Institutional links

E. coli Outbreak: Ontario
Toronto Public Health is investigating an outbreak of E.coli O157 among individuals who attended a picnic in Scarborough's Morningside Park on 1 July. Several hundred people attended the event, which was a reunion for the Punqudutivu Students Association of Sri Lanka. Six cases of E. coli O157 have been confirmed. Four individuals were hospitalized, and one has developed serious kidney complications. Toronto Public Health is asking anyone who attended this picnic on 1 July to watch for symptoms of E. coli. The exact source of contamination in this outbreak is under investigation.
Source: News Release, Toronto Public Health, 12 July 2007

Salmonellosis: Chicago
Chicago Department of Public Health officials are investigating cases of salmonellosis that appear to be related to the Pars Cove Persian Cuisine booth at Taste of Chicago. As 12 July, 126 people have reported that they became ill after they ate food purchased from the booth. Nine of the 126 are laboratory-confirmed cases of salmonellosis, with more results pending. Ten people are known to have been hospitalized. Most of the individuals live in the Chicago area; a few are from downstate and a few others are from other states. Health officials say it is still too early to speculate on whether the bacteria were transmitted by food handlers or came from the food or a food ingredient.
Source: Public Health News, Chicago Department of Public Health, 12 July 2007

Health Care-Associated Staphylococcus aureus Pneumonia: Alberta
A cohort of bacteremic S. aureus pneumonia cases was reviewed to determine the role of health care-associated pneumonia (HCAP) among the cohort, and to assess for differences between community-acquired pneumonia (CAP) and HCAP. Bacteremic S. aureus pneumonia cases were identified from a prospective study of all patients diagnosed with CAP who presented to hospitals in Edmonton, Alberta, between November 2000 and November 2002. There were 28 cases of bacteremic S. aureus pneumonia identified. Fifty-seven per cent were reclassified as having HCAP, and 43% remained classified as having CAP. The CAP cohort was significantly younger than the HCAP cohort (mean age 49.0±23.7 years versus 67.8±18.6 years; P=0.035) with higher rates of intravenous drug use (50% versus 0%; P=0.002). Long-term care facility residence (44%) was common in the HCAP cohort. The HCAP cohort presented with more severe illness, having a higher mean pneumonia severity index score (143.1±41.1 versus 98.2±54.6; P=0.028), and despite fewer embolic complications, there was a trend toward a significantly higher mortality rate (31% versus 0%; P=0.052). Two community-acquired isolates cultured in the setting of intravenous drug use were methicillin-resistant, and no isolates were positive for Panton-Valentine leukocidin. There was evidence of relatedness involving 44% of the HCAP isolates by pulsed-field gel electrophoresis analysis. HCAP accounts for a significant number of cases that, when using traditional definitions, would be classified as CAP. Severity of illness and mortality was excessive within the HCAP group. There was evidence of relatedness and spread of common strains in the HCAP cohort. The present study supports recommendations for treatment guidelines directed toward the entity of HCAP and the empirical coverage of S. aureus among certain high-risk groups.
Source: Canadian Journal of Infectious Diseases and Medical Microbiology, Volume 18, No. 3, May/June 2007

Hepatitis A Vaccination Coverage Among Children Aged 24-35 Months: United States
The highest hepatitis A vaccination coverage levels among children aged 24-35 months and the greatest decline in acute hepatitis A infections occurred in states, counties and communities where hepatitis A vaccination has been routinely recommended since 1999. Hepatitis A vaccine was licensed for use in children ≥24 months of age in 1995. Since 1999, the vaccine has been routinely recommended for children living in states, counties and communities where the rate of hepatitis A virus (HAV) infections was twice the 1987-1997 national average. In 2005, 57% of children aged 24-35 months living in these areas received one dose of hepatitis A vaccine compared with 3 percent of children aged 24-35 months living in areas where no specific vaccination recommendation existed. The national incidence of hepatitis A infections has substantially declined from 12/100,000 in 1995 to 1.5/100,000 in 2005. The decline in HAV infections has been greatest in areas where childhood vaccination has been routinely recommended and rates in these areas now approach those seen in areas where there has been no specific recommendation for childhood vaccination. The 2005 licensure of the hepatitis A vaccine for use in children aged ≥12 months and the 2006 recommendation for routine hepatitis A vaccination of all children should result in improved coverage and further reductions in disease incidence. Source: Morbidity and Mortality Weekly Report, Volume 56, No. 27, 13 July 2007

This weekly report provides timely information about potential or actual disease problems. 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. It will rely to a large extent on information about incidents being forwarded to the Notifiable Diseases Section as early as possible. This can be done by contacting Carole Scott at tel: (613) 957-0334 / fax: (613) 957-2842 / E-mail: Carole.Scott@phac-aspc.gc.ca. Readers are asked not to post any items on websites, nor to publish them in newsletters, nor to pass them to the media and the public without prior consent of the Notifiable Diseases Section, Centre for Infectious Disease Prevention and Control.