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Alberta shifts to allow preventive monkeypox vaccines as some gay men were heading out of province for shots – CBC.ca

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The Alberta government announced on Thursday that it will begin offering the monkeypox vaccine to people who self-identify as meeting the eligibility criteria for targeted prevention prior to an exposure — bringing the province’s policy in line with British Columbia, Ontario and Quebec, where some gay and bisexual Alberta men had been travelling in order to receive shots.

Gay and bisexual men and their advocates have told CBC News that they were frustrated by having to travel to other provinces to get vaccinated against monkeypox.

While British Columbia, Ontario and Quebec have been offering preventative vaccination campaigns targeted at those considered at high risk of being exposed to the virus, until Thursday’s policy shift, Alberta was only giving the shot to people who have actually been exposed.

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But as of July 29, Albertans 18 and older who self-identify as meeting the eligibility criteria for targeted prevention prior to an exposure can get the monkeypox vaccine, Alberta Health said in Thursday’s news release.

Those eligible will include:

  • Transgender, cisgender or two-spirit individuals who self-identify as belonging to the gay, bisexual and other men who have sex with men (gbMSM) community and who meet at least one of the following criteria:   
         

    • Have received a recent (in the last six months) diagnosis of a sexually transmitted infection.
    •    

    • Are planning to have, or in the past 90 days had, sex outside of a mutually monogamous relationship.
    •    

    • Have attended venues for sexual contact within the past 90 days (e.g., bath houses, sex clubs) or may be planning to, or who work/volunteer in these settings.
    •    

  • Any sexual contacts of the individuals described above.
  • Staff and volunteers in a social setting or venue or event where sexual activities between men (individuals described above) may take place.

Some Albertans were seeking shots out of province

Edmonton resident Kory deGroot is planning to head to Montreal next week with his partner on holiday. While there, the two were going to try to get vaccinated because the vaccine wasn’t available to them in Alberta, despite being at higher risk of contracting the virus and fitting the vaccination criteria in other provinces.

The majority of new monkeypox cases in Canada and Europe have occurred in men who have sex with men (MSM) and deGroot, a gay man, said prior to the change that he was frustrated by what he saw as Alberta’s slow reaction to an unfolding public health emergency.

“I don’t want to get [the virus] and you know, I just want to decrease risk,” he said. “I feel like what we’ve learned through the pandemic is just, prevention is key.”

DeGroot searched Alberta Health and AHS websites for ways he might be able to get a monkeypox vaccine but couldn’t find any indication he was eligible. Then he spoke with friends and found out it was being offered in Montreal.

“So we do plan on getting it while we’re there because tourists can get the monkeypox vaccine,” he said.

Many places in Canada have already been approaching vaccination based on self-identified behaviours, vaccinating trans people, gay, bi and other groups of men who have sex with men who are having non-monogamous sex.

An Alberta Health policy dated June 7 said the monkeypox vaccine was only available to those who have been exposed to the virus.

As of Wednesday, Alberta had given out 36 doses of Imvamune, the vaccine used to prevent and treat monkeypox and smallpox. The province currently has 1,200 doses from the federal government and is working with the feds to acquire more, according to an Alberta Health spokesperson.

As of July 26, there have been 13 confirmed case of monkeypox in Alberta.

By comparison, there have been 58 monkeypox cases in B.C., as of July 26.

Vancouver Coastal Health (VCH), the B.C. health authority stretching from Richmond to the Sunshine Coast and part of the Central Coast, started a pre-exposure vaccination campaign on July 1. It targets transgender people, gay, bisexual and other men who have sex with men who meet additional high-risk criteria and are 18 years old and over, a spokesperson said in an email.

A health-care worker prepares monkeypox vaccine in Montreal on July 23, 2022. Tourists are among those lining up to get monkeypox vaccines in Montreal, as the World Health Organization declares the virus a global health emergency. (Graham Hughes/The Canadian Press)

As of July 26, VCH had vaccinated more than 6,000 people — some of whom reside outside of B.C. — at booked clinic appointments and at pop-up outreach clinics at events and businesses in Vancouver’s queer community.

“We are not actively encouraging people from outside of B.C. to seek vaccination at our clinics,” wrote VCH public affairs specialist Jeremy Deutsch, “but if they are in the VCH region and meet the eligibility criteria, they can be vaccinated.”

Deutsch added they did not know how many or what percentage of patients had come from out of province.

A colourized transmission electron micrograph of monkeypox particles (teal) found within an infected cell (brown), is shown in a handout photo captured at the NIAID Integrated Research Facility (IRF) in Fort Detrick, Maryland. (HO-National Institute of Allergy and Infectious Diseases/The Canadian Press)

Many who work in gay men’s health see it only as a matter of time before case numbers start to grow in Alberta.

“Even though our case numbers are still relatively low in comparison to places like Ontario, Quebec and in British Columbia, it’s hard not to see us as behind the eight ball,” said Nolan Hill, a gay men’s heath specialist at the Centre for Sexuality in Calgary. 

