Canadian Outbreak Research Articles

Shiga Toxin–Producing Escherichia coli (STEC) and STEC-Associated Virulence Genes in Raw Ground Pork in Canada

Shiga toxin-producing Escherichia coli (STEC) O157:H7/nonmotile and some non-O157 STEC strains are foodborne pathogens. In response to pork-associated O157 STEC outbreaks in Canada, we investigated the occurrence of STEC in Canadian retail raw ground pork during the period of 1 November 2014 to 31 March 2016. Isolated STEC strains were characterized to determine the Shiga toxin gene (stx) subtype and the presence of virulence genes encoding intimin (eae) and enterohemorrhagic E. coli hemolysin (hlyA). O157 STEC and non-O157 STEC strains were isolated from 1 (0.11%) of 879 and 13 (2.24%) of 580 pork samples, respectively. STEC virulence gene profiles containing both eae and hlyA were found only in the O157 STEC (stx2a, eae, hlyA) isolate. The eae gene was absent from all non-O157 STEC isolates. Of the 13 non-O157 STEC isolates, two virulence genes of stx1a and hlyA were found in four (30.8%) O91:H14 STEC isolates, whereas one virulence gene of stx2e, stx1a, and stx2a was identified in five (38.5%), two (15.4%), and one (7.7%) STEC isolates, respectively, of various serotypes. The remaining non-O157 STEC isolate carried stx2, but the subtype is unknown because this isolate could not be recovered for sequencing. O91:H14 STEC (stx1a, hlyA) was previously reported in association with diarrheal illnesses, whereas the other non-O157 STEC isolates identified in this study are not known to be associated with severe human illnesses. Virulence gene profiles identified in this study indicate that the occurrence of non-O157 STEC capable of causing severe human illness is rare in Canadian retail pork. However, O157 STEC in ground pork can occasionally occur; therefore, education regarding the potential risks associated with STEC contamination of pork would be beneficial for the public and those in the food industry to help reduce foodborne illnesses.

COVID-19 Outbreaks in Canada and the Crisis of Migrant Farmworkers' Social Reproduction:Transnational Labour and the Need for Greater Accountability Among Receiving States.

In 2020, migrant farmworkers in Canada, cast as essential to sustaining the national food supply, experienced relatively high COVID-19 infection rates. Taking Southern Ontario as its focus, this article reveals how the federal government response to COVID-19 in agriculture perpetuated the effects of longstanding laws and policies requiring migrant farmworkers, circumscribed in their ability to politically mobilize on account of their institutionalized deportability, to shoulder disproportionate amounts of economic, social, and health risks. Centering the transnational character of migrant farmworkers’ renewal, it identifies meaningful interventions to limit the structural disempowerment of migrant farmworkers and the externalization of their social reproduction.

Prediction of COVID-19 Waves Using Social Media and Google Search: A Case Study of the US and Canada.

The ongoing COVID-19 pandemic has posed a severe threat to public health worldwide. In this study, we aimed to evaluate several digital data streams as early warning signals of COVID-19 outbreaks in Canada, the US and their provinces and states. Two types of terms including symptoms and preventive measures were used to filter Twitter and Google Trends data. We visualized and correlated the trends for each source of data against confirmed cases for all provinces and states. Subsequently, we attempted to find anomalies in indicator time-series to understand the lag between the warning signals and real-word outbreak waves. For Canada, we were able to detect a maximum of 83% of initial waves 1 week earlier using Google searches on symptoms. We divided states in the US into two categories: category I if they experienced an initial wave and category II if the states have not experienced the initial wave of the outbreak. For the first category, we found that tweets related to symptoms showed the best prediction performance by predicting 100% of first waves about 2–6 days earlier than other data streams. We were able to only detect up to 6% of second waves in category I. On the other hand, 78% of second waves in states of category II were predictable 1–2 weeks in advance. In addition, we discovered that the most important symptoms in providing early warnings are fever and cough in the US. As the COVID-19 pandemic continues to spread around the world, the work presented here is an initial effort for future COVID-19 outbreaks.

A simple model for fitting mild, severe, and known cases during an epidemic with an application to the current SARS-CoV-2 pandemic.

