Invasive bacterial diseases in northern Canada, 1999 to 2018

Grace Huang,Raymond S Tsang,Francesca Reyes-Domingo,Susan G Squires,Irene Martin,Walter H Demczuk,Gregory J Tyrrell,Y Anita Li,Catherine Dickson

doi:10.14745/ccdr.v47i11a09

Abstract

Background: The International Circumpolar Surveillance (ICS) program conducts surveillance on five invasive bacterial diseases: pneumococcal disease (IPD), group A streptococcus (iGAS), Haemophilus influenzae (Hi), meningococcal disease (IMD) and group B streptococcus (GBS). Invasive bacterial diseases have a higher burden of disease in northern populations than the rest of Canada. Methods: To describe the epidemiology of invasive bacterial diseases in northern Canada from 1999 to 2018, data for IPD, iGAS, Hi, IMD and GBS were extracted from the ICS program and the Canadian Notifiable Diseases Surveillance System (CNDSS) and analyzed. Results: The annualized incidence rates for IPD, iGAS, Hi, GBS and IMD were 23.3, 10.5, 8.9, 1.9 and 1.1 per 100,000 population, respectively. The incidence of IPD, iGAS and Hi serotype b were 2.8, 3.2 and 8.8 times higher, respectively, in northern Canada than in the rest of Canada. Rates of disease decreased statistically significantly for IPD (β=−0.02) and increased statistically for iGAS (β=0.08) and Hi serotype a (β=0.04) during the study period. In Northern Canada, the annualized incidence rates for IPD, iGAS and Hi were statistically higher for Indigenous residents than for non-Indigenous residents. The highest incidence rates were among the very young and older age groups. Conclusion: Invasive bacterial diseases represent a high burden of disease in Canada’s northern populations. Indigenous peoples, children and seniors are particularly at risk.

Highlights

Established in 1999, the International Circumpolar Surveillance (ICS) program is a population-based infectious disease surveillance network of circumpolar countries including United States, Canada, Greenland, Iceland, Norway, Sweden, Finland and Russia [1]
Hi type a (Hia) is the predominant serotype in Northern Canada
ICS has been monitoring invasive disease caused by Streptococcus pneumoniae since 1999 and invasive diseases caused by Streptococcus pyogenes, Streptococcus agalactiae (Group B streptococcal disease, GBS), Haemophilus influenzae (Hi) and Neisseria meningitidis since 2000

Summary

Introduction

Established in 1999, the International Circumpolar Surveillance (ICS) program is a population-based infectious disease surveillance network of circumpolar countries including United States, Canada, Greenland, Iceland, Norway, Sweden, Finland and Russia [1]. In Canada, Northern regions (Yukon, Northwest Territories, Nunavut, Labrador, and Quebec Cree and Nunavik) and a network of laboratories, including three reference laboratories (the National Centre for Streptococcus [NCS] (1999–2009), the Laboratoire de santé publique du Québec [LSPQ], and the National Microbiology Laboratory [NML]) participate in the ICS program. The demography of Northern Canada differs from the rest of the country. Especially Indigenous peoples, have higher rates of invasive bacterial diseases (IBDs) compared with the rest of Canada [2,3,4,5,6]. Northern populations are known to be at a higher risk of developing invasive bacterial diseases (IBDs) compared with the rest of Canada. Since the last published study that described IBDs in Northern Canada, a number of vaccines against some bacterial pathogens have been introduced into the routine childhood immunization schedule

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Results

Conclusion