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1 Au Canada, on considere que la rougeole est eradiquee depuis 1998, mais le pays reste vulnerable aux eclosions La multiplication des cas de rougeole a travers le monde accentue [...]

1 Canada has had measles elimination status since 1998 but remains vulnerable to outbreaks Increased measles activity globally raises the risk of travel-related cases in Canada, which can spread rapidly [...]

CONTEXTE : La demande sans precedent de respirateurs N95 durant la pandemie de maladie a coronavirus 2019 (COVID-19) a entraTne une penurie mondiale. Nous avons valide un protocole de decontamination rapide et economique repondant aux normes reglementaires afin de permettre la reutilisation sure de ce type de masque. METHODES : Nous avons contamine 4 modeles courants de respirateurs N95 avec le coronavirus du syndrome respiratoire aigu severe 2 (SRAS-CoV-2) et avons evalue l'inactivation virale apres une desinfection de 60 minutes a 70 [degrees]C et a une humidite relative de 0 %. De meme, nous avons etudie l'efficacite de la desinfection thermique, a une humidite relative allant de 0 %o a 70 %o, de masques contamines a Escherichia coli. Enfin, nous avons examine des masques soumis a de multiples cycles de desinfection thermique : nous avons evalue leur integrite structurelle a l'aide d'un microscope a balayage, et leurs proprietes protectrices au moyen des normes du National Institute for Occupational Safety and Health des Etats-Unis relatives a la filtration particulaire, a la resistance respiratoire et a l'ajustement. RESULTATS : Une seule desinfection thermique a suffi pour que le SRASCoV-2 ne soit plus decelable sur les masques etudies. En ce qui concerne les masques contamines a E. coli, une culture de 24 heures a revele que la bacterie n'etait pratiquement plus decelable sur les masques desinfectes a 70 [degrees]C et a une humidite relative de 50 %o, contrairement aux masques non desinfectes (densite optique a une longueur d'onde de 600 nm : 0,02 [+ or -] 0,02 contre 2,77 [+ or -] 0,09; p < 0,001), mais qu'elle persistait sur les masques traites a une humidite relative moindre. Les masques ayant subi 10 cycles de desinfection avaient toujours des fibres de diametre semblable a celui des fibres des masques non traites, et ils repondaient encore aux normes d'ajustement, de filtration et de resistance respiratoire. INTERPRETATION : La desinfection thermique a reussi a decontaminer les respirateurs N95 sans compromettre leur integrite structurelle ni modifier leurs proprietes. Elle pourrait se faire dans les hopitaux et les etablissements de soins de longue duree avec de l'equipement facilement accessible, ce qui reduirait la penurie de N95., La pandemie de maladie a coronavirus 2019 (COVID-19) a pris d'assaut de nombreux systemes de sante dans le monde. En meme temps, la demande sans precedent d'equipement de protection individuelle [...]

BACKGROUND: Unprecedented demand for N95 respirators during the coronavirus disease 2019 (COVID-19) pandemic has led to a global shortage of these masks. We validated a rapidly applicable, low-cost decontamination protocol in compliance with regulatory standards to enable the safe reuse of N95 respirators. METHODS: We inoculated 4 common models of N95 respirators with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and evaluated viral inactivation after disinfection for 60 minutes at 70[degrees]C and 0% relative humidity. Similarly, we evaluated thermal disinfection at 0% to 70% relative humidity for masks inoculated with Escherichia coli. We assessed masks subjected to multiple cycles of thermal disinfection for structural integrity using scanning electron microscopy and for protective functions using standards of the United States National Institute for Occupational Safety and Health for particle filtration efficiency, breathing resistance and respirator fit. RESULTS: A single heat treatment rendered SARS-CoV-2 undetectable in all mask samples. Compared with untreated inoculated control masks, E. coli cultures at 24 hours were virtually undetectable from masks treated at 70 [degrees]C and 50% relative humidity (optical density at 600 nm wavelength, 0.02 [+ or -] 0.02 v. 2.77 [+ or -] 0.09, p < 0.001), but contamination persisted for masks treated at lower relative humidity. After 10 disinfection cycles, masks maintained fibre diameters similar to untreated masks and continued to meet standards for fit, filtration efficiency and breathing resistance. INTERPRETATION: Thermal disinfection successfully decontaminated N95 respirators without impairing structural integrity or function. This process could be used in hospitals and long-term care facilities with commonly available equipment to mitigate the depletion of N95 masks., As the coronavirus disease 2019 (COVID-19) pandemic has overwhelmed many health care systems worldwide, the unprecedented demand for personal protective equipment (PPE) has exhausted stockpiles and interrupted global supply chains [...]

