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New methods might be needed to catch COVID-19 virus variants in Manitoba – CBC.ca

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Manitoba might have to change the way it watches for concerning variants of the coronavirus that causes COVID-19, after a number of samples initially flagged as possible cases of a dangerous variant came back negative.

Current screening tools rely on genetic markers found in three known variants of concern. However, those markers are also found in other variants that are not considered a concern. 

Samples that are flagged in the initial screening process are then sent for full genomic sequencing, a labour-intensive process.

That’s what happened earlier this month, when initial screening tests on samples from the Manitoba First Nations communities of Pauingassi and Pimicikamak detected a genetic mutation found in several known variants of the virus, including the more contagious B117 variant first detected in the U.K.

Those samples were sent for full genetic sequencing, and health officials determined they were another variant already found in Manitoba — one which has been deemed to have no clinical significance.

An easier way to detect the variant could be developing more specific primers — pieces of genetic material used to test for the virus — that won’t confound the current testing method.

“I think it would be more feasible in terms of … labour and effort and money, to develop specific primers to cope with these mutations,” said Carlos Farkas, a post-doctoral researcher at the University of Manitoba’s Rady Faculty of Medicine who has studied variants and the challenges they pose to current tests.

Speaking at a news conference on Tuesday, Manitoba Chief Provincial Public Health Officer Dr. Brent Roussin said the tests need to be sensitive enough that they don’t miss anything that could be a variant of concern.

“We want it very unlikely that we actually miss something we’re looking for,” he said.

Balancing sensitivity 

Designing a test to catch variants of concern is a matter of balancing sensitivity and specificity, Roussin said.

“We’ll have to continue to work to ensure we have the right targets on our screening tests … to ensure that we’re getting a bit more out of the screening tests,” he said.

Manitoba laboratories have “plans to add additional markers that should be able to better distinguish variants of concern from local variants,” a provincial spokesperson said. That’s consistent with the Canadian COVID-19 Genomics Network’s recommendations, according to the spokesperson.

As of Friday, when three new cases were announced, a total of four cases of the B117 variant had been identified in Manitoba. All four cases were travel-related, health officials have said.

Manitoba health officials aim to sequence around five per cent of the samples received, a number that is in line with other jurisdictions, according to a provincial government spokesperson.

In order to be confident they aren’t missing variant cases in the community, the province needs to significantly increase the volume of samples it sends for genomic sequencing, said Nazeem Muhajarine, an epidemiology professor at the University of Saskatchewan.

“At some point, they need to get into more kind of random testing in order to really be sure about whether we are picking up the variants,” he said.

Catching new variants

Viruses typically mutate as they spread, and most of those variations are inconsequential, virologists say.

But determining whether a new variant is one health officials should worry about is “not straightforward,” said Farkas. 

One way is to study the way a virus behaves in a laboratory. Another is to observe how it is spreading in the community.

“If you live in a community where the community prevalence of COVID  is pretty high … that could also be another piece of information — a flag, if you will,” Muhajarine said.

Pimicikamak, also known as Cross Lake First Nation, has struggled to contain a resurgence of the coronavirus in recent  weeks. In the span of two days, from Feb. 12 to 14, the number of active cases in the community nearly doubled from 42 to 82.

Dozens of recent cases have been linked to superspreader events in the community, including a birthday party, a wake and a funeral, band leadership said Friday. Overcrowded housing in the community is another cause, Chief David Monias told CBC News.

The B117 variant isn’t the only one of concern Manitoba health officials are on the lookout for. The same genetic marker — known as N501Y — is also found in the two other major variants of concern, which were first detected in South Africa and Brazil.

Manitoba is waiting for a delivery of a new reagent, expected to arrive this week, that will enable screening for those variants as well, a provincial spokesperson said.

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Canada to donate up to 200,000 vaccine doses to combat mpox outbreaks in Africa

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The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.

It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.

Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”

Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.

Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.

A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.

On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.

Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”

But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”

“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.

Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.

Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.

Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.

“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.

“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”

This report by The Canadian Press was first published Sept. 13, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

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HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.

The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.

Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.

“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”

The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.

A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.

Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.

“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.

Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.

The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.

“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.

This report by The Canadian Press was first published Sept. 11, 2024.

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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

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ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.

Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.

Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.

Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.

The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.

“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.

Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.

Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.

Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.

A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.

This report by The Canadian Press was first published Sept. 10, 2024.

The Canadian Press. All rights reserved.

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