PLAINS SPEAK on STBBIs, 2019: An emergent challenge for the Prairies

PLAINS SPEAK on STBBIs, 2019: An emergent challenge for the Prairies

Winnipeg, MB March 14th and 15th, 2019

Sexually transmitted and blood borne infection (STBBI) rates—including syphilis, gonorrhea, HBV, HCV, and HIV—are rapidly increasing in the Prairie provinces. Public health professionals are struggling to set programmatic priorities and identify the best interventions to suit the epidemiological context to decrease the burden of infections. Currently in the Prairies, individuals affected by STBBIs frequently present with co-infections and become re-infected. Infections are increasingly associated with challenging circumstances, including unstable housing and substance use, which contribute to onward transmission and complicate public health management.

The National Collaborating Centre for Infectious Diseases, with the support of the National Collaborating Centre for Aboriginal Health, hosted a gathering to provide a platform for knowledge exchange regarding successful programming and interventions for STBBI prevention and response within the Prairie context. This forum brought together public health specialists from the Prairie Provinces, British Columbia, and northern Ontario including practitioners, managers, program coordinators, epidemiologists, researchers, policy makers, community-based partners and knowledge brokers.


  1. To share knowledge of the current drivers, determinants, and trends of STBBIs in the Prairies.
  2. To share and explore features of successful STBBI responses.
  3. To explore interventions to decrease STBBI transmission in people who are disadvantaged by social and structural factors such as addiction and poverty.
  4. To spark discussions towards essential elements for building sustainable public health infrastructure to prevent and rapidly respond to STBBIs.

Plains Speak on STBBIs, 2019: An emergent challenge for the Prairies Meeting Proceedings are available under Publications.

ASP FOUNDATIONS FORUM: An Exchange on UTI Strategies in Long Term Care

WEBINAR  | ASP FOUNDATIONS FORUM: An Exchange on UTI Strategies in Long Term Care

WED, April 18, 2018

An archived copy of this webinar is available upon request. Please email


The National Collaborating Centre for Infectious Diseases (NCCID), in collaboration with Do Bugs Need Drugs? and other national experts, presents the third event in the webinar series: Promising Strategies for Stewardship in Long Term Care.

This webinar continues to expand on the theme of building a foundation to establish antimicrobial stewardship programs (ASPs) in long term care, and to identify promising implementation strategies.

Appropriate testing, diagnosis and treatment of urinary tract infections, which are confounded by the significant prevalence of asymptomatic bacteriuria in aged care settings, remain a priority and challenge for stewardship program leads, as participants in past webinars have attested. This webinar brings several perspectives to bear on stewardship strategies for UTIs, beginning with a presentation by Public Health Ontario on the development of a UTI program with 10 LTC homes in the province.

The speakers explain how implementation science methods contributed to their success and unpack the key strategies required to support implementation of the UTI program. Speakers also share promising results from a pilot evaluation, which demonstrated declines in both rates of urine culturing and antibiotic use in participating LTC homes. The webinar addresses the interests of LTC stewardship leaders in ways to systematize changes in practice and scale up UTI stewardship programs.

Invited discussants, including leads on AMMI Canada’s “Symptom Free Pee” campaign and Alberta’s Do Bugs Need Drugs? Program, among others, help participants reflect on different evidence-informed strategies, transferable lessons from Ontario and other jurisdictions, and what early or essential steps in UTI stewardship look like. An open Q&A session follows, inviting broader engagement by members of this emerging community of practice.

Learning Objectives

At this webinar, participants…

  • Learn about the implementation science method used to develop this UTI program
  • Gain understanding of lessons that can be drawn from evaluation results
  • Consider examples of key strategies for implementation of a UTI program
  • Gain lessons for overcoming barriers to change in practice and systematizing appropriate practice
  • Consider lessons from other jurisdictions on where to start and how to scale up stewardship programs.





Six Features for Success: Stewardship Programs in LTC

WEBINAR | Six Features for Success: Stewardship Programs in LTC

November 29, 2017

The National Collaborating Centre for Infectious Diseases (NCCID), in collaboration with Do Bugs Need Drugs? and other national experts, was pleased to offer a second webinar—Six Features for Success—in the series,”Promising Strategy for Stewardship in Long Term Care.”

This webinar featured Sandra Leung, pharmacy lead for antibiotic utilization and stewardship programs (ASPs) in long term care in the Edmonton area for over 20 years, and Mary Carson, former program coordinator for the Do Bugs Need Drugs antimicrobial stewardship program. The speakers shared lessons learned from antimicrobial stewardship pilots at Alberta Health Services and describe the six key features of successful ASPs in long term care settings. Tools and strategies that might be helpful in establishing ASPs and sustaining practice improvements in other jurisdictions were discussed.


