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Bats and sneezing camels: A tale of two viruses – CBC.ca

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For a few hours on Thursday it appeared the new coronavirus (2019-nCoV) had spread to Saudi Arabia with reports that a nurse in Asir was infected.

But it was a case of mistaken virus identification, quickly corrected.

The unfortunate nurse was actually infected with a different but equally frightening coronavirus — MERS (Middle Eastern respiratory syndrome MERS-CoV) which made the leap from animals to humans in 2012, creating a brand new human disease.

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It was a vivid reminder that for almost a decade there has been a threat from another highly pathogenic never-before-seen virus. MERS was only the second coronavirus ever known to leap from animals to humans and cause a deadly illness. 

The first of these notorious bugs was SARS, (severe acute respiratory syndrome SARS-CoV) which swept the world in the spring of 2003 killing more than 800 people, including 44 Canadians.

2019-nCoV makes 3 

With scant information about the novel virus that has just emerged in China, experts are reviewing the experience of SARS and MERS for important clues about what to expect. 

“The interesting thing about this is that we’re really not sure which way it’s going,” said Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases. “We first thought, well, there really wasn’t much transmission from human to human.”

Now that it’s clear the virus can spread between people, Fauci said the next question is how easily it will spread.

“The real question right now is will it get better at going in what we call ‘sustained transmission’ from human to human. Because if it doesn’t then we have a very good chance of pretty quickly getting our arms around it and, by public health measures, essentially stopping it.” 

Michael Osterholm, an infectious disease specialist at the University of Minnesota, is a veteran of the SARS and MERS outbreaks, and he’s blunt about the current situation. 

“This is a bad disease. It makes people very sick and it can kill you. And so I think that is an important combination. But  the ultimate case fatality rate is still yet to be determined.”

In other words, experts still don’t know how dangerous the new virus is or how it compares to SARS — with a case fatality rate around 10 per cent — or MERS with an estimated fatality rate as high as 30 per cent. 

“I know how this picture is starting but I don’t know how it ends. And so I think that’s the question we’re all asking,” said Osterholm.

Part of the genetic sequence of the new coronavirus 2019-nCoV. (GenBank by Shanghai Public Health Clinical Center & School of Public Health, Fudan University)

The SARS and MERS viruses followed different paths.

SARS began in China in the fall of 2002 and spread around the world quickly. By spring of 2003 it had travelled to 37 countries including Canada, sickening more than 8,000 people.

Still, SARS lacked the ability to spread easily between humans.

“It never really developed the capability of having sustained vigorous transmission from person to person,” said Fauci. “There was clearly person-to-person transmission but it wasn’t like influenza. You had thousands of cases but not millions of cases.”

And after nine frightening months, SARS was extinguished, apparently forever. 

“SARS was actually a huge public health success in that we were able to control contain and eliminate that virus,” said Dr. Catharine Paules, who co-authored a new paper with Fauci about coronavirus infections  published this week in JAMA.

“But then in 2012 we had the emergence of a second animal coronavirus in the human population.”

Michael Osterholm, director of the Center for Infectious Diseases Research and Policy at the University of Minnesota, is a veteran of the SARS and the MERS outbreaks. (University of Minnesota)

MERS first appeared in Jordan in 2012 with cases showing up in 27 countries over eight  years. The U.S. Centres for Disease Control states that all of the MERS cases are linked to travel or residence in countries around the Arabian Peninsula. There was a major outbreak of MERS in a South Korean hospital in 2015 where 186 people were infected and 36 died.

Sneezing camels

So far, public health agencies have been able to limit the human-to-human spread of MERS but they have not been able to eradicate the virus. That’s because MERS has become the camel version of the common cold. 

“The camels will be sneezing or coughing and they sort of sneeze or cough this virus onto people; that’s how we think it’s transmitted,” said Paules.

In the case of SARS, animal-to-human transmission was eliminated when live-animal markets stopped selling small mammals including palm civets, which were found to be carrying the SARS virus.

“Once we realize that palm civets were the primary animal species transmitting is to humans, and the markets were eliminated, we literally shut off the faucet of new infections coming into humans,” said Osterholm.

So far the animal reservoir for the new virus is a mystery. Experts are extremely skeptical about early reports of an association with snakes.

“I know there was a recent publication that came out about snakes but that’s hotly being debated right now as we aren’t even sure that reptiles can get infected with coronaviruses,” said Paules.

“I think many of us thought that that was in error and not likely to be the source,” said Osterholm. “But at this point we have no data otherwise from the Chinese to know what might have been the animal reservoir.”

