10 research outputs found
Public health preparedness in Alberta: a systems-level study
No full textAbstract Background Recent international and national events have brought critical attention to the Canadian public health system and how prepared the system is to respond to various types of contemporary public health threats. This article describes the study design and methods being used to conduct a systems-level analysis of public health preparedness in the province of Alberta, Canada. The project is being funded under the Health Research Fund, Alberta Heritage Foundation for Medical Research. Methods/Design We use an embedded, multiple-case study design, integrating qualitative and quantitative methods to measure empirically the degree of inter-organizational coordination existing among public health agencies in Alberta, Canada. We situate our measures of inter-organizational network ties within a systems-level framework to assess the relative influence of inter-organizational ties, individual organizational attributes, and institutional environmental features on public health preparedness. The relative contribution of each component is examined for two potential public health threats: pandemic influenza and West Nile virus. Discussion The organizational dimensions of public health preparedness depend on a complex mix of individual organizational characteristics, inter-agency relationships, and institutional environmental factors. Our study is designed to discriminate among these different system components and assess the independent influence of each on the other, as well as the overall level of public health preparedness in Alberta. While all agree that competent organizations and functioning networks are important components of public health preparedness, this study is one of the first to use formal network analysis to study the role of inter-agency networks in the development of prepared public health systems.</p
Efficacy and Safety of CVT-E002, a Proprietary Extract of <i>Panax quinquefolius</i> in the Prevention of Respiratory Infections in Influenza-Vaccinated Community-Dwelling Adults: A Multicenter, Randomized, Double-Blind, and Placebo-Controlled Trial
No full textCVT-E002 (a proprietary extract) was found to be effective in the prevention of upper respiratory infections (URIs) in healthy adults, and institutionalized and community-dwelling seniors. A multicenter, randomized, double-blind, placebo-controlled trial was carried out to determine effects of CVT-E002 in the prevention of URIs in influenza-vaccinated community-dwelling adults. 783 community-dwelling adults were randomized to receive placebo, 400 mg or 800 mg treatment/d (1 : 1 : 1) for 6 months. Primary analysis on the incidence of laboratory-confirmed-clinical URIs (LCCUs), including influenza A and B, was performed on those receiving at least one dose. Secondary analysis was performed on study completers and included incidence, severity, and duration of URIs meeting a Jackson-based criteria and safety of CVT-E002. The incidence of LCCUs in the ITT group was 5.5%, 5.2%, and 4.6% in the placebo, 400 mg and 800 mg groups, respectively (P=0.89). Jackson-confirmed URIs were significantly lower in the treated groups (P<0.04). CVT-E002 supplementation reduced the severity and duration of Jackson-confirmed URIs. The results indicate that CVT-E002 can be safely used by similar groups and may prevent symptoms of URIs; larger sample size is warranted.</jats:p
Immunogenicity and safety of 3-dose primary vaccination with combined DTPa-HBV-IPV/Hib vaccine in Canadian Aboriginal and non-Aboriginal infants
No full textAbstractThis study compared immune responses of healthy Aboriginal and non-Aboriginal infants to Haemophilus influenzae type b (Hib) and hepatitis B virus (HBV) components of a DTaP-HBV-IPV/Hib combination vaccine, 1 month after completing dosing at 2, 4 and 6 months of age. Of 112 infants enrolled in each group, 94 Aboriginal and 107 non-Aboriginal infants qualified for the immunogenicity analysis. Anti-PRP concentrations exceeded the protective minimum (≥0.15μg/ml) in ≥97% of infants in both groups but geometric mean concentrations (GMCs) were higher in Aboriginal infants (6.12μg/ml versus 3.51μg/ml). All subjects were seroprotected (anti-HBs ≥10mIU/mL) against HBV, with groups having similar GMCs (1797.9 versus 1544.4mIU/mL, Aboriginal versus non-Aboriginal, respectively). No safety concerns were identified. We conclude that 3-dose primary vaccination with DTaP-HBV-IPV/Hib combination vaccine elicited immune responses to Hib and HBV components that were at least as high in Aboriginal as in non-Aboriginal Canadian infants.Clinical Trial Registration NCT00753649
1087Immunogenicity and Safety of 3-Dose Primary Vaccination with Combined DTPa-HBV-IPV/Hib Vaccine in Canadian Aboriginal and non-Aboriginal Infants
No full textA dose-ranging study of a subunit Respiratory Syncytial Virus subtype A vaccine with and without aluminum phosphate adjuvantation in adults ≥65 years of age
