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/St;<t.
Canada Diseases
Rapport hebdomadaire des
VVeekly Report
maladies au Canaila.
DateolPlblicatlon: October14, 1989
Date de publication: 14octobre 1989
ISSN 0382-232X
CAN ADlAi'l~
t/L~/
Vol.15·41
OCT 2 51989
Contained In this Issue:
Contenu du present numero:
Laboratory Evidence of Human Viral and Selected Non-Viral
Infections in Canada -1988 . . . . . . . . . . . . . . . . . . . . . . . . 205
Announcemenl . . . . . • . • . . . . • • • • • • • • . • . . . . . . . . . 208
Reminder . . . . . . • . • • . • . • • • • • . • • . • • • . • • . • . . . . 208
Signes biologiques de viroses el de certaines infections non virales
humaines au Canada - 1988 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205
Annonce . • • • . . . . . . . . . . • . . • • . • • • • • • • . . • . . • • . . . . . • 208
Rappel .•.••........•..••.••••••.••.•.•••...... 208
LABORATORY EVIDENCE OF HUMAN VIRAL AND
SELECTED NON-VIRAL INFECTIONS IN CANADA-1988
SIGNES BIOLOGIQUES DE VIROSES ET DE CERTAINES
INFECTIONS NON VIRALES HUMAINES AU CANADA-1988
During 1988, 23 diagnostic virology laboratories across Canada
contributed reports of positive findings to the Laboratory Centre for
Disease Control (LCDC) as part of the Canadian Virus Reporting
System. TI1e significant findings of the 1988 data are highlighted in
the following report. Data were unavailable from Manitoba in 1988
and have not been available from Nova Scotia and Prince Edward
Island since 1986. The total number of reports received and
accepted decreased from 40,856in1987 to 30,629 in 1988, with
the average number per laboratory decreasing from 1571 to 1332.
The lack of data from Manitoba represents an estimated loss of
approximately 3000 reports. Table 1 compares the number of
reports submitted per province for 1987 and 1988. New Brunswick
was the only reporting province showing a significant increase in
the reports for 1988.
En 1988, dans le cadre du Programme canadien de declaration des
maladies avirus, 23 laboratoires de virologie d'un bout al'autre du pays
ont communique au Laboratoire de Jutte contre la maladie (LLCM) des
rapports de resultats positifs. Le present article souligne Jes conclusions
importantes tirees des donnees de 1988. Les donnees du Manitoba
n 'etaient pas disponibles pour 1988, et celles de la Nouvelle-Ecosse et de
]'Ile-du-Prince-Edouard ne le sont plus depuis 1986. Le nombre total des
rapports re\)US et acceptes est tombe de 40 856 en 1987 a 30 629 en 1988,
le nombre moyen par laboratoire passant de 1571a1 332. L'absence de
donnees du Manitoba represente une perte evaluee aenviron 3 000
rapports. Le Tableau 1 compare le nombre de rapports presentes par
province en 1987et1988. Parmi !es provinces participantes, seul le
Nouveau-Brunswick a emegistre une hausse notable du nombre des
rapports en 1988.
Table 1 / Tableau 1
Number of Reporting Laboratories and Number of Reports Received by Province In 1988 and 1987
.
