Open Data is part of a broad global movement that is not only advancing science and scientific communication but also transforming modern society and how decisions are made. What began with a call for Open Science and the rise of online journals has extended to Open Data, based on the premise that if reports on data are open, then the generated or supporting data should be open as well. There have been a number of advances in Open Data over the last decade, spearheaded largely by governments. A real benefit of Open Data is not simply that single databases can be used more widely; it is that these data can also be leveraged, shared and combined with other data. Open Data facilitates scientific collaboration, enriches research and advances analytical capacity to inform decisions. In the human and environmental health realms, for example, the ability to access and combine diverse data can advance early signal detection, improve analysis and evaluation, inform program and policy development, increase capacity for public participation, enable transparency and improve accountability. However, challenges remain. Enormous resources are needed to make the technological shift to open and interoperable databases accessible with common protocols and terminology. Amongst data generators and users, this shift also involves a cultural change: from regarding databases as restricted intellectual property, to considering data as a common good. There is a need to address legal and ethical considerations in making this shift. Finally, along with efforts to modify infrastructure and address the cultural, legal and ethical issues, it is important to share the information equitably and effectively. While there is great potential of the open, timely, equitable and straightforward sharing of data, fully realizing the myriad of benefits of Open Data will depend on how effectively these challenges are addressed.
{"title":"Reaping the benefits of Open Data in public health.","authors":"P Huston, V L Edge, E Bernier","doi":"10.14745/ccdr.v45i10a01","DOIUrl":"https://doi.org/10.14745/ccdr.v45i10a01","url":null,"abstract":"<p><p>Open Data is part of a broad global movement that is not only advancing science and scientific communication but also transforming modern society and how decisions are made. What began with a call for Open Science and the rise of online journals has extended to Open Data, based on the premise that if reports on data are open, then the generated or supporting data should be open as well. There have been a number of advances in Open Data over the last decade, spearheaded largely by governments. A real benefit of Open Data is not simply that single databases can be used more widely; it is that these data can also be leveraged, shared and combined with other data. Open Data facilitates scientific collaboration, enriches research and advances analytical capacity to inform decisions. In the human and environmental health realms, for example, the ability to access and combine diverse data can advance early signal detection, improve analysis and evaluation, inform program and policy development, increase capacity for public participation, enable transparency and improve accountability. However, challenges remain. Enormous resources are needed to make the technological shift to open and interoperable databases accessible with common protocols and terminology. Amongst data generators and users, this shift also involves a cultural change: from regarding databases as restricted intellectual property, to considering data as a common good. There is a need to address legal and ethical considerations in making this shift. Finally, along with efforts to modify infrastructure and address the cultural, legal and ethical issues, it is important to share the information equitably and effectively. While there is great potential of the open, timely, equitable and straightforward sharing of data, fully realizing the myriad of benefits of Open Data will depend on how effectively these challenges are addressed.</p>","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6781855/pdf/CCDR-45-252.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41224681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Canadian Notifiable Disease Surveillance System (CNDSS) provides data on diseases that have been identified as priorities for public health monitoring and control. Several advances that have been made on Notifiable Diseases Online, the CNDSS interactive website, are consistent with the Government of Canada's commitment to Open Data. This article provides an update on changes in case definitions that have been made since the case definitions were last published in 2009, and describes updates that have been made to the interactive website since 2013. Changes were made to the case definitions of five diseases. For hepatitis C, the new case definition now distinguishes between acute and chronic infection. For cyclosporiasis, the probable case definition requires an epidemiologic link, with the clarification that this would likely be due to exposure to a common food source. For rabies, the probable case definition now refers to detection of rabies-neutralizing antibody instead of specific antibody titres. For Lyme disease, the revised confirmed and probable case definitions now identify five options for Lyme disease risk areas instead of endemic areas. For tuberculosis the revised case definition now includes nucleic acid amplification testing in addition to culture for diagnosis. The Notifiable Diseases Online website is an interactive tool that enables users to create customized figures and tables. Since a major redesign in 2013, numerous changes have been made to the look and feel of the site. Figures and tables can now be extracted as Excel or PDF files and large datasets are exportable into Excel files for further analysis. Case definitions in the national surveillance system will be updated as needed and its interactive website will continue to be improved and updated in response to user comments.
