Component-specific effectiveness of trivalent influenza vaccine as monitored through a sentinel surveillance network in Canada, 2006-2007.

Background: Trivalent inactivated influenza vaccine (TIV) is reformulated annually to contain representative strains of 2 influenza A subtypes (H1N1 and H3N2) and 1 B lineage (Yamagata or Victoria). We describe a sentinel surveillance approach to link influenza variant detection with component-specific vaccine effectiveness (VE) estimation.

Methods: The 2006-2007 TIV included A/NewCaledonia/20/1999(H1N1)-like, A/Wisconsin/67/2005(H3N2)-like, and B/Malaysia/2506/2004(Victoria)-like components.

The cost of preventing rabies at any cost: post-exposure prophylaxis for occult bat contact.

Investigations conducted by public health in Quebec, Canada, following report of human exposure to a bat were reviewed to evaluate the implementation of the recommendation for rabies post-exposure prophylaxis (RPEP) for household bat exposure (without documented direct contact). Of all RPEP recommended, 12% was for direct bat contact with bite, 7% for direct bat contact without known bite and 81% for household exposure. When bat was not available for testing, RPEP was almost always recommended.

Bat rabies in the United States and Canada from 1950 through 2007: human cases with and without bat contact.

Background: Since the 1980s, rare cases of rabies in humans in Canada and the United States have been almost exclusively caused by the bat-variant virus.

Methods: We reviewed indigenously acquired cases of bat-variant rabies in humans in Canada and the United States from 1950 through 2007.

Results: Of 61 cases identified, 5 occurred after organ transplantation and were excluded from further analysis.

Rapid decline of influenza vaccine-induced antibody in the elderly: is it real, or is it relevant?

Advisory committees have cautioned that influenza vaccine-induced antibody declines more rapidly in the elderly, falling below seroprotective levels within 4 months. We conducted a literature review to assess this assertion. The articles that were included in this review reported antibody levels > or =4 months after influenza immunization in persons > or =60 years old, interpretable in the context of annual influenza vaccine-approval criteria (seroprotection/seroconversion) specified by the Committee for Proprietary Medicinal Products (CPMP) for the elderly.

Human bocavirus infections in hospitalized children and adults.

Studies have reported human bocavirus (HBoV) in children with respiratory tract infections (RTIs), but only occasionally in adults. We searched for HBoV DNA in nasopharyngeal aspirates (NPAs) from adults with exacerbations of chronic bronchitis or pneumonia, from children hospitalized for acute RTIs, and from asymptomatic children during the winter of 2002-2003 in Canada. HBoV was detected in NPAs of 1 (0.

Risk and prevention of meningococcal disease among education workers: A review.

The aims of the present study were to review the risk of invasive meningococcal disease (IMD) among education workers, particularly pregnant women, and to evaluate preventive measures, in a context of endemicity, outbreak or epidemic as observed in the province of Quebec. The literature was reviewed and persons in charge of IMD surveillance in France, Quebec, the United Kingdom and the United States were interviewed. Surveys of asymptomatic carriage of Neisseria meningitidis show that transmission among students is higher than transmission between students and teachers.

Hospitalizations for diarrhea in Quebec children from 1985 to 1998: estimates of rotavirus-associated diarrhea.

Objective: To characterize the incidence and duration of hospitalization due to diarrhea and to assess the proportion of hospitalizations that are attributed to rotavirus-associated diarrhea.

Design: Retrospective study of hospitalization data.

Setting: Hospitals located in Quebec.

Opinions of Quebec parents and vaccinators on the usefulness of chickenpox vaccine.

Background: A chickenpox vaccine was recently licensed in Canada. Because this vaccine has caused some controversy within the health care profession, studies among Quebec parents and vaccine providers were carried out, surveying their opinions concerning chickenpox vaccination.

Methods: Three studies among parents of preadolescents, parents of two-year-old children completely or incompletely vaccinated and vaccinators were completed.

Antibiotic use in children is not influenced by the result of rapid antigen detection test for the respiratory syncytial virus.

Background: Rapid antigen detection test (RADT) for respiratory syncytial virus (RSV) is widely used in children hospitalized with acute respiratory tract infection (ARTI), but its influence on antibiotic (AB) use is uncertain.

Objective: To evaluate if confirmation of RSV infection by RADT modified AB use and elucidate others factors associated with the continuation of antibiotics.

Study Design: Charts of children hospitalized with viral ARTI aged 0-35 months were reviewed.

Trends of hepatitis A hospitalization and risk factors in Quebec, Canada, between 1990 and 2003.

Background: In Canada, targeted vaccination of at risk groups for hepatitis A (HA) is done since the mid 1990s resulting in declining incidence. This study estimated the year and age specific hospitalization rates and distribution of risk factors for HA in Quebec, Canada, between 1990 and 2003.

Methods: Records of patients hospitalized with HA-related diagnostic codes were retrieved from the provincial database.

An outbreak of severe respiratory tract infection due to human metapneumovirus in a long-term care facility.

Background: Human metapneumovirus (hMPV) is a newly described paramyxovirus that is mainly associated with bronchiolitis in children. We sought to describe the epidemiological, virological, and histopathological findings associated with a large outbreak of hMPV infection in a long-term care facility.

Methods: An investigation of the outbreak was performed by public health authorities, who used standardized questionnaires to collect relevant clinical information from all residents of the facility.

