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1 Health Santé Provincial Health Programs Programmes de santé provinciaux Public Health Branch Direction de la santé publique Communicable Disease Control Unit Prévention des maladies transmissibles Fourth Floor, 300 Carlton Street 300, rue Carlton, 4 e étage Winnipeg MB R3B 3M9 Winnipeg MB R3B 3M9 CANADA CANADA Telephone: (04) Téléphone: (04) Fax: (04) Télécopieur: (04) Dear Colleague, Please find attached a copy of Summary of Communicable Diseases for the Month of December 006 for your review. This report reflects the number of reportable communicable diseases for which individuals in Manitoba tested positive* during the month of December 006. The December monthly report is of particular interest as it also reflects a complete calendar year s worth of activity for reportable communicable diseases compared to the previous calendar year. Communicable Diseases In total, there were 35 new infections occurring across 7 communicable diseases** (excluding sexually transmitted infections and HIV) in December 006. The observed number of cases was within the expected ranged for most of the reported communicable diseases, with the exception of BAC Meningitis Haemophilus (observed case; expect 0 cases), Brucellosis (observed case; expect 0 cases), E. coli verotoxigenic (observed 0 cases; expect 0-8 cases), Herpes with unspecified complications (observed case, expect 0 cases), Methicillin Resistant Staphylococcus Aureus (MRSA; 3 cases observed; expected range = 0-98 cases) and Mumps (observed cases; expect 0- cases). The expected number of cases and accompanying range is based on the number of reported cases during November and December and January Comparing 006 year-end totals with those in 005, the Communicable Disease Control Unit witnessed a 3% increase in the overall number of reportable communicable diseases. 006 witness two main outbreaks, both leading to significant increases in reported cases: a summer outbreak of verotoxin producing E. coli resulted in more than a four-fold increase between 005 and 006, and a winter outbreak of Pneumococcal Septicemia saw cases increase by more than 60% from the previous year. Methicillin Resistant Staphylococcus Aureus (MRSA) cases, which make up about one-third of non-sti/hiv related reportable diseases also rose by 9% between 005 and 006. Other diseases showing increases from 005 to 006 include Necrotising Fasciitis (more than doubled), Malaria (70%), and Giardia lamblia (4%). Decreases between 005 and 006 were also observed. Most notably, cases of Pertussis and Vancomycin Resistant Enterococci each dropped by about one-third in 006. Other decreases from 005 include Viral
2 Meningitis Entero (a third fewer cases), Viral Meningitis Echo Virus (a third fewer cases), Tuberculosis (8% decrease), and West Nile Virus (% drop). Sexually Transmitted Infections & Blood-Borne Pathogens There were 370 cases of sexually transmitted infections (chlamydia, gonorrhoea, and syphilis) in December: 59 cases of chlamydia (Ct), 75 cases of gonorrhoea (GC), 3 GC-Ct co-infections, and 5 cases of syphilis. About 63% of all GC and Ct cases in the province were reported in youth between the ages of 5 and 4 years. More than half of GC and Ct cases in December were reported for individuals from the Winnipeg health region, and an additional 9% were from the Burntwood health region. All, but one, cases of Syphilis were reported from Winnipeg health region. The total number of chlamydia infections for 006 was 433; reflecting a 9% increase from 005. Gonorrhoea cases however rose by 35% in 006 compared to 005, reflecting 405 additional infections (575 cases in 006; 7 cases in 005). In December individuals tested positive for hepatitis C (HCV), about half of which were reported from the Winnipeg region. Two-thirds of new HCV cases in December were accounted for by individuals in the year age group. The number of Manitobans who tested positive for hepatitis C in 006 compared to 005 decreased by 3% (35 cases compared to 4 in 