He said there is a lack of information from the provincial government for patients who are increasingly asking about testing and vaccinations for monkeypox when coming in for STI testing.

Instead it’s falling on the community who are often left in the dark, which he said leads to increased stigma and worries of monkeypox being seen as a gay disease.

“That lack of information just I think breeds a sense of mistrust and a sense of feeling left behind by the health system,” he said.

“We’ve seen that there is historical mistrust of the community, in our health systems, starting all the way back in with the AIDS epidemic.”

DeGroot is hopeful the lack of pre-exposure vaccination isn’t because of discrimination but still worries it could be.

“It would be interesting to see the response if it was impacting a different demographic, for sure,” he said.

DeGroot still plans to get his vaccine when he heads to Montreal next week but he worries about the equity issues for those who aren’t planning vacations or just can’t afford the plane ticket.

“If it continues to be like the only way that Albertans can get a vaccine is by travelling out of province,” he says, “that is a huge concern.”

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Toronto reports 2 more measles cases. Use our tool to check the spread in Canada – Toronto Star

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Canada has seen a concerning rise in measles cases in the first months of 2024.

By the third week of March, the country had already recorded more than three times the number of cases as all of last year. Canada had just 12 cases of measles in 2023, up from three in 2022.

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Cancer Awareness Month – Métis Nation of Alberta

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Cancer Awareness Month

Posted on: Apr 18, 2024

April is Cancer Awareness Month

As we recognize Cancer Awareness Month, we stand together to raise awareness, support those affected, advocate for prevention, early detection, and continued research towards a cure. Cancer is the leading cause of death for Métis women and the second leading cause of death for Métis men. The Otipemisiwak Métis Government of the Métis Nation Within Alberta is working hard to ensure that available supports for Métis Citizens battling cancer are culturally appropriate, comprehensive, and accessible by Métis Albertans at all stages of their cancer journey.

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Receiving a cancer diagnosis, whether for yourself or a loved one, can feel overwhelming, leaving you unsure of where to turn for support. In June, our government will be launching the Cancer Supports and Navigation Program which will further support Métis Albertans and their families experiencing cancer by connecting them to OMG-specific cancer resources, external resources, and providing navigation support through the health care system. This program will also include Métis-specific peer support groups for those affected by cancer.

With funding from the Canadian Partnership Against Cancer (CPAC) we have also developed the Métis Cancer Care Course to ensure that Métis Albertans have access to culturally safe and appropriate cancer services. This course is available to cancer care professionals across the country and provides an overview of who Métis people are, our culture, our approaches to health and wellbeing, our experiences with cancer care, and our cancer journey.

Together, we can make a difference in the fight against cancer and ensure equitable access to culturally safe and appropriate care for all Métis Albertans. Please click on the links below to learn more about the supports available for Métis Albertans, including our Compassionate Care: Cancer Transportation program.

I wish you all good health and happiness!

Bobbi Paul-Alook
Secretary of Health & Seniors

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Type 2 diabetes is not one-size-fits-all: Subtypes affect complications and treatment options – The Conversation

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You may have heard of Ozempic, the “miracle drug” for weight loss, but did you know that it was actually designed as a new treatment to manage diabetes? In Canada, diabetes affects approximately 10 per cent of the general population. Of those cases, 90 per cent have Type 2 diabetes.

This metabolic disorder is characterized by persistent high blood sugar levels, which can be accompanied by secondary health challenges, including a higher risk of stroke and kidney disease.

Locks and keys

In Type 2 diabetes, the body struggles to maintain blood sugar levels in an acceptable range. Every cell in the body needs sugar as an energy source, but too much sugar can be toxic to cells. This equilibrium needs to be tightly controlled and is regulated by a lock and key system.

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In the body’s attempt to manage blood sugar levels and ensure that cells receive the right amount of energy, the pancreatic hormone, insulin, functions like a key. Cells cover themselves with locks that respond perfectly to insulin keys to facilitate the entry of sugar into cells.

Unfortunately, this lock and key system doesn’t always perform as expected. The body can encounter difficulties producing an adequate number of insulin keys, and/or the locks can become stubborn and unresponsive to insulin.

All forms of diabetes share the challenge of high blood sugar levels; however, diabetes is not a singular condition; it exists as a spectrum. Although diabetes is broadly categorized into two main types, Type 1 and Type 2, each presents a diversity of subtypes, especially Type 2 diabetes.

These subtypes carry their own characteristics and risks, and do not respond uniformly to the same treatments.

To better serve people living with Type 2 diabetes, and to move away from a “one size fits all” approach, it is beneficial to understand which subtype of Type 2 diabetes a person lives with. When someone needs a blood transfusion, the medical team needs to know the patient’s blood type. It should be the same for diabetes so a tailored and effective game plan can be implemented.

This article explores four unique subtypes of Type 2 diabetes, shedding light on their causes, complications and some of their specific treatment avenues.

Severe insulin-deficient diabetes: We’re missing keys!

