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Disease and medical conditions

Cancer, diabetes and heart disease


  • Commonly diagnosed cancer in women is breast cancer, prostate for men
  • Lung cancer is a leading cause of cancer deaths for both men and women
  • 30 to 35 per cent of all cancers can be prevented by eating well, being active and maintaining a healthy weight
  • Help reduce the chances of developing cancer by:
    • Not smoking or chewing tobacco
    • Have a healthy diet, that includes eating fruits and vegetables, and limits red and processed meats, saturated fats and alcohol as these have been linked to increased risk of several cancers
    • Protecting your skin from ultraviolet rays from the sun that cause sunburns and skin cancer
My CancerIQ

Complete a cancer risk assessment and get your personalized action plan now - myCANCERiQ

More information:

Canadian Cancer Society
Cancer Care Ontario
Prostate Cancer Canada


Diabetes is characterized by high levels of blood sugar, and develops when the body cannot produce enough or properly use insulin, a hormone made in the pancreas that allows the body to use glucose (sugar) for energy.

Without insulin, sugar stays in the blood instead of going into the cells to make energy. Long-term effects can include heart disease, stroke or blindness, kidney failure, reduced sensation or ulcers in the legs and feet.

Type 1 Diabetes

Type 1 diabetes, also known as insulin-dependent diabetes, is not preventable and most commonly targets children or adolescents. In this form of diabetes, the pancreas is not able to supply the body with the insulin it needs. As a result, people with type 1 must inject themselves with insulin every day.

Type 2 Diabetes

Results from insulin resistance where the body cannot use the insulin it produces, or from an insulin deficiency where the body does not produce enough insulin for glucose to be used by body cells. It accounts for about 90 per cent of all diabetes and can be delayed or prevented by maintaining a healthy weight, healthy eating and regular exercise.

  • Can develop after age 40
  • Is increasingly occurring in children
  • Life expectancy for people with type 2 is shortened by 5 to 10 years.

Diabetes Services in Ottawa and the Champlain Local Health Integrated Network

Over nine million Canadians are living with diabetes or prediabetes. Chances are diabetes affects you or someone you know. For more information on types of diabetes, risk factors and signs and symptoms of diabetes, please visit The Canadian Diabetes Association website.

If you have been diagnosed with diabetes by your health care professional and require information on diabetes education programs, foot care services, eye care services, self-management support and financial assistance.  Please visit The Champlain Diabetes Services website.

CHEO Diabetes Clinic Services

The Clinic provides specialized care to children who have type 1 diabetes, type 2 diabetes or impaired glucose tolerance. The clinic provides an insulin pump program, individual or group education sessions, and transition to adult care information sessions.

How to make an appointment

  • Physician referral is preferred. Self-referrals are accepted.
  • Transfers from other centres are accepted but require a written referral from community agencies (i.e. CCAC, etc.).

Mail or fax the referrals form to:
Diabetes Clinic, CHEO
401 Smyth Road
Ottawa, ON K1H 8L1
Fax: 613-738-4236

More information on diabetes:

Canadian Diabetes Association
Health Canada
Gestational Diabetes
Eat Right Ontario
Juvenile Diabetes Research Foundation
Canada's Food Guide to Healthy Eating

Heart disease

Diseases in this category involve the heart including coronary artery disease, heart attack, angina, congestive heart failure, valvular heart disease and congenital heart problems. It is the number one killer of men and women in Canada. Heart disease can be prevented in most people.

There are two types of risk factors for heart disease:

Those that cannot be changed

  • Family history
  • Male gender
  • Post menopause
  • Increasing age

Those that can be changed or managed:

  • Diabetes
  • Smoking and exposure to second-hand smoke
  • Untreated high blood pressure
  • High blood cholesterol and blood triglycerides
  • Lack of physical activity
  • Being overweight
  • Stress level
  • Alcohol use

Warning signs of a heart attack:

  • Chest pain -- such as tightness, heaviness, pressure, burning, or squeezing
  • Radiation of chest pain to arms, neck, back, or jaw
  • Shortness of breath
  • Paleness, sweating, or weakness
  • Nausea, vomiting and/or indigestion
  • Feeling of extreme anxiety, fear or denial

If you experience any warning signs, get help immediately.

Women often experience “softer” symptoms which may come and go, including:

  • Vague chest discomfort
  • Shortness of breath
  • Indigestion-like sensations
  • Unexplained/unusual fatigue


  • Eat a healthy diet
  • Be physically active
  • Live smoke-free
  • Have a healthy weight

Act immediately. Chances of surviving a heart attack are greatest if the symptoms are treated within the first two to three hours of their onset.

Learn CPR. Most heart attacks occur in the home so learning CPR could save the life of someone you know.

Healthy everyday living can help prevent chronic diseases such as heart disease, stroke, cancer and diabetes.

More information:

Ebola virus disease

What is Ebola? 
Are Canadians at risk of contracting Ebola?
I have arrived recently from one of the affected countries- what should I do?
I have arrived recently from one of the affected areas and am feeling unwell - what should I do?  
What are the symptoms of Ebola infection?
Is there treatment for Ebola?
How can Ebola be prevented?
What is the role of Ottawa Public Health?
What is Canada doing?
What hospitals in Ottawa assess and treat patients for Ebola?
Travel Information 

What is Ebola Virus Disease?

Ebola Virus Disease (Ebola) is a rare disease that causes fever in humans and some animals. In its late stages, this serious viral infection can cause internal and external bleeding which can lead to death.


Are Canadians at risk of contracting Ebola?

West Africa is experiencing a serious outbreak of Ebola, currently in Guinea, Liberia and Sierra Leone. There has been confirmed case of Ebola in other countries, including three in the United States. The public health risk to Canadians from Ebola is low as the Ebola virus does not spread easily from person to person. It is spread primarily by direct contact with bodily fluids of a person who is infected with Ebola, not through casual contact.


I have arrived recently from one of the affected countries - what should I do?  

