Objective: The purpose of this report is to describe the epidemiology of invasive meningococcal disease (IMD) in Canada from 2006 to 2011. Methods:Data from the Enhanced Invasive Meningococcal Disease Surveillance System and national population estimates were selected for descriptive and inferential analyses. The geographic, demographic, seasonal and subtype distributions as well as clinical characteristics of the IMD cases were examined. Incidence and mortality rates were calculated per 100,000 population per year; 95% confidence intervals (CI) were calculated for rate comparison. The direct method was used for age standardization. Proportions were compared using the chisquared test at a p<0.05 significance level.Results: During the study period, the mean incidence rates of IMD were 0.58 (total), 0.33 (serogroup B), 0.07 (serogroup C), 0.03 (serogroup W-135) and 0.10 (serogroup Y). The median age for serogroups B, C, W-135 and Y was 16, 43, 38 and 47 years respectively. The mean age-specific incidence rates among infants under 1 year of age (7.35, CI: 5.38-9.32) and children from 1 to 4 years of age (1.89, CI: 1.54-2.24) were significantly higher than those in any other age group. The mean case fatality ratio was 8.1% (range 4.3%-14.3%). The average number of cases that occurred per month was significantly higher (p<0.0001) in winter (18 cases) than in summer (12 cases). Conclusion:IMD is still endemic in Canada. Although individuals at any age can be affected, infants under 1 year of age are at the greatest risk, followed by children aged 1-4 years and individuals aged 15-19 years. Following the implementation of routine childhood immunization programs with monovalent meningococcal C conjugate vaccines (MenC) in all provinces and territories (beginning in 2007), the incidence of serogroup C has decreased significantly over the study period and is now at an all-time low. Serogroup B is the leading cause of IMD, and diseases of serogroup W-135 and Y have stabilized at relatively lower incidence rates. With the addition of immunization programs using quadrivalent conjugate meningococcal vaccines (MCV4), we would expect further reductions in the incidence of meningococcal infection in Canada.
This paper summarizes the most recent Invasive Bacterial Diseases (IBD) Working Group meeting of the International Circumpolar Surveillance (ICS) project. The ICS is a population-based surveillance network for invasive bacterial diseases that provides a mechanism to determine changes in incidence rates and antimicrobial resistance. The meeting took place in Montreal, Canada on February 12-13, 2014. Data were included from participating Canadian provincial and territorial jurisdictions as well as from the State of Alaska. This report is based on the audio records of the meeting as well as the meeting presentations.The ICS IBD Working Group focuses on invasive diseases caused by: Streptococcus pneumoniae (Sp), Neisseria meningitidis (Nm), Haemophilus influenzae (Hi), Group A Streptococcus (GAS) and Group B Streptococcus (GBS). Data on invasive disease caused by each of these organisms were reviewed through December 2012-2013. Although the incidence of some of these vaccine-preventable invasive diseases has decreased, emergence of H. influenzae serotype a (Hia) in both Alaska and Northern Canada was noted. An interlaboratory quality control (QC) program is ongoing to monitor laboratory proficiencies for serotyping.
Background: Invasive pneumococcal disease (IPD) causes significant morbidity in Canada, yet with routine surveillance, it is difficult to interpret current IPD trends in serotype distribution and antimicrobial resistance. The enhanced Invasive Pneumococcal Disease Surveillance System (eIPDSS) pilot project was designed to facilitate a better understanding of IPD trends at the national level by linking epidemiologic and laboratory (epi-lab) data. Objectives: To evaluate the eIPDSS by assessing five attributes (usefulness, data quality, simplicity, acceptability and timeliness) and to develop recommendations for future national IPD surveillance. Methods: An evaluation was developed that assessed the five key attributes through a qualitative survey sent to eight eIPDSS users as well as a quantitative analysis of the eIPDSS database. Recommendations were based on the results of both the survey and the analysis. Results: The response rate to the survey was 100%. The majority of the survey respondents found the eIPDSS to be useful (75%), simple (100%) and acceptable (86%). Analysis of the eIPDSS database revealed that the majority of IPD cases (61%) were assessed as timely. Data quality and data management mechanisms were identified as issues by both survey respondents and the analysis of the database. Consultation with public health, regular audits and upgrades to the platform are recommended to address data quality and management issues. Conclusion: The epi-lab linked data of the eIPDSS enables the detection and analysis of IPD serotype distribution and antimicrobial resistance trends. This web-based system facilitates data collection and is simple, acceptable and timely. With improvements that address data quality and management issues, it is feasible to develop a national surveillance system that links epi-lab data.
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