{"title":"Updates to the Canadian Notifiable Disease Surveillance System and its interactive website.","authors":"S Totten, A Medaglia, S McDermott","doi":"10.14745/ccdr.v45i10a02","DOIUrl":"https://doi.org/10.14745/ccdr.v45i10a02","url":null,"abstract":"<p><p>The Canadian Notifiable Disease Surveillance System (CNDSS) provides data on diseases that have been identified as priorities for public health monitoring and control. Several advances that have been made on Notifiable Diseases Online, the CNDSS interactive website, are consistent with the Government of Canada's commitment to Open Data. This article provides an update on changes in case definitions that have been made since the case definitions were last published in 2009, and describes updates that have been made to the interactive website since 2013. Changes were made to the case definitions of five diseases. For hepatitis C, the new case definition now distinguishes between acute and chronic infection. For cyclosporiasis, the probable case definition requires an epidemiologic link, with the clarification that this would likely be due to exposure to a common food source. For rabies, the probable case definition now refers to detection of rabies-neutralizing antibody instead of specific antibody titres. For Lyme disease, the revised confirmed and probable case definitions now identify five options for Lyme disease risk areas instead of endemic areas. For tuberculosis the revised case definition now includes nucleic acid amplification testing in addition to culture for diagnosis. The Notifiable Diseases Online website is an interactive tool that enables users to create customized figures and tables. Since a major redesign in 2013, numerous changes have been made to the look and feel of the site. Figures and tables can now be extracted as Excel or PDF files and large datasets are exportable into Excel files for further analysis. Case definitions in the national surveillance system will be updated as needed and its interactive website will continue to be improved and updated in response to user comments.</p>","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6781854/pdf/CCDR-45-257.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41224677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Sachdeva, M. Benusic, S. Ota, R. Stuart, J. Maclachlan, V. Dubey, A. Andonov
Background In late 2016 and early 2017, a number of countries began reporting hepatitis A virus (HAV) outbreaks involving person-to-person transmission among men who have sex with men (MSM), people using illicit drugs and homeless or underhoused persons. Objective To describe the epidemiology and public health response to an outbreak of HAV disproportionately affecting MSM in Toronto, Canada from January 2017 to November 2018. Methods Following an increase in the number of cases of HAV in MSM being reported in other countries, enhanced surveillance was performed for all non-travel-related cases of HAV reported from June 1, 2017 to November 1, 2018, including a retrospective analysis of cases reported from January 2017 to June 2017. Descriptive analysis and viral sequencing were performed to describe person-to-person transmission patterns and target interventions. Control strategies included interventions to promote the uptake of preexposure HAV vaccination, including social media campaigns geared to MSM, messaging to healthcare providers and vaccine clinics. Results Based on the outbreak case definitions, 52 confirmed and probable cases of HAV were identified. Over 80% of outbreak cases were male (n=43/52) and, among those for whom data were available, 64% (n=25/39) reported an MSM exposure. Data on hospitalization was available for 51 cases; 56% of confirmed cases (n=23/41) and 40% of probable cases (n=4/10) required hospitalization. Of the cases with serum samples that had HAV sequencing, 83% (n=30/36) had one of the three strains seen circulating in outbreaks among MSM internationally; 72% (n=26/36) were VRD_521_2016, which had been detected in recently reported European outbreaks among MSM. Targeted promotion of publicly-funded vaccination using social media platforms popular with MSM and targeted vaccine clinics were developed to promote HAV awareness and vaccine uptake among MSM. Conclusion Outbreaks of HAV, attributed to person-to-person transmission of strains of HAV that disproportionately affected MSM and were likely to have been imported from international MSM outbreaks, have now occurred in Canada. Genetic sequencing of HAV, risk factor analysis of cases, monitoring trends of vaccine coverage in high-risk groups and initiation of vaccination campaigns that address barriers to HAV preexposure vaccine coverage in the MSM population may prevent future outbreaks.
