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7 cases of severe acute hepatitis reported at Toronto children's hospital – CBC News

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One of Canada’s largest children’s hospitals is reporting seven cases of severe acute hepatitis identified in recent months, which may be part of an unexplained outbreak impacting youth in multiple countries, CBC News has learned.

It’s still unclear how many cases have been reported across Canada, or whether any of the cases under investigation at the Hospital for Sick Children in Toronto — also known as SickKids — are linked to the mysterious instances of serious liver disease among children in the U.K., U.S., Israel and elsewhere.

A spokesperson for SickKids provided the tally in an email, saying the hospital is “closely monitoring” for any cases of severe acute hepatitis and has reported seven cases meeting the “probable case definition” to Public Health Ontario. 

Those cases were identified between Oct. 1, 2021 and April 30, 2022.

“It remains to be seen whether this number represents an increase in cases of unknown origin compared to similar time periods in previous years or if any of these cases will be confirmed to be caused by a novel clinical entity,” SickKids spokesperson Jessamine Luck continued.

100+ cases reported in U.S.

The Public Health Agency of Canada has not yet provided specifics on how many cases are being investigated Canada-wide to determine if they’re related to the unexplained instances of hepatitis elsewhere.

Other countries, however, have been publicizing growing numbers of potentially connected cases, with hundreds of investigations underway globally to determine the root cause of unexplained liver issues among youth.

On Friday, the U.S. Centers for Disease Control and Prevention said 109 cases across various parts of the country are under investigation to determine any possible links. Fourteen per cent of those children required liver transplants, and five died from their illness.

Hepatitis — which refers to inflammation of the liver — is rare among children. It’s typically caused by the family of hepatitis viruses, but can also be sparked by alcohol use, exposure to toxins, or other pathogens.

The cases identified by health officials around the world in recent months don’t appear to have any of those usual causes.

Instead, researchers are probing other theories, including links to infections from an adenovirus or SARS-COV-2, the virus behind COVID-19.

WATCH | Mystery cases of hepatitis among children under investigation:

Cause of rare liver disease outbreak in kids a mystery to experts

14 days ago
Duration 2:00

Doctors aren’t sure what’s causing a mysterious liver disease outbreak that’s been seen in kids from a dozen countries around the world. While at least one child has died, experts insist most children will fully recover from the disease. 2:00

Leading hypothesis in U.K. involves adenovirus

In the U.K., where there have been at least 163 cases of acute, unexplained hepatitis identified in youth under 16 since the start of the year — including 11 cases which required a liver transplant — officials say the leading hypothesis remains focused on adenovirus.

“However, we continue to investigate the potential role of SARS-CoV-2 and to work on ruling out any toxicological component,” the U.K. Health Security Agency (UKHSA) said in a briefing note released on Friday.

Adenovirus — referring to a family of common viruses that typically cause mild cold- or flu-like illness — was the pathogen detected most often, found in more than 70 per cent of the U.K. cases and primarily detected in blood, the UKHSA said. 

SARS-CoV-2 was detected in 18 per cent of cases. Serological testing, a method to determine if someone has antibodies from a prior infection, is also underway.

“A range of other possible pathogens have been detected in a low proportion of cases and are of uncertain significance,” the U.K. briefing note continued. 

The UKHSA is investigating whether a normal adenovirus infection might be behind the instances of hepatitis, due to a variety of factors including a lack of exposure to the virus during the COVID-19 pandemic, an “exceptionally large wave” of infections causing a rare complication to present more often, or an abnormal response to the virus due to a prior or co-infection with SARS-CoV-2.

“I don’t think the answer is a simple smoking gun here,” said Hamilton, Ont.-based infectious diseases specialist Dr. Zain Chagla, of the global investigations into this mystery outbreak.

“Certainly we’ve seen adenoviruses cause hepatitis in immunocompromised populations. But even then: Why now, and why in the context of certain countries, and not others? The context of certain time frames, but not others?” he questioned.

“Is there a cofactor — a toxin, or genetics, or another infection like COVID-19 that might be involved in all of this?”

