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Can J Public Health. 2019 Oct 21. doi: 10.17269/s41997-019-00255-8. [Epub ahead of print]

The unique contribution of a local response group in the field investigation and management of a trichinellosis outbreak in Nunavik (Québec, Canada).

Author information

1
Département de médecine sociale et préventive, Université Laval, 2325 Rue de l'Université, Québec, Québec, G1V 0A6, Canada. julie.ducrocq.1@ulaval.ca.
2
Axe des populations et pratiques optimales en santé, Centre de recherche du Centre Hospitalier Universitaire de Québec, 1050 Chemin Ste-Foy, Québec City, Québec, G1S 4L8, Canada. julie.ducrocq.1@ulaval.ca.
3
Nunavik Regional Board of Health and Social Services, C.P. 900, Kuujjuaq, Québec, J0M 1C0, Canada.
4
Nunavik Research Centre, Makivik Corporation, Kuujjuaq, Québec, J0M 1C0, Canada.
5
Département de médecine sociale et préventive, Université Laval, 2325 Rue de l'Université, Québec, Québec, G1V 0A6, Canada.
6
Axe des populations et pratiques optimales en santé, Centre de recherche du Centre Hospitalier Universitaire de Québec, 1050 Chemin Ste-Foy, Québec City, Québec, G1S 4L8, Canada.
7
Direction de la santé environnementale et de la toxicologie, Institut national de santé publique du Québec, 945 avenue Wolfe, Québec, Québec, G1V 5B3, Canada.
8
Members of the Inuit community of Inukjuak, Nunavik, Québec, Québec, J0M 1M0, Canada.

Abstract

SETTING:

Consumption of raw game meats is important for Inuit health and well-being but may sometimes increase risk of exposure to parasites. In Nunavik, following trichinellosis outbreaks in the 1980s caused by raw walrus consumption, a diagnostic test was developed for the region and offered to all Inuit communities by 1997. Despite this prevention program, an important trichinellosis outbreak occurred in 2013, affecting 18 inhabitants of Inukjuak.

INTERVENTION:

Because the classical outbreak investigation did not rapidly converge toward a common food source or specific event, a local response group, composed of four community members appointed by the Municipal Council as well as the regional public health physician, nurse and wildlife parasitologist, was created. Their objective was to investigate potential sources of infection related to the outbreak, hence the investigation of the types of meats consumed, the movement of meats between and within the community, and the local practices of processing game meat.

OUTCOMES:

Though the source of infection was not fully confirmed, this local investigation identified the distribution of transformed polar bear meat as the most probable source of infection. The creation of this unique, intersectoral and intercultural local response group fostered the use of local knowledge to better understand aspects of the modern food system, and is one of the most innovative outcomes of this investigation.

IMPLICATIONS:

Integrating multiple ways of knowing was critical for the management of this important public health issue and contributed to community members' mobilization and empowerment with respect to local food safety issues.

KEYWORDS:

Inuit; Nunavik; Outbreak; Polar bear meat; Trichinella nativa; Trichinellosis

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