Sandra Leung has been involved with antimicrobial stewardship programs (ASPs) in continuing care since the late 1990s. She participated in the development of Alberta Toward Optimized Practice Urinary Tract Infection and Nursing Home Acquired Pneumonia clinical practice guidelines and checklists, and has been involved clinically as a frontline pharmacist, promoting and leading development of the strategies in the implementation of ASPs. She is currently the Pharmacy Manager for Continuing Care in Edmonton for Alberta Health Services, and the co-chair of the Edmonton Zone Continuing Care Antimicrobial Stewardship Working Group.

Mary Carson was the Program Coordinator for the Do Bugs Need Drugs antimicrobial stewardship program from 1997 until retirement in 2016. Mary worked closely with Toward Optimized Practice of the Alberta Medical Association in the development of clinical practice guidelines and clinical checklists for nursing home acquired pneumonia and urinary tract infections in long term care. With Sandra Leung she co-chaired the Edmonton Zone Continuing Care Antimicrobial Stewardship Working Group and was an active participant in national antimicrobial stewardship working groups since 2005. With over 30 years experience in public health research and education she has a keen interest promoting health-wise behaviours in the community.

Antimicrobial Stewardship (AMS) in Atlantic Canada

WEBINAR / Antimicrobial Stewardship (AMS) in Atlantic Canada

OCTOBER 12, 2017

The Public Health Agency of Canada, with support from the National Collaborating Centre for Infectious Diseases, hosted this webinar on Antimicrobial Stewardship (AMS), and how to advance AMS in the Atlantic.  This session built on the previous collaborative efforts to create an Atlantic AMS community that began in June at an inaugural face-to-face meeting in Halifax. The session was open to all interested in AMS in Atlantic Canada (academia, community/tertiary care hospitals, non-profit organizations).


Dr. Emily Black of the Dalhousie University, College of Pharmacy, provided an overview of a recent point prevalence study conducted in Nova Scotia (in press). The objective of this study was to determine prevalence and characterize antimicrobial use at acute care hospitals in Nova Scotia. Results and targets for quality improvement will be discussed.

Dr. Paul Bonnar of the Nova Scotia Health Authority moderated and lead a brief discussion on next steps for the Atlantic AMS community.

An archived version of this webinar is now available for viewing. Please email Margaret Haworth-Brockman, NCCID Senior Program Manager, for access.

Knowledge Translation on Infectious Diseases for Public Health

WEBINAR / Knowledge Translation on Infectious Diseases for Public Health: Exploring NCCID’s resources

APRIL 10, 2017

Presenter: Margaret Haworth-Brockman, Senior Program Manager, NCCID

This webinar was tailored for Public Health Agency of Canada public health officers (Canadian Public Health Service), field epidemiologists (Canadian Field Epidemiology Program), senior epidemiologists in the Field Services Training Unit, Managers and Regional Coordinators.

The webinar has three main goals:

  1. to describe the mandate and work of NCCID and the other NCCs
  2. to explore some of the tools and resources available on the NCCID website
  3. to encourage discussion on how NCCID resources can be helpful to PHAC field staff and managers

Webinar participants were able to explore interactively some of NCCID’s tools, including the Notifiable Diseases Database (NDDB), the Outbreak Management tool, the Environmental scan on Emerging Diseases Policies and Diseases Debriefs, in addition to learn more about our Alerts, publications and webcasts.

An archived version of this webinar is now available for viewing. Please email Margaret Haworth-Brockman, NCCID Senior Program Manager, for access.

An overview of the current Interim Federal Health Program (IFHP) in Canada

WEBINAR | An overview of the current Interim Federal Health Program (IFHP) in Canada

October 5, 2017

This webinar offered an overview to service providers and policy makers of the current Interim Federal Health Program (IFHP), coverage offered to various refugee streams in Canada. Professor Y.Y. Brandon Chen and Ms. Siffan Rahman discussed in detail the beneficiaries and coverage, the recent changes to the program, registration and reimbursement process for service providers and ongoing challenges and gaps of the IFHP. They also discussed some key findings and recommendations from their respective studies on the current practices of the IFHP.

An archived version of this webinar is now available for viewing. Please email S.M. Zeeshan Qadar at, for access.


