Canadian Christmas dinner volunteer had hepatitis A

It’s mid January, and Canadian health types are now declaring that an Alberta Health Services volunteer at a Christmas dinner was infectious with hepatitis A.

hep.aThe government says guests who attended the Wetaskiwin Mission Church dinner on Dec. 20 may have been exposed to the virus.

Officials say the risk to the public is low, but advise anyone who attended the dinner to monitor themselves and family for symptoms until Feb. 7.

50% of chicken breast Campy positive, irrigation water source of dangerous E. coli: FoodNet Canada 2014 short report

FoodNet Canada tracks illnesses of the gut, commonly known as food poisoning, in Canadians, and traces them back to their sources, such as food, water and animals. These data are analyzed to help determine which sources are causing the most illness among Canadians and help us track illnesses and their causes over time.

smallIn the 2014 surveillance year, FoodNet Canada was active in three sites (partially or throughout the entire year) in Ontario, British Columbia and Alberta. In each location, or “sentinel site,” enhanced human disease surveillance is performed in parallel with active surveillance for specific bacteria, viruses and parasites in the possible sources to which the ill may have been exposed.

The purpose of this report is to present the preliminary findings from the 2014 surveillance year in the sentinel sites. This report will be followed by a comprehensive annual report which will include more extensive analyses of temporal trends and subtyping information for an integrated perspective on enteric disease from exposure to illness.

With the expansion to three sites in 2014, FoodNet Canada is able to provide more valuable information on enteric disease in Canada. This information on enteric disease continues to be essential to the development of robust food and water safety policies in Canada.

  • In 2014, Campylobacterand Salmonella remained the most common causes of human enteric illness in the sentinel sites.
  • Campylobacterwas the most prevalent pathogen found on skinless chicken breast in all sites with close to one-half of all samples testing positive. Across all three sites,Salmonella is the most commonly found pathogen in chicken nuggets, with more than one-quarter of all samples testing positive. Salmonella prevalence on skinless chicken breast ranged across the sites from 15% – 26%. In ground beef, VTEC remains at a low prevalence. Pork chops appear to contain the pathogens of interest (Campylobacter,Salmonella, and Listeria monocytogenes) at relatively low levels.
  • Fresh-cut fruit sampling showed that these products are rarely positive for the parasites, viruses and bacteria tested.
  • On farm, Salmonellawas commonly found in broiler chickens in all sites. Salmonella was also found in turkey in the BC site, but at a lower prevalence than in the broiler chickens. In turkey in the BC site, Campylobacter was again the most common pathogen found in 2014, as in 2013. Campylobacter was also commonly found in beef and dairy manure samples in the ON site, as in previous years. Campylobacter prevalence in broiler chickens was variable across the sites, ranging from 8.7% – 22%.
  • VTEC was found in about one quarter of irrigation water samples in the BC and AB sites.
  • Results from the 2014 FoodNet Canada sampling year have demonstrated that retail meat products, particularly chicken products, remain an important source of human enteric pathogens. Some of this contamination is likely due to high levels on farm and other points along the farm to store continuum. Fresh-cut fruit does not appear to be an important source of enteric disease for Canadians, while irrigation water has the potential to be a source of VTEC in particular. Continued monitoring of human cases and potential sources in the sentinel sites is important to help further understand enteric disease in Canada and detect emerging trends. This information will help protect Canadians and help to develop future public health policy.

To obtain a copy of the full report, please contact: phac-FoodNet.Canada-aspc@phac-aspc.gc.ca

Why can’t it be posted on the Internet?

New food safety rules will affect Canadian growers exporting to the U.S.

Susan Mann of Better Farming writes that Canadian horticultural industry leaders are poring over documents issued by the United States Food and Drug Administration last month outlining new food safety requirements for American growers and businesses shipping produce to the United States.

onion.water.oregonCanadian and Ontario growers exporting produce to the United States may be impacted by the new rules released as part of the American Food Safety Modernization Act and slated to take effect January 26, 2016. The American Food and Drug Administration (FDA) released the three sets of rules November 13. They are: the produce rule governing growing, harvesting, packing, and holding of produce; foreign supplier verification and accreditation of third-party auditors and certification bodies.

Companies and farmers in the states along with those exporting to the United States are being given time to meet the new requirements.

Jim Gorny, vice president of food safety and technology for the U.S.-based Produce Marketing Association, says the rules will have “a significant impact on produce businesses, in that they will affect how businesses operate on a daily basis and set definitive regulatory compliance expectations for FDA regulated businesses.”

