Interim Recommendation for Use of Amantadine for Influenza: Canada
The Public Health Agency of Canada is recommending that health care providers in Canada not prescribe amantadine to treat and prevent influenza during the current flu season. The interim recommendation follows testing showing viruses currently in circulation are resistant to the drug. The National Microbiology Laboratory tested 47 influenza A/H3N2 isolates and found that 43 (91%) are resistant to amantadine. The samples tested were collected from four provinces: British Columbia, Ontario, Saskatchewan and Alberta since September 2005. The results represent a significant increase in resistance compared to previous years and are consistent with the level of antiviral resistance recently reported by the Centers for Disease Control and Prevention (CDC). At this time, oseltamivir (Tamiflu) or zanamivir (Relenza) should be selected if an antiviral medication is recommended for the treatment or prevention of influenza for the remainder of the 2005/2006 influenza season. Testing conducted by CDC indicates oseltamivir remains effective against the H3N2 virus. Testing of influenza isolates for the 2005/2006 season will continue and recommendations will be updated based on results.
Source: Public Health Agency of Canada, 15 January 2006

Misuse of Blood Lancing Devices: Canada
There have been several cases in Canada and abroad where the devices were inappropriately used by healthcare workers to obtain blood samples from multiple patients. This misuse may result in transmission of blood-borne viruses, including hepatitis B virus, and hepatitis C virus. Health Canada is recommending the following: if a lancing device is labeled for single patient home use, do not use it on multiple patients; do not reuse lancets for blood sampling, dispose of them in an appropriate sharps container after a single use; if the non-removable endcap is indicated for use by more than one patient, ensure it is properly disinfected between patients according to instructions in the labelling, if the labelling contains no instructions for disinfection, do not use the device on multiple patients; if a lancing device has a removable endcap, ensure it is changed every time a new patient is tested, do not use the same endcap on different patients. Health Canada reminds health care workers that these devices must be used with care to minimize the risk of transmission of blood-borne diseases.
Source: Advisories Warnings and Recalls, Drugs and Health Products, Health Canada, 13 January 2006

Human T-Cell Lymphotropic Virus Type 1 (HTLV-1): Nunavut
Nunavut health officials report at least one death related to HTLV-1 and fewer than 20 infected persons. In response to the death and reported cases, the Nunavut Department of Health and Social Services began offering testing for HTLV-1 to pregnant women and the population in general in October. As of 7 December 2005, only 300 people had been tested. The precise number of people infected or the number of HTLV-1 related deaths has not been disclosed. Such caution is common in sparsely populated areas where anonymity is difficult. HTLV-1 is rare in Canada, but the number of cases is not known because it's not a reportable disease in most jurisdictions. Canadian Blood Services has been screening donated blood for HTLV-1 since 1990 and reports an average of 10-12 positive tests per 800,000 donations annually (prevalence of 0.0014%). If even 15 people in Nunavut are infected, among a population of 29 000, the prevalence is 0.05%.
Source: Canadian Medical Association Journal, Volume 174, Issue 2, 17 January 2006

The Burden of Illness in International Travellers: Global
In 2004, 763 million people crossed international borders, reflecting an increase of 73% over the course of 15 years. International travel has rebounded since the attacks of September 11, 2001, and is steadily increasing despite a variety of global health crises, the threat of terrorism, and the war in Iraq. Nearly 55% of travelers are vacationing, and about 15% are conducting business, but a growing number are visiting friends and relatives. Typically, such travelers were born in a resource-poor country, now live in a resource-rich country, and are returning to their country of birth to visit. Moreover, though most people travel voluntarily, thousands of uncounted travelers cross borders to flee war or persecution or to seek better opportunities. During the past 25 years, a new specialty of travel medicine has evolved to address the health of these international travelers particularly those who visit resource-poor regions. Travel to these regions carries health risks and requires preventive measures that may be unfamiliar to many physicians.
Source: New England Journal of Medicine, Volume 354, Number 2, 12 January 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.