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1.  Pneumococcal conjugate vaccination in Canadian infants and children younger than five years of age: Recommendations and expected benefits 
Introduction
Streptococcus pneumoniae infection may result in invasive pneumococcal disease (IPD), such as bacteremia, meningitis and bacteremic pneumonia, or in non-IPD, such as pneumonia, sinusitis and otitis media. In June 2001, a heptavalent pneumococcal conjugate vaccine (PCV7) (Prevnar, Wyeth Pharmaceuticals, Canada) was approved for use in children in Canada. The objective of the present paper is to review S pneumoniae-induced disease incidence and vaccine recommendations in Canadian infants and children younger than five years of age. Particular attention is given to the expected benefits of vaccination in Canada based on postmarketing data and economic modelling.
Methods
Searches were performed on PubMed and Web of Science databases and specific Canadian journals using the key words 'pneumococc*', 'vaccine', 'conjugate', 'infant' and 'Canadian'.
Results and Discussion
PCV7 appears to be safe and effective against IPD and non-IPD in children younger than five years of age and, more importantly, in children younger than two years of age (who are at highest risk for IPD). An examination of postmarketing data showed a reduction in incidence of pneumococcal disease in age groups that were vaccinated and in older age groups, indicating the likelihood of herd protection. Concurrently, there was a reduction in the occurrence of antimicrobial-resistant isolates.
Conclusions
The results from the present review suggest that PCV7 is currently benefiting Canadian children and society by lowering S pneumoniae-associated disease. Additional gains from herd protection and further reductions in antimicrobial resistance will be achieved as more Canadian children younger than five years of age are routinely vaccinated with PCV7.
PMCID: PMC2095050  PMID: 18418479
Conjugate; Economic; Infant; Pneumococcus; Post-marketing; Prevnar; Streptococcus pneumoniae
2.  A descriptive study of human Salmonella serotype typhimurium infections reported in Ontario from 1990 to 1998 
BACKGROUND:
Salmonella infections cause gastrointestinal and systemic diseases worldwide and are the leading causes of food-borne illnesses in North America (1-4). Salmonella serotype typhimurium (ST), in particular, is increasingly becoming a major public health concern because of its ability to acquire multiple resistant genes (5,6).
OBJECTIVE:
To describe demographic, temporal and geographical distributions, and reported risk factors of nonoutbreak cases of ST reported to a surveillance system in Ontario.
METHODOLOGY:
Descriptive analyses were performed on data on salmonellosis cases reported in Ontario between 1990 and 1998. Direct age- and sex-standardized rates were computed, and temporal trend analyses were performed using simple linear regression and a general additive model with a locally weighted regression (LOESS) smoother.
RESULTS:
The mean annual rates of infections with all Salmonella serotypes and with ST were 27 cases per 100,000 persons and 3.7 cases per 100,000 persons, respectively. Males and children under five years of age had significantly higher rates of both ST and ST definitive type 104 (DT104) infections. There was also evidence of temporal clustering of all strains of Salmonella, with significantly more cases being reported during the summer. Significantly higher rates of ST DT104 were observed in urban areas compared with rural areas, suggesting potential differences in the geographical distribution of risk factors.
CONCLUSIONS:
Information on demographic, temporal and geographical distributions, and risk factors is critical in planning disease control strategies. Further prospective analytical observation studies are needed to gain a better understanding of the epidemiology of ST and ST DT104 in Ontario, which will better guide disease control decisions.
PMCID: PMC2094948  PMID: 18159468
Ontario; Spatial distribution; Surveillance; Salmonella typhimurium; Salmonella typhimurium DT104; Salmonella serotype typhimurium

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