Infectious Diseases

 

Infectious Diseases Data

In this section:

Overall Yearly and Quarterly Summaries

Cases of infectious diseases of public health significance in Ottawa residents are reportable to the Medical Officer of Health at Ottawa Public Health under the Health Protection and Promotion Act (HPPA) and associated regulations.  Reports are made primarily by laboratories, but healthcare providers are also required to report.

These tables show recent data for infectious diseases of public health significance in Ottawa. Data are presented as crude counts of cases and as incidence rates.

Infectious Diseases of Public Health Significance by Year
Infectious Diseases of Public Health Significance by Year for Ottawa Residents (Number of Cases)

 

Table 1. Cases of infectious Disease of Public Health Significance in Ottawa by year, 2014-2018

Disease

2014 counts

2015 counts

2016 counts

2017 counts

2018 counts

Acute Flaccid Paralysis

1

0

0

0

1

Adverse Vaccine Reaction

58

66

52

55

56

AIDS Cases

3

4

10

11

9

Amebiasis, Confirmed and Probable Cases

73

86

73

76

61

Anthrax

0

0

0

0

0

Blastomycosis

N/A

N/A

N/A

N/A

2

Botulism

0

0

0

0

0

Brucellosis, Confirmed and Probable Cases

0

2

2

0

3

Campylobacter enteritis

224

172

173

191

211

Carbapenamase-producing enterobacteriaceae

N/A

N/A

N/A

N/A

5

Chancroid

0

0

0

0

0

Chickenpox

37

75

78

74

61

Chlamydia

2581

3056

3263

3452

3804

Cholera

0

0

0

1

0

Creutzfeld-Jacob Disease

0

0

0

1

0

Cryptosporidiosis

21

29

45

18

31

Cyclospora

8

13

19

17

24

Diphtheria

0

0

0

0

0

Echinococcus multilocularis infection

N/A

N/A

N/A

N/A

0

Encephalitis

2

4

1

1

8

Giardiasis, Confirmed and Probable

106

134

139

120

132

Gonorrhea

324

328

371

639

899

Haemophilis influenza, type B

0

1

0

0

0

Haemophilus influenzae all types, Invasive

0

1

0

0

17

Hantavirus

0

0

0

0

0

Hemorrhagic Fevers

0

0

0

0

0

Hepatitis A

4

5

5

4

7

Hepatitis B - Carriers

162

152

156

150

165

Hepatitis B - Cases

3

1

4

2

0

Hepatitis C

227

223

221

269

310

HIV Infections

56

47

61

63

77

Influenza A - Seasonal

412

584

521

477

710

Influenza B

110

150

105

110

461

Lassa Fever

0

0

0

0

0

Legionella Infections

2

3

3

4

6

Leprosy

0

0

1

0

0

Listeriosis

2

7

7

3

4

Lyme Disease, Confirmed and Probable Cases

22

73

76

190

91

Malaria

20

17

36

32

N/A

Measles

4

0

2

0

0

Meningitis

10

16

17

21

17

Meningococcal Disease

0

4

3

4

2

Mumps, Confirmed and Probable Cases

0

1

7

4

4

Ophthalmia Neonatorum

0

0

0

0

0

Paralytic Shellfish Poisoning

0

0

0

0

0

Paratyphoid Fever

1

1

1

2

0

Pertussis, Confirmed and Probable Cases

14

29

17

25

21

Plague

0

0

0

0

0

Polio

0

0

0

0

0

Psittacosis/Ornithosis

0

0

0

0

0

Q Fever

0

0

0

0

1

Rabies

0

0

0

0

0

Rubella

0

0

0

0

0

Rubella, Congenital Syndrome

0

0

0

0

0

Salmonellosis

181

157

176

173

178

Shigellosis

27

23

39

27

28

Smallpox

0

0

0

0

0

Streptococcal Infections, Group A Invasive

56

39

42

68

69

Streptococcal Infections, Group B Neonatal

4

0

4

6

4

Streptococcus pneumoniae, Invasive

75

61

71

73

68

Syphilis: Congenital

0

0

0

0

0

Syphilis: Infectious (1o, 2o, early latent)

44

100

136

105

151

Syphilis: Late Latent

51

60

73

58

66

Syphilis: Unspecified

1

5

2

15

44

TB of the Lung

35

29

22

23

21

TB: All cases

51

46

41

45

49

Tetanus

0

0

0

0

0

Trichinosis

0

0

0

0

0

Tularemia

0

0

0

0

0

Typhoid Fever

1

1

2

9

4

VTEC/HUS

3

14

7

4

8

West Nile Virus, Confirmed and Probable Cases

2

0

2

20

7

Yellow Fever

0

0

0

0

N/A

Yersiniosis

8

9

13

13

9

Data Source and Notes for Table 1
Ottawa Public Health. Integrated Public Health Information System (iPHIS), Ontario Ministry of Health and Long-Term Care, 2019. [Extracted on April 30, 2019]
  • iPHIS is a dynamic reporting system which allows for on-going updates to previously entered data. As such, data extracted from iPHIS provides a snapshot of information at the time of data extraction, and can vary from previous and subsequent data extractions.
  • The following diseases are reported as a sum of confirmed and probable cases: amebiasis, giardiasis, brucellosis, Lyme disease, mumps, pertussis, and West Nile Virus.
  • AIDS cases are usually reported only upon diagnosis of HIV infection.
  • All cases, except for tuberculosis (TB) cases and HIV infections, are assigned to a date based on episode date (the earliest of symptom onset, laboratory testing, and reporting). TB cases are assigned based on diagnosis date and HIV infections are assigned based on reported date.
  • There is a lag in reporting associated with most reportable communicable diseases.
  • Reportable communicable diseases are generally underreported due to several factors, which may include low morbidity and incentive for testing, no health care sought, clinical rather than laboratory-based diagnoses, and the inability to identify an aetiological agent from a laboratory specimen.
  • Blastomycosis, Carbapenamase-producing enterobacteriaceae, and Echinococcus multilocularis infection became reportable in May 2018.

  • Yellow fever and malaraia were no longer reportable in 2018.
Infectious Diseases of Public Health Significance by Year for Ottawa Residents (Incidence Rate per 100,000)
Table 2. Incidence rates (per 100,000 population) for infectious Diseases of Public Health Significance in Ottawa by year, 2014-2018

Disease

2014 rates

2015 rates

2016 rates

2017 rates

2018 rates

Acute Flaccid Paralysis

0.1

0.0

0.0

0.0

0.1

Adverse Vaccine Reaction

6.1

6.9

5.4

5.6

5.6

AIDS Cases

0.3

0.4

1.0

1.1

0.9

Amebiasis, Confirmed and Probable Cases

7.7

9.0

7.5

7.7

6.1

Anthrax

0.0

0.0

0.0

0.0

0.0

Blastomycosis

N/A

N/A

N/A

N/A

0.3

Botulism

0.0

0.0

0.0

0.0

0.0

Brucellosis, Confirmed and Probable Cases

0.0

0.2

0.2

0.0

0.3

Campylobacter enteritis

23.7

18.0

17.8

19.3

21.1

Carbapenamase-producing enterobacteriaceae

N/A

N/A

N/A

N/A

0.9

Chancroid

0.0

0.0

0.0

0.0

0.0

Chickenpox

3.9

7.8

8.0

7.5

6.1

Chlamydia

272.7

319.4

335.8

349.7

379.6

Cholera

0.0

0.0

0.0

0.1

0.0

Creutzfeld-Jacob Disease

0.0

0.0

0.0

0.1

0.0

Cryptosporidiosis

2.2

3.0

4.6

1.8

3.1

Cyclospora

0.8

1.4

2.0

1.7

2.4

Diphtheria

0.0

0.0

0.0

0.0

0.0

Echinococcus multilocularis infection

N/A

N/A

N/A

N/A

0.0

Encephalitis

0.2

0.4

0.1

0.1

0.8

Giardiasis, Confirmed and Probable

11.2

14.0

14.3

12.2

13.2

Gonorrhea

34.2

34.3

38.2

64.7

89.7

Haemophilis influenza, type B

0.0

0.1

0.0

0.0

0.0

Haemophilus influenzae all types, Invasive

0.0

0.1

0.0

0.0

1.7

Hantavirus

0.0

0.0

0.0

0.0

0.0

Hemorrhagic Fevers

0.0

0.0

0.0

0.0

0.0

Hepatitis A

0.4

0.5

0.5

0.4

0.7

Hepatitis B - Carriers

17.1

15.9

16.1

15.2

16.5

Hepatitis B - Cases

0.3

0.1

0.4

0.2

0.0

Hepatitis C

24.0

23.3

22.7

27.3

30.9

HIV Infections

5.9

4.9

6.3

6.4

7.7

Influenza A - Seasonal

43.5

61.0

53.6

48.3

70.9

Influenza B

11.6

15.7

10.8

11.1

46.0

Lassa Fever

0.0

0.0

0.0

0.0

0.0

Legionella Infections

0.2

0.3

0.3

0.4

0.6

Leprosy

0.0

0.0

0.1

0.0

0.0

Listeriosis

0.2

0.7

0.7

0.3

0.4

Lyme Disease, Confirmed and Probable Cases

2.3

7.6

7.8

19.2

9.1

Malaria

2.1

1.8

3.7

3.2

N/A

Measles

0.4

0.0

0.2

0.0

0.0

Meningitis

1.1

1.7

1.7

2.1

1.7

Meningococcal Disease

0.0

0.4

0.3

0.4

0.2

Mumps, Confirmed and Probable Cases

0.0

0.1

0.7

0.4

0.4

Ophthalmia Neonatorum

0.0

0.0

0.0

0.0

0.0

Paralytic Shellfish Poisoning

0.0

0.0

0.0

0.0

0.0

Paratyphoid Fever

0.1

0.1

0.1

0.2

0.0

Pertussis, Confirmed and Probable Cases

1.5

3.0

1.7

2.5

2.1

Plague

0.0

0.0

0.0

0.0

0.0

Polio

0.0

0.0

0.0

0.0

0.0

Psittacosis/Ornithosis

0.0

0.0

0.0

0.0

0.0

Q Fever

0.0

0.0

0.0

0.0

0.1

Rabies

0.0

0.0

0.0

0.0

0.0

Rubella

0.0

0.0

0.0

0.0

0.0

Rubella, Congenital Syndrome

0.0

0.0

0.0

0.0

0.0

Salmonellosis

19.1

16.4

18.1

17.5

17.8

Shigellosis

2.9

2.4

4.0

2.7

2.8

Smallpox

0.0

0.0

0.0

0.0

0.0

Streptococcal Infections, Group A Invasive

5.9

4.1

4.3

6.9

6.9

Streptococcal Infections, Group B Neonatal

0.4

0.0

0.4

0.6

0.4

Streptococcus pneumoniae, Invasive

7.9

6.4

7.3

7.4

6.8

Syphilis: Congenital

0.0

0.0

0.0

0.0

0.0

Syphilis: Infectious (1o, 2o, early latent)