Ottawa Public Health is notified by Public Health Ontario of any traveller who is returning to, or visiting, Canada from an Ebola affected country. All travellers from an Ebola affected country are screened by a Public Health Agency of Canada Quarantine Officer upon entry into Canada regarding their travel history and undergo a mandatory health assessment, which includes a temperature check. Travellers to Ontario from an Ebola affected country will be given an Order under the federal Quarantine Act to report to their local public health unit within 24 hours. If you have been given an Order to report to Ottawa Public Health:

  • Call 613-580-6744 ext. 24224 during regular business hours, Monday to Friday from 8:30 a.m. to 4:30 p.m. OR call the number already provided to you by the Quarantine Officer OR if after regular business hours, call 3-1-1 and ask to speak to  Ottawa Public Health
  • A Public Health Nurse will assess your level of risk for infection and provide you with instructions concerning your activities during the 21-day monitoring period


I have arrived recently from one of the affected areas and am feeling unwell - what should I do?

  • If you become ill with a fever and/or if you experience any other symptoms after travelling to countries with declared Ebola outbreaks, call Ottawa Public Health at 613-580-6744.
    • Inform them of your symptoms and your recent travel history, and the travel history of those with whom you have been in close contact.
    • Do not take public transportation if you must seek medical attention

If you require urgent care, call 911.


What are the symptoms of Ebola infection?

  • Symptoms of Ebola infection begin within two to 21 days after exposure.
  • Initial symptoms of Ebola include sudden onset fever (?38°C), muscle pain, headache, sore throat, diarrhea, and chest pain.
  • Signs more specific to Ebola that may present later in some patients can include pink eyes, rash, and both internal and external bleeding. 


Is there treatment for Ebola?

At this time there is no vaccine or specific treatment for Ebola. Severely ill patients require supportive treatment or hospitalization.


How can Ebola be prevented?

To prevent the spread of Ebola, it is recommended to:


What is the role of Ottawa Public Health?

Ottawa Public Health (OPH) nurses are available to answer questions, assess risk of exposure in returning travellers from the Ebola affected area and make recommendations for follow-up such as self-monitoring of symptoms.

OPH is working closely with hospitals and health care providers in the community to ensure timely assessment, management and follow up of returning travellers who become ill. OPH is also coordinating with hospitals and health care partners to provide information to the public regarding the Ebola virus and any associated health risks to the community. 


What is Canada doing?

There have been no known reported cases of Ebola in Canada.

In Ontario, the Minister of Health and Long-Term Care, along with the interim Chief Medical Officer of Health, are taking action to enhance the province's readiness to contain and treat any potential case of Ebola in the province.


What hospitals in Ottawa assess and treat patients for Ebola?

For the Ottawa area, the Children's Hospital of Eastern Ontario and The Ottawa Hospital – General Campus have been designated as the referral hospitals to treat potential cases of Ebola in Ottawa.  Additional measures undertaken by the provincial government are outlined in a news release and a backgrounder issued October 17.

Public Health Ontario and PHAC provide guidance to health care professionals to ensure that proper guidelines are in place to help prevent the virus from spreading.

PHAC continually monitors many infectious diseases and emerging infectious diseases in Canada. The agency works with provincial and national governments, and international partners including the World Health Organization.

National and provincial authorities continue to monitor the Ebola situation overseas. They have provided guidelines for health care providers in Ontario should an ill patient report they have travelled to a country where an Ebola outbreak has been declared.


Travel Information

For information regarding travel notices or restrictions please visit the Public Health Agency of Canada Travel Health Notices.

For further information on Ebola, call Ottawa Public Health at 613-580-6744 to speak to a Public Health Nurse, or visit the following websites:


Enterovirus D68

What is Enterovirus D68?
How is this Enterovirus D68 strain different?
When should I be concerned about my child’s symptoms and what should I do?
Who is most affected by Enterovirus D68?
How does the virus spread?
What can I do to protect myself and/or my children?
How does someone get tested for Enterovirus D68?
How is it treated?
What is Ottawa Public Health’s role?

What is Enterovirus D68?

Enterovirus D68 (EV-D68) is a strain of a family of common viruses that cause respiratory or “cold” symptoms such as fever, cough, runny nose, sneezing and sore throat. Enteroviruses usually spread in the summer and fall in North America and there is a spike in this type illness every year when kids go back to school.


How is this Enterovirus D68 strain different?

Children, especially young children, are becoming more ill with this strain of the virus than other enterovirus strains. In the United-States, many children have been hospitalized for breathing problems. There have been no deaths directly linked to the Enterovirus-D68 strain (as of September 19, 2014).


When should I be concerned about my child’s symptoms and what should I do?

Mild symptoms: Children with mild symptoms such as fever, cough, runny nose, sneezing or sore throat should see a primary care provider such as a family doctor, a nurse practitioner or go to a walk-in clinic, if the parent is concerned.

Severe Symptoms: Breathing problems are the main concern. Children with laboured breathing or wheezing (a high-pitched whistling sound when inhaling/exhaling) should be seen by a healthcare provider. Children who appear to be struggling to breathe need to be taken to an Emergency Department immediately.


Who is most affected by Enterovirus D68?

The most affected groups are children under the age of 5 and children and teenagers with asthma or other breathing problems. They are at higher risk of having severe illness and should be watched more closely for worsening symptoms. Children with asthma or breathing problems should have medications such as inhalers available and there should be a plan of action for breathing problems. Adults will usually get a mild illness or will not get sick at all, but may still spread the virus to others.


How does the virus spread?

Like any other respiratory or “cold” virus, it is spread from person-to-person or through contact with surfaces that are contaminated with the bodily fluids of an infected person, like saliva or mucus. It is also spread through droplets from coughs or sneezes. 


What can I do to protect myself and/or my children?

