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Four ways to ward off the flu this season

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The following article was provided by Brittany McMullan, a registered dietitian at Zehrs Orillia.
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As the leaves begin to fall and the days get colder, flu season is just around the corner. It’s time to start thinking about immunity, and how to best prepare our bodies to keep us healthy.

There is so much information out there right now, it can be challenging to sort through and figure out where to start. Luckily, there are a variety of ways we can protect ourselves from the flu without relying on supplements and fancy health products. Here are some of my tips on how we can stay healthy this fall.

Eat a variety of whole foods

It’s important to get the daily vitamins and minerals your body needs. A high-fibre, plant-rich diet with plenty of immune-supporting nutrients can help build and maintain a strong immune system. Immune-supporting nutrients can be found in fruits and vegetables, such as broccoli, carrots, spinach, mangoes, and sweet potatoes. If you’re unsure whether you’re getting enough, I’m available to help and can recommend foods or supplements (if needed) to incorporate into your diet.

Reach for vitamin C- and vitamin D-rich foods

Often we reach for vitamin C or vitamin D supplements at the onset of cold and flu symptoms, but we should be trying to get these nutrients in before we start to feel sick. Vitamin D helps mediate our immune systems while vitamin C is a critical micronutrient that helps encourage the production of white blood cells. These cells help protect the body against infections (like flu). Vitamin C can be found in oranges, kiwis, and peppers, while vitamin D can be found in foods like salmon, fortified dairy, and mushrooms.

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Drink water

Hydration is important to keep your body and immunity at its best. Water helps prevent infections, delivers nutrients to cells, and regulates body temperature. It is also vital for the functioning of all our organs and plays a key role in keeping our immune systems functioning at high quality. Did you know your body is made up of 60 per cent water? Every cell in our body needs water to function properly. If we are dehydrated, our immune systems could start to break down. To help identify if you are adequately hydrated, pay attention to the colour of your urine. Aim for pale yellow (the colour of lemonade) or clear — this indicates good hydration status. Remember, by the time we are thirsty, we are likely already dehydrated.

Get your flu shot

Eating healthy and staying hydrated are a few tools that protect us, but the best way to protect you and your family from the flu is by getting your annual flu shot. Be sure to get your flu shot at your local Zehrs Pharmacy when they become available, to reduce your chance of getting the flu.

If you’re looking for health advice this flu season, I’m here to help. As your local Orillia registered dietitian at Zehrs, I provide a range of services such as virtual one-on-one consultations, store tours and recipe ideas. To discuss, book an appointment with me at zehrs.ca/dietitians.

Thai mango salad

Ingredients

  • 1 small clove garlic, minced
  • Half red finger chili, sliced in thin rounds (with seeds)
  • 1 tsp granulated sugar
  • 3 tbsp fresh lime juice
  • 4 tsp fish sauce
  • 1 tbsp PC 100% Pure First-Pressed Canola Oil
  • 2 PC Flavour Burst Kent Mangoes
  • 2 carrots, cut in thin matchsticks
  • 2 green onions, thinly sliced
  • Half sweet red pepper, cut in thin matchsticks
  • 1/3 cup lightly packed cilantro leave
  • 1/3 cup PC Fresh Mint lightly packed leaves
  • 1/3 cup PC Dry Roasted Lightly Seasoned Peanuts

Instructions 

  1. Stir together garlic, chili, sugar, lime juice, fish sauce and oil in large bowl until sugar is dissolved. Set aside.
  2. Peel mangoes with vegetable peeler. Cut flesh away from pits. Cut one mango into thin matchsticks and thinly slice the other.
  3. Add mangoes, carrots, onions, pepper, cilantro and mint to lime dressing in bowl; toss to combine. Transfer to platter; sprinkle with peanuts.

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Ontario child vaccinations years behind following pandemic – CP24

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Ontario is still playing catch-up on routine vaccinations that many children missed during the pandemic and public health officials are warning that it could take years to solve the problem.

“What we see around the world is when the vaccination rates drop, you have a resurgence of vaccine preventable disease,” Dr. Anna Banerji, a Toronto-based pediatric infectious disease specialist, told CTV News Toronto.

