The purpose of this communication is to provide information for you to share with front line health care providers, including emergency department staff and laboratory technicians. This includes a summary of recent infectious disease activity of measles and viral hemorrhagic fever (VHF), in addition to clinical features, laboratory testing procedures and infection, prevention and control (IPC) practices for measles which will assist in mitigating further transmission.
Canada has been free of endemic measles since 1998; however, measles occurs globally and remains a serious and common disease in many countries. In Ontario, importation and travel-related cases still occur and have contributed to further transmission among populations without immunity. Between 2009 and 2012, 27 confirmed cases were reported in Ontario, of whom, 25 were directly or indirectly associated with travel outside of Canada. As of March 31, 2014, 11 cases of measles have been reported in Ontario, of whom, all were directly or indirectly associated with travel to the Philippines, Thailand and Europe. Information on clinical features of measles in addition to laboratory testing and IPC practices is available on the Public Health Ontario website: http://www.publichealthontario.ca/en/eRepository/Measles_Update_for_Clin... 
In addition, the Disease-Specific Chapter (Appendix A) and Provincial Case Definition (Appendix B) for Measles have been updated and are effective immediately.
A summary of the changes related to measles is also included in the Document History sections of the Disease-Specific Chapters of Appendix A and Provincial Case Definitions of Appendix B. These documents are available through the Ontario Public Health Standards (OPHS) website at the following link:
Ebola Virus Disease – West Africa
The Ministry of Health of Guinea has notified the World Health Organization of a rapidly evolving outbreak of Ebola Virus Disease (EVD) in the country. As of March 28, 2014, a total of 112 confirmed and suspected cases including 70 deaths have been reported in Guinea. This includes six health care workers -- 4 confirmed and 2 suspected cases. Further reports of suspected cases in border areas of Liberia and Sierra Leone are being investigated. In addition, recent attention has focused on a Saskatchewan resident who was suspected of having EVD. He was a returning traveler who presented with clinically compatible signs and symptoms; however, all VHFs have since been ruled out. Additional information on clinical aspects, laboratory testing and IPC practices will follow shortly.
Travel has always been associated with potential risk/s to the health of travelers. These situations highlight the importance of routinely asking if a patient has travelled, to what location/s and in what activities he/she participated. The answers to these questions will provide valuable information regarding potential exposures to infectious diseases, assist with prompt diagnosis, allow appropriate treatment and prevent/limit the spread of disease.
I hope you find this information useful, and I thank you for your ongoing vigilance in anticipating, preventing, identifying and responding to communicable and infectious disease threats in our province. Please use your established communication channels for sharing this information with health care providers in your jurisdiction.
Find the downloadable pdf below.