Nombre de laoorato1res ayant presenle des rapports et nombre de rapports requs par province en 1987 et 1988
Number of
Laboratories Reporting/
Nombre de laboratolres
ayant resente des rap~orts
198
Province
British Columbia/
Colombie-Britannique
Alberta
Saskatchewan
Manitoba
Ontario
Quebec/Quebec
New Brunswick/
Nouveau-Brunswick
Newfoundland/Terre-Neuve
Nova Sco~a & Prince Edward Island/
Nouvelle- cosse et Tie-du-Prince Edouard
Total
f
1 87
3
2
2
0
11
2
3
2
2
1
13
2
2
0
23
Number of Reports Received/
Nombre de rapports regus
1988
3880
4176
1845
Percent Change in
Number of Rd?orts/
Pourcentage 'ecart
dans le nombre de rapports
1987
-35%
-31%
-14%
16770
1421
5961
6076
2137
3074
19821
1891
2
1451
1086
822
1074
+77%
+1%
0
26
NR/AR
NR/AR
30,629
40,856
NR/AR
-15%
-25%
-25%
NR- Not reporting
AR-Aucun rapporl
The 5 most frequently identified agents in i 988 accounted for
74% of all reports. These agents are listed in Table 2 in comparison
with those of 1987 1• Chlamydia trachomatis and herpes simplex
virus (HSV) were again the 2 most frequently reported agents
followed by hepatitis B virus and human immunodeficiency virus
I Socood Class MalRogis~alion No. 5670 I
Health and Welfare
Canada
Santa et Bien-etre social
Canada
205
Les 5 agents identifies le plus souvent en 1988 comptaient pour 74%
de la totalite des rapports. Le Tableau 2 presente ces agents en
comparaison de ceux de 1987 1• Chlamydia trachomatis et l'herpesvirus
simplex (HVS) sont toujours en tete, suivis du virus de l 'Mpatite B
(VHB) et du virus de l'immunodeficience humaine de type 1 (VIH-1).
J
CourriEI' de la dooxi<mo classo- Enregistroment n' 5670
Canada
Table 2 / Tableau 2
Frequency of Laboratory. Findings
Frequence des diagnos lcs blologlques
1988
Rank/
Rang
Agent
Number/
Nombre
1987
%
ofTotal/
du total
Chlamydia trach~matis•'
9179
30
Herpes Simplex Virus/
Virus de !'herpes simplex
Hepatitis B Virus/
Virus de l'hepatite B
8931
29
1898
6
4
Human Immunodeficiency Virus-1/
Virus de l'immunodeticience humaine-1
1557
5
5
Respiratory Syncytial Virus/
Virus respiratoire syncytial
1507
5
7557
25
2
3
All Others/Autres (total)
Total·
Agent
Herpes Simplex Virus/
Virus de !'herpes simplex
Chlamydia trachomatis
Hepatitis B Virus/
Virus de l'Mpatite B
Human Immunodeficiency Virus-1/
Virus de l'immunodeficience humaine-1
Rotavirus
All Others/Autres (total)
30,629
Number/
Nombre
%
of Total/
du total
14079
35
9776
24
2431
6
2174
5
1838
4
10558
26
40,856
Total
type 1 (HIV-1). Sexual contact plays a significant role in the transmission of
these 4 agents. Of the total 30,629 reports received, clinical information was
given for 21134, including 32% of all reports of the C. trachomatis. The
most common clinical information cited on the C. trachomatis reports was
disease of the skin or mucous membrane (12% of reports), urinary tract
disease (4%) and pelvic inflammatory disease (2% ). Five percent of the
C. trachomatis reports were from healthy individuals with no apparent
illness. Sixty-one percent of all reports of HSV were associated with skin
and/or mucous membrane disease.
Les contacts sexuels jouent un role important dans la transmission de ces
4 agents. Surles 30 629 rapports re~:us, 21134 contenaient des donnees
cliniques, notamment 32% des rapports sur C. trachomatis. Acet egard,
ces demiers precisaient le plus souvent une atteinte cutanee ou muqueuse
(12% des rapports). une infection urinaire (4%) et une inflammation
pelvienne (2%). Parmi les rapports sur C. trachomatis, 5% concernaient
des sujets sains sans maladie apparente. Au total, 61 % des rapports sur
l'HVS etaient associes des atteintes cutanees OU muqueuses.
There was a 59% increase in the number ofreports of respiratory
syncytial virus (RSV) in 1988 compared to 1987 making it the fifth most
frequently reported agent in 1988. Seventy-nine percent of all RSV reports
in 1988 occurred between the months of January to May with March being
the peak month. Age was specified in 86% of all RSV reports. This
information indicated that 45% of these infections occurred in persons less
than 6 months of age, 65% in those less than 1-year-old and 93% in those
aged 0-4 years.
