COMMUNICABLE DISEASES - GENERAL

Eyes of New-Born 1. The following are requirements that shall be complied with in respect of communicable diseases of the eyes of a new-born child for the purposes of section 33 of the Act: 1. Within one hour after delivery, or as soon afterwards as is practicable, there shall be instilled into each conjunctival sac of the new-born child such quantity of 1 per cent solution of silver nitrate or other effective ophthalmic agent as is necessary to destroy any infectious agent that might cause ophthalmia neonatorum without causing injury to the child, unless, at any point during the pregnancy of the mother of the child, a parent of the child requests, in writing, to their physician, public health nurse or other health care professional person, that the drops not be instilled. 1.1 If a parent of the child requests that the drops not be instilled in accordance with paragraph 1, the physician, public health nurse or other health care professional person attending at the birth of the child may grant the request only if the physician, public health nurse or other health care professional person is satisfied that, i. the parent of the child making the request has received information on the benefits and risks of administration of the ophthalmic agent, ii. the parent has received information on the likely consequences of non-administration of the ophthalmic agent, and iii. an assessment has been done by a member of a health profession set out in Schedule 1 of the Regulated Health Professions Act, 1991 to confirm there is no serious risk of transmission to the child of an infectious agent that might cause ophthalmia neonatorum. 2. Every physician, public health nurse or other health care professional person who attended at the birth of the child and who is aware that an eye of the new-born child has become reddened, inflamed or swollen, within two weeks after birth of the child shall report in writing to the medical officer of health, i. the name, age and home address of the child, ii. where the child is located, if not at home, and iii. the conditions of the eye that have been observed. R.R.O. 1990, Reg. 557, s. 1; O. Reg. 143/18, s. 1. Rabies 2. (1) A physician, registered nurse in the extended class, veterinarian, police officer or any other person who has information concerning either or both of the following shall, as soon as possible, notify the medical officer of health and provide the medical officer of health with the information, including the name and contact information of the exposed person: 1. Any bite from a mammal. 2. Any contact with a mammal that is conducive to the potential transmission of rabies to persons. O. Reg. 501/17, s. 1. (2) The owner or the person having the care and custody of an animal, (a) that has bitten or is suspected of having bitten a person; or (b) that is suspected by the medical officer of health of having rabies, shall provide the medical officer of health with such information and assistance with respect to the animal as the medical officer of health requires. R.R.O. 1990, Reg. 557, s. 2 (2). 3. (1) A medical officer of health who receives information under section 2 and who finds any person has been exposed to a rabid or suspected rabid animal so as to require rabies post-exposure prophylaxis shall provide information, including details of exposure and prophylaxis administered, to the Ministry. O. Reg. 501/17, s. 2 (1). (2) A medical officer of health or public health inspector who is of the opinion that a dog, cat or ferret may be rabid shall cause the dog, cat or ferret to be confined and isolated for at least ten days from all animals and persons, except the person caring for the dog, cat or ferret, (a) at the place of residence of the person caring for the dog, cat or ferret, if the dog, cat or ferret is free from symptoms of any disease; or (b) in a pound or veterinary hospital at the expense of the municipality in which the person caring for the dog, cat or ferret resides if the dog, cat or ferret exhibits symptoms of any disease or if, in the opinion of the medical officer of health or public health inspector, the person is unlikely to confine and isolate the dog, cat or ferret. R.R.O. 1990, Reg. 557, s. 3 (2); O. Reg. 501/17, s. 2 (2). (2.1) A medical officer of health or public health inspector who is of the opinion that a horse, cow, bull, steer, calf, sheep, pig or goat may be rabid shall cause it to be confined and isolated for at least 14 days from all animals and persons, except the person caring for it, (a) at the location where the horse, cow, bull, steer, calf, sheep, pig or goat is ordinarily housed; or (b) at a veterinary hospital at the expense of the municipality in which the person caring for the horse, cow, bull, steer, calf, sheep, pig or goat