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

{"title":"Quality over quantity in active tick surveillance: Sentinel surveillance outperforms risk-based surveillance for tracking tick-borne disease emergence in southern Canada.","authors":"Camille Guillot, Catherine Bouchard, Kayla Buhler, Roxane Pelletier, François Milord, Patrick Leighton","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Lyme disease (LD) emerged in southern Québec at the start of the century, with many municipalities now endemic. A coordinated active surveillance programme has been in place in the province of Québec since 2014, including a limited number of sentinel field sites resampled each year and a larger set of accessory field sites that change yearly according to the LD surveillance signal. We aimed to evaluate whether a sentinel approach to active surveillance was more representative of LD risk to human populations, compared to risk-based surveillance.</p><p><strong>Methods: </strong>We compared enzootic hazard measures (average nymph densities) from sentinel and accessory sites with LD risk (number of human LD cases) across the study area between 2015 and 2019 using local bivariate Moran's I analysis.</p><p><strong>Results: </strong>Hazard measures from sentinel sites captured spatial risk significantly better than data from accessory sites (χ²=20.473, <i>p</i><0.001). In addition, sentinel sites successfully tracked the interannual trend in LD case numbers, whereas accessory sites showed no association despite the larger sample size.</p><p><strong>Conclusion: </strong>Where surveillance aims to document changes in tick-borne disease risk over time and space, we suggest that repeated sampling of carefully selected field sites may be most effective, while risk-based surveillance may be more usefully applied to confirm the presence of emerging disease risk in a specific region of interest or to identify suitable sites for long-term monitoring as LD and other tick-borne diseases continue to emerge.</p>","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"49 2-3","pages":"50-58"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10715827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138815859","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":"Community-based COVID-19 outbreak of the B.1.1.7 (Alpha) variant of concern in Newfoundland, February to March 2021.","authors":"Alexandra Nunn, Andrea Morrissey, Ashley Crocker, Kaitlin Patterson, Joanne Stares, Kerri Smith, Laura Gilbert, Krista Wilkinson","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>From March 2020 to January 2021, Newfoundland and Labrador experienced 408 coronavirus disease 2019 (COVID-19) cases (incidence 78 per 100,000). In February and March 2021, a community outbreak of the B.1.1.7 (Alpha) variant occurred in the Eastern Regional Health Authority. This article describes the epidemiology of this variant of concern outbreak, identifies settings that likely contributed to spread and informs recommendations for public health measures (PHMs).</p><p><strong>Methods: </strong>Provincial surveillance data were linked with case interview data and a school class roster. Descriptive epidemiological methods were used to characterize the outbreak. Secondary attack rates (SAR) were calculated for households and classrooms.</p><p><strong>Results: </strong>This outbreak involved 577 laboratory-confirmed and 38 probable cases. Whole genome sequencing determined cases were B.1.1.7. The median age was 31 years and the highest proportion of cases were in the 15 to 19-year age group (29%); 293 (51%) were female and 140 (24%) were asymptomatic upon identification. Early cases were linked to a high school, sports activities, a restaurant and social gatherings. As the outbreak progressed, cases were associated with household transmission, a daycare, healthcare settings and a workplace. The unadjusted SAR estimate among laboratory-confirmed cases was 24.4% for households and 19.3% for classroom exposures. When adjusted for other potential exposures, SAR estimates were 19.9% for households and 11.3% for classrooms.</p><p><strong>Conclusion: </strong>This outbreak demonstrated how B.1.1.7 spread rapidly through a community with previously low COVID-19 transmission and few preventative PHMs in place. Implementation and compliance with school and community-based PHMs is critical for preventing transmission during outbreaks.</p>","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"49 2-3","pages":"59-66"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10715830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138815851","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":"Treatment of severe human mpox virus infection with tecovirimat: A case series.","authors":"Koray K Demir, Michaël Desjardins, Claude Fortin, Simon Grandjean-Lapierre, Arpita Chakravarti, François Coutlée, Gerasimos Zaharatos, Jean Morin, Cécile Tremblay, Jean Longtin","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Tecovirimat (TCV, TPOXX^®) is an orthopox-specific antiviral drug indicated for the treatment of smallpox. There is also a mechanistic basis for its use in mpox infection. However, its approval was based on animal studies, and its efficacy and side-effect profile in human patients with disease is unknown.</p><p><strong>Methods: </strong>During the 2022 international mpox epidemic, clinicians in Canada accessed TCV from the Public Health Agency of Canada's National Emergency Strategic Stockpile for severe cases of mpox disease. We describe the use of TCV in nine adults with severe mpox virus infection in Montréal, Canada.