Invasive Meningococcal Disease (IMD) Case Definition: Canada
The national case definition for invasive meningococcal disease underwent revision in 2005. The case definition was approved by the Canadian Public Health Laboratory Network, the Council of Chief Medical Officers of Health and the Public Health Agency of Canada. Effective 1 January 2006, a confirmed case includes demonstration of N. meningitidis DNA by appropriately validated nucleic acid test from a normally sterile site. Both confirmed and probable cases of IMD are notifiable at the national level. For further details, please refer to the ‘Guidelines for the Prevention and Control of Meningococcal Disease' (http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/05vol31/31s1/index.html) and the ‘Case Definitions for Diseases Under National Surveillance' (http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/00vol26/26s3/index.html).
Source: Immunization and Respiratory Infections and Surveillance and Risk Assessment Divisions, Public Health Agency of Canada, 4 January 2006

Pertussis: Ontario
Toronto's Medical Officer of Health has issued an advisory to parents of young children to be aware of the symptoms of whooping cough. There has been a significant increase in the number of cases of whooping cough reported in Toronto since early November. There have been 54 cases in this period and of these 40 were children less than five years of age. There were 62 cases reported in the previous ten months of the year. Advisory notices are being sent to schools and day cares. A public health alert has been sent to hospital emergency rooms and infection disease practitioners. The increase in cases has not been attributed to one source and may be the result of a general decline in protection from the vaccine, which wears off over time.
Source: News Release, Toronto Public Health, 22 December 2005

Outbreaks of E. Coli O157:H7 Associated with Petting Zoos: North Carolina, Florida and Arizona
During 2004-2005, three outbreaks of E. coli O157:H7 infections occurred among agricultural fair, festival, and petting zoo visitors in North Carolina, Florida, and Arizona. One hundred eight cases, including 15 cases of hemolytic uremic syndrome (HUS), were reported in the North Carolina outbreak; 63 cases, including seven HUS cases, were reported in the Florida outbreak; and two cases were reported in Arizona. No fatalities occurred. Illnesses primarily affected children who visited petting zoos at these events. This report summarizes findings from these outbreak investigations, which indicated the need for adequate control measures to reduce zoonotic transmission of E. coli O157:H7.
Source: Morbidity and Mortality Weekly Report, Volume 54, No. 50, 23 December 2005

Survey of the Management, Prevention, and Surveillance of Clostridium difficile: United Kingdom
The Health Protection Agency and the Healthcare Commission have published the interim findings of a national survey of the management, prevention, and surveillance of Clostridium difficile in NHS acute trusts. Questionnaires were sent to directors of infection prevention and control. Responses were received from 118 of the 173 trusts (68%) in England. The results showed: 38% of trusts said they do not have restrictions in place to prevent the inappropriate use of antibiotics; >33.3% of respondents reported that they are unable to routinely isolate patients with C.difficile infection; 11% said they have a ward that can be used for isolating patients with C.difficile; <50% use the same recognized definition of an outbreak; 40% reported that, in the event of an outbreak, they do not routinely follow guidance, which recommends that they should inform the consultant in communicable disease control; most of the trusts surveyed also reported that they do not routinely inform the relevant authority that is responsible for monitoring their performance i.e. the strategic health authority, or Monitor in the case of NHS foundation trusts; 66.6% felt that the reported incidence of C.difficile infection has increased in their trust during the past 3 years.
Source: Communicable Disease Weekly Report, Volume 15, Number 51, 23 December 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.