Public health risks of raw milk consumption: Lessons from a case of paediatric hemolytic uremic syndrome.

Pasteurization of raw milk is mandatory before sale in Canada and has been demonstrated to reduce the risk of food-borne illness associated with milk consumption. Consumption of raw milk sparks urgent concern from a public health perspective since it has been linked to numerous outbreaks by enteric organisms, particularly Escherichia coli-related illnesses and complications in pediatric populations. The sale and distribution of raw milk is illegal in Canada, based on these significant health risks, but growing popular interest and trends in consuming raw dairy products reflect changes in consumer preferences. Although the consumption of raw milk has been an ongoing issue, this new trend is alarming and action is needed to prevent serious consequences as seen in children and other populations with reduced immunity such as the elderly and pregnant people. This commentary explores key issues identified by a local public health unit during the investigation of a recent paediatric case of hemolytic uremic syndrome related to an E. coli O157:H7 infection that occurred within the context of consumption of raw milk. The main objective of this article is to highlight that the health risks and sequelae associated with consumption of raw milk far outweigh any potential benefits, with severe consequences particularly among children. Data and health impacts, distribution, regulation, pasteurization and proposed practice recommendations are also identified and discussed.

Epidemiological analysis of the emergence and disappearance of the SARS-CoV-2 Kappa variant within a region of British Columbia, Canada.

Background: The 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. Objectives: To 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. Methods: Clinical 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. Results: A 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. Conclusion: Epidemiological 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.

Obesity prevalence in large US cities: association with socioeconomic indicators, race/ethnicity and physical activity.

BACKGROUND: Obesity has a complex association with socioeconomic factors. Further clarification of this association could guide population interventions. METHODS: To determine the relationship between obesity prevalence, socioeconomic indicators, race/ethnicity, and physical activity, we performed a cross-sectional, multivariable linear regression, with data from large US cities participating in the Big Cities Health Inventory. RESULTS: Increased household income was significantly associated with decreased obesity prevalence, for White (-1.97% per 10 000USD), and Black (-3.02% per 10 000USD) populations, but not Hispanic. These associations remained significant when controlling for the proportion of the population meeting physical activity guidelines. Educational attainment had a co-linear relationship with income, and only a bachelor's degree or higher was associated with a lower prevalence of obesity in White (-0.30% per percentage) and Black (-0.69% per percentage) populations. No association was found between obesity prevalence and the proportion of the population meeting physical activity guidelines for any race/ethnicity grouping. CONCLUSION: At the population level of large US cities, obesity prevalence is inversely associated with median household income in White and Black populations. Strategies to increase socioeconomic status may also decrease obesity. Targeting attainment of physical activity guidelines as an obesity intervention needs further appraisal.

A cluster of Bacillus cereus bacteremia cases among injection drug users.

Bacillus cereus is a ubiquitous spore-forming organism that is infrequently implicated in extraintestinal infections. The authors report three cases of B cereus bacteremia among injection drug users presenting within one month to an urban tertiary care hospital. Treatment with intravenous vancomycin was successful in all three cases. While temporal association suggested an outbreak, molecular studies of patient isolates using pulsed-field gel electrophoresis did not suggest a common source. A review of the association of B cereus infections with heroin use and treatment of this pathogen is provided.

Le Bacillus cereus est un organisme sporulé omniprésent qui est parfois responsable d'infections extra-intestinales. Les auteurs rendent compte de trois cas de bactériémie à B cereus chez des consommateurs de drogue injectable qui ont consulté au cours du même mois dans un hôpital urbain de soins tertiaires. Dans les trois cas, un traitement intraveineux à la vancomycine a donné de bons résultats. L'association temporelle laissait suggérer une éclosion, mais des études moléculaires d'isolats de patients par électrophorèse en champ pulsé n'évoquaient pas une source commune. Les chercheurs proposent une analyse de l'association des infections à B cereus à la consommation d'héroïne et du traitement de cet agent pathogène.