{"title":"Community outbreak of hepatitis A disproportionately affecting men who have sex with men in Toronto, Canada, January 2017-November 2018.","authors":"H. Sachdeva, M. Benusic, S. Ota, R. Stuart, J. Maclachlan, V. Dubey, A. Andonov","doi":"10.14745/ccdr.v45i10a03","DOIUrl":"https://doi.org/10.14745/ccdr.v45i10a03","url":null,"abstract":"Background\u0000In late 2016 and early 2017, a number of countries began reporting hepatitis A virus (HAV) outbreaks involving person-to-person transmission among men who have sex with men (MSM), people using illicit drugs and homeless or underhoused persons.\u0000\u0000\u0000Objective\u0000To describe the epidemiology and public health response to an outbreak of HAV disproportionately affecting MSM in Toronto, Canada from January 2017 to November 2018.\u0000\u0000\u0000Methods\u0000Following an increase in the number of cases of HAV in MSM being reported in other countries, enhanced surveillance was performed for all non-travel-related cases of HAV reported from June 1, 2017 to November 1, 2018, including a retrospective analysis of cases reported from January 2017 to June 2017. Descriptive analysis and viral sequencing were performed to describe person-to-person transmission patterns and target interventions. Control strategies included interventions to promote the uptake of preexposure HAV vaccination, including social media campaigns geared to MSM, messaging to healthcare providers and vaccine clinics.\u0000\u0000\u0000Results\u0000Based on the outbreak case definitions, 52 confirmed and probable cases of HAV were identified. Over 80% of outbreak cases were male (n=43/52) and, among those for whom data were available, 64% (n=25/39) reported an MSM exposure. Data on hospitalization was available for 51 cases; 56% of confirmed cases (n=23/41) and 40% of probable cases (n=4/10) required hospitalization. Of the cases with serum samples that had HAV sequencing, 83% (n=30/36) had one of the three strains seen circulating in outbreaks among MSM internationally; 72% (n=26/36) were VRD_521_2016, which had been detected in recently reported European outbreaks among MSM. Targeted promotion of publicly-funded vaccination using social media platforms popular with MSM and targeted vaccine clinics were developed to promote HAV awareness and vaccine uptake among MSM.\u0000\u0000\u0000Conclusion\u0000Outbreaks of HAV, attributed to person-to-person transmission of strains of HAV that disproportionately affected MSM and were likely to have been imported from international MSM outbreaks, have now occurred in Canada. Genetic sequencing of HAV, risk factor analysis of cases, monitoring trends of vaccine coverage in high-risk groups and initiation of vaccination campaigns that address barriers to HAV preexposure vaccine coverage in the MSM population may prevent future outbreaks.","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81140183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Choucrallah, L. Sarmiento, S. Ettles, F. Tanguay, M. Heisz, E. Falardeau
Background The Laboratory Incident Notification Canada (LINC) surveillance system monitors laboratory incidents reported under the Human Pathogens and Toxins Act. The year 2018 marks the third complete year of data. Objective To describe the laboratory exposure and laboratory-acquired infection incidents that occurred in Canada in 2018 compared to previous years, and then by sector, human pathogens and toxins involved, number of affected persons, incident type and root causes. Methods Laboratory incidents that occurred in 2018 were reported through the LINC system. The number of laboratory incidents, people exposed and laboratory-acquired infections were compared to previous years, then the incidents were analyzed by sector, human pathogen or toxin involved, the type of incident, people exposed, route of exposure and root causes. Microsoft Excel 2016 was used for descriptive analysis. Results In 2018, there were 89 exposure incidents to human pathogens and 235 people were exposed. There were five suspected and one confirmed laboratory-acquired infections. This was approximately twice the number of exposure incidents that were reported in 2017 (n=44) and 2016 (n=46). The highest number of exposure incidents occurred in the academic and hospital sectors, and the ratio of incidence to licences was the lowest in the private sector. The majority of incidents (n=50; 56%) involved Risk Group 2 human pathogens that were manipulated in a Containment Level 2 laboratory. Most exposures were related to sharps or procedures and the most common people exposed were laboratory technicians. Human interaction and standard operating procedures were the leading root causes. Conclusion Although overall the annual incidence of laboratory exposures in Canada remains relatively low, the incidence was higher in 2018 than in previous years. Whether this is a true increase in incidence or an increase in reporting is not known at this time as baseline estimates are still being established.
