Invasive Haemophilus influenzae type a (iHia) disease was detected in Alaska and Northern Canada in 2002 and 2000, respectively. From 2006 to 2017, 164 iHia cases (Alaska=53, Northern Canada=111) were reported. Rates of iHia disease per 100,000 persons were higher in Northern Canada compared to Alaska and were significantly higher in Indigenous (Alaska 2.8, Northern Canada 9.5) compared to non-Indigenous populations (Alaska 0.1, Northern Canada=0.4). Disease rates were highest in Indigenous children <2 years of age (Alaska 56.2, Northern Canada=144.1) and significantly higher than in non-Indigenous children <2 (Alaska 0.1, Northern Canada 0.4). The most common clinical presentation in children <5 years was meningitis of age and pneumonia in persons ≥5 years old. Most patients were hospitalised (Alaska=87%, Northern Canada=89%) and fatality was similar (Alaska=11%, Northern Canada=10%). MLST testing showed sequence types ST23 and ST576 in Northern Canada and ST576, ST23 and ST56 in Alaska. Alaska and Northern Canada have high rates of iHia disease. A vaccine is needed in these regions to protect young children.

Objectives This report aims to use tetanus hospitalization data to describe the epidemiology in Canada from 1995 to 2019 and to assess progress on national reduction targets, including validating that Canada has eliminated maternal and neonatal tetanus (MNT). Methods Tetanus hospitalizations and fatalities occurring between 1995 and 2019 were retrieved from the Canadian Institute for Health Information (CIHI) and Statistics Canada. Cases coded with ICD-10 codes A33, A34, or A35 as the primary diagnosis (or ICD-9 equivalents) were included. The Canadian national case definition was used for generic tetanus and definitions from the World Health Organization were referenced for MNT. R version 4.0.2 was used for analyses. Results From 1995 to 2019, 155 non-MNT, 6 neonatal, and 0 maternal tetanus cases were retrieved from CIHI. However, all 6 neonatal cases were excluded after validating with provincial/territorial public health officials. In the same time period, there were 91 national notifications of tetanus. Cases were distributed relatively equally across the country, with the exception of the territories, where zero cases were reported. Adults 75 and over had significantly higher incidence rates compared to younger age groups (p<0.001). Ten deaths were reported during the timeframe. Conclusion Tetanus incidence remains low and hospitalization data reveal that Canada has met its reduction target of maintaining 5 cases or fewer annually in recent years. For MNT, Canada has successfully met the elimination target of zero cases. Continued vaccination efforts must be practiced for all age groups, including those aged 75 years and older, to sustain targets moving forward.

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Background: The International Circumpolar Surveillance (ICS) program conducts surveillance on five invasive bacterial diseases: pneumococcal disease (IPD), group A streptococcus (iGAS), Haemophilus influenzae (Hi), meningococcal disease (IMD) and group B streptococcus (GBS). Invasive bacterial diseases have a higher burden of disease in northern populations than the rest of Canada. Methods: To describe the epidemiology of invasive bacterial diseases in northern Canada from 1999 to 2018, data for IPD, iGAS, Hi, IMD and GBS were extracted from the ICS program and the Canadian Notifiable Diseases Surveillance System (CNDSS) and analyzed. Results: The annualized incidence rates for IPD, iGAS, Hi, GBS and IMD were 23.3, 10.5, 8.9, 1.9 and 1.1 per 100,000 population, respectively. The incidence of IPD, iGAS and Hi serotype b were 2.8, 3.2 and 8.8 times higher, respectively, in northern Canada than in the rest of Canada. Rates of disease decreased statistically significantly for IPD (β=−0.02) and increased statistically for iGAS (β=0.08) and Hi serotype a (β=0.04) during the study period. In Northern Canada, the annualized incidence rates for IPD, iGAS and Hi were statistically higher for Indigenous residents than for non-Indigenous residents. The highest incidence rates were among the very young and older age groups. Conclusion: Invasive bacterial diseases represent a high burden of disease in Canada’s northern populations. Indigenous peoples, children and seniors are particularly at risk.