Bird flu outbreak at Colorado farm as 5 workers reported positive: Experts warn of ‘turning point,’ call for urgent action | Canada News Media
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Bird flu outbreak at Colorado farm as 5 workers reported positive: Experts warn of ‘turning point,’ call for urgent action

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For months, fearing that the current version of bird flu had a much higher chance of spreading to humans than previous iterations, experts have pushed for a more aggressive response from U.S. health agencies to reduce human exposure and prevent a potential pandemic. The urgency of those requests is about to rise.

Late on Sunday, the Colorado Department of Public Health and Environment reported that five people have tested positive for bird flu among workers at an egg farm in Weld County, Colorado. Four of those cases have been confirmed by the federal Centers for Disease Control and Prevention(CDC), and one test is pending confirmation.

The cases emanated from a major flu outbreak at the farm, which affected nearly 1.8 million chickens. The workers were in the process of destroying those chickens, a process known as culling.

Colorado’s governor has declared a disaster emergency in response to the outbreak, and the announcement by state health officials of the positive cases represents a grim landmark. It denotes the first time a cluster of human infection has been reported on a single farm in the U.S., and it again raises the stakes on the seriousness of this virus.

A turning point

State health officials said the workers exhibited mild symptoms, including conjunctivitis (pink eye) and respiratory issues, and no one was hospitalized. But the incident marks the kind of turning point that experts have worried over for some time.

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“I am extremely concerned that we are on the brink of this being really already in humans—and once it’s in humans, it is going to be a real problem to control,” says Seema Lakdawala, a microbiologist and immunologist at Emory University who specializes in influenza. “I will tell you that what has been driving me the past few months is trying to prevent H5 from becoming a pandemic…I have never felt that we were as close as we are now.”

In its own way, the CDC echoes that concern, referencing in general terms the “pandemic potential” of H5N1 and other novel flu viruses once humans are in the mix. But the agency added that it hasn’t yet seen genetic changes in the virus that would make human transmission more likely, and it continues to judge the risk to the general public as low.

Farmworkers on the front lines

This basic concern—a virus that already has shown the ability to adapt to multiple animal species, now jumping to humans—is what prompted experts and researchers to begin clamoring for more testing of both animals and workers on farms, including blood tests, as well as for vaccinations and antivirals at the ready. They also want farmworkers to be educated about the importance of wearing personal protective equipment–and for the CDC, USDA, and other health agencies, especially those at the state level, to step up the urgency.

Farmworkers are considered to be on the front lines of risk because of their proximity to both chickens and dairy cattle, two species in which H5N1 has already been found in alarming numbers in the U.S.—and that is with limited testing of both animals and those who work near them. The key, experts say, is to broaden testing practices now, not later. Waiting for more clusters of infection to appear, they say, is an open invitation to mass spread.

“I’d like to see them swabbing from not just the symptomatic people that they’ve talked about, but also asymptomatic people on the same farm in the family circle unit and in the community,” says immunologist Rick Bright, a former federal health official. “And I’d like to see them taking blood samples for serology testing.”

Serologic testing could help to identify people who have been infected and had either mild or asymptomatic H5N1 disease that investigators may be missing. If the testing came back positive for a family member of an infected worker, for example, it could be indicative of human-to-human transmission. “And, that’s really important to see,” says Bright.

The CDC’s release on the events included the news that the agency was sending a team to assist Colorado’s investigation “at the state’s request.” The wording was noteworthy. Despite the national implications of a virus spreading from animal to human, and potentially from human to human (there is no evidence of that yet), the CDC still has to be invited to participate in any single state’s investigation of the problem.

Individual farms cannot be forced by the federal agency to test either animals or workers. Such authority resides with state and sometimes county or local agencies, and researchers say past experience suggests that many farms will be reluctant to a testing process that could lead to their shutdown or loss of their workforce.

But there are other issues that cry out for quick resolution. One of them, experts say, is a horrible lag time in reporting the results of testing by the U.S. Department of Agriculture, or USDA.

“We have not seen increased transparency from the USDA,” says Bright. “Last week they dumped about 80 viruses into the database, and when you look at those 80 viruses, they were a bunch of viruses collected from birds. The samples were collected throughout 2023 and into early 2024. It’s ridiculous…By not being transparent and timely with their data, the USDA is really forcing a lot of guesswork.”