</p><p><strong>Results: </strong>Five patients were treated for severe and potentially life-threatening head and neck symptoms, while four were treated for genitourinary or anorectal disease. Two-thirds of patients were also treated for suspected bacterial superinfection. All patients recovered (median time to resolution of severe symptoms: nine days) without relapse or hospital readmission. No patients reported adverse events attributable to TCV and no patients stopped their treatment early.</p><p><strong>Conclusion: </strong>Our experience suggests that TCV is well tolerated and may accelerate recovery in severe cases. These preliminary, observational data may also be explained by concomitant treatment for superinfection and are limited by the absence of a control group. Controlled, clinical trials should be conducted to clarify the attributable benefit of TCV in severe mpox infection.</p>","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"49 2-3","pages":"76-80"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10715828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138815860","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":"Summary of the NACI Statement on Public Health Level Recommendations on the Use of Pneumococcal Vaccines in Adults, Including the Use of 15-valent and 20-valent Conjugate Vaccines.","authors":"Aleksandra Wierzbowski, Robert Pless, Kyla J Hildebrand","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Age and certain medical/social conditions are risk factors for invasive pneumococcal disease (IPD). For prevention of IPD, the National Advisory Committee on Immunization (NACI) has recommended the 23-valent polysaccharide pneumococcal vaccine, PNEU-P-23, for adults 65 years of age and older and adults over 18 years of age living with certain underlying conditions. NACI has also recommended 13-valent conjugate pneumococcal vaccine, PNEU-C-13, for adults; however, in publicly funded programs, this recommendation is limited to individuals with risk factors for IPD. Two new conjugate vaccines, PNEU-C-15 and PNEU-C-20, have been authorized by Health Canada for prevention of IPD in adults. This article summarizes NACI public health recommendations for pneumococcal vaccines in adults given these new conjugate vaccines that provide additional serotype coverage over PNEU-C-13.</p><p><strong>Methods: </strong>Key studies evaluating the immunogenicity and safety of PNEU-C-15 and PNEU-C-20 were reviewed. The Grading of Recommendations, Assessment, Development and Evaluations framework methodology was used to assess the certainty of evidence.</p><p><strong>Results: </strong>The PNEU-C-15 and PNEU-C-20 vaccines showed comparable immune responses, and safety profiles for all mild, moderate, and severe adverse events, to the currently used vaccines. No data were available on the efficacy or effectiveness of PNEU-C-15 or PNEU-C-20. Economic evidence and feasibility assessments supported the use of the PNEU-C-20 vaccine.</p><p><strong>Conclusion: </strong>NACI recommends PNEU-C-20 for adults 65 years of age and older, 50-64 years of age and living with factors placing them at higher risk of pneumococcal disease, and 18-49 years of age with immunocompromising conditions, with PNEU-C-15+PNEU-P-23 an alternative.</p>","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"49 23","pages":"81-86"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10715826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138815849","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":"Wastewater surveillance for earlier detection of seniors congregate living COVID-19 outbreaks in Peterborough, Ontario.","authors":"Thomas Piggott, Mohamed Kharbouch, Michael Donaldson, Carolyn Pigeau, Donna Churipuy, Gillian Pacey, Christopher Kyle","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The coronavirus disease 2019 (COVID-19) pandemic has disproportionately affected seniors living in congregate living settings. The evolving surveillance context has led to novel use of wastewater surveillance to monitor levels of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in these settings. This study presents a pilot of upstream congregate living wastewater surveillance of SARS-CoV-2 for the detection of COVID-19 outbreaks and the effects of early public health interventions. We monitored localized wastewater SARS-CoV-2 levels from four congregate living settings March 15, 2021 to October 1, 2022 and correlated these levels with suspected and confirmed COVID-19 outbreaks determined by other methods. We identified five wastewater signals that correlated with confirmed outbreaks and three wastewater signals that did not correlate with subsequent outbreaks. In the five confirmed outbreaks, the wastewater signal was detected 2-10 days (median, five days) prior to confirmation of the outbreak by case testing. This pilot demonstrates upstream sampling for SARS-CoV-2 in wastewater may effectively detect outbreaks prior to their detection through symptomatic case testing and could support a balanced approach to outbreak response in congregate living settings, leading to increased wellbeing of these residents.</p>","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"49 2-3","pages":"35-43"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10715756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138815862","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 cross-sectional investigation of HIV prevalence and risk factors among African, Caribbean and Black people in Ontario: The A/C Study.","authors":"Lawrence Mbuagbaw, Winston Husbands, Shamara Baidoobonso, Daeria Lawson, Muna Aden, Josephine Etowa, LaRon Nelson, Wangari Tharao","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The human immunodeficiency virus (HIV) epidemic has disproportionately affected African, Caribbean and Black (ACB) communities in Canada. We investigated the prevalence and factors associated with HIV infection among ACB people in Ontario.