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'Horrifying' number of syphilis infections in Alberta reaching pre-antibiotic levels – CBC.ca

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Despite advances in health care, the number of syphilis infections is skyrocketing across Alberta, reaching their highest levels in about 70 years. 

Cases of the disease in Alberta have exploded since 2000, when only 17 were reported. By 2020, there were 2,509 cases in the province.

“The highest rates we’ve seen since the 1940s, which is, of course, the pre-antibiotic era,” said Dr. Ameeta Singh, an infectious disease specialist who works at Edmonton’s Royal Alexandra Hospital. 

“Despite all of our advances, we are seeing a horrifying rate of syphilis cases.”

Syphilis was cited by Dr. Deena Hinshaw, Alberta’s chief medical officer of health, as one of the worrisome health threats going unchecked while resources are tied up with COVID-19. Devoting more resources to those threats was the key reason for Alberta’s controversial rolling back of COVID-19 measures, announced in late July. 

The disease is a bacterial infection, usually spread by sexual contact, that infects millions around the world each year. Without treatment, syphilis may attack major organs resulting in death. 

Most cases in Edmonton

Almost half the cases were in Edmonton, which had about three times as many as were reported in Calgary. In fact, Edmonton has one of the highest syphilis rates in Canada. 

In the first three months of 2021, there were 765 cases reported in Alberta.

LISTEN | Infectious disease expert talks about what’s driving Alberta’s high syphilis rates: 

Radio Active9:47Syphilis numbers rising

Doctor Ameeta Singh is a Clinical Professor in the Division of Infectious Diseases at the University of Alberta. 9:47

The popularity of social media apps being used for dating, such as Facebook, might be part of the reason for the surge, said Singh.

As well, people may also be taking fewer precautions and using condoms less frequently, she told CBC Edmonton’s Radio Active.  

There is also a significant link between methamphetamine and sexually transmitted infections. 

“Not only does the drug stimulate the sex drive, but it also encourages risky behaviour,” said Singh. 

Edmonton also has the highest rate per capita for methamphetamine use, according to a wastewater survey by Statistics Canada. The agency has been testing wastewater in five major cities since 2019. 

The last time syphilis was this prevalent in Alberta was in 1948, just a few years after penicillin became widely available and cases began to decline.

“Remarkably, the bacteria has not developed resistance to penicillin,” said Singh, noting that it is still used as a treatment today.

In 1998, Canada announced a goal to eliminate syphilis. However, the following year an outbreak was reported in downtown Vancouver and soon after another in northern Alberta. 

Infectious diseases expert Dr. Ameeta Singh, with the Royal Alexandra Hospital in Edmonton, says to fight the province’s increasing numbers of syphilis, heightened public awareness is essential to push individuals to get tested. (Submitted by Dr. Ameeta Singh)

 

Disease can be passed to babies

Syphilis can be particularly alarming for pregnant women as it can be passed to the baby and result in stillbirths. 

Singh said about 15 per cent of cases in Alberta occur in pregnant women. 

“And many of those women are disproportionately affected by other social determinants of health, such as homelessness, poverty, addictions and mental health issues.”

A syphilis outbreak was declared in 2019 by Alberta Health Services after 12 stillborn births. 

This problem is not solely Alberta’s as the disease is also surging across Canada, the United States and Australia. 

To fight the increasing numbers, Singh said heightened public awareness is essential to push individuals to get tested. 

Rapid testing is also in the works for syphilis and HIV to give patients a preliminary result within minutes. 

“If we find someone is syphilis-positive, we can offer treatment right there, which will hopefully prevent transmission as well as complications,” Singh said. 

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'Waning immunity?' Some experts say term leads to false understanding of COVID-19 vaccines – CBC.ca

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The idea of waning immunity has picked up steam in recent weeks, with some countries using it to justify rolling out third-dose COVID-19 vaccine boosters to their populations. But immunologists say the concept has been largely misunderstood.

While antibodies — proteins created after infection or vaccination that help prevent future invasions from the pathogen — do level off over time, experts say that’s supposed to happen.

And it doesn’t mean we’re not protected against COVID-19.

