Canada communicable disease report = Releve des maladies transmissibles au Canada最新文献

{"title":"<i>Toxoplasma gondii</i>: How an Amazonian parasite became an Inuit health issue.","authors":"S J Reiling,&nbsp;B R Dixon","doi":"10.14745/ccdr.v45i78a03","DOIUrl":"https://doi.org/10.14745/ccdr.v45i78a03","url":null,"abstract":"<p><p><i>Toxoplasma gondii</i> is a protozoan parasite that originated in the Amazon. Felids (mammals in the cat family) are the only definitive hosts. These animals shed large numbers of infectious oocysts into the environment, which can subsequently infect many intermediate hosts, including birds, mammals and, possibly, fish. Human <i>T. gondii</i> seroprevalence is high in some parts of the Canadian Arctic and is associated with adverse health consequences among Inuit population. Since the range of felids does not extend to the Arctic, it is not immediately obvious how this parasite got from the Amazon to the Arctic. The objectives of this overview are to summarize the health impacts of <i>T. gondii</i> infection in Inuit in Canada's North and to consider how this infection could have reached them. This article reviews the prevalence of <i>T. gondii</i> infection in terrestrial and marine animals in the Canadian Arctic and discusses their potential role in the foodborne transmission of this parasite to humans. Two distribution factors seem plausible. First, felids in more southern habitats may release infectious oocysts into waterways. As these oocysts remain viable for months, they can be transported northward via rivers and ocean currents and could infect Arctic fish and eventually the marine mammals that prey on the fish. Second, migratory terrestrial and marine intermediate hosts may be responsible for carrying <i>T. gondii</i> tissue cysts to the Arctic, where they may then pass on the infection to carnivores. The most likely source of <i>T. gondii</i> in Inuit is from consumption of traditionally-prepared country foods including meat and organs from intermediate hosts, which may be consumed raw. With climate change, northward migration of felids may increase the prevalence of <i>T. gondii</i> in Arctic wildlife.</p>","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"45 7-8","pages":"183-190"},"PeriodicalIF":0.0,"publicationDate":"2019-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6615440/pdf/ccdr-45-183.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41224687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A public health enhanced surveillance system for a mass gathering event.","authors":"C. Huot, A. Paradis, K. Hammond-Collins, M. Bélair, J. Villeneuve, Nicholas Brousseau, I. Goupil-Sormany, J. Riffon","doi":"10.14745/CCDR.V45I78A05","DOIUrl":"https://doi.org/10.14745/CCDR.V45I78A05","url":null,"abstract":"Background\u0000From June 7 to June 9, 2018, a G7 Summit was held in the Canadian province of Quebec. This international political mass gathering event posed a number of potential risks to public health.\u0000\u0000\u0000Objective\u0000To assess three additional monitoring strategies to detect public health threats during a mass gathering event.\u0000\u0000\u0000Intervention\u0000In addition to routine public health monitoring, a partnership was created and three monitoring strategies were put in place three days before, during and six days after the G7 event: the analysis of data on the presenting complaint and discharge diagnosis from 11 emergency departments in the area using the logical Early Aberration Reporting System; the daily polling of key health partners with an online questionnaire; and the analysis of calls to Info-Santé, a government-run telephone consultation service for the public regarding health and social issues.\u0000\u0000\u0000Results\u0000Emergency room data produced 78 alerts from the presenting complaints and 39 alerts from the discharge diagnoses. Of these 117 alerts, two were investigated (one in the respiratory and one in the neurological-muscular categories) and no other interventions were required. With a few exceptions, all of the health partners completed the online survey each day and no signal of concern was generated. Compared with historical data, no increase or differences in calls to Info-Santé were detected during the monitoring period.