Protection from this virus is the same as what is done for other respiratory or “cold” viruses including:

  • Wash hands often with soap and water for at least 15 seconds:
    • After being in a public place or outdoors
    • After coughing, sneezing or blowing your nose
    • After visiting the washroom
    • Before preparing or eating food
    • Before and after visiting with people who are sick
  • Avoid touching eyes, nose and mouth with unwashed hands
  • Avoid kissing, hugging, and sharing cups or eating utensils with people who are sick
  • Clean frequently touched surfaces, such as doorknobs and toys
  • Use an alcohol-based hand sanitizer if you can’t wash your hands with soap and water
  • Cough or sneeze into a tissue, your arm or your sleeve – not your hand
  • Stay at home when you are ill

For more simple steps on how to prevent the spread of germs that cause enterovirus and other illnesses, visit Prevent the Spread of Germs  


How does someone get tested for Enterovirus D68?

Testing for the virus strain is not done routinely because the treatment is the same for all respiratory viruses, but it is possible to test in some situations.


How is it treated?

There is treatment that can be very helpful to reduce symptoms, starting with rest and drinking lots of fluids. When severe breathing difficulties or wheezing occurs, medicines or devices are available in hospital to help breathing.


What is Ottawa Public Health’s role?

Ottawa Public Health (OPH) is working closely with hospitals and healthcare providers in the community to ensure there is proper assessment and management of this illness. 


Lyme Disease

image of a blaglegged tick

Lyme disease is an important health concern in many parts of Canada and is spread by the bite of blacklegged ticks infected with the bacterium Borrelia burgdorferi. Most people are infected with Lyme disease through the bite of an immature tick called a nymph.

Nymphs are tiny (less than 2 mm, about the size of a poppy seed) and difficult to see. Nymphs feed during the spring and summer months. Adult ticks are much larger and are more likely to be discovered and removed before they have had time to transmit the bacteria. Adult blacklegged ticks are most active during spring and again in late summer and fall.

The blacklegged tick that carries the bacteria that can cause Lyme disease is present in the Ottawa area, across Eastern Ontario, and the Outaouais region of Quebec. Ottawa is now considered an at-risk area for Lyme disease.

Ottawa Public Health has seen an increase in the number of cases of Lyme disease reported in the Ottawa area over time, as well as an increase in the number of cases of Lyme disease likely acquired in the Ottawa area. This is most likely a result of growing Lyme disease awareness and increase in tick populations in Eastern Ontario.

Ottawa Public Health is committed to reducing the health risks to residents posed by Lyme disease through prevention, education and awareness, as well as surveillance. Preventing tick bites is key to the prevention of Lyme disease.image showing various sizes of ticks


Populations of blacklegged ticks are growing and expanding into new areas. This means that the risk of contracting Lyme disease is on the rise across Canada. Though ticks can be found almost anywhere outdoors, they are often found in tall grasses, bushes wooded and forested areas.

Ottawa Public Health recommends practicing these simple steps to help minimize exposure to ticks, and help you enjoy the outdoors safely:

  • Apply a Health Canada approved mosquito repellent containing DEET or icaridin to exposed skin and clothing
  • Wear long pants, a long sleeved shirt, shoes and socks to cover exposed skin
  • Tuck your pants into your socks
  • Wear light coloured clothing to spot ticks easier
  • If possible, stay on the trails when hiking in the woods or walking in long grass
  • Do a “full body” check on yourself, your children, and pets for ticks. Pay careful attention around your toes, knees, groin, armpits and scalp.

Blacklegged ticks are very small and not easy to see which is why you should perform a full body check on yourself, your children and your pets after being outdoors. The sooner ticks are removed from the body the less likely they are to spread Lyme disease.


How can I reduce the number of blacklegged ticks around my home?

 You can’t get rid of ticks completely, but you can reduce the number of ticks present in your yard. Here are some tips to help make your environment less favourable to ticks by:

  • Keeping the grass in your yard mowed
  • Removing brush and fallen leaves from the edges of your property, especially if your yard is bordered by woods or fields of tall grass
  • Cleaning up areas under and around bird feeders to reduce the attraction of small critters such as mice and voles that carry ticks
  • Discouraging deer from entering your yard, as ticks also feed on these animals
  • Keeping your woodpile neat, dry, off the ground, and away from your house


What if I find a tick?

If you find a tick on your body, remove it as soon as possible. The risk of getting Lyme disease increases with the length of time the tick remains attached to your body.

Since Ottawa is now considered an at-risk area for Lyme disease, it is important to contact your doctor if you believe a tick has been attached to you for 24 or more hours, or if you are unsure how long the tick has been attached to you, so that your doctor can determine if you need treatment with antibiotics. Treatment with antibiotics would be considered when:

  • the tick has been attached for 24 or more hours or is fully or partially engorged and
  • it has been less than or equal to 72 hours since the tick has been removed.

If the tick was attached for less than 24 hours and its body does not appear swollen from feeding or if you removed a tick and more than 72 hours have passed, you should still be on the lookout for signs and symptoms of Lyme disease for the next 30 days. If you do develop symptoms, consult your health care provider.

Removing ticks

how to remove a tick

  • Use tweezers or a “Tick Key”
  • Grasp the tick's head as close to the skin as possible and pull slowly until the tick is removed. Do not twist or rotate the tick. Do not use a match, lotion or anything else on the tick.
  • Wash the bite site with soap and water
  • If the tick has bitten a human, and you would like to get it tested as part of Ottawa Public Health’s tick monitoring, you can find more testing information below.
  • If you don’t want to have the tick tested, you can dispose of a live tick by submersing it in alcohol, placing it in a sealed bag/container, wrapping it tightly in tape, or flushing it down the toilet


Lyme Disease – Signs and Symptoms

Early and accurate diagnosis and treatment of Lyme disease is key to avoid more serious illness and the potential for long-term complications. Long-term complications can involve muscle and joint pain, irregular heartbeat, and nervous system disorders (involving the brain, nerves and spinal cord).an image of circular red rash from lyme disease

Symptoms usually begin within three days to one month after being bitten by an infected tick.