{"title":"Surveillance of laboratory exposures to human pathogens and toxins: Canada 2018.","authors":"D. Choucrallah, L. Sarmiento, S. Ettles, F. Tanguay, M. Heisz, E. Falardeau","doi":"10.14745/ccdr.v45i09a04","DOIUrl":"https://doi.org/10.14745/ccdr.v45i09a04","url":null,"abstract":"Background\u0000The Laboratory Incident Notification Canada (LINC) surveillance system monitors laboratory incidents reported under the Human Pathogens and Toxins Act. The year 2018 marks the third complete year of data.\u0000\u0000\u0000Objective\u0000To describe the laboratory exposure and laboratory-acquired infection incidents that occurred in Canada in 2018 compared to previous years, and then by sector, human pathogens and toxins involved, number of affected persons, incident type and root causes.\u0000\u0000\u0000Methods\u0000Laboratory incidents that occurred in 2018 were reported through the LINC system. The number of laboratory incidents, people exposed and laboratory-acquired infections were compared to previous years, then the incidents were analyzed by sector, human pathogen or toxin involved, the type of incident, people exposed, route of exposure and root causes. Microsoft Excel 2016 was used for descriptive analysis.\u0000\u0000\u0000Results\u0000In 2018, there were 89 exposure incidents to human pathogens and 235 people were exposed. There were five suspected and one confirmed laboratory-acquired infections. This was approximately twice the number of exposure incidents that were reported in 2017 (n=44) and 2016 (n=46). The highest number of exposure incidents occurred in the academic and hospital sectors, and the ratio of incidence to licences was the lowest in the private sector. The majority of incidents (n=50; 56%) involved Risk Group 2 human pathogens that were manipulated in a Containment Level 2 laboratory. Most exposures were related to sharps or procedures and the most common people exposed were laboratory technicians. Human interaction and standard operating procedures were the leading root causes.\u0000\u0000\u0000Conclusion\u0000Although overall the annual incidence of laboratory exposures in Canada remains relatively low, the incidence was higher in 2018 than in previous years. Whether this is a true increase in incidence or an increase in reporting is not known at this time as baseline estimates are still being established.","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88990634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Morton, K. Meghnath, M. Gheorghe, A. Fitzgerald-Husek, J. Hobbs, L. Honish, S. David
Background Cyclospora is an intestinal parasite that is not endemic in Canada. However, national outbreaks of locally acquired cases have been reported since 2013. These outbreaks were suspected to be associated with consumption of produce imported from countries where Cyclospora is endemic. Identification of the source can be challenging because of reporting delays and limited traceability of produce. Objective To report on a national outbreak of locally acquired cyclosporiasis, highlight the challenges of investigating these outbreaks and document the first time use of a control bank to recruit controls for a national outbreak case-control study in Canada. Methods Cases of cyclosporiasis were identified through provincial laboratory testing and reported through provinces to the national level. Cases were interviewed about food exposures using a questionnaire and food exposures reported by cases were compared to Foodbook reference values. To narrow down the food items of interest, a matched case-control study was conducted. Controls for the study were recruited primarily from a control bank, that is, a list of individuals who had previously agreed to participate in public health-related surveys. Results In total, 87 cases of locally acquired cyclosporiasis with onset or report dates between May 19, 2016 and August 10, 2016 were reported by four provinces. Comparing case exposures to Foodbook reference values identified several food items of interest, including blackberries, other berries, herbs and leafy greens. The case-control study identified only blackberries and mesclun greens as significantly more frequently consumed by cases than controls. Due to lack of product details for blackberries and mesclun greens, the source of the outbreak was not conclusively identified. Conclusion Blackberries were the primary food item of interest, but could not be identified as the conclusive source due to lack of traceability. The control bank was found to be a useful tool for control recruitment.
{"title":"Use of a case-control study and control bank to investigate an outbreak of locally acquired cyclosporiasis in Canada, 2016.","authors":"V. Morton, K. Meghnath, M. Gheorghe, A. Fitzgerald-Husek, J. Hobbs, L. Honish, S. David","doi":"10.14745/ccdr.v45i09a01","DOIUrl":"https://doi.org/10.14745/ccdr.v45i09a01","url":null,"abstract":"Background\u0000Cyclospora is an intestinal parasite that is not endemic in Canada. However, national outbreaks of locally acquired cases have been reported since 2013. These outbreaks were suspected to be associated with consumption of produce imported from countries where Cyclospora is endemic. Identification of the source can be challenging because of reporting delays and limited traceability of produce.\u0000\u0000\u0000Objective\u0000To report on a national outbreak of locally acquired cyclosporiasis, highlight the challenges of investigating these outbreaks and document the first time use of a control bank to recruit controls for a national outbreak case-control study in Canada.\u0000\u0000\u0000Methods\u0000Cases of cyclosporiasis were identified through provincial laboratory testing and reported through provinces to the national level. Cases were interviewed about food exposures using a questionnaire and food exposures reported by cases were compared to Foodbook reference values. To narrow down the food items of interest, a matched case-control study was conducted. Controls for the study were recruited primarily from a control bank, that is, a list of individuals who had previously agreed to participate in public health-related surveys.\u0000\u0000\u0000Results\u0000In total, 87 cases of locally acquired cyclosporiasis with onset or report dates between May 19, 2016 and August 10, 2016 were reported by four provinces. Comparing case exposures to Foodbook reference values identified several food items of interest, including blackberries, other berries, herbs and leafy greens. The case-control study identified only blackberries and mesclun greens as significantly more frequently consumed by cases than controls. Due to lack of product details for blackberries and mesclun greens, the source of the outbreak was not conclusively identified.\u0000\u0000\u0000Conclusion\u0000Blackberries were the primary food item of interest, but could not be identified as the conclusive source due to lack of traceability. The control bank was found to be a useful tool for control recruitment.","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82206796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Noftall, K. Noftall, M. Taylor, L. Hoang, L. Hoang, E. Galanis, E. Galanis
