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Escherichia coli O103 outbreak associated with minced celery among hospitalized individuals in Victoria, British Columbia, 2021. 2021年,不列颠哥伦比亚省维多利亚州住院患者中与切碎的芹菜相关的大肠杆菌O103爆发。
Courtney Smith, Allison Griffiths, Sandra Allison, D. Hoyano, L. Hoang
BackgroundIn April 2021, a Shiga toxin-producing Escherichia coli (E. coli) (STEC) O103 outbreak was identified among patients at two hospitals in Victoria, British Columbia (BC). The objective of this study is to describe this outbreak investigation and identify issues of food safety for high-risk products prepared for vulnerable populations.MethodsConfirmed cases of E. coli O103 were reported to the Island Health communicable disease unit. The provincial public health laboratory conducted whole genome sequencing on confirmed case isolates, as per routine practice for STEC in BC. Exposure information was obtained through case interviews and review of hospital menus. Federal and local public health authorities conducted an inspection of the processing plant for the suspect source.ResultsSix confirmed cases of E. coli O103 were identified, all related by whole genome sequencing. The majority of cases were female (67%) and the median age was 61 years (range 24-87 years). All confirmed cases were inpatients or outpatients at two hospitals and were exposed to raw minced celery within prepared sandwiches provided by hospital food services. A local processor supplied the minced celery exclusively to the two hospitals. Testing of product at the processor was infrequent, and chlorine rinse occurred before mincing. The spread of residual E. coli contamination through the mincing process, in addition to temperature abuse at the hospitals, are thought to have contributed to this outbreak.ConclusionRaw vegetables, such as celery, are a potential source of STEC and present a risk to vulnerable populations. Recommendations from this outbreak include more frequent testing at the processor, a review of the chlorination and mincing process and a review of hospital food services practices to mitigate temperature abuse.
2021年4月,在不列颠哥伦比亚省维多利亚州的两家医院的患者中发现了产志贺毒素的大肠杆菌(E. coli) (STEC) O103疫情。本研究的目的是描述这次疫情调查,并确定为脆弱人群准备的高风险产品的食品安全问题。方法将确诊的O103大肠杆菌病例报告至岛卫生传染病科。根据BC省产志贺毒素大肠杆菌的常规做法,省公共卫生实验室对确诊病例分离株进行了全基因组测序。暴露信息是通过病例访谈和医院菜单审查获得的。联邦和地方公共卫生当局对可疑来源的加工厂进行了检查。结果共检出6例O103大肠杆菌,均经全基因组测序鉴定。大多数病例为女性(67%),中位年龄为61岁(24-87岁)。所有确诊病例均为两家医院的住院或门诊病人,并接触了医院食品服务部门提供的预制三明治中的生剁碎芹菜。当地一家加工厂专门向这两家医院供应切碎的芹菜。很少在加工厂对产品进行检测,并且在切碎之前进行氯冲洗。在切碎过程中残留的大肠杆菌污染的传播,加上医院的温度滥用,被认为是导致这次疫情的原因。结论芹菜等生蔬菜是产志毒素大肠杆菌的潜在来源,对易感人群存在风险。这次疫情的建议包括在加工厂进行更频繁的检测,对氯化和切碎过程进行审查,并对医院食品服务的做法进行审查,以减少温度滥用。
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引用次数: 2
Epidemiological analysis of the emergence and disappearance of the SARS-CoV-2 Kappa variant within a region of British Columbia, Canada. 加拿大不列颠哥伦比亚省某地区SARS-CoV-2 Kappa变体出现和消失的流行病学分析
Cher Ghafari, M. Benusic, N. Prystajecky, H. Sbihi, Kimia Kamelian, L. Hoang
BackgroundThe Kappa variant is designated as a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant of interest (VOI). We identified 195 Kappa variant cases in a region of British Columbia, Canada-the largest published cluster in North America.ObjectivesTo describe the epidemiology of the Kappa variant in relation to other circulating SARS-CoV-2 variants of concern (VOC) in the region to determine if the epidemiology of the Kappa variant supports a VOI or VOC status.MethodsClinical specimens testing positive for SARS-CoV-2 collected between March 10 and May 2, 2021, were screened for the detection of known circulating VOCs; approximately 50% of specimens were subsequently selected for whole genome sequencing (WGS). Epidemiological analysis was performed comparing the characteristics of Kappa cases to the main circulating variants in the region (Alpha and Gamma) and to non-VOC/VOI cases.ResultsA total of 2,079 coronavirus disease 2019 (COVID-19) cases were reported in the region during the study period, of which 54% were selected for WGS. The 1,131 sequenced cases were categorized into Kappa, Alpha, Gamma and non-VOC/VOI. While Alpha and Gamma cases were found to have a significantly higher attack rate among household contacts compared to non-VOI/VOC cases, Kappa was not.ConclusionEpidemiological analysis supports the designation of Kappa as a VOI and not a VOC. The Alpha and Gamma variants were found to be more transmissible, explaining their subsequent dominance in the region and the rapid disappearance of the Kappa variant. Variant surveillance strategies should focus on both detection of established VOCs and detection of potential new VOCs.
