A month after the first case was identified in Ottawa, 11 cases of monkeypox have been confirmed in the city, Public Health Ontario says.
A month after the first case was identified in Ottawa, 11 cases of monkeypox have been confirmed in the city, Public Health Ontario says.
The majority of cases in Ontario remain centred in Toronto, where 124 have been laboratory-confirmed. Cases are also beginning to show up in smaller centres, including Leeds, Grenville and Lanark, which reported its first confirmed case earlier this week.
There are now 156 confirmed cases of monkeypox across Ontario and eight suspect cases: all but one of whom are men.
The average age of confirmed cases is 37.3 years and the most common symptoms being reported include rash, oral or genital lesions, swollen lymph nodes, headache, fever, chills, myalgia and fatigue.
Just nine of the people with confirmed cases have had to be hospitalized, according to PHO.
The province’s chief medical officer of health, Dr. Kieran Moore, noted recently there had not been rapid growth in cases of monkeypox, which he attributed to the vaccination strategy.
More than 8,000 people across the province have been administered smallpox vaccine which is being given to those who contract the virus, their close contacts and anyone considered at risk.
Ottawa Public Health is offering the vaccine to eligible clients at its sexual health clinic and operating ongoing vaccination clinics at Centretown Community Health Centre.
The vaccine is available to people who have been exposed to the virus plus people who received diagnoses of bacterial sexually transmitted infection in the past two months, have had two or more sexual partners within the past 21 days, have attended a venue for sexual contact within 21 days, had anonymous casual sex during the same time period or engaged in sex for work.
Monkeypox, which is in the same family as smallpox, had been rarely seen outside of parts of Africa, where it is endemic, until this year when cases began spreading in many parts of the world.
On Tuesday, as global cases reached 9,200, the World Health Organization announced it would convene a second emergency meeting next week to determine whether monkeypox posed a global health threat.
The cases have been reported across 63 countries since earlier this year. There were slightly more than 6,000 cases reported globally as recently as July 4.
Health officials say monkeypox, which causes a rash and lesions along with flu-like symptoms, is not a sexually transmitted disease and can be spread through close contact. Most cases to date have been among men who have had sex with men.
The virus can enter the body through broken skin, the respiratory tract or the mucous membrane, including the eyes, nose or mouth.
Risk of infection is low for the general population, the Public Health Agency of Canada says.
The North Bay Parry Sound District Health Unit says it has received a very limited number of monkeypox PrEP vaccine doses.
PrEP is a vaccine that is administered prior to contact with the virus.
“Due to low supply, appointments for the monkeypox vaccine for eligible individuals will be booked on a first come first served basis,” says a news release.
“We recognize the issues with such limited access to the monkeypox PrEP vaccines and regret that offering an equitable booking approach is difficult to do at this time,” explains Dr. Carol Zimbalatti, Public Health Physician at the Health Unit. “We continue to work with the province to advocate for additional supply, but understandably, with no evidence of transmission of monkeypox locally, we expect most of the vaccine to continue to go to public health districts with more monkeypox cases.”
Should more vaccine become available, the public will be notified.
To get on the list, call 1-800-563-2808 ext. 5252 and leave a message Wednesday between 9. to 10 a.m.
Monkeypox is a rare disease not common in North America. It spreads through close contact with a person infected with the virus, or their clothing or linens. Monkeypox can enter the body through skin-to-skin contact with body fluids and through mucus membranes or respiratory droplets during prolonged face-to-face contact.
Anyone, regardless of sexual orientation, age, or gender can spread monkeypox through contact with body fluids, monkeypox sores, or by sharing contaminated items.
For more information on monkeypox and its symptoms visit myhealthunit.ca/monkeypox. If you believe you may have monkeypox, please call the Health Unit at 1-800-563-2808 ext. 5229.
TORONTO — Ontario’s top doctor says the province’s current monkeypox vaccination strategy is working and cases of the virus appear to be levelling off, but some who work with people in shelters say the immunization program should be expanded to better serve those communities.
Chief Medical Officer of Health Dr. Kieran Moore said the province has vaccinated more than 20,000 people against monkeypox so far, with the priority group being gay, bisexual and other men who have sex with men that meet certain criteria.
