CANADA (ONTARIO) – POSSIBLE SURGICAL CJD TRANSMISSION
A woman who was operated on at the Hotel–Dieu Grace Hospital in Windsor on March 11, 2001, later tested positive for Creutzfeldt–Jakob Disease (CJD). Neurosurgeons at the hospital learned of the test result, which is about 85 percent accurate, on May 7. The hospital subsequently suspended all surgery and disinfected the operating rooms and surgical equipment. The hospital has begun contacting patients who have undergone neurosurgery since March. While the risk of iatrogenic transmission is very small, normal sterilization protocols reduce, but do not eliminate that risk, as the infectious agent is resistant to standard sterilization procedures. Iatrogenic transmission of CJD from contaminated surgical instruments such as dura mater grafts has been reported previously in Japan and Thailand. As of November 1997, approximately 43 patients were believed to have contracted the infection in this manner in Japan. CJD is extremely rare and leads to progressive dementia and loss of physical functions, inevitably resulting in death.
[PROMED 5/14/01, 11/20/97]

CANADA (SASKATCHEWAN) – CRYPTOSPORIDIOSIS OUTBREAK
More than 100 flu–like illnesses in the town of North Battleford in west–central Saskatchewan are believed to be the result of a contaminated water supply. The parasite, Cryptosporidium parvum, was found in a water–treatment plant that serves the town, and is presumed to have entered the water supply through a faulty filtration system. Health officials stated that 36 cases of cryptosporidiosis have been confirmed through laboratory testing, and may have been responsible for one death. The Environment Department recently released the names of 119 communities in Saskatchewan that have problems with their water treatment facilities. According to the Environment Minister, nearly a third of these lack minimum treatment standards.
[REUTERS 5/7/01; PROMED 5/6/01, CANADIAN PRESS 5/16/01]

CANADA (OTTAWA) – METHICILLIN–RESISTANT STAPHYLOCOCCUS AUREUS OUTBREAK IN HOSPITALS
Ottawa hospitals have treated about 50 cases of methicillin–resistant Staphylococcus aureus (MRSA) following its introduction into a hospital by a patient from the United Kingdom. The director of the Ottawa Hospital’s Infection Prevention and Control Program emphasized that the community is not at risk and that this particular bacteria is not particularly dangerous as it can be successfully treated with antibiotics. The hospitals have had to respond to MRSA outbreaks since 1990. Nonetheless, hospital officials state that they are following strict procedures such as isolating infected patients. In a hospital outbreak, patients with weak immune systems are those most susceptible to the infection.
[OTTAWA CITIZEN 5/17/01, http://www.ottawacitizen.com]

CANADA (ALBERTA) – CALICIVIRUS OUTBREAK IN SCHOOL
An outbreak of viral gastroenteritis affected 163 children and 16 teachers at an elementary school in Calgary on May 2. The virus has been identified as belonging to the calicivirus family, and samples have been sent to the Centers for Disease Control and Prevention (CDC) for further testing. Caliciviruses are commonly spread through the consumption of contaminated food or beverages, and can cause nausea, diarrhea, vomiting, abdominal pain, fever, and malaise. While the source of the infection is not clear, the school’s water has been ruled out as a possible source. The school has disinfected the walls, floors, and handrails in order to minimize the risk of further infections.
[CANADIAN PRESS 5/16/01; PROMED 5/17/01]

U.S. (NJ) – WEST NILE VIRUS DETECTED IN CROWS
As of May 20, five crows found dead in two counties of New Jersey have tested positive for the West Nile Virus (WNV). Both of these counties exhibited high crow mortality last year. Most counties in New Jersey have been conducting surveillance activities since March, but these are the first reports of WNV in the country in 2001. Testing dead birds has proven to be an effective early–warning system, as the virus can infect birds before it infects people. Such increased awareness can alert health officials to the need to increase surveillance and control measures of mosquito populations.

WNV first appeared in New York two years ago. Since then, it has infected tens of thousands of birds and at least 81 people, including nine deaths. The most effective way to prevent infection is to take precautions to reduce the risk of being bitten by a mosquito.
[NJ WNV WEB SITE, http://www.state.nj.us/governor/westnile/index.html; PROMED
5/7/01, 5/8/01, 5/15/01, 5/20/01]

MEXICO – SUSPECTED IMPORTED MEASLES
A small outbreak of measles in the Benito Juarez Municipality in Mexico occurred in a 33–year–old male of U.S. nationality and his wife and daughter. The index case was the 33–year–old male, whose illness began on April 13. He had recently had contact with some Koreans on March 15, and had traveled to a convention in Dallas on March 22. According to the Texas Department of Health, there has been only one reported case of measles in the state, which occurred in an adoptee exposed in China with onset on February 14. The CDC confirmed that there were no reported cases that may have traveled through Dallas or Houston during the relevant time period in March. While there has been an outbreak in Korea with approximately 40,000 cases, the date of contact with the Koreans is outside of the average 14–day exposure period. It is not known whether any specimens for viral isolation were obtained from the index case.
[PROMED 5/4/01, 5/5/01]

EL SALVADOR – SUSPECTED IMPORTED MEASLES
The El Salvador Ministry of Health confirmed the first two cases of measles in the country since eradication of the disease in 1996. The cases occurred in two brothers who recently returned from Europe. The cases are thought to be imported. In response, health authorities announced plans to vaccinate university students, and to establish sanitary cordons in the international airport and at overland border crossings. Neighboring countries have also enhanced prevention measures by increasing vaccinations and notifying residents of border regions. The Guatemalan government sent 200,000 doses of measles vaccine to the El Salvadoran Ministry of Health.
[PROMED 5/14/01, 5/17/01]