Kappa变异被指定为严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)感兴趣变异(VOI)。我们在加拿大不列颠哥伦比亚省的一个地区发现了195例Kappa变异病例,这是北美公布的最大的集群。目的描述Kappa变异体与该地区其他流行的SARS-CoV-2关注变异体(VOC)的流行病学关系,以确定Kappa变异体的流行病学是否支持VOI或VOC状态。方法对2021年3月10日~ 5月2日采集的SARS-CoV-2阳性临床标本进行筛查,检测已知循环VOCs;大约50%的标本随后被选中进行全基因组测序(WGS)。对Kappa病例与该地区主要流行变异(Alpha和Gamma)以及非voc /VOI病例的特征进行流行病学分析。结果研究期间,该地区共报告2019冠状病毒病(COVID-19) 2079例,其中54%入选WGS。1131例测序病例分为Kappa、Alpha、Gamma和非voc /VOI。与非VOC /VOC病例相比,Alpha和Gamma病例在家庭接触者中的发病率明显更高,而Kappa则不然。结论流行病学分析支持将Kappa指定为VOI,而不是VOC。α和γ变异被发现更具传染性,这解释了它们随后在该地区的主导地位和Kappa变异的迅速消失。变异监测策略应侧重于发现已存在的挥发性有机化合物和发现潜在的新挥发性有机化合物。
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引用次数: 0
The Yukon's experience with COVID-19: Travel restrictions, variants and spread among the unvaccinated. 育空地区应对COVID-19的经验:未接种疫苗的旅行限制、变异和传播。
Sara McPhee-Knowles, Brynn Hoffman, L. Kanary
The Yukon's experience with coronavirus disease 2019 (COVID-19) has been an interesting one; the territory successfully implemented travel restrictions to limit importing the virus and rolled out vaccines quickly compared to most Canadian jurisdictions. However, the Yukon's first wave of COVID-19 in June and July 2021 overwhelmed the healthcare system due to widespread transmission in unvaccinated children, youth and adults, despite high vaccination uptake overall and mandatory masking. This experience highlights the importance of continued support for public vaccination programs, widespread vaccine uptake in paediatric populations, and the judicious relaxation of non-pharmaceutical interventions in all Canadian jurisdictions as they reopen while more contagious variants emerge.
