Abstract
Objectives
This study was undertaken to measure the incidence of echinococcosis and trichinellosis hospitalization in Canada, and to compare these incidence rates between residents of northern regions and the rest of the Canadian population.
Methods
Cases hospitalized in 2001–2005 for either echinococcosis or trichinellosis were retrieved from the hospital morbidity database (HMDB) held by the Canadian Institute for Health Information. Crude and standardized incidence rates were calculated by province and by latitude range.
Results
A total of 108 echinococcosis and 14 trichinellosis hospitalizations were found, yielding incidence rates of 0.72 and 0.09 per million per year, respectively. There was a clear south-north gradient in the incidence of echinococcosis hospitalization, the highest incidence (2.9 per million per year) being found north of the 55th parallel. The risk of echinococcosis hospitalization was also significantly higher in women than in men (RR 1.92, 95% CI 1.2–2.87). For trichinellosis, the highest incidence (42 per million per year) was found in Nunavut and Northern Québec.
Conclusion
Incidence of hospitalization for echinococcosis and trichinellosis is low at the national level. However, significantly higher rates have been measured in northern regions of Canada despite the fact that both diseases are theoretically preventable and that a Trichinella control program is in place in Nunavik. Further efforts, probably educational in nature, will be required to reduce the incidence of these infections in high-risk areas.
Key words: Echinococcosis, trichinellosis, hospitalization, Canada
Résumé
Objectifs
Cette étude a été entreprise pour mesurer l’incidence des hospitalisations causées par la trichinose et l’échinococcose au Canada et pour comparer les taux mesurés chez les habitants des régions nordiques à ceux mesurés chez les autres Canadiens.
Méthode
Les cas hospitalisés de 2001 à 2005 pour l’échinococcose ou la trichinose ont été extraits de la base de données sur la morbidité hospitalière (BDMH) de l’Institut canadien d’information sur la santé. Les taux d’incidence bruts et standardisés ont été calculés par province et par intervalle de latitude.
Résultats
En tout, 108 hospitalisations causées par l’échinococcose et 14 par la trichinose ont été trouvées. Les taux d’incidence de ces deux maladies étaient respectivement de 0,72 et 0,09 par million par année. Il y avait un clair gradient sud-nord pour l’incidence des hospitalisations causées par l’échinococcose, l’incidence la plus élevée (2,9 par million par année) ayant été mesurée au nord du 55e parallèle. Le risque d’hospitalisation causée par l’échinococcose était aussi plus élevé chez les femmes que chez les hommes (RR 1,92, IC 95% 1,29–2,87). Pour la trichinose, l’incidence la plus élevée (42 par million par année) a été mesurée au Nunavut et dans le nord du Québec.
Conclusion
L’incidence des hospitalisations causées par la trichinose et l’échinococcose est faible au niveau national. Toutefois, des taux significativement plus élevés ont été mesurés dans les régions nordiques du Canada, et ce bien que les deux maladies soient théoriquement évitables et qu’un programme de prévention de la trichinose soit en place au Nunavik. Des efforts accrus, probablement de nature éducative, seront nécessaires pour réduire l’incidence de ces deux maladies dans les régions à risque.
Mots clés: échinococcose, trichinose, hospitalisations, Canada
Footnotes
Conflict of Interest: None to declare.
