August 24, 2001

West Nile (WN) virus: Canada
As of August 23, 2001 there have been 3,310 dead birds reported to the WN virus dead bird surveillance program. Of the 1,379 dead birds that have been submitted for testing, the diagnostic protocol has been completed on 1,293. A dead crow, picked up in the City of Windsor, Ontario on August 8^th was confirmed as positive for WN virus on August 22^nd . This is the first laboratory-confirmed positive WN virus specimen in Canada. The news releases issued by the Medical Officer of Health for Windsor-Essex County, Ontario, and the Ontario Ministry of Health and Long Term Care can be found at http://www.wechealthunit.org and http://www.gov.on.ca/health/. A dead blue jay, picked up in Oakville, Ontario on August 13^th was reported as preliminary presumptive positive on August 19^th . Confirmatory tests are currently being conducted on this blue jay. To date, all other specimens have tested negative. For further information on dead bird submissions by province or for general information regarding WN virus please consult the Health Canada website at: http://www.phac-aspc.gc.ca/wnv-vwn/.
Source: Canadian Cooperative Wildlife Health Centre; Bureau of Infectious Diseases, Centre for Infectious Disease Prevention and Control and the National Microbiology Laboratory, Public Health Agency of Canada.

Botulism : British Columbia
The B.C. Centre for Disease Control (BCCDC) is warning people not to eat fermented salmon roe ("stink eggs") after three B.C. residents and one Yukon resident developed botulism between August 5 to 12 inclusive. Three of the four affected people still require support of ventilators to keep them alive. The poisoning occurred in two separate incidents from two separate home-processed batches from northwestern B.C. Both poisoned batches have since been removed. According to the Director of Epidemiology at the BCCDC, the botulism toxin (or poison) can start out by causing typical symptoms of food poisoning, vomiting and nausea. But it later progresses to dry mouth, blurred vision, slurred speech and muscle weakness. It can leave victims completely paralyzed and unable to breathe without the help of a machine. The toxin is produced by a germ found in the soil and in animal and plant matter. In the absence of air (as in sealed bottles, cans, plastic wrap or underground) it will grow well and produces the deadly paralytic toxin. The public is reminded that BCCDC does not recommend the consumption of "stink eggs" because they pose a very serious health risk. However, recognizing that "stink eggs" are a traditional aboriginal food, the risk of botulism can be reduced by using alternate methods of treating fish eggs such as curing or sun-drying. Storing fermented eggs in glass jars, with a cheesecloth covering, and regular stirring of eggs to aerate the container will decrease the risk of botulism but cannot eliminate that risk. Unrefrigerated eggs should not be stored in sealed plastic bags or containers at any point after harvesting.
Source: BCCDC News, BC Centre for Disease Control Website, August 14, 2001

Methicillin-Resistant Staphylococcus aureus (MRSA) Infection: Canada
MRSA was first reported in Canada in 1981. Since then, the organism has been identified in many Canadian health-care facilities, and one report has documented the rapid interprovincial spread of a single clone of MRSA. Community-acquired MRSA has also been described, particularly for Aboriginal communities in the Prairie provinces. However, nationwide data describing the incidence and epidemiology of MRSA in Canada were not available before 1995. In that year, national surveillance for MRSA was started in sentinel hospitals participating in the Canadian Nosocomial Infection Surveillance Program. Preliminary results of this surveillance have indicated a significant increase in the number of patients infected or colonized with MRSA in each of the past few years. A total of 4,507 patients infected or colonized with MRSA were identified between January 1995-December 1999. The rate of MRSA increased each year from a mean of 0.95 per 100 S. aureus isolates in 1995 to 5.97 per 100 isolates in 1999. Most of the increase in MRSA occurred in Ontario, Quebec and the western provinces. Of the 3,009 cases for which the site of MRSA acquisition could be determined, 86% were acquired in a hospital, 8% were acquired in a long-term care facility and 6% were acquired in the community. A total of 1,603 patients (36%) were infected with MRSA. The most common sites of infection were skin or soft tissue (25% of MRSA infections), pulmonary tissues (24%) and surgical sites (23%); 13% of the patients were bacteremic. An epidemiologic link with a previously identified MRSA patient was suspected in 53% of the cases. Molecular typing indicated that 81% of the isolates could be classified as related to 1 of the 4 Canadian epidemic strains of MRSA.
Source: Canadian Medical Association Journal, Vol 165, No 1, July 10, 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]