“We have been able to get the vaccines that we need from our federal partners, we’ve been able to staff our immunization clinics to meet the needs of our population, we have the funding necessary and the partnerships to ensure that our health system protects those at risk from this virus,” Moore said in a recent interview.
“Our response in Ontario has been quite robust. We’ve got a long ways to go still, but it appears that our total number of (monkeypox) cases is plateauing.”
But for some, the province’s vaccination strategy doesn’t do enough to protect those living in high-risk settings like homeless shelters, noting a recent confirmed monkeypox case in a person who attended a Toronto shelter.
Diana Chan McNally, a community worker at a Toronto centre for people in need, said she believes monkeypox vaccines should be broadly available to those living in shelters given the congregate nature of the settings and the fact those who live there might share belongings.
“This kind of laissez-faire attitude towards the vaccine is part and parcel of the fact that we don’t seem to prioritize creating special protocols or really taking into account the unique conditions that can lead to monkeypox infection in the shelter system,” said Chan McNally.
She also said the current monkeypox vaccine strategy doesn’t account for intersections between people who live in shelters and those who might be eligible for the shot, such as sex workers and people in the LGBTQ community experiencing homelessness, who may not have access to city-run immunization clinics.
“Why we can’t bring, even in small amounts, dedicated amounts of the vaccine to the priority groups within the shelter system, I don’t know,” she said. “I think that’s something that could potentially help mitigate any potential for spread.”
Chan McNally also said she wants to see the shot offered to shelter workers. “If we protect their health, we can protect other people in the shelter system,” she said.
Toronto Public Health held pop-up monkeypox vaccine clinics at the shelter where a case was recently reported, which Moore says is part of Ontario’s “ring immunization” strategy targeting those who may have been exposed to a known case.
Patricia Mueller, CEO of Homes First, the company that oversees the shelter where the case was confirmed, said there have been no further cases of monkeypox linked to that one. She said their staff, the city and Toronto Public Health acted quickly to move the infected individual to an isolation and recovery site and set up a vaccination clinic.
Mueller added that shelter workers are considered low risk for monkeypox infection.
Rita Shahin, associate medical officer of health at Toronto Public Health, said the city is not currently planning a larger monkeypox vaccine program for all shelter residents, though those who meet the criteria are eligible for the shot.
“We need to watch where the disease is, who’s most at risk, and if we see additional cases or spread in the shelter system, that’s certainly something we would look at,” Shahin said.
Shahin also said the city’s monkeypox vaccine supply is “fairly limited,” though Moore said the province has a “significant reserve” of doses ready for emergency situations.
Thomas Tenkate, a professor at the School of Occupational and Public Health at Toronto Metropolitan University, said he agrees men who have sex with men should remain the primary group targeted for monkeypox vaccination based on transmission trends, but added that pop-up clinics in shelters could be a way to proactively curb spread of the virus.
“If you’re going to vaccinate people who are in shelters, the strategies have to be different than the general community,” Tenkate said. “People who use shelters or are homeless, you really have to go to them.”
He said another challenge to vaccinating those in shelter settings is understanding their health history to flag any possible complications from getting the shot. “That might be a limiting factor to implementing it as well,” he said.
Public Health Ontario reported a total of 449 confirmed cases of monkeypox in the province as of Thursday, up from 423 on Tuesday. The agency’s latest report said the majority of cases — more than 77 per cent — were reported in Toronto.
It also said almost all the people infected are male, with only two reported in female patients. The virus generally doesn’t spread easily and is transmitted through prolonged close contact via respiratory droplets, direct contact with skin lesions or bodily fluids, or through contaminated clothes or bedding.
— With files from Allison Jones.
This report by The Canadian Press was first published Aug. 8, 2022.
Researchers are seeking thousands of volunteers in the U.S. and Europe to test the first potential vaccine against Lyme disease in 20 years in hopes of finding a better way to fight the tick-borne threat.
Lyme disease, caused by bacteria entering the body through the bite of an infected tick, is a growing problem, with reports of case numbers rising and warming weather helping ticks expand their habitat.
