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).

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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)
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