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Reaping the benefits of Open Data in public health. 获取开放数据在公共卫生方面的好处。
P Huston, V L Edge, E Bernier

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.

开放数据是一场广泛的全球运动的一部分,这场运动不仅推动了科学和科学交流,而且改变了现代社会和决策方式。从呼吁开放科学和在线期刊的兴起开始,已经扩展到开放数据,前提是如果数据报告是公开的,那么生成的或支持的数据也应该是公开的。在过去的十年里,开放数据取得了许多进步,主要是由政府带头的。开放数据的真正好处不仅仅是单个数据库可以更广泛地使用;这些数据也可以被利用、共享,并与其他数据相结合。开放数据促进了科学合作,丰富了研究,提高了决策的分析能力。例如,在人类和环境健康领域,访问和组合各种数据的能力可以促进早期信号检测,改进分析和评估,为计划和政策制定提供信息,提高公众参与能力,提高透明度,提高问责制。然而,挑战依然存在。需要大量的资源来实现向开放和可互操作的数据库的技术转变,这些数据库可以使用通用协议和术语访问。在数据生成器和用户中,这种转变还涉及一种文化变化:从将数据库视为受限制的知识产权,到将数据视为共同利益。在进行这一转变时,需要考虑到法律和道德因素。最后,在努力修改基础设施和解决文化、法律和道德问题的同时,公平有效地共享信息也很重要。尽管开放、及时、公平和直接共享数据具有巨大潜力,但充分实现开放数据的无数好处将取决于如何有效应对这些挑战。
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引用次数: 46
Updates to the Canadian Notifiable Disease Surveillance System and its interactive website. 加拿大法定疾病监测系统及其互动网站的更新。
S Totten, A Medaglia, S McDermott

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.

加拿大法定疾病监测系统提供已被确定为公共卫生监测和控制重点的疾病数据。全国疾病预防控制系统互动网站“法定疾病在线”取得的一些进展符合加拿大政府对开放数据的承诺。本文提供了自2009年上一次发布案例定义以来案例定义变化的最新情况,并描述了自2013年以来对交互式网站的更新。对五种疾病的病例定义进行了修改。对于丙型肝炎,新的病例定义现在区分了急性和慢性感染。对于环孢子虫病,可能的病例定义需要流行病学联系,并澄清这可能是由于接触了常见的食物来源。对于狂犬病,可能病例的定义现在是指检测狂犬病中和抗体,而不是特异性抗体滴度。对于莱姆病,修订后的确诊和疑似病例定义现在确定了莱姆病风险区而不是流行区的五种选择。对于结核病,修订后的病例定义现在除了用于诊断的培养外,还包括核酸扩增检测。法定疾病在线网站是一个交互式工具,用户可以创建自定义的图表。自2013年进行重大重新设计以来,网站的外观和感觉发生了许多变化。图形和表格现在可以提取为Excel或PDF文件,大型数据集可以导出到Excel文件中进行进一步分析。国家监测系统中的病例定义将根据需要进行更新,其互动网站将继续根据用户意见进行改进和更新。
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引用次数: 2
Community outbreak of hepatitis A disproportionately affecting men who have sex with men in Toronto, Canada, January 2017-November 2018. 2017年1月至2018年11月,加拿大多伦多甲型肝炎社区爆发对男男性行为者的影响不成比例。
H. Sachdeva, M. Benusic, S. Ota, R. Stuart, J. Maclachlan, V. Dubey, A. Andonov
BackgroundIn 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.ObjectiveTo describe the epidemiology and public health response to an outbreak of HAV disproportionately affecting MSM in Toronto, Canada from January 2017 to November 2018.MethodsFollowing 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.ResultsBased 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.ConclusionOutbreaks 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.