4.6

10.5

14.0

10.6

15.1

Syphilis: Late Latent

5.4

6.3

7.5

5.9

6.6

Syphilis: Unspecified

0.1

0.5

0.2

1.5

4.4

TB of the Lung

3.7

3.0

2.3

2.3

2.1

TB: All cases

5.4

4.8

4.2

4.6

4.9

Tetanus

0.0

0.0

0.0

0.0

0.0

Trichinosis

0.0

0.0

0.0

0.0

0.0

Tularemia

0.0

0.0

0.0

0.0

0.0

Typhoid Fever

0.1

0.1

0.2

0.9

0.4

VTEC/HUS

0.3

1.5

0.7

0.4

0.8

West Nile Virus, Confirmed and Probable Cases

0.2

0.0

0.2

2.0

0.7

Yellow Fever

0.0

0.0

0.0

0.0

N/A

Yersiniosis

0.8

0.9

1.3

1.3

0.9

 

Data Source and Notes for Table 2
Population estimates for 2014 to 2018, Ontario Ministry of Health and Long-Term Care, IntelliHEALTH Ontario. [Extracted by Ottawa Public Health in February 2017]

Ottawa Public Health. Integrated Public Health Information System (iPHIS), Ontario Ministry of Health and Long-Term Care, 2019. [Extracted on April 30, 2019]

  • iPHIS is a dynamic reporting system which allows for on-going updates to previously entered data. As such, data extracted from iPHIS provides a snapshot of information at the time of data extraction, and can vary from previous and subsequent data extractions.
  • The following diseases are reported as a sum of confirmed and probable cases: amebiasis, giardiasis, brucellosis, Lyme disease, mumps, pertussis, and West Nile Virus.
  • AIDS cases are included in the table but are usually reported only upon diagnosis of HIV infection.
  • All cases, except for tuberculosis (TB) cases and HIV infections, are assigned to a date based on episode date (the earliest of symptom onset, laboratory testing, and reporting). TB cases are assigned based on diagnosis date and HIV infections are assigned based on reported date.
  • There is a lag in reporting associated with most reportable communicable diseases.
  • Reportable communicable diseases are generally underreported due to several factors, which may include low morbidity and incentive for testing, no health care sought, clinical rather than laboratory-based diagnoses, and the inability to identify an aetiological agent from a laboratory specimen.
  • Rates based on small numbers (e.g., for vaccine-preventable diseases) may fluctuate dramatically from year to year, even when there is no meaningful difference. Year to year comparisons of these diseases should be interpreted with caution.
  • Rates are calculated as reports per 100,000 population.
  • Blastomycosis, Carbapenamase-producing enterobacteriaceae, and Echinococcus multilocularis infection became reportable in May 2018.
  • Yellow fever and malaraia were no longer reportable in 2018.
Infectious Diseases of Public Health Significance by Quarter

 

Disease

2019  Cases (Q1, Q2,   and Q3)

2019 Rate (Q1, Q2, and Q3)

2018 Cases (Q1, Q2, and Q3)

2018 Rate (Q1, Q2, and Q3)

2018 Total Cases

2018 Total Rate

Quarter 1 (2019)

Quarter 2 (2019)

Quarter 3 (2019)

Historical Ave. for Quarter 3, 2019

Acute Flaccid Paralysis

0

0.0

1

0.1

1

0.1

0

0

0

0.2

Adverse Event Following Immunization (AEFI)

20

2.6

34

4.4

56

5.5

11

9

0

8.8

AIDS Cases

4

0.5

5

0.6

11

1.1

2

2

0

1.8

Amebiasis (confirmed & probable)

42

5.4

49

6.3

61

6.0

19

8

15

16.6

Anthrax

0

0.0

0

0.0

0

0.0

0

0

0

0.0

Blastomycosisª

2

0.3

2

0.3

2

0.2

0

1

1

0.2

Botulism

0

0.0

0

0.0

0

0.0

0

0

0

0.0

Brucellosis (confirmed & probable)

0

0.0

3

0.4

4

0.4

0

0

0

1.2

Campylobacter enteritis

150

19.3

171

22.1

214

21.1

45

49

56

70.4

Carbapenamase-producing enterobacteriaceaeª

14

1.8

7

0.9

10

1.0

2

6

6

0.8

Chancroid

0

0.0

0

0.0

0

0.0

0

0

0

0.0

Chickenpox

29

3.7

54

7.0

61

6.0

12

7

10

11.4

Chlamydia

2912

375.6

2784

359.1

3807

374.7

989

893

1030

829.0

Cholera

0

0.0

0

0.0

0

0.0

0

0

0

0.2

Creutzfeld-Jakob Disease

0

0.0

0

0.0

0

0.0

0

0

0

0.0

Cryptosporidiosis

24

3.1

31

4.0

31

3.1

11

4

9

18.2

Cyclospora

42

5.4

24

3.1

24

2.4

2

18

22

7.2

Diphtheria

0

0.0

0

0.0

0

0.0

0

0

0

0.0

Echinococcus multilocularis infectionª

0

0.0

0

0.0

0

0.0

0

0

0

0.0

Encephalitis

7

0.9

5

0.6

8

0.8

2

3

2

1.4

Giardiasis (confirmed & probable)

77

9.9

98

12.6

132

13.0

17

23

37

43.8

Gonorrhea

598

77.1

664

85.6

899

88.5

211

189

198

143.6

Haemophilus influenzae disease,
  all types, invasive

12

1.5

9

1.2

17

1.7

5

5

2

0.8

Haemophilus influenzae disease, type B, invasive

0

0.0

0

0.0

0

0.0

0

0

0

0.0

Hantavirus

0

0.0

0

0.0

0

0.0

0

0

0

0.0

Hemorrhagic Fevers

0

0.0

0

0.0

0

0.0

0

0

0

0.0

Hepatitis A

21

2.7

5

0.6

7

0.7

6

7

8

1.4

Hepatitis B - Carriers

144

18.6

124

16.0

165

16.2

50

55

39

37.0

Hepatitis B - Cases

0

0.0

0

0.0

0

0.0

0

0

0

0.2

Hepatitis C (all infections)

207

26.7

247

31.9

309

30.4

66

66

75

59.8

Hepatitis C (newly acquired)

25

3.2

27

3.5

35

3.4

16

7

2

2.2

Hepatitis C (pending classification)

47

6.1

129

16.6

140

13.8

1

6

40

8.8

Hepatitis C (previously acquired)

135

17.4

91

11.7

134

13.2

49

53

33

10.2

HIV Infections (all)

30

3.9

57

7.4

76

7.5

13

6

11

14.2

HIV Infections (not recently acquired)

10

1.3

38

4.9

52

5.1

6

2

2

6.6

HIV Infections (pending timing)

13

1.7

0

0.0

0

0.0

3

2

8

0.0

HIV Infections (recently acquired)

2

0.3

5

0.6

7

0.7

2

0

0

2.8

HIV Infections (unknown timing)

1

0.1

5

0.6

6

0.6

1

0

0

3.8

Influenza - Outbreak Associated  Cases

457

58.9

912

117.6

951

93.6

314

143

0

0.0

Influenza A

590

76.1

629

81.1

710

69.9

461

127

2

3.0

Influenza B

18

2.3

456

58.8

461

45.4

1

16

1

0.6

Lassa Fever

0

0.0

0

0.0

0

0.0

0

0

0

0.0

Legionella Infections

6

0.8

6

0.8

6

0.6

1

3

2

1.8

Leprosy

0

0.0

0

0.0

0

0.0

0

0

0

0.0

Listeriosis

5

0.6

2

0.3

3

0.3

3

2

0

2.0

Lyme Disease (confirmed & probable)

119

15.3

85

11.0

92

9.1

0

18

101

56.6

Lymphogranuloma venereum (confirmed & probable)‡

3

0.4

2

0.3

3

0.3

2

1

0

2.6

Measles

3

0.4

0

0.0

0

0.0

2

1

0

0.4

Meningitis

12

1.5

9

1.2

17

1.7

2

5

5

5.0

Meningococcal Disease

0

0.0

1

0.1

2

0.2

0

0

0

0.8

Mumps (confirmed & probable)

6

0.8

4

0.5

4

0.4

2

3

1

0.6

Ophthalmia Neonatorum

0

0.0

0

0.0

0

0.0

0

0

0

0.0

Paralytic Shellfish Poisoning

0

0.0

0

0.0

0

0.0

0

0

0

0.0

Paratyphoid Fever

2

0.3

0

0.0

0

0.0

1

1

0

0.0

Pertussis (confirmed & probable)

25

3.2

9

1.2

21

2.1

3

9

13

6.6

Plague

0

0.0

0

0.0

0

0.0

0

0

0

0.0

Polio

0

0.0

0

0.0

0

0.0

0

0

0

0.0

Psittacosis/Ornithosis

0

0.0

0

0.0

0

0.0

0

0

0

0.0

Q Fever

0

0.0

1

0.1

1

0.1

0

0

0

0.0

Rabies (human cases)

0

0.0

0

0.0

0

0.0

0

0

0

0.0

Rubella

0

0.0

0

0.0

0

0.0

0

0

0

0.0

Rubella, Congenital Syndrome

0

0.0

0

0.0

0

0.0

0

0

0

0.0

Salmonellosis

131

16.9

149

19.2

179

17.6

54

32

45

49.8

Shigellosis

18

2.3

23

3.0

29

2.9

8

3

7

9.0

Smallpox

0

0.0

0

0.0

0

0.0

0

0

0

0.0

Streptococcal Infections, Group A Invasive

51

6.6

53

6.8

69

6.8

17

18

16

7.4

Streptococcal Infections, Group B Neonatal

2

0.3

3

0.4

4

0.4

2

0

0

0.6

Streptococcus pneumoniae, Invasive

55

7.1

48

6.2

68

6.7

20

20

15

10.4

Syphilis: Congenital

0

0.0

0

0.0

0

0.0

0

0

0

0.0

Syphilis: Infectious (1o, 2o, early latent)

123

15.9

118

15.2

159

15.6

47

42

34

28.4

Syphilis: Late Latent

33

4.3

55

7.1

69

6.8

16

8

9

15.0

Syphilis: Not yet classified

32

4.1

0

0.0

2

0.2

1

4

27

0.2

Syphilis: Unspecified

27

3.5

21

2.7

27

2.7

13

11

3

4.2

TB of the Lung

27

3.5

16

2.1

22

2.2

12

10

5

7.8

TB: All cases

40

5.2

37

4.8

51

5.0

17

14

9

12.8

Tetanus

0

0.0

0

0.0

0

0.0

0

0

0

0.0

Trichinosis

6

0.8

0

0.0

0

0.0

4

1

1

0.0

Tularemia

0

0.0

0

0.0

0

0.0

0

0

0

0.0

Typhoid Fever

3

0.4

3

0.4

4

0.4

1

0

2

1.0

VTEC/HUS

2

0.3

6

0.8

8

0.8

0

1

1

4.0

West Nile Virus (confirmed & probable)

1

0.1

6

0.8

7

0.7

0

0

1

6.0

Yersiniosis

14

1.8

8

1.0

9

0.9

7

3

4

3.4

 

Data Source and Notes for Table 3

1) Case counts for all diseases were downloaded from the integrated Public Health Information System (iPHIS), Ontario Ministry of Health and Long-Term Care on November 8, 2019.