Y.Y. Brandon Chen is an Assistant Professor at the University of Ottawa’s Faculty of Law, Common Law Section. He holds Master of Social Work and Juris Doctor degrees from the University of Toronto, and is currently a Doctor of Juridical Science candidate at the same university. His research program focuses on the examination of health inequities facing marginalized populations, particularly noncitizens and racialized minorities. His published work has touched on such topics as health rights litigation, refugee health care, social determinant of health, and medical tourism. Between 2009 and 2011, Y.Y. was publicly appointed to the Ontario Advisory Committee on HIV/AIDS. He served as the Co-Chair of the Committee for Accessible AIDS Treatment from 2014 to 2016. He is currently a Board member of the Canadian Centre on Statelessness.

Siffan Rahman is a Program Manager at Somerset West Community Health Centre who oversees the activities of the Ottawa Newcomer Health Centre, which serves and advocates for immigrants and refugees in different capacities. She sits on the Ottawa Local Immigration Partnership’s Health and Wellbeing Sector Table and co-chairs a working group striving to increase access to mental health services for immigrants and refugees. Siffan is a member of the Board of Directors of the Canadian Association of Community Health Centres and co-chairs its Newcomer Health working group. She also sits on the advisory committee of Connecting Ottawa. Siffan has a B.Sc. in Psychology and is currently enrolled in the Masters of Health Administration program at University of Ottawa.

Note: Funding for the series was provided by the Public Health Agency of Canada. The opinions expressed are those of the speaker(s) and do not necessarily reflect the official views of the Public Health Agency of Canada or NCCID.

Building Bridges: Creating Sustainability in the Newcomer Health Clinic through Planned Transitions to Community Providers

Building Bridges: Creating Sustainability in the Newcomer Health Clinic through Planned Transitions to Community Providers

September 19, 2017


The National Collaborating Centre for Infectious Diseases (NCCID) continues its series of public health podcasts and webinars on refugee health. This time our webinar will offer an overview of the Newcomer Health Clinic practice under Nova Scotia Health Authority (NHSA). This will include the model of care, patient readiness and screening procedures devised by the transitional newcomer health clinic. Ms. Ashley Sharpe and Dr. Tim Holland will discuss in detail the transition model developed to move patients from our specialized refugee health clinic to community primary care providers. This will include a discussion regarding current research to validate the model with some preliminary results.

For an archived version of this webinar, contact Zeeshan Qadar via


Ashley Sharpe

Ashley is a registered nurse and health services lead in Primary Heath Care, Nova Scotia Health Authority. She supports collaborative family practices, including the Newcomer Health Clinic, which serves refugee populations in Halifax, Nova Scotia and area. From 2012-2015 she worked with displaced populations and others as a nurse with Médecins Sans Frontières/Doctors Without Borders in several different countries. This passion led her first to the nurse position at the Newcomer Health Clinic in 2015 when it opened under the banner of Nova Scotia Health Authority, before moving on to a health services lead position. As Newcomer Health Clinic nurse, her work included clinical care as well as planning for the 2016 Syrian Refugee influx as well as developing and implementing the transition model for the clinic.

Dr. Tim Holland

After completing a degree in philosophy and psychology, Tim Holland began study at Dalhousie medical school in 2007. His interest in Refugee Health began during his Family Medicine Residency in Halifax. Shortly after completing his residency, he began work with the Immigration Services Association of Nova Scotia and the Halifax Refugee Clinic to found a health clinic for refugees in Halifax. The Newcomer Health Clinic opened its doors to Refugees in May of 2014 (previously known as the Transitional Health Clinic for Refugees). Since that time, he has continued to be a physician lead for this clinic, which included overseeing the historic arrival of the Syrian Refugee Influx of 2016. He is also a member of the Steering Committee for Canadian Clinicians for Refugee Care.

Aside from his work at the Newcomer Health Clinic, Dr. Holland is also the Chair of Ethics for the Canadian Medical Association, Chair of the Policy and Health Issues Committee for Doctors Nova Scotia and President-Elect of Doctors Nova Scotia. Aside from these “extra-curricular” pursuits, Dr. Holland splits his clinical time between Emergency Medicine and Family Medicine. He currently divides clinical time equally between Emergency Medicine in Truro, Nova Scotia and Family Medicine. Dr. Holland’s family medicine time is equally divided between Refugee Health (at the Newcomer Health Clinic in Halifax) and First Nations health (at the Sipekne’katik Health Center in Indian brook, Nova Scotia).

Funding for the series was provided by the Public Health Agency of Canada. The opinions expressed are those of the speaker(s) and do not necessarily reflect the official views of the Public Health Agency of Canada or the host organization, National Collaborating Centre for Infectious Disease (NCCID).

Atlantic Health Organizations Meet to Address Antimicrobial Stewardship in Halifax

For immediate release

Atlantic Health Organizations Meet to Address Antimicrobial Stewardship in Halifax

June 8, 2017 (Halifax) – The National Collaborating Centre for Infectious Diseases (NCCID) and the Public Health Agency of Canada are pleased to greet representatives from across the Atlantic provinces today to discuss strategies for improving the use of antimicrobials such as antibiotics.