\u0000\u0000\u0000Conclusion\u0000The three additional monitoring strategies developed to detect events of public health importance during the 2018 G7 Summit in Quebec were successful in gathering timely data for analysis. Close collaboration and good participation from the different partners were essential to this project. However, because no public health event occurred, it was not possible to determine whether the enhanced surveillance system had sufficient speed and sensitivity for timely detection and response.","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"26 1","pages":"212-224"},"PeriodicalIF":0.0,"publicationDate":"2019-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88044251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human rabies postexposure prophylaxis and rabid terrestrial animals in Ontario, Canada: 2014-2016.","authors":"D. Middleton, L. Friedman, S. Johnson, S. Buchan, B. Warshawsky","doi":"10.14745/CCDR.V45I78A02","DOIUrl":"https://doi.org/10.14745/CCDR.V45I78A02","url":null,"abstract":"Background\u0000The number of rabid terrestrial animals in Ontario has decreased markedly since the 1970s and 1980s. However, the number of recommended rabies postexposure prophylaxis (RPEP) courses has not decreased proportionally. The decision to recommend RPEP for terrestrial animal exposures should be based on a risk assessment that considers the prevalence of rabies in these animals within a jurisdiction, among other factors.\u0000\u0000\u0000Objective\u0000To explore trends in RPEP recommendations for exposures to terrestrial animals in Ontario in relation to the recency of terrestrial animal rabies cases by public health unit (PHU) jurisdiction.\u0000\u0000\u0000Methods\u0000RPEP recommendation data for the 36 Ontario PHUs were obtained from the Ontario integrated Public Health Information System and animal rabies data by PHU were obtained from the Ministry of Natural Resources and Forestry. We calculated the annual RPEP recommendation rates for terrestrial animals by PHU for 2014 to 2016, and plotted the 2016 rates in relation to the year of the most recently identified rabid terrestrial animal in the PHU.\u0000\u0000\u0000Results\u0000Between 2014 and 2016, the annual RPEP recommendation rates for terrestrial animal exposures by PHU ranged from 3.0 to 35.2 per 100,000 persons, with a median of 11.9 RPEP recommendations per 100,000 persons. In 2016, ten PHUs had not identified a rabid terrestrial animal in their jurisdiction for more than15 years. Five of these PHUs had RPEP recommendation rates above the provincial median.\u0000\u0000\u0000Conclusion\u0000Along with other factors, consideration of the occurrence of rabies in terrestrial animals in a jurisdiction can assist in the risk assessment of dogs, cats or ferrets that are not available for subsequent observation.","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"16 1","pages":"177-182"},"PeriodicalIF":0.0,"publicationDate":"2019-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79778397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of <i>Clostridioides difficile</i> infection in Canada: A six-year review to support vaccine decision-making.","authors":"Y Xia,&nbsp;M C Tunis,&nbsp;C Frenette,&nbsp;K Katz,&nbsp;K Amaratunga,&nbsp;S Rhodenizer Rose,&nbsp;A House,&nbsp;C Quach","doi":"10.14745/ccdr.v45i78a04","DOIUrl":"https://doi.org/10.14745/ccdr.v45i78a04","url":null,"abstract":"<p><strong>Background: </strong>Two vaccines against <i>Clostridioides difficile</i> infections (CDI) are currently in phase III trials. To enable decision-making on their use in public health programs, national disease epidemiology is necessary.</p><p><strong>Objectives: </strong>To determine the epidemiology of hospital-acquired CDI (HA-CDI) and community-associated CDI (CA-CDI) in Canada using provincial surveillance data and document discrepancies in CDI-related definitions among provincial surveillance programs.</p><p><strong>Methods: </strong>Publicly-available CDI provincial surveillance data from 2011 to 2016 that distinguished between HA-CDI and CA-CDI were included and the most common surveillance definitions for each province were used. The HA-, CA-CDI incidence rates and CA-CDI proportions (%) were calculated for each province. Both HA- and CA-CDI incidence rates were examined for trends. Types of disparities were summarized and detailed discrepancies were documented.</p><p><strong>Results: </strong>Canadian data were analyzed from nine provinces. The HA-CDI rates ranged from 2.1/10,000 to 6.5/10,000 inpatient-days, with a decreasing trend over time. Available data on CA-CDI showed that both rates and proportions have been increasing over time. Discrepancies among provincial surveillance definitions were documented in CDI case classifications, surveillance populations and rate calculations.</p><p><strong>Conclusion: </strong>In Canada overall, the rate of HA-CDI has been decreasing and the rate of CA-CDI has been increasing, although this calculation was impeded by discrepancies in CDI-related definitions among provincial surveillance programs. Nationally-adopted common definitions for CDI would enable better comparisons of CDI rates between provinces and a calculation of the pan-Canadian burden of illness to support vaccine decision-making.</p>","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"45 7-8","pages":"191-211"},"PeriodicalIF":0.0,"publicationDate":"2019-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6615439/pdf/CCDR-45-191.