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Background: Omicron is the current predominant variant of concern of SARS-CoV-2. We hypothesized that vaccination alters outcomes of patients hospitalized with COVID-19 during the Omicron wave and that these patients have different characteristics and outcomes than in previous waves. Methods: This is a substudy of the Host Response Mediators in Coronavirus (COVID-19) Infection (ARBs CORONA I) trial, which included adults admitted to hospital with acute COVID-19 up to July 2022 from 9 hospitals in British Columbia, Ontario and Quebec. We excluded emergency department visits without hospital admission, readmissions and admissions for another reason. Using adjusted regression analysis, we compared mortality and organ dysfunction between vaccinated (≥ 2 doses) and unvaccinated patients during the Omicron wave, as well as between all patients in the Omicron and first 3 waves of the COVID-19 pandemic. Results: During the Omicron wave, 28-day mortality was significantly lower in vaccinated (n = 19/237) than unvaccinated hospitalized patients (n = 12/127) (adjusted odds ratio [OR] 0.36, 95% confidence interval [CI] 0.15--0.89); vaccinated patients had lower risk of admission to the intensive care unit, invasive ventilation and acute respiratory distress syndrome and shorter hospital length of stay. Patients hospitalized during the Omicron wave had more comorbidities than in previous waves, and lower 28-day mortality than in waves 1 and 2 (adjusted OR 0.38, 95% CI 0.24--0.59; and 0.42, 95% CI 0.26--0.65) but not wave 3 (adjusted OR 0.81, 95% CI 0.43--1.51) and had less organ dysfunction than in the first 2 waves. Interpretation: Patients who were at least double vaccinated had lower mortality than unvaccinated patients hospitalized during the Omicron wave. Patients hospitalized during the Omicron wave had more chronic disease and lower mortality than in the first 2 waves, but not wave 3. Changes in vaccination, treatments and predominant SARS-CoV-2 variant may have decreased mortality in patients hospitalized during the Omicron wave. [ABSTRACT FROM AUTHOR]

Background: Vaccination against herpes zoster is being considered in many countries. We conducted a multi centre prospective study to describe the impact of herpes zoster and postherpetic neuralgia on health-related quality of life. Methods: From October 2005 to July 2006, 261 outpatients aged 50 years or older with herpes zoster were recruited from the clinical practices of 83 physicians within 14 days after rash onset. The Zoster Brief Pain Inventory was used to measure severity of pain and interference with activities of daily living because of pain. The EuroQol EQ-5D assessment tool was used to measure quality of life. These outcomes were assessed at recruitment and on days 7, 14, 21, 30, 60, 90, 120, 150 and 180 following recruitment. Results: Acute herpes zoster interfered in all health do - mains, especially sleep (64% of participants), enjoyment of life (58%) and general activities (53%). The median duration of pain was 32.5 days. The median duration of interference with activities of daily living because of pain varied between 27 and 30 days. Overall, 24% of the participants had postherpetic neuralgia (pain for more than 90 days after rash onset). Anxiety and depression, enjoyment of life, mood and sleep were most frequently affected during the postherpetic neuralgia period. The mean EQ-5D score was 0.59 at enrolment and remained at 0.67 at all follow-up points among participants who reported clinically significant pain. Interpretation: These data support the need for preventive strategies and additional early intervention to reduce the burden of herpes zoster and postherpetic neuralgia. [ABSTRACT FROM AUTHOR]

The article focuses on the population use of antibiotics and how antibiotic resistance can be reduced. It provides an overview of the risks associated to the use of antimicrobials that results from selective pressure. It highlights the effect of drug prescription to population and antibiotic resistance, and concludes that increased population use of antibiotics is associated to increased drug resistance. It points out that physicians can aid in the reduction of antibiotic prescription and proliferation of resistant organisms. It delineates the failures on the comprehension of population-level effects of antibiotic prescription. Tables that depict the relation between population use of antibiotic and drug resistance, as well as the impact of population level interventions are presented.