“If someone had measles and they were with a group of unvaccinated kids, then for every person that has measles, they typically would infect about nine or 10 other kids. And so it’s extremely, extremely infectious.”

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About 60 per cent of seven-year-olds are fully vaccinated against the measles—as well as other illnesses such as mumps and varicella—according to a report published by Public Health Ontario in the end of March.

This is a significant drop from coverage in 2019-2020, when those numbers were between 82 per cent and 86 per cent.

Ontario has seen a mild resurgence of the measles this year, with 13 cases identified in 2024 so far.

Of the seven children infected, five children were unvaccinated while the immunization status of two others were unknown.

Three of the adults had two doses of the vaccine while one was unvaccinated and the status of two others are unknown. All but one case has been tied to travel.

In 2023 there were seven lab-confirmed cases of measles reported in Ontario.

 

For the 2022-2023 school year, just under 60 per cent of seven-year-olds were vaccinated against diphtheria, tetanus, polio and pertussis. Immunization coverage rates were similar for 17-year-olds with the exception of the polio vaccine, which has a strong 90 per cent coverage rate.

Hepatitis B coverage among 12-year-old students stands at about 58.4 per cent for that school year, while HPV immunization coverage is at 47.8 per cent.

A spokesperson for Public Health Ontario said factors such as lack of in-person health care and delayed non-essential appointments during the COVID-19 pandemic negatively affected childhood vaccinations.

School immunization programs were also put on hold due to closures. The report noted that while in-person classes resumed for most students in 2021-2022, most public health units didn’t resume immunization programs until the following year.

“This was very disruptive to the delivery of immunizations during routine well-child visits and for adolescents needing their tetanus-diphtheria-pertussis booster at 14-16 years of age,” officials said in a statement.

“This has probably led to under-reporting of immunizations to public health, but the degree to which this under-reporting has impacted our coverage estimates is unclear.”

Some communities may also have a general difficulty accessing health care, Banerji said, adding that factors such as miscommunication with new immigrants or misinformation can also play a part.

“The reason why we’re living so long and the reason why kids aren’t dying at a young age is three things really: It’s access to clean water, sanitation and vaccination,” she added.

“I think that people forget that.”

Could take 7 years for Peel to catch up

At a meeting last week, Peel’s Medical Officer of Health Dr. Katherine Bingham said that about 50 per cent of students in the region were missing at least one mandated vaccine dose.

A report presented to Reel Region’s council noted that “multi-year strategies” are needed to address the backlog and disruptions to routine childhood immunizations.

“Without significant dedicated resources, we estimate it will take seven years to complete screen and catch-up and achieve pre-pandemic coverage rates,” Bingham said in the meeting.

In Toronto, it is unclear when immunization coverage rates will return to pre-pandemic levels.

“This is a really important question,” Dr. Vinita Dubey, Associate Medical Officer of Health, told CTV News Toronto.

According to city data, there is 57.1 per cent immunization coverage for Toronto students between grades 10 and 12 for Hepatitis B.

Coverage for the HPV vaccine is 50 per cent and the meningococcal quadrivalent vaccine is 77.5 per cent.

“Why are we 10 per cent lower when we are doing the same program that we did pre-pandemic and that’s, I think, something that we really need to pay close attention to. Is it vaccine fatigue, is it vaccine hesitancy, or is it just complacency?”

Dubey says the vaccination rates in Toronto speak to the importance of school immunization programs, especially for vaccines that require multiple doses over time.

“These vaccines can prevent cancers and it’s the kind of thing that you ideally get before you’re ever exposed to these infections. And then it will give you that protection into your life.”

‘We need to be resourced’

The COVID-19 pandemic showed that if resources are funnelled into immunization programs, they can be successful, Dubey said.

“We need to pay attention to that. We may actually need to put in more efforts to get back to where we were. It’s not just restarting what we had,” she added. “We need to be resourced accordingly.”

In November, Toronto’s Board of Health asked for $3.8 million from the Ministry of Health to support catch-up immunizations through vaccinations clinics as well as the promotion of routine vaccination.

