Candida auris now reportable to Public Health under provincial law

Advisory Alert

January 3, 2025

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To: Local Health System Partners

FOR IMMEDIATE ATTENTION

Amendments to the Health Protection & Promotion Act Regulations

Ontario Regulation 135/18 (Designation of Diseases) and Ontario Regulation 569 (Reports) under the Health Protection and Promotion Act (HPPA) have been amended.

Effective January 1, 2025, Candida auris (C. auris) is a newly designated Disease of Public Health Significance (DoPHS) and is reportable to the Medical Officer of Health (MOH).

Case and outbreak definitions

• Confirmed cases include those who are detected by an accredited microbiology laboratory from active screening and clinical infections.
• Suspect outbreaks may be considered in a hospital or long-term care home if:
  • a single confirmed case is identified in a facility that has not seen a case previously OR
  • two or more confirmed cases are identified within a facility even if they present on different units and present months apart
• Confirmed outbreaks in a hospital or long-term care home occurs when:
  • evidence of transmission between patients is identified OR
  • an epidemiological link between patients is identified OR
  • the hospital or long-term care home considers, based on their policies, transmission has occurred or if the incidence of C. auris at the facility is higher than expected even without a clear link between patients.

Identification, management, and infection control resources

Although the prevalence of C. auris in Ontario is low, the emergence of multidrug resistant organisms within Canadian health care facilities requires an integrated approach to surveillance and infection control across the broader health sector. With no or limited treatment options, even a single transmission event of C. auris is of concern.

C. auris can cause a range of infections, and symptoms are often non-specific. Risk factor-based screening (see screening checklist below) can help to identify clients, patients, or residents at increased risk of having an antibiotic resistant organism.

Public Health Ontario (PHO) disease-specific resources include:

• interim Guide for Infection Prevention and Control (PDF)
• an infographic on Management of a Single New Case of C. auris (PDF)
• Candida auris reference identification and susceptibility testing (PDF)
• screening checklist to identify patients, clients, or residents who may be at increased risk

The Ministry of Health has also posted the attached disease-specific appendix on the Ontario Public Health Standards webpage.

Reporting

C. auris and other diseases of public health significance must be reported to the the MOH by faxing or emailing the communicable disease notification form to 705.677.9618 or HPT_Fax_Confidential@phsd.ca.

If you have any questions, please contact the Control of Infectious Disease Program at 705.522.9200, ext. 772 (toll-free 1.866.522.9200), Monday to Friday, 8:30 a.m. to 4:30 p.m., or after-hours and on weekends at 705.688.4366.

Sincerely,

Original Signed By

Mustafa Hirji, MD, MPH, FRCPC
Acting Medical Officer of Health and Chief Executive Officer

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This item was last modified on January 3, 2025