We compared personal histories of 57 cases and 122 age-matched controls to identify possible environmental determinants of Parkinson's disease (PD). Odds ratios (OR) adjusted for sex, age, and smoking were computed using stepwise logistic regression. We found a statistically significant increased risk for working in orchards (OR = 3.69, p = 0.012, 95% CI = 1.34, 10.27) and a marginally significant increased risk associated with working in planer mills (OR = 4.11, p = 0.065, 95% CI = 0.91, 18.50). A Fisher's exact test of the association between PD development and (1) paraquat contact, and (2) postural tremor gave statistically significant probability estimates of 0.01 and 0.03, respectively. The relative risk of PD decreased with smoking, an inverse relationship supported by many studies.

An outbreak investigation in British Columbia during the late spring of 2009 provided the first indication of an unexpected association between receipt of TIV and pH1N1 illness. This led to 5 additional studies through the summer 2009 in Canada, each of which corroborated these initial findings.

Diagnosis of botulism in two teenaged sisters in Montreal led to the identification of 36 previously unrecognized cases of type B botulism in persons who had eaten at a restaurant in Vancouver, British Columbia, during the preceding 6 weeks. A case-control study implicated a new vehicle for botulism, commercial chopped garlic in soybean oil (P less than 10(-4)). Relatively mild and slowly progressive illness, dispersion of patients over at least eight provinces and states in three countries, and a previously unsuspected vehicle had contributed to prolonged misdiagnoses, including myasthenia gravis (six patients), psychiatric disorders (four), stroke (three), and others. Ethnic background influenced severity of illness: 60% of Chinese patients but only 4% of others needed mechanical ventilation (P less than 10(-3]. Trypsinization of serum was needed to show toxemia in one patient. Electromyography results with high-frequency repetitive stimulation corroborated the diagnosis of botulism up to 2 months after onset. Although botulism is a life-threatening disease, misdiagnosis may be common and large outbreaks can escape recognition completely.

Twenty-nine confirmed cases of Salmonella nima enterocolitis in Canada and four cases in the United States were traced to gold-foil wrapped chocolate coins from Belgium. Illness in Canadian cases occurred between September 1985 and October 1986 where the primary case in each of 24 affected families was a child ≤ 14 years of age. A product recall was issued on October 3, 1986 in Canada. Quantitative analysis of four composite samples of suspect chocolate by the most probable number (MPN) technique showed levels of 4.3 to 24.0 S. nima per 100 g product. These levels of contamination and consumption of approximately 25 g of chocolate by primary cases suggest that small numbers of S. nima precipitated clinical symptoms.

Please cite this paper as: Janjua et al. (2012) Transmission dynamics and risk factors for pandemic H1N1‐related illness: outbreak investigation in a rural community of British Columbia, Canada. Influenza and Other Respiratory Viruses 6(3), e54–e62. Objective  To characterize the first‐wave epidemiologic features of influenza‐like illness (ILI) associated with the novel pandemic A/H1N1 [A(H1N1)pdm09] virus. Methods  We used generalized linear mixed models (GLMM) to assess risk factors and non‐parametric and/or parametric distributions to estimate attack rates, secondary attack rates (SAR), duration of illness, and serial interval during a laboratory‐confirmed community outbreak of A(H1N1)pdm09 clustered around on‐reserve residents and households of an elementary school in rural British Columbia, Canada, in late April/early May 2009. ILI details were collected as part of outbreak investigation by community telephone survey in early June 2009. Results  Overall, 92/408 (23%) of participants developed ILI and 36/408 (9%) experienced medically attended ILI (MAILI). The overall SAR in households was 22%: highest among participants 1–4 years of age (yoa) (50%) followed by <1 yoa (38%), 5–8 yoa (20%), 10–19 yoa (13%), 20–49 yoa (20%), and 50–64 yoa (0%). The median serial interval was estimated at 3·5 days (95% CI: 2·1–5·1). In multivariable GLMM analysis, having a chronic condition (OR: 2·58; 95% CI: 1·1–6·04), younger age [1–8 yoa: OR: 4·63; 95% CI: 2·25–9·52; 9–19 yoa: OR: 1·95; 95% CI: 0·97–3·9 (referent: ≥20 yoa)] and receipt of 2008–2009 influenza vaccine (OR: 2·68; 95% CI: 1·37–5·25) were associated with increased risk of ILI. Median duration of illness was 9 days, longer among those with chronic conditions (21 days). Median time to seeking care after developing illness was 4·5 days. On‐reserve participants had higher chronic conditions, household density, ILI, MAILI, and SAR. Conclusions  During a community outbreak of A(H1N1)pdm09‐related illness, we identified substantial clinical ILI attack rates exceeding 20% with secondary household attack rates as high as 50% in young children. The serial interval was short suggesting a narrow period to prevent transmission.