One of the major difficulties with modelling an ongoing epidemic is that often data is limited or incomplete, making it hard to estimate key epidemic parameters and outcomes (e.g. attack rate, peak time, reporting rate, reproduction number). In the current study, we present a model for data-fitting limited infection case data which provides estimates for important epidemiological parameters and outcomes. The model can also provide reasonable short-term (one month) projections. We apply the model to the current and ongoing COVID-19 outbreak in Canada both at the national and provincial/territorial level.

North American cold events following sudden stratospheric warming in the presence of low Barents-Kara Sea sea ice

While the relationship between the Arctic sea ice loss and midlatitude winter climate has been well discussed, especially on the seasonal mean scale, it remains unclear whether the Arctic sea ice condition affects the predictability of North American cold weather on the subseasonal time scale. Here we find that, in the presence of low Barents-Kara Sea (BKS) sea ice, sudden stratospheric warmings (SSWs) can favor surface cold spells over North America at the subseasonal timescale based on observations and model experiments. A persistent ridge of wave-2 pattern emerges over the Bering Sea-Gulf of Alaska several weeks after the SSW onset, with a coherent structure from the stratosphere to the surface, which, in turn, is conducive to synoptic cold air outbreaks in Canada and midwestern USA. This highlights a planetary wave pathway relating to BKS sea ice changes, by which the stratospheric polar vortex impacts the regional surface temperature on the subseasonal scale. In contrast, this mechanism does not occur with positive BKS sea ice anomaly. These findings help to improve the subseasonal predictability over North America, especially under the background of rapid change of Arctic sea ice in a warming world.

Temporal estimates of case-fatality rate for COVID-19 outbreaks in Canada and the United States.

Estimates of the case-fatality rate (CFR) associated with coronavirus disease 2019 (COVID-19) vary widely in different population settings. We sought to estimate and compare the COVID-19 CFR in Canada and the United States while adjusting for 2 potential biases in crude CFR. We used the daily incidence of confirmed COVID-19 cases and deaths in Canada and the US from Jan. 31 to Apr. 22, 2020. We applied a statistical method to minimize bias in the crude CFR by accounting for the survival interval as the lag time between disease onset and death, while considering reporting rates of COVID-19 cases less than 50% (95% confidence interval 10%-50%). Using data for confirmed cases in Canada, we estimated the crude CFR to be 4.9% on Apr. 22, 2020, and the adjusted CFR to be 5.5% (credible interval [CrI] 4.9%-6.4%). After we accounted for various reporting rates less than 50%, the adjusted CFR was estimated at 1.6% (CrI 0.7%-3.1%). The US crude CFR was estimated to be 5.4% on Apr. 20, 2020, with an adjusted CFR of 6.1% (CrI 5.4%-6.9%). With reporting rates of less than 50%, the adjusted CFR for the US was 1.78 (CrI 0.8%-3.6%). Our estimates suggest that, if the reporting rate is less than 50%, the adjusted CFR of COVID-19 in Canada is likely to be less than 2%. The CFR estimates for the US were higher than those for Canada, but the adjusted CFR still remained below 2%. Quantification of case reporting can provide a more accurate measure of the virulence and disease burden of severe acute respiratory syndrome coronavirus 2.

Time series forecasting of COVID-19 transmission in Canada using LSTM networks.

On March 11 th 2020, World Health Organization (WHO) declared the 2019 novel corona virus as global pandemic. Corona virus, also known as COVID-19 was first originated in Wuhan, Hubei province in China around December 2019 and spread out all over the world within few weeks. Based on the public datasets provided by John Hopkins university and Canadian health authority, we have developed a forecasting model of COVID-19 outbreak in Canada using state-of-the-art Deep Learning (DL) models. In this novel research, we evaluated the key features to predict the trends and possible stopping time of the current COVID-19 outbreak in Canada and around the world. In this paper we presented the Long short-term memory (LSTM) networks, a deep learning approach to forecast the future COVID-19 cases. Based on the results of our Long short-term memory (LSTM) network, we predicted the possible ending point of this outbreak will be around June 2020. In addition to that, we compared transmission rates of Canada with Italy and USA. Here we also presented the 2, 4, 6, 8, 10, 12 and 14 th day predictions for 2 successive days. Our forecasts in this paper is based on the available data until March 31, 2020. To the best of our knowledge, this of the few studies to use LSTM networks to forecast the infectious diseases.

