#Drug #Decriminalization: A Matter of #Justice and #Equity, Not Just Health (Am J Prev Med., abstract)

[Source: American Journal of Preventive Medicine, full page: (LINK). Abstract, edited.]

Drug Decriminalization: A Matter of Justice and Equity, Not Just Health

Hakique N. Virani, MD1, Rebecca J. Haines-Saah, PhD2

DOI: https://doi.org/10.1016/j.amepre.2019.08.012

Published online: November 15, 2019



Since 2016, more than 10,300 Canadians have died of an apparent opioid-related overdose, with the majority involving fentanyl or fentanyl analogs.1 This unprecedented public health crisis has decreased life expectancy at birth in the country’s most affected provinces of Alberta and British Columbia.2 Concerned by this epidemic of overdoses, Canadian advocates for drug policy reform have welcomed the recent recommendation from British Columbia’s Provincial Health Officer that drug possession for personal use be decriminalized.

© 2019 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Keywords: Opioids; Illicit drugs; Society; Canada.


#Paradoxical clade- and age-specific #vaccine #effectiveness during the 2018/19 #influenza A #H3N2 #epidemic in #Canada: potential imprint-regulated effect of vaccine (I-REV) (Euro Surveill., abstract)

[Source: Eurosurveillance, full page: (LINK). Abstract, edited.]

Paradoxical clade- and age-specific vaccine effectiveness during the 2018/19 influenza A(H3N2) epidemic in Canada: potential imprint-regulated effect of vaccine (I-REV)

Danuta M Skowronski 1,2, Suzana Sabaiduc 1, Siobhan Leir 1, Caren Rose 1,2, Macy Zou 1, Michelle Murti 3,4, James A Dickinson 5, Romy Olsha 3, Jonathan B Gubbay 3,4, Matthew A Croxen 6,7, Hugues Charest 8, Nathalie Bastien 9, Yan Li 9, Agatha Jassem 1,2, Mel Krajden 1,2, Gaston De Serres 8,10,11

Affiliations: 1 British Columbia Centre for Disease Control, Vancouver, Canada; 2 University of British Columbia, Vancouver, Canada; 3 Public Health Ontario, Toronto, Canada; 4 University of Toronto, Toronto, Canada; 5 University of Calgary, Calgary, Canada; 6 Alberta Precision Laboratories, Edmonton, Alberta; 7 University of Alberta, Edmonton, Canada; 8 Institut National de Santé Publique du Québec, Québec, Canada; 9 National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada; 10 Laval University, Quebec, Canada11 Centre Hospitalier Universitaire de Québec, Québec, Canada

Correspondence:  Danuta M Skowronski

Citation style for this article: Skowronski Danuta M, Sabaiduc Suzana, Leir Siobhan, Rose Caren, Zou Macy, Murti Michelle, Dickinson James A, Olsha Romy, Gubbay Jonathan B, Croxen Matthew A, Charest Hugues, Bastien Nathalie, Li Yan, Jassem Agatha, Krajden Mel, De Serres Gaston. Paradoxical clade- and age-specific vaccine effectiveness during the 2018/19 influenza A(H3N2) epidemic in Canada: potential imprint-regulated effect of vaccine (I-REV). Euro Surveill. 2019;24(46):pii=1900585. https://doi.org/10.2807/1560-7917.ES.2019.24.46.1900585

Received: 19 Sep 2019;   Accepted: 04 Nov 2019




The Canadian Sentinel Practitioner Surveillance Network reports vaccine effectiveness (VE) for the 2018/19 influenza A(H3N2) epidemic.


To explain a paradoxical signal of increased clade 3C.3a risk among 35–54-year-old vaccinees, we hypothesise childhood immunological imprinting and a cohort effect following the 1968 influenza A(H3N2) pandemic.


We assessed VE by test-negative design for influenza A(H3N2) overall and for co-circulating clades 3C.2a1b and 3C.3a. VE variation by age in 2018/19 was compared with amino acid variation in the haemagglutinin glycoprotein by year since 1968.