Background Shiga toxin-producing Escherichia coli (STEC) can cause severe illness including bloody diarrhea and hemolytic-uremic syndrome (HUS) through the production of Shiga toxins 1 (Stx1) and 2 (Stx2). E. coli O157:H7 was the most common serotype detected in the 1980s to 1990s, but improvements in laboratory methods have led to increased detection of non-O157 STEC. Non-O157 STEC producing only Stx1 tend to cause milder clinical illness. Exclusion guidelines restrict return to high-risk work or settings for STEC cases, but most do not differentiate between STEC serogroups and Stx type. Objective To analyze British Columbia (BC) laboratory and surveillance data to inform the BC STEC exclusion guideline. Methods For all STEC cases reported in BC in 2011-2017, laboratory and epidemiological data were obtained through provincial laboratory and reportable disease electronic systems, respectively. Incidence was measured for all STEC combined as well as by serogroup. Associations were measured between serogroups, Stx types and clinical outcomes. Results Over the seven year period, 984 cases of STEC were reported. A decrease in O157 incidence was observed, while non-O157 rates increased. The O157 serogroup was significantly associated with Stx2. Significant associations were observed between Stx2 and bloody diarrhea, hospitalization and HUS. Conclusion The epidemiology of STEC has changed in BC as laboratories increasingly distinguish between O157 and non-O157 cases and identify Stx type. It appears that non-O157 cases with Stx1 are less severe than O157 cases with Stx2. The BC STEC exclusion guidelines were updated as a result of this analysis.
{"title":"Shiga toxin-producing Escherichia coli in British Columbia, 2011-2017: Analysis to inform exclusion guidelines.","authors":"K. Noftall, K. Noftall, M. Taylor, L. Hoang, L. Hoang, E. Galanis, E. Galanis","doi":"10.14745/ccdr.v45i09a03","DOIUrl":"https://doi.org/10.14745/ccdr.v45i09a03","url":null,"abstract":"Background\u0000Shiga toxin-producing Escherichia coli (STEC) can cause severe illness including bloody diarrhea and hemolytic-uremic syndrome (HUS) through the production of Shiga toxins 1 (Stx1) and 2 (Stx2). E. coli O157:H7 was the most common serotype detected in the 1980s to 1990s, but improvements in laboratory methods have led to increased detection of non-O157 STEC. Non-O157 STEC producing only Stx1 tend to cause milder clinical illness. Exclusion guidelines restrict return to high-risk work or settings for STEC cases, but most do not differentiate between STEC serogroups and Stx type.\u0000\u0000\u0000Objective\u0000To analyze British Columbia (BC) laboratory and surveillance data to inform the BC STEC exclusion guideline.\u0000\u0000\u0000Methods\u0000For all STEC cases reported in BC in 2011-2017, laboratory and epidemiological data were obtained through provincial laboratory and reportable disease electronic systems, respectively. Incidence was measured for all STEC combined as well as by serogroup. Associations were measured between serogroups, Stx types and clinical outcomes.\u0000\u0000\u0000Results\u0000Over the seven year period, 984 cases of STEC were reported. A decrease in O157 incidence was observed, while non-O157 rates increased. The O157 serogroup was significantly associated with Stx2. Significant associations were observed between Stx2 and bloody diarrhea, hospitalization and HUS.\u0000\u0000\u0000Conclusion\u0000The epidemiology of STEC has changed in BC as laboratories increasingly distinguish between O157 and non-O157 cases and identify Stx type. It appears that non-O157 cases with Stx1 are less severe than O157 cases with Stx2. The BC STEC exclusion guidelines were updated as a result of this analysis.","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72677830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
DG Murphy, R. Dion, M. Simard, ML Vachon, Valérie Martel-Laferrière, B. Serhir, J. Longtin
Background Molecular phylogenetics are generally used to confirm hepatitis C virus (HCV) transmission events. In addition, the Laboratoire de santé publique du Québec (LSPQ) has been using molecular phylogenetics for surveillance of HCV genotyping since November 2001. Objectives To describe the emergence of a specific lineage of HCV genotype 4d (G4d) and its characteristics using molecular phylogenetics as a surveillance tool for identifying HCV strain clustering. Methods The LSPQ prospectively applied Sanger sequencing and phylogenetic analysis to determine the HCV genotype on samples collected from November 2001 to December 2017. When a major G4d cluster was identified, demographic information, HIV-infection status and syphilis test results were analyzed. Results Phylogenetic analyses performed on approximately 22,000 cases identified 122 G4d cases. One major G4d cluster composed of 37 cases was singled out. Two cases were identified in 2010, 10 from 2011-2014 and 25 from 2015-2017. Cases in the cluster were concentrated in two urban health regions. Compared to the other G4d cases, cluster cases were all male (p<0.001) and more likely to be HIV-positive (adjusted risk ratio: 4.4; 95% confidence interval: 2.5-7.9). A positive syphilis test result was observed for 27 (73%) of the cluster cases. The sequences in this cluster and of four outlier cases were located on the same monophyletic lineage as G4d sequences reported in HIV-positive men who have sex with men (MSM) in Europe. Conclusion Molecular phylogenetics enabled the identification and surveillance of ongoing transmission of a specific HCV G4d lineage in HIV-positive and HIV-negative men in Quebec and its cross-continental spread. This information can orient intervention strategies to avoid transmission of HCV in MSM.
