Clinicians' views of drug therapies are affected by the common use of relative risk reductions in both trial reports and advertisements, by end-point emphasis, and, above all, by underuse of summary measures that relate treatment burden to therapeutic yields in a clinically relevant manner.

Blinded reviewers and editors in this study, but not nonblinded reviewers, gave better scores to authors with more previous articles. These results suggest that blinded reviewers may provide more unbiased reviews and that nonblinded reviewers may be affected by various types of bias.

Background: This study examined the relationship between the bacteriological contamination of drinking water from private wells and acute gastrointestinal illness (AGII), using current government standards for safe drinking water.

During the 2000-2001 influenza immunization campaign in Canada, a new adverse event, oculo-respiratory syndrome (ORS), was noted in association with administration of vaccine supplied by one manufacturer. The original case definition for ORS specified bilateral conjunctivitis, facial edema, or respiratory symptoms beginning 2-24 h after influenza vaccination and resolving within 48 h after onset. To characterize the spectrum, severity, and impact of ORS, we contacted persons who had reported any influenza vaccine-associated adverse event in British Columbia, Canada, during the 2000-2001 vaccination campaign. With use of a standardized telephone interview, we collected information from 609 (79%) of 769 eligible persons. Thirteen percent of ORS-affected persons reported onset 48 h, and 42% considered the symptoms to be severe. The surveillance case definition for ORS for 2001-2002 was revised to include onset

Between December 2016 and April 2017, two cases of invasive Group A Streptococcus (GAS) infections were reported at a Canadian military training facility. An outbreak was declared and a field investigation was launched to characterize the outbreak and identify associated risk factors to limit transmission. Throat culture data from military personnel at the garrison were analyzed. Investigators tracked invasive GAS cases and non-invasive hospitalized GAS cases, and conducted site visits and case interviews. Sensitivity and specificity for a rapid antigen detection test were evaluated. Molecular typing and phylogenomic relationships of outbreak isolates were analyzed using whole-genome sequencing. During this outbreak, four invasive cases were reported and six non-invasive cases were hospitalized. In a sample of 705 throat cultures examined, 35.2% were GAS-positive. Among 65 platoon contacts of one invasive case, 30.2% were GAS-positive. Reluctance to seek medical care, challenges in following cough etiquette, and low compliance with antibiotics were identified among recruits. The rapid antigen detection test had low sensitivity (31.6%) during the outbreak. The outbreak sequence type was emm6.4 and outbreak isolates were highly related phylogenetically, differing by 0-4 single nucleotide variants. This is the first report of a GAS outbreak among Canadian military trainees. Increased surveillance of GAS infections, increased control measures and outbreak-specific clinical guidelines were implemented in-garrison. No further invasive GAS cases were identified. A GAS surveillance system was implemented and efforts to improve antibiotic compliance and medical consultation were recommended.

No abstract

The Canadian Forces (CF) adopted the EPINATO surveillance system in 1996 to monitor disease and injury morbidity in deployed settings. The Directorate of Force Health Protection, CF Health Services Group initiated an evaluation of EPINATO in Task Force Bosnia-Herzegovina in August 2003. Two methods were used to assess coding reliability: a chart audit and Sick Parade Register review. Stakeholder interviews were conducted evaluating data flow, reporting structure, and key system attributes. Reliability (K, 95% confidence interval) was good in 4 of 24 categories--sexually transmitted diseases, K = 0.75 (0.50, 1.00); eye disorders, K = 0.51 (0.15, 0.88); ears/nose/ throat, K = 0.51 (0.33, 0.69); lower respiratory infections, K = 0.49 (95% confidence interval 0.34, 0.65)-but otherwise was poor. EPINATO is not an effective, reliable tool for CF deployment health surveillance. An improved health surveillance system is required to ensure disease and injury aberrations are detected and optimal preventive programs and policies are in place for deployed CF military members.

No abstract