Comparativement 1987, le nombre des rapports sur le virus
respiratoire syncytial (VRS) a grimpe de 59% en 1988, pla~ant le VRS
au 5c: rang des agents signales le plus souvent au cours de l' annee. Parmi
tous ces rapports, 79% concemaient des cas survenus entre janvier et
mai, un pie ayant ete enregistre en mars. L'iige etait precise dans 86%
des rapports sur le VRS, revelant que 45% des infections ont ete
observees chez des sujets de moins de 6 mois, 65% chez des moins de
1 an, et 93% chez des sujets de 0 4 ans.
Table 3 lists the agents most
frequently associated with
respiratory symptoms. RSV was
cited most frequently, accounting
for 39% of these reports, an
increase of 19% from 1987. fu
1987, Mycoplasma pneumoniae
was the agent most frequently
reported in association with
respiratory symptoms (23% of all
such reports), but in 1988 only 6%
of reports citing respiratory disease
involved this agent. Th~number of
reports of influenza B virus
increased from 13 ill 1987 to 458
in 1988 and it was cited in 11 % of
reports of respiratory dise_ase.
fufluenza B v~s was implicated in
several nursing· home outbreaks in
Canada in 19883.4.5• fufluenza A
and B together accounted for 21 %
ofreports citing respiratory
symptoms in 1988, whereas in
1987 these 2 agents only accounted
for 4% of such reports.
a
a
a
Table 3 /Tableau 3
Agents Most Frequently Associated with Res~lratory Sym1>toms
Agents assocles te plus souvent ades sympfomes resplratolres
1988
Agent
O/o
. Respiratory Syncytial Virus/
Virus respiratoire syncytial
Influenza B VirusNirus de la grippe B
Mycoplasma pneumonias
Other Agents/Autres agents
Number of ReportslNombre de rapports
Percent o!Tcital Reports/
Pourcentage du total des rapports
Table 4 lists the agents most frequently associated with gastrointestinal
symptoms. The figures from 1988 are very similar to those of 1987.
Rotavirus was again the agent most frequently reported in association with
206
%
39
11
10
Influenza A VirusNirus de la grippe A
Parainfluenza Virus (all types)/
Virus paragrippal (tous types) .
Adenovirus/Adenrivirus
1987
21
0
4
10
10
8
13
6
16
23
29
3043
3099
10
8
Le Tableau 3 fait etat des agents
associes le plus souvent ades
symptomes respiratoires. Le VRS
vient en tete, representant 39% de
ces rapports, soit 19% de plus qu' en
1987. Mycoplasma pneumoniae, qui
occupait ce rang en 1987 (23% des
rapports de cette categorie), n'etait
incrimine en 1988 que dans 6% des
rapports mentionnant une atteinte
respiratoire. Le_nombre des rapports
sm le virus de la grippe B a grimpe
de 13 en 1987 8.458 en 1988, ce
virus figurant dans 11% des rapports
d 'atteinte respiratoire. En 1988, il a
ere incrimine dans plusieurs
flamooes recensees au Canada dans
des foyers pour personnes iigees3.4•5.
Ensemble, les vhus grippaux A et B
representaient 21 % des rapports de
1988 faisant etat de symptomes
respiratoires, tandis qu 'en 1987 ils
ne comptaient que pour 4% de ces
rapports.
0
a
Le Tableau 4 presente les agents associes le plus souvent des
symptomes gastro-intestinaux. Les chiffres de 1988 sont tres pres de
ceux de 1987. Le rotavirus est encore au premier rang, avec 50% des
gastrointestinal disease (50% of the
reports). Eighty-one percent of all
reports of rotavirus infection occurred
in children less than 4 years of age.