The compliance dates depend on the size of a business, Gorny says. Large businesses with more than US $500,000 annually in sales have two years to comply with the new regulations and four years to meet the new water testing provisions. Small farms, defined as US $250,000 to $500,000 a year in sales, have three years to comply with the rules and five years to fall in line with the water rules. Very small farms, US $25,000 to $250,000 in sales annually, have four years to comply with the rules overall and six years for the water rules.

Heather Gale, executive director of CanadaGAP, the Canadian food safety program for the fresh fruit and vegetable sector, says they will be reviewing the new U.S. rules and comparing them to the requirements in Canada’s program. The program’s analysis will be published on its website sometime “in the new year,” Gale says.

Al Krueger, executive assistant with the Ontario Processing Vegetable Growers, says by email Ontario cucumber growers are “already doing what’s required under the new Food Safety Modernization Act.”

Another part of the American package of new food safety rules is the Foreign Supplier Verification Program. It specifies importers are required to verify food imported into the United States has been produced to the same food safety standards required of U.S. producers, Gorny says.

Why is contaminated feed still circulating, 15 years later? CFIA says small amount of feed likely cause of Alberta mad cow disease

Canada’s food safety watchdog says a small amount of leftover contaminated feed was the most plausible cause of mad cow disease discovered last February on a farm near Edmonton.

bse.canadaThe Canadian Food Inspection Agency released a report Monday that says no part of the Black Angus beef cow entered the human food or animal feed systems.

The report says no significant events could be linked to the discovery of bovine spongiform encephalopathy (BSE) near Edmonton and no other sick animals were found.

The February case — the 19th in Canada — prompted a few countries to place temporary restrictions on Canadian beef imports.

An investigation report says the cow was born at a nearby farm almost two years after Canada brought in more strict controls on animal feed to prevent BSE. A previous case was diagnosed on the same birth farm in an animal born in 2004.

“No significant events could be linked with this case but the potential for the carry-over of a small amount of residual contaminated feed could not be discounted,” says the report.

Chlorine is still a friend: Gastro from water wells in Canada

Waterborne illness related to the consumption of contaminated or inadequately treated water is a global public health concern.

water.well.ontAlthough the magnitude of drinking water-related illnesses in developed countries is lower than that observed in developing regions of the world, drinking water is still responsible for a proportion of all cases of acute gastrointestinal illness (AGI) in Canada.

The estimated burden of endemic AGI in Canada is 20·5 million cases annually – this estimate accounts for under-reporting and under-diagnosis. About 4 million of these cases are domestically acquired and foodborne, yet the proportion of waterborne cases is unknown. There is evidence that individuals served by private systems and small community systems may be more at risk of waterborne illness than those served by municipal drinking water systems in Canada. However, little is known regarding the contribution of these systems to the overall drinking water-related AGI burden in Canada.

Private water supplies serve an estimated 12% of the Canadian population, or ~4·1 million people. An estimated 1·4 million (4·1%) people in Canada are served by small groundwater (2·6%) and surface water (1·5%) supplies. The objective of this research is to estimate the number of AGI cases attributable to water consumption from these supplies in Canada using a quantitative microbial risk assessment (QMRA) approach. This provides a framework for others to develop burden of waterborne illness estimates for small water supplies. A multi-pathogen QMRA of Giardia, Cryptosporidium, Campylobacter, E. coli O157 and norovirus, chosen as index waterborne pathogens, for various source water and treatment combinations was performed. It is estimated that 103 230 AGI cases per year are due to the presence of these five pathogens in drinking water from private and small community water systems in Canada.

In addition to providing a mechanism to assess the potential burden of AGI attributed to small systems and private well water in Canada, this research supports the use of QMRA as an effective source attribution tool when there is a lack of randomized controlled trial data to evaluate the public health risk of an exposure source. QMRA is also a powerful tool for identifying existing knowledge gaps on the national scale to inform future surveillance and research efforts. 

Estimating the burden of acute gastrointestinal illness due to Giardia, Cryptosporidium, Campylobacter, E. coli O157 and norovirus associated with private wells and small water systems in Canada

Epidemiology and Infection, August 2015, pages 1-16, DOI: 10.1017/S0950268815002071

H.M. Murphy, M.K. Thomas, P.J. Schmidt, D.T. Medeiros, S. McFadyen, and K.D.M. Pintar

http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=10034786&fulltextType=RA&fileId=S0950268815002071

Foodborne outbreaks in Canada 2008-2014

Background: Enteric outbreak investigation in Canada is performed at the local, provincial/territorial (P/T) and federal levels. Historically, routine surveillance of outbreaks did not occur in all jurisdictions and so the Public Health Agency of Canada, in partnership with P/T public health authorities, developed a secure, web-based Outbreak Summaries (OS) Reporting System to address this gap.

canada.colbert.oct.14Objective: This analysis summarizes the foodborne outbreak investigations reported to the OS Reporting System between 2008 and 2014.