  • Circular, red rash (often, but not always, looks like a ‘bull’s-eye’ ), which slowly expands around the tick bite area
  • Fatigue (tiredness)
  • Fever or chills
  • Headache
  • Muscle and joint aches
  • Swollen lymph nodes
  • Numbness or tingling
  • Spasms or weakness

If you develop symptoms of Lyme disease, consult your health care provider.


Steps to reduce your pet’s exposure to ticks

If your pet spends lots of time outdoors, a tick check should be part of your daily routine. While dogs and cats cannot directly transmit Lyme disease to people, a tick may enter your home on your pet’s back and move on to bite a human.

To help reduce the chances of your pet carrying a tick that may transmit Lyme disease:

  • Talk to your veterinarian about ways to protect your pet from ticks. There are many topical products that can help repel or kill ticks, and for dogs there is a vaccine.
  • Check your pet daily for ticks, especially if it spends time in wooded or overgrown areas
  • Remove any ticks right away and dispose
    • Use tweezers or a “Tick Key”
    • Grasp the tick's head as close to the skin as possible and pull slowly until the tick is removed. Do not twist or rotate the tick. Do not use a match, lotion or anything else on the tick.
    • Wash the bite site with soap and water
    • Dispose of a live tick by submersing it in alcohol, placing it in a sealed bag/container, wrapping it tightly in tape, or flushing it down the toilet
    • When your pet is examined by a veterinarian, ask for a thorough tick check


Monitoring Lyme disease in Ottawa

Ottawa Public Health staff regularly conducts tick dragging and collects ticks from the public to monitor tick populations and to test for Lyme disease. The number of cases of Lyme disease in humans reported in Ottawa has increased over time.


Is there a Lyme disease vaccine?

Unfortunately, a Lyme disease vaccine is not available in Canada.

For more information:


Get your tick tested

Ticks that have bitten humans in the City of Ottawa can be submitted through Ottawa Public Health for testing. As this is a surveillance and identification program only, results may not be available for a number of months, and the results are not used to make medical treatment decisions.

If you have been bitten by a tick, follow these steps to remove the tick and contain the tick for testing:

  • Use tweezers or a “Tick Key”
  • Grasp the tick's head as close to the skin as possible and pull slowly until the tick is removed. Do not twist or rotate the tick. Do not use a match, lotion or anything else on the tick.
  • Wash the bite site with soap and water
  • Place the tick in an empty pill vial or zip-lock bag with a moistened paper towel
  • Contact 3-1-1 or Ottawa Public Health to schedule an appointment to submit the tick for testing, ph: 613-580-6744 or email:

If you have been bitten by a tick outside of the City of Ottawa, please contact the Public Health Unit for that area to see if they are testing ticks.

Ticks retrieved from animals may be submitted to the Public Health Agency of CanadaPlease note, Ottawa Public Health is not involved in this process.

Middle East Respiratory Syndrome – Coronavirus (MERS-CoV)

What is Middle East Respiratory Syndrome?

Middle East Respiratory Syndrome is a viral respiratory illness caused by a coronavirus. MERS-CoV is a new coronavirus that has not been seen in humans before. So far this virus is rare but may cause serious illness, including death. MERS-CoV has occurred mainly in residents of, or travellers to, certain Middle Eastern countries.

What are the symptoms of MERS-CoV infection?

The main symptoms of MERS-CoV are fever and cough as well as shortness of breath and breathing difficulties. The illness may range, from persons who test positive without any symptoms or symptoms of a common cold, to others with serious illness similar to a severe pneumonia.

Who is at risk of contracting MERS-CoV?

MERS-CoV does not spread easily from person to person. In cases where MERS-CoV has spread between people, it was to those people who were in close contact with the sick person: family members, co-workers, healthcare workers, and patients. Almost all persons who become seriously ill have pre-existing medical conditions such as weakened immune systems, or chronic diseases. The virus has been identified in camels, but it is not known how it is transmitted to humans.

Is there treatment for MERS-CoV?

At this time there is no vaccine or specific treatment for MERS-CoV infection. Some individuals may require supportive treatment or hospitalization.

How can MERS-CoV be prevented?

To prevent the spread of MERS-CoV infection, it is recommended to:

  • Before travelling to the Middle East consult the travel links below for advice
  • If you become ill with a fever and/or shortness of breath after travelling to the Middle East, notify your healthcare professional of your symptoms and your recent travel history, and the travel history of those with whom you have been in close contact
  • For protection from any respiratory illness such as colds, or flu adopt the healthy habits found at: Prevent the Spread of Germs

What is Canada doing?

The Public Health Agency of Canada (PHAC) is continually monitoring the disease and conducting surveillance for severe acute respiratory illnesses in Canada. The agency collaborates with provincial governments and international partners including the World Health Organization.

PHAC provides guidance to health care professionals to ensure that proper guidelines are in place to help prevent the virus from spreading in healthcare settings. The National Microbiology Lab tests can rapidly detect MERS-CoV and other severe respiratory illnesses.

The Ontario Ministry of Health and Long-Term care has provided guidelines for health care providers in Ontario. The Provincial Infectious Diseases Advisory Committee (PIDAC) has updated its MERS-CoV document to include screening and patient management.

What is the role of Ottawa Public Health?

Ottawa Public Health investigates all reports of suspected MERS-CoV infection, works with health care providers in the Ottawa community to ensure timely follow up, and collaborates with Public Health Ontario to monitor the situation in the province.