“If you want to put some money on it you’d get a bat involved,” said Fauci. “SARS went from the bat to the palm civet cat to the human and MERS went from the bat to the camel to human. I don’t have any idea what the animal is for this one but I would not be surprised if a bat was involved somewhere.”

Dr. Catharine Paules, an infectious disease specialist at Penn State University in Hershey, Pa., co-authored a new paper about coronaviruses. (Penn State Health Hershey)

There are also major questions about the transmissibility of the new virus. Scientists still don’t know how the virus spreads, although Fauci said environmental tests revealed traces of the virus at the market in Wuhan, China.

“They did environmental samples and it was able to be seen on some of these inanimate objects in the fish market,” he said. “Though no one has yet done the definitive experiment of seeing whether it stays alive on a doorknob or not, I wouldn’t be surprised if it did last for a limited period of time on inanimate objects.”

Fauci said it appears to take about six days for someone who has been infected to show symptoms, but it’s not clear whether the virus can be spread by someone who does not appear to be sick. 

“But there are anecdotes, for example the individual from Seattle who got infected does not remember coming into contact with anyone that was sick nor does he remember coming into contact with any animals nor did he feel that he had any exposures, yet he got infected.”

‘Super-spreaders’

A grim aspect of all three diseases is the phenomenon of the super-spreader — a person who, for some reason that’s still not well understood, is able to infect a large number of people.

“That’s one of the big mysteries,” said Osterholm.  “Super-spreaders have been individuals who have been severely ill and even people who’ve been moderately ill. Why they’re putting out so much virus is just not clear.”

In the case of MERS, Osterholm said one person in a South Korean emergency room was able to infect 82 people in 2015.

In the case of SARS, one super-spreader in Beijing was responsible for a chain of infections in 76 people. 

It’s been reported that one man in Wuhan infected 14 hospital workers, which could be the first evidence of a super-spreader in this outbreak.  But because it happened during surgery, the infection could be related to the surgical procedures.

“I think we have to still be a little bit careful, because this individual actually had had surgery and anytime you intubate somebody you know you may very well have induced a higher rate of spreading the virus,” said Osterholm.

Lessons from SARS and MERS

One of the encouraging aspects of the SARS story is that the virus was contained, said Osterholm, pointing to Canada, where most of the more than 400 infections and 44 deaths happened in and around Toronto.

“While Canada suffered miserably because of what was going on in Toronto, there weren’t even any cases in Calgary, and Winnipeg,” he said.

“So what we need to get people to understand is that we can’t say this isn’t going to come to every country in the world. It’s unlikely, but it could. But when it does, it’s going to likely be largely an institution-based outbreak like a hospital.”

“So that just helps give people a sense that we’re not all going to die from this,” he said.

Training to respond to a viral threat

At her hospital in Hershey, Pa., Paules is part of a team that trains regularly to respond to an emerging viral threat. 

She said some of the strategies developed during the SARS and MERS outbreaks are already bein used, including the closing of animal markets and airport screening. 

“Some of those things have been able to get up and running very quickly, probably because of the lessons learned from SARS,” said Paules. 

China was able to sequence the new virus and get that critical genetic code to the world quickly. Diagnostic tests have been developed, which means cases can be identified and isolated to contain the spread.

“I think some of the things from SARS and MERS that have really helped us here is how quickly the Chinese authorities were able to globally circulate the sequence of this virus,” said Paules, who echoes Osterholm’s point that most people don’t have to worry about this virus.

“I would be concerned if I was in some of these areas in China. I would not myself probably decide to travel to any of those areas right now. But here sitting in my office in Hershey, Pennsylvania I have a low concern that this virus is going to impact me personally, although I’m concerned for the global community.”

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Kevin Neil Friesen Obituary 2024 – Crossings Funeral Care

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It is with heavy hearts that we announce the peaceful passing of Kevin Neil Friesen age 53 on Thursday, March 28, 2024 at the Bethesda Regional Health Centre.

A funeral service will be held at 2:00 pm on Thursday, April 4, 2024 at the Bothwell Christian Fellowship Church, with viewing one hour prior to the service.

A longer notice to follow.  

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Spring allergies: Where is it worse in Canada? – CTV News

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The spring allergy season has started early in many parts of Canada, with high levels of pollen in some cities such as Toronto, Ottawa and Montreal.

Daniel Coates, director of Aerobiology Research Laboratories in Ottawa, expects the elevated amounts to continue next week for places, such as most of Ontario, if the temperature continues to rise. Aerobiology creates allergen forecasts based on data it collects from the air on various pollens and mould spores.

Pollens are fertilizing fine powder from certain plants such as trees, grass and weeds. They contain a protein that irritates allergy sufferers.

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Although pollen levels declined after a cold spell in some places, he said they are soaring again across parts of Canada.