2) Population data were downloaded from IntelliHEALTH Ontario, Ontario Ministry of Health and Long-Term Care in February 2017.

3) Rates are per 100,000 population.

4) All cases, except for Tuberculosis (TB), are assigned to a date based on the earliest of symptom onset, laboratory testing, and reporting. TB cases are reported by diagnosis date rather than episode date (i.e. a hierarchy of dates which corresponds to symptom onset date for most cases). 

5) The following diseases are reported as a sum of confirmed and probable cases:  amebiasis, giardiasis, brucellosis, Lyme disease, lymphogranuloma venereum, mumps, pertussis, and West Nile Virus.

6) The historical average is a three-quarter average, centered around the quarter of interest, for the past five years.

7) Each mention of significance refers to statistical significance (the likelihood of a result being due to chance, as determined by the p-value of a chi-square test). It does not explicitly refer to clinical or public health importance.

8) AIDS cases are included in the table but are usually reported only upon diagnosis of HIV infection.

9) Beginning in 2011, HIV infections are categorized as recent or older infections according to whether evidence suggests infection within the 12 months prior to diagnosis.  For more information, please see Friedman, O’Bryne, and Roy.  Comparing those diagnosed early versus late in the HIV infection:  implications for public health.  Int J STD AIDS 2016; 693-701.  There can be a long lag between the report of an HIV infection and categorization as recent or older; for this reason, statistical tests are not carried out for recent and older HIV.

10) The bacteria Chlamydia trachomatis is responsible for many diseases in humans, including chlamydia and lymphogranuloma venereum (LGV). Although reporting specifically on lymphogranuloma venereum is not required by Public Health Ontario, Ottawa Public Health has chosen to presents data on LGV in this report following a suspected local outbreak in during the summer of 2013.

11) Case counts for unspecified syphilis are not stable because many cases are classified as unspecified only temporarily.  For this reason, statistical tests are not carried out for unspecified syphilis.

12) Beginning in 2018, hepatitis C infections are categorized as recently- or previously-acquired according to whether evidence suggests infection within the 24 months prior to diagnosis.  For more information, please see the Ontario Infectious Disease Protocol (http://www.health.gov.on.ca/en/pro/programs/publichealth/oph_standards/docs/hep_c_cd.pdf ).  There can be a long lag between the report of a hepatitis C infection and categorization as recent or previously-acquired; for this reason, statistical tests are not carried out for recently- and previously-acquired hepatitis C. 

13) Blastomycosis, Carbapenamase-producing enterobacteriaceae, and Echinococcus multilocularis infection became reportable in May 2018.

 

 

Enteric Diseases (e.g., Food and Water-borne) and Risk Factors

Enteric or gastrointestinal (GI) illnesses are often acquired through the ingestion of contaminated food or water. They can also be transmitted from person-to-person through fecal-oral contact, and transmission among sexual partners is being increasingly recognized.

Overall Trends

  • GI illnesses most frequently reported in Ottawa continue to be campylobacter enteritis (211 cases), salmonellosis (179 cases) and giardiasis (132 cases); these illnesses made up 75% (n=522/698) of all enteric illnesses reported in Ottawa during 2018  (Figure 1). [1]
  • The incidence of some enteric illnesses was higher in 2018 than in 2014: giardiasis (132 cases in 2018 vs 106 in 2014), and cyclosporiasis (24 cases in 2018 vs 8 in 2014). 
  • Incidence of all enteric, food, and water-borne infections reported in Ottawa during 2018 were similar to provincial averages.[2]

Figure 1. Number of enteric infections, Ottawa, 2018Horizontal bar chart of the number of enteric, food and water-borne infections reported by Ottawa residents in 2018

 

Data Source and Notes for Figure 1

Ottawa Public Health. Integrated Public Health Information System (iPHIS), Ontario Ministry of Health, 2019. [Extracted on May 16, 2019]

  • iPHIS is a dynamic reporting system which allows for on-going updates to previously entered data. As such, data extracted from iPHIS provides a snapshot of information at the time of data extraction, and can vary from previous and subsequent data extractions.
  • The following diseases are reported as a sum of confirmed and probable cases: amebiasis, giardiasis, and brucellosis.
  • Cases are assigned to a date based on episode date (the earliest of symptom onset, laboratory testing, and reporting). 
  • There is a lag in reporting associated with most reportable infectious diseases.
  • Reportable infectious diseases are generally underreported due to several factors, which may include low morbidity and incentive for testing; no health care sought; clinical rather than laboratory-based diagnoses; and the inability to identify an aetiological agent from a laboratory specimen.
Data Tables for Figure 1
Table 4. Number of enteric infections, Ottawa, 2018

Disease

Counts

Campylobacter enteritis

211

Salmonellosis

179

Giardiasis

132

Amebiasis

61

Shigellosis

29

Cryptosporidiosis

31

Cyclospora

24

Yersiniosis

9

Typhoid Fever

4

Hepatitis A

7

Verotoxin-producing E. Coli / Hemolytic Uremic Syndrome

8

Listeriosis

3

Paratyphoid Fever

0

Cholera

0

Botulism

0

Paralytic Shellfish Poisoning

0

Trichinosis

0

  • Although GI illnesses are reported throughout the year, a higher number of cases are reported during summer months (Figure 2)  
  • Seasonal patterns in GI illnesses are often linked to increases in travel, warmer temperatures, outdoor activities, and social gatherings.  

Figure 2. Rate of all enteric infections, and the number campylobacter enteritis, salmonellosis, and giardiasis infections , Ottawa, 2018, by episode month

Figure 2 is a bar graph of the number of campylobacter enteritis, salmonellosis, and confirmed and probable giardiasis infections reported by Ottawa residents by month in 2018. There is a line that represents the rate of all three of these types of infections per 100,000 population by month in 2018. The figure has been converted into a table below.

 Data Source and Notes for Figure 2

Ottawa Public Health. Integrated Public Health Information System (iPHIS), Ontario Ministry of Health, 2019. [Extracted on June 3, 2019]

  • iPHIS is a dynamic reporting system which allows for on-going updates to previously entered data. As such, data extracted from iPHIS provides a snapshot of information at the time of data extraction, and can vary from previous and subsequent data extractions.
  • There is a lag in reporting associated with most reportable infectious diseases.
  • Reportable infectious diseases are generally underreported due to several factors, which may include low morbidity and incentive for testing; no health care sought; clinical rather than laboratory-based diagnoses; and the inability to identify an aetiological agent from a laboratory specimen.
  • Rates are calculated as reports per 100,000 population.
 Data Table for Figure 2

Table 5. Rates of all enteric infections, and the number of campylobacter enteritis, salmonellosis, and giardiasis cases, Ottawa, 2018, by episode month

Disease

Jan

Feb

Mar

Apr

May

Jun

Jul

Aug

Sep

Oct

Nov

Dec

Campylobacter enteritis

12

11

11

16

18

12

29

39

23

20

13

7

Salmonellosis

13

19

24

13

17

11

24

15

13

9

9

12

Giardiasis

9

5

9

9

13

7

10

20

16

12

13

9

Overall enterics rate (per 100,000 population)

4.6

4.7

5.7

4.6

5.6

5.2

9.3 9.5 5.9

4.8

4.0 3.7

Respiratory Diseases, Diseases Transmitted by Direct Contact, and Risk Factors

Respiratory infections and diseases transmitted by direct contact are infections that can spread from person to person through droplets in air (from a person coughing or sneezing) or through direct contact with an infected person. The epidemiology and symptoms of each disease can vary depending on the infectious agent.

Overall Trends
  • Incidence of most respiratory diseases and diseases transmitted by direct contact reported to Ottawa Public Health (OPH) in 2018 have been similar over the past 5 years, with the exception of seasonal influenza, invasive group A streptococcal (iGAS) disease and tuberculosis (TB). [1]

Figure 3. Number of respiratory infections and diseases transmitted by direct contact, 2018, and the number of influenza infections, 2018-2019, Ottawa

Figure 3 is a bar graph of the number of respiratory infections and diseases transmitted by direct contact reported by Ottawa residents in 2018. The figure has been converted into a table below.

Data Source and Notes for Figure 3

Ottawa Public Health. Integrated Public Health Information System (iPHIS), Ontario Ministry of Health, 2019. 

  • iPHIS is a dynamic reporting system which allows for on-going updates to previously entered data. As such, data extracted from iPHIS provides a snapshot of information at the time of data extraction, and can vary from previous and subsequent data extractions.
  • Only active tuberculosis (TB) disease (not latent infection) reported to OPH are captured in the figure. 
  • All cases, except for TB, are assigned to a date based on episode date (the earliest of symptom onset, laboratory testing, and reporting). TB cases are assigned based on diagnosis date.
  • Reportable infectious diseases are generally underreported due to several factors, which may include low morbidity and incentive for testing; no health care sought; clinical rather than laboratory-based diagnoses; and the inability to identify an aetiological agent from a laboratory specimen.
Data Table for Figure 3

 

Table 6. Number of respiratory infections and diseases transmitted by direct contact, 2018, and the number of influenza infections during the 2018-2019 Influenza season, Ottawa

Disease

Counts

Influenza A - 2018/2019 Season

666

Streptococcal Infections, Group A Invasive

69

TB: All cases

49

TB of the Lung

21

Influenza B - 2018/2019 Season

23

Legionella Infections

6

Carbapenamase-producing enterobacteriaceae

5

Streptococcal Infections, Group B Neonatal

4

Blastomycosis (confirmed & probable)

2

Meningococcal Disease

2

Echinococcus multilocularis infection

0

Leprosy

0

Psittacosis/Ornithosis

0

Influenza

Influenza, commonly known as the "flu", is a respiratory infection caused by the influenza virus. Influenza can easily spread from person to person. Common symptoms of influenza infections are fever, cough, chills, muscle aches, sore throat, headaches, loss of appetite, stuffy or runny nose, and fatigue. Annual influenza immunization is the most effective way to protect yourself and others against influenza.

