Image courtesy IPAC Canada
National Infection Control Week (NICW) begins October 15. We are recognizing this year's theme of "No Borders" and making available a series of PHO resources on our website to help you raise awareness about Infection Prevention and Control (IPAC) in your own organization. An annual event since 1989, we celebrate and recognize the efforts of health care workers across Ontario, whose commitment to IPAC protects the health of Ontarians.
On October 16, be part of our PHO Grand Rounds presentation, Cabrapenemase-producing Enterbacteriaceae (CPE) - Bacteria Without Borders. Speakers Camille Achonu and Kasey Gambeta will speak on the epidemiology of CPE in Ontario and a coordinatted approach to prevention and control among public health, IPAC, medical and laboratory professionals.
Registration is available for in-person attendance, or via webinar.
With flu season right around the corner, PHO has been busy reviewing and refreshing the respiratory virus surveillance system. You’ll notice a revised surveillance package for public health units (PHU) and changes to come for an updated Ontario Respiratory Pathogen Bulletin (ORPB)—but that’s not all. Our Communicable Disease Emergency Preparedness and Response and Laboratory teams gave us a behind-the-scenes look at the planning and preparation that goes into flu season.
Q: What is PHO’s role during flu season?
Throughout the year we monitor influenza and other respiratory virus trends. We post these data weekly on our interactive website. From November to April we amplify this surveillance with a weekly report with data we receive from PHUs, the PHO laboratory, Public Health Agency of Canada (PHAC) and the National Microbiology Laboratory.
PHO’s Laboratory, via its 11 sites, performs primary diagnostic testing for influenza and other respiratory agents to support both acute care and outbreak management across Ontario. During the influenza season, PHO provides technical expertise to the Ministry of Health and Long-Term Care and respond to numerous science and technical requests from PHUs. This includes consultation support for the management of respiratory infection outbreaks.
Additionally, PHO monitors out-patient influenza vaccine effectiveness through its participation in the Sentinel Practitioner Surveillance Network. If you’re a practitioner interested in contributing to this important surveillance as a sentinel, please contact our coordinator: firstname.lastname@example.org or 647-792-3187.
Q: Why is influenza surveillance important?
Influenza is a rapidly changing virus. It is hard to predict exactly what will be circulating and how severe it will be in terms of causing illness, deaths and outbreaks. Every Fall we monitor for the first signals of local influenza activity. The data gives us some indications of what might be coming in the months ahead. In general, seasons with heavy influenza A(H3N2) activity are worse seasons with increased numbers of cases of influenza, hospitalizations, deaths and outbreaks compared to influenza A(H1N1) seasons.
Assessing and reporting on activity levels of influenza throughout the season helps inform health care providers and the community, as well as the public health community. Increasing influenza activity may activate additional control measures or communications to ensure everyone is aware and taking the necessary steps to reduce the burden of influenza illness.
Q: What does it mean when we start seeing influenza cases now?
We provide year round influenza testing in the laboratory, so it is possible to have some cases each week from June to September. In the summer months, many of these will be in people who travelled to other parts of the world where influenza is more common at this time of year.
Once we start detecting a continuous increase in influenza activity among cases who did not travel or start seeing spread in the community—i.e., an influenza outbreak in a long-term care home, we are more alert to this potentially being the start of influenza activity for the season. We report the start of the season on the ORPB webpage based on these surveillance indicators.
For more information about influenza and respiratory infections contact email@example.com.
It’s that time of year again!
The ramp up to TOPHC 2019 has officially begun with the call for abstracts. Here’s your chance to share your public health topic and shape the conversation at the upcoming conference.
From March 27 to 29, 2019, public health professionals from across Ontario will gather to explore how strategy, leadership and practice can align to address changes in the public health sector.
The learning objectives for TOPHC 2019 are to:
- Describe the implementation and impact of evidence-based and evidence-informed strategies, programs and policies to promote and protect the public’s health.
- Identify considerations and approaches for enhancing collaboration and partnerships to address current and emerging public health issues.
- Recognize gaps in and challenges to current public health practice and policy and discuss opportunities and potential solutions to address these gaps.
- Apply new or enhanced skills to questions and concerns facing public health professionals and our clients.
The deadline to submit an abstract is Monday, October 22 at 7 p.m.
It is a time of transformation within public health, with the new Ontario Public Health Standards, as well as emerging and ongoing health issues that present new opportunities and challenges for today’s public health professionals. Collaboration and information sharing will be instrumental to provide high quality public health service throughout Ontario for years to come.