“So the worst is definitely British Columbia right now, followed by Ontario and Quebec and then the Prairies and Atlantic Canada for the upcoming weeks,” said Coates in a video interview with CTVNews.ca. “We are seeing pollen pretty much everywhere, including the Maritimes.”

He said pollen has increased over the past 20 years largely due to longer periods of warm weather in Canada.

Meanwhile, the Maritimes is one of the best places to live in Canada if you have seasonal allergies, in part because of its rocky territory, Coates said.

With high levels of cedar and birch pollen, British Columbia is the worst place for allergy sufferers in Canada, he added.

“British Columbia is going strong,” Coates explained, noting the allergy season started “very early” in the province in late January. “It has been going strong since late January, early February and it’s progressing with high levels of pollen, mostly cedar, but birch as well, and birch is highly allergenic.”

Causes of high pollen levels

Coates expects a longer allergy season if the warm weather persists. He notes pollen is increasing in Canada and worldwide, adding that in some cases the allergy season is starting earlier and lasting longer than 15 years ago.

He says tree pollen produced last year is now being released into the air because of warmer weather.

“Mother nature acts like a business,” he said. “So you have cyclical periods where things go up and down. … So when it cooled down a little bit, we saw (pollen) reduce in its levels, but now it’s going to start spiking.”

Along with warmer weather, another factor in higher pollen levels is people planting more male trees in urban areas because they don’t produce flowers and fruits and are less messy as a result, he said. But male trees produce pollen while female ones mostly do not.

Moulds

Coates said moulds aren’t as much of a problem.

“They’ve been mainly at lower levels so far this season,” he explained. “Moulds aren’t as bad in many areas of Canada, but they’re really, really bad in British Columbia.”

In B.C., moulds are worse because of its wet climate and many forested areas, he said.

Coping with allergies

Dr. Blossom Bitting, a naturopathic doctor and herbal medicine expert who works for St. Francis Herb Farm, says a healthy immune system is important to deal with seasonal allergies.

“More from a holistic point of view, we want to keep our immune system strong,” she said in a video interview with CTVNews.ca from Shediac, N.B. “Some would argue allergies are an overactive immune system.”

Bitting said ways to balance and strengthen the immune system include managing stress levels and getting seven to nine hours of restful sleep. “There is some research that shows that higher amounts of emotional stress can also contribute to how much your allergies react to the pollen triggers,” Bitting said.

Eating well by eating more whole foods and less processed foods along with exercising are also important, she added. She recommends foods high in Omega-3 Fatty Acids such as flaxseeds, flaxseed oil, walnuts and fish. Fermented foods with probiotics such as yogurt, kimchi and miso, rather than pasteurized ones, can keep the gut healthy, she added. Plant medicines or herbs such as astragalus, reishi mushrooms, stinging nettle and schisandra can help bodies adapt to stressors, help balance immune systems or stabilize allergic reactions, she said.

To cope with allergies, she recommends doing the following to reduce exposure to pollen:

  • Wear sunglasses to get less pollen into the eyes;
  • Wash outdoor clothes frequently, use outer layers for outside and remove them when you go inside the house;
  • Use air purifiers such as with HEPA (high efficiency particulate air) filters;
  • Wash pets and children after they go outside;
  • Keep the window closed on days with high pollen counts.

Mariam Hanna, a pediatric allergist, clinical immunologist and associate professor with McMaster University in Hamilton, Ont., says immunotherapy can help patients retrain their bodies by working with an allergist so they become more tolerant to pollens and have fewer symptoms.

“Some patients will need medications like over-the-counter antihistamines or speaking with their doctor about the right types of medications to help with symptom control,” she said in a video interview with CTVNews.ca.

Coates recommends people check pollen forecasts and decrease their exposure to pollen since no cure exists for allergies. “The best is knowing what’s in the air so that you can adjust your schedules, or whatever you’re doing, around the pollen levels.”

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Do you need a spring COVID-19 vaccine? Research backs extra round for high-risk groups

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Recent studies suggest staying up-to-date on COVID shots helps protect high-risk groups from severe illness

New guidelines suggest certain high-risk groups could benefit from having another dose of a COVID-19 vaccine this spring — and more frequent shots in general — while the broader population could be entering once-a-year territory, much like an annual flu shot.

Medical experts told CBC News that falling behind on the latest shots can come with health risks, particularly for individuals who are older or immunocompromised.

Even when the risk of infection starts to increase, the vaccines still do a really good job at decreasing risk of severe disease, said McMaster University researcher and immunologist Matthew Miller.

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Who needs another COVID shot?

