The following background information is abstracted from Gideon www.GideonOnline.com and the Gideon e-book series. [1,2]

Time and Place:
The first case of Lyme disease in Canada was reported from Quebec in 1984.
– Approximately 100 cases had been reported as of 1990 (67 of these from Ontario); 205 as of 1994 (105 of these autochthonous).
– As of 1997, cases were reported from New Brunswick, Quebec, Ontario, southern Manitoba and British Columbia.
– 280 cases were reported from Ontario during 1981 to 1998 (127 locally acquired); 172 during 1999 to 2004 (31 locally-acquired).
– 20 cases were reported in Alberta during 1989 to 2008.
– Nova Scotia reported its first locally-acquired case of Lyme disease in 2002.
– 93 cases were confirmed in British Columbia during 1997 to 2008 (true number estimated at 142).

Vectors and Reservoirs:
– The local vectors include the deer tick (Ixodes scapularis), western blacklegged tick (I. pacificus) and rabbit tick (Haemaphysalis leporispalustris – possibly an enzootic vector in Alberta).
– As of 2000, I. scapularis had been found in over 250 locations in Canada including Ontario, Newfoundland, Nova Scotia , New Brunswick, Quebec, Manitoba, Prince Edward Island and Saskatchewan; the Long Point Peninsula on Lake Erie (southern Ontario); Point Pelee National park and Rondeau Provincial Park on the north shore of Lake Erie; and Atlantic Canada.
– I. pacificus is found in the southern and coastal regions of British Columbia (Borrelia burgdorferi has also been found in Ixodes angustus in these areas), the Gulf Islands and Vancouver Island.
– Passerine birds appear to disperse infected ticks in Canada.
– An infected tick (Ixodes scapularis) was found on a bird (common yellowthroat = Geothlypis trichas) in Nova Scotia (1999).
– Borrelia burgdorferi has been identified in an additional avian tick species, Ixodes auritulus.
– Borrelia garinii has been identified in seabird ticks (Ixodes uriae) in Newfoundland. Ixodes uriae is a known parasite of deer mice (Peromyscus maniculatus) on the Gannet Island Archipelago, Newfoundland and Labrador.

Prevalence surveys:
12.5% I. scapularis, including 10.1% of ticks collected from humans (2006 publication)
8% of I. scapularis nymphs recovered from northward migrating birds in non-endemic areas of Eastern Canada (2005 to 2006)
11.4% of ticks collected from songbirds (2004 to 2006)
67% of tick pools collected at Turkey Point Provincial Park, Ontario (2005 to 2006)
29.5% of ticks infesting songbirds, nationwide (2011 publication)

References:
1. Berger SA. Infectious Diseases of Canada, 2012. 496 pages, 107 graphs, 3130 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-canada/
2. Berger SA. Lyme Disease: Global Status, 2012. 73 pages, 65 graphs, 593 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/lyme-disease-global-status/

In analyzing a recent case in Canada ex Dominican Republic, it is interesting to compare the background of rabies in these two countries. [1-4] While human rabies is clearly more common in the Dominican Republic (graph 1), the incidence of animal rabies is higher in Canada (graph 2).

Skunks and foxes account for over 50% of aminal rabies in Canada, while dogs, mongoose and ruminants account for most cases in the Dominican republic. The number of rabid dogs reported by the two countries has been strikingly similar through much of the past four decades (graph 3).

References:

References:
1. Berger SA. Infectious Diseases of Canada, 2012. 496 pp, 107 graphs, 3130 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-canada/
2. Berger SA. Infectious Diseases of the Dominican Republic, 2012. 339 pp, 53 graphs, 1314 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-the-dominican-republic/
3. Berger SA. Rabies: Global Status, 2012. 376 pp, 546 graphs, 1375 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/rabies-global-status/
4. Gideon graph tool at http://www.GIDEONonline.com/wp/wp-content/uploads/Gideon-Graphs.pps

Rates of salmonellosis in Canada are strikingly similar to those of giardiasis, and low in comparison with rates reported by the other major English-speaking countries. [1-3] [1-3] See graphs:

References:
1. Gideon graph tool at http://www.GIDEONonline.com/wp/wp-content/uploads/Gideon-Graphs.pps
2. Berger SA. Infectious Diseases of Canada, 2012. 496 pp, 107 graphs, 3130 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-canada/
3. Berger SA. Salmonellosis: Global Status, 2012. 252 pp, 300 graphs, 2297 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/salmonellosis-global-status/

