Estimating the burden of illness caused by domestic waterborne Legionnaires' disease in Canada: 2015-2019.

Legionellosis is a disease caused by the bacterium Legionella that most commonly presents as Legionnaires' disease (LD), a severe form of pneumonia. From 2015 to 2019, an average of 438 LD cases per year were reported in Canada. However, it is believed that the actual number of cases is much higher, since LD may be underdiagnosed and underreported. The purpose of this study was to develop an estimate of the true incidence of illnesses, hospitalizations, and deaths associated with LD in Canada. Values were derived using a stochastic model, based on Canadian surveillance data from 2015 to 2019, which were scaled up to account for underdiagnosis and underreporting. Overall, there were an estimated 1,113 (90% CrI: 737-1,730) illnesses, 1,008 (90% CrI: 271-2,244) hospitalizations, and 34 (90% CrI: 4-86) deaths due to domestically acquired waterborne LD annually in Canada from 2015 to 2019. It was further estimated that only 36% of illnesses and 39% of hospitalizations and deaths were captured in surveillance, and that 22% of illnesses were caused by Legionella serogroups and species other than Legionella pneumophila serogroup 1 (non-Lp1). This study highlights the true burden and areas for improvement in Canada's surveillance and detection of LD.

Modifiable management practices to improve udder health in dairy cattle during the dry period and early lactation: A scoping review.

The objective of this scoping review was to characterize all available literature on modifiable management practices used during the dry period that have been evaluated for their effects on udder health in dairy cattle during the dry period and the subsequent lactation. Five databases and two conference proceedings were searched for relevant literature. Articles published in or after 1990 were eligible for inclusion. Eligible interventions or exposures were restricted to modifiable management practices; however, antimicrobial and teat sealant products were enumerated but not further characterized, as systematic reviews have been published on this topic. Other modifiable management practices were reported in 229 articles. Nutrition (n = 79), which included ration formulation and delivery (n = 44) and vitamin and mineral additives (n = 35), was the most commonly reported practice, followed by vaccines (n = 40) and modification of dry period length (n = 27). Risk of clinical mastitis (CM) was the most commonly reported outcome (n = 151); however, reporting of outcome risk periods varied widely between articles. Cure of existing intramammary infections (IMI) over the dry period (n = 40) and prevention of new IMI over the dry period (n = 54) were most commonly reported with a risk period between calving and 30 d in milk. Future systematic reviews with meta-analyses could target management practices such as nutrition, vaccines, and dry period length to quantify their effects on improving udder health during the dry period and early lactation. However, the variation in reporting of time at risk for CM and other outcomes challenges the ability of future synthesis work to inform management decisions on the basis of efficacy to cure or prevent IMI and CM. Consensus on which core outcomes should be evaluated in mastitis research and the selection of consistent risk periods for specific outcomes in animal trials is imperative.

A Systematic Review and Meta-Analysis of Depression among Farming Populations Worldwide.

A systematic review and meta-analysis were conducted to determine the overall prevalence of depression among farming populations globally, and explore any heterogeneity present. Eligible studies were primary research articles published in English, which involved the collection of data for the purpose of determining the prevalence of depression among a farming population. Four relevant databases were searched in January 2019. Potential for bias was assessed using a modified Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. From 7662 records, 72 articles were deemed relevant and had data extracted. Of these, 45 utilized the Center for Epidemiologic Studies-Depression Revised scale (CES-D/DR) to quantify depression, 42 of which were conducted in the United States (U.S.). As a result, meta-analyses were restricted to this geographic location. Substantial heterogeneity was seen in the initial whole-group analysis (I2 = 97%), and while sub-group exploration suggested a significantly higher prevalence of depression among migrant farm workers (26%, 95% CI = 21-31%) than in studies examining a non-migrant farming population (12%, 95% CI = 8-17%), substantial heterogeneity remained (I2 = 96%), indicating that the majority of between study variation was due to factors other than sampling error. Additionally, the majority of studies (81%) in migrant farm worker populations were published since 2010, while only 21% of studies in non-migrant farming populations were published in this timeframe. It is possible with recent efforts to de-stigmatize mental illness, participants in more recent studies may be more likely to self-report depressive symptoms. Hence, while it appears that migrant farmworker populations may have an elevated prevalence of depression, it is also apparent that little research in the U.S. has been done to evaluate depression among non-migrant farming populations in recent years. Perhaps a reporting bias may account for some of the difference between the two populations. A research gap also appears to exist in estimating the prevalence of depression among farming populations outside of the US. Assessment for bias at the study level revealed challenges in reporting of key study design elements, as well as potential for selection bias in the majority of studies.