At-a-glance - Sentinel surveillance of emergency department presentations for barbecue brush-related injuries: the electronic Canadian Hospitals Injury Reporting and Prevention Program, 2011 to 2017. / Aperçu - Surveillance par sentinelle des blessures associées aux brosses à barbecue traitées dans des services d'urgence : la plate-forme électronique du Système canadien hospitalier d'information et de recherche en prévention des traumatismes, 2011-2017.

A barbecue (BBQ) brush is a common household item designed for cleaning grills used for barbecuing. Data from the electronic Canadian Hospitals Injury Reporting and Prevention Program database were analysed to estimate the frequency of injuries related to BBQ brushes as a proportion of all injuries, as well as to describe characteristics associated with such injury events. Between April 1, 2011 and July 17, 2017, BBQ brush injuries were observed at a frequency of 1.5 cases per 100 000 eCHIRPP cases (N = 12). Findings suggest that in addition to risks associated with the ingestion of loose BBQ brush bristles attached to foods, loose bristles could also result in injury via other mechanisms.

RÉSUMÉ: Une brosse à barbecue (BBQ) est un article de ménage très courant destiné à nettoyer les grilles de BBQ. Les données de la base de données de la plate-forme électronique du Système canadien hospitalier d'information et de recherche en prévention des traumatismes (eSCHIRPT) ont été analysées afin d'estimer la fréquence des blessures associées aux brosses à BBQ par rapport à l'ensemble des blessures, ainsi que de décrire les caractéristiques associées à ces accidents. Entre le 1er avril 2011 et le 17 juillet 2017, on a observé des blessures associées aux brosses à une fréquence de 1,5 cas par 100 000 cas dans l'eSCHIRPT (N = 12). Les résultats indiquent qu'outre les risques associés à l'ingestion de poils tombés de la brosse à BBQ et attachés aux aliments, ces poils pourraient aussi causer des blessures par d'autres mécanismes.

Hospitalization for Influenza A Versus B.

BACKGROUND: The extent to which influenza A and B infection differs remains uncertain. METHODS: Using active surveillance data from the Canadian Immunization Monitoring Program Active at 12 pediatric hospitals, we compared clinical characteristics and outcomes of children ≤16 years admitted with laboratory-confirmed influenza B or seasonal influenza A. We also examined factors associated with ICU admission in children hospitalized with influenza B. RESULTS: Over 8 nonpandemic influenza seasons (2004-2013), we identified 1510 influenza B and 2645 influenza A cases; median ages were 3.9 and 2.0 years, respectively (P < .0001). Compared with influenza A patients, influenza B patients were more likely to have a vaccine-indicated condition (odds ratio [OR] = 1.30; 95% confidence interval [CI] = 1.14-1.47). Symptoms more often associated with influenza B were headache, abdominal pain, and myalgia (P < .0001 for all symptoms after adjustment for age and health status). The proportion of deaths attributable to influenza was significantly greater for influenza B (1.1%) than influenza A (0.4%); adjusted for age and health status, OR was 2.65 (95% CI = 1.18-5.94). A similar adjusted OR was obtained for all-cause mortality (OR = 2.95; 95% CI = 1.34-6.49). Among healthy children with influenza B, age ≥10 years (relative to <6 months) was associated with the greatest odds of ICU admission (OR = 5.79; 95% CI = 1.91-17.57). CONCLUSIONS: Mortality associated with pediatric influenza B infection was greater than that of influenza A. Among healthy children hosptialized with influenza B, those 10 years and older had a significant risk of ICU admission.

Leading Indicators and the Evaluation of the Performance of Alerts for Influenza Epidemics.

BACKGROUND: Most evaluations of epidemic thresholds for influenza have been limited to internal criteria of the indicator variable. We aimed to initiate discussion on appropriate methods for evaluation and the value of cross-validation in assessing the performance of a candidate indicator for influenza activity. METHODS: Hospital records of in-patients with a diagnosis of confirmed influenza were extracted from the Canadian Discharge Abstract Database from 2003 to 2011 and aggregated to weekly and regional levels, yielding 7 seasons and 4 regions for evaluation (excluding the 2009 pandemic period). An alert created from the weekly time-series of influenza positive laboratory tests (FluWatch, Public Health Agency of Canada) was evaluated against influenza-confirmed hospitalizations on 5 criteria: lead/lag timing; proportion of influenza hospitalizations covered by the alert period; average length of the influenza alert period; continuity of the alert period and length of the pre-peak alert period. RESULTS: Influenza hospitalizations led laboratory positive tests an average of only 1.6 (95% CI: -1.5, 4.7) days. However, the difference in timing exceeded 1 week and was statistically significant at the significance level of 0.01 in 5 out of 28 regional seasons. An alert based primarily on 5% positivity and 15 positive tests produced an average alert period of 16.6 weeks. After allowing for a reporting delay of 2 weeks, the alert period included 80% of all influenza-confirmed hospitalizations. For 20 out of the 28 (71%) seasons, the first alert would have been signalled at least 3 weeks (in real time) prior to the week with maximum number of influenza hospitalizations. CONCLUSIONS: Virological data collected from laboratories was a good indicator of influenza activity with the resulting alert covering most influenza hospitalizations and providing a reasonable pre-peak warning at the regional level. Though differences in timing were statistically significant, neither time-series consistently led the other.

Estimating influenza deaths in Canada, 1992-2009.

BACKGROUND: Poisson regression modelling has been widely used to estimate the disease burden attributable to influenza, though not without concerns that some of the excess burden could be due to other causes. This study aims to provide annual estimates of the mortality and hospitalization burden attributable to both seasonal influenza and the 2009 A/H1N1 pandemic influenza for Canada, and to discuss issues related to the reliability of these estimates. METHODS: Weekly time-series for all-cause mortality and regression models were used to estimate the number of deaths in Canada attributable to influenza from September 1992 to December 2009. To assess their robustness, the annual estimates derived from different parameterizations of the regression model for all-cause mortality were compared. In addition, the association between the annual estimates for mortality and hospitalization by age group, underlying cause of death or primary reason for admission and discharge status is discussed. RESULTS: The crude influenza-attributed mortality rate based on all-cause mortality and averaged over 17 influenza seasons prior to the 2009 A/H1N1 pandemic was 11.3 (95%CI, 10.5 - 12.1) deaths per 100 000 population per year, or an average of 3,500 (95%CI, 3,200 - 3,700) deaths per year attributable to seasonal influenza. The estimated annual rates ranged from undetectable at the ecological level to more than 6000 deaths per year over the three A/Sydney seasons. In comparison, we attributed an estimated 740 deaths (95%CI, 350-1500) to A(H1N1)pdm09. Annual estimates from different model parameterizations were strongly correlated, as were estimates for mortality and morbidity; the higher A(H1N1)pdm09 burden in younger age groups was the most notable exception. INTERPRETATION: With the exception of some of the Serfling models, differences in the ecological estimates of the disease burden attributable to influenza were small in comparison to the variation in disease burden from one season to another.