Travel Information

For information regarding travel notices or restrictions please visit: Travel Health Notice

For further information call Ottawa Public Health Information at 613-580-6744, visit, or visit the websites listed below:

Ottawa's Health is in Your Hands

Healthy habits are important to protect yourself and others from potentially harmful germs.  Germs are types of microbes, such as bacteria or viruses, which can cause diseases.  They are spread directly from person to person, or indirectly by touching a surface that has been contaminated with them.  Harmful germs can sometimes lead to serious illness, particularly in vulnerable populations such as young children, the elderly, or people with underlying medical conditions.  To reduce the spread of germs and to prevent yourself and others from getting sick, Ottawa Public Health recommends that you:

  1. Wash your hands with soap and water, or use hand sanitizer
  2. Cover your coughs and sneezes with a tissue or your arm, not your hand
  3. Stay Home if you are sick
  4. Get immunized

What is Hand hygiene?

Hand hygiene is the most important way to prevent you and others from getting sick due to an infection. Hand hygiene refers to the cleaning of your hands by either washing them or applying alcohol-based hand rub. Consistently practicing good hand hygiene is essential to reduce the spread of infection in your at home, in daycares, schools, workplaces, and public places.

When should you clean your hands?

It is important to wash your hands:
  • Before, during, and after preparing food
  • Before eating food
  • Before and after caring for someone who is sick
  • Before and after treating a cut or wound
  • Before and after changing contact lenses
  • After using the toilet
  • After changing diapers or assisting a child who has used the toilet
  • After blowing your nose, coughing, or sneezing
  • After being in a public place or outdoors
  • After touching an animal, feeding an animal, or picking up animal waste
  • After handling garbage

How should you clean your hands?

If you have soap and clean running water available, you can wash your hands to reduce the spread of germs.  However, if soap and water are not available, you can use an alcohol-based hand sanitizer that contains at least 60% alcohol. 

How to wash your hands with soap and water:

  • Wet your hands under warm, running water
  • Apply liquid soap
  • Lather and rub hands for at least 20 seconds (hint: if you don’t have a timer, sing happy birthday twice!)
  • Rinse your hands 
  • Towel or air dry your hands
  • Turn the taps off with a towel or your arm/sleeve

How to clean your hands with a hand sanitizer

  • Place a quarter-size drop of alcohol-based hand sanitizer in your palm
  • Rub your hands together, palm to palm
  • Rub the back of each hand with palm and fingers of the other hand
  • Rub around each thumb
  • Rub the fingertips of each hand, back and forth in the other hand
  • Rub until your hands are dry (at least 15 seconds)

Quick tip: Applying a non-scented moisturizer to your hands daily will also help ensure your skin remains healthy and prevents chapping leading to optimal hand health!  

Hand Hygiene for Children

To find out more about hand hygiene and children, you can go to:

The Science behind Hand Hygiene

Germs are types of microbes which can cause diseases.  Hand-to-hand contact between two people can spread germs that cause mild illnesses, such as the common cold, or more severe or life-threatening infections such as measles or meningitis.  Even if your hands appear to be clean, they may still be carrying germs that can lead to illness.  Good hand hygiene practices are important to prevent the spread of germs to others and to avoid getting sick yourself.  Evidence shows that good hand hygiene:

Reduces the number of people who get sick with diarrhea by 31%1

Reduces the number of people who get sick with respiratory illness by 21%1

Hand Hygiene Frequently Asked Questions

Why is hand washing the best way for you to reduce spread of germs? 

Hand washing remains the best way for people to reduce the spread of germs in most situations because:

  •  alcohol-based hand rubs are often used incorrectly by people; for example, they may not use an appropriate amount of ABHR or may wipe it off before it has dried
  • soap and water is more effective for killing certain types of germs
  • soap and water is more effective when hands are visibly soiled
Why should I wash my hands for 20 seconds?

While scientists are still expanding their evidence in this area, experts suggest that washing your hands for only 10 seconds does not allow enough time to achieve a good lather and enough friction to properly clean hands.  Also, most people tend to overestimate how long they spend washing their hands, so a target of 20 seconds helps make sure people wash their hands long enough for germs to be effectively removed.

Can I use alcohol-based hand rub when my hands have dirt on them?

Alcohol-based hand rub is not recommended for visibly soiled hands because the alcohol is inhibited by organic matter.  If your hands are visibly dirty and no running water is available, use a moistened towelette to remove the visible soil and follow with alcohol-based hand rub.

Are alcohol-based hand sanitizers safe to use?

Yes, if used correctly.  Using a quarter-size drop and rubbing hands for 15 seconds allows the alcohol content of the product to completely evaporate so there is no residue left on the hands.

Why do they recommend an alcohol-based hand rub with at least 60% alcohol?

Research has shown that alcohol-based hand rubs with an alcohol concentration between 60-95% are more effective at killing germs than those with a lower alcohol concentration2

Cover your coughs and sneezes with a tissue or your arm, not your hand

To stop the spread of germs that can make others sick, you should always cover your mouth and nose with a tissue when you cough or sneeze and put your used tissue in a waste basket.  If you don’t have a tissue, cough or sneeze into your upper sleeve, not your hand.

Why cover your coughs and sneezes?

Coughs can force out thousands of tiny droplets of saliva which can spread germs.  In fact, 3,000 droplets are expelled in a single cough, and some of the droplets can fly out of your mouth at speeds of up to 50 miles per hour.1  Sneezes are even worse than coughs for spreading germs because they can produce as many as 40,000 tiny droplets of saliva which can exit your nose and mouth at speeds greater than 200 miles per hour.1 By covering your coughs and your sneezes, you can help prevent the spread of germs to others.  Also, always remember to wash your hands after coughing or sneezing.

Stay home if you are sick

If it is possible, stay home from work or school when you are sick.  Staying home helps prevent spreading your illness to others.  In particular, young children, people over 65 years of age, and those with compromised immune systems are at greater risk of severe illness and even death from common viruses, such as influenza (“the flu”).

