MONTREAL — 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.
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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.
This interview, which took place June 6, 2022, has been edited and condensed for length and clarity.
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This report by The Canadian Press was first published June 11, 2022.
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 government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
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HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