005). Seven new cases of HIV were reported in December, bringing the year-to-date total to 83 new cases. After a couple of years of steadily increasing rates, the number of newly reported HIV infections observed a 8% decrease in 006 form 005. Outbreak Summary Reports of suspected or confirmed outbreaks are directed to the CDC Unit by: (a) a phone call/ from public health staff within a RHA; (b) a phone call/ from Cadham Provincial Laboratory advising of the assignment of an outbreak code; or (c) completion and submission of an outbreak form In 006, 44 outbreaks were reported to the Communicable Disease Control Unit; 98 of which occurred among residents of a personal care home. About 70% of the reported outbreaks were for gastrointestinal symptoms, while one quarter of the reported outbreaks (4%) were for respiratory symptoms. An infectious agent was confirmed in a little less than half of all outbreaks (45%) in 006. Of the 44 reported outbreaks: - 5% were lab confirmed as Small Round Enteric Virus - 7% Influenza A - 5% Scabies - % each Clostridium Difficile and verotoxin producing E. coli Please feel free to contact the Communicable Disease Control Unit Epidemiologist should you have any questions about the content of this summary at Suresh.Khatkar@gov.mb.ca Cheers, Dr. Suresh Khatkar Epidemiologist, Communicable Diseases
3 *Note: Data for the monthly summary are aggregated based on the earliest of: symptom onset date, specimen collection date, or report date. For the majority of cases, the date used will be the specimen collection date. **Note: The following communicable diseases are reportable to the Director of Communicable Disease Control for surveillance purposes, and are not reported out for public health follow-up: ascariasis (ICD9: 7.0) blastomycosis (ICD9: 6.0) clostridium difficile (ICD9: 558.) haemophilus influenzae, non-b (ICD9: 04.59) influenza A (ICD9: 487.A) influenza B (ICD9: 487.B) leishmaniasis unspecified (ICD9: 085.9) methicillin or vancomycin resistant staphylococcus aureus (MRSA/VRSA) penicillin-resistant streptococcus pneumoniae (ICD9: 48.9) schistosomiasis (ICD9: 0) streptococcus pneumoniae other site (ICD9: 04.) strongyloides (ICD9: 7.) tuberculosis (ICD9: 03, 0, 00 cases and contacts of tuberculosis are managed by the Provincial Tuberculosis Control Programme located at the Health Sciences Centre) vancomycin resistant enterococci (VRE)
4 SUMMARY OF COMMUNICABLE DISEASE FOR December 006 MONTHLY TOTAL YEAR-TO-DATE ICD9 DISEASE/INFECTION Expected* Ex. Range** AMEBIASIS ANTHRAX 7.0 ASCARIASIS B. CEREUS BAC. MENINGITIS - E.COL 30.0 BAC. MENINGITIS - HAEM 30.9 BAC. MENINGITIS - OTHER BAC. MENINGITIS - PNEUM BAC. MENINGITIS - STAPH BAC. MENINGITIS - STREP BAC.MENINGITIS-LISTERIA 6.0 BLASTOMYCOSIS BOTULISM 03 BRUCELLOSIS 005. C. PERFRINGENS CAMPYLOBACTER CLOSTRIDIUM DIFFICILE CREUTZFELD-JACOB DISEASE CRYPTOSPORIDIOSIS DENGUE FEVER DENGUE HEMORRHAGIC FEVER V0.4 DIPH.CARRIERS DIPHTHERIA CASES 3.4 DIPHYLLOBOTHRIUM SPP E. COLI-VEROTOXIGENIC ENCEPHALITIS FOOD POISONING OTHER GIARDIA LAMBLIA H.I.B.-NON MTGS HAEM. INFLUENZAE (non-b) HANTA VIRUS 83. HEMOLYTIC UREMIC SYNDROME 070. HEPATITIS A HEPATITIS B HEPATITIS C HERPES-W-UNSPEC COMPL A INFLUENZA A 487.B INFLUENZA B A83.0 JAPANESE ENCEPHALITIS LEGIONELLA LEISHMANIASIS LEPROSY 07.0 LISTERIA MONOCYTOGENES LYME DISEASE MALARIA MEASLES MENINGOCOCCAL CSF MENINGOCOCCAL ARTHROPATH 036. MENINGOCOCCEMIA BLOOD B95.6 MRSA MUMPS N.MENINGITIDIS OTHER NECROTIZING FASCIITIS NECROTIZING MYOSITIS 33.9 OTHER ENCEPHALITIS PARAPERTUSSIS * Mean of 5 month totals, from previous, comparable and subsequent months for the past 5 years ** Mean +/- standard deviations of mean Data collected for less than 5 years. CDC Surveillance Unit, Public Health Branch, Manitoba Health Monday, February 9, 007 Page
