March 2022 Board of Health Meeting - 2021 Summary – Infectious Disease Prevention Department Information Report

Meeting Document Type
Information Report
2021 Summary – Infectious Disease Prevention Department


Infectious Disease Prevention


March, 2022


2021 Summary – Infectious Disease Prevention Department


The Health Protection and Promotion Act 1990 (HPPA), R.S.O., 1990, and Ontario Reg. 135/18, outlines the requirements for physicians, practitioners, and institutions to report any disease of public health significance (DOPHS) to the Medical Officer of Health (MOH). The Ontario Public Health Standards (OPHS) describe the mandatory programs and services that are to be delivered by the board of health, which includes infectious and communicable diseases prevention and control.

The Windsor-Essex County Health Unit (WECHU) Infectious Disease Prevention (IDP) department includes a multidisciplinary team of professionals including Public Health Nurses (PHNs), Health Promotion Specialist, Infection Control Practitioner (ICP) and clerical support. The IDP team delivers programs and services addressing sexually transmitted blood-borne infections (STBBI)/Sexual Health Clinic; tuberculosis (TB); and communicable diseases (CD).

STBBI/Sexual Health:

Results of the 2020 Syphilis Survey Report, released in 2021 via the Sexual Advisory Committee, identified a gap in both knowledge and awareness of syphilis amongst the general population and local healthcare practitioners (HCPs).  Case numbers for the human immunodeficiency virus (HIV) in WEC in the 1st quarter of 2021 increased from previous years. Nine cases of HIV were reported in WEC from January 1 to March 31, 2021 compared to an average of 4.6 cases in the first quarter of the previous 5 reporting years. The HIV rate in WEC leveled as 2021 progressed to a total of 17 HIV cases. A comparison of the previous 5 years showed a yearly average of 21.8 HIV cases per year in WEC.  While the HIV rate in WEC was lower in 2021 than previous years, the crude rate averaged 4.0 HIV cases per 100,000 residents in WEC whereas the provincial crude rate was 3.7.

In response to the increased incidences of HIV cases that were observed in the initial part of 2021, a HIV Alert was posted on the Canadian Network for Public Health Intelligence (CNPHI) website, operated by the Public Health Agency of Canada in April of 2021. A comprehensive social media campaign was consequently developed to improve sexual health and well-being within WEC. The communication campaign included the development of syphilis awareness posters, banners, billboards, and social media messaging. Syphilis awareness banners were adapted and published in the WE Pride magazine (2021/2022) and as part of the 2021 WEC Pride Fest. Additionally, billboards were also posted in three WEC locations that shed light on the spread of STIs and promoted the use of condoms.

In order to engage our community, social media platforms, Facebook, Grindr, and Instagram were also utilized to increase STI awareness. PHNs were also involved in Pozitive Pathways podcasts (two episodes: syphilis and gonorrhea) and as AM800 guest speakers (two events: oral sex and syphilis).

PHNs continue to support resources, capacity building efforts for HCPs and community partners to support the appropriate diagnosis, treatment, and knowledge dissemination as it pertains to STIs. As a result of the change to the WECHU service delivery model, updates were made to our syphilis reporting form, and WECHU website. WECHU’s STI Guide was also updated to align with provincial/national STI guidelines and provides information about ordering STI medications. HCPs are able to request Bicillin-LA and other STBBI medications from the WECHU (free of charge).


In 2021, there was a total of 17 active TB cases, and 146 cases of Latent TB Infections (LTBI) in WEC, as well as a TB cluster investigation identified at a local farm, crossing two sites and 4 cases. Services for both active and latent TB cases were delivered at either the client’s home, in-person at the WECHU clinic, or virtually. To increase awareness of TB, and TB reporting requirements among community partners (e.g. Shoppers Drug Mart, Tecumseh Medical Clinic), an outreach campaign was undertaken in 2021. Communication outlining updated HIV testing recommendations for individuals with active TB and LTBI, and a revised TB reporting form was distributed to physicians and pharmacists in WEC. Reminder magnets were also included to compliment the letter (Appendix A). The reminder magnets highlighted the need to call the health unit before dispensing TB medication and informing the health unit if a positive TB skin test has been identified.