WATCH | Hepatitis cases among children a medical mystery, says specialist:

Rare liver illness in children a ‘medical mystery,’ says specialist

14 days ago
Duration 5:47

A liver illness affecting 169 children in the U.S. and Europe is, so far, a ‘medical mystery,’ says infectious disease specialist Dr. Isaac Bogoch, and it’s premature to attribute it to any one virus or cause. 5:47

Israeli team exploring links to COVID-19

Unexplained cases of hepatitis have been identified in an array of countries, and at varying points in the pandemic, with significant numbers being reported in recent months following alerts sent out by officials in the U.S. and U.K.

What’s unclear, whether in global reports or the numbers under investigation in Toronto, is exactly how these tallies compare to the typical baseline rate for unexplained hepatitis in children.

“There’s just so much uncertainty,” said Chagla, including why certain regions are reporting more cases than others. 

In Israel, Dr. Yael Mozer Glassberg — head of the liver transplant unit at Schneider Children’s Medical Center — said her team has treated multiple children who faced strange instances of hepatitis, but hasn’t seen a “huge jump” in overall numbers.

Medical staff analyzed those recent cases, including genetic testing, and the only link between them was that each one had faced a previous bout of COVID-19, identified through serological testing and each family’s medical history. None of the patients tested positive for adenovirus, Mozer Glassberg told CBC News.

“I can’t say that this is the same thing that happens right now around the world,” she said. “But we had seven definite cases like that [since Feb. 2021] and right now we’ve hospitalized the eighth one.”

Two infants required transplants, but Mozer Glassberg said it’s not uncommon for hepatitis in that age group to present with no clear cause, raising questions about whether those two cases were linked to the others.

Given variations in testing for COVID-19 around the world, it may also be tough to determine any possible links to prior infections from SARS-CoV-2, adding another layer of uncertainty to this global puzzle. 

“Maybe it’s a new virus. Maybe it’s not [adenovirus]. Maybe it’s not even post-COVID… maybe it’s a combination of the two,” Mozer Glassberg said.

Physicians say possible symptoms of hepatitis can include jaundice — yellowing eyes and skin — dark urine, pale stool, abdominal pain, and vomiting.

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What’s the greatest holiday gift: lips, hair, skin? Give the gift of great skin this holiday season

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Give the gift of great skin this holiday season

Skinstitut Holiday Gift Kits take the stress out of gifting

Toronto, October 31, 2024 – Beauty gifts are at the top of holiday wish lists this year, and Laser Clinics Canada, a leader in advanced beauty treatments and skincare, is taking the pressure out of seasonal shopping. Today, Laser Clincs Canada announces the arrival of its 2024 Holiday Gift Kits, courtesy of Skinstitut, the exclusive skincare line of Laser Clinics Group.

In time for the busy shopping season, the limited-edition Holiday Gifts Kits are available in Laser Clinics locations in the GTA and Ottawa. Clinics are conveniently located in popular shopping centers, including Hillcrest Mall, Square One, CF Sherway Gardens, Scarborough Town Centre, Rideau Centre, Union Station and CF Markville. These limited-edition Kits are available on a first come, first served basis.

“These kits combine our best-selling products, bundled to address the most relevant skin concerns we’re seeing among our clients,” says Christina Ho, Senior Brand & LAM Manager at Laser Clinics Canada. “With several price points available, the kits offer excellent value and suit a variety of gift-giving needs, from those new to cosmeceuticals to those looking to level up their skincare routine. What’s more, these kits are priced with a savings of up to 33 per cent so gift givers can save during the holiday season.

There are two kits to select from, each designed to address key skin concerns and each with a unique theme — Brightening Basics and Hydration Heroes.

Brightening Basics is a mix of everyday essentials for glowing skin for all skin types. The bundle comes in a sleek pink, reusable case and includes three full-sized products: 200ml gentle cleanser, 50ml Moisture Defence (normal skin) and 30ml1% Hyaluronic Complex Serum. The Brightening Basics kit is available at $129, a saving of 33 per cent.

