Drug Resistance Tuberculosis: Canada/United States
On 25 May, the Public Health Agency of Canada (PHAC) was notified by the US Centers for Disease Control and Prevention (CDC) about a US citizen, recently diagnosed with extensively drug-resistant tuberculosis (XDR-TB), who arrived in Montreal on a flight from Prague, Czech Republic, and then drove to the US via the Champlain, New York, border crossing. The individual is now in contact with CDC officials and is in a U.S. hospital undergoing further evaluation. The results of the assessments to date indicate that the individual’s level of infectiousness is low. The likelihood of transmission to fellow passengers appears to be low at this time. Although brief contact with an infectious individual poses little to no risk for transmission, PHAC is releasing the flight number and a toll-free phone number so that passengers on this flight can receive the appropriate information for follow-up. Czech Airlines flight # 0104 departed Prague on 24 May and arrived at Montreal International Airport the same day. For passengers on this flight seeking more information, please call 1-866-225-0709. PHAC is working with the US CDC and other public health authorities to first identify and locate the passengers who sat within two rows of the individual to recommend appropriate follow-up. This approach is consistent with the WHO guidelines for TB contact tracing. As an added precaution, PHAC is working with its provincial and territorial partners to identify and refer the remaining Canadian passengers to their local public health authority. PHAC will also work with its international partners to refer the remaining passengers to their national health ministries.
Source: Public Health Agency of Canada, 29 May 2007

Mumps Outbreak: Maritimes (Update)
Mumps cases are currently being reported in seven Canadian provinces (Nova Scotia 302, New Brunswick 56, Prince Edward Island 2, Ontario 12, Manitoba 2, Alberta 2, and British Columbia 2). The outbreak activity remains centred in Nova Scotia and New Brunswick localities with sporadic exportations to other provinces. All cases reported outside of the Maritimes are either linked to cases in the Maritimes or are close contact of these cases. To date, there has been no sustained transmission outside of the Maritimes. As of 25 May, 378 confirmed cases of mumps had been reported from the affected provinces (confirmed cases are either laboratory-confirmed OR clinically compatible and linked to a laboratory-confirmed case). Information on date of onset is known for 345 of the 378 confirmed mumps cases reported. The remaining 33 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, 29 May 2007

Possible Cases of Measles: British Columbia
The BC Centre for Disease Control is asking health care professionals and the public to be alert for possible cases of measles after a visiting Japanese student was recently diagnosed with the disease. Before being admitted to hospital on the weekend, the student visited several locations in Vancouver, Victoria and Burnaby as part of a high school group. Japan is one of several countries currently experiencing outbreaks and has reported 700 cases of measles throughout the country so far in 2007. Worldwide, more than 20 million people get sick with measles each year. Of these cases, an estimated 345,000 are fatal.
Source: Health Alert, BC Centre for Disease Control, 29 May 2007

Salmonella: England and Wales
The Health Protection Agency is carrying out an investigation into a rise in the number of human cases of Salmonella Senftenberg. Twenty six cases have been reported to the Agency from England and Wales since the beginning of April 2007 which compares to fewer than ten cases in the same time period in 2006 and 2005. This is the same serotype of Salmonella that has been identified in one sample of fresh basil for which the Food Standards Agency has issued a food alert. Molecular typing has demonstrated that at least some of the strains of Salmonella Senftenberg from patients are the same as that from the basil. Food, Water and Environmental Laboratories have tested a variety of fresh herbs taken from retail premises and the study showed that six samples of imported fresh herbs were found to contain Salmonella, of which five were fresh basil. The reports of people suffering from Salmonella Senftenberg have been reported from all areas across the country and most cases are between the ages of 15 and 64 years of age.
Source: Press Release, Health Protection Agency, 25 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.