Multidrug-Resistant Shigella sonnei Bacteremia among Persons Experiencing Homelessness, Vancouver, British Columbia, Canada.

Increased invasive bloodstream infections caused by multidrug resistant Shigella sonnei were noted in Vancouver, British Columbia, Canada, during 2021-2023. Whole-genome sequencing revealed clonal transmission of genotype 3.6.1.1.2 (CipR.MSM5) among persons experiencing homelessness. Improvements in identifying Shigella species, expanding treatment options for multidrug resistant infections, and developing public health partnerships are needed.

A fresh look at an old vaccine: does BCG have a role in 21st century Canada?

INTRODUCTION: In Canada, bacille Calmette-Guerin (BCG) vaccine is now primarily given to First Nations and Inuit (FNI) neonates living in tuberculosis (TB) endemic areas. With declining TB rates, attention has shifted from the protective effects of BCG to reports of serious vaccine-associated adverse events (VAAE). METHODS: Surveillance data were reviewed to assess TB burden and trends, BCG coverage, and VAAE among FNI people in the 1990s. RESULTS: TB among FNI people living on reserve was 25 times higher than the Canadian-born, non-Aboriginal rate between 1997 and 2000. Paediatric TB rates declined from 149 per 100,000 in 1990 to 23 per 100,000 in 2000, with one case of TB meningitis and one TB fatality (due to congenital TB) reported in the 0-4 age group. Nine cases of disseminated BCG infection occurred in a 21-year period among children with congenital or acquired immunodeficiencies. The estimated rate of disseminated BCG infection was 205 per 1,000,000 (95% CI 62-678). DISCUSSION: BCG provides protection against severe forms of childhood TB. However, in a country with publicly funded health care and declining TB rates, it is important to consider VAAE. Disseminated BCG infection increases mortality among children with immunodeficiency disorders, which now have successful therapies. Although TB remains a threat in FNI communities, early detection and treatment of TB infection may be a more appropriate intervention.

Antenatal seroprevalence of herpes simplex virus type 2 (HSV-2) in Canadian women: HSV-2 prevalence increases throughout the reproductive years.

BACKGROUND: This study sought to provide the first population estimates of herpes simplex type 2 (HSV-2) seroprevalence in Canada. GOAL: To measure the antenatal seroprevalence of HSV-2 antibodies in reproductive age women. STUDY DESIGN: An anonymous unlinked seroprevalence study used stored sera collected from pregnant women in British Columbia during 1999. Randomized sampling within age strata selected a total of 1215 subjects, ages 15 to 44 years. Serologic testing used the Gull Meridian Test. Overall prevalence was directly standardized to the 1999 Canadian female population. RESULTS: The age-adjusted prevalence for HSV-2 was 17.3% (95% CI, 15.2-19.4). Prevalence ranged from 7.1% (ages, 15-19 years) to 28.1% (ages, 40-44 years), with the largest increases after the age of 24 years. CONCLUSIONS: The HSV-2 seroprevalence among pregnant women in British Columbia is similar to that in the United States and other countries. Seroprevalence continues to rise through the later reproductive years. This observation may relate to continued transmission, an age cohort effect, or both.