from April 22 to 29, 2017. Read on below to see what’s going on at PHO this week!

It is also Vaccination Week in the Americas and World Immunization Week. Immunization has had great success in protecting Ontarians, Canadians and the rest of the world. Between two and three million lives are saved every year by current immunization activities. 

This awareness week promotes the importance of how vaccines boost the power of the immune system to fight diseases and encourages everyone, including parents and health care providers, to ensure that people of all ages are immunized on time and receive all recommended vaccines to protect them from serious diseases. 

Our research, reports, infographics, and technical advice, expertise and guidance all demonstrate the value of PHO’s work in immunization and to our clients, partners, and the public.

Check out these PHO Events during NIAW 2017: 

quarantine tent.pngTravel back in time at the Quarantine Tent! (April 25)

Ever wonder what life was like before vaccines? Take a walk through history with this interactive exhibit and learn more about what it was like to have diseases such as Diphtheria, Small Pox, Spanish Flu, Polio and more! 

Visit the event page for more information. 

PHO Rounds with Dr. Shelley Deeks and Dr. Sarah Wilson (April 25)

The publicly-funded infant rotavirus immunization program in 2011 led to a subsequent decrease in disease burden. This presentation will review recent research studies describing: 

  • the safety of rotavirus vaccine

  • the success of Ontario’s rotavirus immunization program in reducing healthcare utilization for acute gastroenteritis.

  • factors associated with the uptake of rotavirus vaccine in Ontario

Visit the event page to register!

Stay tuned to our blog for more NIAW 2017 updates!

April 20
In case you missed it: Sexually transmitted infections in Ontario webinar series
Session 1: Overview of bacterial STIs (January 23, 2017)
Session 2: Chlamydia and gonorrhea (February 13, 2017)
Session 3: Infectious syphilis (March 20, 2017)​

Recordings and slides from Public Health Ontario’s three-part series on sexually transmitted infections (STIs) in Ontario are now available! 

The World Health Organization estimates that 357 million new STIs are acquired annually. Canada and Ontario have seen troubling growth in the rates of STIs in the last several years. 

STI cases in Ontario (2005 to 2015)
  • ​Chlamydia: 78% increase
  • Gonorrhea: 78% increase
  • Infectious Syphilis: 198% increas

From the Reportable Disease Trends in Ontario tool.

This series is directed towards those working in or studying sexual health in public health, health care and community settings.

 These presentations will help you to:

  • Learn about changes in the epidemiology of STIs, including the rates and volume of cases, geographical distribution and priority populations.
  • Understand available diagnostic methods, and recommendations and considerations for testing.
  • Apply treatment recommendations for chlamydia, gonorrhea and infectious syphilis, as well as additional case and contact management considerations.

For more information about STIs in Ontario, check out our new interactive Reportable Disease Trends in Ontario tool.​ 

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