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Canadian heading World Health Organization's fight against monkeypox – KelownaNow

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A Canadian is playing a major role in the World Health Organizations’ fight against monkeypox.

Dr. Rosamund Lewis, the technical lead for the effort to combat a global outbreak of the virus at the WHO’s Health Emergencies Programme, grew up in Thunder Bay, Ont., and Ottawa.

A graduate of McGill University’s school of medicine, Lewis practiced in Montreal before joining the WHO. The organization is currently working to quell the spread of monkeypox, which comes from the same family of viruses as smallpox.

The Canadian Press reached Lewis in Geneva, Switzerland for an interview.

What do we know about the propagation of this disease?

We think it’s spread by rodents, but we don’t know what species it naturally lives in. In Africa, we find the virus in the Congo Rope Squirrel, the Gambian pouched rat, the dormouse and things like that. People hunt in the forest and bring back this while meat that they need to prepare. That’s the traditional type of exposure (to the virus). It’s also possible the family is eating undercooked meat. This meat could also be sold in a market, so even people who don’t have any direct exposure to the forest can be exposed.

But an other major factor is that smallpox was eradicated in 1980, so people who were born after 1980, or in certain countries after 1960 or 1970, didn’t have the opportunity to be vaccinated against smallpox.

Has monkeypox been seen in the west before?

There were two cases in the United Kingdom in 2021 and two in the United States, also in 2021. There was also an outbreak in the U.S. in 2003, but it had nothing in common with the current situation. It was very strange. It involved prairie dogs that were imported to be sold as pets, and children started to get sick after being scratched or bitten. It took around three months to understand the nature of the outbreak and to contain it.

How did the current outbreak begin?

We received reports from the United Kingdom, once again. It was a traveller who returned from Nigeria and discovered that she had monkeypox and I said to myself, “okay, it’s started.” The U.K. found an outbreak in a family, and it was completely unexpected because it involved three members of the same family. It was the first time that we saw monkeypox outside of Africa in someone who had not recently travelled, so that was new. (The British) then found it in their laboratories’ samples that tested positive and that came from men who had sexual relations with other men.

At the same time, Portugal reported an outbreak of people with undiagnosed lesions. They were negative for herpes, negative for syphilis, so the Portuguese were searching for information, and relatively quickly, Portugal and the U.K. realized that they were facing the same thing.

It was men having who had sex with men, who had participated in certain events and then returned home.

The first cases were all associated with travel from central Europe. That’s about where we are now, except that we’re seing a lot of cases and it’s spreading in this group of people who have frequent physical contact with more than one person, possibly in a very short period of time, so the conditions are right for rapid transmission and propagation.

So there is an opportunity to act that should not be missed?

Yes, and it’s crucial to take advantage (of this time) before the virus affects a more general population, family members, children, vulnerable people, for example, people who are HIV-positive. But we can’t be alarmist. The vast majority of cases are still being reported in this group, so it’s there that the transmission is happening, it’s not too late to stop the outbreak in this group, although it might be difficult. That said, there are still a lot of things that we don’t know about the virus, and we have to be honest and admit that. The virus itself might have gone through changes that make it more transmissible, but we have certainty seen behaviours that make it more transmissible. This disease presents as an infectious disease that spreads through close contact, including sexual contact. So the message to the public is this: educate yourself, learn to recognize the signs and symptoms, know in what circumstances you could be infected, protect yourself and protect others and, when in doubt, seek a diagnosis.

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Feeling vexed by long COVID? Treatment may soon be available – North Shore News

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Grace Parraga’s phone has been ringing off the hook since Tuesday with calls from long COVID patients from across Canada, the U.S. and the U.K. 

Parraga is the lead researcher of a new study that’s identified a minuscule abnormality in the lungs of long COVID patients that can contribute to the prolonged breathing difficulty they may experience post-infection.

Following the announcement of their findings, Parraga said people have been reaching out to her, excitedly seeking further clarification on their long COVID symptoms. Parraga, a professor at Western University’s Schulich School of Medicine and Dentistry and Tier 1 Canada Research Chair in Lung Imaging, said the response has been very humbling.