Influenza A(H3N2) VE was 17% (95% CI: −13 to 39) overall: 27% (95% CI: −7 to 50) for 3C.2a1b and −32% (95% CI: −119 to 21) for 3C.3a. Among 20–64-year-olds, VE was −7% (95% CI: −56 to 26): 6% (95% CI: −49 to 41) for 3C.2a1b and −96% (95% CI: −277 to −2) for 3C.3a. Clade 3C.3a VE showed a pronounced negative dip among 35–54-year-olds in whom the odds of medically attended illness were > 4-fold increased for vaccinated vs unvaccinated participants (p < 0.005). This age group was primed in childhood to influenza A(H3N2) viruses that for two decades following the 1968 pandemic bore a serine at haemagglutinin position 159, in common with contemporary 3C.3a viruses but mismatched to 3C.2a vaccine strains instead bearing tyrosine.


Imprinting by the first childhood influenza infection is known to confer long-lasting immunity focused toward priming epitopes. Our findings suggest vaccine mismatch may negatively interact with imprinted immunity. The immunological mechanisms for imprint-regulated effect of vaccine (I-REV) warrant investigation.

©  This work is licensed under a Creative Commons Attribution 4.0 International License.

Keywords: Seasonal Influenza; Vaccines; H3N2; Origin Antigenic Sin; Canada.


Application of national #pollutant #inventories for #monitoring trends on #dioxin #emissions from stationary #industrial sources in #Australia, #Canada and #EU (PLOS One, abstract)

[Source: PLOS One, full page: (LINK). Abstract, edited.]


Application of national pollutant inventories for monitoring trends on dioxin emissions from stationary industrial sources in Australia, Canada and European Union

Khushbu Salian , Vladimir Strezov, Tim J. Evans, Mark Taylor, Peter F. Nelson


Published: October 25, 2019 / DOI: https://doi.org/10.1371/journal.pone.0224328



Industrial sources, including iron ore sintering, municipal waste incineration and non-ferrous metal processing have been prominent emitters of dioxins to the environment. With the expanding industrial sectors, many international conventions were established in order to reduce the emission of dioxins in the past two decades. The Stockholm convention, a global monitoring treaty, entered into force in 2004 with the aim to promote development of strategies to reduce or eliminate dioxin emissions. According to the convention, parties are required to develop national inventory databases to report emission levels and develop a national implementation plan (NIP) to reduce further dioxin emissions. In order to understand the trend of dioxin emissions since 1990s this study provides a comparative assessment of dioxin emissions from different industrial sources by deriving emission data from the national inventory databases of Australia, Canada and the 28 European countries (EU-28). According to the data collected, iron and steel production and electricity generation were the highest emitters of dioxins in 2017 for Europe, Canada and Australia, when compared to other stationary industrial sources. The change in the trend of dioxin emissions from the iron and steel industry and the public electricity sector was also assessed. The emission of dioxins during 1990–2017 from both iron and steel production and electricity generation revealed a relative decreasing trend, except for Spain and Italy who showed higher level of emissions from iron and steel production in 2017. Furthermore, comparing emission data for metal production revealed that the blast furnace process was the prominent emitter of dioxins comparing to electric arc furnace process. Further investigation was performed to compare the amount of dioxin emitted from three different fuel types, black coal, brown coal and natural gas, used for electricity generation in Australia. The study showed that dioxin emissions from brown coal were higher than black coal for the last two years, while power production from natural gas emits the lowest amounts of dioxins to the environment.


Citation: Salian K, Strezov V, Evans TJ, Taylor M, Nelson PF (2019) Application of national pollutant inventories for monitoring trends on dioxin emissions from stationary industrial sources in Australia, Canada and European Union. PLoS ONE 14(10): e0224328. https://doi.org/10.1371/journal.pone.0224328

Editor: Bing Xue, Institute for Advanced Sustainability Studies, GERMANY

Received: May 21, 2019; Accepted: October 10, 2019; Published: October 25, 2019

Copyright: © 2019 Salian et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the manuscript and its Sources are referenced.

Funding: This research was funded by the Australian Government through the Australian Research Council Linkage Projects funding scheme, project number LP160101600 (https://www.arc.gov.au/) to VS, TE, MT and PF. ARC played no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Keywords: Environmental pollution; Toxic chemicals; Dioxins; EU; Australia; Canada.


#Population-level #impact and #herd effects following the introduction of #HPV #vaccination programmes: updated systematic review and meta-analysis (Lancet, abstract)

[Source: The Lancet, full page: (LINK). Abstract, edited.]