Physicians, pharmacists and public health staff will share information on successes and challenges in ensuring appropriate use of antibiotics and helping to reduce resistance to life-saving treatments. “We are really pleased to be part of the growing interest and momentum in effective and appropriate use of antimicrobials,” said Yoav Keynan, co-Scientific Director at the NCCID. “This event builds upon work we have been engaged in across the country for over a year. The Atlantic Region in particular has a strong role to play in leading the way for other parts of Canada.”

Antimicrobial resistance has been in the news more and more and is considered a significant threat to human health by the World Health Organization. It has been estimated that by 2050, annual deaths due to AMR could reach 10 million worldwide, overtaking deaths due to diabetes and cancer combined. And AMR is not just a human health threat; it is a complex issue that has animal, agricultural, environmental and economic implications.

Antimicrobial stewardship involves systems-wide organization and approaches to monitoring the most effective use of antimicrobials drugs, and promoting their appropriate use according to national and international guidelines. It is one of four pillars of the Government of Canada’s Federal Framework for Action on AMR, which identifies AMS as conserving the effectiveness of existing treatments through infection prevention and control guidelines, education and awareness, regulations, and oversight.

“The groundwork has been laid and there is considerable expertise in this country. Now our task is to reinforce and support AMS programs locally so that patients, practitioners and policy-makers are committed and involved”, said Margaret Haworth-Brockman, Senior Program Manager at the NCCID.

For more information on AMR and AMS, and to find additional resources, please contact NCCID at or 1-204-318-2591.

What can Big Data do for Public Health?

WEBINAR / What can Big Data do for Public Health?

MAY 17, 2017

New information was presented on the potential contributions of big data for infectious diseases surveillance and the investigation of foodborne outbreaks in Canada. Recognizing the potential for big data as a resource for public health planning and decision-making, NCCID commissioned a summary of evidence with the objectives of:

  1. Understanding big data resources related to infectious diseases surveillance;
  2. Exploring options and challenges in visualizing and analyzing the resulting information; and
  3. Highlighting examples of how big data have been applied to foodborne illnesses.

In this presentation, Dr. Cheryl Waldner, DVM, PhD (University of Saskatchewan) gave an overview of big data, its opportunities and limitations for public health, and describe examples related to foodborne illnesses.

An archived version of this webinar is now available for viewing. Please email Margaret Haworth-Brockman, NCCID Senior Program Manager, for access.

Antimicrobial Stewardship in Long Term / Elder Care

WEBINAR | Antimicrobial Stewardship in Long Term / Elder Care: The Case To Act, A Call To Leaders

Presented by: The National Collaborating Centre for Infectious Diseases (NCCID) and Do Bugs Need Drugs? Alberta Health Services

MARCH 9, 2017

An archived version of this webinar is now available for viewing. Please email Harpa Isfeld-Kiely, NCCID Senior Project Manager, for access.

This March 9, 2017 webinar was developed for senior leaders, decision makers and innovators in long term care—administrators, medical directors, directors of care, or program managers—in provincial, private or voluntary sector organizations. Leads were asked to invite key staff who implement antimicrobial stewardship programs (e.g. infection prevention and control specialists, or nurse practitioners).


The emergence of antimicrobial resistant (AMR) microorganisms in care facilities and their spread into the community places patients at risk and contributes to a major public health challenge. To respond effectively, leaders require knowledge of the challenges and opportunities to take action.

The first in a series, this webinar invited leaders and decision makers in long term care to consider the evidence for AMR harms, leading practices relevant to LTC settings, and their own role in initiating and advancing antimicrobial stewardship programs. Key findings on common diagnoses in LTC for which antibiotics are prescribed, as well as campaigns and initiatives designed to address inappropriate prescribing and use of antimicrobials were presented. Future webinars will provide implementers with information on how to begin stewardship programs in LTC.

Featured speakers included Dr. John Conly, one of Canada’s foremost experts on antimicrobial resistance and stewardship programs. As well, other innovators in antimicrobial stewardship initiatives, Dr. Victor Leung and Dr. Gregory German, provided examples based on their work relevant to long term / elder care in Pacific and Atlantic regions, respectively.

The webinar included a live Q&A with the presenters. Participants had an opportunity to comment on challenges to implementing AMS programs, information needs of leaders and their teams, and their interest in a national network to help identify and spread leading practices in AMS for long term care settings.

