National influenza mid-season report, 2020-2021.

Canada's national influenza season typically starts in the latter half of November (week 47) and is defined as the week when at least 5% of influenza tests are positive and a minimum of 15 positive tests are observed. As of December 12, 2020 (week 50), the 2020-2021 influenza season had not begun. Only 47 laboratory-confirmed influenza detections were reported from August 23 to December 12, 2020; an unprecedentedly low number, despite higher than usual levels of influenza testing. Of this small number of detections, 64% were influenza A and 36% were influenza B. Influenza activity in Canada was at historically low levels compared with the previous five seasons. Provinces and territories reported no influenza-associated adult hospitalizations. Fewer than five hospitalizations were reported by the paediatric sentinel hospitalization network. With little influenza circulating, the National Microbiology Laboratory had not yet received samples of influenza viruses collected during the 2020-2021 season for strain characterization or antiviral resistance testing. The assessment of influenza vaccine effectiveness, typically available in mid-March, is expected to be similarly limited if low seasonal influenza circulation persists. Nevertheless, Canada's influenza surveillance system remains robust and has pivoted its syndromic, virologic and severe outcomes system components to support coronavirus disease 2019 (COVID-19) surveillance. Despite the COVID-19 pandemic, the threat of influenza epidemics and pandemics persists. It is imperative 1) to maintain surveillance of influenza, 2) to remain alert to unusual or unexpected events and 3) to be prepared to mitigate influenza epidemics when they resurge.

Does the public receive and adhere to boil water advisory recommendations? A cross-sectional study in Newfoundland and Labrador, Canada.

BACKGROUND: Highly publicized water supply problems highlight the importance of safe drinking water to the public. Boil water advisories (BWAs) are an important precautionary measure meant to protect public health by ensuring drinking water safety. Newfoundland and Labrador, Canada is a prime location for exploring public notification practices and adherence to recommendations as there were a total of 215 BWAs, affecting 6 % of the provincial population, in 145 communities between April 2006 and March 2007 when data for the present study were collected. METHODS: Residents who received household water from a public water supply were randomly selected for a telephone interview. Collected data included participants' notification of boil water advisory, satisfaction with information provided, and their adherence to recommendations. RESULTS: Most participants learned that a BWA had been issued or lifted in their community through radio, television, or word of mouth. BWAs were issued for a range of operational reasons. Almost all participants who had experienced a BWA reported wanting more information about the reasons a BWA had been issued. Low adherence to water use recommendations during a BWA was common. CONCLUSIONS: This study is first to report on public adherence to boil water advisory recommendations in Canada. The findings raise public health concerns, particularly given the high number of BWAs issued each year. Further studies in partnership with community stakeholders and government decision-makers responsible for overseeing public water systems are needed to assess the perceptions of BWAs, the reasons for non-adherence, and to identify information dissemination methods to increase information uptake and public adherence with acceptable uses of public drinking water during a BWA.

Antimicrobial resistance in Escherichia coli isolated from retail milk-fed veal meat from Southern Ontario, Canada.

This study estimated the prevalence of Escherichia coli isolates in fresh retail milk-fed veal scallopini pieces obtained from grocery stores in Ontario, Canada. In addition, the prevalence and antimicrobial resistance patterns were examined for points of public health significance. One hundred fifty-three milk-fed veal samples were collected over the course of two sampling phases, January to May 2004 and November 2004 to January 2005. E. coli isolates were recovered from 87% (95% confidence interval, 80.54 to 91.83%) of samples, and antimicrobial susceptibility testing was conducted on 392 isolates. The prevalence of resistance to one or more antimicrobials was 70% (274 of 392), while the resistance to five or more antimicrobials was 33% (128 of 392). Resistance to ceftiofur (2.8%), ceftriaxone (3.6%), nalidixic acid (12%), and ciprofloxacin (3.8%) alone or in combination was observed. Eighty-five resistance patterns were observed; resistance to tetracycline only (7.4%) was observed most frequently. Individual antimicrobial resistance prevalence levels were compared with grain-fed veal and retail beef data from samples collected in Ontario. In general, resistance to individual antimicrobials was observed more frequently in E. coli isolates from milk-fed veal than in isolates from grain-fed veal and beef. Resistance to one or more antimicrobials and to five or more antimicrobials in E. coli isolates was more frequent in isolates from milk-fed veal than in isolates from grain-fed veal and beef. This study provides baseline data on the occurrence of resistance in E. coli isolates from milk-fed veal that can be compared with data for other commodities. Additionally, E. coli resistance patterns may serve as an indicator of antimicrobial exposure.

Factors associated with disease survival after surgical resection in Chinese patients with hepatocellular carcinoma.

OBJECTIVE: The aim of this cohort study was to investigate clinical outcome and prognostic factors after surgical resection for hepatocellular carcinoma (HCC). MATERIALS AND METHODS: A total of 1,157 HCC patients undergoing hepatic resection between 1998 and 2003 were included in this study. Univariate and multivariate analyses were performed to examine factors affecting clinical outcome and recurrence. RESULTS: Surgical procedures consisted of 1,011 (87.4%) anatomical resections, including 205 (17.7%) extended hepatectomies, 324 (28.0%) hemihepatectomies, 482 (41.7%) segmental resections, and 146 (12.6%) local resections. The results suggest that 56.6% of patients had a recurrence of HCC during the study period and the main recurrence type was intrahepatic (542; 83.1%). The median survival time was 45 months. The 1-, 3- and 5-year overall disease-free survival rates for the study population were 74%, 47%, and 39% respectively. CONCLUSIONS: The results of proportional hazard analyses suggest that tumor size, number of nodules and vascular invasion were significant predictors for poor survival rates.