</p><p><strong>Methods: </strong>A cross-sectional survey of first- and second-generation ACB people aged 15-64 years in Toronto and Ottawa (Ontario, Canada). We collected sociodemographic information, self-reported HIV status and offered dried blood spot (DBS) testing to determine the prevalence of HIV infection. Factors associated with HIV infection were investigated using regression models.</p><p><strong>Results: </strong>A total of 1,380 people were interviewed and 834 (60.4%) tested for HIV. The HIV prevalence was 7.5% overall (95% confidence interval [CI] 7.1-8.0) and 6.6% (95% CI 6.1-7.1) in the adult population (15-49 years). Higher age (adjusted odds ratio [aOR] 2.8; 95% CI 2.77-2.82), birth outside of Canada (aOR 4.7; 95% CI 1.50-14.71), French language (aOR 9.83; 95% CI 5.19-18.61), unemployment (aOR 1.85; 95% CI 1.62-2.11), part-time employment (aOR 4.64; 95% CI 4.32-4.99), substance use during sex (aOR 1.66; 95% CI 1.47-1.88) and homosexual (aOR 19.68; 95% CI 7.64-50.71) and bisexual orientation (aOR 2.82; 95% CI 1.19-6.65) were associated with a positive HIV test. Those with a high school (aOR 0.01; 95% CI 0.01-0.02), college (aOR 0.00; 95% CI 0.00-0.01) or university education (aOR 0.00; 95% CI 0.00-0.01), more adequate housing (aOR 0.85; 95% CI 0.82-0.88), a higher social capital score (aOR 0.61; 95% CI 0.49-0.74) and a history of sexually transmitted infections (aOR 0.40; 95% CI 0.18-0.91) were less likely to have a positive HIV test.</p><p><strong>Conclusion: </strong>Human immunodeficiency virus infection is linked to sociodemographic, socioeconomic, and behavioural factors among ACB people in Ontario.</p>","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"48 10","pages":"429-437"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10730175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833861","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 laboratory exposures to human pathogens and toxins, Canada, 2021.","authors":"Emily R Thompson, Maryem El Jaouhari, Nadine Eltayeb, Christine Abalos, Megan Striha, Rojiemiahd Edjoc, Collins Ayoo, Samuel Bonti-Ankomah","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The Laboratory Incident Notification Canada surveillance system monitors laboratory incidents that are mandated to be reported under the <i>Human Pathogens and Toxins Act</i> and the <i>Human Pathogens and Toxins Regulations</i>. This article describes laboratory exposure incidents that occurred in Canada in 2021 and individuals affected in these incidents.</p><p><strong>Methods: </strong>We extracted all laboratory incidents occurring in licensed Canadian laboratories in 2021 from the Laboratory Incident Notification Canada system and analyzed them using the software R. We calculated the rate of exposure incidents and performed descriptive statistics by sector, root cause, activity, occurrence type and type of pathogen/toxin. Analysis of the education level, route of exposure, sector, role and laboratory experience of the affected persons was also conducted. We conducted seasonality analysis to compare the median monthly occurrence of exposure incidents between 2016 and 2020 to monthly incidents in 2021.</p><p><strong>Results: </strong>Forty-three exposure incidents involving 72 individuals were reported to Laboratory Incident Notification Canada in 2021. There were two confirmed laboratory-acquired infections and one suspected infection. The annual incident exposure rate was 4.2 incidents per 100 active licenses. Most exposure incidents involved non-Security Sensitive Biological Agents (n=38; 86.4%) and human risk group 2 (RG2) pathogens (n=27; 61.4%), with bacteria (n=20; 45.5%) and viruses (n=16; 36.4%) as the most implicated agent types. Microbiology was the most common activity associated with these incidents (n=18; 41.9%) and most incidents were reported by the academic sector (n=20; 46.5%). Sharps-related (n=12; 22.2%) incidents were the most common, while human interaction (e.g. workload constraints/pressures/demands, human error) (n=29, 28.2%) was the most common root cause. Most affected individuals were exposed through inhalation (n=38; 52.8%) and worked as technicians or technologists (n=51; 70.8%). Seasonality analyses revealed that the number of exposure incidents reported in 2021 were highest in September and May.</p><p><strong>Conclusion: </strong>The rate of laboratory incidents was slightly lower in 2021 than in 2020. The most common occurrence type was sharps-related while issues with human interaction was the most cited root cause.</p>","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"48 10","pages":"484-491"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10730106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833882","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":"Modelling COVID-19 transmission using IDSIM, an epidemiological-modelling desktop app with multi-level immunization capabilities.","authors":"Eleodor Nichita, Mary-Anne Pietrusiak, Fangli Xie, Peter Schwanke, Anjali Pandya","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong><b>:</b> The coronavirus disease 2019 (COVID-19) pandemic has placed unprecedented demands on local public health units in Ontario, Canada, one of which was the need for in-house epidemiological modelling capabilities. The objective of this study is to develop a native Windows desktop app for epidemiological modelling, to be used by public health unit epidemiologists to predict COVID-19 transmission in Durham Region.</p><p><strong>Methods: </strong><b>:</b> The developed app is an implementation of a multi-stratified compartmental epidemiological model that can accommodate multiple virus variants and levels of vaccination, as well as public health measures such as physical distancing, contact tracing followed by quarantine and testing followed by isolation. It was used to investigate the effects of different factors on COVID-19 transmission, including vaccination coverage, vaccine effectiveness, waning of vaccine-induced immunity and the advent of the Omicron variant. The simulation start date was November 22, 2021.