Projecting demand for critical care beds during COVID-19 outbreaks in Canada.

Increasing numbers of coronavirus disease 2019 (COVID-19) cases in Canada may create substantial demand for hospital admission and critical care. We evaluated the extent to which self-isolation of mildly ill people delays the peak of outbreaks and reduces the need for this care in each Canadian province. We developed a computational model and simulated scenarios for COVID-19 outbreaks within each province. Using estimates of COVID-19 characteristics, we projected the hospital and intensive care unit (ICU) bed requirements without self-isolation, assuming an average number of 2.5 secondary cases, and compared scenarios in which different proportions of mildly ill people practised self-isolation 24 hours after symptom onset. Without self-isolation, the peak of outbreaks would occur in the first half of June, and an average of 569 ICU bed days per 10 000 population would be needed. When 20% of cases practised self-isolation, the peak was delayed by 2-4 weeks, and ICU bed requirement was reduced by 23.5% compared with no self-isolation. Increasing self-isolation to 40% reduced ICU use by 53.6% and delayed the peak of infection by an additional 2-4 weeks. Assuming current ICU bed occupancy rates above 80% and self-isolation of 40%, demand would still exceed available (unoccupied) ICU bed capacity. At the peak of COVID-19 outbreaks, the need for ICU beds will exceed the total number of ICU beds even with self-isolation at 40%. Our results show the coming challenge for the health care system in Canada and the potential role of self-isolation in reducing demand for hospital-based and ICU care.

Changes in processing and labelling of frozen chicken products available to consumers in Vancouver

Background: Between May 2017 and May 2019, 18 Salmonella outbreaks in Canada were linked to raw chicken, resulting in the recall of 13 chicken products. Most of these products contained frozen raw breaded chicken, such as chicken nuggets, chicken fries, and breaded chicken burgers. (Public Health Agency of Canada, 2019) These products are especially risky for consumers because they may appear precooked, resulting in inadequate food safety measures being taken. (Catford, Ganz, & Tamber, 2017). Due to this concern, as of April 1, 2019, all frozen raw breaded chicken product manufacturers are required to follow one of four Salmonella control measures set out by the Canadian Food Inspection Agency (CFIA). The simplest option for processors is to precook their products to destroy Salmonella bacteria and produce a ready-to-eat product. (Government of Canada, Canadian Food Inspection Agency, & Food Safety and Consumer Protection Directorate, 2019a) Methods: Data was collected from all frozen chicken products available at 14 retail locations in Metro Vancouver that were randomly selected in previous studies carried out in 2018 and 2019 by the British Columbia Centre for Disease Control (BCCDC) and British Columbia Institute of Technology (BCIT) students. The processing status of the products surveyed in this study (n=466) was compared to those collected in the previous studies done in 2018 and 2019, respectively (n=383; n=415). Other information collected included whether product packaging contained statements of internal temperature, requirements for thermometer use, and additional food safety instructions. Data on these parameters collected in the current study (n=466) were compared to similar data collected in 2008 (n=24) and in 2018 (n=67). Photos were taken of all product labels and relevant data from the photos was compiled in Microsoft Excel. Statistical analyses were done using chi-square tests performed using NCSS 2019 software. Results: The proportion of surveyed frozen chicken products that were cooked as opposed to raw increased from 38% in 2018 to 41% in 2019 to 69% in 2020. The proportion of products containing statements regarding required internal temperatures increased from 58% in 2008 to 96% in 2018 and then decreased to 86% in 2020. 0%, 4.5%, and 1.7% of products surveyed in 2008, 2018, and 2020, respectively, included an indication to use a food thermometer. 79%, 57%, and 25% of products surveyed in the same years included additional food safety statements. Conclusions: This study showed that the ratio of cooked to uncooked frozen chicken products available to consumers in the Metro Vancouver area has increased since the CFIA’s Salmonella control measure requirements for frozen breaded chicken manufacturers were implemented in 2019. The 28% and 26% increase since 2018 and 2019, respectively, suggests that many frozen chicken product manufacturers are complying with the CFIA requirements by using a validated cook process to reduce Salmonella in their products. This study also showed that, since 2019, there has been a significant decline in the proportion of frozen chicken products that contain information about internal cooking temperatures and additional food safety information on their packaging.

