Diverticulitis is a condition that affects many Canadians as they get older. It generally occurs in people over 40 and becomes more common as they age. Diverticulitis is the condition of having one or more diverticula (sacs that form by a fold in the lining of the intestinal wall). These sacs can trap feces that move through the intestine. It is quite common for Canadians to already have diverticula and be unaware of the condition as there are usually no symptoms until inflammation and/or bleeding occurs. Diverticulitis can also appear in the gastrointestinal tract above the stomach which can trap food. Esophageal diverticula do not cause any serious health problems, but trapped food can cause the food to back up when a person bends over and/or lies down.

Once the diverticula have become inflamed the condition is then known as diverticulitis which can become a serious health problem. It is believed that diverticula are usually caused by muscle spasms, or by pairs of muscles that do not contract in a synchronized manner. This puts pressure around the blood vessels that pass through the inside of the wall of the large intestine (colon). The most common symptom of inflammation is abdominal pain which usually occurs in the lower left side of the abdomen. Cramping, nausea, vomiting, bloating, fever, chills and sudden change in bowel habits can also signal diverticulitis.

Bleeding can occur when feces get lodged in a diverticulum and the bowel draws fluid out of feces before ejecting it. If the feces stays lodged for a long time it can become hard and dry, which can erode the blood vessels. This can cause a large amount of blood to be released from the rectum, as well as small amounts of blood being released on a continual basis. Any bleeding that does not stop always requires medical attention. A colonoscopy can be used to identify the site of the bleeding as well as to stop the bleeding. For people with chronic bleeding surgery may be necessary to remove the affected part of the colon.

Diverticulitis can cause infections that are easily treated with antibiotics. If an infection is left untreated, an abscess (localized collection of pus) can form in the wall of the colon. An abscess can cause swelling as well as destroy the surrounding tissue. If the abscess remains small and in the wall of the colon it usually can be treated with a course of antibiotics. If the abscess does not respond to antibiotics a doctor may need to insert a catheter through the skin in order to help drain the abscess.

Peritonitis can occur when large parts of the abdominal cavity become inflamed. It always causes a fever and the belly very often is bloated and feels very hard. As well, a person may feel extremely ill with nausea and vomiting. Peritonitis can cause death within a few hours if it is not treated. This can be caused by perforations that leak pus out of the colon and in turn form a large abscess in the abdominal cavity.

Diverticulitis is more common in North America, Australia and England where diets typically are not high in fiber. Industrialized countries that have diets that are high in processed foods have higher cases of diverticulitis than countries in Asia or Africa, where these food products are not as common in people's daily diets. If you have been diagnosed with diverticulitis, changing your diet as well as regular exercise can be very beneficial. Talk to your health care professional about the best way to manage your condition, as well as possible medical procedures that may be required.

A fast food restaurant has been linked to over one hundred suspected and confirmed cases of E. coli in North Bay, Ontario. Health officials have reported that the outbreak appears to have originated from a Harvey's restaurant. The particular restaurant in question was ordered to close after initial laboratory tests traced the strain of E. coli 0157:H7 to the specific location.

There are currently 158 cases of suspected E. coli; so far 35 have been confirmed. Health officials speculate that the origin of the outbreak stems from improper food handling (i.e. improperly sanitized counter surface) rather than originating from the food products, as no symptoms have occurred from patrons of other Harvey's restaurants throughout the province which would have received the same food products.  However, there are cases being reported from other parts of Ontario as the particular Harvey's location was patronized by travelers. Cases are being investigated in Toronto, Muskoka, Simcoe, Sudbury, Belleville and Trenton, as well as other neighboring communities in Northern Ontario. Currently 18 cases have been ruled out as originating from the Harvey's location.

Many Canadians still remember the E. coli outbreak that occurred in Walkerton, Ontario in May, 2000 where 2300 people became ill and 7 people died as a result of the town's water supply becoming contaminated. The Walkerton outbreak which was ultimately found to be a result of manure from a farmer’s field that was located near one of the town wells was Canada's most severe outbreak of E. coli. Canadian health authorities usually report only a few thousand cases of E. coli sickness per year for the whole country.

The term E. coli is an abbreviation for Escherichia coli and is a form of bacteria most commonly found in the intestines of humans as well as animals. There are hundreds of strains of the bacterium, with many strains being harmless to humans. However E. coli 0157:H7 is identified as the most dangerous to humans as it produces a powerful toxin that can cause severe illness. While the bacterium is mostly found in meat, it can also be found in unpasteurized milk and apple cider, as well as raw vegetables, cheese and contaminated water. Fruits and vegetables that grow close to the ground are susceptible to contamination as they can come into contact with improperly composted cattle manure that is used as a fertilizer. It can contaminate water as the bacteria that causes E. coli can be washed into creeks, rivers, etc. that may ultimately end up in sources for drinking water.