“We do this as scientists with the hope of helping people,” she said.

Human lungs, the organ under examination in this research, pack 2,400 kilometres of airways within them, Parraga explained. Stretched out across Canada, those airways would be long enough to start in Vancouver and reach all the way to Thunder Bay.

“That’s what’s packed inside of you to allow you to live,” Parraga said.

At the end of those airways are 500 million air sacs. When you inhale, oxygen moves into those tiny air sacs and hops onto your red blood cells. As you exhale, carbon dioxide hops off of those cells and is sent out of your body.

Using a very high spatial resolution MRI method, the research team was able to measure the function at the tip of those 500 million air sacs.

What they found, is an abnormally low red blood cell signal in the lungs of these long COVID patients that’s affecting their ability to breathe.

Parraga said it’s likely the lungs’ blood vessel tree is blocked by tiny, microscopic clots.

“That’s something that you can’t see with chest X-rays or CT scans, or any other method,” she said.

The study was conducted at five centres across Ontario that house this specific MRI technology and observed 34 long COVID patients.

Parraga said her team is now focusing on translating their work to other centres across Canada that also have this technology, such as BC Children’s Hospital and St. Paul’s Hospital in Vancouver.

Long-awaited evidence

Until now, Parraga said long COVID has been a vexing infection to have. Standard clinical tests are unable to pick up on this tiny piece of evidence that indicates something is wrong.

“Folks [with long COVID] look normal. The chest X-ray looks normal, the CT scan looks normal,” she said. 

“This is the first evidence that something is not normal.”

The study’s findings serve as a relief, Parraga said. As researchers, she said it’s encouraging to find something that they understand and is consistent with their previous understanding of lung infections.

“If you’re not feeling well, you can’t walk to the mailbox and think straight, you do start to wonder if it’s in your head,” she said. “I think that physicians were concerned and that really started us on this hunt.”

Parraga said she thinks the study is providing people with hope, knowing that this abnormality is something physicians can understand and treat.

Next steps: treatment

The discovery is only the first step in the journey to treating long COVID patients experiencing difficulty breathing. Following the release of the study, Parraga said her focus is now shifting to determine the why and how factors of the infection.

“We’ve identified the what, the where, and the when. [Now], the clinical folks are going to be using that information to target treatments,” she said.

Parraga said she plans to continue following the study’s participants “for as long as they want to come to the lab.” With their participation, she hopes to answer questions such as why certain people are susceptible to long COVID and what’s going to happen to these patients in the long term. 

In the meantime, Parraga and her team are taking a moment to reflect upon their success in a unique way, after sharing their results with the study’s participants.

“We created a word cloud from their emails back to us… [with] words like understanding, thank you, congratulations, thoughtful,” she said. “It was very humbling and fulfilling to see that.”

“That’s why we do this. To help people.”

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COVID-19 boosters recommended for the fall, Canada's vaccine advisory body says – CBC News

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People at high risk of severe disease from COVID-19 infection should be offered a booster shot this fall, regardless of how many boosters they’ve previously received, the National Advisory Committee on Immunization (NACI) said on Wednesday. 

That group includes everyone age 65 and older, NACI’s updated guidance said

Everyone else — age 12 to 64 — “may be offered” the additional doses in the fall, NACI said. 

NACI said it will provide recommendations on the type of booster to be given when evidence about multivalent vaccines — which prime the body’s defences against multiple variants, including Omicron and its subvariants — becomes available.

“Manufacturers are working on new COVID-19 vaccines, including multivalent vaccines and vaccines specifically targeting VOCs [variants of concern], although their exact characteristics and timing of availability in Canada are not yet known,” NACI said. 

World Health Organization Director General Tedros Adhanom Ghebreyesus said in a statement on Wednesday that Omicron subvariants BA.4 and BA.5 have caused COVID-19 case numbers to rise in 110 countries, “causing overall global cases to increase by 20 per cent.”

Dr. Theresa Tam, Canada’s chief public health officer, has also said those Omicron subvariants appear to be on the rise in this country. 

