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. 2021 Nov 10;47(11):491-499.
doi: 10.14745/ccdr.v47i11a09.

Invasive bacterial diseases in northern Canada, 1999 to 2018

Grace Huang  1 , Irene Martin  2 , Raymond S Tsang  2 , Walter H Demczuk  2 , Gregory J Tyrrell  3 , Y Anita Li  1 , Catherine Dickson  1 , Francesca Reyes-Domingo  1 , Susan G Squires  1
Affiliations

Invasive bacterial diseases in northern Canada, 1999 to 2018

Grace Huang et al. Can Commun Dis Rep. .

Abstract

Background: The International Circumpolar Surveillance (ICS) program conducts surveillance on five invasive bacterial diseases: pneumococcal disease (IPD), group A streptococcus (iGAS), Haemophilus influenzae (Hi), meningococcal disease (IMD) and group B streptococcus (GBS). Invasive bacterial diseases have a higher burden of disease in northern populations than the rest of Canada.

Methods: To describe the epidemiology of invasive bacterial diseases in northern Canada from 1999 to 2018, data for IPD, iGAS, Hi, IMD and GBS were extracted from the ICS program and the Canadian Notifiable Diseases Surveillance System (CNDSS) and analyzed.

Results: The annualized incidence rates for IPD, iGAS, Hi, GBS and IMD were 23.3, 10.5, 8.9, 1.9 and 1.1 per 100,000 population, respectively. The incidence of IPD, iGAS and Hi serotype b were 2.8, 3.2 and 8.8 times higher, respectively, in northern Canada than in the rest of Canada. Rates of disease decreased statistically significantly for IPD (β=-0.02) and increased statistically for iGAS (β=0.08) and Hi serotype a (β=0.04) during the study period. In Northern Canada, the annualized incidence rates for IPD, iGAS and Hi were statistically higher for Indigenous residents than for non-Indigenous residents. The highest incidence rates were among the very young and older age groups.

Conclusion: Invasive bacterial diseases represent a high burden of disease in Canada's northern populations. Indigenous peoples, children and seniors are particularly at risk.

Keywords: Haemophilus influenzae; Indigenous health; epidemiology; meningococcal disease; pneumococcal disease; streptococcus; surveillance; vaccine.

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Conflict of interest statement

Competing interests: None.

Figures

Figure 1
Figure 1
Overall crude incidence rates of invasive bacterial diseases in the ICS regions by disease and year, 1999–2018 Abbreviation: ICS, International Circumpolar Surveillance
Figure 2
Figure 2
Distribution of invasive pneumococcal disease serotypes in northern Canada, by year and by vaccine serotypea, 1999–2018 Abbreviations: PCV7, 7-valent pneumococcal conjugate vaccine; PCV10, 10-valent pneumococcal conjugate vaccine; PCV13, 13-valent pneumococcal conjugate vaccine; PPV23, 23-valent pneumococcal polysaccharide vaccine a For the purposes of this graph, PCV7 includes all serotypes covered by the PCV7 vaccine, PCV10 includes the three additional serotypes not covered by the PCV7 vaccine, PCV13 includes the three additional serotypes not covered by the PCV10 vaccine, and PPV23 includes all serotypes not covered by any of the conjugate vaccines
Figure 3
Figure 3
Distribution of iGAS cases by emm type in northern Canada, 2014–2018 Abbreviation: iGAS, invasive group A streptococcus
Figure 4
Figure 4
Distribution of invasive Haemophilus influenzae serotypes in northern Canada by year, 2000–2018 Abbreviations: a, invasive Haemophilus influenzae serotype a; b, invasive Haemophilus influenzae serotype b; c, invasive Haemophilus influenzae serotype c; d, invasive Haemophilus influenzae serotype d; f, invasive Haemophilus influenzae serotype f; NT, non-typeable strains
Figure 5
Figure 5
Distribution of invasive meningococcal disease cases, by year and serogroup, northern Canada, 2000–2018 Abbreviations: B, invasive meningococcal disease serotype B; C, invasive meningococcal disease serotype C; W, invasive meningococcal disease serotype W; Y, invasive meningococcal disease serotype Y
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