Please refer to the Seasonal Respiratory Infections and Enteric Outbreaks Surveillance Reports webpage for up-to-date and historical seasonal influenza data and reports. The 2018-2019 influenza season covers the period from September 2018 to August 2019.

  • Influenza virus circulation follows a seasonal pattern, and most infections are reported between fall and spring (Figure 4). [1]
  • Influenza activity was lower than usual during the 2018-2019 respiratory disease season. [1]
  • Laboratory-confirmed influenza cases, the numbers of influenza outbreaks in institutions (i.e., hospitals, long-term care homes, and retirement homes), influenza-related deaths, and influenza-related hospitalizations were lower than the past season.
  • The incidence of influenza in Ottawa in 2018 was lower than the average of Ontario-less-Ottawa (58/100,000 vs. 71/100,000). [2]

Each fall, the Universal Influenza Immunization Program (UIIP) makes influenza immunization available to all residents. During the 2018-19 influenza season, close to half (46%) of residents aged 18 to 64 years reported receiving an influenza immunization while (86%) of residents 65 years of age and older received an influenza immunization, which was similar to previous influenza seasons for both age groups. [3] Please refer to the Influenza Immunization webpage for more information.

Figure 4. Number of reported laboratory-confirmed influenza cases by type and episode week, Ottawa, September 2018 (week 35) to August 2019 (week 34), and historical trends

A figure showing the number of laboratory confirmed influenza cases by week for Ottawa residents. The figure shows that most cases for the 2018/2019 season were reported from December to April. The figure has been converted into a table below.

 

 Data Source and Notes for Figure 4

Ottawa Public Health. Integrated Public Health Information System (iPHIS), Ontario Ministry of Health, 2019.

  • iPHIS is a dynamic reporting system which allows for on-going updates to previously entered data. As such, data extracted from iPHIS provides a snapshot of information at the time of data extraction, and can vary from previous and subsequent data extractions.
  • Reportable infectious diseases are generally underreported due to several factors, which may include low morbidity and incentive for testing; no health care sought; clinical rather than laboratory-based diagnoses; and the inability to identify an aetiological agent from a laboratory specimen.
  • wk: week
  • All influenza cases are assigned to a date based on episode date (the earliest of symptom onset, laboratory testing, and reporting).
Data Table for Figure 4
Table 7. Number of reported laboratory-confirmed influenza cases by type and episode week, Ottawa, September 2018 (week 35) to August 2019 (week 34), and historical trends

Flu Week 

Influenza A

2018-19

Influenza B

2018-19

2015-2016

2016-2017

2017-2018

Week 35

0

0

0

1

0

Week 36

0

0

0

0

2

Week 37

0

0

0

1

0

Week 38

1

0

0

1

1

Week 39

0

0

3

0

1

Week 40

1

0

0

0

0

Week 41

0

0

1

1

3

Week 42

5

0

1

0

0

Week 43

2

0

1

0

1

Week 44

3

0

0

1

0

Week 45

1

0

1

2

0

Week 46

3

2

0

1

4

Week 47

2

1

1

2

3

Week 48

6

0

1

5

9

Week 49

15

1

4

10

3

Week 50

7

1

1

14

13

Week 51

8

0

4

42

25

Week 52

20

0

3

60

36

Week 1

30

0

3

61

72

Week 2

38

0

7

50

85

Week 3

42

0

5

39

76

Week 4

37

0

14

34

59

Week 5

40

0

18

38

62

Week 6

37

0

29

35

89

Week 7

46

0

41

28

106

Week 8

37

0

54

25

118

Week 9

42

0

56

27

117

Week 10

31

0

61

16

72

Week 11

37

1

63

25

46

Week 12

26

0

22

12

41

Week 13

18

0

24

19

39

Week 14

31

0

19

11

36

Week 15

34

2

14

12

28

Week 16

20

2

13

11

13

Week 17

13

1

11

14

8

Week 18

13

1

9

7

8

Week 19

5

0

12

1

5

Week 20

4

2

2

7

2

Week 21

7

2

3

2

0

Week 22

0

2

3

2

0

Week 23

0

1

0

1

1

Week 24

1

1

0

0

0

Week 25

1

1

0

1

0

Week 26

0

1

0

1

0

Week 27

0

1

0

0

0

Week 28

0

0

0

0

0

Week 29

0

0

0

2

0

Week 30

1

0

0

0

0

Week 31

0

0

0

0

0

Week 32

0

0

0

0

1

Week 33

1

0

0

0

1

Week 34

0

0

0

0

1

Invasive Group A Streptococcal (iGAS) Disease

Invasive group A steptococcal (iGAS) infections can occur in skin, soft tissue, joints, the respiratory tract, or normally sterile sites of the body. Most serious iGAS cases are sterile site infections in the blood, spinal fluid, or soft tissue.

  • Chronic disease and underlying medical conditions, drug and alcohol use, and being homeless or underhoused were common risks identified among individuals with iGAS infections in Ottawa during 2018. [1] These risks are consistent with iGAS at-risk populations identified elsewhere in Canada. [4]
  • In 2018, 69 iGAS cases in Ottawa residents were reported to OPH, which is higher than it was 5 years ago (56 cases in 2014).  [1]
  • OPH continues to monitor iGAS infections among people who are homeless or underhoused in Ottawa, and collaborate with community partners to reduce the risk of infection transmission in shelter settings.
  • 2018 rates in Ottawa were lower than in Ontario-less-Ottawa. A significant increase was seen during 2014-18 across the rest of Ontario. [2]
Tuberculosis

 Tuberculosis (TB) is an infection caused by a group of Mycobacterium bacteria species.

  • In 2018, 49 cases of TB (4.8 per 100,000) were reported among Ottawa residents.  The rate of TB in Ottawa has not changed much over the last 10 years. [1] The incidence of TB in Ottawa in 2018 was the same as the average of Ontario-less-Ottawa.  [2]

  • Among the cases reported in Ottawa in 2018, 43% were pulmonary.  Two-thirds of pulmonary cases were male.  The average age at diagnosis was 51 years for men and 41 years for women. 

  • 85% of active TB infections diagnosed in Ottawa between 2014 and 2018 were among residents born outside Canada. Most frequently reported birth countries among these individuals include India, Somalia, Philippines, Ethiopia, Haiti, and China. [1] These countries are reported to be high TB incident regions by the World Health Organization. [5]  Among Canadian-born individuals in Ottawa, Indigenous people have higher rates of TB. [1]  People in Ottawa who are marginally housed also experience disproportionately higher rates of TB.

Long-term Care, Retirement Home, and Hospital Outbreaks

Respiratory and gastroenteritis infection outbreaks in institutions and public hospitals are reportable to local public health authorities.

Respiratory Outbreaks
  • The total number of respiratory outbreaks reported in Ottawa's institutions and public hospitals during the 2017-2018 season was similar to past seasons, but a higher number of outbreaks were caused by influenza B than in previous years (Figure 5). [1]
  • The increase in influenza B and influenza A and B respiratory outbreaks was likely due to the increased circulation of influenza B.

Figure 5. Number of respiratory infection outbreaks in institutions and public hospitals reported to Ottawa Public Health between September 2017 and September 2018, and the mean of the previous three seasons

Line and bar graph showing the number of respiratory infection outbreaks in institutions and public hospitals reported to Ottawa Public Health between September 2017 and September 2018, and the previous three season mean

Data Source and Notes for Figure 5

Ottawa Public Health. Integrated Public Health Information System (iPHIS), Ontario Ministry of Health and Long-Term Care, 2018. [Extracted on September 1, 2018]

  • iPHIS is a dynamic reporting system which allows for on-going updates to previously entered data. As such, data extracted from iPHIS provides a snapshot of information at the time of data extraction, and can vary from previous and subsequent data extractions.
  • Influenza cases and respiratory outbreaks in institutions and public hospitals meeting Ontario Ministry of Health and Long-Term Care (MOHLTC) case definitions for Diseases of Public Health Significance (DPHS), according to Ontario Public Health Standards: Requirements for Programs, Services, and Accountability (Standards): Infectious Diseases Protocol, are presented.
  • wk: week
Data Table for Figure 5
Table 8. Number of respiratory infection outbreaks in institutions and public hospitals reported to Ottawa Public Health between September 2017 and September 2018, and the mean of the previous three seasons

Surveillance Week

Non-influenza outbreaks

Influenza A outbreaks

Influenza B outbreaks

Influenza A and B outbreaks

Three season mean

Week 35 - 27 Aug

0

0

0

0

0.67

Week 36 - 03 Sep

2

0

0

0

0.67

Week 37 - 10 Sep

1

0

0

0

1.33

Week 38 - 17 Sep

1

0

0

0

2.67

Week 39 - 24 Sep

1

0

0

0

1.00

Week 40 - 01 Oct

4

1

0

0

2.33

Week 41 - 08 Oct

0

0

0

0

2.00

Week 42 - 15 Oct

0

0

0

0

2.00

Week 43 - 22 Oct

1

0

0

0

0.33

Week 44 - 29 Oct

2

0

0

0

1.00

Week 45 - 05 Nov

0

0

0

0

0.67

Week 46 - 12 Nov

1

0

0

0

0.67

Week 47 - 19 Nov

0

0

0

0

1.33

Week 48 - 26 Nov

0

0

0

0

0.33

Week 49 - 03 Dec

1

1

0

0

2.33

Week 50 - 10 Dec

1

1

1

0

2.33

Week 51 - 17 Dec

1

0

1

0

6.67

Week 52 - 24 Dec

2

1

2

0

9.00

Week 1 - 31 Dec

0

5

5

0

8.33

Week 2 - 07 Jan

6

3

5

0

9.67

Week 3 - 14 Jan

3

5

1

0

5.33

Week 4 - 21 Jan

3

3

1

0

4.00

Week 5 - 28 Jan

1

1

1

1

9.33

Week 6 - 04 Feb

0

2

3

0

4.33

Week 7 - 11 Feb

0

4

3

0

4.33

Week 8 - 18 Feb

2

2

5

0

5.00

Week 9 - 25 Feb

3

4

3

2

3.67

Week 10 - 04 Mar

1

2

0

1

3.00

Week 11 - 11 Mar

1

1

0

0

5.00

Week 12 - 18 Mar

1

3

1

1

4.00

Week 13 - 25 Mar

0

1

1

0

1.00

Week 14 - 01 Apr

1

1

1

0

1.00

Week 15 - 08 Apr

3

0

0

1

3.00

Week 16 - 15 Apr

4

0

0

0

0.33

Week 17 - 22 Apr

1

0

2

0

1.33

Week 18 - 29 Apr

0

0

1

0

2.00

Week 19 - 06 May

1

1

0

0

1.33

Week 20 - 13 May

1

0

0

0

0.33

Week 21 - 20 May

0

0

0

0

0.67

Week 22 - 27 May

1

0

0

0

1.00

Week 23 - 03 Jun

0

0

0

0

0.67

Week 24 - 10 Jun

0

0

0

0

0.67

Week 25 - 17 Jun

0

0

0

0

0.00

Week 26 - 24 Jun

3

0

0

0

0.33

Week 27 - 01 Jul

0

0

0

0

0.00

Week 28 - 08 Jul

2

0

0

0

0.33

Week 29 - 15 Jul

1

0

0

0

0.67

Week 30 - 22 Jul

0

0

0

0

1.67

Week 31 - 29 Jul

2

0

0

0

0.33

Week 32 - 05 Aug

0

0

0

0

0.33

Week 33 - 12 Aug

1

0

0

0

1.00

Week 34 - 19 Aug

2

0

0

0

0.33

  

Gastroenteritis Outbreaks
  • The total number of gastroenteritis outbreaks reported in Ottawa's institutions and public hospitals during the 2017-2018 season was lower than the previous 3 seasons (Figure 6). [1]
  • Two Clostridium difficile infection (CDI) outbreaks in public hospitals were reported to Ottawa Public Health during the 2017-2018 season.