Population-level impact and herd effects following the introduction of human papillomavirus vaccination programmes: updated systematic review and meta-analysis

Mélanie Drolet, PhD, Élodie Bénard, MSc, Norma Pérez, MSc, Prof Marc Brisson, PhD  on behalf of theHPV Vaccination Impact Study Group

Published: June 26, 2019 / DOI: https://doi.org/10.1016/S0140-6736(19)30298-3




More than 10 years have elapsed since human papillomavirus (HPV) vaccination was implemented. We did a systematic review and meta-analysis of the population-level impact of vaccinating girls and women against human papillomavirus on HPV infections, anogenital wart diagnoses, and cervical intraepithelial neoplasia grade 2+ (CIN2+) to summarise the most recent evidence about the effectiveness of HPV vaccines in real-world settings and to quantify the impact of multiple age-cohort vaccination.


In this updated systematic review and meta-analysis, we used the same search strategy as in our previous paper. We searched MEDLINE and Embase for studies published between Feb 1, 2014, and Oct 11, 2018. Studies were eligible if they compared the frequency (prevalence or incidence) of at least one HPV-related endpoint (genital HPV infections, anogenital wart diagnoses, or histologically confirmed CIN2+) between pre-vaccination and post-vaccination periods among the general population and if they used the same population sources and recruitment methods before and after vaccination. Our primary assessment was the relative risk (RR) comparing the frequency (prevalence or incidence) of HPV-related endpoints between the pre-vaccination and post-vaccination periods. We stratified all analyses by sex, age, and years since introduction of HPV vaccination. We used random-effects models to estimate pooled relative risks.


We identified 1702 potentially eligible articles for this systematic review and meta-analysis, and included 65 articles in 14 high-income countries: 23 for HPV infection, 29 for anogenital warts, and 13 for CIN2+. After 5–8 years of vaccination, the prevalence of HPV 16 and 18 decreased significantly by 83% (RR 0·17, 95% CI 0·11–0·25) among girls aged 13–19 years, and decreased significantly by 66% (RR 0·34, 95% CI 0·23–0·49) among women aged 20–24 years. The prevalence of HPV 31, 33, and 45 decreased significantly by 54% (RR 0·46, 95% CI 0·33–0·66) among girls aged 13–19 years. Anogenital wart diagnoses decreased significantly by 67% (RR 0·33, 95% CI 0·24–0·46) among girls aged 15–19 years, decreased significantly by 54% (RR 0·46, 95% CI 0.36–0.60) among women aged 20–24 years, and decreased significantly by 31% (RR 0·69, 95% CI 0·53–0·89) among women aged 25–29 years. Among boys aged 15–19 years anogenital wart diagnoses decreased significantly by 48% (RR 0·52, 95% CI 0·37–0·75) and among men aged 20–24 years they decreased significantly by 32% (RR 0·68, 95% CI 0·47–0·98). After 5–9 years of vaccination, CIN2+ decreased significantly by 51% (RR 0·49, 95% CI 0·42–0·58) among screened girls aged 15–19 years and decreased significantly by 31% (RR 0·69, 95% CI 0·57–0·84) among women aged 20–24 years.


This updated systematic review and meta-analysis includes data from 60 million individuals and up to 8 years of post-vaccination follow-up. Our results show compelling evidence of the substantial impact of HPV vaccination programmes on HPV infections and CIN2+ among girls and women, and on anogenital warts diagnoses among girls, women, boys, and men. Additionally, programmes with multi-cohort vaccination and high vaccination coverage had a greater direct impact and herd effects.


WHO, Canadian Institutes of Health Research, Fonds de recherche du Québec – Santé.

Keywords: HPV; Vaccines; Cancer; Canada.


#Polio-like #Manifestation of #Powassan Virus #Infection with Anterior Horn Cell Involvement, #Canada (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 25, Number 8—August 2019 / Research Letter

Polio-like Manifestation of Powassan Virus Infection with Anterior Horn Cell Involvement, Canada

Christopher Picheca1, Vignan Yogendrakumar1  , James I. Brooks, Carlos Torres, Elizabeth Pringle, and Jocelyn Zwicker

Author affiliations: University of Ottawa, Ottawa, Ontario, Canada



Evidence of spinal cord involvement in Powassan virus infection is largely limited to mouse models. We report a case of a polio-like illness caused by Powassan virus infection in a 62-year-old man in Canada. Magnetic resonance imaging showed T2 hyperintensities in the anterior horns of the cervical spinal cord.

Keywords: Powassan virus; Acute flaccid paralysis; Canada.