The symptoms of E. coli are generally characterized by severe abdominal cramping. This cramping occurs from merely hours after exposure, but can also take up to 10 days to show up. Diarrhea (sometimes bloody) can also occur in people who have been exposed to E. coli. It is possible for someone to have no symptoms, but still spread the bacteria to other people, who can then become quite ill. People who have suffered E. coli 0157:H7 poisoning are at a 30% higher risk of developing either high blood pressure or kidney damage, according to a Canadian study that was released in 2008. While most cases will resolve on their own within 5-10 days, a small number of cases of E. coli contamination can lead to a condition known as hemolytic uremic syndrome (HUS). This is a life-threatening condition which is treated in the intensive care units of hospitals. HUS kills approximately 3-5 % of people who contract it; it can also lead to lifelong complications for its survivors. These complications can include lifelong health issues such as blindness, paralysis as well as kidney failure.

 As E. coli can also be spread via human contact, it is also urged that people who are exhibiting symptoms do not go to their workplace so as to prevent spreading the bacteria. The bacteria is most often spread from person-to-person but can also be spread by hand-to-mouth contact. Anyone who has been infected with E. coli should not share dishes, glassware and/or cutlery with anyone else. As well, all bedding, towels, facecloths, etc. should be washed separately with hot water and bleach. Washing hands often and thoroughly will help reduce the possibility of spreading E. coli to other people, as well as not handling food products when actively sick (i.e. diarrhea). Ensure that all raw fruits and vegetables are washed thoroughly before cooking and/or cutting them; disinfect all cutting surfaces and utensils before and after as well.

If you suspect that you may have been exposed to this (or any other) E. coli outbreak it is important to contact your local health department to advise them of your situation. It is also important to receive medical care to ensure that all steps are being taken to ensure a speedy and full recovery. For more information regarding this or any other related topics, visit the Public Health Agency of Canada.

Ontario public health officials are trying to contact 27 people who have been exposed to tuberculosis from a passenger on a bus traveling from Toronto to Windsor this past August. The passengers are being publicly urged to contact their local health units in order to be tested for TB as a safeguard. As the TB bacteria cannot be detected for at least 3 weeks following exposure, people may not be aware that they could potentially become ill. The risk that other passengers may have been exposed is low, but it is still necessary to be tested to determine if anyone else has caught the disease.

Approximately 1600 new cases of TB are reported in Canada every year, so the risk of developing the disease is relatively low. However, it can have serious health risks, so it is important for Canadians to recognize the symptoms as well as minimize the risk of becoming infected. TB is transmitted by frequent exposure to someone that has active tuberculosis; the bacterium is spread via sneezing, singing, coughing, etc. It is not as contagious as other diseases such as influenza or the chicken pox.

Most people can be exposed to TB bacteria and not develop the disease. It is possible for the immune system to effectively kill the germs. If this doesn't happen the bacteria can remain alive in the body which is called TB infection. Someone with TB infection will show no symptoms and not fall ill; they are also at no risk of spreading the disease. TB infection occurs when the immune system cannot stop the bacteria from growing; this risk is highest within 2 years of becoming infected. Approximately 10% of people will become infected with tuberculosis within their lifetime.

The symptoms of tuberculosis in the lungs are:

• bad cough that lasts longer than 3 weeks
• pain in the chest
• feeling very weak and/or tired
• coughing up blood and/or sputum
• loss of appetite
• fever and/or night sweats

A simple skin test can determine whether or not a person has a TB infection. This is accomplished by a very small amount of non-infectious TB protein being injected under the surface of the skin; a hard swelling will develop within 48-72 hours if the person is infected. At this point the health care provider will probably recommend antibiotic treatment in order to prevent the infection from developing into TB disease. Additional tests as well as chest x-rays may be needed in order to determine whether or not TB disease is present.

For those people who have TB disease it is extremely important to be treated as soon as the disease has been determined. A course of antibiotics for a minimum of 6 months is needed in order to kill all of the TB bacteria. Finishing the course of treatment is vital in order to prevent the risk of developing a strain of the disease that will be drug resistant, which is harder as well as more expensive to treat. As well, people who do not finish the treatment also pose a risk of spreading TB to others.