育空地区在2019年冠状病毒病(COVID-19)方面的经历很有趣;与加拿大大多数司法管辖区相比,该地区成功实施了旅行限制,以限制病毒的进口,并迅速推出了疫苗。然而,育空地区在2021年6月和7月爆发的第一波COVID-19疫情使医疗保健系统不堪重负,原因是未接种疫苗的儿童、青年和成人广泛传播,尽管总体上疫苗接种率很高,并且强制掩蔽。这一经验强调了继续支持公共疫苗接种规划的重要性,在儿科人群中广泛接种疫苗,以及在加拿大所有司法管辖区重新开放而传染性更强的变种出现时明智地放松非药物干预措施。
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引用次数: 4
Divergences between healthcare-associated infection administrative data and active surveillance data in Canada. 加拿大医疗保健相关感染管理数据与主动监测数据之间的差异
Virginie Boulanger, E. Poirier, Anne MacLaurin, C. Quach
BackgroundAlthough Canada has both a national active surveillance system and administrative data for the passive surveillance of healthcare-associated infections (HAI), both have identified strengths and weaknesses in their data collection and reporting. Active and passive surveillance work independently, resulting in results that diverge at times. To understand the divergences between administrative health data and active surveillance data, a scoping review was performed.MethodMedline, Embase and Cumulative Index to Nursing and Allied Health Literature along with grey literature were searched for studies in English and French that evaluated the use of administrative data, alone or in comparison with traditional surveillance, in Canada between 1995 and November 2, 2020. After extracting relevant information from selected articles, a descriptive summary of findings was provided with suggestions for the improvement of surveillance systems to optimize the overall data quality.ResultsSixteen articles met the inclusion criteria, including twelve observational studies and four systematic reviews. Studies showed that using a single source of administrative data was not accurate for HAI surveillance when compared with traditional active surveillance; however, combining different sources of data or combining administrative with active surveillance data improved accuracy. Electronic surveillance systems can also enhance surveillance by improving the ability to detect potential HAIs.ConclusionAlthough active surveillance of HAIs produced the most accurate results and remains the gold-standard, the integration between active and passive surveillance data can be optimized. Administrative data can be used to enhance traditional active surveillance. Future studies are needed to evaluate the feasibility and benefits of potential solutions presented for the use of administrative data for HAI surveillance and reporting in Canada.
背景:虽然加拿大既有国家主动监测系统,也有用于医疗保健相关感染(HAI)被动监测的行政数据,但两者在数据收集和报告方面都有各自的长处和短处。主动监测和被动监测是独立工作的,有时会产生不同的结果。为了了解行政卫生数据和主动监测数据之间的差异,进行了范围审查。方法检索1995年至2020年11月2日期间加拿大的medline、Embase、护理和相关健康文献累积指数以及灰色文献,以英语和法语评估单独使用行政数据或与传统监测相比较的研究。在从选定的文章中提取相关信息后,对调查结果进行了描述性总结,并提出了改进监测系统以优化整体数据质量的建议。结果16篇文章符合纳入标准,包括12项观察性研究和4项系统评价。研究表明,与传统的主动监测相比,使用单一行政数据来源进行HAI监测并不准确;然而,结合不同来源的数据或将管理数据与主动监测数据相结合可以提高准确性。电子监视系统还可以通过提高发现潜在HAIs的能力来加强监视。结论虽然HAIs的主动监测结果最准确,仍然是金标准,但主动和被动监测数据的整合可以优化。管理数据可以用来加强传统的主动监测。未来的研究需要评估在加拿大使用行政数据进行HAI监测和报告的潜在解决方案的可行性和效益。
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引用次数: 2
Canadian Public Health Laboratory Network Statement on Point-of-Care Serology Testing in COVID-19. 加拿大公共卫生实验室网络关于COVID-19护理点血清学检测的声明。
Group Respiratory Virus Infections Working
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引用次数: 0
Multisystem inflammatory syndrome in children in Canada. 加拿大儿童多系统炎症综合征。
Meghan Laverty, M. Salvadori, S. Squires, M. Ahmed, Lisa Eisenbeis, Santina J Lee, Annick Des Cormiers, Y. A. Li
This article provides a summary of the epidemiology of multisystem inflammatory syndrome in children (MIS-C) cases reported nationally in Canada by provincial and territorial health authorities. Multisystem inflammatory syndrome in children is a post-viral inflammatory syndrome that temporally follows coronavirus disease 2019 (COVID-19). Symptoms may include fever, abdominal pain, vomiting, diarrhea, skin rash and other signs of inflammation. In Canada, MIS-C is rare, with 269 cases reported to the Public Health Agency of Canada between March 11, 2020 and October 2, 2021. One hundred forty-two (53%) of these cases were lab-confirmed COVID-19 cases or epidemiologically-linked with COVID-19 cases. Cases have been reported in infants as young as one week to youth as old as 18 years, with a median age of six years. Cases were more likely to occur in males than females (58% vs 42%, respectively; p=0.006). Almost all MIS-C cases (99%) required hospitalization and 36% required intensive care unit admission. No deaths have been reported to date. The time trend of MIS-C aligns with the incidence rate time trend of COVID-19 reported in children, with a two to six-week lag.