References
- 1.Appleyard GD, Gajadhar AA. A review of trichinellosis in people and wildlife in Canada. Can J Public Health. 2000;91(4):293–97. doi: 10.1007/BF03404292. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Somily A, Robinson JL, Miedzinski LJ, Bhargava R, Marrie TJ. Echinococcal disease in Alberta, Canada: More than a calcified opacity. BMC Public Health. 2005;5(1):34. doi: 10.1186/1471-2458-5-34. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Moro P, Schantz PM. Cystic echinococcosis in the Americas. Parasitol Int. 2006;55:S181–S186. doi: 10.1016/j.parint.2005.11.048. [DOI] [PubMed] [Google Scholar]
- 4.Miller MJ. Hydatid infection in Canada. CMAJ. 1953;68(5):423–34. [PMC free article] [PubMed] [Google Scholar]
- 5.Villeneuve A. Les zoonoses parasitaires. L’infection chez les animaux et chez l’homme. Montréal: Presses de l’Université de Montréal; 2003. [Google Scholar]
- 6.Al-Saghier M, Taylor MC, Greenberg HM. Canadian-acquired hydatid disease: A case report. Can J Infect Dis. 2001;12(3):178–82. doi: 10.1155/2001/302738. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7.MacLean JD, Viallet J, Law C, Staudt M. Trichinosis in the Canadian Arctic: Report of five outbreaks and a new clinical syndrome. J Infect Dis. 1989;160(3):513–20. doi: 10.1093/infdis/160.3.513. [DOI] [PubMed] [Google Scholar]
- 8.MacLean JD, Poirier L, Gyorkos TW, Proulx JF, Bourgeault J, Corriveau A, et al. Epidemiologic and serologic definition of primary and secondary trichinosis in the Arctic. J Infect Dis. 1992;165(5):908–12. doi: 10.1093/infdis/165.5.908. [DOI] [PubMed] [Google Scholar]
- 9.Serhir B, MacLean JD, Healey S, Segal B, Forbes L. Outbreak of trichinellosis associated with arctic walruses in northern Canada, 1999. Can Commun Dis Rep. 2001;27(4):31–36. [PubMed] [Google Scholar]
- 10.Proulx JF, MacLean JD, Gyorkos TW, Leclair D, Richter AK, Serhir B, et al. Novel prevention program for trichinellosis in inuit communities. Clin Infect Dis. 2002;34(11):1508–14. doi: 10.1086/340342. [DOI] [PubMed] [Google Scholar]
- 11.Gajadhar AA, Bisaillon JR, Appleyard GD. Status of Trichinella spiralis in domestic swine and wild boar in Canada. Can J Vet Res. 1997;61(4):256–59. [PMC free article] [PubMed] [Google Scholar]
- 12.Appleyard GD, Forbes LB, Gajadhar AA. National serologic survey for trichinellosis in sows in Canada 1996–1997. Can Vet J. 2002;43(4):271–73. [PMC free article] [PubMed] [Google Scholar]
- 13.WHO. International Classification of Diseases. Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death. Geneva, Switzerland: World Health Organization; 1977. [Google Scholar]
- 14.WHO. International Classification of Diseases. Geneva: World Health Organization; 1992. [Google Scholar]
- 15.Statistics Canada 2002. Profile of Age and Sex, for Canada, Provinces, Territories and Forward Sortation Areas, 2001 Census. Catalogue no. 95F0486XCB2001003.
- 16.Parkinson AJ, Butler JC. Potential impacts of climate change on infectious diseases in the Arctic. Int J Circumpolar Health. 2005;64(5):478–86. doi: 10.3402/ijch.v64i5.18029. [DOI] [PubMed] [Google Scholar]
- 17.Kuhnlein HV, Receveur O. Local cultural animal food contributes high levels of nutrients for arctic Canadian indigenous adults and children. J Nutr. 2007;137(4):1110–14. doi: 10.1093/jn/137.4.1110. [DOI] [PubMed] [Google Scholar]
- 18.Vuitton DA, Zhou H, Bresson-Hadni S, Wang Q, Piarroux M, Raoul F, Giraudoux P. Epidemiology of alveolar echinococcosis with particular reference to China and Europe. Parasitology. 2003;127:S87–S107. doi: 10.1017/S0031182003004153. [DOI] [PubMed] [Google Scholar]
- 19.Craig PS, McManus DP, Lightowlers MW, Chabalgoity JA, Garcia HH, Gavidia CM, et al. Prevention and control of cystic echinococcosis. Lancet Infect Dis. 2007;7(6):385–94. doi: 10.1016/S1473-3099(07)70134-2. [DOI] [PubMed] [Google Scholar]
- 20.Craig PS, Larrieu E. Control of cystic echinococcosis/hydatidosis: 1863–2002. Adv Parasitol. 2006;61:443–508. doi: 10.1016/S0065-308X(05)61011-1. [DOI] [PubMed] [Google Scholar]
- 21.Schellenberg RS, Tan BJK, Irvine JD, Stockdale DR, Gajadhar AA, Serhir B, et al. An outbreak of trichinellosis due to consumption of bear meat infected with Trichinella nativa in 2 northern Saskatchewan communities. J Infect Dis. 2003;188(6):835–43. doi: 10.1086/378094. [DOI] [PubMed] [Google Scholar]