John Maynard Conly

On January 30, 2001, the federal Immigration Department's headquarters in Ottawa were evacuated and shut down following a bioterrorism scare, which turned out to be a hoax. The building reopened 48 h later, after it was determined that the substance found was not anthrax (1). In the same week, a similar hoax forced the evacuation of an Ontario provincial government building in Toronto (1).

Knowledge about Whipple's disease began to emerge in 1907, when George Hoyt Whipple recognized the first case of the disease that now bears his name. He reported the case of a 36-year-old physician with "a gradual loss of weight and strength, stools consisting chiefly of neutral fat and fatty acids, indefinite abdominal signs, and a peculiar multiple arthritis" (1). Findings at autopsy consisted of poly-serositis, aortic valve vegetations and deposition of fat in the intestinal mucosa and regional lymph nodes with marked infiltration by foamy macrophages (1). It was originally thought to be a disorder of fat metabolism, and the term 'intestinal lipodystrophy' was proposed. Whipple's disease has since been recognized as a rare, multivisceral, chronic disease with a clinical presentation dominated by a symptom triad of diarrhea, weight loss and malabsorption. However, digestive symptoms are often preceded for months or years by other symptoms, the most common being arthralgia, although cardiovascular, neurological or pulmonary involvement may be more prominent at times. Once considered the ideal case report, recent characterization ofTropheryma whippeliiby means of broad range bacterial ribosomal DNA polymerase chain reaction (PCR) analysis (2,3) and its subsequent cultivation (4) has led to a veritable explosion of individual case reports, case series and hitherto unrecognized manifestations of the disease, such that it is now considered an underdiagnosed infectious disease (5). It is timely to provide an update on new developments in Whipple's disease.

In April 2000, the American Thoracic Society published guidelines for targeted tuberculin testing and the treatment of latent tuberculosis infection (LTBI) (1). These guidelines are a joint statement of the American Thoracic Society and the Centers for Disease Control and Prevention, and were endorsed by both the Infectious Diseases Society of America and the American Academy of Pediatrics. Similar recommendations were published by the Infectious Diseases Society of America in its guidelines for the treatment of tuberculosis (TB) (2). These updated guidelines were developed in recognition of the importance of treating LTBI as one component of eliminating TB in the United States ‐ a goal reiterated in 1999 by the Advisory Council for the Elimination of Tuberculosis (3) ‐ but also realizing the differing risks and benefits of treatment for patients based on their individual risks of developing active disease or drug toxicity (4). The 2000 edition of the Canadian Tuberculosis Standardsprovided similar recommendations for the treatment of LTBI (formerly known as chemoprophylaxis) and reminded us of the two major Canadian TB elimination initiatives: the National Tuberculosis Elimination Strategy (Medical Services Branch, 1992), with the aim of eliminating TB in First Nations people by 2010, and the National Consensus Conference on Tuberculosis (Health Canada, 1997), with an interim goal of a 5% reduction in the number of TB cases each year in Canada (5). Given the recent publication of the American guidelines and the updated Canadian Tuberculosis Standards (Fifth Edition), it was considered timely to remind readers of the evidence supporting the use of antituberculous chemotherapy in the treatment of latent infection.

Pertussis or whooping cough is an acute infectious disease of the respiratory tract caused principally by Bordetella pertussis and less commonly by Bordetella parapertussis (1). Until two decades ago, pertussis in adults was a medical curiosity (2‐4), but with the purification of specific Bordetella species antigens, the development of reliable enzyme immunoassays allowing accurate serological diagnosis and better understanding of the duration of immunity from vaccination, it has been clearly demonstrated that B pertussis is a common cause of prolonged cough in adults. Indeed, its incidence has been increasing gradually over the past decade in both adults and adolescents. Given the recognition of the importance of pertussis as a cause of prolonged cough in adults and the advent of the new acellular pertussis vaccines, it is timely to review current concepts of the pathogenesis of pertussis, its epidemiology in adults and the utility of the anticipated impact of the acellular vaccine.

A multicenter prospective, randomized, controlled trial, with 0.5% tincture of chlorhexidene versus 10% povidone-iodine as cutaneous antisepsis for c