Methods: Finalised reports of investigations between 2008 and 2014 for all participating jurisdictions in Canada were extracted and descriptive analysis was carried out for foodborne outbreaks on etiological agent, severity of illness, outbreak duration, exposure setting and outbreak source.

Results: There were 115 reported foodborne outbreaks included in the analysis. This represents 11.2% of all outbreaks reported in the enteric module of the OS Reporting System between 2008 and 2014. Salmonella was the most commonly reported cause of foodborne outbreak (40.9%) and Enteritidis was the most common serotype reported. Foodborne outbreaks accounted for 3,301 illnesses, 225 hospitalizations and 30 deaths. Overall, 38.3% of foodborne outbreaks were reported to have occurred in a community and 32.2% were associated with a food service establishment. Most foodborne outbreak investigations (63.5%) reported a specific food associated with the outbreak, most frequently meat.

Conclusion: The OS Reporting System supports information sharing and collaboration among Canadian public health partners and offers an opportunity to obtain a national picture of foodborne outbreaks. This analysis has demonstrated the utility of the OS Reporting System data as an important and useful source of information to describe foodborne outbreak investigations in Canada.

Funding for this program was provided by the Public Health Agency of Canada.

An overview of foodborne outbreaks in Canada reported through Outbreak Summaries: 2008-2014

CCDR: Volume 41-11, November 5, 2015: Foodborne Illness

Bélanger P, Tanguay F, Hamel M, Phypers M

http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/15vol41/dr-rm41-11/ar-01-eng.php#footnote1

fbi.cdn.table.nov.15

Food fraud nothing new: But we will survive

Historian Madeleine Ferrieres, until recently Professor of Modern History at the University of Avignon and the author of my favorite food book, 2002’s Mad Cow, Sacred Cow, said in a recent interview, “we still live with the illusion of modernity, with the false idea that what happens to us is new and unbearable. These are not risks that have arisen, but our consumer behavior has changed.”


What’s new is better tools to detect fraud, which also presents an opportunity: those who use the real deal should be able to prove it through DNA testing and brag about it.

The days of faith-based food safety are coming to a protracted close.

As Ferrieres wrote in her book,

“All human beings before us questioned the contents of their plates. … And we are often too blinded by this amnesia to view our presents food situation clearly. This amnesia is very convenient. It allows us to reinvent the past and construct a complaisant, retrospective mythology.”

I’ve quoted those words before, but increasingly find myself reinventing the past.

That’s OK, just sorta boring, so I coach and play hockey.

CBC’s (that’s the Canadian Broadcasting Corporation, and it’s in Canada) Marketplace, which has always had a flair for the dramatic, broadcast an episode tonight about labeling, mis-labeling, and food fraud.

They interviewed me about 2 am my time today, probably as a follow-up; I tried to shift to a broader discussion, they were more interested in gotcha-style; bottom line, all food purchases are faith-based, no matter how well you think you know a farmer, and food fraud has been going on as long as people have sold food.

Supermarket workers are speaking out to CBC’s Marketplace about how stores tamper with best-before dates and how it can make food unsafe.

For five years, Mohammad Saffari has worked as a bakery clerk at a Loblaws store in Montreal. He says he was told to change best-before dates on fresh or frozen bakery items such as cheesecakes, muffins and pastries that were weeks or months past the best-before date.

Saffari says he was told to take cheesecakes that had passed their best-before dates and add toppings, so they would appear fresh.

He says cakes were then given a new best-before date and put back on the shelves for sale.

“I decorate it and I’m selling expired stuff for $13.99,” he says. “I won’t eat this cheesecake myself. But I sell it to you.”

‘You think other stores don’t do it?’

Saffari approached Marketplace after he became frustrated with being asked to change dates. “I couldn’t take it anymore,” he says. “I was on sick leave for three to four months because of the pressure; because what you’re doing you’re not proud of and you’re forced to do it.”

After speaking up about this on a number of occasions, Saffari decided to secretly record a conversation with his supervisor where he asks about the practice. He shared the recording with Marketplace.

