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Acquired Immunodeficiency Syndrome (AIDS) -- Canada

As of November 25, 1983, Canada's Laboratory Centre for Disease Control (LCDC) has received reports of 51 cases of AIDS. Patients have ranged in age from 20 to 53 years, with 80% occurring in the 20- to 39-year age group. Forty-four (86%) were males. Forty-nine percent of all patients were homosexuals; however, the number of heterosexual patients (43%) is increasing; most are Haitians, and two are hemophilia patients.

Twenty-eight AIDS patients were Canadian-born; 17 were Haitian; and the remaining six were either born in other countries or of unknown birthplace. Twenty-three (45%) of these patients resided in Quebec; 17 (33%), in Ontario; six (12%), in British Columbia; two (4%), in Nova Scotia; one (2%), in Alberta; one (2%), in Manitoba; and one (2%), in Newfoundland. The onset of AIDS in three patients occurred in 1979; in four, in 1980; in eight, in 1981; in 17, in 1982; and in 17, in 1983 (up to November 25); dates of onset are unknown in the remaining two.

Symptoms, including prodromal complaints, were as follows: excessive weight loss (20%), generalized lymphadenopathy (16%), fever (15%), dyspnea (10%), oral thrush (10%), and skin lesions (5%). Kaposi's sarcoma (KS) was diagnosed in 11 (22%) patients, Pneumocystis carinii pneumonia (PCP) in 27 (53%), and other opportunistic infections in the remainder. KS and PCP were the only diagnoses in 14, while multiple infections with Candida albicans, cytomegalovirus, herpes simplex virus, Toxoplasma gondii, and Cryptococcus neoformans were found in 22 KS or PCP patients. The opportunistic infections group included combinations of these same organisms with one Histoplasma capsulatum infection. Mycobacterium tuberculosis was isolated in seven Haitian and two Canadian-born patients. One isolate each of M. avium-intracellulare, M. terrae, and M. scrofulaceum was reported.

The highest mortality rate (65%) occurred among patients of Haitian origin, with toxoplasmosis being the fatal infection in six of the 11 deaths. The mortality rate in the homosexual group was 48%, with PCP accounting for 50%.

Infants have not been included in these statistics because of the uncertainty in distinguishing their illnesses from previously described congenital immunodeficiency syndromes. Four such reports have reached LCDC, three involving children of Haitian origin and one possibly associated with exchange transfusions shortly after birth. Reported in Canada Diseases Weekly Report, 1983;9:186-7, by S Handzel, MD, Bureau of Epidemiology, LCDC, Ottawa, Ontario.

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