Health
Hundreds of dead gulls found as ‘unprecedented’ avian flu outbreak continues in Nova Scotia
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Dr. Ted Leighton visited Bear Island near Digby, N.S., in mid-August, and knew something was amiss when he spotted a couple of seagulls acting oddly.
“They were behaving in a way that suggested some sort of neurological disorder,” said Leighton, a retired veterinary pathologist and wildlife health researcher.
He noticed something else, too.
“I could see that there was an awful lot of scavenging going on. You could see a gull or two picking away at something dead on the beach, repeated again and again and again down the straight shoreline, as I could see it. So I thought there must be some substantial mortality going on.”
Leighton, an internationally renowned scholar in wildlife disease, didn’t have a chance to investigate further that day, but when he returned to Bear Island on Sept. 3, his suspicions were confirmed.
“There were skeletal remains all over the place,” he said. “Often it was just wings and breastbone, no flesh at all, sometimes feathers.”
Leighton said it’s impossible to know how many seagulls died on the island recently because the tides wash carcasses into the Annapolis Basin twice a day, but he said the number is definitely in the hundreds.
Leighton believes highly pathogenic avian influenza is to blame for the die-off.
“It’s very unlikely that it’s anything else, but of course one has to do the expensive work of testing for the virus to be sure.”
Bear Island is accessible by foot at low tide and is the occasional destination of hikers and climbers. The Town of Digby recently asked people to stay off the island.
An unprecedented year
Leighton collected some specimens from the island, which will be sent to the Canadian Wildlife Health Cooperative (CWHC) for testing. The cooperative, which Leighton co-founded and then headed for many years, provides disease surveillance and tracking of mortality events in wildlife across Canada.
Dr. Megan Jones, the Atlantic regional director of the CWHC and an assistant professor in the department of pathology and microbiology at the Atlantic Veterinary College, said it’s been an unprecedented year for avian influenza in the Atlantic provinces and across the continent.
She said normally, in the first six months of a year, the Atlantic office of the cooperative does about 300 diagnostic tests on wildlife, but this year, staff did 1,400 tests in that period. The organization has faced such high demand that it now has to prioritize certain cases because it’s already spent its entire diagnostic budget for the year.
From January to March, about nine per cent of the tests came back positive for the highly pathogenic avian influenza, and between April and June, that number had risen to about 20 per cent.
“It’s a challenge because there’s really not much we can do,” Jones said. “They’re going to congregate, there’s no social distancing, so there’s not much we can really do about it besides track it and try to minimize transmission.”
Glen Parsons, the manager of the sustainable wildlife use program at Nova Scotia’s Department of Natural Resources and Renewables, said the province has received reports of dead birds in every county, and has seen cases of highly pathogenic avian influenza from Yarmouth to Sydney.
Parsons said the virus is transmitted through direct contact, including through feces and liquids, so people are advised not to touch or approach sick or dead birds and to refrain from feeding birds.
Anyone in Nova Scotia who finds a sick or dead bird or animal should call Natural Resources at 1-800-565-2224.
Tracking H5N1
North America’s outbreak of highly pathogenic avian influenza, a strain of H5N1, began in Newfoundland last December with the discovery of the virus at an exhibition farm. After that, a case cropped up in a Canada goose in Nova Scotia, and then in other birds in New Brunswick and Prince Edward Island. In the intervening months, the virus has spread throughout the continent after sweeping across Europe last year.
It has caused significant mortalities in wild bird populations, and has been found in foxes in Nova Scotia and Prince Edward Island as well as harbour seals in Quebec. In other parts of Canada and the U.S., it has been found in skunks, raccoons and bobcats, Jones said.
This particular strain of H5N1 has not caused significant disease in humans, but public health officials closely track any cases, as transmission of the virus to humans could cause a global outbreak.
The CWHC sends samples of all positive cases in wildlife to the National Centre for Foreign Animal Diseases lab in Winnipeg that does genetic sequencing of the virus to try to catch any mutations that may make it more likely to infect people.