“Every store does the same f—ing thing. You think other stores don’t do it?” the supervisor says on tape.

“Everyone f—s with the dates, Mo. Because at the end of the year, the managers, their bonus, you understand?”

In an email, Johanne Héroux, a senior director at Loblaws, told Marketplace:

“As a company, we are fully committed to upholding the highest standards in terms of product quality and safety. We have strict protocols in place to ensure their application across all our stores and departments.

“As for the store-specific allegations brought to our attention and in accordance with our zero tolerance policy regarding actions that jeopardize the safety and quality of our products, an investigation was undertaken immediately. Necessary actions will be taken upon completion of the ongoing investigation.”

Problems industry-wide

But Saffari is only one of a number of former and current supermarket employees who spoke out about how supermarkets change best-before dates.

Marketplace heard from people who have worked in the bakery, meat and produce departments of a number of different grocery stores, both chains and independent. They described a number of tricks that supermarkets employ to make food appear fresh.

These tactics include grinding old meat with fresher meat, marinating old meat in sauces that mask the smell, cutting mould off fruit and vegetables for party trays, and cutting cakes in half to facilitate a faster sale after the best-before has passed.

One insider also says his store took meat that had gone brown from sitting out, and dipped it in blood to make it look redder. Others said they would take mouldy fruit off custard tarts, replace it and glaze it to make it look fresh.

In each of these cases, food was put out with new best-before dates that significantly extended the shelf life.

Food treated this way can harbour microbes that can make you sick, says Keith Warriner, a microbiologist at the University of Guelph.

Best-before dates aren’t a guarantee that food is safe to eat. Other factors, such as the way food is stored, can make a big difference.

For dry food, such as cookies, crackers and pasta, best-before dates are a guarantee of freshness and flavour, and don’t mean that food past that date is unsafe to eat.

So how do you know that the food you’re buying is fresh? Employees recommend buying meat from the back of the shelf, and avoiding pre-marinated or cut foods. They also suggest buying whole cakes, pies and tarts.

Been there, done that: Canada creates science-minister post, and wear a damn poppy

I must be getting old that I can remember news from 25 years ago and today’s journalists can’t even be bothered to look at wiki.

winegard.2Canada’s new prime minister, Justin Trudeau, took office on 4 November — and as one of his first acts, created the post of Minister of Science.

Except it was done in 1990.

I was the first journalist to interview Bill Winegard when he was named Canada’s first Minister of Science in 1990. Guelph (that’s in Canada), where Winegard had served as university president, was still viewed as a cow-town by the uppities in Ottawa, and what was with all this science stuff?

Bill was always generous with his time, and quick with a barb. He’s still fighting the good fight at 91. As a public figure, we university journos had fun with Bill, but he took it all in stride, and I can’t think of a better representative for Guelph.

Below is from the Guelph Mercury last year, and apt as Remembrance Day approaches.

Bill Winegard is a Second World War veteran, a former federal government cabinet minister and a past president of the University of Guelph

Next May will be 100 years since a man from Guelph, John McCrae, wrote the most popular and the most renowned poem of the First World War. He was a doctor, a soldier and a true humanitarian. To understand the significance of the poem and our fight for freedom, let us take a trip.

Let us go to Flanders Fields.

Let us go to Wimereux Cemetery in France, a relatively small cemetery where as we walk amidst the headstones of the 200 young Canadians buried there we pause at the headstone of Lieutenant Colonel John McCrae.

Still in France, we move on to Beny sur Mer Canadian War Cemetery, where surrounded by pine and maple trees, 2,049 young Canadians are buried, most having lost their lives during the D-Day fighting and the Battle for Caen.

To Holland now, and to the largest Canadian War Cemetery in the Netherlands—Groesbeek, where there are 2,338 graves.        

If we travel to Denmark, to the War Cemetery in Esbjerg, among the 247 Commonwealth graves we will find a grave marked James Shield Norton, aged 20 years, from Caledonia, Ontario. He was my best friend.

In Italy, we will stop at the cemetery at Ortona, which contains the graves of hundreds of D-Day dodgers.

If we travel to Korea, we will find the graves of the 516 soldiers who lost their lives in that conflict.

winegard.nov.14Even before the First World War, Canada was part of the Boer War. We sent 8,000 troops, including my grandfather. Two hundred fifty Canadians died.

In the First World War, Canada, with a population of roughly eight million, had 640,000 people in uniform, including my grandfather and father. Seventy-two thousand were killed and 175,000 wounded—one of which was my father at age 16. Forty Canadians died each day. One in 10 Canadians did not come home, including 219 from Guelph.

