Methicillin-resistant Staphylococcus aureus (MRSA): Canada
MRSA has become endemic worldwide in hospitals, and community associated MRSA is spreading into the community at large. An extensive review of the literature was conducted to gather epidemiology, health care resource utilization and cost data for MRSA in Canadian settings. The current MRSA burden was estimated using available cost data and the most recent epidemiology data. The rate of MRSA in Canadian hospitals increased from 0.46 to 5.90 per 1000 admissions between 1995 and 2004, while community-associated MRSA continued to spread into the community. Patients harbouring MRSA required prolonged hospitalization (average 26 days of isolation per patient), special control measures, expensive treatments and extensive surveillance. Total cost per infected MRSA patient averaged $12,216, with hospitalization being the major cost driver (81%), followed by barrier precautions (13%), antimicrobial therapy (4%) and laboratory investigations (2%). The most recent epidemiological data, combined with available cost data, suggest that direct health care cost attributable to MRSA in Canada, including cost for management of MRSA-infected and -colonized patients and MRSA infrastructure, averaged $82 million in 2004 and could reach $129 million in 2010. MRSA is a costly public health issue that needs to be tackled if the growing burden of this disease in Canadian hospitals and in the community is to be limited.
Source: Canadian Journal of Infectious Diseases and Medical Microbiology, Volume 18, No. 1, January/February 2007

Salmonella Outbreak: United States (Update)
As of 27 February, 370 persons infected with the outbreak strain of Salmonella Tennessee have been reported to CDC from 42 states. Among 294 patients for whom clinical information is available, 60 (20%) were hospitalized. No deaths have been attributed to this infection. Onset dates, which are known for 256 patients, ranged from 1 August 2006 to 16 February 2007, and 62% of these illnesses began after 1 December 2006. Public health officials from several states have isolated Salmonella from open jars of peanut butter of both Peter Pan and Great Value brand. For nine jars, the serotype has been confirmed as Tennessee and DNA fingerprinting has shown that the pattern is the outbreak strain. FDA officials and the peanut butter manufacturer are working collaboratively to learn more about production of peanut butter to determine how it may have become contaminated.
Source: Centers for Disease Control and Prevention, 27 February 2007

Measles Among Adults Associated with Adoption of Children in China: United States
On 15 August 2006, the Missouri Department of Health and Senior Services was notified of a measles case in a Missouri resident who had recently traveled to China. The patient had traveled with a group of 11 families seeking to adopt children from three orphanages in Guangdong Province. Members of the group traveled separately but stayed at the same hotel in Guangdong Province between 13-17 July. This report describes the multistate investigation that followed, which identified two additional measles cases. None of the three patients recalled contact during travel with anyone who appeared ill. All three patients recovered fully, and no secondary cases were identified among family members, other travelers, patients, or medical staff who might have been exposed. Because of delays in diagnoses (the earliest case was identified 2 weeks after rash onset), no control measures were indicated. Communicable diseases that are no longer endemic in the United States continue to occur among travelers, often resulting in delayed recognition and delayed notification of public health authorities. Because of the risk for spread in the community of imported communicable diseases such as measles, thorough investigation is needed to determine possible sources of infection and the extent of disease spread in the community.
Source: Morbidity and Mortality Weekly Report, Volume 56, No. 7, 23 February 2007

Influenza: New York
The New York State Department of Health announced that influenza has been classified as widespread in New York based on laboratory confirmed cases and reports of influenza outbreaks in 55 counties including New York City. The death of a four-month-old infant from Oneida County was reported earlier this month from complications resulting from Type A influenza. This is the second childhood death reported this year in New York believed to be related to flu. Compared to previous years in New York, there have been more flu-related hospitalizations reported among younger age groups this flu season. Children under 19 years of age have comprised 60 percent of this season's flu-related hospitalizations.
Source: Health News, New York State Department of Health, 22 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.