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No full textInterpretation: First Nations and Métis adults responded robustly to ASO3-adjuvanted pandemic (H1N1) 2009 vaccine. Virtually all participants showed protective titres, including those with chronic health conditions. Trial registration: ClinicalTrials.gov trial register no. NCT.01001026. Abstrac
Comparison of safety and immunogenicity of two doses of investigational hepatitis B virus surface antigen co-administered with an immunostimulatory phosphorothioate oligodeoxyribonucleotide and three doses of a licensed hepatitis B vaccine in healthy adults 18–55 years of age
No full textIdentification and Epidemiology of Severe Respiratory Disease due to Novel Swine-Origin Influenza A (H1N1) Virus Infection in Alberta
No full textBACKGROUND: In March 2009, global surveillance started detecting cases of influenza-like illness in Mexico. By mid-April 2009, two pediatric patients were identified in the United States who were confirmed to be infected by a novel influenza A (H1N1) strain. The present article describes the first identified severe respiratory infection and the first death associated with pandemic H1N1 (pH1N1) in Canada.METHODS: Enhanced public health and laboratory surveillance for pH1N1 was implemented throughout Alberta on April 24, 2009. Respiratory specimens from all patients with a respiratory illness and travel history or those presenting with a severe respiratory infection requiring hospitalization underwent screening for respiratory viruses using molecular methods. For the first severe case identified and the first death due to pH1N1, histocompatibility leukocyte antigens were compared by molecular methods.RESULTS: The first death (a 39-year-old woman) occurred on April 28, 2009, and on May 1, 2009, a 10-year-old child presented with severe respiratory distress due to pH1N1. Both patients had no travel or contact with anyone who had travelled to Mexico; the cases were not linked. Histocompatibility antigen comparison of both patients did not identify any notable similarity. pH1N1 strains identified in Alberta did not differ from the Mexican strain.CONCLUSION: Rapid transmission of pH1N1 continued to occur in Alberta following the first death and the first severe respiratory infection in Canada, which were identified without any apparent connection to Mexico or the United States. Contact tracing follow-up suggested that oseltamivir may have prevented ongoing transmission of pH1N1.Peer Reviewe
Identification and Epidemiology of Severe Respiratory Disease due to Novel Swine-Origin Influenza A (H1N1) Virus Infection in Alberta
No full textBACKGROUND: In March 2009, global surveillance started detecting cases of influenza-like illness in Mexico. By mid-April 2009, two pediatric patients were identified in the United States who were confirmed to be infected by a novel influenza A (H1N1) strain. The present article describes the first identified severe respiratory infection and the first death associated with pandemic H1N1 (pH1N1) in Canada
Estimating the impact of influenza vaccination and antigenic drift on influenza-related morbidity and mortality in England & Wales using hidden Markov models
No full textInfluenza causes substantial morbidity and mortality in some influenza sea-
sons, especially among the elderly. Influenza seasons dominated by circula-
tion of influenza A/H3N2 virus tend to result in more morbidity and mor-
tality than seasons dominated by influenza A/H1N1 or influenza B viruses.
Influenza viruses undergo constant mutation, called antigenic drift, which
is largely driven by host immunity. It has been shown that antigenic drift
in influenza A/H3N2 virus proceeds in a punctuated, as opposed to contin-
uous, fashion. A cluster of antigenically similar influenza A/H3N2 viruses
appears to remain dominant for between 1 and 8 influenza seasons before
being supplanted by a new cluster. Influenza seasons when a new cluster
becomes dominant may result in higher morbidity and mortality than other
seasons. Influenza vaccine effectiveness varies between influenza seasons be-
cause of the different subtypes in circulation and the degree of antigenic
match between vaccine and circulating variants. In each influenza season in
recent years, over 70% of the population of England & Wales aged > 65 has
been vaccinated, though the impact of this high coverage on population level
morbidity and mortality is unknown. Multivariate time series models were
fitted to reports of laboratory confirmed influenza, sentinel general practi-
tioner (GP) consultations for influenza-like-illness, and all deaths registered
to underlying pneumonia or influenza in England & Wales from 1975/76 to
2004/05. The models successfully distinguish influenza
- attributable GP
consultations and deaths from GP consultations and deaths that would be
expected in the absence of influenza. This distinction is made jointly by
the laboratory reports and the non-laboratory confirmed surveillance data.
It is not possible to use the multivariate time series models to quantify
the average effect of the appearance of a new cluster of influenza A/H3N2
virus variants, or vaccine impact, on influenza
- attributable morbidity or
mortality in the data analyzed. Reasons for this are discu
