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As temperatures rise, dengue fever infections keep surging around the world

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In Bangladesh, roughly 300,000 people have been infected with dengue this year during the country’s worst-ever outbreak of the mosquito-transmitted disease. By mid-November, the death toll hit close to 1,500, as hospitals in the densely populated South Asian country struggled to cope with the surge in patients.

Neighbouring India is also experiencing more and more outbreaks, along with Sri Lanka to the south, where 60,000 cases of dengue have been reported just this year. In Mexico, cases rose more than 330 per cent in 2023 compared to 2022, and Argentina, Bolivia, Brazil, and Peru are also reporting high rates of infections.

The disease — known as “breakbone fever,” due to the severe muscle and joint pains it can cause — is also appearing far beyond its usual range in tropical and subtropical climates.

Dozens of dengue cases not tied to travel abroad have been reported across several European countries, including Italy, France, and Spain. Chad, a landlocked country at the crossroads of North and Central Africa, experienced its first known outbreak this year. Meanwhile several U.S. states announced locally acquired cases in recent months, including the country’s first known infections in California.

The explosive spread of dengue, through the mosquitos known for carrying the virus, offers a case study in how climate change, human movement, and rising temperatures are all coaligning to fuel the expansion of potentially deadly threats to human health. And, scientists warn, even countries like Canada that have avoided dengue’s wrath could experience local transmission of the virus in the decades ahead.

“The frequency of outbreaks is ever increasing,” Himmat Singh, a scientist at the National Institute of Malaria Research in New Delhi, told the British Medical Journal. “Mosquitoes are evolving as humans have pushed them to adapt.”

WHO scientists ring alarms

While eye-catching climate impacts such as extreme weather events and heat waves will be front and centre at the first dedicated Health Day being held on Sunday at COP28, the World Health Organization (WHO) recently warned our changing climate is also “catalyzing a surge in infectious diseases like dengue” and is calling for health-focused climate action from global governments.

The organization’s chief scientist, Dr. Jeremy Farrar, told Reuters in October that he expects dengue will become a major threat in the southern U.S, southern Europe, and new parts of Africa this decade — as warmer temperatures create the conditions for the mosquitoes carrying the infection to spread.

Dengue virus is transmitted by the Aedes aegypti mosquito, a tropical species which also spreads the viruses behind diseases such as Zika, chikungunya, and yellow fever.

“They harbour a lot of these nasty viruses,” said virologist Stephen Barr, an associate professor in Western University’s department of microbiology and immunology. “What researchers know is that the traits these mosquitoes have, that are favourable for spreading these viruses, occur in the range of temperatures from about 24 to 29 C.”

A health worker fumigates mosquitos to help mitigate the spread of dengue inside a home, at La Primavera shantytown in Piura, Peru, Saturday, June 3, 2023. Dengue, a viral disease transmitted by a mosquito, causes flu-like symptoms, such as muscle pain and fever. (Martin Mejia/The Associated Press)

The species can survive year-round when temperatures are warm enough, and females lay their eggs in areas of shallow, stagnant water, which can mean spaces as small as household containers, potted plants, or even a bottle cap.

“Once the mosquito habitat is established, it only takes one or two people to bring the virus into that habitat for the mosquito to [spread it],” said Dr. Amila Heendeniya, a clinical infectious diseases physician at the Winnipeg Regional Health Authority and an assistant professor at the University of Manitoba.

Researchers say warming temperatures and shifts in rainfall patterns due to climate change are creating ideal conditions for these mosquitoes to breed, particularly in areas such as Bangladesh where monsoon-level rain is being reported earlier in the season.

In Pakistan, there has been an ongoing dengue epidemic since 2011, said Dr. Imran Hassan Khan, chair of the country’s Dengue Expert Advisory Group. The mosquitoes appear to be adapting to a longer rainy season, and now likely live throughout homes where they can infect people with this virus at any time of day, he explained.

“We’re unable to eradicate it,” he added. “It’s impossible to eradicate it.”

Rates of the disease have risen eight-fold around the world in the last two decades, WHO figures suggest. Scientists also suspect far more cases are going unreported, given the wide range of potential symptoms, from internal bleeding, organ failure and death on the severe end, all the way to mild ailments or even no symptoms at all.

 

Insect-borne infections on the rise thanks to climate change

 

Featured VideoDiseases carried by insects that infect humans, like Lyme disease and West Nile virus, are on the rise in Canada. The shorter, less severe winters due to climate change have allowed those insects to expand their range.

2nd infections can be worse than the 1st

One of the most alarming aspects of dengue’s rapid rise is that one exposure to the virus doesn’t protect you from infection with a different serotype — and can actually mean your second round is worse.

There are four distinct serotypes of dengue, explained Thais dos Santos, advisor for surveillance and control of arboviral diseases at the Pan American Health Organization (PAHO).

“In terms of immunity, they act as four distinct viruses,” she said, adding that one dengue infection is thought to provide life-long immunity to that specific serotype, but not the others. “Once you get that secondary infection it has been well-documented that you’re more likely to have severe symptoms.”

The mechanism at play is known as “antibody-dependent enhancement,” in which the antibodies against dengue produced by someone’s immune system fall to a low range. Research suggests that leads to a domino effect where the few antibodies still left are able to bind to the virus, pull it into cells, and give it space to replicate — but their level remains too low to actually kill those invaders.

“Your body starts fighting it, but not really properly,” explained Heendeniya, who said that haywire immune response leads to an increased risk of internal bleeding and hemorrhagic fever.

Why that reaction happens with dengue to a degree not seen in many other infections is still not fully understood, but researchers note what’s clear is that it complicates the use of vaccines. Two commercially available dengue vaccines are being used by various countries, but most global guidance recommends only vaccinating children in high-risk areas who have had a prior confirmed infection, given there’s also a risk for severe disease if someone catches dengue after immunization.

“I think we’re still trying to understand a lot of those mechanisms, and everyone’s immune system is going to be different… there’s so much we still don’t know,” said Barr.

A hand with tongs and mosquitos in a lab dish.
The Wolbachia bacteria prevents the bugs from being able to transmit viruses such as dengue (World Mosquito Program)

Half of world’s population now at risk

Questions about how dengue operates are now more pressing as climate change and widespread human migration are expected to fuel its continued spread, with potentially dire consequences. Already, roughly half of the world’s population is now at risk, with an estimated 100 to 400 million infections occurring every year, the WHO has said.

“For the longest time, dengue was considered an ’emerging’ infectious disease,” Heendeniya said. “I would say it has already emerged.”

Modelling studies also project wider expansion of the virus within specific countries. One paper in the Lancet Planetary Health, for instance, projected a higher risk of dengue through much of mainland China by the year 2100.

As for Canada, the dengue virus isn’t found in mosquitos here — at least not yet. But Barr warns that could change. Local transmission in countries such as France and Croatia was only reported for the first time in 2010, WHO data shows.

Canada’s historically colder climate hasn’t provided the conditions for these mosquitoes to thrive year-round, Barr said. However, an adult Aedes aegypti was found in a trap in Ontario for the first time in 2017, a discovery health officials believe signaled the species is now becoming established.

Rising temperatures, Barr warned, could make this country more hospitable, and if more of these mosquitoes hitch a ride here, locally-acquired dengue infections in the years ahead could become a real possibility.

“Dengue is always a plane ride away,” he said.

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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.

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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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