Highlights

Influenza vaccination coverage

Image courtesy of © 2012 Thinkstock

All ethnic groups in Canada, with the exception of black Canadians, had higher uptake of influenza vaccination than white Canadians. These findings are based on 437 488 people’s responses in several cycles of the Canadian Community Health Survey. Public health practitioners need to understand barriers affecting their communities to ensure optimal vaccine coverage, say the authors. See Research, page 1673

Although studies have consistently shown ethnic and racial disparities in vaccination coverage, the groups at risk will vary depending on the social and epidemiologic contexts at a particular time and place. Rather than focus on race and ethnicity, public health interventions to improve coverage should recognize the importance of such contexts to define appropriate risk groups, identify evidence-based interventions and measure effectiveness over time, says Gessner. See Commentary, page 1661

Phimosis and urinary tract infection

There is no variation in risk of urinary tract infection with visibility of the urethral meatus in uncircumcised boys. Dubrovsky and colleagues screened 440 boys for whom the emergency department physician suspected urinary tract infection; they compared infection rates with respect to the presence or retractability of the foreskin. Clinicians should use circumcision status alone, not the degree of phimosis, to decide which boys should undergo investigation for urinary tract infection, say the authors. See Research, page E796

Shingles does not increase cancer risk

Image courtesy of © 2012 Thinkstock

Patients with a recent episode of herpes zoster are not at increased risk of cancer. This study used routine health insurance data to follow 35 871 people with newly diagnosed herpes zoster for a median follow up of 3.68 years to count new cases of cancer. It is unnecessary to conduct extensive investigation for occult malignancy following an episode of herpes zoster, say the authors. See Research, page E804

Tackling cancer in low-income countries

Image courtesy of © 2012 Thinkstock

Five percent of global health spending on cancer occurs in low- and middle-income countries, which have almost 80% of the worldwide burden of cancer. According to Ginsburg and colleagues, Canadians could implement the innovative interventions and solutions that are urgently needed to reduce the growing burden of cancer in these countries. The authors call for the development of a Canadian global cancer network to help with planning, capacity building, research, and resources commitment. See Analysis, page 1699

False-positive HTLV serology

After intravenous immunoglobulin transfusion for toxic myelopathy, a 29-year-old man with leukemia had positive tests for antibodies to several viruses. Savary Bélanger and colleagues trace the results of testing from before the transfusion to several months after and show that the antibodies had been passively transferred during transfusion. The possibility of passive transfer of antibodies should be considered when interpreting a positive test result after transfusion. See Practice, page 1709

“Bath salts”

Image courtesy of © 2012 Thinkstock

The use of “bath salts,” or synthetic cathinones, is increasing in Canada and elsewhere. Toxicity and dependence can occur with use. If a patient shows signs of a sympathomimetic toxidrome with negative urine toxicology results, cathinones toxicity should be considered. See Practice, page 1713