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Background. With invasive Haemophilus influenzae serotype b (Hib) disease controlled by vaccination with conjugate Hib vaccines, there is concern that invasive disease due to non-serotype b strains may emerge. Objective. This study characterized invasive H. influenzae (Hi) isolates from Nunavut, Canada, in the post-Hib vaccine era. Methods. Invasive H. influenzae isolates were identified by conventional methods at local hospitals; and further characterized at the provincial and federal public health laboratories, including detection of serotype antigens and genes, multi-locus sequence typing and antibiotic susceptibility. Results. Of the 89 invasive H. influenzae cases identified from 2000 to 2012, 71 case isolates were available for study. There were 43 serotype a (Hia), 12 Hib, 2 Hic, 1 Hid, 1 Hie, 2 Hif and 10 were non-typeable (NT). All 43 Hia were biotype II, sequence type (ST)-23. Three related STs were found among the Hib isolates: ST-95 (n =9), ST-635 (n =2) and ST-44 (n =1). Both Hif belonged to ST-124 and the 2 Hic were typed as ST-9. The remaining Hid (ST-1288) and Hie (ST-18) belonged to 2 separate clones. Of the 10 NT strains, 3 were typed as ST-23 and the remaining 7 isolates each belonged to a unique ST. Eight Hib and 1 NT-Hi were found to be resistant to ampicillin due to b-lactamase production. No resistance to other antibiotics was detected. Conclusion. During the period of 2000-2012, Hia was the predominant serotype causing invasive disease in Nunavut. This presents a public health concern due to an emerging clone of Hia as a cause of invasive H. influenzae disease and the lack of published guidelines for the prophylaxis of contacts. The clonal nature of Hia could be the result of spread within an isolated population, and/or unique characteristics of this strain to cause invasive disease. Further study of Hia in other populations may provide important information on this emerging pathogen. No antibiotic resistance was detected among Hia isolates; a small proportion of Hib and NT-Hi isolates demonstrated resistance to ampicillin due to b-lactamase production. [ABSTRACT FROM AUTHOR]

Introduction: Certain types of the Human Papillomavirus (HPV) are sexually transmitted and highly associated with development of cervical dysplasia and cervical cancer but the distribution of HPV infection in the North, particularly amongst First Nations, Metis, and Inuit peoples, is little known. The purposes of the study are to identify the prevalence of type-specific HPV infections and the association of different HPV types with cervical dysplasia among women in Northern Canada. Methods: This was a cross-sectional study with attendants of the routine or scheduled Pap testing program in the Northwest Territories (NWT), Nunavut, Labrador and Yukon, Canada. Approximately half of each sample was used for Pap test and the remaining was used for HPV genotyping using a Luminex-based method. Pap test results, HPV types, and demographic information were linked for analyses. Results: Results from 14,598 specimens showed that HPV infection was approximately 50% higher among the Aboriginal than the non-Aboriginal population (27.6% vs. 18.5%). Although the most common HPV type detected was HPV 16 across region, the prevalence of other high risk HPV types was different. The age-specific HPV prevalence among Aboriginal showed a 'U' shape which contrasted to non-Aboriginal. The association of HPV infection with cervical dysplasia was similar in both Aboriginal and non-Aboriginal populations. Conclusions: The HPV prevalence was higher in Northern Canada than in other Areas in Canada. The prevalence showed a higher rate of other high risk HPV infections but no difference of HPV 16/18 infections among Aboriginal in comparison with non-Aboriginal women. This study provides baseline information on HPV prevalence that may assist in surveillance and evaluation systems to track and assess HPV vaccine programs. [ABSTRACT FROM AUTHOR]

Background: A variety of routine childhood and adolescent meningococcal vaccination programs using monovalent (serogroup C) and quadrivalent (A, C, Y, W) conjugate vaccines have been implemented in Canada since 2002, resulting in a decrease in invasive meningococcal disease (IMD) incidence, particularly in serogroup C. Meningococcal vaccines have also been used for outbreak response, including the multicomponent vaccine serogroup B vaccine. This report describes the epidemiology of IMD in Canada from 2012 to 2019., Methods: Case data were obtained from the National Enhanced IMD Surveillance System between January 1, 2012 and December 31, 2019. Isolates were sent to the National Microbiology Laboratory for confirmation of serogroup and further studies including phenotype and clonal complex identification., Results: A total of 983 cases of IMD were reported between 2012 and 2019. Overall, the age-adjusted incidence of IMD from 2012 to 2019 was 0.34 cases per 100,000 population per year when standardized to the Canadian 2011 population age distribution (95% CI: 0.32-0.36). Infants younger than one year of age had the highest average age-specific incidence rate (3.6 cases per 100,000 population per year, 95% CI: 2.8-4.3). The highest age-adjusted incidence rate was associated with serogroup B (0.17 cases per 100, 000 population per year, 95% CI: 0.16-0.19). Prior to 2015, most invasive serogroup W isolates were identified as clonal complex 22 (ST-22 CC) and the increase in serogroup W in Canada in recent years has been associated with the replacement of the endemic ST-22 CC with the hyper-virulent ST-11 CC., Conclusion: Invasive meningococcal disease is a rare but severe infection in Canada that mostly affects the very young. Serogroup B continues to account for the greatest proportion of disease. Serogroup W associated with ST-11 CC is becoming a growing contributor of disease in all age groups not protected by serogroup W-containing vaccines., Competing Interests: Competing interests: None., (Public Health Agency of Canada, 2022.)