Health

Get kids up-to-date on vaccinations, watch for signs of invasive Strep A: doctors

Published

8 months ago

January 20, 2024

The recent deaths of six children in Ontario and four children in British Columbia from a bacterial infection is grabbing parents’ attention. Doctors say severe cases of invasive Group A streptococcal infection are extremely rare. Here’s what to know about the disease that is showing up in record numbers this season and also puts adults, especially those aged 65 and older, at risk.

What is Group A streptococcus?

Streptococci bacteria are commonly found in the throat and on skin. Dr. Monika Naus, medical director of immunization programs and vaccine preventable diseases at the BC Centre for Disease Control, said some people have no symptoms but others may get strep throat, a mild illness often accompanied by a fever. It resolves on its own within a few days or is treated with antibiotics. A sore throat, on the other hand, usually comes with a cough, runny nose or other cold-like symptoms.

How does someone get infected with invasive Group A streptococcal infection, or iGAS?

The illness becomes invasive when bacteria enter the bloodstream or deep tissue, sometimes through an open wound or the nose and throat. It is passed on through direct contact with discharges from those membranes or with infected skin lesions, Naus said.

What are some ways to prevent infection?

Washing hands, especially before cooking or eating, is one protective measure, as is keeping any cuts or wounds clean and watching for redness or other signs of infection. Staying home when sick and getting vaccinated against influenza and COVID-19 is also important.

Naus said even a paper cut could lead to infection.

“I’m not meaning to scare anyone but it doesn’t have to be a serious trauma. Sometimes strep infections can be initiated by what’s called blunt trauma, which means the skin wasn’t even pierced. But the organisms were on the skin and entered the body that way.”

A viral infection, such as the flu, can allow Strep A bacteria to invade the body, making those infections more common in the winter months.

British Columbia has had 60 cases of the invasive illness in people under age 20 compared with thousands of cases of influenza and respiratory syncytial virus, or RSV, which is more likely to sicken young children and older adults.

What should parents be watching for?

“It’s a fine line trying to tell the difference between a child who’s miserable because they’re on their first or second day of a fever from the flu and a child who’s getting into trouble.” Naus said.

However, parents should be on the lookout for prolonged fever, difficulty breathing, sandpapery red rash or a swollen tongue, sometimes called strawberry tongue. A child who is groggy and has a tough time waking up should also raise concerns.

A child whose condition is deteriorating could also have pneumococcus disease, though children are vaccinated against it starting at two months.

While there is no vaccine for invasive Group A streptococcus, Naus urged parents to at least get their kids vaccinated against influenza and COVID-19.

“It can prevent those infections, and those infections can be a precursor to a more serious bacterial infection.”

Who is most at risk?

Dr. Upton Allen, head of infectious diseases at Toronto’s Hospital for Sick Children, said people with a weakened immune system are most susceptible to infection. In Ontario, children between five and nine have become ill, as have adults 65 and older, he said.

“Among adults, those with long-term illnesses such as cancer, diabetes, kidney disease and on special medications such as corticosteroids may be at higher risk,” Allen said. “Some of these infections may be mild but some may have severe outcomes.”

Families should be mindful that lesions sometimes caused by chickenpox may become infected and cause Step A infection, he said, urging parents to ensure their kids get routine vaccinations.

“Certainly, we have had concerns during the COVID period, and we all should advocate for there to be strong efforts to ensure that vaccines are up-to-date.”

What are severe but rare forms of Group A strep?

In very rare cases, Group A strep can cause necrotizing fasciitis, a flesh-eating disease; meningitis; cerebral spinal infection; toxic shock syndrome, which causes multi-organ failure; low blood pressure and kidney failure.

Naus said none of the four children who died in British Columbia were believed to have developed any of those conditions.

This report by The Canadian Press was first published Jan. 20, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

Camille Bains, The Canadian Press

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Health

Canada to donate up to 200,000 vaccine doses to combat mpox outbreaks in Africa

Published

3 days ago

September 13, 2024

Anne Joseph

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.

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Health

How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

Published

5 days ago

September 11, 2024

Anne Joseph

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.

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Health

Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

Published

6 days ago

September 10, 2024

Anne Joseph

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.

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