5 MONTHLY TOTAL YEAR-TO-DATE ICD9 DISEASE/INFECTION Expected* Ex. Range** PARATYPHOID 07. PASTEURELLA MULTOCIDA PERTUSSIS PNEUM. SEPTICEMIA PSITTACOSIS Q FEVER 33.8 REYE'S SYNDROME 39 RHEUMATIC FEVER RUBELLA 77.0 RUBELLA CONGENTIAL 04. S.PNEUM.OTHER SALMONELLA SCHISTOSOMIASIS SHIGELLOSIS SMALLPOX STAPHYLOCOCCAL STAPHYLOCOCCUS AUREUS STREP PNEUMONIA - PR STREP.PNEUM.ARTHRITIS STREPT GLOMERULONEPHRITIS STREPT TOXIC SHOCK STREPTOCOCCUS PNEUMONIAE STRONGYLOIDES TETANUS 30.9 TOXOPLASMOSIS TRICHINOSIS TRYPANOSOMA CRUZI 03 TUBERCULOSIS - NON-RESP TUBERCULOSIS - RESP TUBERCULOSIS-PRIM TULAREMIA TYPHOID 08.9 TYPHUS B96.8 VANCOMYCIN R. ENTEROCOCCI VIBRIO PARAHAEMOLYTICUS VIRAL HEP. OTHER VIRAL MENINGITIS-COXSACK VIRAL MENINGITIS-ECHO VIRAL MENINGITIS-ENTERO VIRAL MENINGITIS-H SIMP VIRAL MENINGITIS-UNSPEC 0 0- B95.7 VRSA 06. W. EQUINE ENCEPHALITIS 96 WNV ASYMPTOMATIC INFECTION 3 98 WNV NEUROLOGICAL SYNDROME WNV NON-NEUROLOGICAL SYND WNV UNCLASSIFIED YERSINIA ENTEROCOLITICA * Mean of 5 month totals, from previous, comparable and subsequent months for the past 5 years ** Mean +/- standard deviations of mean Data collected for less than 5 years. CDC Surveillance Unit, Public Health Branch, Manitoba Health Monday, February 9, 007 Page
6 SUMMARY OF COMMUNICABLE DISEASE BY AGE AND GENDER FOR December 006 < Missing Total ICD9 Disease Name F M F M F M F M F M F M F M F M F M F M F M F M F M age/gendr AMEBIASIS 30.0 BAC. MENINGITIS - HAEM B 30. BAC. MENINGITIS - PNEUM 6.0 BLASTOMYCOSIS 3 03 BRUCELLOSIS CAMPYLOBACTER CLOSTRIDIUM DIFFICILE E.COLI FOOD POISONING OTHER 007. GIARDIA LAMBLIA HEPATITIS B HEPATITIS C HERPES-W-UNSPEC COMPL 487.A INFLUENZA A B95.6 MRSA MUMPS NECROTIZING FASCIITIS NEISSERIA MGTS(0ther) SALMONELLA 8 0 SCHISTOSOMIASIS STAPHYLOCOCCUS AUREUS 038. STREP.PNEUMOCOCCAL SEPTIC STREPTOCOCCAL SEPTICEMIA 03 TUBERCULOSIS - NON-RESP. 0 TUBERCULOSIS - RESP TUBERCULOSIS-PRIM. CDC Surveillance Unit, Public Health Branch, Manitoba Health Monday, February 9, 007 Page
7 < Missing Total ICD9 Disease Name F M F M F M F M F M F M F M F M F M F M F M F M F M age/gendr B96.8 VANCOMYCIN RES. ENTER VIRAL MENINGITIS-COXSACK 96 WNV Asymptomatic Infectio 98 WNV Neurological Syndrome WNV Non-Neurological Synd CDC Surveillance Unit, Public Health Branch, Manitoba Health Monday, February 9, 007 Page
8 SUMMARY OF COMMUNICABLE DISEASE BY REGION (RHA) FOR December 006 ICD9 Disease/Infection Winnipeg Brandon N.Eastman S.Eastman Interlake Central Assiniboine Parkland Norman Burntwood Churchill OOP Missing TOTAL Case Referred to:* F P F P F P F P F P F P F P F P AMEBIASIS 30.0 BAC. MENINGITIS - HAEM B 30. BAC. MENINGITIS - PNEUM 6.0 BLASTOMYCOSIS 3 03 BRUCELLOSIS CAMPYLOBACTER CLOSTRIDIUM DIFFICILE E.COLI FOOD POISONING OTHER 007. GIARDIA LAMBLIA HEPATITIS B HEPATITIS C HERPES-W-UNSPEC COMPL 487.A INFLUENZA A B95.6 MRSA MUMPS NECROTIZING FASCIITIS NEISSERIA MGTS(0ther) SALMONELLA SCHISTOSOMIASIS STAPHYLOCOCCUS AUREUS 038. STREP.PNEUMOCOCCAL SE PTIC STREPTOCOCCAL SEPTICEM IA TUBERCULOSIS - NON-RESP. 0 TUBERCULOSIS - RESP TUBERCULOSIS-PRIM. B96.8 VANCOMYCIN RES. ENTER VIRAL MENINGITIS-COXSACK 96 WNV Asymptomatic Infectio 98 WNV Neurological Syndrome * F=Federal Jurisdiction (includes First Nations and Inuit Health Branch and Stony Mountain Penitentiary) P=Provincial Jurisdiction Page 3 CDC Surveillance Unit, Public Health Branch, Manitoba Health Monday, February 9, 007
9 ICD9 Disease/Infection Winnipeg Brandon N.Eastman S.Eastman Interlake Central Assiniboine Parkland Norman Burntwood Churchill OOP Missing TOTAL Case Referred to:* F P F P F P F P F P F P F P F P 97 WNV Non-Neurological Synd Missing Investigation Forms (Jan. to end of November) * F=Federal Jurisdiction (includes First Nations and Inuit Health Branch and Stony Mountain Penitentiary) P=Provincial Jurisdiction Page 3 CDC Surveillance Unit, Public Health Branch, Manitoba Health Monday, February 9, 007
