BOARD OF HEALTH

A G E N D A

Date of Meeting:Tuesday, October 13, 1998Enquiry:Christine Archibald

Metro Hall, 55 John Street,carchiba@city.toronto.

Torontoon.ca

DECLARATIONS OF INTEREST PURSUANT TO THE MUNICIPAL CONFLICT OF INTEREST ACT

CONFIRMATION OF MINUTES OF MEETING HELD ON SEPTEMBER 15, 1998

PRESENTATIONS

1.2:10 pmCYCLOSPORA OUTBREAK IN SPRING 1998

Presentation by Dr. Barbara Yaffe, Associate Medical Officer of Health and Director of Communicable Disease Control

Medical Officer of Health

(October 1, 1998)

Recommending that:

(1)The Ontario Minister of Health make cyclosporiasis a reportable disease in Ontario;

(2)the Federal Minister of Health make cyclosporiasis a reportable disease in Canada and put in place mechanisms for active surveillance of important foodborne diseases such as cyclosporiasis;

(3)the Ontario Minister of Health recommend that laboratories in Ontario routinely test for cyclospora oocysts in stool specimens submitted for ova and parasites;

(4)Toronto Public Health continue to increase awareness and knowledge about foodborne illnesses by providing relevant and timely information to health care providers and the public;

(5)Health Canada, in conjunction with Agriculture and AgriFood Canada (AAFC) and the Canadian Food Inspection Agency (CFIA), conduct further basic and applied research on the biology and epidemiology of cyclospora, e.g. mechanisms by which contamination occurs, effectiveness of control measures during high produce production periods;

(6)Health Canada and the CFIA develop a coordinated approach to the development of policies regarding importation of fresh produce which includes:

(a)a more vigilant and rigorous approach, erring on the side of public health and safety;

(b)comprehensive risk assessment, including review of relevant international epidemiological data and studies conducted by other health agencies; and

(c)work in partnership with the U.S. as appropriate;

(7)Toronto Public Health continue to actively participate in discussions re the spring 1999 policy for Guatemalan raspberry importation, and take the position that there should be a restriction on these imports until:

(a)further information is available from Guatemala on the farm tracebacks from the 1996, 1997 and 1998 outbreaks;

(b)more is known about the mechanism of contamination with cyclospora; and

(c)there is independent audit evidence of compliance by individual farm with the Model Plan of Excellence (MPE);

(8)the Board of Health express support for and interest in participation in the development of a coordinated and coherent foodborne outbreak investigation protocol at the federal level by Health Canada, AAFC and the CFIA, in consultation with health and agricultural authorities at the provincial and municipal levels;

(9)CFIA ensure that their inspectors receive training in doing comprehensive food traceback investigations as per the Centers for Disease Control & Prevention (CDC) protocol;

(10)the Ontario Minister of Health provide increased funding for the Public Health Branch to provide strong support and coordination in multi-regional and province-wide outbreaks;

(11)the Ontario Minister of Health provide continued funding for the Central Public Health Laboratory to enhance research and investigative abilities re foodborne pathogens and provide opportunities to liaise with international counterparts;

(12)the Ontario Minister of Agriculture, Food and Rural Affairs invite a municipal public health representative to join the newly-formed Steering Committee to develop a Food Safety Strategy for Ontario;

(13)Health Canada and the CFIA amend federal health protection legislation with respect to potential foodborne illnesses to permit them to take health protective actions based on "reasonable and probable grounds" and afford protection from personal liability for any act "done in good faith" (i.e. similar to the Ontario Health Protection & Promotion Act);

(14)Health Canada, in consultation with the CFIA, conduct an investigation to establish the mode of cyclospora contamination in raspberries;

(15)the CFIA examine the feasibility of requiring the implementation of preventive and control measures such as those contained in the MPE to all imported and domestically grown produce (based on the fact that such measures are not specific to raspberries or cyclospora and would contribute to the overall minimization of the risk of contamination of other food-borne pathogens);

(16)the CFIA consult with stakeholders including the general public, and health and environment agencies at the local, provincial and federal level to develop the position paper on the development of a Code of Practice for the production, harvesting and packaging of fresh fruits and vegetables for the CODEX Alimentarius Commission;

(17)the Medical Officer of Health review the health and environmental impacts of available food treatment technologies and assess their effectiveness in eliminating foodborne pathogens;