About our Presenters

Dr. John Conly, Foothills Medical Centre, AB

John Conly MD is trained in internal medicine and infectious disease and is a Professor of Medicine at the University of Calgary. He currently serves as a member of the WHO Advisory Group on Integrated Antimicrobial Surveillance and the PHAC Expert Advisory Group on Antimicrobial Resistance. He was a past Chairman of the Board for the Canadian Committee on Antibiotic Resistance and previous Vice-Chair for the Canadian Expert Drug Advisory Committee. He has published over 300 papers and has received numerous career honours for clinical service, mentorship, teaching, research, and innovation.

Dr. Greg German, Queen Elizabeth Hospital, PEI

Greg German is the Medical Microbiologist and infectious disease consultant for P.E.I. He is the medical lead of Health PEI antibiotic stewardship efforts. Nationally, Greg serves on several AMR working groups, including co-chair for the antimicrobial resistance working group of the Canadian Public Health Laboratory Network. He co-developed and actively champions a program targeting LTC and UTI diagnostics that was created by the Association of Medical Microbiology and Infectious Disease Canada. In 2015 the Medical Society for P.E.I. awarded him the President’s Leadership award for his infection and antibiotic expertise.

Dr. Victor Leung, Providence Health Centre, BC

Victor Leung completed fellowships in Infectious Diseases and Medical Microbiology at McGill University.  He is currently the Medical Director for Infection Prevention and Control, and the Medical Lead for the Antimicrobial Stewardship Program at Providence Health Care in BC.  He is interested in implementing interventions to prevent nosocomial infections and optimize antimicrobial use.  He also wants to improve efficiency of surveillance systems for nosocomial infections.

Moderator: Simon Habegger, Alberta Health Services (AHS)

Simon leads Do Bugs Need Drugs?, a community education program on Antimicrobial Stewardship at AHS. He and his colleagues build on a twenty year history of stewardship program development in the province that has seen particular success working with long-term care administrators. Simon holds degrees in Biological Anthropology and International Health. He has worked as an educator in college-level nursing and science programs, as well as a coordinator with other community education outreach programs (HIV Edmonton, Canadian Diabetes Association).

Communicating the Risk of Infectious Diseases in a Changing Climate

Communicating the Risk of Infectious Diseases in a Changing Climate

Presented by: National Collaborating Centre for Infectious Diseases (NCCID) and National Collaborating Centre for Environmental Health (NCCEH)

WEBINAR / 8 March 2017

An archived version of this webinar is now available for viewing. Please email NCCID’s Elnaz Shadabi for access.

What means are available to public health practitioners for effectively communicating the risk of infectious diseases to the public? When a new outbreak emerges, how can public health convey facts and risks accurately to the public and to policy makers? How are risks interpreted by various audiences?

These are examples of some of the questions that public health professionals may grapple with during a new infectious disease outbreak or re-emergence of an existing one. To ensure that both the public and policy makers receive the most accurate information, the means and methods of communication utilized by healthcare providers must be effective. This March 8, 2017 webinar provided different perspectives on communicating risk in an “environment” of change: the intersection of climate change and infectious disease emergence and resurgence. The webinar had two main goals: to present a range of perspectives on good communication about risk for public health stakeholders; and, to allow for discussion on communication for public health, using examples that relate to emerging and resurging infectious diseases in the context of changing climate.

Moderator and Presenters

Dr. Christine Navarro has been an Associate Medical Officer of Health with Toronto Public Health since August 2014. While training as an epidemiologist, she worked with the Public Health Agency of Canada before getting her medical degree. Christine completed her specialty training in Public Health and Preventive Medicine at the University of Toronto in 2014. Her portfolio at Toronto Public Health focuses on Environmental Health.

Dr. Craig Stephen is a veterinary epidemiologist, professor in the Department of Veterinary Microbiology at the University of Saskatchewan, and clinical professor at the School of Population and Public Health at the University of British Columbia. He is the CEO of the Canadian Wildlife Health Cooperative. He has worked in Canada and internationally on ecohealth approaches to emerging infectious diseases.

Dr. Anne-Marie Nicol is a knowledge translation scientist at the National Collaborating Centre for Environmental Health. She holds a PhD in Epidemiology from UBC and a Masters of Environmental Studies from York University. Her area of research is risk communication and perception and the roles they play in risk management, particularly in public health. She also teaches health communication, as well as human health risk assessment, at Simon Fraser University as an Associate Professor.

Dr. Negar Elmieh is an interdisciplinary researcher who applies both quantitative and qualitative methods to complex health, environment, risk and policy issues. She will share lessons learned from past zoonotic outbreaks on how we can best communicate new threats and balance risk from infection versus potential interventions.