The relationship between hot temperatures and hospital admissions for psychosis in adults diagnosed with schizophrenia: A case-crossover study in Quebec, Canada.

INTRODUCTION: Some studies have found hot temperatures to be associated with exacerbations of schizophrenia, namely psychoses. As climate changes faster in Northern countries, our understanding of the association between temperature and hospital admissions (HA) for psychosis needs to be deepened. OBJECTIVES: 1) Among adults diagnosed with schizophrenia, measure the relationship between mean temperatures and HAs for psychosis during summer. 2) Determine the influence of individual and ecological characteristics on this relationship. METHODS: A cohort of adults diagnosed with schizophrenia (n = 30,649) was assembled using Quebec's Integrated Chronic Disease Surveillance System (QICDSS). The follow-up spanned summers from 2001 to 2019, using hospital data from the QICDSS and meteorological data from the National Aeronautics and Space Administration's (NASA) Daymet database. In four geographic regions of the province of Quebec, a conditional logistic regression was used for the case-crossover analysis of the relationship between mean temperatures (at lags up to 6 days) and HAs for psychosis using a distributed lag non-linear model (DLNM). The analyses were adjusted for relative humidity, stratified according to individual (age, sex, and comorbidities) and ecological (material and social deprivation index and exposure to green space) factors, and then pooled through a meta-regression. RESULTS: The statistical analyses revealed a statistically significant increase in HAs three days (lag 3) after elevated mean temperatures corresponding to the 90th percentile relative to a minimum morbidity temperature (MMT) (OR 1.040; 95% CI 1.008-1.074), while the cumulative effect over six days was not statistically significant (OR 1.052; 95% IC 0.993-1.114). Stratified analyses revealed non statistically significant gradients of increasing HAs relative to increasing material deprivation and decreasing green space levels. CONCLUSIONS: The statistical analyses conducted in this project showed the pattern of admissions for psychosis after hot days. This finding could be useful to better plan health services in a rapidly changing climate.

Detection of COVID-19 case clusters in Québec, May-October 2020.

OBJECTIVES: The Quebec Public Health Institute (INSPQ) was mandated to develop an automated tool for detecting space-time COVID-19 case clusters to assist regional public health authorities in identifying situations that require public health interventions. This article aims to describe the methodology used and to document the main outcomes achieved. METHODS: New COVID-19 cases are supplied by the "Trajectoire de santé publique" information system, geolocated to civic addresses and then aggregated by day and dissemination area. To target community-level clusters, cases identified as residents of congregate living settings are excluded from the cluster detection analysis. Detection is performed using the space-time scan statistic and Poisson statistical model, and implemented in the SaTScan software. Information on detected clusters is disseminated daily via an online interactive mapping interface. RESULTS: The number of clusters detected tracked with the number of new cases. Slightly more than 4900 statistically significant (p ≤ 0.01) space-time clusters were detected over 14 health regions from May to October 2020. The Montréal region was the most affected. CONCLUSION: Considering the objective of timely cluster detection, the use of near-real-time health surveillance data of varying quality over time and by region constitutes an acceptable compromise between timeliness and data quality. This tool serves to supplement the epidemiologic investigations carried out by regional public health authorities for purposes of COVID-19 management and prevention.

RéSUMé: OBJECTIFS: L'Institut national de santé publique du Québec (INSPQ) a reçu le mandat d'élaborer un outil de détection automatisé des agrégats spatio-temporels des cas de COVID-19 afin d'aider les régions à détecter des situations nécessitant des interventions de santé publique. Cet article vise à décrire la méthodologie utilisée et à présenter les principaux résultats obtenus. MéTHODE: Les nouveaux cas de COVID-19 proviennent du Système d'information Trajectoire de santé publique, ils sont géolocalisés à l'adresse civique, puis agrégés par jour et par aire de diffusion. Afin d'isoler la transmission communautaire, les cas identifiés comme résidents d'un milieu de vie fermé sont exclus des analyses de détection des agrégats. La méthode de détection est la statistique de balayage spatio-temporel basée sur le modèle de Poisson et implantée dans le logiciel SaTScan . Les agrégats détectés sont diffusés quotidiennement dans une interface cartographique web interactive. RéSULTATS: Le nombre d'agrégats détectés varie en fonction du nombre de nouveaux cas. Un peu plus de 4 900 agrégats spatio-temporels statistiquement significatifs (p ≤ 0,01) ont été détectés dans 14 régions sociosanitaires entre mai et octobre 2020. La région de Montréal est la plus touchée. CONCLUSION: Considérant l'objectif d'une détection d'agrégats en temps opportun, l'utilisation des données de vigie sanitaire en temps quasi réel, dont la qualité est variable dans le temps et selon les régions, constitue un compromis acceptable. Il s'agit d'un outil complémentaire aux enquêtes épidémiologiques menées par les autorités régionales de santé publique dans la gestion et la prévention des impacts populationnels de la COVID-19.

Mosquitoes Know No Borders: Surveillance of Potential Introduction of Aedes Species in Southern Québec, Canada.

Current climatic conditions limit the distribution of Aedes (Stegomyia) albopictus (Skuse, Diptera: Culicidae) in the north, but predictive climate models suggest this species could establish itself in southern Canada by 2040. A vector of chikungunya, dengue, yellow fever, Zika and West Nile viruses, the Ae. Albopictus has been detected in Windsor, Ontario since 2016. Given the potential public health implications, and knowing that Aedes spp. can easily be introduced by ground transportation, this study aimed to determine if specimens could be detected, using an adequate methodology, in southern Québec. Mosquitoes were sampled in 2016 and 2017 along the main roads connecting Canada and the U.S., using Biogent traps (Sentinel-2, Gravide Aedes traps) and ovitraps. Overall, 24 mosquito spp. were captured, excluding Ae. Albopictus, but detecting one Aedes (Stegomyia) aegypti (Skuse) specimen (laid eggs). The most frequent species among captured adults were Ochlerotatus triseriatus, Culex pipiens complex, and Ochlerotatus japonicus (31.0%, 26.0%, and 17.3%, respectively). The present study adds to the increasing number of studies reporting on the range expansions of these mosquito species, and suggests that ongoing monitoring, using multiple capture techniques targeting a wide range of species, may provide useful information to public health with respect to the growing risk of emerging mosquito-borne diseases in southern Canada.