In severe insulin-deficient diabetes, beta cells limit production of the keys that unlock cells to allow entry of sugar from the blood.
(Lili Grieco-St-Pierre, Jennifer Bruin/Created with BioRender.com)

Insulin is produced by beta cells, which are found in the pancreas. In the severe insulin-deficient diabetes (SIDD) subtype, the key factories — the beta cells — are on strike. Ultimately, there are fewer keys in the body to unlock the cells and allow entry of sugar from the blood.

SIDD primarily affects younger, leaner individuals, and unfortunately, increases the risk of eye disease and blindness, among other complications. Why the beta cells go on strike remains largely unknown, but since there is an insulin deficiency, treatment often involves insulin injections.

Severe insulin-resistant diabetes: But it’s always locked!

A diagram of three closed locks and lots of keys

In severe insulin-resistant diabetes, the locks start ignoring the keys, triggering the beta cells to produce even more keys to compensate.
(Lili Grieco-St-Pierre, Jennifer Bruin/Created with BioRender.com)

In the severe insulin-resistant diabetes (SIRD) subtype, the locks are overstimulated and start ignoring the keys. As a result, the beta cells produce even more keys to compensate. This can be measured as high levels of insulin in the blood, also known as hyperinsulinemia.

This resistance to insulin is particularly prominent in individuals with higher body weight. Patients with SIRD have an increased risk of complications such as fatty liver disease. There are many treatment avenues for these patients but no consensus about the optimal approach; patients often require high doses of insulin.

Mild obesity-related diabetes: The locks are sticky!

Illustration of a lock and key

In mild obesity-related diabetes, the locks are ‘sticky,’ making it difficult for the keys to open the locks.
(Lili Grieco-St-Pierre, Jennifer Bruin/Created with BioRender.com)

Mild obesity-related (MOD) diabetes represents a nuanced aspect of Type 2 diabetes, often observed in individuals with higher body weight. Unlike more severe subtypes, MOD is characterized by a more measured response to insulin. The locks are “sticky,” so it is challenging for the key to click in place and open the lock. While MOD is connected to body weight, the comparatively less severe nature of MOD distinguishes it from other diabetes subtypes.

To minimize complications, treatment should include maintaining a healthy diet, managing body weight, and incorporating as much aerobic exercise as possible. This is where drugs like Ozempic can be prescribed to control the evolution of the disease, in part by managing body weight.

Mild age-related diabetes: I’m tired of controlling blood sugar!

Illustration of a lock and a beta cell

In people with mild age-related diabetes, both the locks and the beta cells that produce keys are tired, resulting in fewer keys and stubborn locks.
(Lili Grieco-St-Pierre, Jennifer Bruin/Created with BioRender.com)

Mild age-related diabetes (MARD) happens more often in older people and typically starts later in life. With time, the key factory is not as productive, and the locks become stubborn. People with MARD find it tricky to manage their blood sugar, but it usually doesn’t lead to severe complications.

Among the different subtypes of diabetes, MARD is the most common.

Unique locks, varied keys

While efforts have been made to classify diabetes subtypes, new subtypes are still being identified, making proper clinical assessment and treatment plans challenging.

In Canada, unique cases of Type 2 diabetes were identified in Indigenous children from Northern Manitoba and Northwestern Ontario by Dr. Heather Dean and colleagues in the 1980s and 90s. Despite initial skepticism from the scientific community, which typically associated Type 2 diabetes with adults rather than children, clinical teams persisted in identifying this as a distinct subtype of Type 2 diabetes, called childhood-onset Type 2 diabetes.




Read more:
Indigenous community research partnerships can help address health inequities


Childhood-onset Type 2 diabetes is on the rise across Canada, but disproportionately affects Indigenous youth. It is undoubtedly linked to the intergenerational trauma associated with colonization in these communities. While many factors are likely involved, recent studies have discovered that exposure of a fetus to Type 2 diabetes during pregnancy increases the risk that the baby will develop diabetes later in life.

Acknowledging this distinct subtype of Type 2 diabetes in First Nations communities has led to the implementation of a community-based health action plan aimed at addressing the unique challenges faced by Indigenous Peoples. It is hoped that partnered research between communities and researchers will continue to help us understand childhood-onset Type 2 diabetes and how to effectively prevent and treat it.

A mosaic of conditions

Illustration of different subtypes of Type 2 diabetes

Type 2 diabetes is a mosaic of conditions, each with its own characteristics.
(Lili Grieco-St-Pierre, Jennifer Bruin/Created with BioRender.com)

Type 2 diabetes is not uniform; it’s a mosaic of conditions, each with its own characteristics. Since diabetes presents so uniquely in every patient, even categorizing into subtypes does not guarantee how the disease will evolve. However, understanding these subtypes is a good starting point to help doctors create personalized plans for people living with the condition.

While Indigenous communities, lower-income households and individuals living with obesity already face a higher risk of developing Type 2 diabetes than the general population, tailored solutions may offer hope for better management. This emphasizes the urgent need for more precise assessments of diabetes subtypes to help customize therapeutic strategies and management strategies. This will improve care for all patients, including those from vulnerable and understudied populations.

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