A recent outbreak in Aukland belies the fact that rates of hepatitis A in New Zealand are low. In fact, since 2000 incidence figures for all forms of viral hepatitis in this country have even been exceeded by those of leptospirosis and rheumatic fever [1] – see graph [2]:

During the same period, rates of hepatitis A among the six major English-speaking countries have been decreasing, and continue to be surprisingly similar – see graph:

Only one country in this group, the United States, employs routine vaccination against Hepatitis A. Two other countries, Canada and Australia, administer the vaccine to high-risk populations only. [2]

References:
1. Berger SA. Infectious Diseases of New Zealand, 2012. 413 pp, 136 graphs, 1534 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-new-zealand/
2. Gideon graph tool at http://www.GIDEONonline.com/wp/wp-content/uploads/Gideon-Graphs.pps
3. Berger SA. Hepatitis A: Global Status, 2012. 166 pp, 181 graphs, 1189 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/hepatitis-a-global-status/

Note featured in ProMED

As in several other countries, including the United States, rates of syphilis in Canada decreased and later “rebounded” in parallel with an initial explosion and later decline in AIDS reporting. [1, 2] See graph [3]:

References:
1. Berger SA. Infectious Diseases of Canada, 2012. 496 pp, 107 graphs, 3106 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-canada/
2. Berger SA. Syphilis: Global Status, 2012. 238 pp, 339 graphs, 970 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/syphilis-global-status/
3. Gideon graph tool at http://www.GIDEONonline.com/wp/wp-content/uploads/Gideon-Graphs.pps

Note featured on ProMED

A recent episode involving contaminated jelly belies the fact that current botulism rates in Canada are only half those reported in the United States [see graph]

The following background data on botulism in Canada are abstracted from the Gideon e-book series. [1,2] Primary references are available on request.

Historical background:
The first outbreak of botulism in Canada was recorded in 1919.
- A total of 100 outbreaks involving over 230 cases had been reported to 2005.
- Botulism is primarily encountered among the First Nations and Inuit people.
- Rates of 30 per 100,000 per year are reported among the Inuit.
- Most cases in recent years have been caused by fermented salmon roe (‘stink eggs’ or ‘gink’) in British Columbia; and fermented sea mammal meat among the Inuit.
- 14 outbreaks (63 cases, 35 fatal) were reported during 1919 to 1954.
- 61 outbreaks (122 cases, 21 fatal) were reported during 1971 to 1984 – Inuit people accounted for 92.6% of the patients, and 59% of the cases caused by raw, parboiled or “fermented” meats from marine mammals. Fermented salmon eggs or fish accounted for 23% of the outbreaks.

Canada’s first case of infant botulism was reported in 1971.
- 27 cases of infant botulism were reported during 1979 to 2006 – including 22 type A and 5 type B.
- As of 2008, infant botulism had been reported in 26 countries – with highest numbers in United States – followed by Argentina, Australia, Canada, Italy, and Japan.

Food recalls:
2006 – Lots of imported Italian olives, American carrot juice, chili sauce and pasteurized canned crab were recalled due to contamination with botulism toxin.
2007 – A recall was issued for clams and cod liver sold in mason jars.
2010 – A recall was issued for peperoni products sold in British Columbia.
2011 – A case of botulism on Vancouver Island let to the recall of watermellon jelly.

Notable outbreaks:
1974 – Outbreaks (10 cases in 4 outbreaks, 4 fatal) of type E botulism were reported among indigenous peoples. Walrus, Arctic char, seal and fermented salmon eggs were implicated.
1977 (publication year) – Outbreaks (12 cases in 2 outbreaks) of type A and B botulism were reported among Inuit peoples.
1985 – An outbreak (36 cases) in the United States and Canada was associated with chopped garlic in soybean oil served in a restaurant in Vancouver, Canada.
1991 – An outbreak of type A botulism was reported in Ottawa.
1995 – Outbreaks (16 cases in 7 outbreaks, 0 fatal) and one case of infant botulism were reported – implicated foods included muktuk, micerak (fermented fat of marine mammals), seal, walrus and marinated/smoked fish.
1996 – Outbreaks (10 cases in 5 outbreaks, 0 fatal) of foodborne botulism were reported – implicated foods included seal, fermented fish, beluga whale and micerak.
1997 – Outbreaks (18 cases in 7 outbreaks, 1 fatal) were reported – including 9 cases in Quebec acquired from seal igunaq and 4 cases in the Northwest Territories acquired from beluga whale and caribou fat.
1999 – An outbreak (3 cases) of type B botulism in Ontario was ascribed to home-canned tomatoes.
2001 – Outbreaks (4 cases in 2 outbreaks, 1 fatal) in British Columbia were ascribed to fermented salmon roe.
2006 – An outbreak (4 cases) in the United States was associated with commercially-canned carrot juice. Three additional cases in Toronto were associated with the same product.
2009 – An outbreak (3 cases) of type E botulism in France was related to vacuum packed hot-smoked Canadian whitefish purchased in Finland.

