E. coli: Manitoba (Update)
The Winnipeg Regional Health Authority (WRHA) is continuing to investigate increased numbers of cases of E. coli infection that have occurred since the middle of July 2006. Forty cases have occurred in August, most in the first 2 weeks of the month. Since January 2006, there have been 65 cases so far this year and 14 cases have required hospitalization since June. The majority of cases continue to be associated with consuming or preparing ground beef products.The concentration of E. coli cases occuring in the first two weeks of August corresponds to the distribution of contaminated meats to several Winippeg area food retail outlets and restaurants during this time. Establishments have been inspected and measures taken to improve food handling practices. WRHA believes that these measures have been successful, however ongoing monitoring will continue.
Source: Winnipeg Regional Health Authority, 1 September 2006

Prenatal Screening for HIV - Survey of Postpartum Women and Audit of Current Prenatal Screening Practices: Nova Scotia
Current guidelines for screening for HIV infections in Nova Scotia recommend an opt-in approach in which patients are counselled and consent to testing. The objectives of the present study were to measure adherence to these recommendations, to explore women’s knowledge, attitudes, beliefs and behaviours concerning HIV screening, and to compare these results with prenatal screening practices for rubella, hepatitis B and group B streptococcus. All women who gave birth consecutively at the IWK Health Centre (Halifax) during a seven-week period were recruited. Study participants were interviewed to determine their knowledge, attitudes and beliefs concerning prenatal screening. Hospital and laboratory records were reviewed for information concerning prenatal screening and perinatal treatment to audit screening practices. A total of 279 patients were enrolled in the study, representing 58% of those eligible. The HIV screening rate was 72%, compared with 95% for rubella, 89% for hepatitis B and 24% for group B streptococcus. Of the participants tested for HIV, 80% were aware of being tested. Of all the study participants, 17% indicated having received pretest counselling about HIV, 56% volunteered to be tested for HIV, 78% received the test results, and 3.8% received post-test counselling. More participants preferred an opt-out approach to HIV screening (50%), where testing is routinely performed on everyone, rather than the opt-in approach (43%). Participants displayed a similar preference for screening for the other infections. HIV prenatal testing rates in Nova Scotia are comparable with those of other provinces that recommend an opt-in approach, but are lower than testing rates for opt-out programs. Most study participants were not screened using the recommended opt-in approach.
Source: Canadian Journal of Infectious Diseases and Medical Microbiology, Volume 17, No. 4, July/August 2006

Human Plague: United States
In 2006, a total of 13 human plague cases have been reported among residents of four states: New Mexico (7 cases), Colorado (3 cases), California (2 cases), and Texas (1 case). This is the largest number of cases reported in a single year in the United States since 1994. Dates of illness onset ranged from 16 February to 14 August; 2 (15%) cases were fatal. The median age of patients was 43 years (range: 13-79 years) and 8 (62%) were female. Five (38%) patients had primary septicemic plague, and the remaining 8 (62%) had bubonic plague. Two (15%) patients developed secondary plague pneumonia, leading to administration of antibiotic prophylaxis to their health-care providers. This report summarizes 6 of the 13 cases, highlighting the severity and diverse clinical presentations of plague and underscoring the need for prompt diagnosis and treatment when plague is suspected.
Source: Morbidity and Mortality Weekly Report, Volume 55, No. 34, 1 September 2006

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.