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41224688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surveillance of Echinococcus tapeworm in coyotes and domestic dogs in Winnipeg, Manitoba: Abstract.","authors":"Cck Tse, J. Bullard, R. Rusk, D. Douma, PJ Plourde","doi":"10.14745/CCDR.V45I78A01","DOIUrl":"https://doi.org/10.14745/CCDR.V45I78A01","url":null,"abstract":"Background\u0000The Echinococcus species, including E. multilocularis and E. canadensis, are tapeworms that primarily infect canids such as dogs, foxes and coyotes, but which can also infect humans. In humans, E. multilocularis can cause alveolar echinococcosis; a serious condition that mimics metastatic malignancy and has a poor prognosis. It is known that coyotes in rural Manitoba are infected with Echinococcus species, but it is not known if coyotes in peri-urban areas are also infected.\u0000\u0000\u0000Objectives\u0000To document and map Echinococcus species in wild canids and domestic dogs in Winnipeg, Manitoba (Canada).\u0000\u0000\u0000Methods\u0000There were 169 fecal samples collected between April 18 and June 1, 2018. These included 44 samples of domestic dog feces, 122 of coyote scat, one of fox scat and two of coyote colonic tissue specimens. Samples were frozen (-80°C) for at least 72 hours to inactivate tapeworm ova. Polymerase chain reaction analyses of E. multilocularis and E. canadensis were performed on all frozen samples.\u0000\u0000\u0000Results\u0000Echinococcus multilocularis-positive samples were detected in nine (10.6%) of 85 locations, with one positive sample in a suburban Winnipeg dog park and two positive samples in a popular provincial park. No dog samples were positive for E. multilocularis; one sample was positive for E. canadensis. In contrast, nine coyote samples (7.3%) were positive for E. multilocularis and eight samples (6.5%) were positive for E. canadensis. The one fox sample was positive for each. Overall, six samples (3.6%) were positive for both infections.\u0000\u0000\u0000Conclusion\u0000This is the first confirmation of the presence of E. multilocularis in coyote feces in the metropolitan area of Winnipeg, Manitoba. In light of the risk this could pose to domestic dogs and human health, periodic surveillance that maps the distribution of this tapeworm could inform the need for additional public health actions.","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"44 1","pages":"171-176"},"PeriodicalIF":0.0,"publicationDate":"2019-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86111405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence for optimal HIV screening and testing intervals in HIV-negative individuals from various risk groups: A systematic review.","authors":"K. Timmerman, M. Weekes, G. Traversy, P. Prabakhar, T. Austin, S. Ha, B. Anwar","doi":"10.14745/CCDR.V44I12A05","DOIUrl":"https://doi.org/10.14745/CCDR.V44I12A05","url":null,"abstract":"Background\u0000Human immunodeficiency virus (HIV) testing plays a crucial role in Canada's HIV prevention and treatment efforts and is the first step to achieving the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 targets; however, how often Canadians, including populations at increased risk of HIV exposure, should be tested is unclear. We conducted a systematic literature review to determine the optimal HIV screening and testing intervals.\u0000\u0000\u0000Objective\u0000To examine the current evidence on HIV testing intervals in HIV-negative individuals from various risk groups and to assess the potential harms and patients' values and preferences associated with different testing frequencies.\u0000\u0000\u0000Methods\u0000We searched MEDLINE/PubMed, Scopus, Embase, the Cochrane Library, PsychINFO and EconLit for studies on different frequencies of HIV testing published between January 2000 and September 2016. An additional search was conducted for grey literature published between January 2000 and October 2016. Data extraction included study characteristics, participants, exposure, outcomes and economic variables. The quality of the studies was assessed and results summarized.\u0000\u0000\u0000Results\u0000Of the 2,702 articles identified from the searches, 27 met the inclusion criteria for review. This included assessments of HIV testing intervals among the general population, men who have sex with men, people who use injection drugs and sex workers. Optimal testing intervals across risk groups ranged from one-time testing to every three months. Data from modelling studies may not be representative of the Canadian context. Few studies identified potential harms of increased screening, specifically an increase in both false positive and false negative results. There were only two studies that addressed patient values and preferences concerning HIV screening, which suggested that the majority of participants were amenable to routine screening through their primary care provider.