July 2, 2004

Final Report: National Immunization Strategy: Canada
Over the past several years, the Advisory Committee on Population Health and Health Security (ACPHHS) has supported the development of a national approach to addressing immunization issues in Canada. During this period, numerous meetings and consultations with federal, provincial, and territorial (F/P/T) public health representatives and other relevant stakeholders were undertaken to identify and develop collaborative approaches to strengthening immunization in Canada. The "Final Report: National Immunization Strategy," describes the key components and supporting activities associated with a national immunization strategy in Canada. In June 2003, the Conference of F/P/T Deputy Ministers of Health accepted this document as advice in moving forward with immunization issues in Canada. It was recognized, however, that not all jurisdictions would have the necessary funding available to implement the approach outlined in this document, particularly as it relates to the collaborative purchase of new vaccines. The final report can be accessed on line.
Source: Public Health Agency of Canada, Health Canada, June 2004

Salmonella Infection from Raw/Undercooked Chicken Nuggets and Strips: Canada
An article published by the BC Centre for Disease Control and Health Canada in the June issue of the Journal of Food Protection describes a newly found link between salmonella infections and eating raw or undercooked chicken nuggets and strips. The study found that consumer misconceptions may be contributing to the risk of infection. One third of people surveyed thought that frozen nuggets/strips were pre-cooked. In fact, the majority of brands on the market are made from raw chicken and need to be thoroughly cooked according to package instructions. In the study, people reported washing their hands less often after handling frozen nuggets/strips than after handling obviously raw chicken. Almost 30% of those surveyed reported using the microwave sometimes or always when cooking these products. Microwave cooking is not recommended because it may not cook the product thoroughly due to uneven heating. Chicken nuggets/strips are often eaten by families and young children. In the study, a quarter of Salmonella cases were in children less than 5 years of age. As a result of these findings, labelling requirements for raw products with a cooked appearance are in the process of being amended. Product labels will soon be required to clearly indicate when the product is raw or uncooked.
Source: News Release, BC Centre for Disease Control and Public Health Agency of Canada, Health Canada, 28 June 2004

Group A Streptococcal Infection: Belgium
In April 2004, a dozen cases of invasive group A streptococcal (GAS) infections were reported by several hospitals in Brussels and Flanders. Most cases presented with a severe clinical picture requiring intensive care. Four deaths were reported in a one week period (14-18 April). In the same period, the Streptococcus pyogenes reference laboratory at the University of Antwerp also reported a sudden increase in the number of invasive GAS isolates submitted in April. In the 2 month period 1 April - 31 May 2004, 55 cases of invasive GAS infections were reported from the three regions, including 6 deaths (outcome reported in 15 cases). Twenty nine per cent of the cases (n=15) were in patients under 5 years of age, and 69% were in adults (20 years and older, n=36). In the 25 cases for which the clinical picture has been reported, 56% (n=14) presented as septicaemia with or without toxic shock syndrome (TSS). Other frequent clinical presentations were pneumonia, empyema and necrotising fasciitis. Of the 6 reported deaths (2 children, 4 adults), 5 presented with septicaemia and/or TSS. No geographic clustering was observed. Isolates have been sent and typed at the reference laboratory for 75% (n=41) of the reported cases. GAS was isolated mainly from blood (71%), pleural fluid, synovial fluid and wounds. Thirty nine percent of isolates (n=16) were emm type 1 and 24% (n=10) emm 100-104. Isolates were susceptible to common antibiotics, such as the beta-lactams and macrolides.
Source: Eurosurveillance Weekly, Volume 8, Issue 26, 24 June 2004

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.