Jennifer Gommerman, an immunologist with the University of Toronto, said the term “waning immunity” has given people a false understanding of how the immune system works.

“Waning has this connotation that something’s wrong, and there isn’t,” she said. “It’s very normal for the immune system to mount a response where a ton of antibodies are made and lots of immune cells expand. And for the moment, that kind of takes over.

WATCH | Waning immunity sparks debate about need for COVID-19 booster shots: 

Waning immunity sparks debate about need for COVID-19 booster shots

25 days ago

Recent studies show a drop in effectiveness for COVID-19 vaccines, but the lack of information about how severe breakthrough cases were has sparked a debate about whether booster shots are necessary. 2:03

“But it has to contract, otherwise you wouldn’t have room for subsequent immune responses.”

Antibody levels ramp up in the “primary response” phase after vaccination or infection, “when your immune system is charged up and ready to attack,” said Steven Kerfoot, an associate professor of immunology at Western University in London, Ont.

Memory of pathogen remains

They then decrease from that “emergency phase,” he said. But the memory of the pathogen and the body’s ability to respond to it remain.

Kerfoot said B-cells, which make the antibodies, and T-cells, which limit the virus’s ability to cause serious damage, continue to work together to stave off severe disease long after a vaccine is administered. While T-cells can’t recognize the virus directly, they determine which cells are infected and kill them off quickly.

Recent studies have suggested the T-cell response is still robust several months following a COVID-19 vaccination.

“You might get a minor infection … [but] all of those cells are still there, which is why we’re still seeing very stable effectiveness when it comes to preventing severe disease,” Kerfoot said.

In the U.S., an advisory panel to the Food and Drug Administration overwhelmingly decided on Friday against offering Pfizer COVID-19 booster shots to most Americans — limiting third doses to those aged 65 and older or at high risk for severe disease. (Kirsty Wigglesworth/The Associated Press)

A pre-print study released this week by Public Health England suggested that protection against hospitalization and death remains much higher than protection against infection, even among older adults.

So the concept of waning immunity depends on whether you’re measuring protection against infection or against severe disease, Kerfoot said.

Ontario reported 43 hospitalized breakthrough cases among the fully vaccinated on Friday, compared with 256 unvaccinated hospitalized infections. There were 795 total new cases in the province that day, 582 among those who weren’t fully vaccinated or had an unknown vaccination status.

British Columbia, meanwhile, saw 53 fully vaccinated COVID-19 patients hospitalized over the last two weeks, compared with 318 unvaccinated patients.

“You’ll hear people say that vaccines aren’t designed to protect infection, they’re designed to prevent severe disease,” Kerfoot said. “I wouldn’t say necessarily it’s the vaccine that’s designed to do one or another … that’s just how the immune system works.”

Moderna, Pfizer back need for booster

Moderna released real-world data this week suggesting its vaccine was 96 per cent effective at preventing hospitalization, even amid the more transmissible delta variant, and 87 per cent effective at preventing infection — down from 94 per cent efficacy seen in clinical trials last year.

Moderna CEO Stéphane Bancel said that dip “illustrates the impact of waning immunity and supports the need for a booster to maintain high levels of protection.”

Pfizer-BioNTech has argued the same with its own data, and an advisory panel to the U.S.-based Food and Drug Administration voted Friday to endorse third doses for those aged 65 and older or at high risk for severe disease.

However, the panel rejected boosters for the general population, saying the pharmaceutical company had provided little safety data on extra jabs.

The University of Toronto’s Gommerman said the efficacy data presented by Moderna doesn’t signal the need for a third dose.

“The fact it protects 87 per cent against infection, that’s incredible,” she said. “Most vaccines can’t achieve that.”

Bancel said Moderna’s research, which has yet to be peer reviewed, suggested a booster dose could also extend the duration of the immune response by re-upping neutralizing antibody levels.

Looking beyond the antibody response

But Dr. Sumon Chakrabarti, an infectious physician in Mississauga, Ont., said looking solely at the antibody response is misleading and could be falsely used as justification for an infinite number of boosters.

Israel, which has opened third doses for its citizens, recently talked about administering fourth doses in the near future.