References:
1. Berger SA. Infectious Diseases of Canada, 2011. 475 pp. Gideon e-book series, http://www.gideononline.com/ebooks/country/infectious-diseases-of-canada/
2. Berger SA. Botulism: Global Status, 2011. 80 pp. Gideon e-book series, http://www.gideononline.com/ebooks/disease/botulism-global-status/

In recent years, reported rates of trichinosis in Mexico have decreased to levels which are comparable to those of the United States. In fact, Canada now reports the highest rates for North America (see graph). [1,2]

Chronology of trichinosis outbreaks in Mexico (primary reference available on request) [1,2]

Notable outbreaks:
1979 (publication year) – An outbreak was reported among family members in Naucalpan.
1981 (publication year) – An outbreak was reported in Villanueva, Zacatecas.
1984 (publication year) – Outbreaks were reported in Zacatecas.
1985 (publication year) – An outbreak was reported in Zacatecas.
1985 – An outbreak was reported in a government office in Federal District.
1986 (publication year) – An outbreak was reported in Durango.
1990 (publication year) – An outbreak (4 cases) among family members in Iztapalapa was caused by raw sausage.
1992 (publication year) – An outbreak (166 cases) in Delicias City, Chihuaha was caused by contaminated pork sausage.
1992 (publication year) – An outbreak (3 cases) among members of a family in Zapopan was related to consumption of raw pork.
1994 – An outbreak (7 cases) in France was associated with horsemeat imported from Mexico.
2001 (publication year) – An outbreak (5 symptomatic and 17 asymptomatic cases) was reported in Mexico State.

References:
1. Berger SA. Infectious Diseases of Mexico, 2010. 439 pp. Gideon e-books. http://www.gideononline.com/ebooks/country/infectious-diseases-of-mexico/
2. Berger SA. Trichinosis: Global Status, 2010. 81 pp. Gideon e-books. http://www.gideononline.com/ebooks/disease/trichinosis-global-status/

Appeared in ProMED:

The following background information on “newer” viral respiratory infections in Canada was abstracted from GIDEON:

Prevalence surveys

• Human matapneumovirus (HMPV) is found in 4.1 per cent of adults with community-acquired pneumonia (2005 publication).
• HMPV is found in 9.5 per cent of respiratory specimens from the community and 25 per cent of outbreaks; median age was 24 months (Calgary, 2007 publication).
• HMPV is found in 14.8 per cent of patients with acute respiratory tract infection (4 provinces, 2001 to 2002 influenza season).
• HMPV is found in 8 per cent of acute lower respiratory tract infections (Montreal, 2001).
• HMPV is found in 3.9 per cent of pediatric inpatients and outpatients (Alberta, 2002 to 2003).
• HMPV is found in 6 per cent of children below age 3 years hospitalized for acute respiratory tract infections (Quebec, 2001 to 2002).
• HMPV is found in 13.5 per cent of children aged under 5 years, 26.1 per cent of children aged 6 to 10 years, 32.3 per cent of children aged 11 to 15 years, 99.0 per cent of persons agd 16 to 30 years, 91.7 per cent of adults aged 31 to 60 years, 93.8 per cent of persons aged over 60 years in Saskatchewan seropositive (2007 publication).
• HMPV is found in 4 per cent of adults hospitalized with community-acquired pneumonia (Edmonton, 2008 publication).

(more…)

As quoted in ProMED:

Regarding recent outbreaks of human metapneumovirus infection in Saskatchewan, a large number of prevalence surveys have been published for newer respiratory tract viruses in Canada. The following are abstracted from the GIDEON Database

Human metapneumovirus (HMPV)
4.1 percent of adults with community-acquired pneumonia (2005 publication)
9.5 percent of respiratory specimens from the community and 25 percent of outbreaks – median age 24 months (Calgary, 2007 publication)
14.8 percent of patients with acute respiratory tract infection (4 provinces, 2001 to 2002 influenza season)
8 percent of acute lower respiratory tract infections (Montreal, 2001)
3.9 percent of pediatric inpatients and outpatients (Alberta, 2002 to 2003)
6 percent of children below age 3 years hospitalized for acute respiratory tract infections (Quebec, 2001 to 2002)
4 percent of adults hospitalized with community-acquired pneumonia (Edmonton, 2008 publication)
(more…)