Stay tuned for resources to help you create an abstract. For more information about TOPHC, visit our website or contact firstname.lastname@example.org.
PHO is an active participant in Emergency Preparedness Week (May 6-12). This annual event is a Canada-wide venture to promote awareness of individual and family preparedness. Emergency preparedness encourages individuals and organizations to take actions that will keep them protected during emergencies. This shared responsibility ensures that when unexpected events occur that could negatively impact the health of Ontarians, PHO is ready to work with our public health partners and staff to minimize that impact.
Depending on the type of emergency, PHO may be involved in supporting the Ministry of Health and Long-Term Care, public health units, and other health professionals as they plan for and respond to health emergencies. This support can take the form of the continued provision of scientific and technical advice, as well as the continuity of laboratory services.
In addition to having established emergency protocols in place, PHO offers an online course in Emergency Preparedness aimed at public health professionals. The Public Health Emergency Preparedness online course discusses definitions, concepts and strategies over a series of three modules. A certificate of completion is available after accessing all three modules.
PHO remains committed to emergency preparedness and ensuring that we are able to continue our essential services, even in unpredictable times.
For three days in March, members of Ontario’s public health community gathered to exchange ideas, learn and gain inspiration from each other at the eighth annual Ontario Public Health Convention (TOPHC).
We were extremely pleased to have more than 1,000 registrants for TOPHC this year – our most ever. TOPHC also included: 50 sessions, 5 full-day workshops, 88 academic posters, 781 unique visitors to the TOPHC 2018 mobile app and many interesting conversations and insights shared through our social media feeds.
I enjoyed connecting with many of you throughout TOPHC as we engaged with this year’s theme: Leadership. Partnership. Change. Some highlights for me include:
• The Sheela Basrur Centre Lecture on promoting truth and reconciliation in public health with Pat Mandy, Kevin Lamoureux, Dr. Marcia Anderson and Dr. Rosana Salvaterra. They discussed strategies for how we can advance the Truth and Reconciliation Commission of Canada’s “calls to action” in our work and shared perspectives and experiences from both Indigenous health and public health. As the first plenary session at TOPHC they helped set the tone for a thoughtful, energetic and engaging convention.
• The Hot TOPHC plenary session on working together to achieve an integrated health system with Dr. Vera Etches, Dr. Rita Valaitis, Dr. Doug Manuel, Dr. Penny Sutcliffe, Cynthia Martineau and Liane Fernandes. Our panel provided public health unit, Local Health Integration Network (LHIN) and health system partner perspectives on challenges and opportunities when collaborating under the Patients First legislation.
• Dr. Brian Goldman from CBC’s White Coat, Black Art’s insightful talk about combating fake health news at the first ever TOPHC Talks session.
• The opportunity to participate in the Dalla Lana School of Public Health (University of Toronto)’s In the Loop alumni event, which was held on site at TOPHC. It featured Dr. Timothy Caulfield who gave a talk on “Science-ploitation.”
• Ontario’s Chief Medical Officer of Health Dr. David Williams’ advice for the next generation of public health practitioners at the Fireside Chat for students.
• Day 3 remarks by Roselle Martino, Assistant Deputy Minister, Population and Public Health at the Ministry of Health and Long-Term Care on a changing public health landscape, which helped set the stage for the day’s five full-day workshops – a new format for TOPHC this year.
• The five full-day workshops, which sold out before the start of TOPHC. Special thanks to the workshop organizers and presenters who put so much work, time and thought into developing and running their sessions.
TOPHC is truly a public health community event and wouldn’t be possible without your support. Thank you again to everybody who participated and especially to our TOPHC partners, the Ontario Public Health Association (OPHA) and the Association of Local Public Health Agencies (alPHA).
For those of you who were unable to attend or missed a session that you were interested in, we will be posting presentations on the TOPHC website in the next few weeks. In the meantime, I encourage you to visit the TOPHC blog to read recaps on select sessions.
I always come away from TOPHC feeling energized and inspired by our discussions. I look forward to continuing the conversation with you throughout the year and hopefully seeing you on March 27-29 for TOPHC 2019 at the Beanfield Centre in Toronto.
National Immunization Awareness Week 2018 (NIAW) kicks off April 21 and we are continuing our annual tradition of presenting all of the expertise, resources, and research available to you from Public Health Ontario.
