Federal public health strategies to minimize the importation of communicable diseases into Canada.

BACKGROUND: The global spread of communicable diseases is a growing concern largely as a result of increased international travel. In Canada, although most public health management of communicable diseases occurs at the front line, the federal government also takes actions to prevent and mitigate their importation. OBJECTIVE: To describe the role of the Public Health Agency of Canada (PHAC) in minimizing the importation of communicable diseases through preventive measures taken before travellers leave Canada and through early detection and prompt containment measures taken when travellers arrive in the country with a potential communicable disease. INTERVENTIONS: PHAC works to minimize the importation of communicable diseases into Canada by developing evidence-based travel health advice and targeted outreach activities geared to the public and to health care professionals. On the basis of the Quarantine Act and the International Health Regulations (2005), PHAC also conducts inspections of conveyances such as aircraft and boats and works with partners to conduct border screening to assess ill travellers entering the country. CONCLUSION: PHAC plays an important role in preventing and minimizing the importation of communicable diseases into Canada in conjunction with clinicians, public health authorities at all levels of government and other federal government departments.

Laboratory diagnosis of mumps in a partially immunized population: The Nova Scotia experience.

BACKGROUND: In 2007, Atlantic Canada experienced a large outbreak of mumps predominately in university students who had received a single dose of measles, mumps and rubella vaccine. The present study describes the performance characteristics of reverse transcriptase polymerase chain reaction (RT-PCR) on buccal and urine specimens and immunoglobulin M (IgM) serology in this partially immune population. METHODS: Patients presenting with symptoms suspicious for mumps had a serum, urine and a buccal swab collected for diagnostic testing. Persons were classified as a 'confirmed' case according to the Public Health Agency of Canada's definition. Sera were tested using an enzyme-linked immunoassay. Detection of mumps virus in buccal swabs and urine samples was performed by RT-PCR. RESULTS: A subset of 155 cases and 376 non-cases that had all three specimens submitted was used for calculating the performance characteristics. The sensitivity of RT-PCR on buccal swabs, urine specimens and IgM serology were 79%, 43% and 25%, respectively. The specificity of RT-PCR on buccal swabs, urine specimens and IgM serology was 99.5%, 100% and 99.7%, respectively. Only 12 of 134 (9%) patients had positive urine specimens in the presence of negative oral swabs. CONCLUSION: RT-PCR on buccal swabs is the ideal specimen for diagnosis. Testing an additional urine sample in an outbreak setting did not increase the diagnostic yield significantly, but doubled testing volume and cost. In addition, the data suggest that, in this partially immune group, IgM serology has little value in the diagnosis of acute infection.

Computational simulation of blood flow in human systemic circulation incorporating an external force field.

A quasi-one-dimensional non-linear mathematical model for the computation of the blood flow in the human systemic circulation is constructed. The morphology and physical modelling of the whole system (arteries, capillaries and veins) are completed by different methods for the different vessel generations. A hybrid method is used to solve the problem numerically, based on the governing equation (continuity, momentum and state equations), the input boundary conditions and the predetermined initial conditions. The two-step Lax-Wendroff finite-difference method is used to compute variables for each individual vessel, and the characteristic method is employed for the computation of internal boundary conditions of the vessel connection and the input and output system boundary conditions. Using this approach, blood flow, transmural pressure and blood velocity are computed at all vessel sites and for each time step. The pressure and flow waveforms obtained show reasonable agreement with clinical data and results reported in the literature. When an external conservative force field is applied to the system, the results computed from the model are intuitively correct. The term representing the external pressure added to the system by the muscle, which represents active control on the cardiovascular system, is also embodied in this model.

Theoretical model for assessing haemodynamics in arterial networks which include bypass grafts.

The paper presents a theoretical model which can be used to simulate a vascular network which includes loops and bypass grafts, a feature not possible with previous models. Using the linearised Navier-Stokes equations, the linearised equation of a uniform thick-walled viscoelastic tube, and the equation of continuity, the model is applied to a vascular network which includes a bypass graft. This method represents each segment of an artery or graft by a four-terminal-network whose A, B, C, D parameters are functions of the frequency and physical characteristics of the segment. The model predicts the flow and pressure waveforms at any point in the human arterial network very accurately when compared with data obtained from normal patients, patients with arterial stenoses and for hypertensive patients. The model also gives results which are in close agreement with hydraulic experimental data for the input impedance of systems with bypass loops.

In vitro effect of benzimidazole drugs on the enzymes of lipid metabolism in Trichuris globulosa.

The effects of 2 benzimidazole drugs, fenbendazole and thiabendazole, on the enzymes of lipid metabolism of an intestinal nematode parasite, Trichuris globulosa, have been studied. In vitro addition of these drugs inhibited the activity of these enzymes in both male and female worms. Inhibition is competitive in the case of the lipogenic enzymes, malate dehydrogenase and glucose-6-phosphate dehydrogenase; whereas, it is noncompetitive in the case of the lipolytic enzyme, triacylglycerol lipase. Cholesterol biosynthesis is, however, not affected.

Simulation of coronary artery revascularization.

Simulation of the commonly constructed geometries of aorto-coronary bypass anastomoses was carried out using especially fabricated distensible tubes and a pulsatile pump. The system pressure was maintained between 80 and 120 mmHg. The total mean flow was set at 250 ml min-1 (Reynolds number of 200) and the pulsatile frequency was varied from 0 to 2 Hz. A water-glycerine mixture having a density and viscosity similar to that of blood was used throughout. A 16 mm film of the front of black dye injected proximal to the anastomosis was made as the dye approached and passed through the anastomosis. Anastomotic geometries consisted of: end to side, parallel, 45 degree angle, and 90 degree angle. Stenoses, located in the tube representing the coronary artery, were simulated using a bevelled insert which represented an 80-85% area reduction. Flow visualization revealed that distensible tubes gave more realistic flow patterns than rigid tubes, a result particularly evident when a stenosis was present. Pulsatile flow demonstrated considerably more mixing than steady flow. The use of pulsatile flow in distensible tubing with a partial stenosis showed retrograde flow through the stenosis which was not evident for either steady flow or for flow in rigid tubing. The flow at the anastomatic site of the graft having an angle of 0 degrees showed a jetting action with a zone of recirculating fluid being present whereas for a 90 degree graft a distinct helical flow was formed distal to the anastomosis.