Although few in number, it is
noteworthy that in 1988 there were 3
reports ofHIV-22, 3 of human
T-lymphotrophicvirus 1 (HTLV-1)
and 2 of delta hepatitis virus.
In October 1987, the LCDC
introduced a service for parvovirus
B19 testing. Only 151 reports of
parvovirus B19 (from Newfoundland)
were received via the Canadian Virus
Reporting System in 1988, but there
were actually 420 positive diagnoses
made llt the LCDC in 1988 from 1100
specimens submitted for B 19 testing.
Laooratories should report positive
results of all specimens originating
from their laboratory including those
forwarded on to other laboratories for
testing.
rapports. Au total, 81 % des
infections rotavirus concemaient
des enfants de moins de 4 ans.
a
Table 4 / Tableau 4
Agents Most Frequently Associated with Gastrointestinal Symptoms
Agents assocles le plus souvent des symptomes gastro·intestinaux
1987
1988
Agent
%
%
50
25
42
27
3
3
1
2
3
4
3
13
1891
4
20
2599
6
6
Rotavirus
Adenovirus/Adenovirus
Respiratory Syncytial Virus/
Virus resp1ratoire syncytial
Reovirus/Reovirus
Norwalk-like A~nl/
Agent pseudo- orwalk
Human Immunodeficiency Virus-1/
Virus de l'immunodeficience humaine-1
Other Agents/Autres agents
Number of Reports/Nombre de rapports
Percent ofTotal Reports/
Pourcentage du total des rapports
The Canadian Virus Reporting System was revised for 1989 to help ease
the workload for participating laboratories and to obtain a better
denominator for evaluating changes in the frequency of reported laboratory
diagnoses of a particular agent. Beginning in January 1989, laboratories
were requested to submit only monthly listings of the number of positive
laooratory diagnoses of each agent together with the total number of
specimens submitted to their virology diagnostic service. Previously,
numerical lists of agents diagnosed but not reported individually on the
standard report form for computer entry could not be accommodated;
however, this can now be done on the new system. Some laooratories which
had stopped participating because of the work involved in the completion of
reports resumed submission of data in 1989. In the future, even though less
detailed information will be available on individual cases, it is hoped that
changes in the number of positive reports will be able to be related to the
total number of specimens submitted and the number of laooratories
participating so that these factors will be considered in the numerical shifts
observed in Canada.
References
1. Parker C, Weber J, Garnett M-J, Neumann P. Laboratory evidence of
human viral and selected non-viral infections in Canada-1987. CDWR
a
a
a
a
Ref6rences
1.
Parker C, Weber J, Garnett M-J, Neumann P. Signes biologiques de
viroses et de certaines infections non virales humaines au Canada,
1987. RHMC 1988; 14:165-8.
Neuniann P, Lepine D, Woodside M, Levesque J, Frenette S,
O'Shaughnessy M. Infection VIH-2 dece/ee au Canada. Ibid: 125-6.
1988; 14:165-8.
Neuman P, Lepine D, Woodside M, Levesque J, Frenette S,
O' Shaughnessy M. HW-2 infection <!eJected in Canada. Ibid: 125-6.
2.
3.
Findley E, Martin GK, McCausland J, Basrur SV. Probable outbreak
ofinjluenzaB in a nursing home-Ontario. Ibid: 83-4. ·
3.
4.
Simor AB, Sharpe S, Byrne S, Cruz T, McLaughlin B. lnfluenza B
outbreak in a home for the aged-Ontario. Ibid: 181-4.
~obinson H, Bryant H. Influenza B outbreak in a nursing
·· home;Alberta. Ibid: 213-4.
En octobre 1987, le LLCM a
introduit un service de recherche du
parvovirus B19. En 1988, le
Programme canadien de declaration
des maladies virus n' a regu que 151
rapports sur le parvovirus B19, (de
Terre-Neuve) mais 42Q diagnostics
positifs ont en fait ete etablis au
LLCM partir de 1100 echantillons
presenres aux fins de la recherche du
B19. Les laboratoires devraient
signaler les resultats positifs de tous
leurs echantillons, y compris de ceux
qu'ils ont fait analyser ailleurs.
