Multi-State Outbreak of E. coli O157:H7 Infections: United States
State health officials and the Centers for Disease Control and Prevention (CDC) have identified a widespread outbreak of E. coli O157:H7 infections due to fresh spinach in the United States. The Food and Drug Administration issued a press release on 14 September adivising consumers not toe ach fresh spinach. As 20 September 21, 157 persons infected with the outbreak strain of E. coli O157:H7 have been reported to CDC from 23 states. Among the ill persons, 83 (52%) were hospitalized, 27 (17%) developed a type of kidney failure (hemolytic-uremic syndrome), and an adult in Wisconsin died. One hundred thirteen (71%) were female and 11 (7%) were children under 5 years old. Among ill persons who provided the date when their illnesses began, 92% became ill between 19 August and 5 September. The case with the earliest illness onset known to be associated with consumption of fresh spinach began having symptoms on 19 August. The states that have reported cases are Arizona (4 cases), California (1), Colorado (1), Connecticut (3), Idaho (4), Illinois (1), Indiana (8), Kentucky (7), Maine (2), Michigan (4), Minnesota (2), Nebraska (8), New Mexico (5), Nevada (1), New York (11), Ohio (20), Oregon (5), Pennsylvania (7), Utah (17), Virginia (1), Washington (3), Wisconsin (41), and Wyoming (1).
Source: Health Alerts, Centers for Disease Control and Prevention, 15 and 21 September 2006

Laboratory-Confirmed Influenza-Associated Hospitalizations Among Children in the Metropolitan Toronto and Peel Region by Active Surveillance, 2004-2005: Canada
Influenza infection causes considerable morbidity in the pediatric population. The high number of hospitalizations due to influenza infection has a significant impact on the health care system in Canada. Despite these observations, there is little information about influenza-associated hospitalization rates and outcomes in Canadian children to inform vaccine policy and management recommendations. Advances in rapid laboratory-based diagnostic testing provide the opportunity to accurately assess the burden of influenza infection.Hospitalization rates were calculated based on epidemiologic and clinical features in a pediatric population within the metropolitan Toronto/Peel region. These data were collected through active surveillance for the 2004-2005 season. The total number of children ≤= 16 years old who were admitted to a hospital in the metropolitan Toronto/Peel region with influenza for the 2004-2005 season was 184. Ninety-nine (54%) were infected with influenza A and 85 (46%) with influenza B. One hundred and three (55%) were admitted to one of 13 Toronto Invasive Bacterial Disease Network hospitals, and 81 (44%) were admitted to the Hospital for Sick Children. Males accounted for 59% (n =109) of the hospitalizations. Ninety-seven (53%) of the patients were < 24 months of age. Of these, 42 (43%) were aged 0 to 6 months and 55 (57%) were aged 6 to 24 months. The overall population based hospitalization rate was 0.25 per 1,000; the rate varied according to age and was highest among those < 2 years of age (0.81 per 1,000). The number of cases admitted in 2004-2005 peaked in February with 74 cases reported.
Source: Canada Communicable Disease Report, Volume 32, No. 18, 15 September 2006

Effect of Pneumococcal Vaccination: A Comparison of Vaccination Rates in Patients with Bacteremic and Nonbacteremic Pneumococcal Pneumonia: United States
Despite the widespread acceptance of the 23-valent pneumococcal capsular polysaccharide vaccine (PPV), its protective effect continues to be disputed. The vaccination status of every patient at a veterans medical center in Houston, Texas, for whom a culture yielded Streptococcus pneumoniae during a 4.5-year period, comparing rates of prior PPV administration in patients with: bacteremic pneumococcal pneumonia; all-invasive pneumococcal disease; nonbacteremic pneumococcal pneumonia; acute exacerbation of chronic bronchitis (AECB) due to S. pneumoniae, and pneumococcal colonization were recorded. The principal comparisons were with patients who had bacteremic pneumonia or any invasive pneumococcal disease and those with nonbacteremic pneumococcal pneumonia. Also compared were vaccination rates in patients who had nonbacteremic pneumonia with vaccination rates in patients with AECB or pneumococcal colonization. The rate of prior PPV vaccination was lower among patients with bacteremic pneumococcal pneumonia (39.7%) or any invasive pneumococcal disease (38.0%) than among patients with nonbacteremic pneumonia (57.6%), AECB (60.0%), or pneumococcal colonization (57.8%). PPV conferred a 54% protection rate against bacteremic versus nonbacteremic pneumococcal pneumonia. There was no apparent protection against nonbacteremic pneumonia compared, for example, with colonized persons or with those who had AECB. PPV provides moderate protection against invasive pneumococcal disease but does not protect against nonbacteremic pneumococcal pneumonia. These findings suggest the importance of a continued search for a better pneumococcal vaccine
Source: Clinical Infectious Diseases, Volume 43, No. 8, 15 October 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.