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The author reports that U.S. Centers for Disease Control officials are concerned by evidence suggesting Clostridium difficile is spreading out of hospitals and into the community. Cases have already penetrated communities in Quebec, Canada. Massive overuse by hospitals of a class of antibiotics known as fluoroquinolones favored the genetic selection of a tougher form of the bacterium. Hospital spread and case studies are discussed.

This article focuses on the trend in the food industry for adding nutrients to products to appeal to health-conscious consumers. Beverage maker Smart (fx) is just one player in a huge new business trend -- foods and drinks with special qualities designed to appeal to health-conscious consumers. All across the food industry, from fledgling firms to giant conglomerates, companies are finding new ways to cook up increasingly exotic -- and supposedly healthful -- things to feed us. They're hoping consumer unease about genetically modified Frankenfood, mad cow disease, irradiation and bovine growth hormones will drive a new market in health-oriented foods. But are these new additive-laden "superfoods" the nutritional nirvana their proponents claim them to be, or are they simply another marketing ploy? Within the industry, they're known as "functional foods," edibles enhanced with various substances that supposedly boost the original food's basic nutritional value and -- it is hoped -- reduce the consumer's risk of chronic disease. But all this new science raises an enormous potential for, on the one hand, misleading claims by manufacturers and, on the other, rampant skepticism among consumers. Federal regulations allow manufacturers to make one of only five generic health claims on their product labels. Maintaining a healthy diet and lifestyle takes time and effort. Given our chicken-finger-licking, remote-control ways, and our stubborn reluctance to follow Canada's Food Guide to Healthy Eating, magic-bullet solutions to our health problems are awfully tempting. Hence the hype around functional foods, says Bill Jeffery, national coordinator of the Centre for Science in the Public Interest in Ottawa, a consumer advocacy organization. The new superfood makers say they have their consumers' health in mind, but they're facing a determined, skeptical opposition as they try to improve their foothold in Canada.

As Canadians anguish over how to protect themselves from severe acute respiratory syndrome (SARS), health authorities take note of what went wrong. All around Hong Kong, people go about their business in masks. The economy's losing tens of millions of dollars, commuters shun public transit and the World Health Organization (WHO), in a rare move, says stay away unless a visit is absolutely necessary. One high-rise apartment tower has been emptied, its residents quarantined in special camps built on the outskirts. The city is trying to come to grips with SARS, the mysterious ailment, likely viral in origin, that had stricken 761 people there, and 2,354 in 18 countries worldwide, by last week, killing at least 85. As labs worldwide--including Health Canada's maximum-security facility in Winnipeg (page 24)--pressed the search for the cause of SARS, the WHO maintained a global health alert, calling for any patient with atypical pneumonia to be isolated and imploring a jittery world to be watchful. In Canada, another global hot spot with more than 180 suspected and probable cases and eight deaths (with a ninth under investigation) by the end of last week, health authorities stress that the risk to the general population is extremely low. There are no non-urgent transfers of patients between health-care facilities, and in the Toronto region, elective surgeries are cancelled and some clinics closed. INSET: HOW A NEW DIESEASE STALKED THE GLOBE.

Discusses contaminated drinking water in Canada as of May 21, 2001. The health risks associated with waterborne bacteria, viruses, and protozoa; The identification of several waterborne diseases; Discussion of Cryptosporidium, E. coli 0157:H7, Norwalk, Shigella, Giardia, and Toxoplasma; The public demand for governmental water regulations in Canada.

This article discusses the way that health officials in Canada are preparing for a possible breakout of the avian flu. For months now the warnings have been relentless: the avian flu, rampaging through Southeast Asia, could morph into some sort of monstrous microbe. Currently, this particular strain has devastated commercial poultry flocks in Vietnam, Cambodia, South Korea, Thailand, Indonesia, Japan, Hong Kong and large parts of China. This much is true: H5N1 has a lot of people worried, and for a host of good reasons. Still, a significant segment of the health-care community questions whether this particular bird flu will be the one that triggers a pandemic. Neither the flu nor the threat of a pandemic should be taken lightly, says Dr. Richard Schabas, chief of staff at York Central Hospital in Richmond Hill, Ont., and a former chief medical officer of health for Ontario. Earl Brown, a University of Ottawa professor who specializes in flu virus evolution, says that while H5N1 concerns him, suggestions it could kill one in six people on the planet are way out of line. The 1918 Spanish flu killed so massively because of circumstances unlikely to repeat themselves, argues Paul Ewald, an evolutionary biologist at the University of Louisville in Kentucky. The H5N1 strain was first discovered in Hong Kong in 1997, where six of 18 hospitalized patients died. Infection was linked to bird farms and markets teeming with live poultry. There have been three serious pandemics in the past century: 1918 and two milder outbreaks, which nevertheless killed millions, in 1957 and 1968.

This article presents a profile of the Sault Ste. Marie Group Health Centre in Ontario, Canada. Her regular family doctor wasn't available, so restaurateur Rosetta Sicoli acted on the recommendation of an acquaintance and tried Sault Ste. Marie's Group Health Centre. With 58,000 registered patients on its roster, its strength lies in the full spectrum of what it offers under one roof--from family physicians and specialists to laboratory services, a pharmacy and an eyeglass dispensary--and its impressive degree of personalized care. Health czar Roy Romanow has cited the Sault model as the way of the future. Her two elderly parents, who speak only broken English, get almost all their care at the centre, and their doctors phone Sicoli to update her on their conditions. One of the first larger facilities to get into electronic record-keeping, Group Health's file-searching capabilities have improved treatment for diabetics and helped cut hospital readmissions for congestive heart failure by at least 30 per cent, says Dr. Lewis O' Brien, a family doctor and the lead physician in the electronic data project.

