Health Professionals Update - Vol. 18, No. 28

From
Nicholas Brandon, MD, MA, MSc, CCFP, FRCPC 
Associate Medical Officer of Health

In this issue

• Update: Critically low stock of rabies immunoglobulin and vaccine now stabilizing.
• Update: Measles outbreak in Ontario has been officially declared over.

Key message

• Rabies immunoglobulin and vaccine stock for post-exposure prophylaxis is stabilizing within the province.
• Peel Public Health will return to delivering all vaccine doses at one time for the entire series (except in extenuating circumstances).
• Prior to requesting rabies post-exposure prophylaxis (PEP), physicians must contact Peel Public Health to discuss risk assessments and to determine whether PEP is warranted.
• Physicians can contact Peel Public Health at 905-799-7700. A Public Health Inspector is available 24/7 to receive reports of potential animal exposures. An Associate Medical Officer of Health is also available for consultations, as required.

Update: Critically low stock of rabies immunoglobulin and vaccine now stabilizing

Peel Public Health was notified in August 2025 that there was a critically low stock of rabies immunoglobulin and vaccine within the province. There has been a series of shortages in 2025. This stock of immunoglobulin and vaccine is now starting to stabilize and Peel Public Health can move back to delivering the full course of vaccine for post-exposure prophylaxis in a single delivery. Rabies vaccine stock will continue to be monitored.

Rabies is a disease of public health significance (O. Reg 135). Rabies is a virus transmitted through the saliva of infected mammals by bites, scratches or contact with mucous membranes (e.g., mouth, nose, eyes). Rabies post-exposure vaccine consists of 4 doses (Days 0, 3, 7, and 14). For individuals who have not been previously immunized against rabies, rabies immunoglobulin is usually also administered on Day 0.

NOTE: All animal exposures or bites which can transmit rabies must be reported to the patient's local public health unit as required under the Health Protection and Promotion Actand Ontario Regulation 557.  Physicians can contact Peel Public Health at 905-799-7700. Public Health will do a risk assessment and help determine whether post-exposure prophylaxis is warranted. Exposures to domestic pets such as cats, dogs, and ferrets may not be considered high-risk and may not warrant rabies vaccine; especially if the animal can be isolated for observation over a 10-day period.

Measles outbreak in Ontario officially declared over

Thanks to the collaborative efforts of all system partners, the Ontario measles outbreak has been declared over, effective October 6, 2025. At this time, the outbreak immunization strategy used by highly impacted public health units will also end, and the routine immunization schedule should be followed across the province.

More information

• Ministry of Health Management of Potential Rabies Exposures Guideline, 2020
• Peel Public Health - Health Professionals Update - Vol. 18, No. 20
• Peel Public Health - Health Professionals Update - January 21, 2025
• Peel Public Health - Health Professionals Update - September 6, 2024

Contact us

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