Monkeypox infections continue to rise in Canada as the U.S. and the WHO declare the outbreak an emergency, leaving some experts concerned about the risk of further outbreaks.
There have been fewer than 1,000 confirmed cases in Canada since May, as of Friday. But on a per capita basis, the number of monkeypox cases in total in Canada has surpassed the United States.
On July 27, Chief Public Health Officer Dr. Theresa Tam encouraged those at highest risk from monkeypox to get vaccinated, saying an “urgent” response is needed to address the outbreak.
But even though monkeypox has spread primarily among men who have sex with men, Dr. Donald Vinh, an infectious disease specialist at McGill University Health Centre in Montreal, tells CTV National News that there is a strong chance the infection could spread outside of that community.
“I’m not saying that we have to panic. I think we just need to be prepared that there’s a possibility that this virus could spread to the larger general public, and so we shouldn’t be surprised of that possibility,” he said.
Monkeypox often presents as a flu-like infection with a rash and spreads through close personal contact with someone who is symptomatic.
While monkeypox has been endemic to certain parts of Africa for decades, it has also been neglected, Vinh said.
And while the smallpox vaccine does protect against monkeypox, questions remain over whether those who were inoculated decades ago will still be protected from the disease today.
“And so this is something else that we need to learn, and learn pretty quickly,” Vinh said.
The Biden administration in the U.S. declared monkeypox a public health emergency on Thursday.
This came after the World Health Organization (WHO) declared monkeypox a public health emergency of international concern on July 23.
However, Canada has yet to make a similar declaration
In a statement to CTVNews.ca, a spokesperson for the Public Health Agency of Canada (PHAC) said the Government of Canada “acknowledges the WHO’s determination and recognizes that the global monkeypox outbreak requires an urgent global response.”
The spokesperson said more than 80,000 doses of the smallpox vaccine Imvamune have been sent to provinces and territories.
“PHAC also continues to work closely with international, provincial and territorial health partners to gather information on this evolving outbreak and to determine the best course of action to stop the spread of monkeypox in Canada,” the statement said.
“Canada will also continue to work with the WHO and international partners to strengthen the global response to the current monkeypox outbreak.”
Asked what Canada’s current vaccine stockpile status is, and the ability for Canada to increase its supply through additional procurements, the spokesperson said the agency “does not disclose details concerning medical countermeasures held by the NESS (National Emergency Strategic Stockpile), including types or quantities, due to security implications and requirements.”
At the local level, some are making efforts on the vaccination side.
This weekend, the public health unit in Windsor, Ont., will host its first monkeypox vaccine clinic at Sunday’s Pride event.
But on Friday, Ottawa Public Health announced it had to cancel its monkeypox vaccine clinics for the day “due to an unforeseeable short-term vaccine supply issue.”
Kerry Bowman, an assistant professor in the Temerty Faculty of Medicine at the University of Toronto, said it’s still unclear where the monkeypox outbreak is going, but he believes there is more Canada can do.
“There’s a picture of a lack of clarity as to who’s eligible and the vaccination process itself is quite limited,” Bowman said.
Health officials have recommended vaccinations for high-risk groups, including health-care workers and men who have sex with men and have recently had multiple sexual partners.
But Bowman says he is also concerned about monkeypox spreading to non-human animals.
“I would like to see it contained because my fear is that it will become endemic — embedded — that it will get into non-human species the way I’ve seen it do in Africa, it will just keep circulating and coming back on people regularly,” he said.
With files from CTVNews.ca’s Rachel Aiello, The Associated Press and CNN.
Hunting for Pi – the next variant after Omicron – in the toilet – Gavi, the Vaccine Alliance
Disease detectives are on the lookout for the next variant of COVID-19 and since the virus is still in such high circulation worldwide the virus is constantly mutating. This means it could be evolving to better evade vaccines and attack our immune systems. Although Omicron was milder than the variants came before it, scientists have warned the next variant – which will probably be called Pi – could be far more deadly.
“A lot of the lineages we are finding make Omicron look pedestrian.”
Sifting through sewage
As SARS-CoV-2 can be shed in faecal matter for weeks after the respiratory symptoms clear, wastewater is an obvious place to look for new variants.