Figure 6. Number of gastroenteritis outbreaks in Ottawa institutions and public hospitals, September 2017 to September 2018, and the mean of the three previous three seasons

Line and bar graph showing the number of gastroenteritis outbreaks in Institutions and public hospitals reported to Ottawa Public Health between September 2017 and September 2018, and the previous three season mean.

Data Source and Notes for Figure 6

Ottawa Public Health. Integrated Public Health Information System (iPHIS), Ontario Ministry of Health and Long-Term Care, 2018. [Extracted on September 1, 2018]

  • iPHIS is a dynamic reporting system which allows for on-going updates to previously entered data. As such, data extracted from iPHIS provides a snapshot of information at the time of data extraction, and can vary from previous and subsequent data extractions.
  • Clostridium difficile Infection (CDI) outbreaks in public hospitals meeting Ontario Ministry of Health and Long-Term Care (MOHLTC) case definitions for Diseases of Public Health Significance (DPHS), according to Ontario Public Health Standards: Requirements for Programs, Services, and Accountability (Standards): Infectious Diseases Protocol, are presented.
  • wk: week
Data Table for Figure 6
Table 9. Number of gastroenteritis outbreaks in Ottawa institutions and public hospitals, September 2017 to September 2018, and the mean of the previous three seasons

Surveillance Week

CDI

Norovirus

All other enterics

Three season mean

Week 35 - 27 Aug

0

0

0

0.0

Week 36 - 03 Sep

0

0

0

0.3

Week 37 - 10 Sep

0

0

1

0.7

Week 38 - 17 Sep

0

0

0

0.7

Week 39 - 24 Sep

0

0

0

0.3

Week 40 - 01 Oct

0

0

0

0.0

Week 41 - 08 Oct

0

0

0

0.3

Week 42 - 15 Oct

0

0

0

0.3

Week 43 - 22 Oct

0

0

0

0.3

Week 44 - 29 Oct

0

0

0

0.0

Week 45 - 05 Nov

0

0

0

0.7

Week 46 - 12 Nov

0

0

0

0.3

Week 47 - 19 Nov

0

0

1

0.3

Week 48 - 26 Nov

0

0

1

0.7

Week 49 - 03 Dec

0

0

1

0.7

Week 50 - 10 Dec

0

1

1

1.0

Week 51 - 17 Dec

0

1

1

0.0

Week 52 - 24 Dec

1

1

2

1.0

Week 1 - 31 Dec

0

2

2

3.3

Week 2 - 07 Jan

0

1

1

2.7

Week 3 - 14 Jan

0

1

0

3.0

Week 4 - 21 Jan

0

2

1

1.7

Week 5 - 28 Jan

0

1

0

3.7

Week 6 - 04 Feb

0

0

0

3.3

Week 7 - 11 Feb

0

0

1

1.3

Week 8 - 18 Feb

0

0

2

2.7

Week 9 - 25 Feb

0

1

1

4.0

Week 10 - 04 Mar

0

0

1

3.3

Week 11 - 11 Mar

0

0

0

3.3

Week 12 - 18 Mar

0

0

0

4.3

Week 13 - 25 Mar

0

0

2

2.7

Week 14 - 01 Apr

0

0

0

3.7

Week 15 - 08 Apr

1

0

0

1.3

Week 16 - 15 Apr

0

1

0

3.0

Week 17 - 22 Apr

0

0

0

2.7

Week 18 - 29 Apr

0

0

0

1.3

Week 19 - 06 May

0

0

1

0.7

Week 20 - 13 May

0

0

0

0.3

Week 21 - 20 May

0

0

0

1.0

Week 22 - 27 May

0

0

0

1.0

Week 23 - 03 Jun

0

0

0

0.3

Week 24 - 10 Jun

0

0

0

0.0

Week 25 - 17 Jun

0

0

0

0.0

Week 26 - 24 Jun

0

0

0

0.0

Week 27 - 01 Jul

0

0

0

0.3

Week 28 - 08 Jul

0

0

0

0.0

Week 29 - 15 Jul

0

0

0

0.0

Week 30 - 22 Jul

0

0

0

0.0

Week 31 - 29 Jul

0

0

0

0.3

Week 32 - 05 Aug

0

0

0

0.0

Week 33 - 12 Aug

0

0

0

0.3

Week 34 - 19 Aug

0

0

0

0.0

Sexually Transmitted and Blood-borne Infections (STBBIs) and Risk Factors

Some sexually transmitted and blood-borne infections (STBBIs) are spread through body fluids (e.g., blood, vaginal fluid, semen) while others are spread through non-sexual activities such as sharing needles used for injecting drugs.

  • Reportable sexually transmitted infections include chlamydia, gonorrhea, hepatitis B, human immunodeficiency virus (HIV), syphilis, and rarely, hepatitis C.
  • Reportable blood-borne infections include hepatitis B, hepatitis C, and HIV.
  • Certain reportable infections can be transmitted both through blood and sexually, these include hepatitis B, HIV, and rarely, hepatitis C.
Overall Trends
  • The incidence of several sexually-transmitted infections has increased significantly over the past five years, whereas the rate of transmission of bloodborne infections has been relatively steady.
  • Trends in sexually transmitted and blood-borne infections (STBBIs) are associated with factors such as age, ethnicity, income, gender, and sexual orientation. [6]  Populations most affected by STBBIs in Ottawa include youth; gay, bisexual, and other men who have sex with men (MSM); people who use drugs; and people who come from a country where infection is common. [1]

Figure 7. Number of reported sexually transmitted and blood-borne infections, Ottawa, 2018

A bar graph of the number of reported sexually transmitted and bloodborne infections among Ottawa residents in 2018. The figure has been converted into a table below.

Data Source and Notes for Figure 7

Ministry of Health and Long-term Care (MOHLTC), integrated Public Health Information System (iPHIS), extracted by Ottawa Public Health, May 21, 2019.

  • iPHIS is a dynamic reporting system which allows for on-going updates to previously entered data. As such, data extracted from iPHIS provides a snapshot of information at the time of data extraction, and can vary from previous and subsequent data extractions.
  • HIV: human immunodeficiency virus
  • AIDS: acquired immunodeficiency syndrome
  • Reportable communicable diseases are generally underreported due to several factors, which may include low morbidity and incentive for testing; no health care sought; clinical rather than laboratory-based diagnoses; and the inability to identify identify an aetiological agent from a laboratory specimen.
  • AIDS cases are included in the table but are usually reported only upon diagnosis of HIV infection.
  • All cases, except for HIV infections, are assigned to a year based on episode date (the earliest of symptom onset, laboratory testing, and reporting). HIV infections are assigned to a year based on reported date.  In some cases, particularly for HIV, infection may not have occurred prior to the assigned year.
  • There is a lag in reporting associated with most reportable communicable diseases.
Data Table for Figure 7
Table 8. Number of reported sexually transmitted and blood-borne infections, Ottawa, 2018

Infection

Number of cases

Chlamydia

3,806

Gonorrhea

899

Hepatitis C - Acute & Chronic

309

Hepatits B - Chronic

166

Syphilis: Infectious

159

HIV (including AIDS)