resides if, in the opinion of the medical officer of health or public health inspector, the person is unlikely to confine and isolate it. O. Reg. 501/17, s. 2 (3). (3) Despite subsection (2) or (2.1), a medical officer of health or public health inspector, (a) may require the detention of an animal for the purpose of a veterinary examination for evidence of rabies and based on the results of the examination may cause the animal to be confined and isolated for such period as is necessary to determine that the animal is free from symptoms of rabies; or (b) may require the destruction of any animal at any time for the purpose of having a laboratory examination to determine if the animal is in the infective stage of rabies. O. Reg. 501/17, s. 2 (4). (4) In the case of a dog, cat or ferret, clause (3) (b) only applies where the dog, cat or ferret is unclaimed or where permission is given by the owner for the destruction of the dog, cat or ferret. O. Reg. 501/17, s. 2 (4). (4.1) A medical officer of health or public health inspector may require laboratory examination of a deceased animal for the purpose of determining if the animal was in the infective stage of rabies. O. Reg. 68/23, s. 1 (1). (5) The costs of a veterinary examination or destruction referred to in subsection (3) or (4) shall be borne by the municipality in which the animal is detained or the destruction is performed. R.R.O. 1990, Reg. 557, s. 3 (5); O. Reg. 68/23, s. 1 (2). (6) A medical officer of health shall, as soon as possible, notify and provide particulars to the Ministry where the medical officer of health has reason to believe that an animal, (a) is rabid; or (b) has been in contact with another animal that is known to have rabies or that is suspected of having rabies. O. Reg. 501/17, s. 2 (5). (7) Where, after a laboratory examination, an animal is found to have been rabid or when there is clinical evidence of rabies, the medical officer of health shall so inform, (a) the owner or person who had been caring for the animal; and (b) every person known to have been in contact with the animal during the infective stage of the disease and the person’s attending physician or registered nurse in the extended class. R.R.O. 1990, Reg. 557, s. 3 (7); O. Reg. 420/07, s. 2. (8) Where an animal has bitten a person or is suspected of being rabid and has had contact with a person and the animal dies or is killed prior to the completion of an appropriate observation period, the medical officer of health shall notify the Ontario Association of Veterinary Technicians Rabies Response Program to arrange for the collection of an animal specimen for rabies testing. O. Reg. 501/17, s. 2 (6). Psittacosis — Ornithosis 4. (1) A director of a laboratory or a veterinarian who knows or suspects that a captive bird or birds, a poultry flock or an equid is infected with the agent of psittacosis or ornithosis shall notify the Ministry, in the case of a director of a laboratory, or notify the medical officer of health, in the case of a veterinarian. O. Reg. 495/24, s. 1 (1). (2) A medical officer of health who knows or suspects that a captive bird or birds, a poultry flock or an equid is infected with the agent of psittacosis or ornithosis shall, (a) determine the extent of the infection; (b) act to prevent the spread of the infectious agent; and (c) notify the Ministry of the extent of the infection and the action being taken. R.R.O. 1990, Reg. 557, s. 4 (2); O. Reg. 501/17, s. 3; O. Reg. 495/24, s. 1 (2). (3) A medical officer of health who knows or suspects that a captive bird or birds, a poultry flock or an equid is infected with the agent of psittacosis or ornithosis shall require the owner, at the owner’s expense, to take the following steps until the medical officer of health is of the opinion that the bird or birds, poultry flock or equid is free of the infective agent: 1. Isolate or isolate and treat the bird or birds, poultry flock or equid. 2. Have a laboratory examination performed on fecal or tissue specimens of the bird or birds, poultry flock or equid. O. Reg. 495/24, s. 1 (3). (4) A medical officer of health shall require the owner, at the owner’s expense, to destroy the bird or birds, poultry flock or equid and disinfect the premises where, (a) isolation and treatment are not, or are unlikely to be, effective in preventing the spread of infection; (b) requested by the owner; or (c) the person having care and custody of the bird or birds, poultry flock or equid has failed to isolate or treat the bird or birds, poultry flock or equid. O. Reg. 495/24, s. 1 (3). 