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TropicalMed
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Emerging Trends of Infectious Diseases in Canada
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Emerging Trends of Infectious Diseases in Canada

A special issue of Tropical Medicine and Infectious Disease (ISSN 2414-6366).

Deadline for manuscript submissions: 6 July 2025 | Viewed by 3951

Special Issue Editor

Dr. Yazdan Mirzanejad

E-Mail Website
Guest Editor
Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
Interests: climate change; travel health; migrant health; surveillance; OneHealth; vaccine-preventable diseases; tuberculosis; vector-borne diseases; neglected tropical diseases

Special Issue Information

Dear Colleagues,

Emerging trends in infectious diseases in Canada reveal a dynamic landscape influenced by climate change, global travel, close interactions with livestock or wild animals, and increased antimicrobial resistance. Rising global temperatures and altered ecosystems have expanded the geographic range for key vector-borne diseases such as Lyme disease, tick-borne illnesses like anaplasmosis and babesiosis, and West Nile virus. Furthermore, urbanization and travel have complicated the overlapping interactions between humans, intermediate hosts (e.g., livestock and rodents), and insect/arthropod vectors.

The resurgence of vaccine-preventable diseases post pandemic, including measles and pertussis, underscores the critical role of immunization programs to manage downstream impacts of vaccine hesitancy. The COVID-19 pandemic highlighted the need for robust public health infrastructure and preparedness to manage novel pathogens. Genomic surveillance and advanced diagnostics are enhancing the ability to detect and respond to outbreaks more swiftly.

Additionally, the ongoing opioid crisis and disruptions to comprehensive healthcare have exacerbated the spread of bloodborne infections like HIV, hepatitis C, and tuberculosis among vulnerable populations. Moreover, Canada's multicultural population requires tailored public health strategies to address its diverse healthcare needs and disparities. Ongoing research, active surveillance, and interdisciplinary collaboration for clinical guidelines are essential to mitigate the impact of these emerging infectious diseases.

Dr. Yazdan Mirzanejad
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Tropical Medicine and Infectious Disease is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • zoonoses
  • climate change
  • travel health
  • migrant health
  • surveillance
  • CATMAT
  • OneHealth
  • vaccine-preventable diseases
  • tuberculosis
  • Lyme disease
  • tick-borne diseases
  • mosquito-borne diseases
  • vector-borne diseases
  • neglected tropical diseases

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Published Papers (6 papers)