Get immunized

Annual influenza immunization is the safest and most effective way to avoid getting the flu or to reduce the severity of your symptoms if you do get sick, and to keep from spreading this virus to others.  For more information, visit the Public Health Agency of Canada’s website ‘Getting the facts – then get your flu shot’ 


1. Aiello AE.,& Coulbourn RM.,& Perez V., & Larson EL., 2008 Aug. Effect of hand hygiene on infectious disease risk in the community setting: a meta-analysis. Am J Public Health. Retrieved from

2. Kampf G, & Kramer A. 2004 Oct. Epidemiologic background of hand hygiene and evaluation of the most important agents for scrubs and rubs. Clin Microbiol Rev. Retrieved from

3. Jason Socrates Bardi. June 14, 2009. The Gross Science of a Cough and a Sneeze. Live Science. Retrieved from

Hand Hygiene Resources

Learn more about preventing the spread of germs in the below resources prepared by OPH.

The information below is available in other formats. Contact Ottawa Public Health at 613-580-6744 or request the document in an accessible format.


  • Is a deadly disease caused by a virus that attacks the central nervous system (brain and spinal cord) of warm-blooded animals (mammals) – such as raccoons, skunks, foxes, coyotes, and bats
  • It’s fatal to animals and humans, if not treated
  • It’s spread from the saliva of an infected animal to another animal or human through a bite, contact with an open wound or with a mucus membrane (mouth, nasal cavity, eyes)
  • It causes brain damage
  • Animals can be infectious for days before showing any signs of the disease
  • Ontario has a successful rabies control program that has greatly reduced incidents of rabies
  • Report stray or strangely acting animals to the Humane Society at 613-725-3166 or By-law Services by calling 3-1-1
  • If you are bitten or scratched, report it to Ottawa Public Health by calling 613-580-6744 or 3-1-1 after business hours. Seek medical attention immediately.
  • Information on teaching children to prevent dog bites
  • Find out more on bats and raccoon rabies

What are the symptoms of rabies in animals

An animal will show signs of rabies from 3 to 12 weeks after infection. The following are examples of suspicious behaviour:

  • Wild animals seem friendly or tame
  • Normally nocturnal animals are active during the day
  • Wild animals do not run away when approached by a human or domestic animal
  • Animals’ normal instinctive self-preservation is contradicted by their actions
  • Animals exhibit signs of excitement, meanness or aggressive behaviour
  • Animals with paralyzed hind legs or drooping heads
  • Pets seem to have a hard time walking, eating or drinking
  • There may be froth at the mouth
  • May attack objects or other animals

What are the symptoms of rabies in humans?

Symptoms usually appear three to eight weeks after the bite, but sometimes they can appear as soon as five days afterwards. They may also take seven years to appear.

Early symptoms are:

  • Restlessness and irritability
  • Fatigue
  • Slight fever
  • Cough and sore throat
  • Increased saliva and tears
  • Headache
  • General malaise

As the disease progresses, symptoms include:

  • Hyperactivity and violent behaviour
  • Confusion
  • High fever
  • Irregular heartbeat
  • Irregular breathing
  • Insomnia
  • Anxiety
  • Slight or partial paralysis
  • Excitation and hallucinations
  • Trouble swallowing
  • Hydrophobia (fear of water)

Prevent rabies

  • Don't let your pets roam free, especially at night when nocturnal animals like foxes, skunks, bats and raccoons are out
  • It is mandatory to have your dog or cat regularly vaccinated against rabies. The vaccine protects against all strains of rabies. By vaccinating your pet, you are also protecting your family.
  • Avoid animals that act strangely
  • Appreciate wildlife from a distance. Never feed or handle wild animals, especially those that appear aggressive or sick.
  • Teach your children not to approach animals, even if they seem friendly
  • Never keep a wild animal as a pet
  • Take measures to stop raccoons and other wildlife from moving into your house, garage or garden
  • If you see a baby animal that appears to be orphaned, leave it alone. Chances are its mother is nearby. Even if she is not, the possible danger to you outweighs the good you might do for the animal. Instead, notify:
    • The Rideau Valley Wildlife Center at 613-258-9480
    • The Ottawa Humane Society at 613-725-1532
    • The Ministry of Natural Resources at 613-258-8214
    • Check the Ontario Wildlife Rehabilitation & Education Network

Rabies exposure and treatment

  • If you have been bitten or scratched by a possibly rabid animal, contact your doctor or go to the nearest hospital emergency department.
  • Immediately wash the affected skin area thoroughly with soap and water. If saliva from the animal is on your clothing, wash it immediately in hot soapy water.
  • All dog and cat bites should be seen by a doctor and reported to the City.
  • Rabies is deadly, so all bites and scratches from a suspect animal must be reported.
  • The patient, doctor or hospital must report the incident to the Ottawa Public Health at 613-580-6744.
  • When bitten by a dog, it is important to obtain the name and address of the owner.

There is a Rabies Post Exposure Prophylaxis vaccine (RPEP) which is administered by a doctor in five doses. The vaccine is highly effective at preventing rabies if given as soon as possible following an exposure. Most deaths due to rabies occur in people who fail to seek medical attention. If you are receiving treatment for rabies, you cannot give it to anyone unless you actually become sick with the disease.

Pet exposed to rabies

  • Don't handle your pet because there may be fresh saliva from a rabid animal on its coat
  • Isolate your pet
  • Contact your city's animal-control agency, humane society, local Canadian Food Inspection Agency office or your veterinarian

More information:

Ontario Ministry of Natural Resources


What is Tuberculosis?

Tuberculosis (TB) is an infectious disease caused by bacteria that are spread from person to person through the air. It usually affects the lungs, but can also affect other parts of the body, such the brain, the kidneys or the spine. Tuberculosis is preventable, treatable and curable.

There are 9 million new cases of TB disease in the world each year; 1,600 cases per year in Canada. In Ottawa, there are an average of 50 new cases of TB disease reported every year.

How is TB spread?

TB bacteria are released into the air when a person with TB disease of the lungs or throat coughs, sneezes, talks or sings. These bacteria can stay in the air for several hours, depending on the environment. A person who breathes in the air containing these bacteria can become infected; this is called TB infection.

What is TB infection?

