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Health Canada Reporting Above Average Flu Season

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Health Canada says flu activity remains at above expected levels typical this time of year.

The latest national influenza report is for the week ending December 3, 2022.

It shows that of the approximately 9,800 lab-confirmed cases of the flu, the vast majority were the Influenza A strain. 41 per cent of detections in week 48 were among people 19 years of age and younger. That’s down slightly from 45 per cent in the previous week.

For the flu season starting August 28th—weeks 35 to 48—292 lab-confirmed flu outbreaks have been reported nation-wide.

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Hospitalizations due to influenza remain elevated across the country with the highest cumulative hospitalization rates among children under the age of five and adults over the age of 65.

It has been a rough flu season across the province, but it doesn’t look like case counts will start declining quite yet.

That’s according to Chief Medical Officer of Health, Dr. Janice Fitzgerald.

She says there has been a rise in cases of the flu over the last little while, and based on trends across the country she believes that there’s still a little ways to go before the province reaches the peak of the season.

Fitzgerald explains that there’s some evidence to suggest that other jurisdictions are beginning to turn a corner, but she thinks this province still has a way to go.

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Deadly fungal infections a concern in patients post-COVID-19, flu | CTV News – CTV News Calgary

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While fungi are not about to start turning the human race into zombies, like in the HBO blockbuster series The Last of Us, the World Health Organization (WHO) says invasive fungal infections are an increasing threat to human health.

Aspergillosis is one fungal infection common in our environment but, in some circumstances, it can turn deadly. In an average day, most of us will inhale hundreds to thousands of Aspergillus spores with no adverse effects, but for people with weakened immune systems it can cause deadly infections. That includes people undergoing cancer treatments, or bone marrow transplants, but it is now recognized that some viral infections, like influenza (flu) and SARS-CoV-2 (COVID-19) increase the risk of deadly fungal infection even in otherwise healthy people.

“When these kinds of things happen in the ICU, it can be devastating because even advanced medicines still can’t treat these infections,” said Dr. Bryan Yipp, an intensive care physician and researcher at the University of Calgary.

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“Once many of these infections really get ingrained and take over, clearing them with medications alone, antifungal or anti microbials, can be very difficult.”

Dr.Yipp began studying Aspergillus — a type of fungus that is a common mould — and its connection to viral infections in 2019, following three deaths in intensive care units of patients initially admitted for influenza, but who subsequently died of the fungal infection.

“It was very much a surprise when people first started identifying the fungus in the lung.  There was a lot of discussion around the table of ICU doctors, infectious disease doctors, asking ‘Was Aspergillosis really the cause of death, or was this just a secondary finding?'” said Yipp. “The pathologists who looked at the samples and the autopsies, were convinced that it was Aspergillosis that was the main problem.”

UCalgary researchers have determined exposure to Aspergillus, a common fungal mould, can lead to a potentially dangerous Aspergillosis infection in people with weakened immune systems.

Working in Yipp’s lab, lead researcher Nicole Sarden, a PhD candidate, isolated the mechanism by which the immune system starts failing to prevent fungal infections.

“In healthy humans. specific immune cells, called B cells, produce molecules (antibodies) that basically tag invaders so that other cells in the immune system, called neutrophils, can recognize them, eat them, and clear the infection,” said Sarden

“But when you have infections with viruses, such as influenza, or if you get COVID, these molecules are no longer present, which means that the immune systems that are trying to eat, and clear the fungi cannot do it because they cannot see it.”

Working with both mice and human blood and tissue samples, the researchers discovered that following a viral infection, neutrophils could identify a fungal infection and surround it but did nothing to destroy it.  

“The virus kills the B cells, no messenger molecules exist, so the neutrophils that would normally attack, the fungus, are blinded. They sit there and don’t know what to do,” said Sarden.

The research team also discovered that reintroducing Aspergillosis reactive antibodies can protect infected mice, leading to hopes a similar treatment will be available in the near future for humans with Aspergillosis infections.

While Yipp and Sarden focused on Aspergillus, it is not the only fungus that can cause serious, or fatal infections. It is estimated fungal infections kill an estimated 1.5 million people worldwide every year. Most of those are due to four different fungi; Cryptococcus, Candida, Aspergillus, and Pneumocystis.  Since the advent of COVID, a previously rare infection of the fungus Mucormycosis has been increasing rapidly in India. It affects the sinuses, brains and lungs of its victims. The rise in Mucormycosis has also been seen in patients who are recovering or have recently recovered from COVID.

Yipp is hopeful the research being conducted at Calgary’s Cumming School of Medicine could lead to treatments for these infections as well.

“We have some hunches that that could be a similar mechanism to what we see here with what we have found.” said Yipp. “So we think that this could be applied to multiple different types of fungi around the world.”

The research team, led by Sarden, published their findings in the journal Science Translational Medicine.

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Barrie hospital declares COVID outbreak in transitional care unit – BarrieToday

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Royal Victoria Regional Health Centre (RVH), in collaboration with the Simcoe Muskoka District Health Unit, declared a COVID-19 outbreak in the Barrie hospital’s transitional care unit on Friday, Jan. 27.

According to RVH, eight patients have tested positive for COVID-19 and have been isolated.

“Enhanced cleaning measures are underway, as well as swabbing of patients and staff,” RVH said in a news release Monday afternoon. 

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Admissions to the unit are on hold at this time, and visitors are not permitted. However, RVH says some exceptions may apply.

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Guidance for diagnosing and managing migraine – News-Medical.Net

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Migraine is a major cause of disability, affecting about 12% of people. A 2-part series published in CMAJ (Canadian Medical Association Journal) on diagnosing and managing the condition with both acute and preventive therapy provides guidance for clinicians. https://www.cmaj.ca/lookup/doi/10.1503/cmaj.211969.

“The goal of treatment of migraine attacks is to provide rapid relief from pain and other migraine-related symptoms, to restore patient function and to prevent recurrence,” writes Dr. Tommy Chan, Department of Clinical Neurological Sciences, Western University, London, Ontario, with coauthors.

“A stratified approach to treatment that empowers patients to choose from different options, depending on attack symptoms and severity, and encourages them to combine medications from different classes (e.g., nonsteroidal anti-inflammatory drugs and triptans) for severe or prolonged attacks, is preferred.”

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Part 2 of the review, which will be published February 6, focuses on preventive treatment to reduce the frequency and severity of migraine attacks.

Journal reference:

Tzankova, V., et al. (2023) Diagnosis and acute management of migraine. Canadian Medical Association Journal. doi.org/10.1503/cmaj.211969.

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