People with a weakened immune system are more at risk of developing TB infection and/or disease. People who have HIV/AIDS are 50-170 times more likely to develop TB disease; therefore this population group should always be tested for TB. Conversely, people who test positive for TB infection and/or disease should also get tested for HIV in order to help the physician determine the best course of treatment. Other populations that have an increased risk for TB infection are anyone:

• who has come into close contact with someone who has or is suspected to have active TB
• with a history of active TB and/or has had an x-ray suggesting that they had TB in the past but did not receive treatment
• who is living in an Aboriginal community that has a high rate of TB infection and/or disease
•  who is living or working at a long-term care facility, correctional facility
• who has had an organ transplant and is being treated with immunity-suppressing drugs
• who has a lung disease known as silicosis
• who has chronic lung failure and requires dialysis
• who has cancer of the head and/or neck
•  who has been infected with the TB bacteria within the past 2 years
•  who has had a chest x-ray that shows signs of old TB
• who is being treated with glucocorticoids
• who is receiving treatment with tumor necrosis factor alpha inhibitors (for auto-immune disorders such as rheumatoid arthritis)
• who has any type of diabetes
• who is underweight with a body mass index of under 20
• who smokes one pack of cigarettes or more per day
• who is under five years old when first infected with the bacteria

If you suspect that you have been exposed to someone that has tuberculosis, make an appointment with your health care provider for testing. You can also visit The Lung Association website for more information regarding tuberculosis.

Age-related macular degeneration (AMD) has long been the leading cause of severe vision loss in Canadians. As age is one of the predominant risk factors for developing this condition, all Canadians over 50 years of age are strongly encouraged to learn more about the warning signs, as well as having an understanding of what this condition entails.

AMD gradually takes away central vision by the slow degeneration of the macula (a small area located in the very centre of the retina). Due to the slow and painless progress of this condition, AMD can remain undetected until it reaches the more advanced stage; routine eye exams however can detect it in its earlier stages. Therefore it is highly recommended that all people over 50 have their eyes regularly examined. In rare cases AMD can progress incredibly fast, i.e. weeks and/or months, resulting in permanent central vision blindness. It is imperative that AMD be caught as quickly as possible as earlier treatment usually results in less vision loss.

AMD is characterized by either 'dry' or 'wet'. Dry AMD occurs first; all people who have wet AMD have had the dry form of the condition. For 85-90% of people however, AMD will stay at the dry level and not progress to the advanced wet AMD. Dry AMD happens when light sensitive cells in the macula begin to break down; this causes gradual blurring of the central vision. As it progresses some individuals may see a blurry spot in the center of their vision. This loss of central vision increases as less of the macula can function. This can happen to either one eye or both; it is possible that both eyes may be affected at different times as well. For those who have AMD in one eye there is an increased likelihood that AMD will develop in the other eye. It is also possible to have AMD in both eyes and have the eyes progress to wet AMD at different interval.

A common early sign of dry AMD is drusen, which are yellow deposits located under the retina. Scientists are uncertain about the connection between drusen and AMD; what is known is that an increase in size and/or number of drusen raises the likelihood of developing into advanced dry AMD or wet AMD. Drusen alone does not cause vision loss, and many people can have a few small drusen in their eyes and not progress into AMD. However, people who have drusen should be regularly tested by their eye care professional in order to monitor this condition.

Wet AMD (also known as advanced AMD), occurs when abnormal blood vessels start to grow under the macula. These blood vessels are usually quite fragile and often leak blood and fluids, which raise the macula from its normal location at the back of the eye. This damage occurs rapidly, resulting in a greater loss of central vision. Wet AMD tends to be quite unpredictable and can appear very suddenly. There is no set schedule of when dry AMD changes into wet AMD; one of the early symptoms of wet AMD is the appearance of straight lines that are suddenly wavy. This, as well as any other vision change, should be reported immediately to your eye care professional as a comprehensive dilated eye exam is necessary.

There is currently no known cure for either dry or wet AMD. However, there are different treatments, depending on which type of AMD you have that can halt the progress of the condition. People who have the dry form of AMD can slow the progression and/or reduce vision loss by using specific high dose ocular vitamin therapy. As well, lifestyle changes such as quitting smoking and/or and improved diet can have a positive impact on reducing the chance/speed of progression of the disease. As well, vision should be monitored on a regular basis in order to track the progression.

Currently effective treatment is not available for all forms of wet AMD. Research is progressing, but at this date only 3 treatments for wet AMD have been approved by Health Canada. Although these treatments will not cure the condition, they can be very effective in halting the progression of wet AMD. They are:

Laser Photocoagulation (LPC): This method uses a high energy beam of light (laser) to destroy the fragile, leaky blood vessels. However, this method poses a risk of damaging surrounding healthy tissue as well as some vision. As well, there is a high risk of developing new blood vessels after this treatment; repeated treatments are usually necessary. Laser surgery is only used to treat a very small percentage of people who have wet AMD; it is usually most effective on those whose leaky blood vessels have developed away from the fovea (central part of the macula).

