Objective To characterize SARS-CoV-2 transmission following a COVID-19 outbreak in an emergency childcare centre (ECCC) in April 2020 in Quebec, Canada. Methods The study population consisted of all the children and employees who attended the ECCC as well as household contacts of the confirmed COVID-19 cases. Of the 120 individuals in the study, five cases were confirmed by epidemiological link and 25 were identified as COVID-19 by RT-PCR among which 19 were analyzed by viral whole genome sequencing. Descriptive epidemiology, social network visualization, and phylogenetic analysis were used to characterize viral transmission. Results Phylogenetic analysis identified two separate introductions of distinct lineages of SARS-CoV-2 and estimated an average effective reproductive number of R e = 1.9 (range 0.9-4.9) with a mean doubling time of 3.2 days (range 2.1-5.2). The first and most prevalent lineage was introduced by two asymptomatic children who were likely infected by their parent, a confirmed COVID-19 case working in a long-term care centre. Among infected household adults, attack rates were significantly higher in mothers than in fathers (risk ratio = 4.5; 95% CI 1.1-18.7). The extent of transmission makes it one of the largest documented outbreaks in a daycare in Canada. Conclusion The analyses carried out showed the probable origin and direction of the transmission of the infection (adult-child, child-adult, and child-child), thus highlighting how asymptomatic children can efficiently transmit SARS-CoV-2.
RésuméObjectif Caractériser la transmission du SRAS-CoV-2 à la suite d'une éclosion de COVID-19 dans un service de garde d'urgence en milieu scolaire (SGUMS) en avril 2020 au Québec, Canada.
This study was performed to assess whether nifedipine could prevent the decrease in hepatic cytochrome P450 induced by acute moderate hypoxia or an inflammatory reaction. Rabbits were subjected to acute moderate hypoxia (PaO2 > 37 mmHg), with or without pretreatment with nifedipine (0.5 mg kg-1 subcutaneously every 8 h, for 48 h). Another group received 5 mL of turpentine subcutaneously with or without pretreatment with nifedipine (0.5 mg kg-1 s.c. every 8 h, for 72 h). The kinetics of 2.5 mg kg-1 of theophylline were studied in all rabbits up to 8 h, at which time total cytochrome P450 and malondialdehyde were assessed in the liver. Compared with control rabbits, hypoxia and an inflammatory reaction increased theophylline plasma concentrations, as a result of 3 decrease in theophylline systemic clearance. Both experimental conditions reduced hepatic cytochrome P450 by 40 to 50% and increased hepatic malondialdehyde by approximately 50% (P < 0.05). In control animals, pretreatment with nifedipine did not influence theophylline kinetics, the liver content in cytochrome P450 or malondialdehyde. Pretreatment with nifedipine partially prevented the hypoxia- and the inflammation-induced decrease in liver cytochrome P450; however, nifedipine did not prevent the decrease in theophylline clearance or the increase in liver malondialdehyde. It is concluded that nifedipine affords a partial protection against hypoxia- or inflammation-induced hepatic cellular injury.
Objectives The objective of this study is to describe an important waterborne outbreak of gastrointestinal illness observed in a rural municipality of Quebec. Methods A population-based retrospective cohort study was conducted to identify risk factors associated with acute gastroenteritis. Indirect surveillance data were used to estimate the extent and the resolution of the epidemic. Results The cohort consisted of 140 randomly selected individuals of whom 22 met the illness case definition (15.7% attack rate). The epidemic curve was similar to the evolution of antidiarrheal products sold by the only pharmacy in town and calls made to the Health Info Line. Bivariate analysis led to identifying five risk factors of gastrointestinal illness: consumption of municipal water, contact with someone with acute gastroenteritis (within and outside of the household), contact with a child in daycare, and being less than 35 years of age. Drinking municipal water had the highest risk ratio (RR = 24.31; 95% CI = 1.50-393.4). Drinking water from a private artesian well was a protective factor (RR = 0.28; 95% CI = 0.09-0.90). Conclusion This study highlighted that managing the risks associated with the consumption of untreated drinking water remains an important public health challenge, particularly in small rural municipalities vulnerable to climate variability.
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