5. (1) An owner or person having the care and custody of a bird or birds, poultry flock or an equid who is informed by the medical officer of health that the bird or birds, poultry flock or equid is infected or suspected of being infected with the agent of psittacosis or ornithosis shall provide the medical officer of health with information regarding the sources of the animals and any recent distribution of the animals from the premises and shall identify persons who may have become ill as a result of exposure to the animals. O. Reg. 495/24, s. 2. (2) Where a bird or birds, poultry flock or an equid is isolated under paragraph 1 of subsection 4 (3), the owner or person having the care and custody of such animals shall notify the medical officer of health as soon as possible if any of the animals die during the isolation period and the animals shall be retained and disposed of as directed by the medical officer of health. O. Reg. 495/24, s. 2. 6. Poultry or other birds for human consumption originating from a flock in which ornithosis has been diagnosed shall only be slaughtered for food if the medical officer of health of the health unit in which the slaughterhouse is located is satisfied that the conditions of the proposed slaughter will provide protection to the employees of the slaughterhouse from the agent of psittacosis or ornithosis and the medical officer of health gives permission in writing for the slaughter. R.R.O. 1990, Reg. 557, s. 6. Avian Influenza, Novel Influenza Viruses and Echinococcus multilocularis 6.1 (1) A veterinarian or director of a laboratory who knows or suspects that a captive bird or birds or a poultry flock is infected with an avian influenza virus or that one or more animals is infected with a novel influenza virus shall immediately notify the Ministry, in the case of a director of a laboratory, or notify the medical officer of health, in the case of a veterinarian, and shall provide the Ministry or the medical officer of health with such information and assistance with respect to the bird or birds, poultry flock, animal or animals as the Ministry or medical officer of health requires, including, but not limited to, (a) the location of the bird, birds, poultry flock, animal or animals; and (b) contact information for the owner or owners of the bird, birds, poultry flock, animal or animals. O. Reg. 501/17, s. 4; O. Reg. 495/24, s. 3 (1). (2) A medical officer of health who knows or suspects that a captive bird, birds, poultry flock, or mammal species is infected with an avian influenza or novel influenza virus shall, (a) determine the extent of the infection; (b) act to prevent the spread of the infectious agent to humans; and (c) notify the Ministry of the extent of the infection and the action being taken. O. Reg. 501/17, s. 4. (3) A veterinarian or director of a laboratory who knows or suspects that one or more definitive host animals is infected with Echinococcus multilocularis shall, within one business day, notify the Ministry, in the case of a director of a laboratory, or shall notify the medical officer of health, in the case of a veterinarian, and shall provide the Ministry or the medical officer of health with such information and assistance with respect to the animal or animals as the Ministry or medical officer of health requires, including, but not limited to, (a) the location of the animal or animals; and (b) contact information for the owner or owners of the animal or animals. O. Reg. 501/17, s. 4; O. Reg. 495/24, s. 3 (2). (4) A medical officer of health who knows or suspects that one or more definitive host animals is infected with Echinococcus multilocularis shall, (a) determine the extent of the infection; (b) act to prevent the spread of the infectious agent to humans; and (c) notify the Ministry of the extent of the infection and the action being taken. O. Reg. 501/17, s. 4; O. Reg. 495/24, s. 3 (3). (5) In this section, “definitive host” means any species, particularly wild or domestic canids or felids, capable of carrying adult tapeworms in their intestines or capable of shedding tapeworm eggs in their feces. (“hôte définitif”) “novel influenza virus” means any influenza virus not already known to be endemically circulating in Ontario’s animal species. O. Reg. 501/17, s. 4; O. Reg. 495/24, s. 3 (4). Zoonotic Mycobacterium Tuberculosis Complex in Animals 6.2 (1) A veterinarian or director of a laboratory who knows or suspects that one or more animals is infected with Mycobacterium tuberculosis complex shall notify immediately the Ministry, in the case of a director of a laboratory, or notify the medical officer of health, in the case of a veterinarian, and shall provide the Ministry or medical officer of health with such information and assistance with respect to the animal or animals as the Ministry and medical officer of health require, including, but not limited to, (a) the location of the animal or animals; and (b) contact information for the owner or the person having the care and custody of the