1 Des agences de sante publique a l'echelle de la planete se sont dites preoccupees des nombreux cas d'hepatite aigue grave d'etiologie inconnue chez les enfants En date du 8 [...]

BACKGROUND: Health care-associated infections are a common cause of patient morbidity and mortality. We sought to describe the trends in these infections in acute care hospitals, using data from 3 national point-prevalence surveys. METHODS: The Canadian Nosocomial Infection Surveillance Program (CNISP) conducted descriptive point-prevalence surveys to assess the burden of health care-associated infections on a single day in February of 2002, 2009 and 2017. Surveyed infections included urinary tract infection, pneumonia, Clostridioides difficile infection, infection at surgical sites and bloodstream infections. We compared the prevalence of infection across the survey years and considered the contribution of antimicrobial-resistant organisms as a cause of these infections. RESULTS: We surveyed 28 of 33 (response rate 84.8%) CNISP hospitals (6747 patients) in 2002, 39 of 55 (response rate 71.0%) hospitals (8902 patients) in 2009 and 47 of 66 (response rate 71.2%) hospitals (9929 patients) in 2017. The prevalence of patients with at least 1 health care-associated infection increased from 9.9% in 2002 (95% confidence interval [CI] 8.4%-11.5%) to 11.3% in 2009 (95% CI 9.4%-13.5%), and then declined to 7.9% in 2017 (95% CI 6.8% 9.0%). In 2017, device-associated infections accounted for 35.6% of all health care-associated infections. Methicillin-resistant Staphylococcus aureus (MRSA) accounted for 3.9% of all organisms identified from 2002 to 2017; other antibiotic-resistant organisms were uncommon causes of infection for all survey years. INTERPRETATION: In CNISP hospitals, there was a decline in the prevalence of health care-associated infection in 2017 compared with previous surveys. However, strategies to prevent infections associated with medical devices should be developed. Apart from MRSA, few infections were caused by antibiotic-resistant organisms., Health care-associated infections represent substantial burden on health care systems in highly developed countries, including Canada. (1-3) In 2002, health care-associated infection developed in an estimated 5% of patients admitted [...]

BACKGROUND: The clinical and molecular epidemiology of health care-associated Clostridium difficile infection in nonepidemic settings across Canada has evolved since the first report of the virulent North American pulsed-field gel electrophoresis type 1 (NAP1) strain more than 15 years ago. The objective of this national, multicentre study was to describe the evolving epidemiology and molecular characteristics of health care-associated C. difficile infection in Canada during a post-NAP1epidemic period, particularly patient outcomes associated with the NAP1 strain. METHODS: Adult inpatients with C. difficile infection were prospectively identified, using a standard definition, between 2009 and 2015 through the Canadian Nosocomial Infection Surveillance Program (CNISP), a network of 64 acute care hospitals. Patient demographic characteristics, severity of infection and outcomes were reviewed. Molecular testing was performed on isolates, and strain types were analyzed against outcomes and epidemiologic trends. RESULTS: Over a 7-year period, 20 623 adult patients admitted to hospital with health care-associated C. difficile infection were reported to CNISP, and microbiological data were available for 2690 patients. From 2009 to 2015, the national rate of health care-associated C. difficile infection decreased from 5.9 to 4.3 per 10000 patient-days. NAP1 remained the dominant strain type, but infection with this strain has significantly decreased over time, followed by an increasing trend of infection with NAP4 and NAP11 strains. The NAP1 strain was significantly associated with a higher rate of death attributable to C. difficile infection com pared with non-NAP1 strains (odds ratio 1.91, 95% confidence interval [CI] 1.292.82). Isolates were universally susceptible to metronidazole; one was nonsusceptible to vancomycin. The proportion of NAP1 strains within individual centres predicted their rates of health careassociated C. difficile infection; for every 10% increase in the proportion of NAP1 strains, the rate of health care-associated C. difficile infection increased by 3.3% (95% CI 1.7%-4.9%). INTERPRETATION: Rates of health care-associated C. difficile infection have decreased across Canada. In nonepidemic settings, NAP4 has emerged as a common strain type, but NAP1, although decreasing, continues to be the predominant circulating strain and remains significantly associated with higher attributable mortality., Clostridium difficile infection is the most common infectious cause of health care-associated diarrhea among hospital-admitted patients in developed countries and can lead to substantial morbidity and mortality. (1,2) In 2002, [...]