Le Programme canadien de declaration des maladies virus a et6
modifie en 1989 afin d'attenuer la charge de travail des laboratoires
participants, et d'obtenir un meilleur denominateur pour I' evaluation des
changements de la frequence des diagnostics biolo giques signal es pour un
agent donne. Acompter de janvier ~989, les laboratoires ont ete pries de ne
presenter que des listes mensuelles du nombre de diagnostics biologiques
. positifs pour chaque agent, ainsi que du nombre total d' echantillons
presentes leur service de diagnostic virologique. Avant, il etaitimpossible
d'accepter des listes numeriques d'agerits qui, bfon que diagnostiques,
n •etaient pas signales separement sur la formule normalisee de declaration
pour I' enregistrement informatique; avec le nouveau sysreme, c' est
maintenant possible. Certains laboratoires, qui avaient abandonne le·
programme parce qu 'il etait astreignant de remplir les rapports, y
participentdenouveau en 1989. Al'avenir, meme s'ily auramoins de
details stir Jes cas particuliers, nous esperons pouvoir rapprocher, d'une
part, des changements dans le nombre des rapports positifs et, d' autre part,
le nombre total d' echantillons presentes et le nombre des laooratoires
participants, ce qui penp.ettra de tenir compte de ces facteurs dans Jes
changements numeriques observes au Canada.
2.
5.
Il convient de noter que, meme
s 'ils etaient peu nombreux, il y a eu
en 1988, 3 rapports sur le VIH-22, 3
sur le virus humaill T-lymphotrophe
de type 1 (HTLV-1) et 2 sur le virus
de l'.Mpatite delta.
a
a
Findley E, Martin GK, McCausland J, Basrur SV; Poussee probable
. de grippe B. dans unfoyer pour personnes /Jgees - Ontario. Ibid: 83-4.
4. Simor AB, Sharpe S, Byrne S, Cniz T, McLaughlin B. P~Ussee de
grippe B dans unfoyerpour personnes ~gees - Ontario. Ibid: 181-4.
5. Robinson H, Bryant H. Poussee de grippe B dans unfoyer pour
personnes /Jgees - Alberta. Ibid : 213-4.
Acknowledgements
Remerclements
The cooperation of the Directors and staff of the contributing Canadian
virus laboratories who collect and submit these data is greatly appreciated.
Computer data entry was performed by Dawn Elliott, Bureau of
Microbiology.
Nous tenons remercier de leur collaboration les directeurs et le
personnel des laboratoires canadiens de virologie participants, qui
recueillent et pres entent ces donnees. L' enregistrement des donnees a ete
effectue par Dawn Elliott, Bureau de microbiologie.
207
a
Source: Catherine Parker, BSc, John M Weber; PhD, National
Laboratory for Special Pathogens, Bureau ofMicrobiology,
Mary-Jane Garnett, BSc, Division ofBiometrics, Laboratory
Centre for Disease Control, Ottawa.
Source: Catherine Parker, BSc, John M Weber, PhD, Laboratoire
national pour des pathogenes speciaux, Bureau de microbiologie,
Mary-Jane Garnett, BSc, Division de la biometrie, Laboratoire
de lutte contre la maladie, Ottawa.
Announcement
Announce
239 SEMINAIRE ANNUEL SUR L'INFECTION - ECOSSE
23rd ANNUAL SEMINAR ON INFECTION - SCOTLAND
This annual S-day Seminar will be held at Ruchill Hospital, Glasgow,
from 21 to 25 May 1990. A varied program is planned to provide an
update on current aspects of infections including AIDS, food poisoning,
and immunization.
Ce seminaire annuel de S jours aura lieu a l'Hopital Ruchill de Glasgow,
du 21au25 mai 1990. On prepare un programme varie quipermettrade
faire le point sur des aspects actue]s de I 'infection, notamrnent sur le SIDA,
les taxi-infections alimentaires etl'immunisation.
