Publications by authors named "Raymond S Tsang"

Article Synopsis
  • Serotype a (Hia) is becoming a significant cause of serious infections in young Indigenous children in the North American Arctic and Sub-Arctic areas.
  • A study compared the presence of Hia in children with respiratory infections from high-incidence regions like Nunavut to low-incidence areas like Southern Ontario.
  • The study found Hia was present in 3.0% of children in Nunavut versus 0.6% in Southern Ontario, indicating ongoing circulation of the bacteria in Northern communities which could potentially lead to more severe outbreaks.
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Background: serotype a (Hia) has recently emerged as an important cause of invasive disease, mainly affecting young Indigenous children. Carriage of is a pre-requisite for invasive disease and reservoir for transmission. To better understand the epidemiology of invasive Hia disease, we initiated a multicentre study of nasopharyngeal carriage among Canadian children.

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Background: A resurgence of syphilis infections has been described in a number of countries including Canada in the last decade.

Methods: This study identified polymerase chain reaction (PCR) positive syphilis cases based on detection of genes (, , and ) in 3,350 clinical specimens obtained from patients in the province of Manitoba, Canada between 2017 and 2020. Patient demographics were obtained from specimen requisition forms.

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Over the past few years, the increase in infectious syphilis outbreaks in major urban centres and remote or rural locations in Canada, often affecting hard-to-reach patient populations, has renewed an interest and urgency in studying the use of point-of-care tests (POCTs) that can provide test results at the time and place of primary health care delivery, obviating the repeat visit necessary with traditional syphilis serology or molecular diagnostic tests. In 2015, the Canadian Public Health Laboratory Network released its first laboratory guideline for the use of POCTs in the diagnosis of syphilis in Canada. Although Canada has no licensed POCT, two POCTs (Syphilis Health Check and the DPP® HIV Syphilis System) have received US Food and Drug Administration (FDA) approval under premarket approval applications.

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Article Synopsis
  • - Since 2002, Canada has implemented meningococcal vaccination programs, leading to a decline in invasive meningococcal disease (IMD), particularly for serogroup C, while also responding to outbreaks with vaccines for serogroup B.
  • - Between 2012 and 2019, there were 983 reported cases of IMD, with the highest incidence in infants under one year and serogroup B being the most prevalent strain during this period.
  • - Recent trends show a concerning rise in serogroup W infections linked to a more virulent strain (ST-11 CC), indicating a shift in the epidemiological landscape of IMD in Canada.
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Background: Syphilis is a sexually transmitted disease that can have atypical clinical presentations. Conventional laboratory tests to confirm the diagnosis are not rapid enough to affect clinical decision on treatment and contact tracing. Rapid point-of-care tests (POCT) can be useful for control of infectious diseases; however, no POCT for syphilis detection is currently available in Canada.

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Article Synopsis
  • The ICS program monitors five invasive bacterial diseases in northern Canada, which have a higher prevalence compared to the rest of the country.
  • Data from 1999 to 2018 revealed significant differences in incidence rates, with Indigenous residents facing higher rates of IPD, iGAS, and Hi compared to non-Indigenous populations.
  • Overall, these diseases pose a serious health risk, particularly for Indigenous peoples, children, and seniors in northern regions.
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Article Synopsis
  • - The introduction of the Hib conjugate vaccine has shifted the landscape of invasive infections, leading to more cases caused by non-typeable and non-Hib strains.
  • - Researchers identified nine invasive serotype e (Hie) strains in British Columbia that completely lack fucose operon genes, mainly from blood cultures of three female and six male patients between 2011 and 2018.
  • - Despite the genetic deletion, these fucose operon-negative Hie strains maintained high similarity to the most common strains in the area, suggesting it did not hinder their ability to spread or cause disease.
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Introduction: serogroup B is an important infectious agent in developed countries, including Canada. Infants are particularly susceptible to infection with serogroup B because of immature immune systems, pathogen virulence factors and changing serogroup dynamics in the post-vaccination era. Currently, the Ontario provincial government does not include serogroup B in its routine publicly funded meningococcal vaccination program.

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The global re-emergence of syphilis is an exigent public health issue requiring both clinicians and public health practitioners to become familiar with the myriad manifestations of this great imitator. This report describes a case of an originally undiagnosed chronic oral syphilitic chancre, subsequently confirmed by both PCR and immunohistochemistry.

