February 7, 2003

E. coli O157 Outbreak: Ontario (Update)
The City of Hamilton is continuing its investigation of an outbreak of E. coli O157:H7 infection. The Ontario Central Public Health Laboratory in Toronto has matched the E. coli O157:H7 from left-over haggis samples to E. coli O157:H7 found in stool samples using DNA testing methods. The samples of left-over haggis were recovered from the home refrigerators of three families that had attended the event. The Haggis was sold from a meat shop in Hamilton during the period up to and including 25 January 2003. The affected product was sold in packages of various weights without any specific code or UPC. Sixty-one of 236 people interviewed to date have reported illness; 15 cases have been laboratory confirmed. Nine persons were hospitalized. To this point in its investigation, the Social and Public Health Services Department has not detected any evidence of this product causing E. coli related illness outside of this event. The investigation began on 26 January with the notification of three cases of illness. The illness was traced back to a single social event held in Hamilton on 18 January where haggis was served.
Source: News Release, City of Hamilton, 4 February 2003

Pneumococcal Conjunctivitis: Maine
On 18 October 2002, the nurse at an elementary school in Westbrook, Maine, notified the Maine Bureau of Health of an increase in the number of students with conjunctivitis. During the period of 23 September to the 18 October, a total of 31 students in kindergarten and in first and second grades either were reported by parents to the nurse as having conjunctivitis or had conjunctivitis diagnosed by the nurse at school. Conjunctival swab cultures from five (38%) of the 13 students who were tested initially grew Streptococcus pneumoniae. This outbreak was caused by an uncommon strain of Streptococcus pneumoniae. This is the first time this strain of bacteria has caused an outbreak of conjunctivitis among young children; previously recognized outbreaks have occurred among college-aged adults. Although the children were not seriously ill, the outbreak resulted in lost school days for ill children and costs to their parents for provider visits and missed work.
Source: Morbidity and Mortality Weekly Report, Vol 52, No 4, 31 January 2003

West Nile Virus Infection: New York City
The New York City Department of Health and Mental Hygiene (DOHMH) has issued a summary of West Nile virus (WNV) infection in New York City for 2002. In total, 29 human cases of WNV were reported from all five boroughs with more than two-thirds (20) occurring in people over the age of 65. There were three WNV-related deaths: a 73-year-old man from Queens, a 75-year-old man from the Bronx, and an 83-year-old man from Staten Island. Twenty-eight cases were diagnosed with encephalitis or aseptic meningitis which usually require hospitalization. One case had no symptoms of encephalitis or meningitis, and did not require hospitalization. West Nile virus can cause a mild illness called West Nile fever, which resolves itself and does not usually require hospitalization. A 2000 DOHMH study found that for every hospitalized case of WNV, there are approximately 150 milder infections that do not cause illness, or cause illness not severe enough to require medical care.
Source: Press Release, New York City Department of Health and Mental Hygiene, 22 January 2003

Hepatitis A: Finland
In 2002, 385 microbiologically confirmed cases of hepatitis A were reported in Finland. This was substantially more than during the previous three years, when 48 to 51 annual cases were reported. The incidence among men was almost twice as high as that in women. The median age of cases was 28 years (range 0-74), and the highest rates of disease were among persons aged between 20 and 29 years who accounted for 139 (36%) of all cases. Of reported cases, 260 (68%) occurred in the Helsinki and Uusimaa Health District (HUS). In Helsinki, interviews of cases indicated that in the beginning of the outbreak nearly all cases were current intravenous drug users (IDUs) or could be linked to IDUs. Later in the outbreak, cases were also reported from the general population. This is the second major hepatitis A outbreak among IDUs in Finland since 1994. To prevent further outbreaks, offering hepatitis A vaccine free of charge to IDUs at all points of contact with the health care system should be strongly considered. This outbreak also illustrates the propensity for hepatitis A to spread from IDUs to the general population.
Source: Eurosurveillance Weekly, Vol. 7, No. 5, 30 January 2003

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.