本文概述了加拿大各省和地区卫生当局报告的儿童多系统炎症综合征(MIS-C)病例的流行病学。儿童多系统炎症综合征是冠状病毒病2019 (COVID-19)后暂时出现的病毒后炎症综合征。症状可能包括发烧、腹痛、呕吐、腹泻、皮疹和其他炎症迹象。在加拿大,misc很罕见,在2020年3月11日至2021年10月2日期间,向加拿大公共卫生署报告了269例病例。这些病例中有142例(53%)是实验室确诊的COVID-19病例或与COVID-19病例有流行病学关联。病例报告的婴儿小至一周,大至18岁,中位年龄为6岁。男性比女性更容易发生病例(分别为58%对42%;p = 0.006)。几乎所有MIS-C病例(99%)需要住院治疗,36%需要入住重症监护病房。到目前为止没有死亡报告。MIS-C的时间趋势与报告的儿童COVID-19发病率时间趋势一致,存在2至6周的滞后。
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引用次数: 4
Call for emergency action to limit global temperature increases, restore biodiversity, and protect health: wealthy nations must do much more, much faster. 呼吁采取紧急行动,限制全球气温上升,恢复生物多样性,保护健康:富裕国家必须做得更多,做得更快。
Pub Date : 2021-10-01 DOI: 10.14744/ejmo.2021.00011
L. Atwoli, A. Baqui, T. Benfield, R. Bosurgi, F. Godlee, S. Hancocks, R. Horton, L. Laybourn‐Langton, C. Monteiro, I. Norman, K. Patrick, N. Praities, Marcel G M Olde Rikkert, E. J. Rubin, P. Sahni, Richard Smith, N. Talley, S. Turale, D. Vázquez
No abstract
没有抽象的
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引用次数: 0
Application of natural language processing algorithms for extracting information from news articles in event-based surveillance. 自然语言处理算法在新闻报道信息提取中的应用。
V. Ng, E. Rees, Jingcheng Niu, Abdelhamid Zaghlool
The focus of this article is the application of natural language processing (NLP) for information extraction in event-based surveillance (EBS) systems. We describe common information extraction applications from open-source news articles and media sources in EBS systems, methods, value in public health, challenges and emerging developments.
本文的重点是自然语言处理(NLP)在基于事件的监视(EBS)系统中的信息提取应用。我们描述了EBS系统中常见的从开源新闻文章和媒体来源中提取信息的应用程序、方法、在公共卫生中的价值、挑战和新兴发展。
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引用次数: 12
Towards automating systematic reviews on immunization using an advanced natural language processing-based extraction system. 使用基于自然语言处理的高级提取系统实现免疫系统综述的自动化。
David Begert, Justin Granek, Brian Irwin, Chris Brogly

Evidence-informed decision making is based on the premise that the entirety of information on a topic is collected and analyzed. Systematic reviews allow for data from different studies to be rigorously assessed according to PICO principles (population, intervention, control, outcomes). However, conducting a systematic review is generally a slow process that is a significant drain on resources. The fundamental problem is that the current approach to creating a systematic review cannot scale to meet the challenges resulting from the massive body of unstructured evidence. For this reason, the Public Health Agency of Canada has been examining the automation of different stages of evidence synthesis to increase efficiencies. In this article, we present an overview of an initial version of a novel machine learning-based system that is powered by recent advances in natural language processing (NLP), such as BioBERT, with further optimizations completed using a new immunization-specific document database. The resulting optimized NLP model at the core of this system is able to identify and extract PICO-related fields from publications on immunization with an average accuracy of 88% across five classes of text. Functionality is provided through a straightforward web interface.

