Breakthrough cases of mpox: One-dose vaccination is associated with milder clinical manifestations.

Background: Very few studies have investigated the effectiveness of vaccination in decreasing the severity of breakthrough mpox. Our goal was to estimate the strength of the associations between recent mpox vaccination with MVA-BN and various clinical manifestations of the disease.

Methods: Telephone interviews using standardized questionnaires, upon notification and 28 days later, of the 403 persons with mpox reported to Montreal Public Health in 2022.

Monkeypox in Montréal: Epidemiology, Phylogenomics, and Public Health Response to a Large North American Outbreak.

Background: Monkeypox, a viral zoonotic disease, is causing a global outbreak outside of endemic areas.

Objective: To characterize the outbreak of monkeypox in Montréal, the first large outbreak in North America.

Design: Epidemiologic and laboratory surveillance data and a phylogenomic analysis were used to describe and place the outbreak in a global context.

Analysis of COVID-19 Risk Following a Ring Vaccination Intervention to Address SARS-CoV-2 Alpha Variant Transmission in Montreal, Canada.

Importance: Given limited COVID-19 vaccine availability early in the pandemic, optimizing immunization strategies was of paramount importance. Ring vaccination has been used successfully to control transmission of other airborne respiratory viruses.

Objective: To assess the association of a ring vaccination intervention on COVID-19 spread in the initial epicenter of SARS-CoV-2 Alpha variant transmission in Montreal, Canada.

Infection prevention and control lapse involving medical equipment reprocessing at a family medicine clinic in Ottawa, Ontario, 2018.

Background: In April 2018, Ottawa Public Health identified a large-scale infection prevention and control (IPAC) lapse spanning 15 years related to inadequate reprocessing of reusable critical medical equipment used in a family medicine clinic.

Objectives: To describe the public health response to, and estimate the risk of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) transmission from, this IPAC lapse.

Methods: Patients who underwent a procedure of concern (during which reusable equipment may have been used) at this clinic were identified using Ontario Health Insurance Plan data and individually notified.

Screening for chlamydia and/or gonorrhea in primary health care: protocol for systematic review.

Background: Chlamydia trachomatis and Neisseria gonorrhoeae are the most commonly reported sexually transmitted infections in Canada. Existing national guidance on screening for these infections was not based on a systematic review, and recommendations as well as implementation considerations (e.g.

Systematic review of the accuracy of antibody tests used to screen asymptomatic adults for hepatitis C infection.

Background: Several expert groups, including the United States Preventive Services Task Force and the Canadian Task Force on Preventive Health Care, have recently examined or are currently examining whether primary care physicians should screen asymptomatic adults for hepatitis C virus (HCV) infection. To inform decision-making on HCV screening, we performed a systematic review of the accuracy of antibody tests compared with other immunoassays and RNA detection for screening asymptomatic adults for HCV infection in Canada.

Methods: MEDLINE and Embase databases were searched from 1990 to 2016; resulting citations were uploaded into DistillerSR and independently screened by 2 reviewers.

Risk Factors for Varicella Susceptibility Among Refugees to Toronto, Canada.

Several outbreaks of varicella have occurred among refugees. We aimed to estimate the prevalence of varicella susceptibility among refugees, and identify risk factors for varicella susceptibility. All refugees rostered at Crossroads Clinic in Toronto, Canada in 2011-2014 were included in our study.

Validation of Diagnostic Groups Based on Health Care Utilization Data Should Adjust for Sampling Strategy.

Objective: Valid measurement of outcomes such as disease prevalence using health care utilization data is fundamental to the implementation of a "learning health system." Definitions of such outcomes can be complex, based on multiple diagnostic codes. The literature on validating such data demonstrates a lack of awareness of the need for a stratified sampling design and corresponding statistical methods.

Factors associated with generalized anxiety in workers undergoing work rehabilitation for persistent musculoskeletal pain.

