Increase in Legionnaire's Disease: Ontario
The Middlesex-London Health Unit is reporting an increase in the incidence of Legionnaire's disease in the community. On average, the health unit receives one report per year of an individual contracting the disease, however, since July 2007, the health unit has received reports of Legionnaire's disease in three people who live in London, Ontario and an additional two people who live in Elgin County, but work in London. Of the reported cases, two were received over the summer, while the remaining three were received within the past two weeks. The five individuals who have been infected are males whose ages range between the mid-40s to early 70s; one man has died as a result of the disease. The investigation into the sources of Legionella in these cases is on-going, and so far they have been unable to pinpoint the source or find common links between those who have been infected.
Source: Middlesex-London Health Unit, November 9, 2007

Advisory Committee Statement - Interferon Gamma Release Assays for Latent Tuberculosis Infection: Canada
Recently, in-vitro T-cell based assays that measure interferon-gamma (IFN-γ?) production have been developed for the diagnosis of latent tuberculosis infection. These assays operate on the basis that T-cells previously sensitized to tuberculosis (TB) antigens produce high levels of IFN-γ? when re-exposed to the same mycobacterial antigens. At the present time, two different types of IFN-γ? release assays (IGRAs) are registered for use in Canada and present possible alternatives to the tuberculin skin test. These are the QuantiFERON®-TB Gold In-Tube (Cellestis Limited, Carnegie, Victoria, Australia) and the T-SPOT.TB® (Oxford Immunotec, Oxford, UK) assays. The statement is available online at the following address:
http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/07vol33/acs-10/index-eng.html. Source: Canada Communicable Disease Report, Volume 33, ACS-10, November 1, 2007

Management and Treatment of Hepatitis C Virus in Patients with HIV and Hepatitis C Virus Coinfection: A Practical Guide for Health Care Professionals: Canada
Concomitant HIV and hepatitis C virus (HCV) is a common yet complex coinfection. The present document is a practical guide for treating HCV infection in people coinfected with HIV. Effective antiretroviral therapies have prolonged survival rates for HIV-infected people over the past decade, which have made latent complications of HCV major causes of morbidity and mortality in these patients. Advances in the treatment of HCV (eg, combined pegylated interferon and ribavirin) offer the possibility of eradicating HCV infection in coinfected persons. The treatment of HCV must be considered in all cases. Intensive management of the adverse effects of HCV treatment is one of the factors for the success of these therapies. HCV eradication is predicted to decrease the mortality associated with coinfection and reduce the toxicity of HIV treatment.
Source: The Canadian Journal of Infectious Diseases and Medical Microbiology, Volume 18, Issue 5, September/October 2007

This weekly report provides timely information about potential or actual disease problems. 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. It will rely to a large extent on information about incidents being forwarded to the Notifiable Diseases Section as early as possible. This can be done by contacting Carole Scott at tel: (613) 957-0334 / fax: (613) 957-2842 / E-mail: Carole_Scott@phac-aspc.gc.ca. Readers are asked not to post any items on websites, nor to publish them in newsletters, nor to pass them to the media and the public without prior consent of the Notifiable Diseases Section, Centre for Infectious Disease Prevention and Control.