Porcine Circovirus: Historical Outlooks and Non-Porcine Victims

Porcine circovirus is an important viral species in the genus circovirus. It causes an immerse economic losses in the piggery industry. According to the retrospective studies, PCV2 has circulated before its acclaimed detection from samples taken as of the first outbreak in Canada. A bit far on in time, it has been reported in Europe, United States and Asian countries. The disease is endemic in most pig producing countries. Since then phylogeny studies supported for the immergence of various new Porcine circoviruses variants and genotypes. In addition to its natural reservoirs (wild and feral pigs), it also inhibits calves, goats, canines and mice. Some insects like mosquitoes are also the potential carrier of PCV2 even let it for cross species transmission. Hence those proper prevention measures of the mechanical carrier vectors of the disease should be noted together with the need of efficient vaccine against the pathogenic porcine circoviruses types.

The use of multiple hypothesis-generating methods in an outbreak investigation of Escherichia coli O121 infections associated with wheat flour, Canada 2016-2017.

A Canadian outbreak investigation into a cluster of Escherichia coli O121 was initiated in late 2016. When initial interviews using a closed-ended hypothesis-generating questionnaire did not point to a common source, cases were centrally re-interviewed using an open-ended approach. The open-ended interviews led cases to describe exposures with greater specificity, as well as food preparation activities. Data collected supported hypothesis generation, particularly with respect to flour exposures. In March 2017, an open sample of Brand X flour from a case home, and a closed sample collected at retail of the same brand and production date, tested positive for the outbreak strain of E. coli O121. In total, 76% (16/21) of cases reported that they used or probably used Brand X flour or that it was used or probably was used in the home during their exposure period. Crucial hypothesis-generating techniques used during the course of the investigation included a centralised open-ended interviewing approach and product sampling from case homes. This was the first outbreak investigation in Canada to identify flour as the source of infection.

Sociodemographic and geospatial associations with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections in a large Canadian city: an 11\u2009year retrospective study

BackgroundThe first Canadian outbreak of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) was identified in 2004 in Calgary, Alberta. Using a novel model of MRSA population-based surveillance, sociodemographic risk associations, yearly geospatial dissemination and prevalence of CA-MRSA infections over an 11 year period was identified in an urban healthcare jurisdiction of Calgary.MethodsPositive MRSA case records, patient demographics and laboratory data were obtained from a centralized Laboratory Information System of Calgary Laboratory Services in Calgary, Alberta, Canada between 2004 and 2014. Public census data was obtained from Statistics Canada, which was used to match with laboratory data and mapped using Geographic Information Systems.ResultsDuring the study period, 52.5% of positive MRSA infections in Calgary were CA-MRSA cases. The majority were CMRSA10 (USA300) clones (94.1%; n = 4255), while the remaining case (n = 266) were CMRSA7 (USA400) clones. Period prevalence of CMRSA10 increased from 3.6 cases/100000 population in 2004, to 41.3 cases/100000 population in 2014. Geospatial analysis demonstrated wide dissemination of CMRSA10 annually in the city. Those who are English speaking (RR = 0.05, p < 0.0001), identify as visible minority Chinese (RR = 0.09, p = 0.0023) or visible minority South Asian (RR = 0.25, p = 0.015), and have a high median household income (RR = 0.27, p < 0.0001) have a significantly decreased relative risk of CMRSA10 infections.ConclusionsCMRSA10 prevalence increased between 2004 and 2007, followed by a stabilization of cases by 2014. Certain sociodemographic factors were protective from CMRSA10 infections. The model of MRSA population-surveillance and geomap outbreak events can be used to track the epidemiology of MRSA in any jurisdiction.

Weather-based forecasting of mosquito-borne disease outbreaks in Canada

Weather-based forecasting of mosquito-borne disease outbreaks in Canada

Weather-based forecasting of mosquito-borne disease outbreaks in Canada.

