Primary Care Alberta Clinical Updates
Measles update for health care providers and staff 
The following contains information about important changes to measles case reporting, effective immediately, as well as information on how to appropriately transport lab samples.

*New* Reporting Process for Measles Cases
Please note that the reporting process for measles has changed. Primary care providers should no longer report cases to their Zone Medical Officer of Health. Effective immediately, please use the following process:

All suspected, probable and confirmed cases of measles (from in-person/virtual assessments) must be reported immediately by calling 1-844-343-0971. 

You will be prompted to press 1 if you are reporting a measles case. You will be asked to leave the following information: 
  • Your first and last name and the best number to reach you at. 
  • The patient’s first and last name, date of birth, healthcare number, onset date of symptoms, what symptoms the patient is experiencing, what tests have been ordered and any known links to measles cases including travel. 
  • You will get a call back to collect any missing information if needed between 8 a.m. and 10 p.m., seven days a week.  
Please advise the patient to isolate in their home until they are called with the results of their tests and that they may also receive a call from public health.  
Primary Care Providers can still reach out to their Zone Medical Officer of Health with questions or concerns about measles at the following numbers: 
  • Calgary Zone: 403-264-5615 
  • Central Zone: 403-356-6430 
  • Edmonton Zone: 780-433-3940 
  • North Zone: 1-800-732-8981 
  • South Zone: 403-388-6111 (will need to ask to page MOH) 
  • For those living in a First Nations community: ISC MOH: 780-218-9929 
Note that the following resources have been updated to reflect the new reporting process change: 

Lab Reminder - Appropriate collection and transport of lab samples 
The laboratory diagnosis of measles is critically dependent upon the collection of the right sample(s) sent in the correct transport medium or container, otherwise the sample will be rejected for testing, or the test result will be inaccurate. 

The following are the appropriate samples and transport medium for collection: 

  • Throat and nasopharyngeal swabs MUST be sent in Viral/Universal Transport medium (pink fluid with red cap), the same transport medium as used for influenza and SARS-CoV-2 testing. Do NOT use e-swabs or Reagan-Lowe transport medium.
  • Urine, at least 5 to 10 mL, in a sterile container. Do not use vacutainers or containers with preservatives. 
  • Blood collected in Gold top Vacutainers (SST).

For further information go to: 

If you are sending someone to lab for specimen collection, please call and book ahead with the APL Patient Appointment Line 1-877-702-4486.

New measles resources for Low German speakers
AHS has released a video in Low German giving information on measles. It includes messaging on symptoms, prevention and what to do if you’re exposed. 

To assist in conversations about measles with the Low German-speaking Mennonite community, the Public Health Agency of Canada has prepared a one-pager giving general information on measles, vaccination and exposure processes.

Reminder: Measles resources  
As measles case numbers continue to increase in Alberta, primary care teams are reminded of the following key resources. Note: Measles resources are constantly being updated – please watch for new updates. 

Lab bulletin: New urine cytopathology test requirements 
Urine cytopathology (cytology) is no longer recommended in the initial work-up of patients at risk for bladder cancer. Alberta's new Provincial Hematuria Evaluation Primary Care Pathway outlines more appropriate testing in the initial work-up of both gross and microscopic hematuria. As of May 12, all community urine cytology requests, including requests for patients with hematuria, will be cancelled unless they are ordered by a urologist or are on the recommendation of a urologist. "Urine cytology recommended by urologist" should be written in the Clinical History when requesting urine cytology. 

Lab bulletin: Provincial malaria testing standardization
As of April 14, malaria testing in Alberta has been standardized. Only one specimen will be required to rule out malaria, rather than the previously recommended three. 

Lab bulletin: New process for tests not available in Connect Care  
Effective April 30, health care providers who order in Connect Care will follow a new process to place orders for tests that are not performed by Alberta Precision Laboratories (APL). The “Request for External Sendout Lab Test” consult order should be used for tests that do not have a procedure code in Connect Care. To expedite approvals and avoid test cancellation, contact the appropriate APL medical/scientific staff on-call person in advance of placing the consult order. 

New hand and wrist referral reasons and requirements
The Provincial Adult Plastic Surgery Referral Pathway and the Provincial Adult Orthopedic and Spine Referral Pathway now include three new referral reasons with mandatory requirements: 

  • Cyst of hand/wrist 
    • Trial of 3 aspirations (or reason why unable/inappropriate to aspirate)
    • X-ray of affected joint 
  • Suspected benign mass (hand/wrist) 
    • Imaging confirming solid mass 
    • MRI ordered
  • Suspected malignant mass (hand/wrist)
    • Urgent MRI results

Trigger Finger Patient Pathway: Your journey with trigger finger is now live on MyHealth Alberta, completing the hand and wrist suite on Alberta's Pathway Hub.

Available Clinical Pathways: 
  • Provincial Carpal Tunnel Syndrome (CTS) Primary Care Clinical Pathway
  • Provincial Trigger Finger Primary Care Clinical Pathway
  • Provincial Dupuytren's Disease Primary Care Clinical Pathway
  • Provincial Hand and Wrist Soft Tissue Mass Primary Care Clinical Pathway

Available Patient Pathways: 

  • Carpal Tunnel Syndrome Pathway: Your journey with carpal tunnel syndrome
  • Trigger Finger Pathway: Your journey with trigger finger

AHS Clinical Pharmacology and Toxicology Pearl of the Week: Xylazine 
The Clinical Pharmacology and Toxicology (CPT) Pearls of the Week are short educational summaries of specific CPT topics. They are developed by physician members of the AHS Section of Clinical Pharmacology and Toxicology. Here’s this week’s “Pearl”:
Xylazine is a sedative used in veterinary medicine that has been detected in the illicit drug supply in Alberta, B.C., and Saskatchewan. It is a centrally acting alpha 2 agonist, similar to clonidine. Symptoms of xylazine toxicity include decreased level of consciousness, hypotension, bradycardia, and small pupils. Leg ulcers may be seen with repeated exposure, possibly because of drug-induced low blood flow to the skin.

New Parent and Newborn Line now province-wide 
Primary Care Alberta’s New Parent and Newborn Line, which launched last month in South, Central and North Zones, is now a provincial service. All new parents across Alberta can call 1-833-805-BABY (2229) any time, any day, to get expert advice from registered nurses specializing in postpartum care.

Nurses are available 24/7 to offer support, information and referrals to new parents and caregivers for the first two months after their baby’s birth. Health Link experts receive questions including caring for baby, breastfeeding, mother’s health and baby’s health. 

The provincial line replaces the Early Start Parent Information Line previously available in Calgary and Healthy Beginnings in Edmonton.
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