Methodologic issues regarding the use of three observational study designs to assess influenza vaccine effectiveness.

Background: Influenza causes substantial morbidity and annual vaccination is the most important prevention strategy. Accurately measuring vaccine effectiveness (VE) is difficult. The clinical syndrome most closely associated with influenza virus infection, influenza-like illness (ILI), is not specific.

The effect of changing from whole-cell to acellular pertussis vaccine on the epidemiology of hospitalized children with pertussis in Canada.

Background: Between July 1997 and April 1998, universal childhood immunization programs in Canada changed from using a whole-cell pertussis to a 5-component acellular pertussis-containing vaccine. To assess effects on pertussis epidemiology of this nationwide change, we analyzed hospitalizations during 1991-2004 using the Canadian Immunization Monitoring Program, Active (IMPACT) pertussis database.

Methods: IMPACT is an active surveillance network based in 12 pediatric tertiary-care hospitals across Canada.

A review of interventions triggered by hepatitis A infected food-handlers in Canada.

Background: In countries with low hepatitis A (HA) endemicity, infected food handlers are the source of most reported foodborne outbreaks. In Canada, accessible data repositories of infected food handler incidents are not available. We undertook a systematic review of such incidents to evaluate the extent of viral transmission through food contamination and the scope of post-exposure prophylaxis (PEP) interventions.

Comparison of trip characteristics of children and adults with travel-acquired hepatitis A infection.

We compared the trip characteristics of 84 child and 99 adult cases with travel-acquired hepatitis A (HA). Most pediatric cases had traveled in Asia for more than 30 days and had stayed and eaten most of their meals in the homes of friends and relatives in a country where they had not been born. In contrast, the adults with travel-acquired HA had visited Latin America or the Caribbean for 14 days or less and had stayed primarily in hotels.

Estimating vaccine effectiveness against laboratory-confirmed influenza using a sentinel physician network: results from the 2005-2006 season of dual A and B vaccine mismatch in Canada.

Introduction: We report a case-control design using a sentinel physician network to estimate vaccine effectiveness (VE) against laboratory-confirmed, medically attended influenza (LC-MAI) and provide results for the 2005-2006 season of dual A and B vaccine mismatch in Canada.

Methods: Participants were patients >or=5 years of age presenting with influenza-like illness (ILI) to a sentinel physician in British Columbia, Canada between November 1, 2005 and April 30, 2006. Cases were participants in whom influenza was identified; controls tested negative for influenza A and B by PCR, R-mix and culture.

Solicited adverse events after influenza immunization among infants, toddlers, and their household contacts.

Objectives: We assessed adverse events, including oculorespiratory syndrome, following influenza immunization during the first year of a publicly-funded program for infants, toddlers and their household members in Canada.

Methods: Parents bringing infants and toddlers for influenza immunization to clinics in Quebec or British Columbia consented to structured telephone interview 5 to 10 days later. One adult provided information for all household members.

Impact of the quebec school-based hepatitis B immunization program and potential benefit of the addition of an infant immunization program.

Ten years after a school-based hepatitis B immunization program was implemented, we conducted a study to assess the impact of the program, vaccine failures, risk factors and the number of cases potentially preventable by the addition of an infant vaccination program. The preteen vaccination program is highly effective. An infant immunization program would bring additional benefits.

Infections by human coronavirus-NL in hospitalized children.

Background: A new human coronavirus (HCoV), HCoV-NL, was recently reported for Dutch patients with acute respiratory tract infections (ARTI). Little information is available on the incidence, clinical manifestations and epidemiologic features of HCoV-NL infections.

Methods: We performed a prospective study of symptomatic (case subjects with ARTI) and asymptomatic (control subjects undergoing elective surgery) children, View Article and Find Full Text PDF

Distribution and clinical impact of human respiratory syncytial virus genotypes in hospitalized children over 2 winter seasons.

Sequencing studies of the glycoprotein G gene were performed in human respiratory syncytial virus (hRSV) strains detected by reverse-transcription polymerase chain reaction directly from nasopharyngeal aspirates of hospitalized children < or =3 years old over 2 winters. Clinical data were compared between 106 children infected with group A hRSV (96 GA2 genotypes) and 94 children infected with hRSV group B (62 GB3 genotypes). A severity index was defined by assigning 1 point each for the use of >30% supplemental oxygen, admission to an intensive-care unit, and duration of hospital stay of >5 days.

Seroprevalence of hepatitis A infection in a low endemicity country: a systematic review.

Background: In Canada--a low endemicity country, vaccines for hepatitis A virus (HAV) are currently recommended to individuals at increased risk for infection or its complications. Applying these recommendations is difficult because the epidemiology of HAV infection is poorly defined, complex, and changing. This systematic review aimed to 1) estimate age-specific prevalence of HAV antibody in Canada and 2) evaluate infection-associated risk factors.

Immunogenicity of two paediatric doses of monovalent hepatitis B or combined hepatitis A and B vaccine in 8-10-year-old children.

Hepatitis A and B vaccines are highly immunogenic in three-dose schedules. To obtain an equivalent result in children with two paediatric doses would be of significant benefit. The purpose of this study was to measure the immunogenicity of a two-dose schedule in children with two licensed recombinant HBsAg containing vaccines given at paediatric doses, one of them combined with hepatitis A.