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Research

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14 pages, 875 KiB  
Article
Mycoplasma genitalium Infections and Associated Antimicrobial Resistance in Canada, 1980–2023
by Angela Copete, Mariana Herrera, Camilo Suarez-Ariza, Zipporah Gitau, Maria Arango-Uribe, Rotem Keynan, Camila Oda, Ameeta E. Singh, Stuart Skinner, Cara Spence, Will Riaño, Lauren J. MacKenzie, Ken Kasper, Laurie Ireland, Irene Martin, Jared Bullard, Lucelly Lopez, Diana Marin, Margaret Haworth-Brockman, Yoav Keynan and Zulma Vanessa Ruedaadd Show full author list remove Hide full author list
Trop. Med. Infect. Dis. 2025, 10(5), 139; https://doi.org/10.3390/tropicalmed10050139 - 19 May 2025
Viewed by 267
Abstract
Background: We aimed to describe trends in M. genitalium prevalence and associated resistance in Canada between 1980 and 2022. Methods: Ecological study and a scoping review. We collected publicly available data published by the governments of all Canadian provinces and territories. We also [...] Read more.
Background: We aimed to describe trends in M. genitalium prevalence and associated resistance in Canada between 1980 and 2022. Methods: Ecological study and a scoping review. We collected publicly available data published by the governments of all Canadian provinces and territories. We also systematically searched PubMed, Medline, Embase, and grey literature using the keywords ‘M. genitalium’, ‘Canada’, and all provinces and territories. We reported M. genitalium prevalence, age, sex, gender, symptoms, coinfections, sample types used for diagnosis, and macrolide and fluoroquinolone resistance rates. Results: National or provincial surveillance systems for M. genitalium are absent. Eight studies reported the epidemiology of M. genitalium. The prevalence ranged between 3% in Quebec and 30.3% in Ontario. Half of the patients reported symptoms. The most collected sample for M. genitalium diagnosis was urine, followed by cervical and urethral swabs. Co-infection with Chlamydia trachomatis was reported in 3.3% to 16.4% of cases and with Neisseria gonorrhoeae in 0.0% to 24.0%. Macrolide resistance ranged between 25% and 82.1%, and fluoroquinolone resistance between 0.0% and 29.1%. Conclusions: M. genitalium prevalence and resistance rates varied by sex, gender, province, and specimen type. In the absence of routine surveillance, incomplete data hinders understanding the bacterium’s natural history, its impact on some key groups, and the tracking of antibiotic resistance. Full article
(This article belongs to the Special Issue Emerging Trends of Infectious Diseases in Canada)
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11 pages, 237 KiB  
Article
Current Antimicrobial Susceptibility Trends and Clinical Outcomes of Typhoidal Salmonella in a Large Health Authority in British Columbia, Canada
by Calvin Ka-Fung Lo, Merisa Mok, Cole Schonhofer, Kevin Afra and Shazia Masud
Trop. Med. Infect. Dis. 2025, 10(4), 108; https://doi.org/10.3390/tropicalmed10040108 - 15 Apr 2025
Viewed by 405
Abstract
Background: From 2018 to 2021, travel-related extensively drug-resistant (XDR) Salmonella Typhi was identified in Ontario, Canada. Opportunities remain to characterize typhoidal Salmonella antimicrobial susceptibility trends (including multi-drug resistance phenotypes; MDR) within a large health authority in British Columbia, Canada. Methods: This retrospective study [...] Read more.
Background: From 2018 to 2021, travel-related extensively drug-resistant (XDR) Salmonella Typhi was identified in Ontario, Canada. Opportunities remain to characterize typhoidal Salmonella antimicrobial susceptibility trends (including multi-drug resistance phenotypes; MDR) within a large health authority in British Columbia, Canada. Methods: This retrospective study included patients with Salmonella Typhi or Paratyphi A, B or C bacteremia identified at Fraser Health regional microbiology laboratory from 2018 to 2024. The primary outcome was the proportion of cases with MDR and XDR typhoidal Salmonella. Secondary outcomes included annual antimicrobial susceptibility for ampicillin, ceftriaxone, ciprofloxacin, trimethoprim-sulfamethoxazole, ertapenem, meropenem and azithromycin. Clinical outcomes included hospitalization length, and 30-day mortality, clinical cure and infection relapse. Results: Among 271 patients, most were previously healthy and recently travelled. There were extended spectrum beta-lactamase (1.1%) and MDR (1.5%) typhoidal Salmonella, with no XDR cases observed. In 2024, ciprofloxacin resistance was 96% while susceptibility rates were high for other studied antimicrobials. Within 30 days, no deaths were reported; however, six patients (3%) had infection relapse. Conclusions: Currently, in British Columbia, MDR typhoidal Salmonella remains rare. Empiric ciprofloxacin should be avoided due to persistently high resistance rates. With ongoing travel patterns, it is beneficial for institutions to continue typhoidal Salmonella antimicrobial susceptibility surveillance, and travelers should seek pre-travel health assessments. Full article
(This article belongs to the Special Issue Emerging Trends of Infectious Diseases in Canada)

