Domestic impact of tuberculosis screening among new immigrants to Ontario, Canada.
Canadian Medical Association Journal 187(16):E473 (2015)
All Canadian immigrants undergo screening for tuberculosis (TB) before immigration, and selected immigrants must undergo postimmigration surveillance for the disease. We sought to quantify the domestic health impact of screening for TB in all new immigrants and to identify mechanisms to enhance ...
Relating Tuberculosis (TB) Contact Characteristics to QuantiFERON-TB-Gold and Tuberculin Skin Test Results in the Toronto Pediatric TB Clinic.
Journal of the Pediatric Infectious Diseases So... 4(2):96 (2015)
Few data relate interferon-γ-release-assay results in children to source case sputum status, the best predictor of infectiousness of tuberculosis (TB) patients. We evaluated the QuantiFERON-Gold-in-tube assay (QFT) and tuberculin skin test (TST) in children with different types of TB exposure.
Marked microevolution of a unique Mycobacterium tuberculosis strain in 17 years of ongoing transmission in a high risk population.
PLoS ONE 9(11):e112928 (2014)
The transmission and persistence of Mycobacterium tuberculosis within high risk populations is a threat to tuberculosis (TB) control. In the current study, we used whole genome sequencing (WGS) to decipher the transmission dynamics and microevolution of M. tuberculosis ON-A, an endemic strain re...
The use of videophone for directly observed therapy for the treatment of tuberculosis.
Canadian Journal of Public Health 104(3):e272 (2013)
Unexplained deterioration during antituberculous therapy in children and adolescents: clinical presentation and risk factors.
Pediatric Infectious Disease Journal 31(2):129 (2012)
Patients may unexpectedly deteriorate clinically and/or radiographically during the course of appropriate treatment for tuberculosis. These events have been extensively studied in human immunodeficiency virus-positive patients; however, there are few data about immunocompetent children and adole...
The impact of infection on population health: results of the Ontario burden of infectious diseases study.
PLoS ONE 7(9):e44103 (2012)
Evidence-based priority setting is increasingly important for rationally distributing scarce health resources and for guiding future health research. We sought to quantify the contribution of a wide range of infectious diseases to the overall infectious disease burden in a high-income setting.
The relationship between temperature and ambulance response calls for heat-related illness in Toronto, Ontario, 2005.
Journal of Epidemiology & Community Health 65(9):829 (2011)
Concern over the adverse effects of heat on human health has led to numerous studies assessing the relationship between heat and mortality. Few studies have quantified the impact of heat on morbidity, including ambulance response calls. This study describes the association between temperature an...
Active tuberculosis among homeless persons, Toronto, Ontario, Canada, 1998-2007.
Emerging Infectious Diseases 17(3):357 (2011)
While tuberculosis (TB) in Canadian cities is increasingly affecting foreign-born persons, homeless persons remain at high risk. To assess trends in TB, we studied all homeless persons in Toronto who had a diagnosis of active TB during 1998-2007. We compared Canada-born and foreign-born homeless...
Assessing secondary attack rates among household contacts at the beginning of the influenza A (H1N1) pandemic in Ontario, Canada, April-June 2009: a prospective, observational study.
BMC Public Health 11:234 (2011)
Understanding transmission dynamics of the pandemic influenza A (H1N1) virus in various exposure settings and determining whether transmissibility differed from seasonal influenza viruses was a priority for decision making on mitigation strategies at the beginning of the pandemic. The objective ...
Temporal and spatial variation of heat-related illness using 911 medical dispatch data.
Environmental Research 109(5):600 (2009)
The adverse effect of hot weather on health in urban communities is of increasing public health concern, particularly given trends in climate change.
To demonstrate the potential public health applications of monitoring 911 medical dispatch data for heat-related illness (HRI), using historical d...
Public perceptions of quarantine: community-based telephone survey following an infectious disease outbreak.
BMC Public Health 9:470 (2009)
The use of restrictive measures such as quarantine draws into sharp relief the dynamic interplay between the individual rights of the citizen on the one hand and the collective rights of the community on the other. Concerns regarding infectious disease outbreaks (SARS, pandemic influenza) have i...
Quantifying the impact of community quarantine on SARS transmission in Ontario: estimation of secondary case count difference and number needed to quarantine.
BMC Public Health 9:488 (2009)
Community quarantine is controversial, and the decision to use and prepare for it should be informed by specific quantitative evidence of benefit. Case-study reports on 2002-2004 SARS outbreaks have discussed the role of quarantine in the community in transmission. However, this literature has n...
Development of a surveillance case definition for heat-related illness using 911 medical dispatch data.
Canadian Journal of Public Health 99(4):339 (2008)
The adverse effects of hot weather on public health are of increasing concern. A surveillance system using 911 medical dispatch data for the detection of heat-related illness (HRI) could provide new information on the impact of excessive heat on the population. This paper describes how we identi...
Adverse events associated with high-dose ribavirin: evidence from the Toronto outbreak of severe acute respiratory syndrome.
Pharmacotherapy 27(4):494 (2007)
To distinguish adverse events related to ribavirin therapy from those attributable to severe acute respiratory syndrome (SARS), and to determine the rate of potential ribavirin-related adverse events.
Retrospective cohort study.
Hospitals in Toronto, Ontario, Canada.
A cohort of 306 patients wit...
Household transmission of SARS, 2003.
Canadian Medical Association Journal 175(10):1219 (2006)
In the 2003 outbreak in Toronto (in Ontario, Canada) of severe acute respiratory syndrome (SARS), about 20% of cases resulted from household transmission. The purpose of our study was to determine characteristics associated with the transmission of SARS within households.
A retrospective cohort ...
Public health measures to control the spread of the severe acute respiratory syndrome during the outbreak in Toronto.
New England Journal of Medicine 350(23):2352 (2004)
Toronto was the site of North America's largest outbreak of the severe acute respiratory syndrome (SARS). An understanding of the patterns of transmission and the effects on public health in relation to control measures that were taken will help health officials prepare for any future outbreaks....
Critical reflections on evidence, ethics and effectiveness in the management of tuberculosis: public health and global perspectives.
BMC Medical Ethics 5:E2 (2004)
Tuberculosis is a major cause of morbidity and mortality globally. Recent scholarly attention to public health ethics provides an opportunity to analyze several ethical issues raised by the global tuberculosis pandemic.
Recently articulated frameworks for public health ethics emphasize the impor...
Clinical features and short-term outcomes of 144 patients with SARS in the greater Toronto area.
JAMA 289(21):2801 (2003)
Severe acute respiratory syndrome (SARS) is an emerging infectious disease that first manifested in humans in China in November 2002 and has subsequently spread worldwide.
To describe the clinical characteristics and short-term outcomes of SARS in the first large group of patients in North Ameri...