A spokesperson for the Minister of Health said in a statement they have increased investments to public health units by an average of 16 per cent since 2018.

They also said they restored a 75-25 funding model to public health units in 2023. However the same government also slashed funding 2019 to a formula that had the province funding 70 per cent of funding and 30 per cent being contributed by municipalities.

“We are also working with PHU’s to clarify their roles and responsibilities. All changes are in direct response to the asks of Public Health Units and Municipalities across the province,” the statement says.

“Our government knows it is never too late to get caught up, and back on track with immunization schedules. That is why we are working with our partners, including public health units to catch children up on their routine vaccines. This includes memos from the Chief Medical Officer of Health communicating this focus to PHUs over the last few years. We have seen efforts remain strong across providers, including increases in school-based programs in the last two school years and we will continue to build on this progress.”

There is also a concern that some children may have received their vaccinations but that parents may not have reported it.

The data is reliant on parents and guardians submitting their children’s immunization record to public health units. Both Peel Region and Toronto officials have said it would be beneficial if physicians and clinics could input the data directly into a provincial system.

As it stands, if a child is missing a dose of a mandatory vaccine, public health units have to send parents notifications, threaten students with suspensions, and then actually suspend students if their vaccinations aren’t up to date. Dubey said the process is successful, and both Toronto data as well as numbers provided by Public Health Ontario show that immunizations are starting to slowly go up.

In Peel Region, officials have said that they are currently “mailing orders of suspension to students in Junior Kindergarten to Grade 1 who have not provided updated immunization records”

The ministry did not say if they would consider a provincial immunization registry when asked by CTV News Toronto.

With files from CTV News’ Jesse Tahirali

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As bird flu spreads in cows, fractured U.S. response has echoes of early covid – The Washington Post

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Federal agencies with competing interests are slowing the country’s ability to track and control an outbreak of highly virulent bird flu that for the first time is infecting cows in the United States, according to government officials and health and industry experts.

The response has echoes of the early days of 2020, when the coronavirus began its deadly march around the world. Today, some officials and experts express frustration that more livestock herds aren’t being tested for avian flu, and that when tests and epidemiological studies are conducted, results aren’t shared fast enough or with enough detail. They fear that the delays could allow the pathogen to move unchecked — and potentially acquire the genetic machinery needed to spread swiftly among people. One dairy worker in Texas has already fallen ill amid the outbreak, the second U.S. case ever of this type of bird flu.

Officials and experts said the lack of clear and timely updates by some federal agencies responding to the outbreak recall similar communication missteps at the start of the coronavirus pandemic. They point, in particular, to a failure to provide more details publicly about how the H5N1 virus is spreading in cows and about the safety of the milk supply.

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“This requires multiple agencies to coordinate and communicate internally, but most importantly externally, which doesn’t seem to be happening due to different cultures, priorities, legal responsibilities, scientific expertise, and agility,” said Katelyn Jetelina, an epidemiologist who writes a weekly infectious-diseases newsletter and has closely tracked the avian flu outbreak. “Mix that in with the usual challenges of scientific uncertainty, complexity and, quite frankly global pressure, and you got yourself an utterly, unacceptable mess.”

A senior administration official said there have been “no competing interests.” The White House’s Office of Pandemic Preparedness and Response Policy is coordinating the outbreak response with relevant agencies “that are working quickly and methodically.” The government is “committed to sharing results as soon as possible,” said the official, who spoke on the condition of anonymity to discuss internal deliberations.

“This work is an urgent priority as we work to ensure the continued effectiveness of the federal-state milk safety system and reinforce [the Food and Drug Administration’s] current assessment that the commercial milk supply is safe,” the administration official said.

Until Wednesday, testing for H5N1 in dairy herds was voluntary and limited to cows with certain symptoms. The number of tests per farm was limited, too. That protocol provoked sharp criticism from public health experts. With growing evidence that the virus is more widespread than feared among cows, the U.S. Agriculture Department announced Wednesday that lactating dairy cows must be tested for bird flu before moving across state lines, starting Monday.

Responsibility for monitoring and containing the outbreak is divided among three agencies. USDA leads the investigation into the virus in cows, the FDA oversees food safety, and the Centers for Disease Control and Prevention is monitoring risks to people.