On Tuesday, advisers to the U.S. Food and Drug Administration recommended that the next wave in COVID-19 booster shots should include a component that targets Omicron to combat the more recently circulating subvariants.

NACI recommended that booster shots happen in the fall because, as with other respiratory viruses, “incidence of COVID-19 may increase in the later fall and winter seasons,” and new variants of concern could emerge. 

In addition to those 65 years and older,  NACI strongly recommends a fall booster for:

  • Long-term care residents.
  • People with underlying medical conditions, including cardiac disease, diabetes, cancer and kidney disease.
  • People who are immunocompromised. 
  • People who are pregnant.
  • Adults who are disproportionately affected by COVID-19 (including racialized communities).
  • Adults who are marginalized (including people with disabilities).
  • Adults from First Nations, Inuit and Métis communities. 
  • Residents of congregate living settings, including group homes, shelters, correctional facilities and quarters for migrant workers.

Health officials emphasize that three doses of the current approved vaccines continue to provide good protection against severe COVID-19 illness, hospitalization and death. 

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Quebec COVID-19 hospitalizations rising as new variants gaining ground

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MONTREAL — Quebec is seeing an increase in COVID-19 cases and hospitalizations driven by new Omicron subvariants that account for about 75 per cent of infections, the province’s public health director said Wednesday.

Dr. Luc Boileau said the subvariants, such as BA2.12.1, BA.5 and BA.4, appear to be more transmissible than previous strains but not necessarily more severe. The rise in cases was “expected,” though it came earlier than authorities had thought, he said, adding that the number of new infections should continue to rise in the coming days or weeks before declining.

Boileau said the province doesn’t plan on reimposing any broad-level public health restrictions, but he recommended that people who are over 65 or medically vulnerable take precautions such as wearing a mask. He was firm in his advice against a new provincewide masking order, insisting that such a measure was not “realistic” or necessary at this point.

“We’re not at all on a path to reimpose population-level measures such as mask-wearing, or other measures that needed to be taken in the last two years,” he said.

“We’re not there, and we’re not heading in that direction with the current variants.”

He said people who are over the age of 60, who are immunocompromised or who have chronic illnesses should seek a second booster shot if they haven’t had one or if their last shot was more than three months ago. As well, he said those who want to wear masks should be “encouraged” to do so, especially in crowded places.

His update came as COVID-19 hospitalizations rose by 34 in the previous 24 hours, after a 113-patient rise the day before. There were 1,260 people in hospital with COVID-19 in Quebec, including 35 in intensive care. Health officials also reported four more deaths associated with the novel coronavirus.

Dr. Don Vinh of the McGill University Health Centre says Quebec is facing a “perfect storm” of factors that include the emergence of new variants, waning immunity from vaccination or previous infection, and the removal of public health restrictions.

The new Omicron subvariants BA.4 and BA.5, he said in an interview Tuesday, appear to be gaining ground and finding vulnerable people to infect, especially since the mutations seem to be better able to evade immunity compared with previous strains.

“You put the two together, the new variants and waning immunity from either infection, immunization or a hybrid, and what happens is you have a renewed pool of susceptible people with an emerging variant,” he said.

The rise in hospitalizations, he added, comes at a time when the health system is least prepared to handle it.

Hospital workers at “all levels” are overwhelmed, he said, from paramedics and ambulance drivers to ER staff and the community and home care workers who need to be present to care for frail people leaving hospital.

COVID-19 is also putting increased pressure on the system by forcing sick health-care workers to stay home at a time when they’re most needed, he said. “This a catastrophic, systemic failure being unmasked and perhaps even exacerbated by unmitigated community transmission.”

On Wednesday, Boileau said he was concerned with the impact the increase in cases will have on the system, adding that authorities were working with hospitals to readjust services when necessary. He said, however, that he didn’t expect the new rise in cases to get “very, very high” and that the numbers should begin to decline in the next few weeks.

This report by The Canadian Press was first published June 29, 2022.

 

Morgan Lowrie, The Canadian Press

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