While a vaccine for dogs has long been available, the only Lyme disease vaccine for humans was pulled from the U.S. market in 2002 due to lack of demand, leaving people to rely on bug spray and tick checks.
“There’s currently no Lyme disease vaccine available for humans,” according to Health Canada. “However, there are clinical trials taking place in Europe and the U.S.”
Those trials involve Pfizer and French biotech company Valneva. They are aiming to avoid previous pitfalls in developing a new vaccine to protect both adults and kids as young as five from the most common Lyme strains on two continents.
When the last vaccine was pulled from the market, Pfizer vaccine chief Annaliesa Anderson told the Associated Press that “there wasn’t such a recognition, I think, of the severity of Lyme disease.”
Robert Terwilliger, an avid hunter and hiker, was first in line Friday when the study opened in central Pennsylvania. He’s seen lots of friends get Lyme and is tired of wondering if his next tick bite will make him sick.
“It’s always a worry, you know? Especially when you’re sitting in a tree stand hunting and you feel something crawling on you,” said Terwilliger, 60, of Williamsburg, Pa. “You’ve got to be very, very cautious.”
Exactly how often Lyme disease strikes isn’t clear.
The U.S. Centers for Disease Control and Prevention cites insurance records suggesting 476,000 people are treated for Lyme in the U.S. each year. Pfizer’s Anderson put Europe’s yearly infections at about 130,000.
In Canada, provincial public health units have reported 14,616 human cases of Lyme disease between 2009 and 2021. But the federal government says on its website the numbers are like under-reported “because some cases are undetected or unreported.”
Black-legged ticks, also called deer ticks, carry bacteria that cause Lyme disease. The infection initially causes fatigue, fever and joint pain. Often — but not always — the first sign is a circular red rash around the spot of the tick bite.
Early antibiotic treatment is crucial, but it can be hard for people to tell if they have been bitten, since some ticks are as small as a pin.
Untreated Lyme disease can cause severe arthritis and damage the heart and nervous system. Some people have lingering symptoms even after treatment.
Most vaccines against other diseases work after people are exposed to a germ. The Lyme vaccine offers a different strategy — working a step earlier to block a tick bite from transmitting the infection, according to Dr. Gary Wormser, a Lyme expert at New York Medical College who isn’t involved with the new research.
It does this by targeting an “outer surface protein” of the Lyme bacterium called OspA that’s present in the tick’s gut.
It’s estimated a tick must feed on someone for about 36 hours before the bacteria spreads to its victim. That delay provides time for the antibodies the tick ingests from a vaccinated person’s blood to attack the germs right at the source.
In small, early-stage studies, Pfizer and Valneva reported no safety problems and a good immune response.
The newest study will test the safety and efficacy of the new vaccine, called VLA15. The companies aim to recruit at least 6,000 people in Lyme-prone areas including the Northeast U.S. plus Finland, Germany, the Netherlands, Poland and Sweden.
Subjects will receive three shots of either the vaccine or a placebo between now and next spring’s tick season. A year later, they’ll get a single booster dose.
“We’re really looking at something that’s a seasonal vaccine,” Anderson said, so people have high antibody levels during the months when ticks are most active.
Volunteers for the study can be as young as five and should be at high risk because they spend a lot of time in tick-infested areas, such as hikers, campers and hunters, said Dr. Alan Kivitz, who heads one of the study sites at Altoona Center for Clinical Research in Duncansville, Pa.
In his own practice, Kivitz said “not a single day goes by that someone either has a concern about Lyme disease, could possibly have Lyme disease.”
The new Pfizer-Valneva vaccine is engineered somewhat differently than its predecessor and also targets six Lyme strains in the U.S. and Europe instead of just one.
The Pfizer study will span two tick seasons to get answers — but it’s not the only research into new ways to prevent Lyme.
The University of Massachusetts scientists are working on a vaccine alternative, shots of pre-made Lyme-fighting antibodies. And Yale University researchers are in the early stages of designing a vaccine that recognizes a tick’s saliva — which in animal testing sparked a skin reaction that made it harder for ticks to hang on and feed.
Since different tick species carry many diseases other than Lyme, ultimately “we’re all hoping for a tick-bite prevention vaccine,” Wormser said.
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