Tracking circulating pathogens has long been an important way of finding early signals of the presence of a disease in a community – it was critical in the eradication of polio in India, for example. Researchers are also using these techniques to track the spread of monkeypox.
An initiative to look for SARS-CoV-2 in Bangalore, India, has provided early warnings of COVID-19 infection spikes, with the researchers able to identify which variants of SARS-CoV-2 are circulating, and in roughly what proportions.
Have you read
For much of this year, virologist Dr Dave O’Connor and colleagues at the University of Wisconsin-Madison have been tracking a heavily mutated version of SARS-CoV-2 that they narrowed down to one particular area of Wisconsin.
Scientists are starting to believe that chronic COVID-19 infections lingering for months in people who may have compromised immune systems are a hotbed of new variants, as the virus has a long time to mutate.
The variant Dr O’Connor’s team is tracking first appeared in sewage collected in January 2022, and though it shares numerous mutations with Omicron, it came from an entirely different part of the SARS-CoV-2 family tree. The team have tracked the lineage to a company of 30 employees and are now trying to determine their next move.
The next Omicron?
Dr Marc Johnson, a virologist at the University of Missouri in Columbia, is working with O’Connor to trace wastewater lineages in Wisconsin. With their colleagues, they are hunting so-called ‘cryptic lineages’, which are viral lineages in wastewater that didn’t match anything in global databases of millions of sequences.
These cryptic lineages were significant in that they often had several mutations in the spike protein that SARS-CoV-2 uses to enter our cells – and which our immune system targets. Dr O’Connor told Nature that such lineages could help forecast macro trends in SARS-CoV-2 evolution, which could in turn help the development of variant-proof vaccines and treatments.
For these virologists, a lot is riding on early detection of the next major COVID-19 variant. “A lot of the lineages we are finding make Omicron look pedestrian,” said Dr Johnson.
Canada has now ended its COVID-19 travel restrictions, mask mandates
OTTAWA — As of this morning, travellers to Canada do not need to show proof of vaccination against COVID-19 — and wearing a mask on planes and trains is now optional, though it is still recommended.
People entering the country are no longer subject to random mandatory tests for the virus, and those who are unvaccinated will not need to isolate upon arrival.
Anyone who entered Canada in the last two weeks and was subject to quarantine or testing is off the hook as of today.
And inbound travellers do not need to fill out the controversial ArriveCan app anymore, although they can still use it to fill out their customs declarations at certain airports.
Federal ministers announced the end of the COVID-19 public health restrictions earlier this week, saying the latest wave of the disease has largely passed and travel-related cases aren’t having a major impact.
But Health Minister Jean-Yves Duclos warned restrictions could be brought back again if they are needed.
This report by The Canadian Press was first published Oct. 1, 2022.
The Canadian Press
What do I need to know about this year's flu shot? – CBC.ca
Experts say it’s almost time to roll up your sleeve for the annual flu shot.
But this year, some pharmacists say people have questions about the influenza vaccine rollout, which will coincide with the rollout of COVID-19 vaccines that target Omicron strains — also known as bivalent vaccines.
Ashley Davidson, a pharmacist and associate owner of Shoppers Drug Mart in St. Albert, Alta., has fielded a lot of questions.
“So many people are asking about flu shots and I think a lot of that conversation comes around how do they time their vaccines and what does that look like?” she told Dr. Brian Goldman, host of CBC’s podcast The Dose.
Here’s what experts have to say about this year’s flu vaccines.
What do we know about the upcoming flu season?
The number of flu cases this year could look a little different than what we’ve seen over the last few years.
“What has changed in the last two years is we had historical lows throughout the pandemic and we’ve now been in the time of uncertainty about when is it going to come back, what is it going to look like,” said Dr. Robyn Harrison, vice-chair of the National Advisory Committee on Immunization (NACI) and infectious disease specialist, on Wednesday during a webinar on seasonal influenza.
An example of what could come is Australia’s recent flu season, which happens before Canada’s because it is in the southern hemisphere.
The country recently had its worst season in years, with data from Australia’s Department of Health and Aged Care showing influenza infections were higher than the five-year average and infections notably spiked, then dropped, earlier than usual.