TB infection is also known as Latent Tuberculosis Infection (LTBI). When a person has TB infection, the TB bacteria have entered the body, but are not growing and are dormant, or latent. The person is not sick and cannot spread TB to others. However, the person may develop TB disease in the future.

A tuberculin skin test is the only test for TB infection. Anyone with a positive skin test should have a chest x-ray and medical assessment to rule out TB disease. A person with TB infection can receive treatment to prevent TB disease.

What is BCG?

Bacille Calmette-Guérin (BCG) is a vaccine against TB disease. BCG is commonly used in countries where there is a high rate of TB, but it is not generally recommended in Canada. People who have been vaccinated can still become infected with TB and go on to develop TB disease. BCG vaccination is not a contraindication to tuberculin skin testing.

What is TB disease?

A person develops TB disease when their immune system cannot stop the TB bacteria from growing. This happens when a person is sick, stressed, not eating well or has other diseases such as cancer, diabetes or HIV/AIDS. A person can have pulmonary TB disease, which means the TB bacteria have infected the lungs, and they are able to spread the bacteria to others. They can also have TB disease in many other parts of the body such as the skin, kidneys, spine, brain or lymph nodes.

What are the symptoms of TB disease?

A person with TB disease may have the following symptoms:

  • Cough
  • Fever
  • Night sweats
  • Weight loss
  • Fatigue
  • Loss of appetite

How is TB disease treated?

Tuberculosis disease can be treated and cured. Treatment usually includes taking four different antibiotics for at least 6 months. These antibiotics must be taken every day to make sure that the person does not get sicker and to prevent the TB bacteria from becoming stronger or resistant to the medication. All TB drugs are provided by the Ministry of Health, through Ottawa Public Health, and are free.

What is Multi-Drug-Resistant Tuberculosis (MDR-TB)?

Multi-Drug-Resistant Tuberculosis occurs when the TB bacteria become resistant to some of the TB medications. This can happen if a person with TB infection or TB disease does not take their medication as directed by their physician.

What is extensively drug-resistant tuberculosis (XDR-TB)

Extensively drug-resistant tuberculosis (XDR-TB) is an uncommon type of MDR-TB that is not only resistant to the two most important drugs to fight TB, but is also resistant to two or more of the second-line drugs used to fight TB. This leaves fewer medications that can be used to treat persons with XDR-TB disease. XDR-TB is of special concern for persons with HIV infection or other conditions that can weaken the immune system. As with non drug-resistant TB, these persons are more likely to develop the disease once they are infected, and also have a higher risk of death if they develop the disease

Source: Public Health Agency of Canada

What is the role of Ottawa Public Health?

Public Health Nurses are involved in case management and follow-up of all cases of

TB disease until the patient's treatment is complete. In addition, when a person has been exposed to a case of infectious TB disease, a PHN will arrange for testing of contacts and appropriate medical follow-up.

What should I do if I think I may have TB?

Consult your health care provider immediately if you believe that you have tuberculosis or have been exposed to tuberculosis.


Health Canada

Ministry of Health and Long-Term Care

The Lung Association

Stop TB Canada

Centre for Disease Control (USA)

For further information, call Ottawa Public Health Information at 613-580-6744

West Nile virus

West Nile virus (WNV) is an infection spread by mosquitoes that - in a small number of cases - can cause serious illness.

  • Mosquitoes, especially those from the Culex genus, become infected after biting a bird with the virus.  WNV is originally a bird virus and while the most severely affected species are corvids such as ravens, crows and blue jays, some common bird species such as house sparrows, the common grackle and American robins are also important in amplifying the spread of WNV to bird-feeding mosquitoes.
  • The virus is spread to humans after being bitten by a mosquito infected with WNV.  Horses are also susceptible to WNV after being bitten by an infected mosquito.
  • Most people will not develop any symptoms if infected with WNV, but some may experience flu-like symptoms.  The risk for more serious illness from WNV increases with increasing age, with older adults and the elderly as well as people with weakened immune systems being at higher risk.  Symptoms may include:
    • Flu-like symptoms, including, but not limited to, fever, frontal headache, muscle aches and occasionally a skin rash;
    • Additional symptoms such as neck stiffness, muscle weakness, stupor, disorientation and coma.
  • It can take between three and 14 days before symptoms occur after being bitten by an infected mosquito.

How to protect yourself from mosquito bites

Reduce your chance of infection from vector borne illness by doing the following:

  • Apply an approved mosquito repellent to exposed skin and clothing.
  • Wear long pants, a long-sleeved shirt, shoes and socks to protect exposed skin.
  • Wear light coloured, tightly woven clothing - mosquitoes are attracted to darker colours and can still bite through thin clothing.
  • Avoid the hours between dusk and dawn - periods when mosquitoes are most active - and at any time in shady, wooded areas.  Take extra care to use repellent and protective clothing from dusk to dawn or consider avoiding outdoor activities during these times.
  • Make sure all windows and doors in your home have well-fitting screens that are in good condition.

Eliminate standing water sites around your home

Mosquitoes need water to breed.  Help eliminate mosquitoes around your property by reducing or eliminating areas or objects that can accumulate or retain water. 

Here are some suggestions:

  • Look around/outside your house for containers, receptacles and any other items that might collect water. Be sure to empty them regularly, turn them over when appropriate, or dispose of them accordingly. 
  • Drill holes in the bottom of recycling containers that are left outdoors so that water can drain out.
  • Clean clogged roof gutters; remove leaves and debris that may prevent drainage of rainwater.
  • Ensure all openings to rain barrels are covered with screen mesh at all times.
  • Turn over plastic wading pools and wheelbarrows when not in use.
  • Change the water in birdbaths at least once per week; aerate ornamental ponds or stock them with fish.
  • Keep swimming pools clean and properly chlorinated; remove standing water from pool covers.
  • Use landscaping to eliminate standing water that collects on your property.

