Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) 2004 Report: Canada
In 2004, CIPARS operated two active surveillance components: abattoir surveillance (which involves the collection and analysis of isolates of generic E. coli and Salmonella from the intestinal contents of healthy animals at slaughter) and retail surveillance (which involves the collection and analysis of isolates of generic E. coli, Salmonella, Campylobacter, and Enterococcus from retail meat in Ontario and Québec). CIPARS 2004 data describe patterns in human antimicrobial use and antimicrobial resistance in selected enteric organisms in human and animals across Canada. Multidrug-resistance in numerous Salmonella serovars and the identification of strains resistant to ciprofloxacin and the cephalosporins are of particular concern, as is the observation of fluoroquinolone resistance in Campylobacter isolated from retail chicken. In 2003, the prevalence of resistance to beta-lactam antimicrobials was significantly higher among retail chicken and human S. Heidelberg isolates from Québec, than retail chicken and human isolates from Ontario. In 2004, although the relative frequency of this serovar, in comparison to all isolated Salmonella, decreased significantly for both retail chicken and human isolates, the prevalence of beta-lactam resistance significantly increased in Ontario in both retail chicken and human isolates to reach the same levels found in Québec. The full report can be accessed online at:
http://www.phac-aspc.gc.ca/cipars-picra/pdf/cipars-picra-2004_e.pdf.
Source: Public Health Agency of Canada, 7 July 2006

Consensus Recommendations for the Optimal Use of Enfuvirtide in HIV/AIDS Patients: Canada
An eight-member group consisting of Canadian infectious disease and immunology specialists and a family physician with significant experience in HIV management was convened to update existing recommendations, specifically intended for use by Canadian HIV-treating physicians, on the appropriate use of enfuvirtide in HIV/AIDS patients with resistance to other antiretroviral drugs. Evidence from the literature and expert opinions of the group members formed the basis of the guidelines. Comments on the draft guidelines were obtained from other physicians across Canada with HIV expertise. The final guidelines represent the group's consensus agreement and were developed to guide physicians in optimal practices in patient selection for enfuvirtide treatment and subsequent patient management. The issues considered include positive predictors of response to enfuvirtide, stage of disease, optimization of the background regimen, early indicators of enfuvirtide response, and patient education and support.
Source: The Canadian Journal of Infectious Diseases and Medical Microbiology, Volum 17, No. 3, May/June 2006

The Underrecognized Burden of Influenza in Young Children: United States
The disease burden of influenza infection among children is not well established. Population-based surveillance of medical visits associated with laboratory-confirmed influenza was conducted among children who were younger than five years of age, resided in one of three U.S. counties, and had a medical visit for an acute respiratory tract infection or fever within a certain time period. Nasal and throat swabs were tested for the influenza virus by viral culture and polymerase-chain-reaction assay. Epidemiologic data were collected from parental surveys and chart reviews. Children who were hospitalized were enrolled prospectively from 2000 through 2004 and population-based rates of hospitalizations associated with influenza were calculated. Children who were seen in selected pediatric clinics and emergency departments during two influenza seasons (2002/03 and 2003/04) were also systematically enrolled. The rates of visits to clinics and emergency departments associated with influenza were estimated. The average annual rate of hospitalization associated with influenza was 0.9 per 1000 children. The estimated burden of outpatient visits associated with influenza was 50 clinic visits and 6 emergency department visits per 1000 children during the 2002–2003 season and 95 clinic visits and 27 emergency department visits per 1000 children during the 2003–2004 season. Few children who had laboratory-confirmed influenza were given a diagnosis of influenza by the treating physician in the inpatient (28%) or outpatient (17 %) settings. Among young children, outpatient visits associated with influenza were 10 to 250 times as common as hospitalizations. Few influenza infections were recognized clinically.
Source: New England Journal of Medicine, Volume 355, No. 1, 6 July 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.