\u0000\u0000\u0000Conclusion\u0000There was insufficient evidence to support optimal HIV screening and testing intervals for different populations. Context-specific factors, such as budget allocation, human resources, local epidemiology, socioeconomic factors and risk behaviours, along with clinical judgement, inform whom and how often to screen, suggesting the need for research specific to Canada. Research on patient preferences as well as the benefits and harms of more frequent screening are also indicated.","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"13 1","pages":"337-347"},"PeriodicalIF":0.0,"publicationDate":"2018-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89743003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outbreak of invasive Streptococcus pneumoniae among an inner-city population in Victoria, British Columbia, 2016-2017.","authors":"G. Mckee, A. Choi, C. Madill, J. Marriott, P. Kibsey, D. Hoyano","doi":"10.14745/CCDR.V44I12A02","DOIUrl":"https://doi.org/10.14745/CCDR.V44I12A02","url":null,"abstract":"Background\u0000Invasive pneumococcal disease (IPD) is a significant cause of morbidity and mortality; however, outbreaks of IPD are relatively rare. Homelessness and substance use are known risk factors for IPD and have been associated with several outbreaks in Canada, despite national recommendations for routine childhood and targeted adult pneumococcal vaccination.\u0000\u0000\u0000Objectives\u0000To describe the epidemiology and public health challenges related to an outbreak of novel serotype 4 IPD in a homeless and unstably housed population in Victoria, British Columbia during the autumn and winter of 2016-2017.\u0000\u0000\u0000Results\u0000Prospective, enhanced surveillance was initiated for laboratory confirmed cases reported to public health, including variables recording housing status and substance use. Thirty-three cases of serotype 4 IPD within the Victoria area were reported to public health between August 1, 2016 and September 1, 2017. Compared with other serotypes, these cases were more likely to be middle-aged, homeless or unstably housed, and to have a recent history of substance use. A targeted pneumococcal vaccination campaign was initiated in collaboration with external community organizations; however, these initiatives were challenged by incomplete data and staffing constraints.\u0000\u0000\u0000Conclusion\u0000This report illustrates an outbreak of serotype 4 IPD among an inner-city population with multiple risk factors, including homelessness, unstable housing and substance use. Given the challenges controlling the outbreak, outreach capacity and pneumococcal vaccination coverage is needed among this marginalized population.","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"4 1","pages":"317-322"},"PeriodicalIF":0.0,"publicationDate":"2018-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73065193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation and management of a large community mumps outbreak among young adults in Toronto, Canada, January 2017-February 2018.","authors":"V. Dubey, O. Ozaldin, L. Shulman, R. Stuart, J. Maclachlan, L. Bromley, A. Summers","doi":"10.14745/CCDR.V44I12A01","DOIUrl":"https://doi.org/10.14745/CCDR.V44I12A01","url":null,"abstract":"Background\u0000In 2017, a mumps outbreak was identified in a cohort of 18-34 year olds in Toronto, Canada.\u0000\u0000\u0000Objective\u0000To describe a large community mumps outbreak in an urban centre from January 2017 to February 2018 among young adults.\u0000\u0000\u0000Methods\u0000A broad range of interventions were implemented in an attempt to reach the target audience; including case and contact management, vaccination clinics at schools and clinicians' offices, school exclusions, bar inspections, traditional communication strategies (including health care provider updates and posters) and newer communication strategies (including three sequential social media campaigns).\u0000\u0000\u0000Results\u0000A total of 143 cases of mumps were identified. Although cases' ages ranged from three to 72 years, most (76%) were 18-34 year olds, many of whom had frequented bars and local food establishments in downtown Toronto. 84% (n=120) of the cases were community-acquired. Only 16% (n=23) of the cases reported exposures in schools and post-secondary school institutions. Of those, 39% (n=56) of cases had an unknown vaccination history; 34% (n=49) were either not vaccinated or partially vaccinated with one dose of measles-mumps-rubella vaccine; and 27% (n=38) had received the recommended two doses of mumps vaccine. Determining vaccination status was a challenge, in part due to the lack of a registry. Vaccination was recommended when subjects were known to have had fewer than two doses of vaccine or had an unknown vaccination status. A social media campaign, emphasizing the risk of social activities if not protected from the mumps, yielded over 500,000 impressions from Facebook and Twitter messages and ads and an impressive engagement rate of between 1% and 10x%.