Review

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10 pages, 614 KiB  
Review
An Outbreak of Multidrug-Resistant Shigella flexneri Serotype 2a Among People Experiencing Homelessness in Vancouver
by Victor Leung, Gordon Ritchie, Aleksandra Stefanovic, Colin Lee, Sam Chorlton, Nancy Matic, Marc G. Romney, Althea Hayden and Christopher F. Lowe
Trop. Med. Infect. Dis. 2025, 10(5), 120; https://doi.org/10.3390/tropicalmed10050120 - 28 Apr 2025
Viewed by 367
Abstract
Background: We describe a community-based outbreak of multidrug-resistant Shigella flexneri serotype 2a among people experiencing homelessness (PEH) in Vancouver’s Downtown Eastside during the COVID-19 pandemic. Methods: In this observational cohort study, we followed the Outbreak Reports and Intervention Studies of Nosocomial [...] Read more.
Background: We describe a community-based outbreak of multidrug-resistant Shigella flexneri serotype 2a among people experiencing homelessness (PEH) in Vancouver’s Downtown Eastside during the COVID-19 pandemic. Methods: In this observational cohort study, we followed the Outbreak Reports and Intervention Studies of Nosocomial Infection (ORION) reporting guidelines. We identified cases by laboratory surveillance and collected demographic and clinical data from the medical charts or patient interviews. We implemented enhanced surveillance and disseminated testing and management guidelines. Shigella flexneri isolates were serotyped, and whole-genome sequencing was performed. Results: We identified 101 confirmed cases of Shigella flexneri 2a (80% male; median age 43) between 31 January and 16 December 2021. All the affected individuals experienced homelessness, and substance use disorder was the most common comorbidity (88%). Five patients required ICU hospitalization, and one death occurred within 30 days. Core-genome multilocus sequence typing analysis confirmed a clonal outbreak. All S. flexneri isolates were phenotypically and genotypically multidrug-resistant. Conclusions: COVID-19 exacerbated longstanding public health concerns around the dearth of hygiene and sanitation resources available to PEH. Preventing similar outbreaks will require addressing these risks and finding solutions to the crisis of homelessness in Canada. Full article
(This article belongs to the Special Issue Emerging Trends of Infectious Diseases in Canada)
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11 pages, 1329 KiB  
Review
The State of Antimicrobial Resistance of Gram-Negative Bacilli in Canada
by Jeremy Li, Andrew Walkty, Philippe Lagacé-Wiens, James Karlowsky and George Zhanel
Trop. Med. Infect. Dis. 2025, 10(4), 115; https://doi.org/10.3390/tropicalmed10040115 - 21 Apr 2025
Viewed by 349
Abstract
In the last two decades, there has been an increase in resistance among Gram-negative bacteria in Canada. From 2007 to 2016, the proportion of ESBL-producing isolates among Escherichia coli and Klebsiella pneumoniae isolates increased from 3.5% to 11.1%. There has also been an [...] Read more.
In the last two decades, there has been an increase in resistance among Gram-negative bacteria in Canada. From 2007 to 2016, the proportion of ESBL-producing isolates among Escherichia coli and Klebsiella pneumoniae isolates increased from 3.5% to 11.1%. There has also been an increase in carbapenem use over this time period, which may be contributing to the increasing prevalence of carbapenemase-producing Enterobacterales (CPE) in Canada. CPE, which were historically associated with travel, are now mostly acquired domestically. The prevalence of multi-drug resistant (MDR) Pseudomonas aeruginosa has decreased slightly, possibly due to decreasing use of fluoroquinolones and aminoglycosides. Many of the most effective antimicrobials for the treatment of infections with resistant Gram-negative organisms, including many of the novel β-lactam/β-lactamase inhibitors (βL/βLIs), are not marketed in Canada. A coordinated focus on antimicrobial stewardship and infection control is necessary to slow the spread of resistance and to preserve the efficacy of our current antimicrobials for future generations. Full article
(This article belongs to the Special Issue Emerging Trends of Infectious Diseases in Canada)
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11 pages, 776 KiB  
Review
Generalized Treatment as Prevention Plus Focused Pre-Exposure Prophylaxis Is the Key to Controlling HIV/AIDS
by Julio S. G. Montaner, Viviane D. Lima, Kate A. Salters, Junine Toy, Jeffrey B. Joy, Silvia Guillemi and Rolando Barrios
Trop. Med. Infect. Dis. 2025, 10(3), 75; https://doi.org/10.3390/tropicalmed10030075 - 12 Mar 2025
Viewed by 684
Abstract
Treatment as Prevention (TasP) and Pre-Exposure Prophylaxis (PrEP) are both widely recognized as essential biomedical tools to control HIV/AIDS. TasP calls for the immediate initiation of fully subsidized and supported antiretroviral therapy (ART) following HIV diagnosis. TasP effectively prevents progression to AIDS, and [...] Read more.
Treatment as Prevention (TasP) and Pre-Exposure Prophylaxis (PrEP) are both widely recognized as essential biomedical tools to control HIV/AIDS. TasP calls for the immediate initiation of fully subsidized and supported antiretroviral therapy (ART) following HIV diagnosis. TasP effectively prevents progression to AIDS, and premature AIDS-related deaths among people living with HIV (PLWH), and simultaneously renders HIV non-transmissible, thus preventing onward HIV transmission. In addition, PrEP has proven effective against HIV transmission among high-risk individuals who are adherent to the regimen. PrEP traditionally consists of two antiretrovirals given orally as one pill daily: originally, tenofovir-DF plus emtricitabine (TDF-FTC), and later, tenofovir-AF (TAF) plus FTC (more recently, other options have become available, including long-acting parenteral formulations; however, these are still of limited availability). Over the last two decades, the province of British Columbia has rolled out TasP among all PLWH, and starting in 2018, PrEP was added as a strategy to reach individuals most at risk of acquiring HIV to further accelerate progress in addressing HIV/AIDS as a public health threat. Our “generalized TasP + focused PrEP” program proved to be synergistic (or multiplicative) as it relates to reducing the HIV effective reproduction number (Re). TasP lowers HIV incidence by reducing the pool of individuals able to transmit HIV, which is dependent on the extent of community plasma viral load (pVL) suppression. Meanwhile, PrEP reduces the number of potential new infections among those most susceptible to acquiring HIV in the community, independent of viral load suppression among PLWH. Our results strongly support widespread implementation of the combination of “generalized TasP + focused PrEP” strategy and underscore the importance of long-term monitoring of Re at a programmatic level to identify opportunities for optimizing TasP and PrEP programs. This approach aligns with the United Nations goal of “Ending HIV/AIDS as a pandemic by 2030”, both in Canada and globally. Full article
(This article belongs to the Special Issue Emerging Trends of Infectious Diseases in Canada)
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Other