Running concurrently with NIAW 2018 is Vaccination Week in the Americas and World Immunization Week. Continued vigilance is required at a provincial, national, and international level to ensure that we are all protected from the various vaccine-preventable diseases that represent an ongoing threat to global health. NIAW recognizes the success and impact of vaccines in saving lives in Canada, and reminds us that immunity is our defense against disease. In place since the 1990s, NIAW’s historical prospective demonstrates that vaccines are needed as much now as ever.
PHO continues to offer a variety of resources displaying our work in immunization, including research, reports, and infographics to help you have a clear understanding of the value of vaccines.
On April 24, be part of our PHO Grand Rounds presentation, Integrating CANImmunize with the DHIR: Using technology to connect Ontarians with Public Health. Speakers Dr. Kumanan Wilson and Katherine Atkinson will discuss the use of technology to improve vaccine uptake and series completion and what integration means for Ontarians, clinicians and public health officials. Registration is available for in-person attendance, or via webinar.
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. In addition to spring runoff, Ontario often receives record amounts of rainfall, which can lead to flooding in many
areas. Flooding combined with annual spring runoff can cause a higher-than-usual risk of contaminants, particularly in private well water.
important to take flooding seriously, understand the risks and know what steps
to take to protect you and your family.
What are the
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.
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."
What should I
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
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.
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.
LDCP Cycle 5 has
launched! Read on to see how we’re using collaboration at the local and
provincial levels to tackle public health issues.
What is the LDCP
The Locally Driven Collaborative Projects (LDCP) program
brings public health units together to develop and run research projects on
issues of shared interest related to the Ontario Public Health Standards. We
focus on fostering partnerships, strengthening knowledge transfer, and creating
scientifically sound and relevant projects.
Cycle 5 launch
We are pleased to announce the launch of cycle 5 of the LDCP program. The three new projects for this cycle are:
Cannabis misuse among youth
An examination of key messages, best practices, strategies and interventions to address cannabis misuse among youth.
Ontario Public Health Standard: Chronic Diseases and Injury Prevention, Wellness and Prevention of Injury and Substance Misuse
A provincial framework for healthy community design
Description: There is a need for a legislative framework in Ontario that compels municipalities to incorporate health unit feedback into the development approval, community design plans and evaluability assessment processes to ensure healthy natural/built environments are created
Ontario Public Health Standard: Healthy Environment
Best practices for collaborating with school boards and the Ministry of Education in relation to mental health
Ontario Public Health Standard: School Health
If you are interested in getting involved, please contact LDCP@oahpp.ca. You can learn more on our LDCP webpage.
March is Nutrition Month! To celebrate, here’s five things we learned in the past year about food and nutrition:
1. Two-thirds of packaged foods and drinks in Canada have added sugars
A PHO and University of Waterloo study found that 66 per cent of packaged food products had at least one added sugar in their ingredients list, including baby foods, infant formulas, and many so-called ‘healthier’ foods. See the newsroom article to find out more.
2. On-shelf nutrition labels help supermarket shoppers choose healthier foods
A PHO study looked at an on-shelf labelling system in major super market chains that shared simple, standardized nutrition information to help shoppers make informed and healthy food choices. They found that the labelling system led to increases in the proportion of healthy foods (such as fresh fruits and vegetables) that shoppers purchased. See the newsroom article or the PHO Rounds presentation for more.
3. A nutrition “report card” can help us assess and take action on how our communities support healthy eating
In a PHO Rounds presentation, Dr. Kim Raine described the Alberta’s 2016 Nutrition Report Card on Food Environments for Children and Youth. The report card aims to increase awareness of food environments for children with a focus on health promotion and obesity prevention. See the presentation to find out more.
4. Measuring food literacy is more than just knowing about nutrition or how to cook
A Locally Driven Collaborative Project is creating a tool to measure food literacy in youth, young parents and pregnant women. They discovered that food literacy also includes individual beliefs and attitudes, environmental factors and the ability to apply knowledge and skills to food decisions. Read the report to find out more.
5. Menu labelling in restaurants may help children and youth choose healthier options
A systematic review by PHO found that nutrition labelling on menus in restaurants or school cafeterias may result in lower calorie food choices for children or adolescents. This is the first study of it’s kind to synthesize evidence on menu labelling’s impact on children and adolescents. Read the journal article to find out more.
For more information on Nutrition Month, see the Dietitians of Canada website.