Background: Concerns have been raised that parents may be reluctant to have their daughters receive the human papillomavirus (HPV) vaccine, because of a belief that doing so might be interpreted as condoning earlier and more frequent sexual activity. We determined intentions regarding vaccination among Canadian parents and factors that predicted parental intention to have their daughters vaccinated against HPV. Methods: Parents of children 8-18 years of age, recruited from across Canada, were asked to respond to questions in the context of a grade 6, publicly funded, school-based HPV vaccine program. We performed backward logistic regression analysis to identify factors predictive of parents' intention to have their daughters vaccinated against HPV. Results: Of the 1350 respondents with female children, more than 70% (73.8%; 95% confidence interval [CI] 71.5%- 76.1%) intended to have their daughters undergo vaccination against HPV. In multivariable modelling, parents who had positive attitudes toward vaccines (odds ratio [OR] 9.9, 95% CI 4.7-21.1), those who were influenced by subjective norms (OR 9.2, 95% CI 6.6-12.9), those who felt that the vaccine had limited influence on sexual behaviour (OR 3.2, 95% CI 2.2-4.6) and those who thought someone they knew was likely to get cervical cancer (OR 1.5, 95% CI 1.1-2.1) were more likely to intend that their daughters receive the HPV vaccine. Parents who were older (v. younger) (OR 0.6, 95% CI 0.4-0.8) and those who resided in British Columbia or Yukon Territory (v. Atlantic Canada) (OR 0.5, 95% CI 0.3-0.9) were less likely to intend that their daughters receive the HPV vaccine. Interpretation: Most of the parents surveyed intended that their daughters would receive vaccination against HPV. Overall attitudes toward vaccines in general and toward the HPV vaccine in particular constituted the most significant predictor of parental intention with regard to vaccination. [ABSTRACT FROM AUTHOR]

Because of high transmissibility of HCV among those injecting frequently and using cocaine, the harm reduction initiatives deployed in Vancouver during the study period proved insufficient to eliminate hepatitis C transmission in this population. [ABSTRACT FROM AUTHOR]

Interpretation: Low rates of past HAV infection among Vancouver street youth indicate a low rate of virus circulation in this population, which is vulnerable to hepatitis A outbreaks. An increased risk for HAV infection in IDUs and MSM supports the need to develop routine vaccination programs for these groups also. [ABSTRACT FROM AUTHOR]

Presents a study that assesses the effect of British Columbia, Canada's June 1994 guidelines for prenatal HIV screening on the rate of maternal-fetal HIV transmission and estimates the cost-effectiveness of such screening.

Editorial. Discusses research which studied the appropriateness of diagnostic guidelines for chlamydial cervicitis. What cervicitis is; Research by Sellors et al in this issue; Value of tests as diagnostic tool; Discussion of table; Evaluation of Canadian guidelines for sexually transmitted diseases (STDs); Treatment for high-risk patients, and lower prevalence and low-risk patients; Guidelines from the World Health Organization (WHO).

The article looks at the reliability of serologic testing for Lyme disease. It references the study "A Comparison of Lyme Disease Serologic Test Results From 4 Laboratories in Patients with Persistent Symptoms After Antibiotic Treatment" by B. A. Fallon et al., published in the journal "Clinical Infectious Diseases" in 2014. The authors cite that the incidence and geographic range of Lyne disease are increasing in Canada. The authors recommend using standard laboratory protocols in diagnosis. [ABSTRACT FROM AUTHOR]

Several letters to the editor are presented in response to the article by François Lamontagne and colleagues on the association between receipt of pneumococcal vaccination and a lower risk of myocardial infarction.

The authors elaborate the expansion of the support of the public health team of the "Canadian Medical Association Journal" (CMAJ) for health promotion and disease prevention. They enumerated the three major foci of the public health mission of CMAJ. Emphasis on dissemination of information that has immediate application to medical practice is cited.

Details the efforts of the Canadian government to alleviate the outbreak of the severe acute respiratory syndrome in 2003. Origin of the disease outbreak; Containment measures adopted in Toronto and Vancouver; Recommendations to health officials.

Abstract COUNTRIES WITH A LOW RISK OF HEPATITIS B (HB) lack data on the effectiveness of universal HB vaccination programs for children. British Columbia began a program in 1992, offering HB vaccination to 11 year olds. We conducted an anonymous, unlinked serologic survey 7 years later, analyzing a random sample of specimens (n = 1215) from women aged 15–44 years who had undergone antenatal rubella testing. Among those aged 15–19 years inclusive there was no evidence of chronic HB (HB surface antigen), the proportion with evidence of acute HB (anti-HB core antibody) was only 0.6% (compared with 6.5% for the entire sample), and evidence of protective immunity was strong: the prevalence of anti-HB surface antibody (anti-HBs) was 79.1% (compared with 41.4% for the entire sample) and the geometric mean titre was 34.9 IU/mL (compared with 0.6–0.8 IU/mL for the older groups [p < 0.001]). [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to an article about Lyme disease and the alternative approaches to its diagnosis, which appeared in the previous issue of the magazine.

Editorial. Discusses prenatal HIV testing. Speed of the implementation of prenatal screening; Cost-effectiveness of prenatal HIV testing; Option of only testing high-risk women; Potential obstacles of implementing HIV testing programs.

Presents several recommendations for HIV postexposure prophylaxis for health care workers. Prophylaxis with zidovudine (AZT); Percentage of risk reduced with the prophylaxis; Recommended dosage; Need for appropriate counselling for the exposed worker.