Bright wants to see the most recent few weeks of virus sequences from cows, cats, mice, and humans, in order to understand if the virus is changing in ways that may make it easier to spread or cause more severe disease in people. “And we need them to be uncloaked to be able to determine where and when the blood samples were collected,” the immunologist says.

Even given the problems of coordinating federal, state, and local agencies, the lack of testing on humans in the U.S. is glaring. According to the CDC, barely more than 60 people have been tested for the novel bird flu virus since farm outbreaks began this spring. This testing often involves eye, nose or throat swabs to look for active infection, but does not include blood draws which would be needed for serosurveillance.

“There are barriers for our public health agencies to achieve this, but it would certainly be valuable to have more widespread testing,” says Emory virologist and influenza expert Anice Lowen. Lowen counts farm, dairy, and poultry workers with potential exposure among those in need of testing.

“We really do not have a good idea how much spillover is happening,” the virologist says. “The handful of cases that have been documented are potentially the tip of the iceberg, but we just don’t know because there’s not enough testing going on.”

Bright is among those calling for the CDC to make vaccines available now to farmworkers and others at high risk of contracting bird flu, arguing that it is unethical to do anything less. Though it’s clear that the U.S. lacks the stockpile to effectively vaccinate the full population in the case of a mass outbreak, there is more than enough to begin with those on the front lines.

“There’s no such thing as just a little conjunctivitis. or just a little respiratory (issue) when you’re dealing with a deadly virus,” Bright says. The virus, he adds, has already demonstrated the ability to mutate “very easily, very quickly, and it can cause severe illness and death. So let’s stop it in its tracks, not wait and see and let it get worse.”

Whether the CDC will follow the experts’ suggestions remains an open question. The agency’s response so far has been muted, with no change in official recommendation.

For those who’ve been closely tracking this bird flu, though, the signs are ominous, and they warrant a proactive response-including vaccination of frontline farmworkers. “That’s why we have these stockpiles,” Seema Lackdawala says. “It’s surprising to me that they haven’t been leveraged…We always expected this at some point in time.”

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Health Canada approves updated Moderna COVID-19 vaccine

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TORONTO – Health Canada has authorized Moderna’s updated COVID-19 vaccine that protects against currently circulating variants of the virus.

The mRNA vaccine, called Spikevax, has been reformulated to target the KP.2 subvariant of Omicron.

It will replace the previous version of the vaccine that was released a year ago, which targeted the XBB.1.5 subvariant of Omicron.

Health Canada recently asked provinces and territories to get rid of their older COVID-19 vaccines to ensure the most current vaccine will be used during this fall’s respiratory virus season.

Health Canada is also reviewing two other updated COVID-19 vaccines but has not yet authorized them.

They are Pfizer’s Comirnaty, which is also an mRNA vaccine, as well as Novavax’s protein-based vaccine.

This report by The Canadian Press was first published Sept. 17, 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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These people say they got listeria after drinking recalled plant-based milks

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TORONTO – Sanniah Jabeen holds a sonogram of the unborn baby she lost after contracting listeria last December. Beneath, it says “love at first sight.”

Jabeen says she believes she and her baby were poisoned by a listeria outbreak linked to some plant-based milks and wants answers. An investigation continues into the recall declared July 8 of several Silk and Great Value plant-based beverages.

“I don’t even have the words. I’m still processing that,” Jabeen says of her loss. She was 18 weeks pregnant when she went into preterm labour.

The first infection linked to the recall was traced back to August 2023. One year later on Aug. 12, 2024, the Public Health Agency of Canada said three people had died and 20 were infected.

The number of cases is likely much higher, says Lawrence Goodridge, Canada Research Chair in foodborne pathogen dynamics at the University of Guelph: “For every person known, generally speaking, there’s typically 20 to 25 or maybe 30 people that are unknown.”

The case count has remained unchanged over the last month, but the Public Health Agency of Canada says it won’t declare the outbreak over until early October because of listeria’s 70-day incubation period and the reporting delays that accompany it.

Danone Canada’s head of communications said in an email Wednesday that the company is still investigating the “root cause” of the outbreak, which has been linked to a production line at a Pickering, Ont., packaging facility.