2016年底和2017年初,一些国家开始报告甲型肝炎病毒(HAV)暴发,涉及男男性行为者(MSM)、非法吸毒者和无家可归者或住房不足者之间的人际传播。目的描述2017年1月至2018年11月加拿大多伦多甲型肝炎暴发的流行病学和公共卫生应对情况。方法随着其他国家报告的MSM中HAV病例数量的增加,对2017年6月1日至2018年11月1日报告的所有非旅行相关HAV病例进行了加强监测,包括对2017年1月至2017年6月报告的病例进行回顾性分析。进行描述性分析和病毒测序以描述人与人之间的传播模式和目标干预措施。控制战略包括采取干预措施,促进接触前甲肝疫苗接种,包括针对男男性行为者的社交媒体运动,向卫生保健提供者和疫苗诊所发送信息。结果根据暴发病例定义,共发现52例甲肝确诊和疑似病例。80%以上的暴发病例为男性(n=43/52),在可获得数据的病例中,64% (n=25/39)报告曾接触过男男性接触者。有51个病例的住院数据;56%的确诊病例(n=23/41)和40%的可能病例(n=4/10)需要住院治疗。在血清样本进行甲肝病毒测序的病例中,83% (n=30/36)携带国际上在男男性行为者中暴发流行的三种毒株之一;72% (n=26/36)为VRD_521_2016,该病毒已在最近报告的欧洲MSM暴发中检测到。利用受男男性行为者欢迎的社交媒体平台和有针对性的疫苗诊所,有针对性地促进公共资助的疫苗接种,以提高男男性行为者对甲肝病毒的认识和疫苗接种。结论加拿大现已发生甲型肝炎疫情,原因是甲型肝炎毒株的人际传播,对男同性恋者的影响不成比例,可能是从国际男同性恋者疫情输入的。甲肝病毒的基因测序、病例的风险因素分析、监测高危人群疫苗覆盖率的趋势以及开展疫苗接种运动,以解决男男男性行为人群中甲肝病毒暴露前疫苗覆盖率的障碍,这些都可能预防未来的疫情。
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引用次数: 18
Surveillance of laboratory exposures to human pathogens and toxins: Canada 2018. 实验室暴露于人类病原体和毒素的监测:加拿大2018。
D. Choucrallah, L. Sarmiento, S. Ettles, F. Tanguay, M. Heisz, E. Falardeau
BackgroundThe 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.ObjectiveTo 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.MethodsLaboratory 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.ResultsIn 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.ConclusionAlthough 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.
加拿大实验室事件通报(LINC)监测系统监测根据《人类病原体和毒素法》报告的实验室事件。2018年是该数据的第三个完整年份。目的比较2018年加拿大发生的实验室暴露和实验室获得性感染事件,并按部门、涉及的人类病原体和毒素、受影响人数、事件类型和根本原因进行分类。方法通过LINC系统报告2018年发生的实验室事件。将实验室事件数量、暴露人员数量和实验室获得性感染数量与往年进行比较,然后按部门、涉及的人类病原体或毒素、事件类型、暴露人员、暴露途径和根本原因对事件进行分析。使用Microsoft Excel 2016进行描述性分析。结果2018年共发生人致病菌暴露事件89起,暴露人数235人。有5例疑似感染和1例确诊实验室获得性感染。这大约是2017年(n=44)和2016年(n=46)报告的暴露事件数量的两倍。接触事件发生在学术和医院部门的数量最多,私营部门的发生率与许可证的比率最低。大多数事件(n=50;56%)涉及在2级控制实验室中处理的2级危险组人类病原体。大多数暴露与利器或程序有关,最常见的暴露者是实验室技术人员。人与人之间的互动和标准操作程序是主要的根本原因。结论尽管加拿大实验室暴露的年总体发生率仍然相对较低,但2018年的发生率高于往年。目前尚不清楚这是发病率的真正增加还是报告数量的增加,因为基线估计仍在确定中。
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引用次数: 8
Use of a case-control study and control bank to investigate an outbreak of locally acquired cyclosporiasis in Canada, 2016. 使用病例对照研究和对照库调查2016年加拿大当地获得性环孢子虫病暴发。
V. Morton, K. Meghnath, M. Gheorghe, A. Fitzgerald-Husek, J. Hobbs, L. Honish, S. David
BackgroundCyclospora 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.ObjectiveTo 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.MethodsCases 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.ResultsIn 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.ConclusionBlackberries 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.