{"title":"Molecular surveillance of hepatitis C virus genotypes identifies the emergence of a genotype 4d lineage among men in Quebec, 2001-2017.","authors":"DG Murphy, R. Dion, M. Simard, ML Vachon, Valérie Martel-Laferrière, B. Serhir, J. Longtin","doi":"10.14745/ccdr.v45i09a02","DOIUrl":"https://doi.org/10.14745/ccdr.v45i09a02","url":null,"abstract":"Background\u0000Molecular phylogenetics are generally used to confirm hepatitis C virus (HCV) transmission events. In addition, the Laboratoire de santé publique du Québec (LSPQ) has been using molecular phylogenetics for surveillance of HCV genotyping since November 2001.\u0000\u0000\u0000Objectives\u0000To describe the emergence of a specific lineage of HCV genotype 4d (G4d) and its characteristics using molecular phylogenetics as a surveillance tool for identifying HCV strain clustering.\u0000\u0000\u0000Methods\u0000The LSPQ prospectively applied Sanger sequencing and phylogenetic analysis to determine the HCV genotype on samples collected from November 2001 to December 2017. When a major G4d cluster was identified, demographic information, HIV-infection status and syphilis test results were analyzed.\u0000\u0000\u0000Results\u0000Phylogenetic analyses performed on approximately 22,000 cases identified 122 G4d cases. One major G4d cluster composed of 37 cases was singled out. Two cases were identified in 2010, 10 from 2011-2014 and 25 from 2015-2017. Cases in the cluster were concentrated in two urban health regions. Compared to the other G4d cases, cluster cases were all male (p<0.001) and more likely to be HIV-positive (adjusted risk ratio: 4.4; 95% confidence interval: 2.5-7.9). A positive syphilis test result was observed for 27 (73%) of the cluster cases. The sequences in this cluster and of four outlier cases were located on the same monophyletic lineage as G4d sequences reported in HIV-positive men who have sex with men (MSM) in Europe.\u0000\u0000\u0000Conclusion\u0000Molecular phylogenetics enabled the identification and surveillance of ongoing transmission of a specific HCV G4d lineage in HIV-positive and HIV-negative men in Quebec and its cross-continental spread. This information can orient intervention strategies to avoid transmission of HCV in MSM.","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74594171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Toxoplasma gondii is a protozoan parasite that originated in the Amazon. Felids (mammals in the cat family) are the only definitive hosts. These animals shed large numbers of infectious oocysts into the environment, which can subsequently infect many intermediate hosts, including birds, mammals and, possibly, fish. Human T. gondii seroprevalence is high in some parts of the Canadian Arctic and is associated with adverse health consequences among Inuit population. Since the range of felids does not extend to the Arctic, it is not immediately obvious how this parasite got from the Amazon to the Arctic. The objectives of this overview are to summarize the health impacts of T. gondii infection in Inuit in Canada's North and to consider how this infection could have reached them. This article reviews the prevalence of T. gondii infection in terrestrial and marine animals in the Canadian Arctic and discusses their potential role in the foodborne transmission of this parasite to humans. Two distribution factors seem plausible. First, felids in more southern habitats may release infectious oocysts into waterways. As these oocysts remain viable for months, they can be transported northward via rivers and ocean currents and could infect Arctic fish and eventually the marine mammals that prey on the fish. Second, migratory terrestrial and marine intermediate hosts may be responsible for carrying T. gondii tissue cysts to the Arctic, where they may then pass on the infection to carnivores. The most likely source of T. gondii in Inuit is from consumption of traditionally-prepared country foods including meat and organs from intermediate hosts, which may be consumed raw. With climate change, northward migration of felids may increase the prevalence of T. gondii in Arctic wildlife.