Hydration Heroes is a mix of hydration essentials and active heroes that cater to a wide variety of clients. A perfect stocking stuffer, this bundle includes four deluxe products: Moisture 15 15 ml Defence for normal skin, 10 ml 1% Hyaluronic Complex Serum, 10 ml Retinol Serum and 50 ml Expert Squalane Cleansing Oil. The kit retails at $59.

In addition to the 2024 Holiday Gifts Kits, gift givers can easily add a Laser Clinic Canada gift card to the mix. Offering flexibility, recipients can choose from a wide range of treatments offered by Laser Clinics Canada, or they can expand their collection of exclusive Skinstitut products.

 

Brightening Basics 2024 Holiday Gift Kit by Skinstitut, available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

Hydration Heroes 2024 Holiday Gift Kit by Skinstitut – available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

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Here is how to prepare your online accounts for when you die

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LONDON (AP) — Most people have accumulated a pile of data — selfies, emails, videos and more — on their social media and digital accounts over their lifetimes. What happens to it when we die?

It’s wise to draft a will spelling out who inherits your physical assets after you’re gone, but don’t forget to take care of your digital estate too. Friends and family might treasure files and posts you’ve left behind, but they could get lost in digital purgatory after you pass away unless you take some simple steps.

Here’s how you can prepare your digital life for your survivors:

Apple

The iPhone maker lets you nominate a “ legacy contact ” who can access your Apple account’s data after you die. The company says it’s a secure way to give trusted people access to photos, files and messages. To set it up you’ll need an Apple device with a fairly recent operating system — iPhones and iPads need iOS or iPadOS 15.2 and MacBooks needs macOS Monterey 12.1.

For iPhones, go to settings, tap Sign-in & Security and then Legacy Contact. You can name one or more people, and they don’t need an Apple ID or device.

You’ll have to share an access key with your contact. It can be a digital version sent electronically, or you can print a copy or save it as a screenshot or PDF.

Take note that there are some types of files you won’t be able to pass on — including digital rights-protected music, movies and passwords stored in Apple’s password manager. Legacy contacts can only access a deceased user’s account for three years before Apple deletes the account.

Google

Google takes a different approach with its Inactive Account Manager, which allows you to share your data with someone if it notices that you’ve stopped using your account.

When setting it up, you need to decide how long Google should wait — from three to 18 months — before considering your account inactive. Once that time is up, Google can notify up to 10 people.

You can write a message informing them you’ve stopped using the account, and, optionally, include a link to download your data. You can choose what types of data they can access — including emails, photos, calendar entries and YouTube videos.

There’s also an option to automatically delete your account after three months of inactivity, so your contacts will have to download any data before that deadline.

Facebook and Instagram

Some social media platforms can preserve accounts for people who have died so that friends and family can honor their memories.

When users of Facebook or Instagram die, parent company Meta says it can memorialize the account if it gets a “valid request” from a friend or family member. Requests can be submitted through an online form.

The social media company strongly recommends Facebook users add a legacy contact to look after their memorial accounts. Legacy contacts can do things like respond to new friend requests and update pinned posts, but they can’t read private messages or remove or alter previous posts. You can only choose one person, who also has to have a Facebook account.

You can also ask Facebook or Instagram to delete a deceased user’s account if you’re a close family member or an executor. You’ll need to send in documents like a death certificate.

TikTok

The video-sharing platform says that if a user has died, people can submit a request to memorialize the account through the settings menu. Go to the Report a Problem section, then Account and profile, then Manage account, where you can report a deceased user.

Once an account has been memorialized, it will be labeled “Remembering.” No one will be able to log into the account, which prevents anyone from editing the profile or using the account to post new content or send messages.

X

It’s not possible to nominate a legacy contact on Elon Musk’s social media site. But family members or an authorized person can submit a request to deactivate a deceased user’s account.

Passwords

Besides the major online services, you’ll probably have dozens if not hundreds of other digital accounts that your survivors might need to access. You could just write all your login credentials down in a notebook and put it somewhere safe. But making a physical copy presents its own vulnerabilities. What if you lose track of it? What if someone finds it?