\u0000\u0000\u0000Conclusion\u0000This was the largest mumps outbreak in Toronto in over 20 years. Among young adults, ongoing social media and traditional communication campaigns can contribute to the control of community mumps outbreaks. Encouraging vaccine uptake is desirable, but without a vaccine registry it is difficult to assess vaccination coverage among adults. Susceptible cohorts of young adults who were not adequately vaccinated pose a risk for future outbreaks. Given that almost 30% of the mumps cases were fully vaccinated with two doses of mumps-containing vaccine, even two doses may not provide complete protection.","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"21 1","pages":"309-316"},"PeriodicalIF":0.0,"publicationDate":"2018-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82903068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bringing home unwelcome souvenirs: Travel and drug-resistant bacteria.","authors":"BJ Langford, KL Schwartz","doi":"10.14745/CCDR.V44I11A02","DOIUrl":"https://doi.org/10.14745/CCDR.V44I11A02","url":null,"abstract":"Antimicrobial resistance poses a significant threat to public health globally and in Canada. Wide regional variability in antimicrobial resistance and ongoing increases in global travel present an important risk for the acquisition and transmission of drug-resistant organisms. Travel from high-income to low- and middle-income countries, particularly the Indian subcontinent, present the greatest risks for acquiring a drug-resistant Enterobacteriaceae. Risk factors for returning from travel with drug-resistant organisms include seeking medical care while abroad, travellers' diarrhea and antibiotic use. Health care professionals can play an important role in preventing harm for travellers by counselling patients on the risks of acquiring drug-resistant organisms, appropriate antibiotic prescribing for travellers' diarrhea and tailored empiric therapy for patients presenting with infection after travel.","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"9 1","pages":"277-282"},"PeriodicalIF":0.0,"publicationDate":"2018-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73694602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A scoping review of Lyme disease research relevant to public health.","authors":"J D Greig, I Young, S Harding, M Mascarenhas, L A Waddell","doi":"10.14745/ccdr.v44i10a03","DOIUrl":"10.14745/ccdr.v44i10a03","url":null,"abstract":"<p><p>Lyme disease (LD) is an emerging infectious disease in Canada associated with expansion of the geographic range of the tick vector <i>Ixodes scapularis</i> in eastern and central Canada. A scoping review of published research was prioritized to identify and characterize the scientific evidence concerning key aspects of LD to support public health efforts. Prior to initiation of this review, an expert advisory group was surveyed to solicit insight on priority topics and scope. A pre-tested search strategy implemented in eight databases (updated September 2016) captured relevant research. Pre-tested screening and data characterization forms were completed by two independent reviewers and descriptive analysis was conducted to identify topic areas with solid evidence and knowledge gaps. Of 19,353 records screened, 2,258 relevant articles were included in the review under the following six public health focus areas: a) surveillance/monitoring in North America (n=809); b) evaluation of diagnostic tests (n=736); c) risk factors (n=545); d) public health interventions (n=205); e) public knowledge, attitudes and/or perceptions in North America (n=202); and f) the economic burden of LD or cost-benefit of interventions (n=32). The majority of research investigated <i>Borrelia burgdorferi</i> (n=1,664), humans (n=1,154) and <i>Ixodes scapularis</i> (n=459). Sufficient research was identified for potential systematic reviews in four topic areas: a) accuracy of diagnostic tests; b) risk factors for human illness; c) efficacy of LD intervention strategies; and d) prevalence and/or incidence of LD in humans or <i>B. burgdorferi</i> sensu stricto in vertebrate reservoirs or ticks in North America. Future primary research could focus on closing knowledge gaps, such as the role of less studied vertebrate reservoirs in the transmission cycle. Results of this scoping review can be used to quickly identify and summarize relevant research pertaining to specific questions about LD or <i>B. burgdorferi</i> sensu lato in humans, vertebrate hosts or vectors, providing evidence-informed information within timelines that are conducive for public health decision-making.</p>","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"44 10","pages":"243-256"},"PeriodicalIF":0.0,"publicationDate":"2018-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6707479/pdf/CCDR-44-243.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41224679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}