The flu has returned with a vengeance after being absent for a couple of years during the COVID-19 pandemic. It’s hitting children especially hard. Here’s what doctors say is happening, and why.
What flu strains are we seeing this flu season?
Based on predictions from the World Health Organization on what strains would appear, this year’s flu vaccine protects against two Influenza A strains — H3N2 and H1N1 — and two Influenza B strains which are called B/Victoria lineage and B/Yamagata lineage.
Right now, H3N2 is causing the vast majority of flu cases in Canada. It’s possible that the other strains could start circulating more widely and peak later in the flu season, doctors say.
Over the last decade, Influenza B strains have tended to arrive later in the season, said Dr. Allison McGeer, an infectious diseases specialist and microbi ologist at Sinai Health Systems in Toronto.
Does H3N2 make people sicker than the other strains?
H3N2 can cause more severe illness than other strains, especially among seniors who are more vulnerable, partly because it mutates faster so people don’t have as much acquired immunity protection, said McGeer.
That’s because people appear to accumulate some degree of protection throughout their lives to H1N1 and Influenza B strains, but not for H3N2.
“(For) kids who haven’t really been exposed to influenza before to any significant degree, there’s not a lot of difference in severity between H1N1, H3N2 and B (strains),” McGeer said.
Why are so many kids getting sick right now?
The flu season started early this year, doctors say, which means kids started getting sick earlier. And COVID-19 safety measures, like masking, also kept other viruses like the flu at bay the previous two cold and flu seasons.
“We’re now seeing all our old viral foes coming back to play after being on hiatus for a couple of years,” said Dr. Justin Penner, pediatric infectious diseases specialist at the Children’s Hospital of Eastern Ontario and member of the Canadian Paediatric Society’s infectious diseases and immunization committee.
Kids under five years old are most at risk of getting seriously ill with flu, doctors say. And because of the COVID-19 pandemic precautions, the immune systems of many children under three haven’t previously come in contact with the virus.
“Kids between, you know, zero to three have about a 40 per cent chance of acquiring influenza in any given year,” McGeer said.
“We’ve now got like two and a half cohorts of kids who haven’t been exposed to influenza at all. So they’re all getting sick at the same time.”
Why do some people land in hospital with the flu?
In the vast majority of cases, flu can be treated at home, doctors say.
But like many illnesses, some cases end up being more serious, McGeer said.
“There’s an entire range (of reasons) from just severity of the influenza illness itself to complications,” she said.
Some flu patients might get pneumonia, for example, or a bacterial infection on top of the virus.
Myocarditis and encephalitis are other possible complications of the flu.
People who are immunocompromised can also be at higher risk of severe illness.
“Influenza can also trigger exacerbations of underlying illness,” McGeer said, including heart disease and stroke.
Seniors are also more prone to being hospitalized with the flu, but a higher risk in the older age demographic appears to be offset this year by public health measures such as continued masking in long-term care homes, she said.
Why are so many people reluctant to get the flu vaccine?
The Public Health Agency of Canada says it wants to achieve an 80 per cent flu vaccination rate by 2025, but the uptake falls far short of that each year.
The influenza vaccine has a “bad reputation” because it’s effective but not perfect, said Dr. James Kellner, a pediatric infectious disease specialist and epidemiologist at the University of Calgary.
Based on data from Australia, which already had its flu season, this year’s vaccine appears to be about 50 per cent effective in reducing severe illness from the flu, he said.
That’s a difference that people tend to undervalue, Kellner said.
“Looking at 50 per cent prevention of severe outcomes could certainly have saved a lot of misery across the country (this year).”
The fact that flu vaccinations are needed every year instead of getting a one-time shot also puts some people off, he said.
Plus, “there’s so much fatigue” for public health measures from COVID-19, Kellner said.
“COVID vaccine initial uptake was so successful for a variety of reasons, but a big part of it was that there was this sense of public spirit around it in the collective willingness and desire to do the right thing,” he said.
“It seems that we’ve lost that quite a bit right now.”
Many people also don’t take the flu seriously enough or realize how severe it can be, especially for young children, Kellner said.
“There’s a sense that flu vaccine is not that important and so it’s missed out on a lot.”
Some people also mistakenly think they got the flu even though they were vaccinated, said Penner of the Canadian Paediatric Society.
“People’s perception of what influenza or the flu is, you know, could be a wide variety of different viruses,” he said.
Plus, if people do get the flu even though they’ve been immunized, the vaccine can make the illness less severe, Penner said.
How can we protect ourselves and our families?
The most effective ways to guard against the flu, experts say, are:
— Get the flu vaccine. Doctors say it’s not too late.
— Stay home if you feel unwell
— Masking
— Frequent handwashing
This report by The Canadian Press was first published Dec. 16, 2022.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
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.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
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.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
