Mumps Outbreak: Maritimes (Update)
As of 4 May 2007, 241 confirmed cases of mumps had been reported from the four affected provinces (Nova Scotia 203, New Brunswick 34, Prince Edward Island 1, Ontario 3). Confirmed cases include both laboratory-confirmed cases, as well as, clinically confirmed cases that are linked to laboratory-confirmed cases. In Nova Scotia and New Brunswick, the majority of cases were reported from only one or two public health authorities with limited activity seen elsewhere in these provinces. Approximately 90% and 25% of the cases in Nova Scotia and New Brunswick respectively, are associated with university settings. The viral strain in these outbreaks is identical to the strain (genotype G) detected from the 2005-2006 Nova Scotia outbreaks, the United States' multi-state outbreak in 2006 and the United Kingdom epidemic between 2004 and 2006. The Ontario cases are all linked to cases in the Maritimes. Information on date of onset is known for 217 of the 241 confirmed mumps cases reported. The remaining 24 cases are pending or missing dates of onset. Further information can be obtained online at: http://www.phac-aspc.gc.ca/mumps-oreillons/prof_e.html.
Source: Public Health Agency of Canada, 8 May 2007

National Advisory Committee on Immunization - Statement on Conjugate Meningococcal Vaccine for Serogroups A, C, Y and W135: Canada
Menactra™ is a quadrivalent protein-polysaccharide conjugate vaccine produced by sanofi pasteur limited that provides protection against meningococcal bacterium serogroups A, C, Y and W135. It was approved for use in Canada for persons 2 to 55 years of age since May 2006. The polysaccharide of each meningococcal serogroup in Menactra™ is individually conjugated to a diphtheria toxoid protein carrier. One dose of 0.5 mL contains 4 μg of each of the polysaccharides for serogroups A, C, Y and W135 along with a total of 48 μg of diphtheria toxoid protein carrier. The serogroup coverage provided by Menactra™ is the same as that of Menomune®, the currently available quadrivalent polysaccharide meningococcal product, which is also produced by Sanofi Pasteur. In addition, there are three monovalent meningococcal C conjugate products currently available in Canada: Menjugate® (Novartis Vaccines), NeisVac-C™ (GlaxoSmithKline), and Meningitec™ (Wyeth Canada). As additional information on Menactra™ becomes available and the epidemiology of invasive meningococcal disease changes, the recommendations in this statement will be reviewed. The statement is available online at: http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/07vol33/acs-03/index_e.html
Source: Canada Communicable Disease Report, Volume 33, ACS-3, 1 May 2007

Vulvar Vaccinia Infection after Sexual Contact with a Smallpox Vaccinee: Alaska
On October 10, 2006, an otherwise healthy woman visited a public health clinic in Alaska after vaginal tears that she first experienced 10 days before became increasingly painful. The patient reported having a new male sex partner during 22 September-1 October 2006. A viral swab specimen from a labial lesion of the woman was submitted to the Alaska State Virology Laboratory for viral culture. The viral isolate could not be identified initially and subsequently was sent to U.S. Centers for Disease Control on 9 January 2007, where the isolate was identified as a vaccine-strain vaccinia virus. After vaccinia was identified, investigators interviewed the woman more closely and learned that her new sex partner was a male U.S. military service member stationed at a local military base. Further investigation determined that the service member had been vaccinated for smallpox 3 days before beginning his relationship with the woman. This report describes the clinical evaluation of the woman and laboratory testing performed to identify the isolate. Health-care providers should be aware of the possibility of vaccinia infection in persons with clinically compatible genital lesions who have had recent contact with smallpox vaccinees.
Source: Morbidity and Mortality Weekly Report, Volume 56, No. 17, 4 May 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.