Substance use has
been thrust into the spotlight in the past year, with the rapid increase of
opioid-related deaths and the Health Minister calling the opioid crisis a
“public health emergency”. Coupled with the impending cannabis legalization
fast approaching in July 2018, it’s becoming more important to establish public
health approaches to mitigate the burden of substance use. In such a quickly changing
environment, public health professionals are asking, “Can we keep up”?
“This series provides a much needed forum for us to discuss recent developments, explore opportunities, and advance practice related to substance use.”
- Pamela Leece, Public Health Physician, Public Health Ontario
In response to this evolving environment, Public Health
Ontario is introducing a PHO Rounds series that will focus on substance use to
provide up-to-date and relevant information that will help you and your team
feel more prepared. Our series will focus on surveillance data, local
responses, and evaluation approaches – all presented by the foremost experts in
each of these areas. Please join us for the following three sessions:
March 13: Community-based
Integrated Drug Strategies: Fit for Success? 12:00 p.m. to 1:00 p.m.
Michael Parkinson, Drug strategy specialist, Waterloo
Region Crime Prevention Council
Rob Schwartz, Executive Director, of Ontario
Tobacco Research Unit
17: Legalization of Cannabis, 12:00 p.m.
to 1:00 p.m.
Public Health Nurse and member of the Ontario Public Health Association
Cannabis Task Force
Dr. Lawrence Loh,
Associate Medical Officer of Health, Region of Peel
24: Opioid Surveillance Panel, 12:00
p.m. to 1:00 p.m.
Presenters to be announced.
How can I register?
Visit our for more information on each session, including
registration links. If you have any questions, please contact the PHO Events
Team at email@example.com.
February 13: Opioid Early Warning
Systems, 12:00 p.m. to 1:00 p.m
Dr. David Williams, Chief Medical Officer of
Dr. Kieran Moore, Medical Officer of Health,
Kingston, Frontenac and Lennox & Addington Public Health Unit.
Missed a presentation? Visit our presentations
page to check it out at a later time.
In school, Justin Thielman pursued an undergraduate degree in biology
with a minor in psychology. While he was drawn to the exactness of biology, after
some years studying, he realized he didn’t want to work in a traditional wet
lab. Since he couldn’t decide what his next move was, he moved overseas to
Taiwan to teach English for a year.
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See Justin discuss his walkability research.
After his travels, he returned to Ontario, where he started
taking courses in Public Health, including
some epidemiology courses. He knew right away that he had found the right field
– it was the perfect mix of the social science concepts he loved, and
quantitative measurement and analysis. He applied to M.Sc. programs in
That’s when he started to become enamoured with research. In
his undergrad, he felt he never learned what research was – in biology, they
largely focused on memorization. When he was in his Master’s program, Justin
realized that research has a major creative component – a unique way of thinking and looking at
problems, and this type of analysis fit with his personality and interests.
He was interested in tackling what seemed to him the biggest
health problems – ones that affected the most people: chronic disease and
obesity. He ended up doing his master’s thesis on neighbourhood walkability and
Walkability can be defined by four categories:
- well-connected streets (meaning a direct route
- high population and residential density
- high density of nearby amenities (banks, grocery
- good aesthetics (sidewalks that aren’t all
cracked, good street lighting)
Focusing on the built environment and physical activity also
allowed him to look at a broader population perspective when it comes to chronic
disease and obesity:
“Many people tend to focus on obesity and chronic disease as
an individual level problem – as in, individuals need to change their
behaviours to become healthier. I thought it was just as important to consider
these issues from a context point-of-view – certain environments are more
conducive to living a healthier lifestyle. It’s overly simplistic to chalk it
up to individual choices – to get the full picture you have to look at
contextual factors like neighbourhoods”.
Why the neighbourhood?
What’s significant about this context?
“Neighbourhood is important – because policy has the
potential to influence a neighbourhood [layout], you can change community
design, or change the street network. You can’t influence someone’s individual
home or workplace as much. Each workplace is different and probably managed by
different organizations.” Justin emphasizes the importance of rising above the
individual point of view – to have a positive impact on as many people as
possible using an upstream approach.
How do these concepts
– walkability, the built environment – link with the social determinants of
health, for example?
determinants of health and built environment interact a lot. Someone’s
socioeconomic status will majorly impact the neighbourhood that they choose to
live in. In cities like Toronto, the most walkable neighbourhoods tend to be
the most expensive neighbourhoods. The reverse is true as well – Let’s say
you’re living in an unwalkable built environment that is far from your
workplace. Your commute may add to your stress level, it can take away from
time with your family, and ultimately it negatively affects your health.”