77

AIDS

11

Hepatitis B - Acute

0

Chlamydia
  • Chlamydia is the most frequently reported of all reportable infections. Chlamydia rates are increasing in Ottawa (and in the rest of Ontario).  [1] The incidence in 2018 was 380 infections per 100,000 population (corresponding to 3,806 cases); 5 years ago, in 2013, it was 257 per 100,000.
  • The rate of chlamydia in Ottawa has been higher than the average of Ontario-less-Ottawa (which had 332 cases diagnosed per 100,000 in 2018) since 2014. [2]However, the rate in Ottawa is not the highest in the province. 
  • Ottawa youth 15-29 years of are at highest risk. [1] The highest rate is in females aged 20-24 years (2,720 per 100,000 population).
Gonorrhea
  • Gonorrhea is the second most frequently reported sexually transmitted infection in Ottawa, after chlamydia. Gonorrhea rates are increasing in Ottawa (and in the rest of Ontario). Incidence had been slowly increasing since the early 1990s, but then there was a 72% increase in reported cases between 2016 and 2017 followed by a 41% increase between 2017 and 2018. [1] Gonorrhea incidence in 2018 was 90 infections per 100,000 population (corresponding to 899 cases); 5 years ago, in 2013, it was 27 per 100,000.
  • The rate of gonorrhea in Ottawa is higher than that in Ontario-less-Ottawa, which was 72 cases per 100,000 in 2018). However, the rate in Ottawa is not the highest in the province. [2]
  • Ottawa youth 15-29 years of age and gay, bisexual, and other men who have sex with other men are at highest risk.  The highest rate is in males aged 20-29 years (350 per 100,000 population). The proportion of cases identifying as gay, bisexual, or other men who have sex with men (gboMSM) has been increasing, from 23% in 2013 to 45% in 2018.  However, an increasing number of cases are diagnosed also among men who do not identify as MSM and among women. [1]
Infectious Syphilis
  • Infectious syphilis is the third most frequently reported sexually transmitted infection in Ottawa, after chlamydia and gonorrhea. Prior to 2002, less than one case of infectious syphilis per 100,000 population was reported each year in Ottawa. [1]  However, infectious syphilis has had a resurgence:  in 2002, 2 cases were reported per 100,000; in 2015, 11 cases per 100,000 were reported; and in 2018, 16 cases per 100,000 were reported. A total of 159 cases of infectious syphilis were reported in 2018. 
  • The rate in Ottawa is now higher than in Ontario-less-Ottawa, where the 2018 rate was 13 per 100,000.. [2]  However, the rate in Ottawa is not the highest in the province. 
  • Ninety-seven per cent of Ottawa cases in 2018 are male, and 87% of cases identified as gay, bisexual, and other men who have sex with men (gboMSM) (MSM). [1]  The highest rates in males are in 20-59 year-olds (49 per 100,000 population). 
Hepatitis C
  • In 2018, 31 hepatitis C infections per 100,000 population were reported in Ottawa (corresponding to 309 cases), down from a record high of 96 infections per 100,000 in 1998. The rate of hepatitis C has been consistently lower in Ottawa than the average of Ontario-less-Ottawa. [1,2]
  • More than half (56%) of hepatitis C diagnoses in 2018 were among males.  The highest rates among males were in 35-39 year-olds (71/100,000 population); among females, 25-34 year-olds (48/100,000 population).
  • Injection drug use is the top risk factor among people diagnosed with hepatitis C.  In 2018, 44% of individuals diagnosed with hepatitis C reported injecting drugs at some point in their lifetime. [1]
Human Immunodeficiency Virus (HIV)
  • Human immunodeficiency virus (HIV) incidence in Ottawa was 8 infections per 100,000 population in 2018. Acquired acquired immunodeficiency syndrome (AIDS) incidence was 1 case per 100,000. The incidence has been increasing slightly since 2015, when 5 HIV infections and 0.4 AIDS diagnoses per 100,000 population were reported. [1]
  • The incidence rate of HIV in Ottawa was higher than the average of Ontario-less-Ottawa in 2018, and the rate of AIDS has been higher in Ottawa than the average of Ontario-less-Ottawa since 2016.  However, the rates of HIV and AIDS in Ottawa are not the highest in the province. [2]
  • The highest rate of HIV in Ottawa in 2018 was in males aged 30-34 years (22 per 100,000) and the highest numbers of cases were in those from, or with a sexual partner from, a country where HIV is common (47%); and in gay, bisexual, and other men who have sex with men (MSM) (33%).  Eleven percent of cases were among people who use drugs. [1]  
  • Early diagnosis and treatment of HIV (before onset of AIDS) is associated with fewer complications and better odds of survival. However, only 81% of infections reported in 2018 were older (i.e., occurred more than a year before being reported).  Individuals from a country where HIV is common where more likely to be older infections (97% of infections in this group were older). [7]
Hepatitis B
  • There were no acute hepatitis B cases reported in 2018 , compared with an incidence of 0.7 per 100,000 in of Ontario-less-Ottawa. [1,2] Five or fewer cases of acute hepatitis B have been reported in Ottawa annually during the last 10 years [1]
  • Chronic hepatitis B incidence in 2018 was 17 infections per 100,000 population in Ottawa.  The rate of chronic hepatitis B has been stable for the last 5 years. [1]
  • Individuals at highest risk for hepatitis B are immigrants to Canada from countries where hepatitis B is common. Approximately three-quarters of people diagnosed with chronic hepatitis B during 2018 were born outside Canada. [1]
Sexual Behaviour and Risk Factors for Sexually Transmitted Infections

Sexual health is an important aspect of one’s overall health.  Sexual health, and the ability to have safe and satisfying sexual experiences, is influenced by a number of factors, including sexual behaviours.  Some sexual behaviours are associated with sexually transmitted infections, which are most prevalent in youth 15 to 29 years of age. 

Sexual Behaviour in the General Population

Youth Sexual Activity 

  • Approximately two-thirds (68%) of Ottawa residents aged 15 to 29 years reported ever having vaginal or anal sex, which was similar to the average of Ontario-less-Ottawa (62%) (Figure 8). [8]
  • The proportion of 15 to 29 year olds reporting ever having sex increased with age:  35% of 15 to 19 year-olds, 80% of 20 to 24 year-olds, and 89% of 25 to 29 year-olds (Figure 8).
Figure 8. Percentage of Ottawa youth (15 to 29 years) who reported ever having sex, by age group, in 2015/16

Horizontal bar chart of the percentage of Ottawa residents between 15 and 29 years of age who reported ever having sex, by age group, as of 2015/16 

Data Source and Notes for Figure 8

Canadian Community Health Survey 2015/16. Ontario Share File. Statistics Canada.

  • The Canadian Community Health Survey (CCHS) is an annual national population health survey conducted by Statistics Canada.
  • Error bars represent 95% confidence intervals.
Data Table for Figure 8
Table 10. Percentage of Ottawa youth (15 to 29 years) who reported ever having sex, by age group, 2015/16
Geographic Region, Age Group% Reported Ever Having Sex95% Confidence Intervals
Ottawa, 15 to 29 years 68.1 61.3 - 74.3
Ontario-less-Ottawa, 15 to 29 years 61.5 59.2 - 63.8
Ottawa, 15 to 19 years 35.5 23.1 - 50.2
Ottawa, 20 to 24 years 79.9 68.8 - 87.7
Ottawa, 25 to 29 years 88.8 72.7 - 96

Number of Partners

  • Approximately six of every ten (61%) Ottawa youth aged 15 to 29 years who had sex in the past 12 months reported having one sexual partner (Figure 9), which was the same in Ontario-less-Ottawa. [8]
  • Approximately one-third (31%) of Ottawa youth aged 15 to 29 years who had sex in the past 12 months reported having two or more sexual partners (Figure 9), which was similar to the average of Ontario-less-Ottawa (28%).

Condom Use

  • Almost half (49%) of Ottawa residents aged 15 to 29 years who had sex involving a male in the past 12 months reported using a condom the last time they had sex (Figure 9), which was similar to the average of Ontario-less-Ottawa (54%). [8]

 Testing for Sexually Transmitted Infections

  • More than half (52%) of Ottawa youth aged 15 to 29 years who had sex in the past 12 months reported ever getting tested for sexually transmitted infections (not including HIV) (Figure 9), which was higher than the average of Ontario-less-Ottawa (36%). Of those who were ever tested, 46% reported being tested in the past year. [8]
  • More than a third (37%) of Ottawa youth aged 15 to 29 years who had sex in the past 12 months reported ever getting tested for HIV, which was higher than the average of Ontario-less-Ottawa (26%). Of those ever getting tested, 54% reported being tested in the past year. 

Figure 9. Sexual behaviours among 15 to 29 year-olds in Ottawa who have had sex, 2015/16

 Horizontal bar chart of sexual behaviours among 15 to 29 year-olds who have had sex, Ottawa, 2015/16

Data Source and Notes for Figure 9

Canadian Community Health Survey 2015/16. Ontario Share File. Statistics Canada.

  • The Canadian Community Health Survey (CCHS) is an annual national population health survey conducted by Statistics Canada.
  • STIs include any sexually transmitted infection with the exception of HIV.
  • Error bars represent 95% confidence intervals.
Data Table for Figure 9
Table 11. Sexual behaviours among 15 to 29 year-olds who have had sex, Ottawa, 2015/16
Behaviour% of  Youth (15 to 29 Years) Reporting Behaviour95% Confidence Intervals
Used condom last time having sex 48.5 37.5 - 59.6
One partner in last 12 months 61.2 51.4 - 70.1
Two or more partners in last 12 months 31.1 23.3 - 40.3
Ever tested for STIs 52 40 - 63.7
Tested for STIs in the last year 45.5 33.5 - 58.2
Ever tested for HIV 37.4 27.1 - 49
Tested for HIV in the last year 54.2 40.8 - 67
Sexual Behaviour among those Diagnosed with a Sexually Transmitted Infection
  • Condomless sex is the most common risk factor among individuals in
    Ottawa diagnosed with infections that are transmitted sexually, followed by
    having more than one partner during the incubation period, and having an
    anonymous partner (Table 12).
Table 12. Risk factors for reported sexually transmitted infections, Ottawa, 2018

 Risk Factor

% of chlamydia cases reporting risk factor

% of gonorrhea cases reporting risk factor

% of infectious syphilis cases reporting risk factor

Condomless sex

72%

80%

23%

More than one partner during incubation period

34% 46% 85%

Anonymous partner

2% 17% 42%
 Data Source and Notes for Table 12

Ministry of Health and Long-term Care (MOHLTC), integrated Public Health Information System (iPHIS), extracted by Ottawa Public Health, May 21, 2019.

  • The total percent of reported risk factors may sum to greater than 100% because an individual may report more than one risk factor.

Vaccine Preventable Diseases and Immunization

Vaccine-preventable diseases (e.g., measles, mumps, rubella, diphtheria, tetanus, polio) have historically been a key focus of public health programs in Ottawa. In general, reports of vaccine-preventable diseases to OPH have been low (Figure 10) because of effective immunization programs and high immunization coverage.

Overall Trends
  • The most common reportable vaccine-preventable diseases in 2018 were pneumococcal disease (68 cases) and chickenpox (61 cases).  [1]
  • The rates chickenpox and pneumococcal disease have not changed over the past 5 years.  The rate of pneumococcal disease is not different from Ontario-less-Ottawa,but provincial data for chickenpox are not available for comparison. [2]

Figure 10. Number of cases of vaccine preventable diseases, Ottawa, 2018

Bar chart of the number of cases of vaccine preventable diseases reported to Ottawa Public Health in 2018

 

Data Source and Notes for Figure 10

Ministry of Health (MOH), integrated Public Health Information System (iPHIS), extracted by Ottawa Public Health, May 16, 2019.

  • iPHIS is a dynamic reporting system which allows for on-going updates to previously entered data. As such, data extracted from iPHIS provides a snapshot of information at the time of data extraction, and can vary from previous and subsequent data extractions.
  • Reportable infectious diseases are generally underreported due to several factors, which may include low morbidity and incentive for testing; no health care sought; clinical rather than laboratory-based diagnoses; and the inability to identify an aetiological agent from a laboratory specimen.
  • The following diseases are reported as a sum of confirmed and probable cases: mumps and pertussis.
  • All cases are assigned to a date based on episode date (the earliest of symptom onset, laboratory testing, and reporting).
  • There is a lag in reporting associated with most reportable infectious diseases.
Data Table for Figure 10
Table 13. Number of cases of vaccine preventable diseases, Ottawa, 2018

Vaccine Preventable Disease

Count

Pneumococcal disease

68

Chickenpox

61

Pertussis (confirmed & probable)

21

Mumps (confirmed & probable)

4

Diphtheria

0

Haemophilus influenzae type b, Invasive

0

Measles

0

Acute Flaccid Paralysis

0

Polio

0

Rubella

0

Rubella, Congenital Syndrome

0

Smallpox

0

Tetanus

0

Pertussis (Whooping Cough) 

Pertussis, also known as whooping cough, is a highly contagious infection. Infants under 12 months of age are most at risk of severe disease and death.