10 STD Infection Summary Report - December 006 MONTHLY TOTAL YEAR-TO-DATE DISEASE/INFECTION All Chlamydia Infections All Gonorrhea Infections (including PRNG) All Syphilis Infections Gonorrhea & Chlamydia Co-infections Penicillin Resistant Gonorrhea Infections (PRNG) Suspect PRNG HIV Total Number of STD Cases by Age and Gender - December 006 < Missing Total Disease Name F M F M F M F M F M F M F M F M F M F M F M F M F M age/gendr Chlamydia Only Cases Gonorrhea Only Cases Syphilis Only Cases 5 GC and CT Cases HIV 3 7 Regional STD Distribution - December 006 Disease/Infection Winnipeg Brandon N.Eastman S.Eastman Interlake Central Assiniboine Parkland Norman Burntwood Churchill OOP Missing TOTAL Case Referred to:* F P F P F P F P F P F P F P F P All Chlamydia Infections All Gonorrhea Infections All Syphilis Infections 4 5 GC and CT Infections CDC Surveillance Unit, Public Health Branch, Manitoba Health Monday, February 9, 007 Page 4
11 Missing Investigation Forms (Jan. to end of November) * F=Federal Jurisdiction (includes First Nations and Inuit Health Branch and Stony Mountain Penitentiary) P=Provincial Jurisdiction CDC Surveillance Unit, Public Health Branch, Manitoba Health Monday, February 9, 007 Page 4
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Health Santé Healthy Living Division and Health Programs Division de la vie saine et des programmes de santé Public Health Branch Direction de la santé publique Communicable Disease Control Unit Prévention
More informationTelephone: (204) Téléphone: (204) Fax: (204) Télécopieur: (204)
Health Santé Provincial Health Programs Programmes de santé provinciaux Public Health Branch Direction de la santé publique Communicable Disease Control Unit Prévention des maladies transmissibles Fourth
More informationTelephone: (204) Téléphone: (204) Fax: (204) Télécopieur: (204)
Health Santé Provincial Health Programs Programmes de santé provinciaux Public Health Branch Direction de la santé publique Communicable Disease Control Unit Prévention des maladies transmissibles Fourth
More informationTelephone: (204) Téléphone: (204) Fax: (204) Télécopieur: (204)
Health Santé Provincial Health Programs Programmes de santé provinciaux Public Health Branch Direction de la santé publique Communicable Disease Control Unit Prévention des maladies transmissibles Fourth
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Health Santé Health and Healthy Living Santé et Vie saine Public Health Division Division de la santé publique Communicable Disease Control Unit Prévention des maladies transmissibles Fourth Floor, 300
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Health Santé Health and Healthy Living Santé et Vie saine Public Health Division Division de la santé publique Communicable Disease Control Branch Prévention des maladies transmissibles Fourth Floor, 300
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Health Santé Health and Healthy Living Santé et Vie saine Public Health Division Division de la santé publique Communicable Disease Control Branch Prévention des maladies transmissibles Fourth Floor, 300
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Health Santé Health and Healthy Living Santé et Vie saine Public Health Division Division de la santé publique Communicable Disease Control Branch Prévention des maladies transmissibles Fourth Floor, 300
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Health Santé Health and Healthy Living Santé et Vie saine Public Health Division Division de la santé publique Communicable Disease Control Branch Prévention des maladies transmissibles Fourth Floor, 300
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Health Santé Health and Healthy Living Santé et Vie saine Public Health Division Division de la santé publique Communicable Disease Control Branch Prévention des maladies transmissibles Fourth Floor, 300
More informationTelephone: Téléphone : Fax: Télécopieur :
Health Santé Health and Healthy Living Santé et Vie saine Public Health Division Division de la santé publique Communicable Disease Control Branch Prévention des maladies transmissibles Fourth Floor, 300
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Health Santé Health and Healthy Living Santé et Vie saine Public Health Division Division de la santé publique Communicable Disease Control Branch Prévention des maladies transmissibles Fourth Floor, 300
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