It was not what health-care officials had hoped for, to say the least. Only a week earlier, one of Health Canada's leading authorities on infectious diseases had speculated that SARS -- severe acute respiratory syndrome -- might actually be "easy to control." How quickly things change. By last week, the numbers had more than tripled, and SARS had infected hospital workers who worked far away from the departments where patients were being treated. While it still looked as if only close contact spreads SARS, health authorities directed more than 1,000 people possibly exposed to the mysterious virus in Toronto to be quarantined in their homes. Don't panic -- that was the word from just about every health official who had anything to say. The progress of a potentially fatal disease with no known cause and no cure created fertile ground for public apprehension, not to mention a run on sales of surgical masks. Canada was definitely a hot spot in the world outbreak of SARS, its confirmed cases reaching 28 in and around Toronto, and one in Vancouver. There have been three deaths from SARS, all in Toronto. Still, doctors in Ontario stressed that last week's surge in numbers was among health-care workers who tended SARS patients before anyone knew they should be taking precautions -- wearing a mask, gloves and a surgical gown. Health Canada noted that all Canadian patients had travelled to Asia or had contact with SARS cases in the household or in a health-care setting. Health Canada toughened its travel advisory, recommending that Canadians not fly to affected regions, particularly around southern China. Ottawa was also considering a request from the World Health Organization to screen all passengers flying out of the country for SARS. International efforts to identify what is believed to be a viral agent behind the outbreak continue, with Hong Kong researchers suggesting the bug belongs to the coronavirus family, known for causing the common cold.

The article discusses a cancer treatment that the Canadian federal government may fund. The vaccine, known as Gardasil, fights cervical cancer and genital warts caused by the human papilloma virus (HPV). The disease impacts women much differently than men. The cost is high-$300 million total. Pharmaceutical company Merck manufactures the vaccine.

The article reports that Canada lacks a policy to promote "orphan drugs," life-saving but expensive treatments for rare diseases. Provinces are responsible for deciding whether to fund the drugs on a case-by-case basis, a process that can become mired in bureaucracy. Patient rights advocates say Canadians have the worst access to medicine of any Western nation.

This is an article that discusses the development of a plan to treat stroke victims in Ontario, Canada. Ontario plans to have nine regional centres providing dedicated stroke care unlike anything else in Canada. When that happens, Hamilton paramedic Steve Dewar's job will be even more crucial than it already is. If he can get there within two hours of a stroke's onset, doctors will have just enough time for a powerful clot-busting drug, something not every hospital has the expertise to administer and monitor. The province is also planning prevention clinics to ensure high-risk patients such as diabetics, smokers and the elderly are seen promptly by a specialist and receive all the right artery-checking tests. Plus it wants to group stroke patients together in specific hospitals to improve the quality of care.

There'd been no new Canadian cases of SARS in a month. But the situation went from good to bad to worse in just two days last week. First, Toronto public health officials announced that they suspected five new cases of SARS in a north Toronto hospital. Then, on Friday, they indicated there was a second possible cluster at another hospital in the city's north end, bringing the number of suspected or probable cases to at least 20. Dr. Donald Low, director of microbiology at Mount Sinai Hospital, reported that hundreds of people have been asked to go into quarantine because of possible transmission of the virus at St. John's Rehabilitation Hospital and at North York General Hospital, where two patients died. Hours before the SARS news began to break last week, Toronto Mayor Mel Lastman was praising health-care workers and city residents for their efforts in battling the disease that has struck more than 8,100 people worldwide, killing 689, including 24 in the Toronto region. The latest developments strike an overwhelming blow to Toronto's economy. Having lifted its travel alert to Toronto on May 14, the U.S. Centers for Disease Control re-issued it on Friday.

ANYWAY YOU LOOK AT IT, Health Canada's notion of bombarding food with radiation to kill dangerous germs is going be a tough sell. Most consumers would probably cringe if they knew the cheeseburger they were about to clamp down on had been zapped with enough radiation to kill a horse -- the equivalent of about 30 million chest X-rays. But these are not glow-in-the-dark burgers. Irradiated food is not radioactive. While the process creates chemical by-products in the food, Bruce Lauer, head of Health Canada's food additives and contaminants section, says animal tests show it's safe. Not everyone is convinced. That's partly why Health Canada invited public comment last week after it recommended food processing companies be allowed to irradiate poultry, ground beef, shrimp, prawns and mangos. Consumers at least have a choice. In Canada, food treated with radioactivity must be labelled "treated with radiation," "treated by irradiation" or the equivalent, and bear a symbol called the radura. It's simple: if you don't want irradiated food, don't buy it.

Reports that lawsuits against vaccines are increasing in the U.S. Claims that thimerosal causes autism, attention deficit hyperactivity disorder and speech or language delay; How some health authorities are questioning injections of the mercury compounds; Role of thimerosal; Canada's offer of thimerosal-free vaccines; Lack of a study on long-term effects; Conclusion of the U.S. Institute of Medicine; Health Canada's report; Lawsuits.