M2M Health Notices

Important Health Information for M2M

 

SURVEILLANCE ALERT ISSUED BY

 

December 31, 2009

Increase in Shigella cases among Toronto males

A cluster of Shigella cases among males living in Toronto has recently been identified.

Thirteen cases of shigellosis due to infection with Shigella flexneri, and two cases with

an unspecified Shigella species, have been reported to Toronto Public Health (TPH)

since the beginning of November, 2009. All 15 cases were male, with a mean and

median age of 39 years; 12 (80%) of the cases live in the downtown area.

Although infection with Shigella is more commonly reported among males in Toronto,

the number of cases in the last two months is disproportionately high in this group. The

proportion of cases resulting from infection with S. flexneri is also much higher than

previously reported. Six of the cases reported engaging in sexual activity (oral-anal

contact) as the main risk for infection.

 

Singella bacteria can be transmitted through ingestion of contaminated food or water, or passed from person-to-person, typically through sexual contact. A low infectious dose

is sufficient to cause infection. Symptoms of shigellosis usually begin within one to

three days after being exposed to the bacterium. Infection can cause diarrhea (which

may be bloody), fever, nausea, and vomiting, and illness can last from four to 14 days.

The very young and elderly and those with compromised immune systems are at higher

risk for complications and may experience more severe and longer lasting diarrhea.

Toronto Public Health is requesting clinicians to consider shigellosis in the differential

diagnosis of those presenting with gastroenteritis, inquire about recent sexual activity as

a possible risk factor and request the appropriate diagnostic testing (stool culture).

Patients with symptoms should be advised to refrain from sexual activity that may cause

transmission of infection to others as well as food preparation for others for the duration

of illness. Shigella can be carried asymptomatically and persons who engage in sexual

activity that could expose them or their partners to fecal material should be counselled

to wash their hands and genital/anal areas thoroughly before and after engaging in

sexual activity. Use of protective barrier equipment also reduces the risk of enteric

sexually transmitted infections.

 

Shigellosis is a reportable communicable disease. Please report all suspect and

confirmed cases of shigellosis to Toronto Public Health immediately by calling

416-392-7411 (during work hours) and 416-690-2142 (after hours).

For more information see the TPH fact sheet and background materials on shigellosis at: http://www.toronto.ca/health/cdc/factsheets/shigellosis.htm#04

 

ALERT ISSUED BY: The Ontario Ministry of Health and Long-Term Care 

Infectious Syphilis on the Increase in Ontario

The Ministry of Health and Long-Term Care has informed us of a recent increase in infectious syphilis (Treponema Pallidum) cases in Ontario. 

The Ministry has identified the following trends through analysis of provincial data:

  • More than half (18 out of 36) public health units in Ontario have reported increases in infectious syphilis cases during the first 8 months of 2009 as compared to 2008.
  • The increase in cases is occuring predominantly within the male population.
  • Of reported male cases with risk factor information available, 85% identify as men who have sex with men (MSM).
  • The largest number of cases occur among males aged 40 to 44 years; and the largest increase in recent cases is seen in males between the ages of 15 to 34.
  • 45% of cases are reported to be co-infected with HIV.
Therefore, men who have sex with men (MSM) with the following risk factors should be made aware of the increase in infectious syphilis cases, advised to speak with their doctor or sexual health clinic and get tested:
  • Having had unprotected oral or anal sex
  • Having a history of syphilis infection, HIV or other sexually transmitted infections
  • Having multiple sex partners or a partner with multiple sex partners, within the last year.
    •  

    Accurate diagnosis and treatment of syphilis requires clinical evaluation, and is supported by laboratory data.  Syphilis treatment recommendations are based on the staging of the disease.  Timely staging and treatment diminishes the risk of long-term negative outcomes and further infectious syphilis transmission.

    For more detailed information on Syphilis CLICK HERE

    For information on Durham Region Sexual Health Clinics CLICK HERE

     

     
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