In the Second World War, Canada’s population was 12 million, with one million in uniform, including me and my father and some present here today. Fifty thousand were killed and about 60,000 wounded. Many of my friends were among the 50,000 killed. Twenty Canadians were killed each day over a six-year period, 40 wounded and five taken prisoners of war. Guelph lost 171 soldiers.

In the Korean War, we had 34,000 troops there—more than most people think—with over 500 killed. One of those was from Guelph.

We can’t forget our peacekeepers – really, peacemakers. We have had 113 soldiers killed in the over 50 United Nations missions we have participated in from Zaire to Afghanistan.

Canada’s fighting participation in the conflict in Afghanistan ended this year. We should acknowledge and pay tribute to our exceptionally impressive troops, including the 11th Field Regiment. Canadians showed their respect by lining the bridges and roadways as the bodies were returned to Canada. One hundred fifty-eight hearses travelled down the Highway of Heroes.

There is another set of numbers that is even more shocking. Between the years 2004 and 2014, 160 military personnel have taken their own lives. That means the Canadian military has lost more soldiers to suicide than it did to combat in Afghanistan. These soldiers were very ill and needed help. They needed much more help than was available and they needed care of a special nature.

Instead of being sensitive to the issues, the Government of Canada seemed oblivious to the precarious mental state that many veterans were—and are—battling. For many, professional help was not available. For others, they had to cope with an insensitive government that even changed their point of contact by closing nine regional offices. These offices were familiar places to the veterans and, for the most part, they felt comfortable and safe. But, apparently to reduce costs, they were sent to unfamiliar places hours away, which caused further mental stress. This seems a relatively small matter to us but to the veteran it was one more issue where government seemed to back away from concerns raised in the new Veterans Charter.

The apparent callousness of the Department of Veterans Affairs was further made apparent when, in a class-action suit filed by disabled soldiers, Crown lawyers argued that today’s government shouldn’t be held to historical promises! What a cold-hearted thing to say! If veterans can’t count on government promises, it is a very sad day indeed.

When the Veterans Charter was introduced some years ago, it was welcomed as a way to support the veterans financially, with an understanding that it would be amended as needed. It hasn’t really worked out to the benefit of the veterans. THE GOVERNMENT SPENT BILLIONS PURSUING THE WAR, YET WON’T SPEND THE MILLIONS NESSECARY TO HELP OUR CURRENT VETERANS.

No one seems to have thought of using the spirit of “esprit de corps” to help. By that, I mean there are many veterans that are willing to help their comrades. While those suffering from post traumatic stress disorder need professional help, they could also use the listening ability of former comrades.

It would not be difficult to have former comrades standing by to listen and talk with former or current soldiers in difficulty. Esprit de corps is a very powerful force. Waiting for the veteran to come forward does not and will not work. We must find a way to go to them.

We are once again at war. How sad we are sending more of our men off to battle when we haven’t even resolved the issues left over from Afghanistan. We have to do a much better job taking care of our veterans.

In 1984 there were unresolved issues between the government and veterans. In caucus one day, Prime Minister Brian Mulroney said to the then minister of veterans affairs, the Honourable George Hees, “George, in any dispute between the veteran and the government, the veteran will always be given the benefit of the doubt.” Let us get serious about the health and welfare of the veterans who have served our country. We need a similar declaration from the current government!

Over the past 100 years or more, our veterans and comrades have gone to war. They paid a heavy price for our freedom. It was hard won. Many veterans returning home have counted on Canada doing the honourable thing by taking care of them and their families on their return. We say to the Minister of Veterans Affairs—Minister Fantino—FIX THIS PROBLEM!

We must never forget the sacrifices made. We Will Remember.

 

Important: Explaining Canadian food law and staying out of jail

Ronald L. Doering, a past president of the Canadian Food Inspection Agency and currently counsel in the Ottawa offices of Gowling (Ronald.doering@gowlings.com) writes:

Chance_go_to_jailFood company owners and managers are increasingly at risk of being taken to criminal court to face huge fines and imprisonment, even if they didn’t mean to do anything wrong, didn’t know they were doing anything wrong, or didn’t know that an employee was committing a prohibited act.

Everyone knows it’s a crime to sell unsafe food or mislabelled product, but there are many hundreds of other crimes in our food laws. Moreover, most of these offences are strict liability offences, which means that the Crown must only establish the criminal act; there is no need to prove that the accused intended or allowed the prohibited act to occur, even if the occurrence was totally accidental.

