Impact of Influenza Exposure on Rates of Hospital Admissions and Physician Visits Because of Respiratory Illness Among Pregnant Women: Nova Scotia
Excess deaths have occurred among pregnant women during influenza pandemics, but the impact of influenza during nonpandemic years is unclear. A 13-year (1990-2002) population-based cohort study involving pregnant women in Nova Scotia was conducted. Rates of hospital admissions and physician office visits because of respiratory illness during the influenza season in each trimester of pregnancy was compared with rates during the influenza season in the year before pregnancy and with rates in non-influenza seasons. Poisson regression analyses were performed to estimate rate ratios and 95% confidence intervals (CIs). Of 134,188 pregnant women in the study cohort, 510 (0.4%) were admitted to hospital because of a respiratory illness during pregnancy and 33,775 (25.2%) visited their physician for the same reason during pregnancy. During the influenza seasons, the rate ratio of hospital admissions in the third trimester compared with admissions in the year before pregnancy was 7.9 (95% CI 5.0-12.5) among women with comorbidities and 5.1 (95% CI 3.6-7.3) among those without comorbidities. The rate of hospital admissions in the third trimester among women without comorbidities was 7.4/10,000 woman-months during the influenza season, compared with 5.4 and 3.1/10,000 woman-months during the peri-and non-influenza seasons respectively. Corresponding rates among women with comorbidities were 44.9, 9.3 and 18.9/10,000 woman-months. Only 6.7% of women with comorbidities had received influenza immunization. The data support the recommendation that pregnant women with comorbidities should receive influenza vaccination regardless of their stage of pregnancy during the influenza season. Since hospital admissions because of respiratory illness during the influenza season were also increased among pregnant women without comorbidities, all pregnant women are likely to benefit from influenza vaccination.
Source: Canadian Medial Association Journal, Volume 176, No. 4, 13 February 2007

Salmonella Outbreak: United States
The Canadian Food Inspection Agency (CFIA) and the Public Health Agency of Canada (PHAC) are closely following an investigation by U.S. authorities into possible Salmonella contamination in certain brands of peanut butter distributed in the U.S. The CFIA is working with the FDA and Canadian importers to determine if Peter Pan and Great Value brands of peanut butter have been imported to Canada. If any Canadian distribution is identified, the CFIA will take immediate action to advise the public and verify the effective removal of the product from the marketplace. ConAgra Foods Inc. voluntarily recalled Peter Pan and Great Value brands of peanut butter, following an investigation by the U.S. Food and Drug Administration (FDA). The FDA issued a warning following the discovery of a link between 288 cases of foodborne illness in 39 states and the consumption of certain types of Peter Pan peanut butter. The information was contained in a study carried out by the Centers for Disease Control and Prevention, in cooperation with U.S. states and local health agencies. There have been no known illnesses reported in Canada linked to the U.S. outbreak. The CFIA is working with PHAC and is monitoring health reports across the country to detect any indicators that a similar situation may be present in Canada.
Source: News Release, Canadian Food Inspection Agency, 14 February 2007

Foodborne Botulism: California
In December 2006, the Orange County Health Care Agency (OCHCA) and California Department of Health Services (CDHS) were notified of two potential cases of foodborne botulism in an older Asian couple. A woman aged 67 years visited her physician because of double vision, ptosis, dizziness, difficulty swallowing, slurred speech, drooling, and right arm weakness. The woman's husband, aged 75 years, reported worsening double vision, dizziness, and difficulty swallowing. Both patients were admitted to an intensive care unit. CDHS dispatched botulinum antitoxin to the hospital, and it was administered to the couple. Both patients were hospitalized for more than 1 week with no further symptom progression. Botulinum toxin was not detected in serum or stool samples from the patients. Clostridium botulinum type A was detected in enrichment cultures of the stool samples of both patients. Both patients have some blurred vision but otherwise have recovered. OCHCA visited the couple's home and identified multiple potential sources of intoxication. The patients reported they recently had been eating a new batch of home-prepared fermented tofu. Although both had eaten fermented tofu from this batch every day, the woman ate more than her husband. CDHS Microbial Diseases Laboratory found both C. botulinum type A and botulinum toxin type A in the fermented tofu samples, which had a pH of 6.8. The reason for contamination is not clear. This is the first U.S. report of botulism caused by eating home-prepared fermented tofu.
Source: Morbidity and Mortality Weekly Report, Volume 56, No. 5, 9 February 2007

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.