The fee for the Seminar will be £240 which will include lunch and
coffee each day, and the Seminar Dinner.
Les frais d 'inscription sont de 240£ et comprennent les dejeuners et les
pauses cafe ainsi que le Grand Diner.
Accommodation can be arranged at a nearby hotel at a special
conference rate, and transportation will be provided to and from the
hospital.
Les chambres peuvent etre reservees daru; un hotel voisin un prix
special, et un service de navette sera assure entre I 'hotel et l'hopital.
Additional information and application forms may be obtained by
contacting Mrs. N. Wilson, Communlcable Diseases (Scotland) Unit,
Ruchlll Hospital, Glasgow G20 9NB, Scotland.
Pour obtenir d' autres renseignements et des formulaires d'inscription,
s 'adresser aMadame N. Wilson, Communicable Diseases (Scotland)
Unit, Ruchlll Hospital, Glasgow G20 9NB, Ecosse.
Reminder
Rappel
a
International Health Symposium
Symposium International sur la sante
6·18November1989
Mexico City
Du 6 au 18 ncivembre 1989
Mexico
This will be a conjoint meeting with the participation of several
Canadian and Mexican societies, associations, centres, agencies, institutes,
and university medical school divisions and departments. The program
will be of interest to both specialists and general practitioners providing
an update on relevant topics in international health including AIDS,
diarrheal and respiratory diseases, and prevention of travel-associated
illness.
n s 'agit d'une reunion conjointe alaquelle participeront plusieurs
societes, associations, centres, organismes, etablissements, ainsi que
divisions et departements de facultes de medecine du Canada et du
Mexique. Le programme, qui interessera la fois les specialistes et les
omnipraticiens, fera le point sur des sujets pertinents du domaine de la sante
internationale, notamment sur le sida, les maladies diarrheiques et
respiratoires, et la prevention de la maladie associee aux voyages.
Registration is $380. For further information and registration, contact
Dr. W.A. Black, Provincial Laboratory, 828West10th Avenue,
Vancouver, British Columbia VSZ 1L8 (tel: (604) 660-6029).
Les droits d'inscription sont de 380 $.Pour obtenir d'autres
renseignements et pours 'inscrire, s' adresser au Dr W .A. Black, Provinical
Laboratory, 828West10th Avenue, Vancouver, Colombie-Brltannique
VSZ 1L8 (tel: (604) 660c6029).
Tho Caru.da.Dbeues Weekly Report presents cum:nt infonnationon infectious and other discasca for
1UIYeillancc putposos and lB available free of charge upanrequost Many of the articles contain
prclimlruuy !nfonnatlon and further confimution may bo obtained from tho sources quoted. Tho
DcpartmontofNntiotu!l Hoel th nnd Wclliuo doea nota111umn rospowlbility for accurncy or aulhonticity.
Lo Rnpport lu:bdomn&iro des mnlndioa au Canada, qui fownit des donnCes portinon!Ds 1ur les mnladios
infoctiou.ses et lcs au tres maladies dans lo but de facilitcr lour surveillance, pout etro obtcnu gratuitement aur
demando. Un grand nombm d'articles no conl.ionnont quo dos donnbes sot1lDllllrc1 ms.l.i dcsrcrueigncmonta
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ct du Blon.Stre sociel ne peul Ctre rosp=blo do l'exactltude, nl do l'aulhonticltiS des article" ToutD
po1>onno ocuvnnt dons lo dmnalnc do la annt6 ost invlt6o l coll aborer (dans la languo officiollo do ion
cholx) ct la publicaticm d'un article daru le preiCnl Rapportn'cn cmpacbc pas la publicatinn allleun.
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DlstrlbuUon
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Bweaud 6pi~m.iologie des maladios trWl.'imissibles
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]03IlIK>Rognior
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208
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