循证决策的前提是收集和分析有关某一主题的全部信息。系统综述可以根据 PICO 原则(人群、干预、对照、结果)对不同研究的数据进行严格评估。然而,进行系统性回顾通常是一个缓慢的过程,需要耗费大量资源。根本问题在于,目前的系统性回顾方法无法应对大量非结构化证据带来的挑战。因此,加拿大公共卫生局一直在研究证据合成不同阶段的自动化,以提高效率。在本文中,我们概述了基于机器学习的新型系统的初始版本,该系统由自然语言处理(NLP)领域的最新进展(如 BioBERT)提供支持,并利用新的免疫特定文档数据库完成了进一步优化。经过优化的 NLP 模型是该系统的核心,它能够识别和提取免疫出版物中与 PICO 相关的字段,在五类文本中的平均准确率为 88%。功能通过一个简单的网络界面提供。
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引用次数: 0
National findings from the Tracks survey of people who inject drugs in Canada, Phase 4, 2017-2019. track对加拿大注射吸毒者的调查结果,第4阶段,2017-2019。
J. Tarasuk, Jingxuan Zhang, A. LeMyre, F. Cholette, M. Bryson, D. Paquette
BackgroundThe Tracks survey of people who inject drugs (PWID) collected data in 14 sentinel sites across Canada (2017-2019).ObjectiveTo describe the prevalence of human immunodeficiency virus (HIV) and hepatitis C and associated risk behaviours and to examine trends over time.MethodsInformation regarding socio-demographics, social determinants of health, use of prevention services and testing, drug use, risk behaviours, and HIV and hepatitis C testing, care and treatment was collected through interviewer-administered questionnaires. Biological samples were tested for HIV, hepatitis C antibodies and hepatitis C ribonucleic acid (RNA). Descriptive statistics were calculated and trends over time were assessed.ResultsOf the 2,383 participants, 65.6% were cisgender male, 42.2% were Indigenous, 48.0% completed some high school or less, 62.6% lived in unstable housing and 75.7% had ever been incarcerated. Average age was 40.1 years. The majority experienced stigma and discrimination (88.7%) and physical, sexual and/or emotional abuse in childhood (85.0%) or with a sexual partner (75.9%). The majority reported use of a needle/syringe distribution program (90.1%) and tested for HIV (90.5%) and hepatitis C (90.9%).Among participants who had ever had sex, the majority (59.2%) reported inconsistent condom use during vaginal and/or anal sex with a casual sex partner. Prevalence of HIV was 10.3% (82.9% were aware of infection status) and many (36.9%) were hepatitis C RNA-positive (50.1% were aware of infection status).Most surveillance indicators remained relatively stable from Phase 1 to Phase 4. Changes were found in substances used, and improvements were noted related to HIV and hepatitis C prevalence and care cascade indicators.ConclusionMany PWID in Canada were living in unstable housing and experienced high levels of stigma and discrimination. Prevalence of HIV and hepatitis C was high in some areas. These findings contribute to the evidence base used to inform targeted prevention and control measures.
2017-2019年,注射吸毒者(PWID)的追踪调查收集了加拿大14个哨点的数据。目的描述人类免疫缺陷病毒(HIV)和丙型肝炎的流行情况以及相关的危险行为,并研究其长期趋势。方法通过问卷调查收集社会人口统计学、健康的社会决定因素、预防服务和检测的使用、药物使用、危险行为、艾滋病毒和丙型肝炎检测、护理和治疗等信息。对生物样本进行HIV、丙型肝炎抗体和丙型肝炎核糖核酸(RNA)检测。计算描述性统计数据并评估随时间变化的趋势。结果在2383名参与者中,65.6%为顺性别男性,42.2%为原住民,48.0%高中及以下学历,62.6%居住在不稳定的住房中,75.7%曾被监禁。平均年龄为40.1岁。大多数人在童年时期(85.0%)或与性伴侣(75.9%)经历过耻辱和歧视(88.7%)和身体、性和/或精神虐待(85.0%)。大多数人报告使用了针头/注射器分发方案(90.1%),并进行了艾滋病毒(90.5%)和丙型肝炎(90.9%)检测。在曾经发生过性行为的参与者中,大多数(59.2%)报告在与随意性伴侣进行阴道和/或肛交时不一致地使用安全套。HIV患病率为10.3%(82.9%知晓感染状况),丙型肝炎rna阳性(50.1%知晓感染状况)较多(36.9%)。从第一阶段到第四阶段,大多数监测指标保持相对稳定。发现所使用的物质发生了变化,并注意到与艾滋病毒和丙型肝炎患病率和护理级联指标相关的改善。结论加拿大的许多PWID患者居住在不稳定的住房中,受到高度的污名和歧视。在一些地区,艾滋病毒和丙型肝炎的患病率很高。这些发现有助于为有针对性的预防和控制措施提供证据基础。
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引用次数: 20
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Canada communicable disease report = Releve des maladies transmissibles au Canada
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