Canadians also haven’t had much exposure to flu over the last couple of years because of mask mandates and other public health measures introduced during the pandemic, Davidson said.
“One thing that stands out to me this year is that we won’t have masks in schools. So that is going to increase the potential exposure for flu virus for children as well,” she said.
According to experts, influenza is a serious illness. Up until 2019, it is estimated that there are on average 12,000 hospital stays in Canada due to influenza every year, and about 3,500 deaths each year are caused by the flu, Harrison said.
Influenza is very contagious and spreads by respiratory droplets which cause an infection. Symptoms can vary but commonly include fever, sore throat, runny nose, cough, fatigue and muscle aches.
Who is eligible for a flu shot?
Experts say it’s important to get a flu shot each year as vaccine-induced immunity does wane over time.
There are three types of influenza vaccines approved in Canada, according to NACI:
- Inactivated influenza vaccine
- Recombinant influenza vaccines
- Live attenuated influenza vaccine
Anyone six months of age or older who does not have a known negative reaction to the vaccine should get a flu shot every year.
“The reason why children under six months of age are not included in that is because we know that they don’t mount a good immune response to influenza vaccines,” said Dr. Jesse Papenburg, a pediatric infectious disease and medical microbiology specialist, during Wednesday’s webinar. He is also the chair of the NACI influenza working group.
He said the suggested flu shot schedule for children nine and older and adults is one dose of the influenza vaccine at the beginning of flu season.
For kids aged six months to eight years who have yet to receive a flu shot, NACI recommends two doses given at least four weeks apart.
Who shouldn’t get a flu shot?
Papenburg said NACI recommendations for those who shouldn’t get any of the flu shots include:
- People who have had an anaphylactic reaction to any of the vaccine’s components, except for eggs.
- People who have developed Guillain-Barré syndrome (GBS) within six weeks of a previous flu vaccine (unless another cause has been found).
- Infants under six months of age.
NACI’s recommendations on who shouldn’t get the live attenuated influenza vaccine can be found here.
When should I get a flu shot?
Davidson recommends that people get the influenza vaccine as soon as it’s available.
Canada’s flu season typically lasts from mid-October to April or early May, Davidson said.
“I will often remind patients that although you can get your flu shot right away, it does take about two weeks to develop an immune response to that vaccination,” she said.
“It is important to get your shot as soon as you can to ensure that you have coverage through the flu season.”
Can I get a flu shot and a COVID-19 vaccine at the same time?
For most people, the short answer is yes.
For people age five and older, all seasonal influenza vaccines, including the live-attenuated influenza vaccine, may be given at the same time or before or after other vaccines, including COVID-19 vaccines, according to the most recent recommendations from NACI.
“It is important that you’re protected from both viruses throughout the winter,” said Davidson.
Daybreak Kamloops7:15Flu season expected to be more intense this year
However, kids aged six months to five years shouldn’t receive a COVID-19 vaccine and an influenza shot at the same time, according to NACI, which instead recommends those in this age group wait 14 days between COVID-19 shots and other vaccines.
It’s a precautionary approach “to prevent erroneous attribution of adverse events following immunization to one particular vaccine or the other,” reads the committee’s advice.
How effective are flu vaccines this year?
Experts say influenza vaccines have been proven to help prevent influenza, transmission, complications and hospitalizations.
The effectiveness of flu vaccines can vary year-to-year because it all depends on the strains circulating, Davidson and Harrison said.
For the 2004-2005 flu season to 2019-20, Harrison said the effectiveness of influenza vaccines in Canada has varied between around 40 to 70 per cent.
Every year, World Health Organization (WHO) experts make recommendations on which strains of the influenza virus should be targeted by the vaccines.
This year, WHO recommended three influenza strains — one influenza A (H1N1); one influenza A (H3N2) and one influenza B — for inclusion in the trivalent flu shot.
Although the flu vaccine’s effectiveness can vary, both Harrison and Davidson agree that it does offer protection.
“The effectiveness of the vaccine may not be 100 per cent and may not persist beyond a year, but has impact and that’s why it’s recommended,” Harrison said.
Written and produced by Stephanie Dubois
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