In Canada there is a defence to strict liability offences, a defence that deserves to be better known. In the leading case of R. v. Sault Ste. Marie, the Supreme Court of Canada recognized that in the case of strict liability offences “the accused can avoid liability by proving that he took all reasonable care; the defence will be available if the accused reasonably believed in a mistaken set of facts which, if true, would render the act or commission innocent, or if he took all reasonable steps to avoid the particular event.” Both branches of the defence turn on the notoriously vague concept of reasonableness.

There are several reported cases in environmental law and occupational

 health and safety law that help to define the scope of the defence, but there are very few that deal with food legisla­tion. Since 1992 it is settled law that the defence is available to charges under our Food and Drugs Act (FDA) but there are only three relevant cases to provide practical guidance to the industry. In HMTQ v. Stars Trading Co. (2003 BCSC 833) the company was selling imported coconut juice from Thailand to supermarkets in Canada without listing on the label that it contained sulphites, a potential allergen.

The accused argued the due diligence defence by claiming that it had received assurances from the exporter that the juice was sulphite free. The Canadian Food Inspection Agency (CFIA) had previously warned the company that it should test the product and the company had a history of non-compliance with the FDA. After a good review of the law, the Court held that the accused had not taken all reasonable care and therefore could not rely on the due diligence defence.

ron.doeringIn R. v. Can-na Foods-2 Ltd., Tran Quyen Luu, Jane Jay et al. (2003 ABQB 758) the accused meat manager Luu and the owner Jay were charged with selling horse meat as beef. The court held that all reasonable steps to determine the source of the meat had not been taken  and therefore the due diligence defence was not available. Heavy fines were imposed on the company, the employee and the owner.

In R. v. Ray’s Seafood Market the CFIA charged the accused with seven counts under the Fish Inspection Act of importing fish into Canada without an import licence. Both the trial judge and the Supreme Court judge accepted Ray’s due diligence defence, but the Quebec Court of Appeal quashed the acquittal and ordered a new trial, concluding that Ray’s excuse was es­sentially ignorance of the law, something that is never a defence.

The most significant new development in our law is the passage (though not yet proclaimed) of the Safe Food for Canadians Act. Under section 39 (1) the accused is liable on indictment to a fine of not more than $5 million or to imprisonment for a term of not more than two years or to both, but the person is not to be found guilty “if they establish that they exercised due diligence to prevent the commission of the offence.” The message for owners and senior managers is clear: a strong food safety culture passionately driven from the top down was always necessary to avoid recalls and protect the brand name. Exceeding standards and taking all preventative measures may also be the best way to stay out of jail.

 

 

Norovirus hospitalizes thousands of Canadians annually

Most people get over a bout of norovirus relatively quickly and without a visit to a health care provider. In extreme cases, a couple of days worth of vomit and painful stomach cramps can send folks to the hospital, especially if they become severely dehydrated.

Our hoser colleagues have estimated that between 4000 and 11,000 people are hospitalized as a result of Norovirus annually in Canada, resulting in a cost burden of over $21 million CAD (or about 5 million Timbits).images

Estimated hospitalizations attributed to norovirus and rotavirus infection in Canada, 2006–2010
V.K. Morton, M.K. Thomas and S. A McEwen
Epidemiology and Infection / Volume 143 / Issue 16 / December 2015, pp 3528-3537

Enteric viruses including norovirus and rotavirus are leading causes of gastroenteritis in Canada. However, only a small number of clinical cases are actually tested for these pathogens leading to systematic underestimation of attributed hospitalizations in administrative databases. The objective of this analysis was to estimate the number of hospitalizations due to norovirus and rotavirus in Canada. Hospitalization records for acute gastroenteritis-associated discharges at all acute-care hospitals in Canada between 2006 and 2011 were analysed. Cause-unspecified gastroenteritis hospitalizations were modelled using age-specific negative binomial models with cause-specified gastroenteritis admissions as predictors. The coefficients from the models were used to estimate the number of norovirus and rotavirus admissions. The total annual hospitalizations for rotavirus were estimated to be between 4500 and 10 000. Total annual hospitalizations for norovirus were estimated to be between 4000 and 11 000. The mean total annual cost associated with these hospitalizations was estimated to be at least $16 million for rotavirus and $21 million for norovirus (all figures in Canadian dollars). This study is the first comprehensive analysis of norovirus and rotavirus hospitalizations in Canada. These estimates provide a more complete assessment of the burden and economic costs of these pathogens to the Canadian healthcare system.