Pregnant people, adults over 60, and those with weakened immune systems are most at risk of becoming sick with severe listeriosis. If the infection spreads to an unborn baby, Health Canada says it can cause miscarriage, stillbirth, premature birth or life-threatening illness in a newborn.

The Canadian Press spoke to 10 people, from the parents of a toddler to an 89-year-old senior, who say they became sick with listeria after drinking from cartons of plant-based milk stamped with the recalled product code. Here’s a look at some of their experiences.

Sanniah Jabeen, 32, Toronto

Jabeen says she regularly drank Silk oat and almond milk in smoothies while pregnant, and began vomiting seven times a day and shivering at night in December 2023. She had “the worst headache of (her) life” when she went to the emergency room on Dec. 15.

“I just wasn’t functioning like a normal human being,” Jabeen says.

Told she was dehydrated, Jabeen was given fluids and a blood test and sent home. Four days later, she returned to hospital.

“They told me that since you’re 18 weeks, there’s nothing you can do to save your baby,” says Jabeen, who moved to Toronto from Pakistan five years ago.

Jabeen later learned she had listeriosis and an autopsy revealed her baby was infected, too.

“It broke my heart to read that report because I was just imagining my baby drinking poisoned amniotic fluid inside of me. The womb is a place where your baby is supposed to be the safest,” Jabeen said.

Jabeen’s case is likely not included in PHAC’s count. Jabeen says she was called by Health Canada and asked what dairy and fresh produce she ate – foods more commonly associated with listeria – but not asked about plant-based beverages.

She’s pregnant again, and is due in several months. At first, she was scared to eat, not knowing what caused the infection during her last pregnancy.

“Ever since I learned about the almond, oat milk situation, I’ve been feeling a bit better knowing that it wasn’t something that I did. It was something else that caused it. It wasn’t my fault,” Jabeen said.

She’s since joined a proposed class action lawsuit launched by LPC Avocates against the manufacturers and sellers of Silk and Great Value plant-based beverages. The lawsuit has not yet been certified by a judge.

Natalie Grant and her seven year-old daughter, Bowmanville, Ont.

Natalie Grant says she was in a hospital waiting room when she saw a television news report about the recall. She wondered if the dark chocolate almond milk her daughter drank daily was contaminated.

She had brought the girl to hospital because she was vomiting every half hour, constantly on the toilet with diarrhea, and had severe pain in her abdomen.

“I’m definitely thinking that this is a pretty solid chance that she’s got listeria at this point because I knew she had all the symptoms,” Grant says of seeing the news report.

Once her daughter could hold fluids, they went home and Grant cross-checked the recalled product code – 7825 – with the one on her carton. They matched.

“I called the emerg and I said I’m pretty confident she’s been exposed,” Grant said. She was told to return to the hospital if her daughter’s symptoms worsened. An hour and a half later, her fever spiked, the vomiting returned, her face flushed and her energy plummeted.

Grant says they were sent to a hospital in Ajax, Ont. and stayed two weeks while her daughter received antibiotics four times a day until she was discharged July 23.

“Knowing that my little one was just so affected and how it affected us as a family alone, there’s a bitterness left behind,” Grant said. She’s also joined the proposed class action.

Thelma Feldman, 89, Toronto

Thelma Feldman says she regularly taught yoga to friends in her condo building before getting sickened by listeria on July 2. Now, she has a walker and her body aches. She has headaches and digestive problems.

“I’m kind of depressed,” she says.

“It’s caused me a lot of physical and emotional pain.”

Much of the early days of her illness are a blur. She knows she boarded an ambulance with profuse diarrhea on July 2 and spent five days at North York General Hospital. Afterwards, she remembers Health Canada officials entering her apartment and removing Silk almond milk from her fridge, and volunteers from a community organization giving her sponge baths.

“At my age, 89, I’m not a kid anymore and healing takes longer,” Feldman says.

“I don’t even feel like being with people. I just sit at home.”

Jasmine Jiles and three-year-old Max, Kahnawake Mohawk Territory, Que.

Jasmine Jiles says her three-year-old son Max came down with flu-like symptoms and cradled his ears in what she interpreted as a sign of pain, like the one pounding in her own head, around early July.