{"title":"<i>Toxoplasma gondii</i>: How an Amazonian parasite became an Inuit health issue.","authors":"S J Reiling, B R Dixon","doi":"10.14745/ccdr.v45i78a03","DOIUrl":"https://doi.org/10.14745/ccdr.v45i78a03","url":null,"abstract":"<p><p><i>Toxoplasma gondii</i> is a protozoan parasite that originated in the Amazon. Felids (mammals in the cat family) are the only definitive hosts. These animals shed large numbers of infectious oocysts into the environment, which can subsequently infect many intermediate hosts, including birds, mammals and, possibly, fish. Human <i>T. gondii</i> seroprevalence is high in some parts of the Canadian Arctic and is associated with adverse health consequences among Inuit population. Since the range of felids does not extend to the Arctic, it is not immediately obvious how this parasite got from the Amazon to the Arctic. The objectives of this overview are to summarize the health impacts of <i>T. gondii</i> infection in Inuit in Canada's North and to consider how this infection could have reached them. This article reviews the prevalence of <i>T. gondii</i> infection in terrestrial and marine animals in the Canadian Arctic and discusses their potential role in the foodborne transmission of this parasite to humans. Two distribution factors seem plausible. First, felids in more southern habitats may release infectious oocysts into waterways. As these oocysts remain viable for months, they can be transported northward via rivers and ocean currents and could infect Arctic fish and eventually the marine mammals that prey on the fish. Second, migratory terrestrial and marine intermediate hosts may be responsible for carrying <i>T. gondii</i> tissue cysts to the Arctic, where they may then pass on the infection to carnivores. The most likely source of <i>T. gondii</i> in Inuit is from consumption of traditionally-prepared country foods including meat and organs from intermediate hosts, which may be consumed raw. With climate change, northward migration of felids may increase the prevalence of <i>T. gondii</i> in Arctic wildlife.</p>","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6615440/pdf/ccdr-45-183.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41224687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Huot, A. Paradis, K. Hammond-Collins, M. Bélair, J. Villeneuve, Nicholas Brousseau, I. Goupil-Sormany, J. Riffon
Background From June 7 to June 9, 2018, a G7 Summit was held in the Canadian province of Quebec. This international political mass gathering event posed a number of potential risks to public health. Objective To assess three additional monitoring strategies to detect public health threats during a mass gathering event. Intervention In addition to routine public health monitoring, a partnership was created and three monitoring strategies were put in place three days before, during and six days after the G7 event: the analysis of data on the presenting complaint and discharge diagnosis from 11 emergency departments in the area using the logical Early Aberration Reporting System; the daily polling of key health partners with an online questionnaire; and the analysis of calls to Info-Santé, a government-run telephone consultation service for the public regarding health and social issues. Results Emergency room data produced 78 alerts from the presenting complaints and 39 alerts from the discharge diagnoses. Of these 117 alerts, two were investigated (one in the respiratory and one in the neurological-muscular categories) and no other interventions were required. With a few exceptions, all of the health partners completed the online survey each day and no signal of concern was generated. Compared with historical data, no increase or differences in calls to Info-Santé were detected during the monitoring period. Conclusion The three additional monitoring strategies developed to detect events of public health importance during the 2018 G7 Summit in Quebec were successful in gathering timely data for analysis. Close collaboration and good participation from the different partners were essential to this project. However, because no public health event occurred, it was not possible to determine whether the enhanced surveillance system had sufficient speed and sensitivity for timely detection and response.