#Genomic #investigation of the emergence of invasive #MDR #Salmonella Dublin in #humans and #animals in #Canada (Antimicrob Agents Chemother., abstract)

[Source: Antimicrobial Agents and Chemotherapy, full page: (LINK). Abstract, edited.]

Genomic investigation of the emergence of invasive multidrug resistant Salmonella Dublin in humans and animals in Canada

Chand S. Mangat, Sadjia Bekal, Brent P. Avery, Geneviève Côté, Danielle Daignault, Florence Doualla-Bell, Rita Finley, Brigitte Lefebvre, Amrita Bharat, E. Jane Parmley,Richard J. Reid-Smith, Jean Longtin, Rebecca J. Irwin, Michael R. Mulvey
and on behalf of the Canadian Integrated Program for Antimicrobial Resistance Surveillance Public Health Partnership

DOI: 10.1128/AAC.00108-19



Salmonella enterica subsp. enterica serovar Dublin (S. Dublin) is a zoonotic pathogen that often leads to invasive bloodstream infections in humans that are multidrug resistant. Described here are the results of Canadian national surveillance of S. Dublin from 2003 – 2015 in humans and bovines, principally collected through the Canadian Integrated Program for Antibiotic Resistance Surveillance (CIPARS). An increase in human infections due to multidrug resistant (MDR) S. Dublin was observed in 2010, many of which were bloodstream infections. Phylogenomic analysis of human and bovine isolates revealed a closely-related network that differed by only 0-17 single nucleotide variants (SNVs) suggesting some potential transmission between humans and bovines. Phylogenomic comparison of global publically available sequences of S. Dublin showed that Canadian isolates clustered closely with those from the United States of America. A high correlation between phenotypic and genotypic antimicrobial susceptibility was observed in Canadian isolates. IS26 replication was widespread amongst U.S. and Canadian isolates and caused the truncation and inactivation of the resistance genes strA and blaTEM-1B. A hybrid virulence and MDR plasmid (pN13-01125) isolated from a Canadian S. Dublin isolate was searched against NCBI SRA data of bacteria. The pN13-01125 coding sequences were found in 13 Salmonella serovars but S. Dublin appears to be a specific reservoir. In summary, we have observed the rise of invasive MDR S. Dublin in humans in Canada and found that they are closely related to bovine isolates and to American isolates in their mobile and chromosomal content.

© Crown copyright 2019.

The government of Australia, Canada, or the UK (“the Crown”) owns the copyright interests of authors who are government employees. The Crown Copyright is not transferable.

Keywords: Antibiotics; Drugs Resistance; Bovine; Human; Canada; Samonella enterica.


#Canadian #Pandemic #Influenza #Preparedness: #Antiviral strategy (Can Commun Dis Rep., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Can Commun Dis Rep. 2019 Jan 3;45(1):38-43. doi: 10.14745/ccdr.v45i01a05. eCollection 2019 Jan 3.

Canadian Pandemic Influenza Preparedness: Antiviral strategy.

Henry B1,2.

Author information: 1 Canadian Pandemic Influenza Preparedness Task Group, Chair. 2 Office of the Provincial Health Officer, Victoria, BC.



Antiviral medications are the only influenza-specific pharmaceutical intervention that can be used to mitigate the impact of a pandemic until a vaccine becomes available. The Canadian Pandemic Influenza Preparedness: Planning Guidance for the Health Sector (CPIP) outlines how federal, provincial and territorial governments will work together to ensure a coordinated and consistent health sector approach to pandemic influenza preparedness and response. This article summarizes Canada’s pandemic influenza antiviral strategy as described in the recently updated CPIP Antiviral Annex. The antiviral strategy builds on lessons learned during the 2009 H1N1 pandemic. Key elements of the strategy include ensuring equitable, timely and coordinated access to antivirals through government stockpiles; having regulatory mechanisms in place that facilitate timely access to antivirals; providing timely and evidence-based clinical guidance; maintaining effective stockpile management practices; and monitoring antiviral utilization, effectiveness and safety. Since the CPIP is an evergreen document, this Annex will be updated as new information warrants.

KEYWORDS: antivirals; influenza; pandemic; public health

PMID: 31015817 PMCID: PMC6461127 DOI: 10.14745/ccdr.v45i01a05

Keywords: Pandemic Preparedness; Pandemic Influenza; Antivirals; Canada.