When Jiles heard about the recall soon after, she called Danone Canada, the plant-based milk manufacturer, to find out if their Silk coconut milk was in the contaminated batch. It was, she says.

“My son is very small, he’s very young, so I asked what we do in terms of overall monitoring and she said someone from the company would get in touch within 24 to 48 hours,” Jiles says from a First Nations reserve near Montreal.

“I never got a call back. I never got an email”

At home, her son’s fever broke after three days, but gas pains stuck with him, she says. It took a couple weeks for him to get back to normal.

“In hindsight, I should have taken him (to the hospital) but we just tried to see if we could nurse him at home because wait times are pretty extreme,” Jiles says, “and I don’t have child care at the moment.”

Joseph Desmond, 50, Sydney, N.S.

Joseph Desmond says he suffered a seizure and fell off his sofa on July 9. He went to the emergency room, where they ran an electroencephalogram (EEG) test, and then returned home. Within hours, he had a second seizure and went back to hospital.

His third seizure happened the next morning while walking to the nurse’s station.

In severe cases of listeriosis, bacteria can spread to the central nervous system and cause seizures, according to Health Canada.

“The last two months have really been a nightmare,” says Desmond, who has joined the proposed lawsuit.

When he returned home from the hospital, his daughter took a carton of Silk dark chocolate almond milk out of the fridge and asked if he had heard about the recall. By that point, Desmond says he was on his second two-litre carton after finishing the first in June.

“It was pretty scary. Terrifying. I honestly thought I was going to die.”

Cheryl McCombe, 63, Haliburton, Ont.

The morning after suffering a second episode of vomiting, feverish sweats and diarrhea in the middle of the night in early July, Cheryl McCombe scrolled through the news on her phone and came across the recall.

A few years earlier, McCombe says she started drinking plant-based milks because it seemed like a healthier choice to splash in her morning coffee. On June 30, she bought two cartons of Silk cashew almond milk.

“It was on the (recall) list. I thought, ‘Oh my God, I got listeria,’” McCombe says. She called her doctor’s office and visited an urgent care clinic hoping to get tested and confirm her suspicion, but she says, “I was basically shut down at the door.”

Public Health Ontario does not recommend listeria testing for infected individuals with mild symptoms unless they are at risk of developing severe illness, such as people who are immunocompromised, elderly, pregnant or newborn.

“No wonder they couldn’t connect the dots,” she adds, referencing that it took close to a year for public health officials to find the source of the outbreak.

“I am a woman in my 60s and sometimes these signs are of, you know, when you’re vomiting and things like that, it can be a sign in women of a bigger issue,” McCombe says. She was seeking confirmation that wasn’t the case.

Disappointed, with her stomach still feeling off, she says she decided to boost her gut health with probiotics. After a couple weeks she started to feel like herself.

But since then, McCombe says, “I’m back on Kawartha Dairy cream in my coffee.”

This report by The Canadian Press was first published Sept. 16, 2024.

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

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B.C. mayors seek ‘immediate action’ from federal government on mental health crisis

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VANCOUVER – Mayors and other leaders from several British Columbia communities say the provincial and federal governments need to take “immediate action” to tackle mental health and public safety issues that have reached crisis levels.

Vancouver Mayor Ken Sim says it’s become “abundantly clear” that mental health and addiction issues and public safety have caused crises that are “gripping” Vancouver, and he and other politicians, First Nations leaders and law enforcement officials are pleading for federal and provincial help.

In a letter to Prime Minister Justin Trudeau and Premier David Eby, mayors say there are “three critical fronts” that require action including “mandatory care” for people with severe mental health and addiction issues.

The letter says senior governments also need to bring in “meaningful bail reform” for repeat offenders, and the federal government must improve policing at Metro Vancouver ports to stop illicit drugs from coming in and stolen vehicles from being exported.

Sim says the “current system” has failed British Columbians, and the number of people dealing with severe mental health and addiction issues due to lack of proper care has “reached a critical point.”

Vancouver Police Chief Adam Palmer says repeat violent offenders are too often released on bail due to a “revolving door of justice,” and a new approach is needed to deal with mentally ill people who “pose a serious and immediate danger to themselves and others.”

This report by The Canadian Press was first published Sept. 16, 2024

The Canadian Press. All rights reserved.

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