Instead, consider a password manager that has an emergency access feature. Password managers are digital vaults that you can use to store all your credentials. Some, like Keeper,Bitwarden and NordPass, allow users to nominate one or more trusted contacts who can access their keys in case of an emergency such as a death.

But there are a few catches: Those contacts also need to use the same password manager and you might have to pay for the service.

___

Is there a tech challenge you need help figuring out? Write to us at onetechtip@ap.org with your questions.

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Pediatric group says doctors should regularly screen kids for reading difficulties

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The Canadian Paediatric Society says doctors should regularly screen children for reading difficulties and dyslexia, calling low literacy a “serious public health concern” that can increase the risk of other problems including anxiety, low self-esteem and behavioural issues, with lifelong consequences.

New guidance issued Wednesday says family doctors, nurses, pediatricians and other medical professionals who care for school-aged kids are in a unique position to help struggling readers access educational and specialty supports, noting that identifying problems early couldhelp kids sooner — when it’s more effective — as well as reveal other possible learning or developmental issues.

The 10 recommendations include regular screening for kids aged four to seven, especially if they belong to groups at higher risk of low literacy, including newcomers to Canada, racialized Canadians and Indigenous Peoples. The society says this can be done in a two-to-three-minute office-based assessment.

Other tips encourage doctors to look for conditions often seen among poor readers such as attention-deficit hyperactivity disorder; to advocate for early literacy training for pediatric and family medicine residents; to liaise with schools on behalf of families seeking help; and to push provincial and territorial education ministries to integrate evidence-based phonics instruction into curriculums, starting in kindergarten.

Dr. Scott McLeod, one of the authors and chair of the society’s mental health and developmental disabilities committee, said a key goal is to catch kids who may be falling through the cracks and to better connect families to resources, including quicker targeted help from schools.

“Collaboration in this area is so key because we need to move away from the silos of: everything educational must exist within the educational portfolio,” McLeod said in an interview from Calgary, where he is a developmental pediatrician at Alberta Children’s Hospital.

“Reading, yes, it’s education, but it’s also health because we know that literacy impacts health. So I think that a statement like this opens the window to say: Yes, parents can come to their health-care provider to get advice, get recommendations, hopefully start a collaboration with school teachers.”

McLeod noted that pediatricians already look for signs of low literacy in young children by way of a commonly used tool known as the Rourke Baby Record, which offers a checklist of key topics, such as nutrition and developmental benchmarks, to cover in a well-child appointment.

But he said questions about reading could be “a standing item” in checkups and he hoped the society’s statement to medical professionals who care for children “enhances their confidence in being a strong advocate for the child” while spurring partnerships with others involved in a child’s life such as teachers and psychologists.

The guidance said pediatricians also play a key role in detecting and monitoring conditions that often coexist with difficulty reading such as attention-deficit hyperactivity disorder, but McLeod noted that getting such specific diagnoses typically involves a referral to a specialist, during which time a child continues to struggle.

He also acknowledged that some schools can be slow to act without a specific diagnosis from a specialist, and even then a child may end up on a wait list for school interventions.

“Evidence-based reading instruction shouldn’t have to wait for some of that access to specialized assessments to occur,” he said.

“My hope is that (by) having an existing statement or document written by the Canadian Paediatric Society … we’re able to skip a few steps or have some of the early interventions present,” he said.

McLeod added that obtaining specific assessments from medical specialists is “definitely beneficial and advantageous” to know where a child is at, “but having that sort of clear, thorough assessment shouldn’t be a barrier to intervention starting.”

McLeod said the society was partly spurred to act by 2022’s “Right to Read Inquiry Report” from the Ontario Human Rights Commission, which made 157 recommendations to address inequities related to reading instruction in that province.

He called the new guidelines “a big reminder” to pediatric providers, family doctors, school teachers and psychologists of the importance of literacy.

“Early identification of reading difficulty can truly change the trajectory of a child’s life.”

This report by The Canadian Press was first published Oct. 23, 2024.

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