背景环孢子虫是一种肠道寄生虫,在加拿大并不是地方性的。然而,自2013年以来,据报告在全国暴发了当地获得性病例。怀疑这些暴发与食用从环孢子虫流行国家进口的农产品有关。由于报告延迟和产品的可追溯性有限,确定来源可能具有挑战性。目的报告一起地方性获得性环孢子虫病的全国性暴发,强调调查这些暴发所面临的挑战,并记录加拿大首次使用对照库为全国性暴发病例对照研究招募对照者。方法采用省级实验室检测方法对环孢子虫病病例进行鉴定,并通过各省上报至国家一级。使用问卷对病例进行食物暴露情况访谈,并将病例报告的食物暴露情况与《食物手册》参考值进行比较。为了缩小感兴趣的食物项目,进行了匹配的病例对照研究。研究的对照主要是从对照库中招募的,即先前同意参加公共健康相关调查的个人名单。结果2016年5月19日至2016年8月10日,4个省共报告发病或报告日期为本地获得性环孢子虫病87例。将病例暴露与《食物手册》参考值进行比较,确定了几种感兴趣的食物,包括黑莓、其他浆果、草药和绿叶蔬菜。病例对照研究发现,只有黑莓和青绿色蔬菜的食用频率明显高于对照组。由于缺乏黑莓和青菜的产品细节,疫情的来源尚未最终确定。结论黑莓是研究的主要食品,但由于缺乏可追溯性,无法确定其来源。对照库被认为是对照招募的有用工具。
{"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}
引用次数: 2
Shiga toxin-producing Escherichia coli in British Columbia, 2011-2017: Analysis to inform exclusion guidelines. 2011-2017年不列颠哥伦比亚省产志贺毒素大肠杆菌:为排除指南提供信息的分析
K. Noftall, K. Noftall, M. Taylor, L. Hoang, L. Hoang, E. Galanis, E. Galanis
BackgroundShiga 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.ObjectiveTo analyze British Columbia (BC) laboratory and surveillance data to inform the BC STEC exclusion guideline.MethodsFor 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.ResultsOver 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.ConclusionThe 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.
产志贺毒素的大肠杆菌(STEC)可通过产生志贺毒素1 (Stx1)和2 (Stx2)导致严重疾病,包括血性腹泻和溶血性尿毒症综合征(HUS)。大肠杆菌O157:H7是20世纪80年代至90年代检测到的最常见血清型,但实验室方法的改进导致非O157产志贺毒素大肠杆菌的检测增加。非o157产STEC只产生Stx1倾向于引起较轻的临床疾病。排除指南限制产志贺毒素大肠杆菌病例返回高风险工作或环境,但大多数不区分产志贺毒素大肠杆菌血清组和Stx型。目的分析不列颠哥伦比亚省(BC)实验室和监测数据,为BC省产志贺毒素大肠杆菌排除指南提供依据。方法对2011-2017年BC省报告的所有产志贺毒素大肠杆菌病例,分别通过省级实验室和报告性疾病电子系统获取实验室和流行病学数据。测量所有产志贺毒素大肠杆菌合并的发病率以及血清组。测定血清组、Stx型和临床结果之间的相关性。结果7年间共报告产志贺毒素大肠杆菌984例。O157的发病率下降,而非O157的发病率上升。O157血清组与Stx2显著相关。Stx2与出血性腹泻、住院和溶血性尿毒综合征有显著相关性。结论随着实验室越来越多地区分O157和非O157病例并确定Stx型,BC省STEC的流行病学发生了变化。非O157型Stx1病例的严重程度似乎低于O157型Stx2病例。该分析结果更新了BC产志在大肠杆菌排除指南。
{"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}
引用次数: 7
Molecular surveillance of hepatitis C virus genotypes identifies the emergence of a genotype 4d lineage among men in Quebec, 2001-2017. 2001-2017年魁北克省男性丙型肝炎病毒基因型分子监测发现基因型4d谱系的出现。
DG Murphy, R. Dion, M. Simard, ML Vachon, Valérie Martel-Laferrière, B. Serhir, J. Longtin
BackgroundMolecular 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.ObjectivesTo 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.MethodsThe 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.ResultsPhylogenetic 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.ConclusionMolecular 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.