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The prevalence of ciprofloxacin-resistant Neisseria meningitidis in Canada was studied by testing 346 isolates received at the National Microbiology Laboratory during the calendar years 2013 to 2015. Of the 277 individual invasive and 69 noninvasive isolates tested, only 2 serogroup C (MenC) isolates were found to be resistant to ciprofloxacin. Both MenC were typed as sequence type (ST)-4821, a unique clone found mainly in China, thus suggesting both isolates might be from travel-related or imported cases.

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Despite vaccination, cyclical peaks of Bordetella pertussis incidence rates are still observed in Canada and other developed countries, making pertussis one of the most prevalent vaccine preventable bacterial diseases. In the postacellular vaccine era, evolution of bacterial strains has resulted in strains with altered vaccine antigens. Previous Canadian studies have focused on isolates mainly from the provinces of Ontario and Alberta, with only small numbers of isolates from other provinces.

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Background: With invasive Haemophilus influenzae serotype b (Hib) disease controlled by vaccination with conjugate Hib vaccines, there is concern that invasive disease due to non-serotype b strains may emerge.

Objective: This study characterized invasive H. influenzae (Hi) isolates from Nunavut, Canada, in the post-Hib vaccine era.

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Background: Serogroup B Neisseria meningitidis (MenB) has always been a major cause of invasive meningococcal disease (IMD) in Canada. With the successful implementation of a meningitis C conjugate vaccine, the majority of IMD in Canada is now caused by MenB.

Objective: To investigate IMD case isolates in Atlantic Canada from 2009 to 2013.

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Objectives: Neisseria meningitidis is a leading cause of meningitis and septicaemia. The hyperinvasive ST-11 clonal complex (cc11) caused serogroup C (MenC) outbreaks in the US military in the 1960s and UK universities in the 1990s, a global Hajj-associated serogroup W (MenW) outbreak in 2000-2001, and subsequent MenW epidemics in sub-Saharan Africa. More recently, endemic MenW disease has expanded in South Africa, South America and the UK, and MenC cases have been reported among European and North American men who have sex with men (MSM).

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Background: The epidemiology of invasive meningococcal disease (IMD) in Québec, Canada, has been dominated in the past decade by a clone of serogroup B (MenB) Neisseria meningitidis defined by multi-locus sequence typing (MLST) as sequence type (ST)-269. With the licensure of a new MenB vaccine Bexsero (4CMenB) in Canada, this study characterized invasive N. meningitidis recovered in Québec from 2009 to 2013, with an objective to examine the diversity of the 4CMenB vaccine antigens.

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With the reemergence of syphilis, it is important that both clinical and public health practitioners recognize the various clinical manifestations of this disease (formerly known as "the great imitator") and become familiar with the newer diagnostic tests. Here we report the first case of tonsillar syphilis diagnosed by PCR.

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Syphilis, caused by the bacterium Treponema pallidum subsp. pallidum, is an infection recognized since antiquity. It was first reported at the end of the 15th century in Europe.

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Treponema pallidum subsp. pallidum and/or its nucleic acid can be detected by various methods such as microscopy, rabbit infectivity test or polymerase chain reaction (PCR) tests. The rabbit infectivity test for T.

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We previously reported a shift in the electrophoretic type (ET) of invasive MenC in Canada from predominantly ET-15 to ET-37 in the post-MenC conjugate vaccine period. This study sought to confirm this trend by examining all culture-confirmed invasive MenC case isolates in Canada in the period from 1 January 2009 to 31 December 2013. Of the 50 MenC isolates, 18 belonged to ET-15, 28 belonged to ET-37 (but not ET-15), and four belonged to other clonal types.

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Objective: To detect and characterize pertactin-negative Bordetella pertussis in Canada, especially for isolates collected in recent years.

Methods: A total of 224 isolates from the years 1994-2013 were screened by Western immuno-blot for expression of pertactin. Pertactin-negative isolates were characterized by serotyping, pulsed-field gel electrophoresis (PFGE), and genotyping of their pertactin, fimbriae 3, pertussis toxin subunit 1, and pertussis toxin gene promoter region, as well as the complete sequence of the pertactin gene.

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Bordetella pertussis causes pertussis, a respiratory disease that is most severe for infants. Vaccination was introduced in the 1950s, and in recent years, a resurgence of disease was observed worldwide, with significant mortality in infants. Possible causes for this include the switch from whole-cell vaccines (WCVs) to less effective acellular vaccines (ACVs), waning immunity, and pathogen adaptation.

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