(18)the federal Minister of Agriculture and Agrifood and the provincial Minister of Agriculture, Food and Rural Affairs amend the Canadian Agricultural Products Act, the Consumer Packaging and Labelling Act, and the Ontario Farm Products Grade and Sales Act regarding country of origin labelling for all fresh and cooked fruits and vegetables sold at wholesale, retail or in clerk-served operations to ensure consumers can always acquire information about the origins of the food they are consuming. In making these amendments, the federal and provincial ministers should ensure that their respective amendments cover all possible purchasing scenarios; and

(19)the federal Minister of Agriculture and Agrifood and the provincial Minister of Agriculture, Food and Rural Affairs increase the number of staff available to do enforcement work, particularly concerning country-of-origin labelling at retail to the public.

2.ISSUES RELATED TO THE 1999 BUDGET

Presentation by Medical Officer of Health

(Report from Medical Officer of Health not yet available)

COMMUNICATION REPORTS

3.AIDS PREVENTION PROGRAM UPDATE AND STATUS OF PROVINCIAL FUNDING

Medical Officer of Health

(September 28, 1998)

Recommending:

(1)That the Board of Health advocate to the Minister of Health to establish funding for condom distribution and education through AIDS service organizations, health units and other organizations with significant HIV prevention programs throughout Ontario;

(2)that the Board of Health advocate to the Minister of Health to maintain on-going 100 percent funding at the current level for the AIDS Sexual Health InfoLine (AIDS Hotline);

(3)that the Board of Health advocate to the Minister of Health to establish on-going 100 percent funding at the current level for the Sex Information and Education Council of Canada and Planned Parenthood Ontario; and

(4)that the Board of Health request the Minister of Health to re-affirm the Province's long-term commitment to funding for community-based HIV prevention programs and services, including its newly established funding for the emerging issue of injection drug use as an AIDS risk behaviour; and further to integrate needle-exchange into the new injection drug use projects.

4.PROPOSED FEDERAL TOBACCO LEGISLATION: THE TOBACCO INDUSTRY RESPONSIBILITY ACT (BILL S-13)

Medical Officer of Health

(September 25, 1998)

Recommending:

(1)That the Board of Health endorse Bill S-13, The Tobacco Industry Responsibility Act and express its support to Senator Colin Kenny, sponsor of the Bill, the Prime Minister, the Minister of Health, the Minister of Finance, all members of Parliament for the Greater Toronto Area (GTA), and all members of the Commons Standing Committee on Health;

(2)that the Medical Officer of Health submit a brief on the proposed Federal Tobacco Legislation (Bill S-13) on behalf of the Toronto Board of Health to the Standing Committee on Health; and

(3)that the Board of Health forward this report and its recommendations to all Boards of Health in Ontario, recommending that they support The Tobacco Industry Responsibility Act.

5.DOMESTIC PET PUBLIC EDUCATION PROGRAMS

Medical Officer of Health

(September 29, 1998)

Recommending that:

(1)The Board of Health receive this report for information; and

(2)Toronto Animal Services continue to provide the current level of service with respect to domestic pet public education programs pending a review and resolution of related amalgamation issues.

6.REINVESTMENT OF ANIMAL LICENSING AND REGISTRATION FEES

Medical Officer of Health

(September 28, 1998)

Recommending that:

(1)Toronto Animal Services continue to provide the current level of service with respect to reinvestment of animal licensing and registration fees pending a review and resolution of related amalgamation issues;

(2)the Board of Health recommend to Budget Committee that current licensing revenues continue to be utilized to defray operating expenses; and

(3)any additional licensing and registration revenues be used to fund proactive program initiatives, subject to the review and resolution of these and other amalgamation-related issues.

7.TORONTO ROUNDTABLE ON PROSTITUTION INVOLVING CHILDREN AND YOUTH

Medical Officer of Health

(September 28, 1998)

Recommending:

(1)That the Board of Health receive the report "Toronto Roundtable on Prostitution Involving Children and Youth" for information;

(2)that this report be referred for information to the Child Advocate and to the Task Force on Community Safety; and

(3)that the following recommendation regarding business licencing be referred to the Commissioner of Urban Planning & Development for consideration during the harmonization of licensing by-laws.

"that Toronto City Council consider making changes to Metro licensing by-laws to eliminate the practice of involving children and youth in prostitution in settings such as massage parlours, escort services, bath houses, and adult entertainment establishments."

8.PUBLIC HEALTH GRANTS

(Report from Medical Officer of Health not yet available)