Pandemic influenza (H1N1): our Canadian response.

The emergence of pandemic influenza (H1N1) 2009 in spring 2009 has provided a real test to the pandemic preparations that Canada, other countries and the World Health Organization have undertaken. Although formidable challenges remain, Canada is as well prepared as any country to address the second wave of the pandemic expected in the fall.

Nationwide measles epidemic in Ukraine: the effect of low vaccine effectiveness.

The WHO European Region has a measles elimination target for 2010. Between September 2005 and mid-June 2006, more than 50,000 measles cases were reported in Ukraine; many reportedly had received two doses of measles vaccine and over 60% were among persons 15-29 years old. To investigate vaccine effectiveness (VE), a case-control study was undertaken in Dnepropetrovsk region. VE for two doses of measles vaccine was 93.1%, providing insufficient population immunity for measles elimination. An additional dose of measles vaccine for these age-cohorts is required if Ukraine is to achieve measles elimination. Other republics of the former Soviet Union also need to consider a supplemental dose of measles vaccine for older age groups identified epidemiologically to be at increased risk for measles even though individuals may have already received two doses.

Reducing the global burden of congenital rubella syndrome: report of the World Health Organization Steering Committee On Research Related To Measles and Rubella Vaccines and Vaccination, June 2004.

Rubella and congenital rubella syndrome (CRS) continue to be important health problems in many countries. In June 2004, the World Health Organization Steering Committee on Research Related to Measles and Rubella Vaccines and Vaccination met to evaluate data from research and operational activities and to identify critical scientific issues and gaps in knowledge that need to be addressed to improve the global control of rubella and CRS. Information about surveillance for rubella, natural and vaccine-induced immunity to rubella, laboratory diagnosis, the molecular epidemiological profile of rubella virus, and mathematical modeling to assess the burden of CRS and the impact of rubella vaccination was reviewed. This report summarizes the presentations and recommendations for future research.

Measles and rubella in the World Health Organization European region: diversity creates challenges.

Since 1984, the World Health Organization (WHO) European Region has had targets for reducing the burden of a number of communicable diseases. While some countries have already met the targets for interrupting indigenous measles transmission and for reducing the incidence of congenital rubella syndrome to <1 case per 100,000 births, most have not. The cultural and economic diversity of the region present a number of challenges that must be overcome before the regional targets are met. These include social factors, political will, economic costs associated with supplementary campaigns, and more effective communication with health professionals and the public on the benefits and risks associated with immunization. Most WHO European Region member states are expected to use combined measles-mumps-rubella vaccine within the next 5 years. Consultation within the region is occurring on a strategic plan to meet the targets by 2010.

Canadian Perspectives on Verocytotoxin-Producing Escherichia coli Infection †.

Infection with verocytotoxin-producing Escherichia coli (VTEC) became nationally reportable in 1990. Between 1990 and 1994, the national incidence of reported infections ranged from 3 to 5.3 per 100,000 inhabitants. Most cases are sporadic and are caused by E. coli O157:H7. Recent investigations have identified that, in addition to exposure to undercooked ground beef, contact with cattle, consumption of well water, and exposure to rural environments are important risk factors for VTEC infection. Also, results of case control studies and detection of asymptomatic fecal carriage of E. coli O157:H7 and other VTEC in farm family members and abattoir workers have led to an increasing emphasis on person-to-person spread in the epidemiology of VTEC infection. Controlling E. coli O157:H7 and other VTEC at the farm level may therefore have a broader impact than simply reducing the risk of foodborne VTEC infection. Longitudinal studies on dairy farms have demonstrated that E. coli O157:H7 carriage by cattle at the farm and animal level is often transient, and that cattle, rather than the farm environment, are the major reservoir for this organism on dairy farms. Small herds that are controlled by traditional management practices have the highest risk for VTEC infection. Further studies are likely to result in development of effective strategies to control VTEC at the farm level.

Growing Concerns and Recent Outbreaks Involving Non-O157:H7 Serotypes of Verotoxigenic Escherichia coli.

Verocytotoxin-producing E. coli (VTEC) of serotype O157:H7 have been shown to be important agents of foodborne disease in humans worldwide. While the majority of research effort has been targeted on this serotype it is becoming more evident that other serotypes of VTEC can also be associated with human disease. An increasing number of these non-O157:H7 VTEC have been isolated from humans suffering from HUS and diarrhea. Recently a number of foodborne outbreaks in the USA, Australia, and other countries have been attributed to non-O157:H7 VTEC serotypes. Surveys of animal populations in a variety of countries have shown that the cattle reservoir contains more than 100 serotypes of VTEC, many of which are similar to those isolated from humans. The diversity and complexity of the VTEC family requires that laboratories and public health surveillance systems have the ability to detect and monitor all serotypes of VTEC.