animal or animals. O. Reg. 495/24, s. 4. (2) A medical officer of health who knows or suspects that an animal is infected with Mycobacterium tuberculosis complex shall, (a) determine the extent of the infection; (b) act to prevent the spread of the infectious agent to humans; and (c) notify the Ministry of the extent of the infection and the action being taken. O. Reg. 495/24, s. 4. (3) Any person or persons with known or suspected exposure to an animal infected with Mycobacterium tuberculosis complex, including exposure during any postmortem examination, shall notify the medical officer of health immediately. O. Reg. 495/24, s. 4. (4) A medical officer of health shall require the owner or the person having the care and custody of an animal infected with Mycobacterium tuberculosis complex to destroy the animal and disinfect the premises, at the owner’s expense, if, (a) isolation and treatment are not, or are unlikely to be, effective in preventing the spread of infection; (b) requested by the owner or the person having care and custody of the animal; or (c) the person having care and custody of the animal has failed to isolate or treat the animal. O. Reg. 495/24, s. 4. (5) In this section, “Mycobacterium tuberculosis complex” means any Mycobacterium species which could cause disease in humans including, but not limited to, M. bovis and M. tuberculosis. O. Reg. 495/24, s. 4. Disposal of Corpses 7. Sections 8, 9 and 10 apply to the corpse of a person who was confirmed or suspected as having one of the following infectious agents, as well as the corpse of a person who was isolated for having one of the following infectious agents: 1. Anthrax. 2. Ebola virus disease. 3. Haemorrhagic fevers. 4. Lassa fever. 5. Marburg virus disease. 6. Plague. 7. Smallpox. O. Reg. 501/17, s. 5. 8. (1) As soon as possible after death occurs, the person having custody of a corpse referred to in section 7 shall, (a) place the corpse or cause it to be placed in at least two leak-proof body bags, each one being at least 150 µm thick; and (b) place the corpse and the body bags in a soundly constructed casket or cremation container, or cause them to be placed in such a casket or container. O. Reg. 501/17, s. 5. (2) Where a deceased person was infected with smallpox or anthrax, the casket or cremation container referred to in subsection (1) shall be hermetically sealed. O. Reg. 501/17, s. 5. (3) Once a corpse has been placed in the body bags required under clause (1) (a), no person shall open the bags except as directed by the medical officer of health. O. Reg. 501/17, s. 5. (4) A casket or cremation container referred to in subsection (1) shall, (a) be closed immediately after the corpse is placed in it; and (b) not be opened except as directed by the medical officer of health. O. Reg. 501/17, s. 5. (5) No person shall remove a corpse referred to in section 7 from the location where the individual has died until there has been compliance with subsection (1) and, where applicable, subsection (2). O. Reg. 501/17, s. 5. (6) The medical officer of health may direct that a corpse referred to in section 7 be removed directly to the place of burial or cremation. O. Reg. 501/17, s. 5. (7) No person shall embalm a corpse referred to in section 7 or engage in its hygienic preparation. O. Reg. 501/17, s. 5. (8) No person shall engage in the post-mortem examination of a corpse referred to in section 7, except where the examination is required by a coroner acting in accordance with the Coroners Act. O. Reg. 501/17, s. 5. 9. The medical officer of health may restrict the attendance of persons at the funeral of a corpse referred to in section 7. R.R.O. 1990, Reg. 557, s. 9. 10. No person shall deliver a corpse referred to in section 7 for transportation or carriage unless the following requirements are complied with: 1. The corpse must be enclosed in a soundly constructed casket or cremation container satisfactory to the medical officer of health. 2. If the corpse is being transported or carried by commercial carrier of any kind, the casket or cremation container must be enclosed in an outer case that is sufficiently strong to ensure that the casket or cremation container and the hermetical sealing, if any, will not be broken throughout the transportation or carriage of the corpse by the commercial carrier. O. Reg. 501/17, s. 6. 11. Except as provided in section 6, a reference in this Regulation to the medical officer of health means, (a) a reference to the medical officer of health of the board of health in the health unit in which the person, animal or thing, as the case may be, referred to, resides; or (b) a reference to the medical officer of health of the board of health in the health unit in which the person died, in the case of sections 8, 9 and 10. O. Reg. 501/17, s. 6.