Abstract We report diagnosis and management of the first laboratory-confirmed case of coronavirus disease 2019 (COVID-19) hospitalized in Toronto, Canada. No healthcare-associated transmission occurred. In the face of a potential pandemic of COVID-19, we suggest sustainable and scalable control measures developed based on lessons learned from severe acute respiratory syndrome.

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From March 2014 to December 2016, a cluster of 13 cases of Campylobacter fetus intestinal and extraintestinal infections, including 2 patients with an aortic mycotic aneurysm, caused significant morbidity. The cluster likely resulted from sexual transmission between men having sex with men living in the greater Montreal area, Quebec, Canada.

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A 40-year-old man reported a 5-day history of fever and malaise, followed by a pruritic generalized rash. He had well-demarcated erythematous papules and plaques with scaling. The patient was diagnosed with secondary syphilis. The skin biopsy showed a psoriasiform lichenoid dermatitis with plasma cells. The anti-T. pallidum antibody confirmed the presence of spirochetes. He was also found to be hepatitis C virus and human immunodeficiency virus positive. The characteristic rash of secondary syphilis may appear as maculopapular, evolving initially from macules to small reddish-brown papules with minor scaling later. When the scaling is prominent, lesions can be difficult to differentiate from guttate psoriasis. Typical target lesions are most often associated with erythema multiforme, but they can rarely occur in secondary and congenital syphilis. Syphilis should be suspected in high-risk patients presenting a variety of atypical syndromes such as neurologic symptoms, uveitis or cholestatic hepatitis, especially if palmoplantar lesions are present.

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In this controlled before–after study, wound swabs were only processed for culture, identification, and susceptibility testing if a quality metric, determined by the Q score, was met. Rejection of low-quality wound swabs resulted in a modest decrease in reflexive antibiotic initiation while reducing laboratory workload and generating few clinician requests.

A s of January 2022 in Canada, about 2 300 000 cases of COVID-19 have been confirmed since the beginning of the pandemic, with more than 30 500 deaths. 1 During the first wave of this pandemic (first half of 2020), the province of Quebec, whose population was nearly 8.5 million as of January 2021, 2 had the highest number of COVID-19 cases compared with other provinces. Montréal was the epicentre, accounting for more than one-third of all cases in the province. 3 In the first wave of the pandemic, about 10% of patients who developed COVID-19 in Wuhan, China, required admission to hospital and 5% required admission to the intensive care unit (ICU). 4,5 Older patients and those with existing comorbidities are at higher risk of adverse outcomes. 5 Amid this pandemic, hospitals have tried to continue their usual activities and provide urgent care. Unfortunately, hospital admission represents a potential environment for viral transmission to vulnerable patients. 6 As of February 2021, there were mixed data about outcomes for patients with hospital-acquired (HA) SARS-CoV-2 infection compared with non-hospital-acquired (NHA) infection, as well as inhospital transmission dynamics of SARS-CoV-2. Some studies showed a case fatality rate as high as 36% for patients with HA-COVID-19, 7 while others reported a mortality rate lower than that of patients with NHA-COVID-19. 8 Therefore, we aimed to assess whether mortality and complications were increased in HA cases of SARS-CoV-2 infection when compared with NHA cases at Hôpital Maisonneuve-Rosemont. We also explored the role of patients sharing multi-bed rooms in hospital with respect to in-hospital transmission of SARS-CoV-2.