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The CMA wants to work with national health care groups, such as the Canadian Nurses Association (CNA), to explore ways providers can work collaboratively to provide quality health care. A joint working group of the CMA and the CNA recently examined collaborative care, focusing on examples provided in HIV/AIDS care. The group developed principles to help people work collaboratively in a variety of settings.

To determine the source and extent of an outbreak of Vibrio cholerae O139 Bengal infections among 630 cruise ship passengers to Southeast Asia, a retrospective cohort study was done. Questionnaires were sent to all passengers from the United States, Canada, and the United Kingdom, and serum samples were requested from all passengers reporting diarrhea. A case was defined as diarrheal illness with onset between 8 and 28 February 1994 and a cholera antitoxic antibody titer > or = 800. Six passengers, including 1 with bacteremia, met the case definition. Illness was associated with eating yellow rice at a buffet restaurant in Bangkok on 10 February (relative risk undefined, P = .005). This international outbreak demonstrates foodborne transmission of Vibrio cholerae O139 Bengal, an emerging cause of epidemic cholera in Asia, to tourists from Western countries. Physicians should suspect infection with either V. cholerae O1 or O139 in any patient with severe watery diarrhea after travel to the developing world.

An expert on United Kingdom fertilisation and embryology law comments here on recent Canadian proposals, a summary of which appears on pp 8-11.