The Current19:05Calls for greater access to life-saving treatment for stroke
When Marleen Conacher was taken to a hospital for major stroke treatment for the second time in a week in 2021, she wasn’t treated with a clot-busting drug like she was previously given at North Battleford Hospital in Saskatchewan.
Instead, she was transported directly to Royal University Hospital in Saskatoon, where a stroke team performed an endovascular thrombectomy (EVT).
The procedure involved passing small devices through one of the arteries in her groin, and then using suction, or tubes called stents to pull the stroke-causing blood clot out.
“I don’t recall when they, they put the little claw-like thing up through my groin and it went up through the artery and, and into my brain,” she said. “But I do remember feeling when they had got to it and were pulling it out.”
“It was a great deal of pressure. It did not hurt, but it was a great deal of pressure,” she told The Current‘s Matt Galloway.
Within a few days of the stroke, Conacher was out of the hospital, walking on her own and ready to go shopping.
She said she doesn’t think about the stroke much these days.
“I don’t spend a lot of time, you know, thinking about having a stroke or whatever or that time,” she said. “I just thank the good Lord that I am here.”
EVT procedures are a relatively new option in the field of ischemic stroke treatment. In 2015, a study known as the escape stroke trial led by the University of Calgary’s Hotchkiss Brain Institute found that, overall, positive outcomes for stroke patients increased from 20 per cent to 55 per cent thanks to EVTs.
Today, EVTs are used in about 25 to 30 major hospitals across Canada — and according to the senior study author and stroke specialist Dr. Michael Hill, it’s had a “massive treatment effect.”
“People would come in and they were paralyzed on one side, they couldn’t speak or they were severely affected, and they were leaving the hospital in two or three days,” he told Galloway.
“That was a visible change … whereas [before] people would have stayed many days and weeks for their recovery and rehab, if they survived at all.”
Speed is critical
Hill said the key to this procedure’s success is speed, as “10 or 15 minutes makes a difference.”
That’s why a patient is often greeted at the door by a team of emergency department nurses, physicians and the stroke specialist.
“When we’re alerted to a stroke or suspected stroke syndrome and we’re meeting somebody in the emergency room, we’re hustling to get there and be there before the patient or just after the patient arrives,” said Hill, who is a neurologist at the Foothills Medical Centre in Calgary.
WATCH: Dr. Michael Mayich explains how clots that cause strokes can be removed
Dr. Michael Mayich at the London Health Sciences Centre’s University Hospital explains how a new medical device from Vena Medical is used to remove clots in the brain that cause a stroke and reverse those symptoms.
From there, medical personnel conduct a clinical and imaging assessment to confirm if a patient has a blood clot and where it may be.
If the clot is in a location that is “amenable to a vascular treatment,” then an EVT will be offered.
Sedation can be approached in two ways, he said.
“Sometimes, patients are completely co-operative and we can do it completely awake. Sometimes they require some degree of sedation to keep them still.”
“You can imagine it’s important to do this procedure with your head relatively still. You can’t have them thrashing around.”
A game-changer
Hill said EVTs have a lot of potential in improving stroke treatment, as positive outcomes are a lot more frequent.
“So it’s terrific, right? We get people back to their lives,” he said.
In an ideal world, of course it’s available everywhere because you don’t have a stroke just because you live in the middle of Calgary or the middle of Toronto, right?-Dr. Michael Hill, stroke physician
At the moment, EVTs aren’t available for all Canadians. Hill said the procedure is usually reserved for patients with the most severe forms of ischemic stroke, which occurs when the blood supply to part of the brain is interrupted or reduced.
“It’s a tertiary-level procedure. You’re not going to see it in a small, rural hospital,” he said.
But part of that has to do with the volume of cases needed in order to develop expertise in this field, and it’s big hospitals in major cities that tend to see the most patients.
“So if you’re just doing one a year, you’re more likely to have complications than you are to be successful,” he said. “Whereas if you’re doing 150 a year … everyone’s ready for these things to occur because you’re doing it so frequently.”