Early warning systems to predict infectious disease outbreaks have been identified as a key adaptive response to climate change. Warming, climate variability and extreme weather events associated with climate change are expected to drive an increase in frequency and intensity of mosquito-borne disease (MBD) outbreaks globally. In Canada, this will mean an increased risk of endemic and emerging MBD outbreaks such as West Nile virus and other MBDs. The availability of timely information on the risk of impending MBD outbreaks has important public health implications, by allowing implementation of mosquito control measures and targeted communications regarding the need for increased personal protective measures-before an outbreak occurs. In Canada, both mechanistic and statistical weather-based models have been developed to predict West Nile virus outbreaks. These include models for different species of mosquitoes that transmit West Nile virus in different geographical areas of Canada. Although initial results have been promising, further validation and assessment of forecasting skill are needed before wide scale implementation. Weather-based forecasting for other emerging MBDs in Canada, such as Eastern equine encephalitis, may also be feasible.

Pathophysiological responses of pine defensive metabolites largely lack differences between pine species but vary with eliciting ophiostomatoid fungal species.

Phytopathogenic ophiostomatoid fungi are common associates of bark beetles and contribute to beetle-associated mortality of trees. Mountain pine beetle outbreaks in Canada are facilitating novel associations between its vectored fungi (Grosmannia clavigera, Leptographium longiclavatum and Ophiostoma montium) and jack pine. How the induced defense-related metabolite responses of jack and lodgepole pines vary in response to the fungi is unknown. Understanding this variation is important to clarifying pine susceptibility to and the physiological impacts of infection. We used a comparative metabolite profiling approach to investigate the defense-related signaling, carbon utilization/mobilization, and synthesis responses of both pines to the fungi. Both pine species largely exhibited similar metabolite responses to the fungi. The magnitude of pine metabolite responses positively reflected pathogen virulence. Our findings indicate that pines can recognize and metabolomically respond to novel pathogens, likely due to signals common between the novel fungi and fungi coevolved with the pine. Thus, jack pine is likely as susceptible as lodgepole pine to infections by each of the MPB-vectored fungi. Furthermore, the magnitude of the metabolite responses of both pines varied by the eliciting fungal species, with the most virulent pathogen causing the greatest reduction in carbohydrates and the highest accumulation of defensive terpenes.

Shared genome analyses of notable listeriosis outbreaks, highlighting the critical importance of epidemiological evidence, input datasets and interpretation criteria.

The persuasiveness of genomic evidence has pressured scientific agencies to supplement or replace well-established methodologies to inform public health and food safety decision-making. This study of 52 epidemiologically defined Listeria monocytogenes isolates, collected between 1981 and 2011, including nine outbreaks, was undertaken (1) to characterize their phylogenetic relationship at finished genome-level resolution, (2) to elucidate the underlying genetic diversity within an endemic subtype, CC8, and (3) to re-evaluate the genetic relationship and epidemiology of a CC8-delimited outbreak in Canada in 2008. Genomes representing Canadian Listeria outbreaks between 1981 and 2010 were closed and manually annotated. Single nucleotide variants (SNVs) and horizontally acquired traits were used to generate phylogenomic models. Phylogenomic relationships were congruent with classical subtyping and epidemiology, except for CC8 outbreaks, wherein the distribution of SNV and prophages revealed multiple co-evolving lineages. Chronophyletic reconstruction of CC8 evolution indicates that prophage-related genetic changes among CC8 strains manifest as PFGE subtype reversions, obscuring the relationship between CC8 isolates, and complicating the public health interpretation of subtyping data, even at maximum genome resolution. The size of the shared genome interrogated did not change the genetic relationship measured between highly related isolates near the tips of the phylogenetic tree, illustrating the robustness of these approaches for routine public health applications where the focus is recent ancestry. The possibility exists for temporally and epidemiologically distinct events to appear related even at maximum genome resolution, highlighting the continued importance of epidemiological evidence.

Outbreak of invasive Streptococcus pneumoniae among an inner-city population in Victoria, British Columbia, 2016-2017.