Why is PHO important
to your work?
Justin’s thesis work on walkability led him right into PHO’s
doors – he became the lead epidemiologist on a project looking at Neighbourhood
“All of the walkability work that
I’ve done at PHO has been interesting – the thing that makes it interesting at
PHO is that we have a strong connection with policy-makers and local public health
units, so you have that connection to the people who are using the information.
Sometimes you don’t get this connection at academic institutions, so you can
tailor your work to what is useful to those stakeholders. You can hear input
from different groups, hear what they think is important and let it inform your
Have you ever required laboratory data for a research paper
or report? It seems simple enough to generate this information, but it actually
requires a lot of coordination and expertise.
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Watch Alex talk about lab surveillance and data management at PHO's laboratory.
Let’s go behind the scenes with Alex Marchand-Austin,
manager of lab surveillance and data management at Public Health Ontario, and
see how it all works.
How does one become a
manager of lab surveillance and data management?
Not many children dream of becoming something as specific as
a lab manager in surveillance and data management – so how did Alex get here?
Alex has a Bachelor’s of Science in cell
and molecular biology, and started his career working at the Public Health
Agency of Canada as a liaison officer with PHO not long after graduation. It
was in this position that Alex first worked closely with PHO lab data and was
later recruited to lead the new lab surveillance and data management
department. This wasn’t, however, the end of his educational path.
It’s Alex’s job to manage a team that helps process data
requests from the wealth of data available from Public Health Ontario’s
laboratory. As an intermediary between those who make requests (anyone from
Public Health Units to researchers and academics) and the laboratory, Alex has
to work with his team to interpret and tailor highly technical data to support
This work helps make data that is already valuable from a
clinical perspective even more valuable by extending its use for public health
initiatives. It’s the best of both worlds: when people are already sick, lab
test results help them understand how and start them on the road to treatment.
Going forward, those results can be looked at from a population perspective to
develop public health interventions that prevent them from getting sick in the
The importance of
People might not know how much knowledge and expertise goes
into generating the data that Alex’s team works with: “Although lab tests may
seem to be a simple “answer” to a diagnostic question, there is a lot of work
that goes on behind the scenes to generate it. Designing and validating tests,
skilled lab techniques, complex interpretation of multiple results,patient
factors, quality control, lab computer system design and maintenance, to name
just a few. All of these factors can influence data quality and need to be
considered to various degrees when building a data set for another purpose like
surveillance or research.”
All of this wouldn’t be possible without Alex’s team and
colleagues, a particular point of pride for him: “The amazing people at the lab
put a lot of work into generating great results and are your greatest resource.
We have come together from a variety of backgrounds to form a super
knowledgeable, fun, and helpful group. Their enthusiasm for learning and
problem solving makes me immensely proud to have them as colleagues.”
During his time at PHO, Alex pursued his Master’s of Science,
using his thesis to focus on whole genome sequencing of Bordetella pertussis, the bacteria that causes whooping cough. He
looked at how that technology could be used to describe changes in the bacteria
over time and how monitoring those changes might be important to public health
organizations. The topics explored in those studies are becoming increasingly
relevant to his job, since data from whole genome sequencing is increasingly
being used to enhance public health surveillance and research initiatives.
A major project that Alex has worked on is the HIV data mart.
This is a repository that provides timely, robust HIV data, contributing to:
- clinical care
- planning and evaluation
At local (e.g. clinic, public health unit), regional (e.g.
LHIN) or provincial levels.
The HIV laboratory data mart can help PHO support the
delivery of better clinical and public health services in Ontario, by providing
a better understanding of how many people are affected by HIV in Ontario.
The data mart helps automate a laborious data cleaning and
transformation process that used to be performed manually. This frees up the
time for epidemiologists and analysts to work with high quality data for
analysis and reporting instead of spending the majority of their time cleaning
and formatting. This has already allowed PHO to report on Ontario’s progress in
achieving the 90-90-90
goals set forth by the WHO for the reduction of HIV – and would have been
near impossible without the data mart.
Ultimately, Alex is glad to be a part of the work that
happens at PHO: “PHO brings together experts from a variety of fields to tackle
public health issues from all angles. We have laboratory experts,
epidemiologists, analysts, scientists, physicians, nurses, and all the
supporting staff under one organizational umbrella to support our various
partner’s public health needs. This critical mass of expertise helps anchor a
sometimes seemingly fractured public health system. “