Eastern equine encephalitis virus

  • Eastern equine encephalitis (EEEV) is a very rare, but serious, virus that has rendered one third of all those infected in coma and/or death.  A greater number of cases have resulted in  permanent mental and physical disabilities.
  • Similar to WNV, EEEV is spread by mosquitoes after feeding on birds infected with the virus.
  • The virus is most often identified in mosquitoes which inhabit hardwood swamps and bogs in rural and suburban areas.
  • Humans and several other types of mammals, particularly horses and lamas, can become infected, however they do not spread the disease.
  • There has never been a reported human case of EEEV in Ontario, however detection in mosquitoes and horses in 2009 signified the need for enhanced provincial surveillance.
  • The first symptoms of EEEV are high fever, stiff neck, headache, and lack of energy.  These symptoms appear three to ten days after a bite from an infected mosquito.  Encephalitis – the inflammation and swelling of the brain - is the most dangerous and frequent complication associated with the virus.  The disease gets worse quickly and some patients may go into a coma within a week.

WNV and EEEV Surveillance and Control Program

Ottawa Public Health has a control plan to reduce the risk of the West Nile virus and eastern equine encephalitis. It includes:

  • Public education on personal protection against mosquitoes;
  • Surveillance in the mosquito and human population;
  • Mosquito traps are placed around the City to determine species and densities of mosquitoes. Subsequent tests are carried out on a weekly basis for WNV and EEE;
  • Mosquito larvae surveillance of natural and manmade standing water sites located on City property is ongoing;
  • A biological larvicide (Bacillus thuringiensis subspecies israelensis - Bti) is used on surface waters (e.g., ditches, storm water management ponds) throughout the season and applied as needed.
  • A chemical larvicide (methoprene) is used to treat non-surface waters. Every City owned roadside storm sewer (catch basin) is treated a minimum of three times per season; 
  • Source reduction of mosquito breeding sites on City-owned property;
  • Mosquito control using adulticide (malathion) would only be used only in circumstances deemed absolutely necessary. Evidence of intense transmission in birds, and/or mosquitoes as well as human disease would be used to take this decision. While malathion has never been used in Ottawa, the decision to adulticide rests with the Medical Officer of Health and would depend on updated risk assessments.

Current Statistics: 10 October 2016

Human surveillance 

Cases in the human population of Ottawa

WNV (confirmed and probable) 2

Mosquito surveillance

# of mosquito pools
 tested for WNV to date this year 699
found positive with WNV 14
found positive with EEEV: 0

Application of larvicide

Approximately 110 000 City owned roadside catch basins are treated. Every catch basin is treated three times per year with a chemical larvicide - methoprene. Paint markings next to each catch basin indicate which treatment has been completed: Round 1= Blue, Round 2= Green, Round 3= Orange

Standing water sites - natural and manmade - are monitored weekly. Larvae tests are performed at each standing water site and a biological pesticide - Bti - is used only if needed.

  • The treatment of standing water sites is ongoing and performed as required.  To date, a total of 12.1 hectares has been treated. 

Dead bird surveillance and disposal

  • Effective 2009, Ontario will no longer be conducting a West Nile Virus dead bird surveillance program.  Surveillance of the virus is monitored in the mosquito and human population only.  If residents have noticed three or more dead crows, ravens, blue jays - or any birds of prey - in one particular area, please notify the Canadian Cooperative Wildlife Healthcare Centre (1-866-673-4781).

Disposal of dead birds

Dead birds are NOT to be thrown in the garbage (By-law No. 2006-300).

  • Bury the bird but not in a plastic bag
  • Do not touch the bird with bare hands
  • Use a shovel, a pair of heavy duty gloves, or a thick plastic bag to move the bird
  • Wash hands thoroughly with soap and water after burying dead bird

For more information on Ottawa Public Health's WNV surveillance and control program, call the Ottawa Public Health Information at 613-580-6744 (TTY: 613-580-9656) or email us at for more information. You can also connect with OPH on our Blog, Facebook and Twitter (@OttawaHealth) for the latest public health information.

Zika Virus

Zika is a disease caused by the Zika virus that is spread to people primarily through the bite of an infected Aedes species mosquito, the same mosquito that spreads the dengue and chikungunya viruses. The Aedes mosquito is not found in Canada. Symptoms associated with an infection caused by the Zika virus usually include fever, rash, conjunctivitis, and muscle pain. One out of four infected people develops symptoms of the disease, which are usually mild and can last 2 to 7 days.

How Zika virus is transmitted

Zika virus is transmitted to people primarily through the bite of an infected Aedes species mosquito. An infection in a pregnant woman could be transmitted to her baby through the placenta or during delivery.1

On rare occasions, the virus has also been transmitted through sexual contact with an infected person or a blood transfusion from infected donor.

Zika virus and pregnancy

Because of the uncertainty about the effects of the virus on the fetus during pregnancy, and the possible association with the birth defect microcephaly (baby born with a small head), the Public Health Agency of Canada (PHAC) has issued a travel advisory to Zika affected countries. PHAC recommends that:

  • Pregnant women and those considering becoming pregnant discuss their travel plans with their health care provider to assess their risk and consider postponing travel to areas where the Zika virus is circulating.
  • If travel cannot be postponed, strict mosquito bite prevention measures should be followed to protect themselves against bites.

Zika Questions

I have recently traveled to an area affected by the Zika virus and am feeling unwell – what should I do?

  • If you are a man, or a woman who is not pregnant, you can consult your family health care provider and inform them of your symptoms and your recent travel history
  • If you are a woman who is pregnant, we recommended that you speak with your family physician or nurse practitioner. ‎They will be able to assess your situation, decide if testing is necessary, and arrange any health care that may be needed. 

I have recently traveled to an area affected by the Zika virus and am planning on becoming pregnant soon – what should I do?

  • You should discuss your plan to become pregnant with your family health care provider and  inform them of your recent travel history

For further information on Zika virus, visit the following websites or call Ottawa Public Health at 613-580-6744 to speak to a Public Health Nurse:


1 Government of Canada: Zika Virus