April 11, 2003

Severe Acute Respiratory Syndrome (SARS): Canada and International (Update)
As of 10 April, a total of 98 probable cases have been reported in Ontario (95) and British Columbia (3), including 10 deaths (Ontario); 155 suspect cases have also been reported in British Columbia (32), Alberta (5), Saskatchewan (1), Ontario (111), New Brunswick (2) and Prince Edward Island (4). During the period of 1 November 2002 to 11 April 2003, 2,890 cases of SARS with 116 deaths (2,792 cases, 106 deaths outside of Canada) have been reported to the World Health Organization. Reports have been received from: Brazil (2), Canada (98, 10 deaths), China, Mainland (1,309, 58 deaths), China, Hong Kong SAR (1,059, 32 deaths), China, Taiwan (21), France (5), Germany (6), Italy (3), Japan (4), Kuwait (1), Malaysia (4, 1 death), Republic of Ireland (1), Romania (1), Singapore (133, 9 deaths), South Africa (1), Spain (1), Switzerland (1), Thailand (7, 2 deaths), United Kingdom (5), United States (166), Vietnam (62, 4 deaths). Information updates are posted daily on the Health Canada website: http://www.phac-aspc.gc.ca/sars-sras/index.html and the WHO website: http://www.who.int/csr/don/en/.
Source: Public Health Agency of Canada, 10 April 2003; World Health Organization, 11 April 2003

Drug-Resistant Tuberculosis: Canada
Health Canada has recently published the report, Tuberculosis: Drug resistance in Canada, 2002. Reported susceptibility results of the Canadian Tuberculosis Laboratory Surveillance System. Of the 1,352 isolates in 2002 included for analysis, 172 (12.7%) were resistant to one or more first-line anti-tuberculous drug(s). Resistance to isoniazid (INH) was the most common type of drug resistance (8.1%). Twenty-two isolates (1.6%) were multi-drug resistant tuberculosis (MDR- TB) strains (defined as resistance to at least INH and rifampin (RMP)), of which 15 isolates demonstrated resistance to four or five first-line anti-tuberculous drugs tested. Reporting of these isolates was from Ontario, Manitoba and British Columbia. In addition, Alberta, British Columbia, Manitoba, Ontario and Quebec reported isolates with other patterns of multi-drug resistance. Nunavut, Northwest Territories, Yukon, Newfoundland and Labrador and Prince Edward Island reported that all isolates tested were susceptible to all the first-line anti-tuberculous drugs. The report is available on-line at:
http://www.phac-aspc.gc.ca/publicat/tbdrc02/index.html
Source: Division of Community Acquired Infections, Centre for Infectious Disease Prevention and Control

Salmonellosis: British Columbia
The BC Centre for Disease Control and the Canadian Food Inspection Agency have received more than a dozen reports of Salmonella infections among BC residents which appear to be linked to the consumption of chicken nuggets and chicken strips. Half of the reported illnesses have been children. At least six cases were hospitalized.
Source: BC Centre for Disease Control, 4 April 2003

Influenza Vaccination: United States
In three large managed-care plans, about 58% of the members who were at least 65 years old received the influenza vaccine. During both the 1998-1999 and 1999-2000 influenza seasons, those who were vaccinated had a significantly lower risk of hospitalization for cardiac disease, cerebrovascular disease, and influenza and pneumonia than unvaccinated subjects. Vaccination was also associated with a lower risk of death from any cause. In this observational study with data on more than 286,000 people, those receiving the influenza vaccine had on average more coexisting conditions at base line. Vaccination is thus associated with substantial benefits, including lowering the risk of hospitalization for cardiac and cerebrovascular disease.
Source: New England Journal of Medicine, Vol 348, No 14, 3 April 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.