Still, it’s important to balance that expertise with availability.
“In an ideal world, of course [EVT is] available everywhere because you don’t have a stroke just because you live in the middle of Calgary or the middle of Toronto, right?” He said.
For the time being, Conacher is content with how the procedure turned out — it’s been nearly two years and the only major impact the stroke has had is a bit of memory loss.
Furthermore, as someone who saw her dad suffer paralysis in his left side due to stroke, she’s pleased with the way stroke treatment is evolving.
“If they had things like this, I think he would have been just as fine as I was,” she said.
Produced by Ines Colabrese.
Health
Study shows well-established protective gene for Alzheimer's only safeguards against cognitive decline in men – Sunnybrook Research Institute – Sunnybrook Hospital
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The gene variant is one of three that can affect the chances of a person developing Alzheimer’s disease.
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A new study led by Sunnybrook researchers has found that APOE ε2, a gene variant known to be protective against Alzheimer’s disease, is only protective in men and not women. The research was published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association today.
“Previous research has shown that women have an increased risk of developing Alzheimer’s disease,” says Dr. Jennifer Rabin, senior author of the study and a scientist in the Hurvitz Brain Sciences Program at Sunnybrook Research Institute. “Although factors such as longer survival may contribute to why women are more likely to develop the disease, recent research suggests biological mechanisms may also impact sex differences in Alzheimer’s risk and progression.”
APOE ε2 is one of three inherited gene variants that can affect the chances of a person developing Alzheimer’s disease. Having the APOE ε2 variant decreases risk, whereas having the APOE ε4 variant increases risk. APOE ε3, the most common variant, is believed to have a neutral effect on the disease.
The collaborative study team, which included researchers from Canada and the United States, looked at whether sex modifies the association between the protective APOE ε2 gene variant and cognitive decline, using publicly available data from cognitively unimpaired adults that were part of four observational research sources.
The authors found that across two independent samples of participants, men with APOE ε2 were more protected against cognitive decline compared to women with the same APOE ε2 variant. In addition, men with APOE ε2 were more protected compared to men with the neutral gene variant (APOE ε3/ε3). However, this was not the case in women. In women, those with APOE ε2 were no more protected than those with the neutral gene variant (APOE ε3/ε3). The reasons for these sex-specific effects remain unclear. However, one possibility is that declining estrogen levels that occur with menopause may be a contributing factor given that estrogen has neuroprotective effects.
“These results suggest that the longstanding view that APOE ε2 provides protection against Alzheimer’s disease may require reevaluation,” says Madeline Wood, a graduate student at Sunnybrook and lead author of the study. “Our findings have important implications for developing sex-specific strategies to prevent and treat Alzheimer’s disease, particularly given that women are at a higher risk than men.”
The authors say the next step in their research is to continue to replicate the findings in large and diverse samples and to further investigate the sex-specific effects of APOE ε2 on Alzheimer’s disease biomarkers.
Funding for this study was supported by The Harquail Centre for Neuromodulation, the Dr. Sandra Black Centre for Brain Resilience & Recovery, Canadian Institutes of Health Research, and the Alzheimer’s Society of Canada.
Media Contact:
Samantha Sexton
Communications Manager, Sunnybrook Research Institute
Samantha.sexton@sunnybrook.ca
Health
WHO says medium-risk adults do not need extra COVID jabs – The Jakarta Post – The Jakarta Post
Robin Millard (The Jakarta Post)
PREMIUM
Agence France-Presse/Geneva, Switzerland ●
Thu, March 30 2023
The World Health Organization said on Tuesday it is no longer recommending additional COVID-19 vaccine booster doses for regular, medium-risk adults as the benefit was marginal.
For such people who have received their primary vaccination course and one booster dose, there is no risk in having further jabs but the returns are slight, WHO’s vaccine experts said.
The United Nations health agency’s Strategic Advisory Group of Experts on Immunization (SAGE) issued updated recommendations after its regular biannual meeting.
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