Back in January, Canada’s national vaccine advisory body set the stage for another round of spring vaccinations. In a statement (new window), the National Advisory Committee on Immunization (NACI) stated that starting in spring 2024, individuals at an increased risk of severe COVID may get an extra dose of the latest XBB.1.5-based vaccines, which better protect against circulating virus variants.

That means:

  • Adults aged 65 and up.
  • Adult residents of long-term care homes and other congregate living settings for seniors.
  • Anyone six months of age or older who is moderately to severely immunocompromised.

The various spring recommendations don’t focus on pregnancy, despite research (new window) showing clear links between a COVID infection while pregnant, and increased health risks. However, federal guidance does note that getting vaccinated during pregnancy can protect against serious outcomes.

Vaccinated people can also pass antibodies to their baby through the placenta and through breastmilk, that guidance states (new window).

What do the provinces now recommend?

Multiple provinces have started rolling out their own regional guidance based on those early recommendations — with a focus on allowing similar high-risk groups to get another round of vaccinations.

B.C. is set to announce guidance on spring COVID vaccines in early April, officials told CBC News, and those recommendations are expected to align with NACI’s guidance.

In Manitoba (new window), high-risk individuals are already eligible for another dose, provided it’s been at least three months since their latest COVID vaccine.

Meanwhile Ontario’s latest guidance (new window), released on March 21, stresses that high-risk individuals may get an extra dose during a vaccine campaign set to run between April and June. Eligibility will involve waiting six months after someone’s last dose or COVID infection.

Having a spring dose is particularly important for individuals at increased risk of severe illness from COVID-19 who did not receive a dose during the Fall 2023 program, the guidance notes.

And in Nova Scotia (new window), the spring campaign will run from March 25 to May 31, also allowing high-risk individuals to get another dose.

Specific eligibility criteria vary slightly from province-to-province, so Canadians should check with their primary care provider, pharmacist or local public health team for exact guidelines in each area.

WATCH: Age still best determines when to get next COVID vaccine dose, research suggests:

 

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Age still best determines when to get COVID vaccines, new research suggests

It’s been four years since COVID-19 was declared a pandemic, and new research suggests your age may determine how often you should get a booster shot.

Why do the guidelines focus so much on age?

The rationale behind the latest spring guidelines, Miller said, is that someone’s age remains one of the greatest risk factors associated with severe COVID outcomes, including hospitalization, intensive care admission and death.

So that risk starts to shoot up at about 50, but really takes off in individuals over the age of 75, he noted.

Canadian data (new window) suggests the overwhelming majority of COVID deaths have been among older adults, with nearly 60 per cent of deaths among those aged 80 or older, and roughly 20 per cent among those aged 70 to 79.

People with compromised immune systems or serious medical conditions are also more vulnerable, Miller added.

Will people always need regular COVID shots?

While the general population may not require shots as frequently as higher-risk groups, Miller said it’s unlikely there will be recommendations any time soon to have a COVID shot less than once a year, given ongoing uncertainty about COVID’s trajectory.

Going forward, I suspect for pragmatic reasons, [COVID vaccinations] will dovetail with seasonal flu vaccine campaigns, just because it makes the implementation much more straightforward, Miller said.

And although we haven’t seen really strong seasonal trends with SARS-CoV-2 now, I suspect we’ll get to a place where it’s more seasonal than it has been.

In the meantime, the guidance around COVID shots remains simple at its core: Whenever you’re eligible to get another dose — whether that’s once or twice a year — you might as well do it.

What does research say?

One analysis, published in early March in the medical journal Lancet Infectious Diseases (new window), studied more than 27,000 U.S. patients who tested positive for SARS-CoV-2, the virus behind COVID, between September and December 2023.

The team found individuals who had an updated vaccine reduced their risk of severe illness by close to a third — and the difference was more noticeable in older and immunocompromised individuals.

Another American research team from Stanford University recently shared the results from a modelling simulation looking at the ideal frequency for COVID vaccines.

The study in Nature Communications (new window) suggests that for individuals aged 75 and up, having an annual COVID shot could reduce severe infections from an estimated 1,400 cases per 100,000 people to around 1,200 cases — while bumping to twice a year could cut those cases even further, down to 1,000.

For younger, healthier populations, however, the benefit of regular shots against severe illness was more modest.

The outcome wasn’t a surprise to Stanford researcher Dr. Nathan Lo, an infectious diseases specialist, since old age has consistently been a risk factor for severe COVID.

It’s almost the same pattern that’s been present the entire pandemic, he said. And I think that’s quite striking.

More frequent vaccination won’t prevent all serious infections, he added, or perhaps even a majority of those infections, which highlights the need for ongoing mitigation efforts.

Lauren Pelley (new window) · CBC News

 

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