October 14, 2005

Legionnaires' Disease: Ontario (Update)
Toronto Public Health continues to investigate the Legionnaires' disease outbreak in a nursing home. A total of 71 residents, 23 staff, 14 visitors and 2 individuals who live or work in the immediate vicinity have been affected. There has been 17 deaths among residents. Most of those affected are improving and some have been discharged from hospital. The home remains closed to new admissions and most visitors. The home's ventilation system remains shut down.
Source: News Release, Toronto Public Health, 7, 11 & 13 October 2005

West Nile Virus Through Organ Transplant: New York
Three organ transplant recipients, two of whom are critically ill, contracted West Nile virus (WNv) from an organ donor who resided in New York City. The organ donor died following a severe head injury during an accident. He lived near a park in the Bronx where WNv had recently been detected in mosquitoes. The first recipient, who received a liver, became ill on 11 September with fever, confusion and progressive muscle weakness. The second recipient, who received a lung, became ill with fever, breathing difficulties, confusion and tremors on 13 September. Both recipients were diagnosed with WNv infection and remain hospitalized in critical condition. A kidney recipient tested positive for WNv but was reported to have no symptoms. The fourth recipient, who received a kidney, has so far tested negative for WNv and is well. Screening of organ donors for WNv is not currently required. To date in 2005, there have been 11 human cases of WNv in New York City residents, including two of the patients mentioned above. This is only the second report of WNv transmission through organ transplantation in the United States.
Source: Press Release, New York City Department of Health and Mental Hygiene, 6 October 2005

E. coli O157: United Kingdom
As of 3 October 2005, 157 cases of infection had been reported in an outbreak of VTEC O157 in south Wales. Sixty seven males and 90 females are affected, and 65% of cases are in children of school age. Dates of symptom onset range from 10-30 September and over 40 schools have recorded cases. A 5 year old boy has died. Evidence suggests a link between the outbreak and a supplier of cooked meats to the school meals services. The distribution of cases suggests a centrally distributed product with low levels of contamination rather than a problem in individual schools. Ten of the first 18 primary cases in infected schoolchildren with early symptom onset dates before 17 September were contacted between 16-20 September. All reported having eaten lunch in the school canteen, compared with 8 out of 13 controls who were selected at random from the school register. A single main supplier distributes cooked meats to the affected schools. Local authorities took action on 19 September, after identifying practices that could result in contamination of cooked meat at the supplier's premises. E. coli O157 has been isolated from three samples of sliced cooked meat. Isolates have been confirmed as PT21/28, VT2 and examined by pulsed field gel electrophoresis (PFGE). Results on cultures from 2 samples have so far shown that PFGE profiles of strains from the food samples are indistinguishable from those found in the cases. PFGE typing is continuing on the third strain. Contaminated cooked meats have been associated with previous outbreaks of VTEC O157 infection in the United Kingdom.
Source: Eurosurveillance Weekly, Volume 10, Issue 10, 6 October 2005

Enhanced Surveillance of Lymphogranuloma Venereum (LGV): United Kingdom
Data to the end of September 2005 for the enhanced surveillance of LVG program in the United Kingdom reveals a total of 215 confirmed cases. Of the 215 cases, epidemiological and clinical reports have been received for 147 confirmed cases: 144 cases are in men who have sex with men (MSM), with 2 cases reported in heterosexual men. Cases have been reported from across the United Kingdom, although the majority have been diagnosed in London (71%) and Brighton (14%). The majority of cases continue to be reported in men who have HIV infection (81%), and most are symptomatic with proctitis.
Source: CDR Weekly, Volume 15, Number 40, 6 October 2005

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.