  • A total of 21 pertussis infections (confirmed and probable) were reported to OPH in 2018, including 3 in children under 5 years. (Figure 10). [1]
  • The rate of pertussis in Ottawa in 2018 was lower than the average of Ontario-less-Ottawa (2.1 vs. 2.7/100,000).[10]

Mumps 

Enhanced vigilance against mumps and up-to-date immunization among post-secondary students and those 18 to 30 years of age is recommended.

  • An increase in mumps cases has been noted across Ontario in recent years, particularly in 24-35 year-olds. [2,9]
  • In 2018, Ottawa had a lower rate of mumps (0.4 per 100,000 population) than Ontario-less-Ottawa (0.7 per 100,000 population). The majority of cases were 24 to 35 years of age.

Measles 

While there were no cases of measles in Ottawa in 2018, enhanced vigilance against measles and up-to-date immunization is recommended as Ottawa and other areas have experienced an increase in measles related to international travel by under-immunized residents in 2019.
In the first half of 2019, 3 measles infections were reported to OPH. [1]
Immunization

Immunization through vaccination, is a public health initiative to prevent illness, disability and death from vaccine preventable diseases.  High immunization coverage is essential for the effective prevention and control of vaccine preventable diseases.  

Vaccinations are provided as part of publicly funded health care in Ontario.

Childhood Immunization

Immunization Surveillance by School
Each year, the immunization record of every child attending school in Ottawa is assessed by Ottawa Public Health’s Immunization program for compliance with the Immunization of School Pupils Act (ISPA). Parents are responsible for reporting their child(ren)’s immunization record to Ottawa Public Health. Based on this reported information parents are notified if their child(ren) do not have the required vaccinations for their age according to ISPA or a valid exemption on record. A summary of the post-surveillance vaccination coverage and philosophical exemption rates at each school in Ottawa are compiled at the end of each school year to help tailor support to school boards, schools, parents/guardians, and others to ensure their child is up-to-date for all relevant ISPA vaccines for their age.

https://open.ottawa.ca/datasets/immunization-coverage-and-philosophical-exemption-rates-by-school-2018-2019

Vaccination Coverage by Age and Disease

In addition, children aged 7, 12, 13, and 17 are assessed by Public Health Ontario (PHO) for up-to-date vaccination coverage, which is estimated as the percent who have received the recommended number of doses of a vaccine or have evidence of immunity at a given point in time (Table 14Table 15, Table 16). Many children who are not up-to-date have received some, but not all, recommended doses in a vaccine series. The National Immunization Strategy's vaccination coverage goals, updated in 2017, set coverage targets based on international standards and best practices. [10]

In Ottawa in the 2017-18 school year, the vaccination coverage rate among 7-year-old students surpassed the national goal of 95% coverage for rubella and meningococcal C conjugate and was below the goal for the remaining vaccines (Table 14). [11] Note that these coverage estimates are limited to vaccinations reported to public health. In addition, changes to the vaccination schedule for measles and mumps affecting children born in 2010 (who turned 7 years old in 2017-18) or later mean that 7-year old coverage estimates, in this school year and beyond, for measles and mumps are not directly comparable to those of previous years.

Table 14. Coverage estimates (%) for Ottawa students 7 years of age, by school year, and national coverage goals, by vaccine

Vaccine

2013-14

2014-15

2015-16

2016-17

2017-18‡

National Goal

Measles

92.1

91.9

93.6

94.5

89.3

95

Mumps

91.8

91.6

93.5

94.4

89.2

95

Rubella

98.5

97.8

97.3

98.4

98.5

95

Diphtheria

81.5

83.4

87.1

87.3

87.6

95

Tetanus

81.5

83.4

87.1

87.3

87.6

95

Polio

81.8

83.7

87.6

87.8

88.2

95

Pertussis

81.2

83.2

87.1

87.3

87.5

95

Haemophilus influenzae type b (Hib)*

86.9

84.7

83.2

84.3

84.8

95

Pneumococcal*

79.6

79.7

81.1

83.7

76.2

95

Meningococcal C conjugate (MCC)

82.1

85

88.5

96.9

97.4

95

Varicella†

32.1

45.8

54.3

57.9

85.6

-

Data Sources and Notes for Table 14

Ontario Agency for Health Protection and Promotion (Public Health Ontario). Immunization coverage report for school pupils: 2013-14, 2014-15 and 2015-16 school years. Toronto, ON: Queen’s Printer for Ontario; 2017.

Ontario Agency for Health Protection and Promotion (Public Health Ontario). Immunization coverage report for school pupils in Ontario: 2016-17 school year. Toronto, ON: Queen’s Printer for Ontario; 2018.

Ontario Agency for Health Protection and Promotion (Public Health Ontario). Immunization coverage report for school pupils in Ontario: 2017–18 school year. Toronto, ON: Queen’s Printer for Ontario; 2019.

*Not an ISPA-designated disease. Coverage may be underestimated.

†Added as an ISPA-designated disease in 2014, applicable to children born in 2010 or later.

‡First school year where 7 years old children under assessment were vaccinated for MMR according to the new routine two-dose varicella schedule (second MMR dose given with varicella at ages 4-6 years). Coverage estimates for measles and mumps are thus not directly comparable with previous school years.

In Ottawa in the 2017-18 school year, the vaccination coverage rate among 17-year-old students surpassed the national goal of 95% coverage for measles, mumps, and rubella, was approaching the goal for polio, and was below the goal for diphtheria, tetanus and pertussis (Table 15). [11] These coverage estimates are limited to vaccinations reported to public health.

Table 15. Coverage estimates (%) for Ottawa students 17 years of age, by school year, and national coverage goals, by vaccine

Vaccine

2013-14

2014-15

2015-16

2016-17

2017-18

National Goal

Measles

97.6

95.4

96.2

97.2

          97.3

95

Mumps

95.8

93.8

95.9

97

97.0

95

Rubella

99

97.2

98.1

98.5

98.6

95

Diphtheria

71.3

58.9

77.7

77.5

77.2

90

Tetanus

71.3

59

77.8

77.5

77.2

90

Polio

93.8

91.9

94.3

94.8

94.9

95

Pertussis

57

50.4

70.3

71.8

71.0

90

Data Sources and Notes for Table 15

Ontario Agency for Health Protection and Promotion (Public Health Ontario). Immunization coverage report for school pupils: 2013-14, 2014-15 and 2015-16 school years. Toronto, ON: Queen’s Printer for Ontario; 2017.

Ontario Agency for Health Protection and Promotion (Public Health Ontario). Immunization coverage report for school pupils in Ontario: 2016-17 school year. Toronto, ON: Queen’s Printer for Ontario; 2018.

Ontario Agency for Health Protection and Promotion (Public Health Ontario). Immunization coverage report for school pupils in Ontario: 2017–18 school year. Toronto, ON: Queen’s Printer for Ontario; 2019.

In Ottawa in the 2017-18 school year, the vaccination coverage rate for school-based vaccines was approaching the 90% national goal for MCV4 and was below the goal for hepatitis B and HPV (Table 16) [11].

Table 16. Coverage estimates (%) for school-based vaccines for Ottawa students 12 and 13 years of age, by school year, and national coverage goals, by vaccine

Vaccine

2013-14

2014-15

2015-16

2016-17

2017-18

National Goal

Hepatitis B

72.7

70.1

73.8

74.3

73.2

90

MCV4

77.2

82

79.6

86

86.4

90

HPV (13yr females)

57.5

60.1

64.7

65

-

 

90

HPV (12yr)*

-

-

-

59.9

 62.7

 

Data Source and Notes for Table 16

Ontario Agency for Health Protection and Promotion (Public Health Ontario). Immunization coverage report for school pupils: 2013-14, 2014-15 and 2015-16 school years. Toronto, ON: Queen’s Printer for Ontario; 2017.

Ontario Agency for Health Protection and Promotion (Public Health Ontario). Immunization coverage report for school pupils in Ontario: 2016-17 school year. Toronto, ON: Queen’s Printer for Ontario; 2018.

Ontario Agency for Health Protection and Promotion (Public Health Ontario). Immunization coverage report for school pupils in Ontario: 2017–18 school year. Toronto, ON: Queen’s Printer for Ontario; 2019.

* In the 2016-17 school year, the HPV immunization program expanded to include boys as well as girls, and was delivered in grade 7 instead of grade 8.

 

 Exemptions

Exemptions for one or more ISPA-designated diseases can be issued due to medical or non-medical reasons. A medical exemption can be granted in cases where a child has documented immunity , or has a medical contraindication, for example, is immunosuppressed or has Guillain-Barré syndrome. Non-medical exemptions can be issued on religious or philosophical grounds.

In Ottawa, in the 2017-18 school year, the proportion of 7-and 17-year old students who had either a medical or non-medical exemption for one or more ISPA disease was low, at 2% or less (Table 17). [11]

Table 17. Medical and non-medical exemption estimates (%) for at least one ISPA designated disease, by age, 2017-18 school year.

Age

Medical

Non-Medical

7-year-olds§†

1.5

2.0

17-year-oldsत

0.4

1.9

 Data source and Notes for Table 17

Ontario Agency for Health Protection and Promotion (Public Health Ontario). Immunization coverage report for school pupils in Ontario: 2017–18 school year. Toronto, ON: Queen’s Printer for Ontario; 2019.

 

Influenza Immunization

Each fall, the Universal Influenza Immunization Program (UIIP) makes influenza immunization available to all residents. Ottawa residents can receive a seasonal influenza immunization from their health care provider, a pharmacist, or at an Ottawa Public Health clinic. While the UIIP offers immunization to all Ontarians, there are groups for which influenza immunization is prioritized, who are at high risk of complications or who those who are capable to transmitting influenza to those at high risk for complications. These include, for example, children under five years of age, older adults over 65 years of age, those with chronic conditions and health care workers. [12] There are limited immunization data on these populations. 

  • In 2017, 43% of Ottawa residents aged 12 years and older reported receiving an influenza immunization in the past year. [8]
  • Immunization rates are higher among older adults. During the 2018-19 influenza season, close to half (46%) of residents aged 18 to 64 years reported receiving an influenza immunization while 86% of residents 65 years of age and older received an influenza immunization, which was similar to previous influenza seasons for both age groups (Figure 11).  [3]
Figure 11. Percentage of Ottawa adults reporting influenza immunization by age group and influenza season, 2013/14 to 2018/19

Line chart of the percentage of Ottawa adults reporting influenza immunization by age group and influenza season from 2014/15 to 2018/19

 

Data Source and Notes for Figure 11

Ottawa Public Health. Rapid Risk Factor Surveillance System, 2013-2019.