Agencies have given individual updates on their parts of the outbreak investigation, but Wednesday marked the first time since bird flu was detected in cows four weeks ago that CDC, FDA and USDA, along with other agencies, held a news briefing jointly. On Thursday, government scientists are scheduled to present data about their investigations at a webinar hosted by state health officials.

For weeks, key federal agencies have expressed confidence in the safety of the commercial milk supply, including pasteurized products sold at grocery stores.

But it was two weeks before the FDA responded directly to The Washington Post’s questions about whether the agency was testing milk on grocery store shelves for H5N1. On Tuesday, the agency confirmed that viral particles had been found “in some of the samples,” but it declined to provide details. On Wednesday, an FDA official confirmed fragments were found in milk on shelves but declined to say how many samples the agency has tested, how many had virus fragments and where the milk originated. The testing does not indicate whether virus fragments are active or dead.

Additional testing is underway, but Donald A. Prater, acting director of the FDA’s Center for Food Safety and Applied Nutrition, said the agency has seen nothing to change its assessment that the commercial milk supply remains safe. “We also know that assessments can change as we learn more, and we will be transparent about any changes based on emerging data,” Prater said.

Officials are seeking answers to other key questions: They want to know whether the virus is spreading among cows through mechanical means, such as milking equipment, as evidence suggests, or through the air, which would be more dangerous and lead to more sustained spread. They are also interested in knowing how long livestock will shed virus in their milk once they have recovered from an infection. And, crucially, they will seek to ascertain the risks for human exposure and whether protocols are in place at the state level if additional people test positive.

The investigation “involves different types of samples, different types of studies and really being methodical about how we’re approaching answers to those questions around things like ensuring safety of the food supply,” said one senior government official who spoke on the condition of anonymity to share internal policy discussions.

“We’re not trying to pull the fire alarm here and suggest that there’s more of a risk to people than exists,” said another federal health official, who also spoke on the condition of anonymity to share internal deliberations.

The key to the outbreak resides with the cows.

Public health officials and industry experts say the USDA should be doing broader testing to paint a clearer picture of the scale of the outbreak. The government has been too slow in sharing genetic information and epidemiological studies, they said. More routine testing on herds and even other animals would reduce the risk of spreading the virus to other cattle and poultry farms, public health experts and veterinarians have said.

“Given this is a novel outbreak, testing needs to be done widely and rapidly, investigators need to be on affected farms, and scientists and policymakers need to be bringing it all together to set a coordinated plan of action,” Tom Inglesby, director of the Johns Hopkins Center for Health Security, said in an email last week. Inglesby was the White House testing czar during the Biden administration’s coronavirus response.

“This isn’t just about protecting U.S. agricultural interests,” said Jennifer Nuzzo, director of the Pandemic Center at the Brown University School of Public Health. “This is about protecting human health, protecting farmworkers that may be in harm’s way and preventing another pandemic from happening.”

Nearly three dozen livestock herds in eight states have been infected in the last month. The virus has also spread from dairy farms to poultry farms and infected barn cats. Epidemiologists fear that indicates cows can pass the virus to birds, and possibly other animals, broadening the potential for spread.

Scientists who performed genetic analyses of virus taken from infected animals say the tests suggest the outbreak may have been occurring for longer and across more of the United States than previously thought.

Michael Worobey, a University of Arizona virologist who led a team of scientists who analyzed 239 genetic sequences released Sunday by the USDA, said the evolutionary tree of the virus “resoundingly indicates that this outbreak had a single origin and that it had been circulating under our noses for months before it was noticed.”

“The concerning thing was it meant that all of these outbreaks in at least eight different states traced back to a common ancestor that had been around probably since late 2023 and that meant that this outbreak almost certainly has its tendrils all across the U.S. and perhaps beyond,” Worobey said.

Scientists trying to piece together the outbreak’s genesis said the USDA was too slow in sharing critical genetic data initially, and when “a big dump” of 239 genetic sequences arrived Sunday, it was not comprehensive.

