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Is Canada prepared for a measles outbreak? Many health officials are on high alert

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Vaccine-preventable disease specialists say the severity of the situation in Canada will depend, to a degree, on chance.ANDREW TESTA/The New York Times News Service

A worldwide surge in measles cases combined with lower vaccination rates and one of the year’s busiest travel seasons has many health professionals on high alert for outbreaks and preparing an urgent response to stop further spread of the highly contagious virus.

A measles expert with the World Health Organization said the next few months will be a test of Canada’s vaccination systems and could expose potential weaknesses.

“This is where we find out whether or not the immunization systems are as good as we think,” said Natasha Crowcroft, senior technical adviser for measles and rubella with the WHO. “You can go along thinking everything is fine until measles takes off everywhere.”

There have been nearly two dozen confirmed cases of measles reported in Canada so far this year, compared with just 12 in all of 2023. Of this year’s cases, 12 are in Quebec, with the Montreal area experiencing community transmission of the virus in areas with low vaccination rates. This past week, B.C. confirmed its first case of measles since 2019.

Health officials have urged March break travellers to be cautious, given the increased measles spread worldwide.

The return of measles is cause for concern, not disdain

Vaccine-preventable disease specialists say the severity of the situation in Canada will depend, to a degree, on chance. If an individual acquires measles on an international trip, but lives in a highly vaccinated community, the risks are lower. But if a measles case is introduced into an unvaccinated area or even a hospital with many immune-compromised patients, the situation could be much more difficult to manage.

“It’s always sort of the luck of the draw, where will that imported case come to,” said Monika Naus, medical director of Immunization Programs and Vaccine Preventable Diseases Service at the BC Centre for Disease Control. “That risk is higher if those imported cases come into an under-vaccinated population.”

There was a 79-per-cent increase in measles cases around the world last year, reaching more than 300,000, according to the WHO. Experts say a combination of factors, including disruptions to immunization programs during the pandemic, lack of access in lower- and middle-income countries and vaccine hesitancy or anti-vaccine beliefs, are all part of the problem.


How effective is the measles vaccine?

The measles, mumps and rubella vaccine is around 95 per cent effective, meaning five per cent of those who get it remain susceptible. Imagine a group of 100 individuals, in which 95 are vaccinated and five are not. The unvaccinated people are at risk of catching measles, as are five people in the vaccinated group. If all 100 are exposed to the virus, the five unvaccinated and five of the vaccinated individuals will likely become infected. In the end, 5.3 per cent in the vaccinated group will get sick, compared with all the unvaccinated individuals.

Immune-vaccinated

Susceptible-

vaccinated

Susceptible-

unvaccinated

carly weeks and john sopinski/the globe and mail,

Source: Bc Centre for disease control

How effective is the measles vaccine?

The measles, mumps and rubella vaccine is around 95 per cent effective, meaning five per cent of those who get it remain susceptible. Imagine a group of 100 individuals, in which 95 are vaccinated and five are not. The unvaccinated people are at risk of catching measles, as are five people in the vaccinated group. If all 100 are exposed to the virus, the five unvaccinated and five of the vaccinated individuals will likely become infected. In the end, 5.3 per cent in the vaccinated group will get sick, compared with all the unvaccinated individuals.

Immune-vaccinated

Susceptible-

vaccinated

Susceptible-

unvaccinated

carly weeks and john sopinski/the globe and mail,

Source: Bc Centre for disease control

How effective is the measles vaccine?

The measles, mumps and rubella vaccine is around 95 per cent effective, meaning five per cent of those who get it remain susceptible. Imagine a group of 100 individuals, in which 95 are vaccinated and five are not. The unvaccinated people are at risk of catching measles, as are five people in the vaccinated group. If all 100 are exposed to the virus, the five unvaccinated and five of the vaccinated individuals will likely become infected. In the end, 5.3 per cent in the vaccinated group will get sick, compared with all the unvaccinated individuals.

Immune-vaccinated

Susceptible-

vaccinated

Susceptible-

unvaccinated

carly weeks and john sopinski/the globe and mail, Source: Bc Centre for disease control

Canada eliminated measles in 1998, meaning the virus no longer spreads on its own here; cases are typically introduced through international travel. But if transmission of the virus here continues for more than a year, Canada will lose its measles-free status. That almost happened in 2011, after a major outbreak in Quebec that led to nearly 800 cases.

A 2012 study of that outbreak, published in the Journal of Infectious Diseases, noted that many of the cases spread in school students who had one or two doses of the measles vaccine. But overall vaccination rates were below 95 per cent, which is the threshold needed to keep the virus at bay, according to the WHO.

The study concluded that, considering a small number of vaccinated individuals will remain susceptible to the virus, having even 3-5 per cent of people unvaccinated could be enough to “push the population toward a critical tipping point for epidemic risk.”

Another large outbreak occurred in B.C. in 2014. The outbreak was mainly confined to a religious community that opposes vaccination. But Dr. Naus noted the outbreak didn’t spread beyond the community because of efforts undertaken by its members and public health.

She said that during outbreaks in that community and others that oppose vaccines, health workers will often set up quasi-undercover immunization centres where community members can get vaccinated without anyone else knowing.

“People, members of the community, didn’t want to be shunned by family or friends if they did come forward,” Dr. Naus said, adding that it’s essential for public health to establish trust and maintain communication with communities that reject vaccines.

Health officials say that Canadians who plan on travelling internationally should ensure they’re up to date on their vaccinations. People born before 1970 are presumed to have immunity from the era when measles was highly prevalent in Canada and should receive one dose to ensure they are immune. People born after 1970 need two doses to be immune. Officials advise individuals to check with their health care provider, but given that Canada doesn’t have a national vaccine registry, figuring out who has been vaccinated can be a challenge.

Babies are eligible for their first dose of measles vaccine at one year. Babies aged six to 12 months can get a vaccine if they are travelling internationally (but still require another dose at 12 months).

Measles is one of the most contagious viruses in existence. Almost everyone who comes into contact with the virus will get infected if they aren’t vaccinated or immune from a prior illness. The virus can remain suspended in the air for two hours, meaning a person doesn’t even have to be in the room at the same time as an infected individual to catch it.

One in five people infected require hospital admission. One in 10 will develop a complicating infection, such as pneumonia, while one in 1,000 will develop brain inflammation, which can cause severe problems, including deafness and intellectual disability. Up to three in 1,000 people infected with measles will die.

That’s why health officials are quick to raise the alarm after even a single case is reported, a situation playing out in the York Region of the Greater Toronto Area. On Feb. 29, York Region Public Health said it had confirmed measles in an adult male in his 30s who had not recently travelled or been in contact with a measles case. He was fully vaccinated and his illness was mild.

As soon as the case was confirmed, health officials alerted about 1,800 close contacts and identified those at highest risk for severe complications. So far, no reports of transmission have occurred.

An alert was sent out to advise the public of places the man had visited before he went into isolation. York Region’s associate medical officer of health, Sarah Erdman, said the health unit set up a vaccine clinic and a post-exposure prophylaxis clinic to target higher-risk groups. A person who is exposed to measles has a 72-hour window to receive a vaccine or, in the case of infants under six months, pregnant women or those with compromised immune systems, a blood product containing measles antibodies, to help ward off complications.

Back at the World Health Organization, Dr. Crowcroft said that vaccination rates have been falling around the world, creating a “perfect storm” of risk.

“We’re in a really urgent emergency situation for the rest of the world,” she said. “I don’t get the sense this is being taken seriously. We need urgent action now.”

 

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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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