</p><p><strong>Results: </strong><b>:</b> For the Delta variant, at least 90% of the population would need to be vaccinated to achieve herd immunity. A Delta-variant-only epidemiological curve would be flattened from the start in the absence of immunity waning and within six months in the presence of immunity waning. The percentage of infections caused by the Omicron variant was forecast to increase from 1% to 97% in the first month of the simulation. Total Omicron infections were forecasted to be reduced, respectively, by 26% or 41% if 3,000 or 5,000 booster doses were administered per day.</p><p><strong>Conclusion: </strong><b>:</b> For the Delta variant, both natural and vaccination-induced immunity are necessary to achieve herd immunity, and waning of vaccine-induced immunity lengthens the time necessary to reach herd immunity. In the absence of additional public health measures, a wave driven by the Omicron variant was predicted to pose significant public health challenges with infections predicted to peak in 2-3 months from the start of the simulation, depending on the rate of administration of booster doses.</p>","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"48 10","pages":"449-464"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10732479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833862","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":"Vaccination of children in marginalized neighbourhoods: Equity and diversity challenges with COVID-19 vaccination campaigns.","authors":"Cécile Rousseau, Caroline Quach, Ève Dubé, Anabelle Vanier-Clément, Tara Santavicca, Laurence Monnais-Rousselots","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The coronavirus disease 2019 (COVID-19) pandemic has exacerbated social inequities along ethnic, racial and socio-economic lines, with significant harmful consequences for children. Building on the lessons learned from community-based initiatives, this commentary proposes a reflection around equity, diversity, and inclusion challenges embedded in child vaccination campaigns during an emergency context. We argue that building equitable and inclusive practices around marginalized communities' child vaccination is a multifaceted challenge. Beyond good intentions-wanting to protect children-the risks and benefits associated with highlighting diversity in each intervention need to be carefully considered, especially when it comes to a contested/polarizing procedure such as vaccination with a novel type of vaccine. Often, a one-size-fits-all approach negates and perpetuates structural inequities. In other cases, highlighting diversity and inequities may inadvertently increase stigma and discrimination, and further harm or infantilize targeted communities. By providing multiple perspectives, a transdisciplinary approach can support decision-making in a crisis context.</p>","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"48 10","pages":"420-423"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10730105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833883","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":"Demographic patterns of exposure and transmission for a rural Canadian community outbreak of COVID-19, 2020.","authors":"Kaitlin Patterson, Mathieu Chalifoux, Rita Gad, Shannon Leblanc, Paige Paulsen, Louise Boudreau, Theresa Mazerolle, Mariane Pâquet","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>A coronavirus disease 2019 (COVID-19) community outbreak was declared October 5-December 3, 2020, in the Restigouche region of New Brunswick, Canada. This article describes the epidemiological characteristics of the outbreak and assesses factors associated with its transmission in rural communities, informing public health measures and programming.</p><p><strong>Methods: </strong>A provincial line list was developed from case and contact interviews. Descriptive epidemiological methods were used to characterize the outbreak. Incidence rates among contacts, and by gender for the regional population were estimated.</p><p><strong>Results: </strong>There were 83 laboratory-confirmed cases of COVID-19 identified during the observation period. The case ages ranged from 10-89 years of age (median age group was 40-59 years of age) and 51.2% of the cases were male. Symptom onset dates ranged from September 27-October 27, 2020, with 83% of cases being symptomatic. A cluster of early cases at a social event led to multiple workplace outbreaks, though the majority of cases were linked to household transmission. Complex and overlapping social networks resulted in multiple exposure events and that obscured transmission pathways. The incidence rate among men was higher than women, men were significantly more likely to have transmission exposure at their workplace than women, and men were the most common index cases within a household. No transmission in school settings among children was documented despite multiple exposures.</p><p><strong>Conclusion: </strong>This investigation highlighted the gendered nature and complexity of a COVID-19 outbreak in a rural Canadian community. Targeted action at workplaces and strategic messaging towards men are likely required to increase awareness and adherence to public health measures to reduce transmission in these settings.</p>","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"48 10","pages":"465-472"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10760791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139089864","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}