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Ixodes scapularis and Ixodes pacificus are vectors of a range of pathogens of public health significance in North America. These ticks transmit pathogens to and from wild animal reservoir host species, but also bite humans and expose them to the pathogens. We describe the geographical and temporal distribution of the pathogen Babesia odocoilei, the causative agent of cervid babesiosis. Ixodes spp. ticks collected through active and passive surveillance were submitted to the National Microbiology Laboratory of the Public Health Agency of Canada for analysis of the presence of B. odocoilei from 2018 to 2021. Generalized linear models were constructed to evaluate the temporal change of B. odocoilei prevalence across Canada. Babesia odocoilei-positive I. scapularis are widespread across south-central and eastern regions of Canada, with an overall prevalence of 12.0 % in both nymphs (CI 95 % : 11.4–12.6) and adults (CI 95 % : 11.9–12.1) collected in passive surveillance and 13.2 % (CI 95 % : 12.9–13.5) and 10.0 % (CI 95 % : 9.8–10.2) in nymphs and adult, respectively, collected in active surveillance. A single I. pacificus tick tested positive in active surveillance out of 29 ticks collected in British Columbia, while no B odocoilei-positive I. scapularis were found in passive surveillance among the 11 adult ticks tested. Although B. odocoilei infection prevalence of adult I. scapularis was significantly higher in 2019 (14.1 %) than in 2018 (7.4 %), it remained stable from 2019 to 2021, suggesting that this pathogen may already be well established in endemic tick populations. The results provided in this article represent, to date, the most comprehensive picture of B. odocoilei distribution and prevalence in ticks in Canada and highlight the interest of maintaining One Health surveillance approaches to give added insight into disease transmission cycles for less well-characterized microorganisms.

Moral injuries can occur when perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations. The COVID-19 crisis highlighted the fact that psychosocial stressors at work, such as high emotional demands, are placing Canadian healthcare workers at risk of moral injuries. Evidence linking psychosocial stressors at work to moral injuries are needed to better predict, prevent and manage moral injuries, as these stressors are frequent and modifiable occupational risk factors. This protocol presents a study aiming to: 1) understand workplace events having the potential to either cause or reduce moral injuries, 2) predict the risk and severity of moral injuries using a disease prevention model, 3) identify biological signatures (biomarkers) associated with psychosocial stressors at work and moral injuries and 4) elaborate preliminary guidelines of organizational practices for frontline healthcare workers to reduce and manage moral injuries. This study is a mixed methods research with three components: qualitative, quantitative and biological. The data collection has been completed and because of the COVID-19 pandemic, it was adjusted to allow for gathering qualitative and quantitative data remotely. Frontline healthcare workers and leaders were included. Through focus groups and individual interviews, and an online questionnaire, events and psychosocial working conditions that may increase the risk of moral injuries will be documented. In addition, blood samples which were collected from a sub-sample of volunteer participants will measure an innovative set of biomarkers associated with vulnerability to stress and mental health. Data analyses are ongoing. We anticipate to identify workplace events that may trigger moral injuries. We expect that potential predictors of moral injury risk occurrence and severity will be identified from psychosocial stressors at work that can be improved by implementing organizational practices. We also expect to observe a different mental health state and biological inflammation signature across workers exposed compared to workers not exposed to psychosocial stressors at work. Based on these future findings, we intend to develop preliminary recommendations of organizational practices for managers. This research will contribute to expand our knowledge of the events in the workplace likely to generate or lessen the impact moral injuries, to build a model for predicting the risk of moral injuries at work, all in the specific context of the COVID-19 health crisis among healthcare workers.