March 23, 2001

Invasive Meningococcal Disease: Saskatchewan
On February 21, 2001, Saskatoon District Health - Public Health Services received notification that a teenage girl had been admitted to a local hospital with clinical illness compatible with meningococcemia. She deteriorated rapidly and died approximately 9 hours after admission. Preliminary blood, CSF and skin lesion microscopy and culture did not yield any organisms. After the patient died, serum and CSF specimens were sent for PCR testing at a reference laboratory in Edmonton and the results were positive for N. meningitidis. In the course of obtaining a history from some of the patient's school friends, it was learned that she had attended a rave the previous weekend. It was estimated that 500-1000 people had attended the rave from the four western provinces. Given the nature of activities common in a rave environment and the difficulty in identifying contacts who may have attended, it was decided to release information regarding the possible exposure at the rave. Other jurisdictions were notified of the potential exposure and a press conference was held advising of the possible exposure to meningococcal disease at the rave. A provincial information line was established and staffed by public health employees. Public health nurses visited the patient's high school and the neighbouring schools to allay fears and to identify further contacts. Approximately 120 people were interviewed regarding potential exposure and prophylaxis was initiated for 55 of them. The telephone information line received 300 calls. Most of the calls came from people who had attended the rave or who were concerned that their children had attended the rave. No secondary cases were identified during the surveillance period.
Source: Saskatoon District Health - Public Health Services, Saskatoon, Saskatchewan

Chickenpox Vaccination: Alberta
Vaccination against chickenpox will be added to Alberta's routine immunization programs in the spring of 2001. Alberta's immunization program currently protects children from diphtheria, tetanus, pertussis, polio, measles, mumps, rubella, hepatitis B and haemeophilus influenzae type b (Hib). Chickenpox creates a substantial public health concern: about 36,000 Albertans get chickenpox every year and about 11,000 visit the doctor annually for chickenpox. There are about 160 hospital admissions a year. Target groups for the vaccine in 2001 are: non-immune healthcare workers; families of individuals with a weak immune system (e.g. parents, siblings and caregivers of children with cancer); women of child-bearing age who, during prenatal visits, are identified as not having had chickenpox (pregnant women cannot be vaccinated until after the birth of the baby). Grade 5 students who have not had chickenpox will be offered immunization in school at the same time they receive the second or third dose of the hepatitis B vaccine. Less than one-third of the approximately 40,000 Grade 5 students are expected to need the vaccine. In the summer, health regions will begin to immunize all one-year olds who have not had chickenpox. Planning is underway for the next group to be immunized - children just ready to enter the school system. Alberta Health and Wellness has budgeted $6 million per year over the next 3 fiscal years to fully implement the new chickenpox vaccine program.
Source: Press Release, Alberta Health and Wellness, March 9, 2001

Vancomycin-Resistant Enterococci: Canada
In a study of 300 strains of enterococcal bacteria only one antibiotic, nitrofurnatoin, was effective against them all. Enterococci are a common cause of urinary tract infections, but can cause a variety of other diseases including endocarditis and meningitis. Doctors and hospitals have become increasingly concerned about these bacteria in recent years as they have developed resistance to most antibiotics, including the drug of last resort, vancomycin. In the study, the researchers tested the effectiveness of eight different antibiotics on 300 enterococcal isolates from a hospital, a third of which were resistant to vancomycin. Only the antibiotic, nitrofurantoin, was effective against them all. The researchers concluded that nitrofurantoin may provide effective treatment of urinary tract infections caused by vancomycin-resistant enterococci.
Source: (Journal of) Antimicrobial Agents and Chemoptherapy, Vol 45, Issue 1, January 2001

The details given are for information only and may be very provisional. Where incidents are considered of national importance and are ongoing, the initial report will be updated as new information becomes available.

[Infectious Diseases News Brief]