The WECHU reported zero cases of influenza in 2021. IDP PHNs noted an increase of uncommon diseases reported in 2021, including Creutzfeldt-Jakob Disease (CJD), Echninococcus, and Acute Flaccid Paralysis. In addition, the IDP PHNs worked with the ICP in a number of outbreak situations (gastroenteritis and respiratory) in institutions and hospitals.

Refer to Appendix B for the DOPHS [diseases of public health significance] 2021 case numbers that were retrieved from iPHIS.

Appendix A: TB Reminder Magnets

Photo of TB Fridge magnets

Appendix B: DOPHS 2021 Case Numbers

Note: The table below includes the number of confirmed cases (and probable cases, depending on the DOPHS) from 2021. The date of extraction from iPHIS was on February 16, 2022.

Disease of Public Health Significance # of confirmed cases
  2020 2021
Acute Flaccid Paralysis 0 1
AIDS 0 0
Amebiasis (includes confirmed and probable) 7 4
Anthrax 0 0
Blastomycosis 1 0
Botulism 0 0
Brucellosis 0 0
Campylobacter Enteritis 63 76
Carbapenemase-producing Enterobacteriaceae (CPE) 3 4
Chancroid 0 0
Chlamydial Infections 747 741
Cholera 0 0
Creutzfeldt-Jakob Disease, All Types 0 0
Cryptosporidiosis 3 2
Cyclosporiasis 2 2
Diptheria 0 0
Echinococcus Multilocularis Infection 0 0
Encephalitis 3 1
Encephalitis/Meningitis 0 2
Food Poisoning, All Causes 0 0
Giardiasis 12 11
Gonorrhoea (All Types) 184 249
Group A Streptococcal Disease, Invasive 44 24
Group B Streptococcal Disease, Neonatal 0 2
Haemophilus Influenzae Disease, All Types, Invasive
(includes confirmed and probable)
2 5
Hantavirus Pulmonary Syndrome 0 0
Hemorrhagic Fevers 0 0
Hepatitis A 5 1
Hepatitis B, acute 7 6
Hepatitis B, chronic 23 14
Hepatitis C 80 118
HIV 17 17
Influenza (2019/2020 & 2020/2021) 179 0
Lassa Fever 0 0
Legionellosis 6 9
Leprosy 0 0
Listeriosis 5 1
Lyme Disease (includes confirmed and probable) 5 7
Malaria 0 0
Measles 0 0
Meningitis 4 3
Meningococcal Disease, Invasive
(includes confirmed and probable)
0 0
Mumps (includes confirmed and probable) 0 0
Ophthalmia Neonatorum 0 0
Paralytic Shellfish Poisoning 0 0
Paratyphoid Fever 0 1
Pertussis (Whooping Cough)
(includes confirmed and probable)
1 0
Plague 0 0
Poliomyelitis, Acute 0 0
Psittacosis/Ornithosis 0 0
Q Fever 0 0
Rabies 0 0
Rubella 0 0
Rubella, Congenital Syndrome 0 0
Salmonellosis 46 24
Severe Acute Respiratory Syndrome (SARS) 0 0
Shigellosis 0 0
Smallpox 0 0
Streptococcus Pneumoniae, Invasive 9 10
Syphilis, Early Congenital 0 0
Syphilis, Infectious 57 46
Syphilis, Latent 22 22
Syphilis, Other 5 12
Tetanus 0 0
Trichinosis 0 0
Tuberculosis 11 10
Tuberculosis infection, Latent 173 150
Tularemia 0 0
Typhoid Fever 0 0
Varicella (Chickenpox) 8 5
Verotoxin Producing E. Coli including HUS 1 5
West Nile Virus Illness
(includes confirmed and probable)
4 3
Yellow Fever 0 0
Yersiniosis 4 3


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