Invasive pneumococcal disease (IPD) is a significant cause of morbidity and mortality; however, outbreaks of IPD are relatively rare. Homelessness and substance use are known risk factors for IPD and have been associated with several outbreaks in Canada, despite national recommendations for routine childhood and targeted adult pneumococcal vaccination. To describe the epidemiology and public health challenges related to an outbreak of novel serotype 4 IPD in a homeless and unstably housed population in Victoria, British Columbia during the autumn and winter of 2016-2017. Prospective, enhanced surveillance was initiated for laboratory confirmed cases reported to public health, including variables recording housing status and substance use. Thirty-three cases of serotype 4 IPD within the Victoria area were reported to public health between August 1, 2016 and September 1, 2017. Compared with other serotypes, these cases were more likely to be middle-aged, homeless or unstably housed, and to have a recent history of substance use. A targeted pneumococcal vaccination campaign was initiated in collaboration with external community organizations; however, these initiatives were challenged by incomplete data and staffing constraints. This report illustrates an outbreak of serotype 4 IPD among an inner-city population with multiple risk factors, including homelessness, unstable housing and substance use. Given the challenges controlling the outbreak, outreach capacity and pneumococcal vaccination coverage is needed among this marginalized population.

Large scale biotic damage impacts on forest ecosystem services

ABSTRACTInsect outbreaks are natural phenomena that play a critical role in the development, senescence, and rebirth of forests. However, the damage caused by large-scale epidemics can have landscape scale consequences that are often poorly understood. The recent mountain pine beetle (MPB) outbreak in Canada has impacted a record >18.5 million hectares of pine forests, placing forest values at risk and significantly impacting forest-dependent communities within the region. To assess this impact, an ecosystem service-based approach was applied. Based on land cover information and monitoring data, four ecosystem services were assessed and mapped: merchantable timber, water provisioning, aboveground carbon storage, and vegetation diversity (supporting habitat). Timber is the most impacted provisioning ecosystem service followed by water provisioning, with peak stream flow in affected watersheds being positively related to mortality percent. Effects on carbon storage are substantial, with 20% of total timber aboveground carbon in dead pine trees. These effects may be mitigated, however, by the growth response of residual live trees and forest regeneration. The potential vegetation diversity showed a positive response to MPB-caused tree mortality. The results of our study may help with setting management priorities in response to large-scale biotic damage in forests in British Columbia and elsewhere.