Photodynamic Therapy: This method involves injecting the drug verteporfin into an arm, which then travels throughout the body. This drug will 'stick' to the surface of new blood vessels; when a light is shined on the eye for 90 seconds the light will activate the drug, destroying the new blood vessels. It does not destroy the surrounding healthy tissues, but those who are being treated with this method must avoid any bright lights (indoor and outdoor) for five days after the treatment. It is a painless course of treatment that can be done in a doctor's office and usually takes 20 minutes. This treatment may need to be repeated as the results are often temporary.

Injections: This is the latest method to treat wet AMD and involves injecting drugs directly into the affected eye. Also known as anti-VEGF therapy, the injections work by blocking the growth of new abnormal blood vessels that tend to grow at an abnormally high level in eyes with wet AMD. Injections may need to be done as often as monthly. Successful injection treatments can help slow down vision loss; in some cases it can also improve vision. Injections may need to be done as often as on a monthly basis depending on the rate that the wet AMD is progressing. It is done in a doctor's office; the eye is numbed before injection and afterwards the eye will be monitored.

Research shows that AMD occurs more in people of white origin than those of African American descent. As well, women appear to be at greater risk for this disease than men. Having a family history of AMD can also increase the odds of having the condition. However, there are lifestyle choices that can either lessen the risk, and/or slow down AMD. Smoking has been linked to the increased risk of AMD; obesity has also been linked to the progression of early and intermediate stages of AMD to advanced AMD. Eating a healthy diet of fish and leafy green vegetables can reduce your risk of developing AMD; it is also important to maintain a healthy weight, exercise and maintain a normal blood pressure.

More information can be found about Age-related macular degeneration at AMD Canada, as well as the Canadian National Institute for the Blind.

So far, 15 Canadian deaths have been linked to the listeria outbreak that has now spread throughout most of Canada. Nine deaths in Ontario, one in Alberta and one in British Columbia have been attributed to listeria, either as a contributing factor or the direct cause. 4 deaths in Ontario as well as one death in Quebec and another in Saskatchewan are currently being investigated to determine whether listeria was a contributing factor. As well, the number of listeriosis cases has now reached 33, from the original 17 that had been diagnosed. Another 25 illnesses are being investigated as well to determine whether listeriosis was the cause, as well as 6 more deaths.

The outbreak has been definitively linked to a north Toronto plant of Maple Leaf Foods Inc. The plant has since been closed for mass sterilization. Maple Leaf Foods has recalled almost all products that were produced at this plant; so far over 20 different meat products totaling over 500 000 kilograms, have been recalled. Supermarket chains Loblaw Co. and Sobeys Inc. have recalled close to 50 ready-to-eat sandwiches and other deli products that contain meat that could be contaminated as it originated from the affected Toronto plant. This is due to the uncertainty of what lines have been contaminated in the food plant. Currently, the only meat products that have tested positive for listeria were manufactured in July, but all products that were manufactured from June 2 and forward are being recalled as a preventative measure. King Bean Wholesalers is also recalling 4 different varieties of roast beef sandwiches from stores that are located throughout British Columbia.

Maple Leaf Foods Inc. has taken full responsibility for the listeria outbreak. They have released television commercials as well as full page newspaper ads apologizing to the Canadian public and vowing to do to everything in their power to rectify the situation. The spokesperson for Maple Leaf has stated that the company is in no way is blaming Canada's current food inspection laws and guidelines. Health Canada and the Canadian Food Inspection Agency are supervising and monitoring the food recall at the Toronto plant.  Maple Leaf Foods and the Canadian Food Inspection Agency have set up toll-free phone lines that consumers can call with any questions or concerns. These phone numbers are 1-800-568-5801 and 1-800-442-2342.

Public health officials are warning that the current amount of Canadians that have become ill, or may become ill, from listeriosis will likely increase. Every illness and/or death must be investigated in order to determine whether or not the strain of listeria that has been linked to the tainted meat is actually responsible. They are currently locating and interviewing people in order to establish whether they have been ill with listeria, and to determine the likely source of the contaminated food.

To see the list of all recalled products visit the CFIA website. Remember that there is the possibility of more products that will be recalled. Although this outbreak was initially thought to be in Ontario, other provinces are reporting cases that may be linked to Maple Leaf products. Check with your local health agency to see whether or not these products may have been sold in your region. You may want to check every few days in order to be aware of any new recalls.