{"title":"A public health enhanced surveillance system for a mass gathering event.","authors":"C. Huot, A. Paradis, K. Hammond-Collins, M. Bélair, J. Villeneuve, Nicholas Brousseau, I. Goupil-Sormany, J. Riffon","doi":"10.14745/CCDR.V45I78A05","DOIUrl":"https://doi.org/10.14745/CCDR.V45I78A05","url":null,"abstract":"Background\u0000From June 7 to June 9, 2018, a G7 Summit was held in the Canadian province of Quebec. This international political mass gathering event posed a number of potential risks to public health.\u0000\u0000\u0000Objective\u0000To assess three additional monitoring strategies to detect public health threats during a mass gathering event.\u0000\u0000\u0000Intervention\u0000In addition to routine public health monitoring, a partnership was created and three monitoring strategies were put in place three days before, during and six days after the G7 event: the analysis of data on the presenting complaint and discharge diagnosis from 11 emergency departments in the area using the logical Early Aberration Reporting System; the daily polling of key health partners with an online questionnaire; and the analysis of calls to Info-Santé, a government-run telephone consultation service for the public regarding health and social issues.\u0000\u0000\u0000Results\u0000Emergency room data produced 78 alerts from the presenting complaints and 39 alerts from the discharge diagnoses. Of these 117 alerts, two were investigated (one in the respiratory and one in the neurological-muscular categories) and no other interventions were required. With a few exceptions, all of the health partners completed the online survey each day and no signal of concern was generated. Compared with historical data, no increase or differences in calls to Info-Santé were detected during the monitoring period.\u0000\u0000\u0000Conclusion\u0000The three additional monitoring strategies developed to detect events of public health importance during the 2018 G7 Summit in Quebec were successful in gathering timely data for analysis. Close collaboration and good participation from the different partners were essential to this project. However, because no public health event occurred, it was not possible to determine whether the enhanced surveillance system had sufficient speed and sensitivity for timely detection and response.","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88044251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Middleton, L. Friedman, S. Johnson, S. Buchan, B. Warshawsky
Background The number of rabid terrestrial animals in Ontario has decreased markedly since the 1970s and 1980s. However, the number of recommended rabies postexposure prophylaxis (RPEP) courses has not decreased proportionally. The decision to recommend RPEP for terrestrial animal exposures should be based on a risk assessment that considers the prevalence of rabies in these animals within a jurisdiction, among other factors. Objective To explore trends in RPEP recommendations for exposures to terrestrial animals in Ontario in relation to the recency of terrestrial animal rabies cases by public health unit (PHU) jurisdiction. Methods RPEP recommendation data for the 36 Ontario PHUs were obtained from the Ontario integrated Public Health Information System and animal rabies data by PHU were obtained from the Ministry of Natural Resources and Forestry. We calculated the annual RPEP recommendation rates for terrestrial animals by PHU for 2014 to 2016, and plotted the 2016 rates in relation to the year of the most recently identified rabid terrestrial animal in the PHU. Results Between 2014 and 2016, the annual RPEP recommendation rates for terrestrial animal exposures by PHU ranged from 3.0 to 35.2 per 100,000 persons, with a median of 11.9 RPEP recommendations per 100,000 persons. In 2016, ten PHUs had not identified a rabid terrestrial animal in their jurisdiction for more than15 years. Five of these PHUs had RPEP recommendation rates above the provincial median. Conclusion Along with other factors, consideration of the occurrence of rabies in terrestrial animals in a jurisdiction can assist in the risk assessment of dogs, cats or ferrets that are not available for subsequent observation.
{"title":"Human rabies postexposure prophylaxis and rabid terrestrial animals in Ontario, Canada: 2014-2016.","authors":"D. Middleton, L. Friedman, S. Johnson, S. Buchan, B. Warshawsky","doi":"10.14745/CCDR.V45I78A02","DOIUrl":"https://doi.org/10.14745/CCDR.V45I78A02","url":null,"abstract":"Background\u0000The number of rabid terrestrial animals in Ontario has decreased markedly since the 1970s and 1980s. However, the number of recommended rabies postexposure prophylaxis (RPEP) courses has not decreased proportionally. The decision to recommend RPEP for terrestrial animal exposures should be based on a risk assessment that considers the prevalence of rabies in these animals within a jurisdiction, among other factors.\u0000\u0000\u0000Objective\u0000To explore trends in RPEP recommendations for exposures to terrestrial animals in Ontario in relation to the recency of terrestrial animal rabies cases by public health unit (PHU) jurisdiction.\u0000\u0000\u0000Methods\u0000RPEP recommendation data for the 36 Ontario PHUs were obtained from the Ontario integrated Public Health Information System and animal rabies data by PHU were obtained from the Ministry of Natural Resources and Forestry. We calculated the annual RPEP recommendation rates for terrestrial animals by PHU for 2014 to 2016, and plotted the 2016 rates in relation to the year of the most recently identified rabid terrestrial animal in the PHU.\u0000\u0000\u0000Results\u0000Between 2014 and 2016, the annual RPEP recommendation rates for terrestrial animal exposures by PHU ranged from 3.0 to 35.2 per 100,000 persons, with a median of 11.9 RPEP recommendations per 100,000 persons. In 2016, ten PHUs had not identified a rabid terrestrial animal in their jurisdiction for more than15 years. Five of these PHUs had RPEP recommendation rates above the provincial median.\u0000\u0000\u0000Conclusion\u0000Along with other factors, consideration of the occurrence of rabies in terrestrial animals in a jurisdiction can assist in the risk assessment of dogs, cats or ferrets that are not available for subsequent observation.","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79778397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}