A One Health approach was developed in the province of Manitoba in 2014 to manage human and domestic animal exposures to rabies. Manitoba Rabies Central is a collaboration of 3 provincial departments responsible for animal, human, and environmental health. Since the inception of the program 537 samples from animals suspected of rabies and causing an exposure to a human or domestic animal have been evaluated with 11.3% testing positive, 85.7% testing negative, and 3.0% being unfit for testing. Most of the positive rabies test results came from skunks (52.0%), which accounted for 12.5% of submissions. Dogs and cats accounted for 52.5% of submissions; however, only 18.9% of these animals tested positive for rabies. Domestic animals were more likely to be exposed to a rabid animal (most commonly skunks) than were humans. Humans were more likely to be exposed to dogs and cats (regardless of rabies test result).Approche Une seule santé pour la gestion de la rage au Manitoba, au Canada. Dans la province du Manitoba, une approche Une seule santé a été mise au point en 2014 pour gérer l’exposition des humains et des animaux domestiques à la rage. Manitoba Rabies Central est une collaboration de trois ministères provinciaux responsables pour la santé animale, humaine et environnementale. Depuis la création du programme, 537 échantillons d’animaux suspectés d’être infectés par la rage et de causer une exposition pour un humain ou un animal domestique ont été évalués et 11,3 % ont obtenu des résultats positifs, 85,7 % des résultats négatifs et 3,0 % étaient inaptes pour le test. La majorité des résultats positifs pour la rage provenait des moufettes (52,0 %), ce qui représentait 12,5 % des soumissions. Les chiens et les chats représentaient 52,5 % des soumissions, cependant, seulement 18,9 % de ces animaux ont eu des résultats positifs pour la rage. Il était plus probable que les animaux domestiques soient exposés à un animal enragé (pour la plupart des moufettes) que les humains. Il était plus probable que les humains soient exposés aux chiens et aux chats (sans égard au résultat du test pour la rage).(Traduit par Isabelle Vallières).
After routine mumps immunization programs were implemented in Manitoba in the 1980s, incidence was low, with 0-9 cases of disease annually. In September 2016, a mumps outbreak began in fully vaccinated university students in Winnipeg, Manitoba.We describe the investigation of this province-wide mumps outbreak, which lasted between September 2016 and December 2018. We present the details of public health measures implemented and challenges encountered. Possible contributing factors to the sustained transmission are also provided.Probable and confirmed cases of mumps were investigated by public health departments using the investigation form developed for this outbreak. Confirmed mumps cases were linked to the provincial immunization registry. An outbreak response team planned and implemented control measures across the province.The outbreak began in vaccinated university students in September 2016 and spread across the province. Activity was high and prolonged in the northern remote areas. By the end of 2018, 2,223 cases had been confirmed. All age groups were affected, and incidence was highest among people aged 18-29 years. Two-dose coverage of mumps-containing vaccine in confirmed cases was close to 70%.This prolonged outbreak revealed a large vulnerable population likely resulting from under-vaccination and waning vaccine-induced immunity in the absence of natural boosting from exposure to mumps virus. It is important to maintain high two-dose coverage with mumps-containing vaccines. A third dose of mumps-containing vaccine in future outbreaks may be considered.
See related articles at [www.cmaj.ca/lookup/doi/10.1503/cmaj.191279][1] and [www.cmaj.ca/lookup/doi/10.1503/cmaj.191660][2] KEY POINTS In early July, a previously healthy 37-year-old man presented to a primary care clinic with fever, sore throat, nasal congestion and migratory arthralgia. He also
Lyme disease (LD) surveillance yields useful information to monitor the disease trends and spatial distribution. However, due to several factors, the Manitoba Health surveillance system, as with other systems, could be subject to underreporting.
Lyme disease, the most commonly reported vector-borne disease in North America, is caused by the spirochete Borrelia burgdorferi sensu stricto, which is transmitted by Ixodes scapularis in eastern Canada and Ixodes pacificus in western Canada. Recently, the northward range expansion of I. scapularis ticks, in south-eastern Canada, has resulted in a dramatic increase in the incidence of human Lyme disease. Detecting emerging areas of Lyme disease risk allows public health to target disease prevention efforts. We analysed passive tick surveillance data from Ontario and Manitoba to i) assess the relationship between the total numbers of I. scapularis submissions in passive surveillance from humans, and the number of human Lyme disease cases, and ii) develop province-specific acarological indicators of risk that can be used to generate surveillance-based risk maps. We also assessed associations between numbers of nymphal I. scapularis tick submissions only and Lyme disease case incidence. Using General Estimating Equation regression, the relationship between I. scapularis submissions (total numbers and numbers of nymphs only) in each census sub-division (CSD) and the number of reported Lyme disease cases was positively correlated and highly significant in the two provinces (P ≤ 0.001). The numbers of I. scapularis submissions over five years discriminated CSDs with ≥ 3 Lyme disease cases from those with < 3 cases with high accuracy when using total numbers of tick submission (Receiver Operating Characteristics area under the curve [AUC] = 0.89) and moderate accuracy (AUC = 0.78) when using nymphal tick submissions only. In Ontario the optimal cut-off point was a total 12 tick submissions from a CSD over five years (Sensitivity = 0.82, Specificity = 0.84), while in Manitoba the cut-off point was five ticks (Sensitivity = 0.71, Specificity = 0.79) suggesting regional variability of the risk of acquiring Lyme disease from an I. scapularis bite. The performances of the acarological indicators developed in this study for Ontario and Manitoba support the ability of passive tick surveillance to provide an early signal of the existence Lyme disease risk areas in regions where ticks and the pathogens they transmit are expanding their range.
area of the Interlake-Eastern Regional Health Authority. The second case is a man in his ‘20s who lives in the area of the WRHA. This individual was in direct contact with the index case identified in Manitoba earlier this month. The third case is a youth in his teens who lives in the area of the Southern Health Region. The fourth case is a woman in her 40s who lives in the area of the WRHA. Provincial public health officials are working with the regional health authorities to investigate the cases and identify contacts.
We aimed to evaluate a quality improvement initiative designed to control SARS-CoV-2 (COVID) using the large-scale deployment of antimicrobial photodisinfection therapy (aPDT) for nasal decolonization in a Canadian industrial workplace (a food processing plant).Using a retrospective chart review of treatment questionnaires, linked to COVID laboratory testing results, a quality improvement assessment was analyzed to determine treatment effectiveness and safety.This voluntary aPDT intervention involved the administration of a light-sensitive liquid to the nose followed by nonthermal red-light irradiation on a weekly basis. Employees in food processing industries are at increased risk for COVID infection due to the nature of their work environments. In an effort to mitigate the transmission and consequences of the disease among such workers and the community at large, aPDT was added to a well-established bundle of pre-existing pandemic safety measures (e.g., mask-wearing, testing, contact tracing, workplace-engineered barriers, increased paid sick leave).From December 2020 to May 2021, we found high interest in and compliance with aPDT treatment, along with a statistically significant lower PCR test positivity rate in the study population in comparison to the case rates for the local Canadian province. Treatment safety monitoring and outcomes of the aPDT program demonstrated no serious adverse events.This study suggests nasal photodisinfection provides safe and effective COVID viral suppression when deployed across the majority of workers in an industrial workplace setting.