  • The Rapid Risk Factor Surveillance System (RRFSS) is an ongoing random-digit dialed telephone (landline and cell) population health survey of Ottawa adults aged 18 years and older. 
  • Error bars represent 95% confidence intervals
Data Table for Figure 11
Table 18. Percentage of Ottawa adults reporting influenza immunization by age group and influenza season, 2013/14- 2018/19
Influenza SeasonAge 18 to 64 Years (%)

Age 18 to 64 Years

(95% Confidence Intervals)

Age 65+ Years (%)Age 65+ Years (95% Confidence Intervals)
2013/14 45.8 38.8-52.8 86 78.5-93.4
2014/15 38.6 32.2-45.1 79.9 72.8-87.0
2015/16 36.6 30.0-43.1 79.6 71.7-87.6
2016/17 43.7 36.9-50.4 83.7 75.7-91.7
2017/18 33.5 27.0-40.0 77.9 70.0-85.8
2018/19 45.8 39.0-52.6 85.8 78.4-91.0

Vector-borne Diseases and Risk Factors

Vector-borne diseases in people are diseases transmitted by an insect or other living thing that carries a pathogen that can infect a person who comes into contact with the vector.  Examples include Lyme disease, the bacterial agent of which is carried by a tick, and West Nile virus, which is carried by a mosquito.

Overall Trends
  • Lyme disease and West Nile virus infection are the only two reportable vector-borne diseases that can be acquired locally for which cases were reported in 2018 (Figure 12).  There has been significant Lyme and West Nile activity in Ottawa in recent years. [1]
  • Malaria and yellow-fever are no longer reportable diseases in Ontario. Historical cases in Ottawa were always travel-related.  
  • Four cases of travel-related brucellosis and one case of travel-related Q fever were reported in 2018.
  • No cases of the other reportable vector-borne diseases were reported in Ottawa in 2018:  anthrax, hantavirus pulmonary syndrome, plague, rabies, and tularemia.  

Figure 12. Number of cases of vector-borne and other zoonotic infections, Ottawa, 2018

Horizontal bar chart of the number of cases of vector-borne and other zoonotic infections reported by Ottawa residents in 2018

Figure 13. Number and rate per 100,000 population of Lyme disease cases by year, Ottawa, 2008 to 2018

Line and bar graph showing the number of Lyme disease cases and rates per 100,000 by year from 2008 to 2018

 

Data Source and Notes for Figure 12 & Figure 13

Ministry of Health (MOH), integrated Public Health Information System (iPHIS), extracted by Ottawa Public Health, 2019.  

  • iPHIS is a dynamic reporting system which allows for on-going updates to previously entered data. As such, data extracted from iPHIS provides a snapshot of information at the time of data extraction, and can vary from previous and subsequent data extractions.
  • Reportable communicable diseases are generally underreported due to several factors, which may include low morbidity and incentive for testing; no health care sought; clinical rather than laboratory-based diagnoses; and inability to identify identify an aetiological agent from a laboratory specimen.
  • The following diseases are reported as a sum of confirmed and probable cases: brucellosis, Lyme disease, and West Nile Virus.
  • All cases are assigned to a date based on episode date (the earliest of symptom onset, laboratory testing, and reporting). 
  • There is a lag in reporting associated with most reportable communicable diseases.
 Data Table for Figure 12
Table 19. Number of cases of vector-borne and other zoonotic infections reported by Ottawa residents in 2018
Vector-borne and other zoonotic infectionsNumber of Cases
Anthrax 0
Brucellosis, Confirmed and Probable Cases 4
Echinococcus multilocularis infection 0
Hantavirus 0
Plague 0
Q Fever 1
Rabies 0
Tularemia 0
West Nile Virus, Confirmed and Probable Cases 7
Lyme Disease, Confirmed and Probable Cases 90

Data Table for Figure 13
Year Number of Cases Rate per 100,000
2008 6 0.7
2009 6 0.7
2010 7 0.8
2011 12 1.3
2012 19 2.1
2013 49 5.3
2014 22 2.3
2015 73 7.6
2016 76 7.8
2017 190 19.1
2018 90 8.9
Lyme Disease
  • In 2018, 90 cases of Lyme disease were reported in Ottawa, compared with 6 cases reported in 2008 (Figure 13). [1] Of the 2018 cases, 27% reported exposure within Ottawa, 23% within Ottawa and outside Ottawa, while 51% reported exposure only outside of Ottawa.
  • Compared with the incidence rate of Lyme in the 3 Ontario health units neighbouring Ottawa combined, the rate in Ottawa is lower (30/100,000 vs. 9/100,000). [2,13]
  • Most Lyme cases are reported to Ottawa Public Health (OPH) during months without snow cover, when ticks are most active and people spend more time in outdoor settings. [1]
  • The City of Ottawa is an established Lyme disease risk area. [13]  Tick surveillance work conducted by OPH estimates that 20% or more of ticks in the area are infected with the disease causing bacterium, Borrelia burgdorferi
  • In 2017, 89% of Ottawa adults were aware of Lyme disease, 81% of those aware knew that people can get Lyme from tick, and 62% of these individuals reported performing tick checks or taking steps to protect themselves from tick bites after spending time outdoors. [3]

West Nile Virus Illness

  • In 2018, 7 cases of WNV infection were reported among Ottawa residents. [1] The first case of WNV infection was reported in Ottawa in 2003; 4 cases were reported that year.
  • The incidence of WNV illness in Ottawa in 2018 was similar to the average of Ontario-less-Ottawa (0.7 cases per 100,000 vs. 0.9 case per 100,000). [2]

Rabies

  • The most recent case of rabies acquired in Ontario was in 1967. [15]
  • The distribution of rabies post-exposure prophylaxis (RPEP) for the prevention and treatment of rabies in humans is a resource-intensive OPH program. In 2017, OPH, working alongside local health care providers, coordinated the distribution of RPEP dose to 115 individuals with suspected rabies exposure. [1]

Infectious Diseases Reports

Epidemiology of Reportable Communicable Diseases, Ottawa, 2016
Report: Epidemiology of Reportable Communicable Diseases, Ottawa [PDF 1.0 MB]
Enteric Disease in Ottawa Report, 2011

To better inform the planning and implementation of strategies that address enteric illnesses in Ottawa, Ottawa Public Health compiled the Enteric Disease in Ottawa, 2011 report, which provides data from 2010 about 15 reportable enteric diseases. The report includes the number of cases, incidence by age, sex and time of year, five-year averages and comparison with the rest of Ontario.

Enteric Disease in Ottawa Report [PDF 6.52 MB]

Enteric Disease: Knowledge to Action Report [PDF 886 KB]

Sexually Transmitted Infections and Sexual Health in Ottawa, 2011

The Sexually Transmitted Infections and Sexual Health in Ottawa 2011 report provides an overview of 12 types of sexually transmitted infections (STIs) in Ottawa, the number of cases, incidence rates by age and sex, 10-year averages, comparisons to the rest of Ontario, and a neighbourhood analysis of Chlamydia. The Sexually Transmitted Infections and Sexual Health in Ottawa 2011: Knowledge to Action Report outlines OPH's role in the prevention and control of STIs and promotion healthy sexuality among Ottawa's youth and adult population. 

Sexually Transmitted Infections and Sexual Health in Ottawa report [PDF 1.2 MB] 

Sexually Transmitted Infections and Sexual Health in Ottawa 2011: Knowledge to Action Report [PDF 13.1 MB]

Tuberculosis in Ottawa, 2011

The Tuberculosis in Ottawa 2011 report describes the state of tuberculosis (TB) in Ottawa in 2010 compared with the past and describes disease outcomes, clinical management and risk to the population. Tuberculosis in Ottawa 2011: Knowledge to Action Report outlines OPH's role in the detection, investigation, treatment and prevention of TB. 

Tuberculosis in Ottawa 2011 report [PDF 928 KB]

Tuberculosis in Ottawa 2011: Knowledge to Action Report [PDF12.8 MB]

References

References

  1. Ministry of Health and Long-term Care (MOHLTC), integrated Public Health Information System (iPHIS), extracted by Ottawa Public Health, May 21, 2019.
  2. Public Health Ontario. Query: Ottawa Public Health Unit: Historical Comparisons. Toronto, ON: Ontario Agency for Health Protection and Promotion; May 21, 2019.
  3. Ottawa Public Health. Rapid Risk Factor Surveillance System, 2017.
  4. Teatero, S., McGeer, A., Tyrrell, G.J., Hoang, L., Smadi, H., Domingo, M-C., Levett, P.N., Finkelstein, M., Dewar, K., Plevneshi, A., Athey, T.B.T., Gubbay, J.B., Mulvey, M.R., Martin, I., Demczuk, W., and N. Fittipaldi. Canada-Wide Epidemic of emm74 Group A Streptococcus Invasive Disease, Open Forum Infectious Diseases, Volume 5, Issue 5, 1 May 2018. https://www.doi.org/
  5. World Health Organization. Global tuberculosis 2018. Geneva: World Health Organization; 2018.
  6. Canadian Public Health Association. Factors Impacting Vulnerability to HIV and Other STBBIs
  7. Friedman, DS, O’Byrne P, Roy, M.  Comparing those diagnosed early versus late in their HIV infection: implications for public health.  International Journal of STD & AIDS 28, no. 7 (2017): 693-701.
  8. Ottawa Public Health. Canadian Community Health Survey 2015/16. Ontario Share File. Statistics Canada. 
  9. Public Health Ontario. Mumps. 2018. https://www.publichealthontario.ca/en/BrowseByTopic/InfectiousDiseases/Pages/IDLandingPages/Mumps.aspx
  10. Government of Canada. Vaccination Coverage Goals and Vaccine Preventable Disease Reduction Targets by 2025.  https://www.canada.ca/en/public-health/services/immunization-vaccine-priorities/national-immunization-strategy/vaccination-coverage-goals-vaccine-preventable-diseases-reduction-targets-2025.html#1.0. Last modified 2018-07-23

  11. Ontario Agency for Health Protection and Promotion (Public Health Ontario). Immunization coverage report for school pupils in Ontario: 2017–18 school year. Toronto, ON: Queen’s Printer for Ontario; 2019.

  12. Ontario Ministry of Health and Long-Term Care. Universal Influenza Immunization Program (UIIP). http://www.health.gov.on.ca/en/pro/programs/publichealth/flu/uiip/default.aspx Last modified 2018-09-19
  13. Public Health Ontario. Map of Lyme Disease Risk Areas in Ontario. 2018. http://www.publichealthontario.ca/en/eRepository/Lyme_disease_risk_areas_map.pdf
  14. Public Health Ontario.  September 2012 Monthly Infectious Disease Surveillance Report.  https://www.publichealthontario.ca/-/media/documents/rdto-2012.pdf?la=en
  15. Public Health Ontario. 2018 Rabies Data at a Glance. https://www.publichealthontario.ca/en/diseases-and-conditions/infectious-diseases/vector-borne-zoonotic-diseases/rabies. Last modified 2020-01-20.

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