分子系统遗传学通常用于确认丙型肝炎病毒(HCV)传播事件。此外,自2001年11月以来,qu公共实验室(LSPQ)一直在使用分子系统遗传学监测HCV基因分型。目的研究HCV基因型4d (G4d)特异性谱系的出现及其特征,并用分子系统发育学作为HCV株聚类鉴定的监测工具。方法LSPQ对2001年11月至2017年12月采集的样本进行前瞻性Sanger测序和系统发育分析,确定HCV基因型。当确定一个主要的G4d集群时,对人口统计信息、hiv感染状况和梅毒检测结果进行分析。结果对22000例患者进行系统发育分析,鉴定出122例G4d病例。选出了一个由37个病例组成的主要G4d集群。2010年2例,2011-2014年10例,2015-2017年25例。聚集性病例集中在两个城市卫生区。与其他G4d病例相比,聚集性病例均为男性(p<0.001), hiv阳性的可能性更大(校正风险比:4.4;95%置信区间:2.5-7.9)。聚集性病例中梅毒检测阳性27例(73%)。该聚类和4个异常病例的序列与欧洲hiv阳性男男性行为者(MSM)报告的G4d序列位于同一单系谱系上。结论分子系统遗传学能够识别和监测魁北克hiv阳性和hiv阴性男性中特定HCV G4d谱系的持续传播及其跨大陆传播。这些信息可以指导干预策略以避免HCV在男男性行为者中的传播。
{"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}
引用次数: 8
Toxoplasma gondii: How an Amazonian parasite became an Inuit health issue. 弓形虫:亚马逊寄生虫如何成为因纽特人的健康问题。
S J Reiling, B R Dixon

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.

弓形虫是一种起源于亚马逊的原生动物寄生虫。猫科动物是唯一确定的宿主。这些动物向环境中释放大量具有传染性的卵囊,这些卵囊随后会感染许多中间宿主,包括鸟类、哺乳动物,可能还有鱼类。人类弓形虫血清流行率在加拿大北极的一些地区很高,并与因纽特人的不良健康后果有关。由于猫科动物的范围并没有延伸到北极,目前还不清楚这种寄生虫是如何从亚马逊传播到北极的。本综述的目的是总结弓形虫感染对加拿大北部因纽特人健康的影响,并考虑这种感染是如何传播给他们的。本文综述了弓形虫在加拿大北极陆地和海洋动物中的感染率,并讨论了它们在这种寄生虫食源性传播给人类中的潜在作用。两个分布因素似乎是合理的。首先,南方栖息地的猫科动物可能会将传染性卵囊释放到水道中。由于这些卵囊可以存活数月,它们可以通过河流和洋流向北运输,并可能感染北极鱼类,最终感染捕食这些鱼类的海洋哺乳动物。其次,迁徙的陆地和海洋中间宿主可能负责将弓形虫组织囊肿携带到北极,然后在那里将感染传染给食肉动物。因纽特人弓形虫最可能的来源是食用传统的乡村食品,包括中间宿主的肉和器官,这些食物可能是生吃的。随着气候变化,猫科动物的北迁可能会增加弓形虫在北极野生动物中的流行率。
{"title":"<i>Toxoplasma gondii</i>: How an Amazonian parasite became an Inuit health issue.","authors":"S J Reiling,&nbsp;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}
引用次数: 18
A public health enhanced surveillance system for a mass gathering event. 针对大规模聚集事件的公共卫生强化监测系统。
C. Huot, A. Paradis, K. Hammond-Collins, M. Bélair, J. Villeneuve, Nicholas Brousseau, I. Goupil-Sormany, J. Riffon
BackgroundFrom 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.ObjectiveTo assess three additional monitoring strategies to detect public health threats during a mass gathering event.InterventionIn 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.ResultsEmergency 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.ConclusionThe 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.