A Scoping Review of Enterovirus D-68

Objective: To create a scoping review on enterovirus D-68 (EV-D68) that will serve as a useful tool to guide future research with the aim of filling critical information gaps and supporting the development of public health preparedness activities.Introduction: EV-D68 is a non-polio enterovirus, primarily resulting in respiratory illness, with clinical symptoms ranging from mild to severe. Infection has also been associated with severe neurological conditions like acute flaccid myelitis (AFM). EV-D68 was first discovered in 1962, with infrequent case reports until 2014 at which point a widespread multi-national outbreak mostly affecting the pediatric population occurred across North America, Europe, Southeast Asia and Africa. This outbreak was associated with an increase in AFM, with cases being reported in Canada, the United States, Norway, and France. With this new and emerging threat, public health and other organizations were called upon to implement response measures such as establishment of case definitions, surveillance mechanisms, and recommendations for clinical and public health management. The response to the 2014 outbreak in Canada highlighted several important EV-D68 evidence gaps including a lack of risk factor and clinical information available for non-severe cases, and uncertainty around seasonal, cyclical and secular trends. Given the increased reporting of EV-D68 cases associated with severe outcomes, it's critical that public health establishes what is known about EV-D68 in order to support decision-making, education and other preparedness activities and to highlight priority areas for future research to fill critical knowledge gaps. Scoping reviews provide a reproducible and updateable synthesis research methodology to identify and characterise all the literature on a broad topic as a means to highlight where evidence exists and where there are knowledge gaps. In order to systematically characterise the EV-D68 knowledge base, a scoping review was conducted to map the current body of evidence.Methods: A literature search of published and grey literature on EV-D68 was conducted on May 1, 2017. A standardized search algorithm was implemented in four bibliographic databases: Medline, Embase, Global Health and Scopus. Relevant grey literature was sought from a prioriidentified sources: the World Health Organization, United States Centers for Disease Control and Prevention, the Public Health Agency of Canada, the European Centre for Disease Prevention and Control, and thesis registries. Two-level relevance screening (title/abstract followed by full-text) was performed in duplicate by two independent reviewers using pretested screening forms. Conflicts between the reviewers were reconciled following group discussion with the study team. English and French articles were included if they reported on EV-D68 as an outcome. There were no limitations by date, publication type, geography or study design. Conference abstracts were excluded if they did not provide sufficient outcome information to characterize. The articles were then characterized by two independent reviewers using a pretested study characterization form. The descriptive characteristics of each article were extracted and categorized into one of the following broad topic categories: 1) Epidemiology and Public Health, 2) Clinical and Infection Prevention and Control (IPC), 3) Guidance Products, 4) Public Health Surveillance, 5) Laboratory, and 6) Impact. The Epidemiology and Public Health category contained citations describing prevalence, epidemiological distribution, outbreak data and public health mitigation strategies. Clinical and IPC citations included details regarding symptoms of EV-D68 infection, patient outcomes, clinical investigation processes, treatment options and infection prevention and control strategies. The Guidance category included citations that assess risk, provide knowledge translation or provide practice guidelines. Public Health Surveillance citations provided details on surveillance systems. Citations in the laboratory category included studies that assessed the genetic characteristics of circulating EV-D68 (phylogeny, taxonomy) and viral characteristics (proteins, viral properties). Lastly, the Impact category contained citations describing the social, economic and resource burden of EV-D68 infection. Each broad topic category was subsequently characterised further into subtopics.Results: The search yielded a total of 384 citations, of which 300 met the inclusion criteria. Twenty-six of forty-three potentially relevant grey literature sources were also included. Preliminary literature characterization suggests that the majority of the published literature fell under the topic categories of Epidemiology, Clinical, and Laboratory. There were limited published articles on public health guidance, IPC, surveillance systems and the impact of EV-D68. The grey literature primarily consisted of webpages directed towards the public (what EV-D68 is, how to prevent it, what to do if ill, etc.). This scoping review work is presently underway and a summary of the full results will be presented at the 2018 Annual Conference.Conclusions: The body of literature on EV-D68 has increased since the 2014 outbreak, but overall remains small and contains knowledge gaps in some areas. To our knowledge, this scoping review is the first to classify the entirety of literature relating to EV-D68. It will serve as a useful tool to guide future research with the aim of filling critical information gaps, and supporting development of public health preparedness activities.

Broad spectrum protection of broiler chickens against inclusion body hepatitis by immunizing their broiler breeder parents with a bivalent live fowl adenovirus vaccine

Historically, fowl adenovirus (FAdV) associated inclusion body hepatitis (IBH) was considered a secondary disease in broiler chickens associated with immunosuppression. However, we previously reported the occurrence of IBH as a primary disease in the broiler chicken industry in Canada as a result of infections with various FAdV serotypes. Therefore, the objectives of this study were to develop an immunization strategy in broiler breeders using live FAdV 11-1047 and FAdV8a-TR59 to confer homologous and heterologous protection in broiler progeny against IBH and to study the efficacy of natural exposure of naïve broiler breeders to a vaccine virus from live FAdV vaccinated birds as an immunization technique. Broiler breeders vaccinated orally with FAdV8a-TR59 (1 × 104 TCID50/bird) and FAdV11–1047 (1 × 104 TCID50/bird), FAdV8a-TR59 (1 × 106 TCID50/bird) and FAdV11-1047 (1 × 106 TCID50/bird) or FAdV8b (1 × 106 TCID50/bird) transferred substantial levels of neutralizing antibodies to their progeny. The efficacy of maternal antibodies was studied by challenging 14-day old broiler chickens with 1 × 107 TCID50 of FAdV2–685, FAdV7-x11a like, FAdV8a-TR59, FAdV8b-SK or FAdV11-1047 which are the dominant serotypes causing IBH outbreaks in Canada. Broiler chickens from the low and high dose vaccinated breeders were significantly protected against all serotypes of FAdV (P < 0.05). Comingling of unvaccinated broiler breeders with FAdV-vaccinated broiler breeders was an effective immunization technique for in-contact naïve birds. This study confirms that IBH can be effectively controlled in Canada by vaccination of broiler breeder parents with a bivalent vaccine containing live FAdV8a-TR59 and FAdV11-1047.