“Like what samples they are coming from, when exactly they were collected … and where exactly they were collected,” said Angela Rasmussen, a virologist and principal research scientist at the Vaccine and Infectious Disease Organization at the University of Saskatchewan in Canada.

Public health and veterinary experts say they also want more epidemiological data — including information on the movement of animals, their feed sources and how many workers are on-site — to understand how and where the virus is circulating.

Beth Thompson, South Dakota’s state veterinarian and president of the National Assembly of State Animal Health Officials, said such information needs to be shared quickly.

“It’s like if you just rip one page out of a chapter in a book and hand it to the states, that isn’t the whole chapter,” Thompson said. “We need all of the information to be given back to us.”

The lack of more aggressive testing of livestock and transparent data-sharing has frustrated officials at the Department of Health and Human Services, according to another federal health official and a public health expert who were briefed on the response.

USDA officials may be constrained by their mission to promote new markets for farmers and protect animal health and welfare, said an administration official who spoke on the condition of anonymity to discuss internal deliberations. “They’re just twisting themselves into knots because they’ve got two missions that are, in this instance, pointing in different directions,” the administration official said.

The official suggested the agency is operating at a level of urgency closer to a 4 when it should be a 10, the official said.

Not true, said USDA spokeswoman Marissa Perry.

“USDA’s top priority is containing this emerging animal health issue,” Perry said.

While H5N1 is typically fatal in poultry, the disease in infected cows has been relatively mild, and animals have recovered in a week to 10 days, according to agriculture officials.

The biggest challenge so far has been identifying farms willing to share samples, said Rosemary Sifford, the USDA’s chief veterinary officer. The agency has been testing sick and healthy cows in affected herds, and in recent days began testing in unaffected herds, she said in an interview last week.

The virus appears to be spreading in cows that are producing milk “and the place that those animals are most closely congregated, have the most contact, would be as they’re moving through the milking parlor,” Sifford said. “We are not seeing this virus moving outside the lactating herd.”

This strain of avian flu has been circulating for more than 20 years, but its leap into cows is of significant concern, surprising even longtime observers of the virus. While avian flu has infected humans — especially in Asia — the virus has yet to prove able to spread efficiently in people. But the more the virus jumps animal to animal, the greater the chance mutations will emerge that allow sustained person-to-person transmission, the required next step for a pandemic.

State health officials have tested at least 23 people; only the dairy worker in Texas, who has since recovered, was confirmed positive. Ongoing surveillance of emergency department visits and flu testing results in regions with bird flu have not identified any unusual or concerning patterns, the CDC’s principal deputy director, Nirav Shah, said Wednesday. The risk to the public from bird flu remains low.

For dairy farmers, the potential impact on their business is top of mind.

“Lots of farms aren’t raising their hands to be tested because they don’t want to be known as having an infected herd,” said Keith Poulsen, director of the veterinary diagnostic lab at the University of Wisconsin-Madison.

Jamie Jonker, chief science officer for the National Milk Producers Federation, described as appropriate the USDA announcement on testing and interstate movement. But milk producers are waiting for the USDA’s detailed guidance to know how many tests may need to be performed on milk cows, estimated to number about 8 million, Jonker said.

The testing mandate could help overcome reluctance from some milk producers to allow testing in their herds, the USDA’s Mike Watson said Wednesday. The cost of mandatory testing would be reimbursed by the agency.

A wide swath of federal agencies are mobilizing in the event the highly pathogenic virus evolves.

At highest risk are farmworkers, who, like many in the agriculture sector, are undocumented or do not wish to interact with the government, Shah said.

In an emergency call three weeks ago with state health and lab officials, Shah laid out a detailed list of operational questions state officials needed to answer to prepare for potential exposures in people.

“What nurse and what epidemiologist have you trained up to do this? Do you have the [nasal] swabs ready? Do they know how to approach that conversation in a culturally competent and linguistically competent manner? … Is the lab ready to go?”

Dan Diamond and Fenit Nirappil contributed to this report.

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April 22nd to 30th is Immunization Awareness Week – Oldies 107.7

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<!–April 22nd to 30th is Immunization Awareness Week | Oldies 107.7

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