2018年6月7日至9日,七国集团峰会在加拿大魁北克省举行。这一国际政治大规模集会事件对公共卫生构成了若干潜在风险。目的评价在人群聚集事件中发现公共卫生威胁的另外三种监测策略。干预措施除了常规的公共卫生监测外,还建立了伙伴关系,并在七国集团会议的三天前、期间和六天后实施了三项监测战略:利用逻辑早期异常报告系统分析该地区11个急诊部门提出的投诉和出院诊断数据;每天对主要卫生合作伙伴进行在线问卷调查;以及对为公众提供有关健康和社会问题的政府电话咨询服务info - sant的电话进行分析。结果急诊室数据从主诉中产生78个警报,从出院诊断中产生39个警报。在这117个警报中,调查了两个(一个在呼吸系统,一个在神经-肌肉类别),不需要其他干预措施。除了少数例外,所有卫生合作伙伴每天都完成了在线调查,没有产生任何关注的信号。与历史数据相比,在监测期间,对信息圣诞老人的呼叫没有增加或差异。结论2018年七国集团魁北克峰会期间,为发现具有公共卫生重要性的事件而制定的三项额外监测战略成功地收集了及时的数据以供分析。来自不同合作伙伴的密切合作和良好参与对这个项目至关重要。然而,由于没有发生公共卫生事件,因此无法确定加强后的监测系统是否有足够的速度和灵敏度及时发现和作出反应。
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引用次数: 0
Human rabies postexposure prophylaxis and rabid terrestrial animals in Ontario, Canada: 2014-2016. 加拿大安大略省人类狂犬病暴露后预防和狂犬病陆生动物:2014-2016年。
D. Middleton, L. Friedman, S. Johnson, S. Buchan, B. Warshawsky
BackgroundThe 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.ObjectiveTo 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.MethodsRPEP 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.ResultsBetween 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.ConclusionAlong 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.
自20世纪70年代和80年代以来,安大略省患狂犬病的陆生动物数量显著减少。然而,推荐的狂犬病暴露后预防(RPEP)疗程的数量并没有按比例减少。就陆生动物接触建议RPEP的决定应基于风险评估,该评估应考虑管辖范围内这些动物的狂犬病流行情况以及其他因素。目的探讨安大略省公共卫生单位(PHU)管辖范围内陆生动物暴露RPEP建议的趋势与陆生动物狂犬病病例的关系。方法安大略省36只PHU的srpep推荐数据来自安大略省综合公共卫生信息系统,PHU的动物狂犬病数据来自自然资源和林业部。我们计算了2014年至2016年PHU对陆生动物的年度RPEP推荐率,并绘制了2016年率与PHU中最近发现的陆生动物狂犬病年份的关系图。结果2014 - 2016年,PHU对陆生动物暴露的年度RPEP推荐率为3.0 ~ 35.2 / 10万人,中位数为11.9 / 10万人。2016年,10个phu超过15年未在其管辖范围内发现患有狂犬病的陆生动物。其中5个phu的RPEP推荐率高于省级中位数。结论考虑辖区内陆生动物狂犬病发生情况及其他因素,有助于对无法进行后续观察的犬、猫或雪貂进行风险评估。
{"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}
引用次数: 0
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Canada communicable disease report = Releve des maladies transmissibles au Canada
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