Medical Advisory: New Disease of Public Health Significance – Candida auris

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).

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 the screening checklist in the resource section below) can help to identify clients, patients, or residents at increased risk of having an antibiotic resistant organism.

Action Required

C. auris must be reported to Hamilton Public Health Services Infectious Disease Program by faxing reports to 844-444-0295 (note: this is a temporary fax line).

• Report all confirmed cases of Candida auris infection to Hamilton Public Health Services no later than the next business day.
• Please review the updated list of diseases of public health significance by visiting www.hamilton.ca/infectiousdisease. Please note that there may be a small delay in updating this webpage.

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 suspected 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 occurs if:

• Evidence of transmission between patients is identified; OR
• An epidemiological link between patients is identified; OR
• The hospital/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.