Enhanced surveillance for adverse events following immunization: Two years of dTap catch-up among high school students in Yukon, Canada (2004, 2005).

BACKGROUND: To address the increasing age of pertussis cases, Yukon replaced the Grade 9 tetanus/diphtheria/inactivated polio booster with diphtheria/tetanus/acellular pertussis (dTap) and implemented a dTap catch-up program for Grade 12 students. The program began in June 2004, making Yukon one of the first Canadian jurisdictions to introduce dTap within five years of a tetanus booster. We implemented enhanced surveillance to monitor adverse events following immunization (AEFI) to determine whether students receiving dTap > or =3 to <5 years after their last tetanus booster were at increased risk of severe AEFI. METHODS: Students completed a self-administered AEFI questionnaire one week post-dTap vaccination. Public health professionals contacted students reporting severe AEFI. Health care providers were requested to report AEFI. Symptom rate, severity and duration were compared between students receiving dTap > or =3 to <5 years after their last tetanus booster and those receiving it >5 years later. RESULTS: The > or =3 to <5 years group was more likely than the > or =5 years group to report pain at the injection site (70.6% vs. 61.5%, p=0.038) and less likely to report injection site redness (10.0% vs. 17.3%, p=0.022), injection site swelling (8.9% vs. 16.4%, p=0.013), decreased energy (10.0% vs. 17.1%, p=0.023), body aches (2.2% vs. 7.2%, p=0.014) and sore joints (3.3% vs. 10.1%, p=0.004). Severe AEFI did not differ between the groups (3.3% vs. 5.6%, p=0.232). Health care professionals reported no AEFI. CONCLUSIONS: Results suggest no increased risk of severe AEFI among students receiving dTap > or =3 to <5 years after their last tetanus booster.

West Nile Virus: the buzz on Ottawa residents' awareness, attitudes and practices.

BACKGROUND: In 2002, the City of Ottawa was interested in the public perception of West Nile Virus (WNV) and mosquito control. Their objectives were to assess: awareness of WNV, practices to reduce mosquito sources, personal protective measures, and attitudes towards community-based insecticide programs. METHODS: In July 2002, we administered a telephone survey to a random, stratified sample of urban, suburban and rural Ottawa households. RESULTS: Surveys were completed for 491 households. Most (77.2%) respondents reported they had heard of WNV, and of these, 58.3% reported WNV was an important health issue. Mosquito repellent was the most common personal protective measure, reported among 72.5% of respondents, of whom 76.9% used DEET products. Multivariate regression analyses showed that age was a significant predictor of repellent use, with respondents aged less than 51 years more likely to use repellent than older respondents (ORadj =2.0; 95% CI: 1.2-2.3). This age group was also more likely to use at least one personal protective behaviour (ORadj = 2.5; 95% CI: 1.4-4.5). Of 315 people selecting a justified time to larvicide, 4.8% chose "larvicides should never be used in Ottawa"; 33.4% stated that larviciding would be appropriate "when WNV was detected in birds or mosquitoes"; one third "needed more information" on the health and environmental effects of insecticides, prior to selecting a response. CONCLUSIONS: Our findings highlight the need for public education reinforcing WNV importance, emphasizing the health and environmental effects of insecticides as well as appropriate personal protective behaviours. Such messages should target older and urban residents.