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Vet Parasitol Reg Stud Reports ; 18: 100349, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31796196


Wild canids represent a potential reservoir host for Dirofilaria immitis infection in dogs in Ontario. Since wild canids are not protected by chemoprophylaxis, understanding the epidemiology of D. immmitis in these populations may help elucidate the background risk of infection for dogs. The aim of this study was to determine the prevalence and distribution of D. immitis infection in wild canids across southern Ontario. From February 2016 to March 2017, 290 wild canid carcasses (273 coyotes and 17 foxes) were collected from across the region and assessed for the presence of D. immitis at the time of necropsy. Overall, D. immitis infection was identified in 4.8% (95% CI 2.8-8.0%) of these wild canid carcasses. Among coyotes, 5.1% (95% CI 3.0-8.5%) were positive; no evidence of D. immitis was found in the 17 foxes. Dirofilaria immitis infections in wild canids were detected in two regions of southern Ontario: 12 of the 14 D. immitis infections were detected in the south-western region and two were detected in the eastern region. Our findings provide preliminary insights into the prevalence and geographical distribution of D. immitis in coyotes and foxes in southern Ontario.

Emerg Infect Dis ; 25(2): 265-272, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30666935


Alveolar echinococcosis, the disease caused by infection with the intermediate stage of the Echinococcus multilocularis tapeworm, is typically fatal in humans and dogs when left untreated. Since 2012, alveolar echinococcosis has been diagnosed in 5 dogs, 3 lemurs, and 1 chipmunk in southern Ontario, Canada, a region previously considered free of these tapeworms. Because of human and animal health concerns, we estimated prevalence of infection in wild canids across southern Ontario. During 2015-2017, we collected fecal samples from 460 wild canids (416 coyotes, 44 foxes) during postmortem examination and analyzed them by using a semiautomated magnetic capture probe DNA extraction and real-time PCR method for E. multilocularis DNA. Surprisingly, 23% (95% CI 20%-27%) of samples tested positive. By using a spatial scan test, we identified an infection cluster (relative risk 2.26; p = 0.002) in the western-central region of the province. The cluster encompasses areas of dense human population, suggesting zoonotic transmission.

Doenças dos Animais/epidemiologia , Doenças dos Animais/microbiologia , Equinococose/epidemiologia , Equinococose/microbiologia , Echinococcus multilocularis , Animais , Echinococcus multilocularis/genética , Geografia Médica , Ontário/epidemiologia , Prevalência , Vigilância em Saúde Pública
J Public Health Manag Pract ; 24(3): e1-e8, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-28628585


CONTEXT: Environmental public health practitioners rely on information technology (IT) to maintain and improve environmental health. However, current systems have limited capacity. A better understanding of the importance of IT features is needed to enhance data and information capacity. OBJECTIVE: (1) Rank IT features according to the percentage of respondents who rated them as essential to an information management system and (2) quantify the relative importance of a subset of these features using best-worst scaling. DESIGN: Information technology features were initially identified from a previously published systematic review of software evaluation criteria and a list of software options from a private corporation specializing in inspection software. Duplicates and features unrelated to environmental public health were removed. The condensed list was refined by a working group of environmental public health management to a final list of 57 IT features. The essentialness of features was electronically rated by environmental public health managers. Features where 50% to 80% of respondents rated them as essential (n = 26) were subsequently evaluated using best-worst scaling. SETTING: Ontario, Canada. PARTICIPANTS: Environmental public health professionals in local public health. MAIN OUTCOME MEASURE: Importance scores of IT features. RESULTS: The majority of IT features (47/57) were considered essential to an information management system by at least half of the respondents (n = 52). The highest-rated features were delivery to printer, software encryption capability, and software maintenance services. Of the 26 features evaluated in the best-worst scaling exercise, the most important features were orientation to all practice areas, off-line capability, and ability to view past inspection reports and results. CONCLUSIONS: The development of a single, unified environmental public health information management system that fulfills the reporting and functionality needs of system users is recommended. This system should be implemented by all public health units to support data and information capacity in local environmental public health. This study can be used to guide vendor evaluation, negotiation, and selection in local environmental public health, and provides an example of academia-practice partnerships and the use of best-worst scaling in public health research.