Purpose: To document in workers having a work disability due to a musculoskeletal disorder (MSD), the presence and variation over time of their intolerance of uncertainty and its maintenance factors as defined in Dugas et al.'s generalized anxiety disorder (GAD) model, i.e.

Clinician-patient agreement about the work disability problem of patients having persistent pain: why it matters.

Background: Studies from different fields documenting the differences between clinicians' and workers' representations have not elucidated where the differences exist or how they can be resolved.

Purpose: To define and describe scenarios depicting the differences between clinical judgment, workers' representations about their disability and clinicians' interpretations of these representations.

Methods: A multiple case-study design was used.

Patient, physician, encounter, and billing characteristics predict the accuracy of syndromic surveillance case definitions.

Background: Syndromic surveillance systems are plagued by high false-positive rates. In chronic disease monitoring, investigators have identified several factors that predict the accuracy of case definitions based on diagnoses in administrative data, and some have even incorporated these predictors into novel case detection methods, resulting in a significant improvement in case definition accuracy. Based on findings from these studies, we sought to identify physician, patient, encounter, and billing characteristics associated with the positive predictive value (PPV) of case definitions for 5 syndromes (fever, gastrointestinal, neurological, rash, and respiratory (including influenza-like illness)).

Health and illness representations of workers with a musculoskeletal disorder-related work disability during work rehabilitation: a qualitative study.

Introduction: Distinctions between disease and illness have been criticized for being too theoretical. In practice, however, it may help explain gaps in understanding and miscommunication between health care professionals and patients/injured workers, since each has their own perception of reality. To reduce the gap between health care professionals and patients in understanding the definition of disease, this paper documents general representations of health, illness and work-related musculoskeletal disorders and their influence on the work rehabilitation program.

Accuracy of syndrome definitions based on diagnoses in physician claims.

Background: Community clinics offer potential for timelier outbreak detection and monitoring than emergency departments. However, the accuracy of syndrome definitions used in surveillance has never been evaluated in community settings. This study's objective was to assess the accuracy of syndrome definitions based on diagnostic codes in physician claims for identifying 5 syndromes (fever, gastrointestinal, neurological, rash, and respiratory including influenza-like illness) in community clinics.

Are physicians with better clinical skills on licensing examinations less likely to prescribe antibiotics for viral respiratory infections in ambulatory care settings?

Background: Viral respiratory infections (VRIs) are a common reason for ambulatory visits, and 35% are treated with an antibiotic. Antibiotic use for VRIs is not recommended, and it promotes antibiotic resistance. Effective patient-physician communication is critical to address this problem.

Transforming the meaning of pain: an important step for the return to work.

Unlabelled: Previous studies have found illness representations to be associated with the degree to which patients adopt health behaviours. Surprisingly, pain representations, especially those in a work rehabilitation context, have rarely been explored.

Objective: To conduct a thorough investigation of the pain representations held by workers who were on sick leave due to persistent musculoskeletal pain during the process of an intensive work rehabilitation program.

Accuracy of physician billing claims for identifying acute respiratory infections in primary care.

Objective: To assess the accuracy of physician billing claims for identifying acute respiratory infections in primary care. STUDY SETTING. Nine primary care physician practices in Montreal, Canada (2002-2005).

Predictors of inappropriate antibiotic prescribing among primary care physicians.

Background: Inappropriate use of antibiotics promotes antibiotic resistance. Little is known about physician characteristics that may be associated with inappropriate antibiotic prescribing. Our objective was to assess whether physician knowledge, time in practice, place of training and practice volume explain the differences in antibiotic prescribing among physicians.

Surveillance for Newly Emerging Viruses.

Surveillance is a fundamental tool for public health, producing information to guide actions. Modern surveillance tends to follow health measures such as the incidence of a disease or syndrome or even the occurrence of health-related behaviors. There are many reasons for conducting surveillance, and the data collected and the approach taken to analyzing those data are both influenced by the overall goal of a surveillance system.