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10 pages, 235 KiB  
Case Report
Acute Febrile Illness Accompanied by 7th and 12th Cranial Nerve Palsy Due to Lyme Disease Following Travel to Rural Ecuador: A Case Report and Mini-Review
by Teslin S. Sandstrom, Kumudhavalli Kavanoor Sridhar, Judith Joshi, Ali Aunas, Sheliza Halani and Andrea K. Boggild
Trop. Med. Infect. Dis. 2025, 10(1), 21; https://doi.org/10.3390/tropicalmed10010021 - 14 Jan 2025
Viewed by 1086
Abstract
The causative agent of Lyme disease, Borrelia burgdorferi, is endemic to Canada, the northeastern United States, northern California, and temperate European regions. It is rarely associated with a travel-related exposure. In this report, we describe a resident of southern Ontario, Canada who [...] Read more.
The causative agent of Lyme disease, Borrelia burgdorferi, is endemic to Canada, the northeastern United States, northern California, and temperate European regions. It is rarely associated with a travel-related exposure. In this report, we describe a resident of southern Ontario, Canada who developed rash, fever, and cranial nerve VII and XII palsies following a 12 day trip to Ecuador and the Galapagos islands approximately four weeks prior to referral to our center. Comprehensive microbiological work-up was notable for reactive Borrelia burgdorferi serology by modified two-tier testing (MTTT), confirming a diagnosis of Lyme disease. This case highlights important teaching points, including the classic clinical presentation of acute Lyme disease with compatible exposure pre-travel in a Lyme-endemic region of Ontario, initial manifestations during travel following acquisition of arthropod bites in Ecuador, and more severe manifestations post-travel. Given the travel history to a South American country in which Lyme disease is exceedingly uncommon, consideration of infections acquired in Ecuador necessitated a broad differential diagnosis and more comprehensive microbiological testing than would have been required in the absence of tropical travel. Additionally, cranial nerve XII involvement is an uncommon feature of Lyme neuroborreliosis, and therefore warranted consideration of an alternative, non-infectious etiology such as stroke or a mass lesion, both of which were excluded in this patient through neuroimaging. Full article
(This article belongs to the Special Issue Emerging Trends of Infectious Diseases in Canada)
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