Bases de Dados como Assunto/normas , Saúde Ambiental/métodos , Bases de Dados como Assunto/instrumentação , Saúde Ambiental/instrumentação , Humanos , Ontário , Saúde Pública/instrumentação , Saúde Pública/métodos , Inquéritos e Questionários/normas
Can J Public Health ; 104(1): e28-32, 2013 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-23618117


OBJECTIVES: Tuberculosis (TB) was a major cause of morbidity and mortality in Canada early in the 20th century. Elderly populations in Canada remain at high risk for TB disease. Elderly patients may present atypically, with the result that many active cases can remain undiagnosed. We present an outbreak of TB that occurred in a Residential and Long-Term Care (LTC) facility in Ontario. METHODS: Case finding was carried out through the conventional concentric circle approach. Three rounds of tuberculin skin testing were conducted at 8-12 week intervals. Laboratory analysis was conducted at the Public Health Ontario Laboratories. An indoor air quality assessment was conducted to determine whether inadequate engineering controls were a transmission risk factor. RESULTS: A case of active pulmonary TB was confirmed in May 2010 in a staff member at the facility. By January 2011, 3 additional active cases and 24 latent tuberculosis infections among residents and staff had been identified. Genotyping methods confirmed that the 4 active cases were infected by an identical strain. Nine of 15 locations tested in the facility had air exchange rates below published guidelines. CONCLUSION: Prompt reporting of the initial case allowed for a quick initiation of the epidemiologic investigation. Given the epidemiology of TB in elderly populations, outbreaks should remain a concern for LTC facilities and physicians, even in jurisdictions of low TB incidence. Baseline and annual TB screening for residents and staff, early diagnosis of active TB, and adequate ventilation are important to reduce the incidence of disease.

Surtos de Doenças , Instalações de Saúde , Instituições Residenciais , Tuberculose Pulmonar/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Assistência de Longa Duração , Masculino , Pessoa de Meia-Idade , Ontário/epidemiologia , Fatores de Risco , Adulto Jovem
Can J Public Health ; 103(5): e322-6, 2012 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-23617981


OBJECTIVES: To describe an outbreak of Shiga toxin-producing Escherichia coli (STEC) O157:H7 infection following a four-day family gathering in Ontario. This is the first published account of a STEC O157 outbreak in Canada linked to consumption of pork. METHODS: The outbreak investigation included interviews with food handlers and other key associated persons, inspection of food preparation premises, traceback investigations, case finding, analysis of data from an outbreak questionnaire, and laboratory analysis of samples collected from various sources associated with the outbreak. RESULTS: Several meals, including pork from a pig roast, were served to the 59 attendees, 29 of whom developed gastrointestinal illness following the event. Six cases developed bloody diarrhoea and seven were hospitalized. Leftover pork served the day after the pig roast was the item most significantly associated with an increased risk of illness (p<0.001). STEC O157:H7 was isolated from 11 of the 29 ill attendees, and also from the pork. By pulse-field gel electrophoresis (PFGE), all STEC O157:H7 pork isolates were either identical or closely related to the 11 clinical isolates. No STEC was detected in any other samples. Three Clostridium perfringens isolates, unrelated by PFGE, were obtained from two STEC-positive cases and the pork. CONCLUSION: This outbreak highlights the need for increased awareness of pork as a potential source of STEC O157 infection, and for enhanced education regarding the safe handling, cooking and storage of food, specifically where large cuts of meat are cooked outdoors at events such as pig roasts, a cultural norm in some communities.

Surtos de Doenças , Infecções por Escherichia coli/epidemiologia , Escherichia coli O157/isolamento & purificação , Microbiologia de Alimentos , Carne/microbiologia , Escherichia coli Shiga Toxigênica/isolamento & purificação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Criança , Pré-Escolar , Feminino , Manipulação de Alimentos , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Ontário/epidemiologia , Pesquisa Qualitativa , Suínos , Adulto Jovem
Can J Public Health ; 100(5): 340-3, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19994733


OBJECTIVE: Public health in Ontario delivers, promotes and provides each fall the universal influenza immunization program. This paper addresses the question of whether Ontario public health agencies are able to provide the influenza immunization program within the Ministry of Health fiscal funding envelope of $5 per dose. METHODS: Actual program delivery data from the 2006 influenza season of Wellington-Dufferin-Guelph Public Health (WDGPH) were used to create a model template for influenza clinics capturing all variable costs. Promotional and administrative costs were separated from clinic costs. Maximum staff workloads were estimated. Vaccine clinics were delivered by public health staff in accordance with standard vaccine administration practices. RESULTS: The most significant economic variables for influenza clinics are labour costs and number of vaccines given per nurse per hour. The cost of facility rental was the only other significant cost driver. The ability of influenza clinics to break even depended on the ability to manage these cost drivers. At WDGPH, weekday flu clinics required the number of vaccines per nurse per hour to exceed 15, and for weekend flu clinics this number was greater than 21. We estimate that 20 vaccines per hour is at the limit of a safe workload over several hours. Managing cost then depends on minimizing hourly labour costs. DISCUSSION: The results of this analysis suggest that by managing the labour costs along with planning the volume of patients and avoiding expensive facilities, flu clinics can just break even. However, any increased costs, including negotiated wage increases or the move to safety needles, with a fixed revenue of $5.00 per dose will negate this conclusion.

Assistência à Saúde/economia , Programas de Imunização/economia , Vacinas contra Influenza/economia , Influenza Humana/economia , Saúde Pública/economia , Análise Custo-Benefício , Assistência à Saúde/organização & administração , Humanos , Vacinas contra Influenza/administração & dosagem , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Ontário/epidemiologia