“This idea of waning immunity is being exploited, and it’s really concerning to see,” Chakrabarti said. “There’s this idea that antibodies mean immunity, and that’s true … but the background level of immunity, the durable T-cell stuff, hasn’t been stressed enough.”

While some experts maintain that boosters for the general population are premature, they agree some individuals would benefit from a third jab.

The National Advisory Committee on Immunization has recommended boosters for the immunocompromised, who don’t mount a robust immune response from a two-dose series.

Other experts have argued that residents of long-term care homes, who were prioritized when the rollout began last December, may also soon need a third dose. The English study suggests immunity could be waning in older groups but not much — if at all — among those under age 65.

Chakrabarti said a decrease in protection among older populations could be due more to “overlapping factors,” including their generally weaker immune systems and congregate-living situations for those in long-term care.

Immune cells live for years within bone marrow

“These are people at the highest risk of hospitalization,” he said. “Could [the length of time that’s passed following their doses] be playing a role? Yeah, maybe.”

While we still don’t know the duration of the immune response to COVID-19 vaccination, Gommerman said immune cells typically continue to live within bone marrow and make small amounts of antibodies for “decades.”

“And they can be quickly mobilized if they encounter a pathogen,” she said.

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Coronavirus cases in Quebec rise by 821 with three new deaths and two more hospitalizations – CTV News Montreal

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MONTREAL —
Quebec reported Saturday that 821 more people have tested positive for COVID-19 in the province, bringing the overall number of infections to 402,283.

Of the new infections, 609 people were unvaccinated when they received their positive result, 49 received one dose of vaccine more than two weeks prior, and 163 were double-vaxxed more than a week before the test. 

Hospitalizations rose by two bringing the total number of people receiving care in the province’s hospitals to 264. The ministry reports that 36 people checked in for care, and 34 were discharged. Of the 36, 28 were unvaccinated, two received one vaccine dose more than 14 days prior and six got both jabs more than a week before entering the hospital. 

There are 89 people in intensive care wards, which is six fewer than on Friday.

Three more people have died due to COVID-19, bringing that total to 11,321 since March 2020.

There are 508 active outbreaks in the province.

Quebec’s vaccination rate remains at 88 per cent for one dose of the eligible population and 82 per cent for both doses. 

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Spike in COVID-19 cases is pushing New Brunswick's health-care system to the limit – CTV News Atlantic

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MONCTON, N.B. —
New Brunswick’s jump in COVID-19 cases has overloaded the health-care system this week.

The Horizon Health Network is now looking to hire more staff across the province to help with the growing demand for testing and vaccinations.

The health network has seen an increased demand in testing as COVID-19 cases have soared over the last month.

“Two weeks ago, if you wanted a test, you could walk in or call and get it at almost anytime you wanted,” said Dr. Jeff Steeves with New Brunswick’s Medical Society.

But now, assessment centres are seeing long line ups and delays in testing.

Steeves wants people to get the jab and practice caution during this time to prevent overloading the system even more.

“Remember, we were running short even before COVID, so we’re trying to maintain that,” Steeves said. “Therefore, we can’t divert the staff like we did before, hence the call for new staff.”

Horizon Health’s vice-president said in a statement Friday that they are currently looking to recruit staff at vaccination clinics, assessment centres and school clinics in Moncton, Saint John and Fredericton.

“Given the recent rise in COVID activity in New Brunswick, and the increased demand for these services, we are hoping to replenish our pool of available clinicians and administrative support staff as we ramp up activity at these locations,” said Jean Daigle.

Since the province announced proof of vaccination requirements this week, public health has reported a significant jump in vaccination appointments.

On Wednesday, 1,700 appointments were booked, while yesterday there were 1,929.

Health officials say prior to Wednesday’s number, the recent average for vaccinations was 600 bookings per day. On Thursday, 600 additional vaccines had to be delivered to a clinic in Moncton.

“Things have picked up dramatically,” said Fredericton pharmacist Alistair Bursary, who says they’ve been busy taking calls from people looking to get their first or second dose.

“So, whereas we were doing perhaps 10 patients a day on average now we are probably going to hit 40-50 just at our pharmacy alone,” Bursary said.

While the demand for services continue to climb, those working on the frontlines hope to get the help they need sooner rather than later.

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