Just Like COVID, Bird Flu Virus Is Also Mutating: How Threatful Is It For India?
Alert! Bird flu or the avian influenza virus is mutating. Read on to know everything.
Amid rising fears about a possible fifth wave of COVID-19 in India, experts have warned about the massive spread of Bird Flu virus in the country. In the latest report issued by the health officials of India, the government has sounded alert in Bihar after several cases of H5N1 virus were confirmed in the state. What is more concerning at the moment are the new mutations which experts have noticed in the virus. Let’s understand how threatful are these new mutations in the virus, and where India stands when it comes to facing an outbreak of the H3N1 virus or the bird flu virus.
New Mutation In Bird Flu Virus Shows High Potential For Humans Outbreak
Bird flu is an air-borne infection caused by strains of the influenza virus that primarily infect birds. The mode of transmission of this virus is via infected body fluids of the birds. The virus mainly affects the avian community of the environment. What about the humans? Although experts had shown cases of human transmission of the H3N1 0r H2N3 virus and the possibility of it entering and evading the immune system, the chances of it causing severe outcomes for humans were too low. But this is not the case anymore. A recent study has revealed something unusual and new. According to the scientists, they have identified new mutations in the avian influenza virus H5N1, which recently infected a man in Chile, and may pose a risk of spreading in humans.
According to the European Centre for Disease Control (ECDC), the risk of spread from human to human remains low but the new changes seen are ‘concerning’. It also suggests that the potential risk of human spillover is increasing.
Last month in a statement, Chile’s Health Ministry confirmed that a 53-year-old man has tested positive for the H5N1 virus. As per the medical reports, the man was reported to be in serious but stable condition with a severe pneumonia-like condition.
China Reports First Bird Flu Death
This comes a few days after Chin confirmed the first human death by the Bird Flu virus. The World Health Organisation (WHO) confirmed the death of a 56-year-old Chinese woman due to the H3N8 bird flu strain that is rare in humans. The H3N8 subtype of avian influenza is a rare strain of the virus and it is unusual to spread among the human community.
Talking about this rare case of bird flu death in China, the WHO confirmed that the virus responsible for the infection was influenza A(H3), which is very common in birds and extremely rare for humans. As per the global health body, there were no additional cases reported among people who had been in close contact with the infected individual.
Avian Influenza: Can This Bird Virus Turn Into a Human Virus
The virus responsible for severe human infections has been identified as H7N9 and H5N1. The symptoms that are commonly reported by the patients are like the common flu, such as fever, body aches, sore – throat, and cough. Speaking to the media, Richard J. Webby, a bird flu expert at St. Jude Children’s Research Hospital stated that to become threatful to the human community the H5 virus will have to undergo three major categories of changes. “The sequences from the person in Chile have one of those classes of changes. But we also know that of those three sets of changes, this is the easiest one for the virus to make,” Jude was quoted as saying.
How to detect the H3N1 virus infection in humans? Bird flu infection is usually diagnosed by collecting a swab from the upper respiratory tract of the sick person. “The disease can carry high mortality in humans. Some antiviral drugs, if taken within two days of symptoms, may help. Oseltamivir or Tamiflu is one of the drugs effective against bird flu,” said Dr Nitin Verma Director Pediatrics Rosewalk Healthcare.
Bird Flu Outbreak: How Big Is The Threat For India?
As the speculations of the H5 virus turning into a human virus from a bird virus is on the rise in India, we spoke to Dr Anamika Dubey, Senior Consultant, General Paediatrician, Madhukar Rainbow Children’s Hospital, Malviya Nagar.
Dr Dubey said, “In the United States, there are repeated outbreaks of H5 N1 in wild birds and poultry since 2022. In India H5N1 in poultry farms was first reported in 2006 in Maharashtra. Since then outbreaks of Avian influenza A in poultry farms is reported every year. One human case of H5n1 was notified on 21 July 2021 from Haryana state.”
Talking about the safety measures that one can take during a bird flu outbreak, Dr Dubey said, “As advised by WHO, at all times the public should avoid contact with high-risk environments such as live animal markets/farms and live poultry, or surfaces that might be contaminated by poultry or bird faeces. Hand hygiene with frequent hand washing with soap and water is recommended. Good food safety practices should be followed. There is no evidence to suggest that Influenza a or other avian influenza viruses can be transmitted to humans through properly cooked poultry. There is no epidemiological evidence to suggest that people have been infected with avian influenza virus by consumption of eggs or egg products. However, eggs from areas with outbreaks in poultry should not be consumed raw or partially cooked.”
Common, inexpensive diabetes drug could cut long COVID risk, study finds – CBC.ca
A well-known, inexpensive diabetes drug appears to cut the risk of developing long COVID, hopeful-but-early new research suggests.
The study, published Thursday in the peer-reviewed journal Lancet Infectious Diseases, found outpatient treatment with the drug metformin — a common treatment for Type 2 diabetes — reduced long COVID incidence among infected patients by 41 per cent.
Roughly six per cent of those taking metformin went on to develop the condition, compared to close to 11 per cent of those in the placebo group. Participants on metformin were also less likely to be hospitalized roughly a month after infection by SARS-CoV-2, the virus that causes COVID-19.
“Metformin has clinical benefits when used as outpatient treatment for COVID-19 and is globally available, low-cost and safe,” wrote the research team.
Lead author Dr. Carolyn Bramante, a physician-scientist with the University of Minnesota in Minneapolis, told CBC News that the effect was even larger when metformin was given quickly �— in less than four days — during someone’s infection. She said metformin may be helping patients fight off the virus, or reducing inflammation, though more research is needed to figure out why the drug appears to work.
“Our data don’t suggest anything about whether metformin would treat long COVID in someone who already has it,” she said, “so that’s an important area of research where trials should be done.”
Two other drugs, ivermectin and fluvoxamine, were also studied, but neither made a difference on the incidence of long COVID.
‘Potentially landmark’ findings
The research involved randomized, quadruple-blind trials on roughly 1,400 people at six sites in the U.S., through multiple waves of the pandemic, and looked at both vaccinated and unvaccinated individuals — though only those with first-time infections.
Outside medical experts say it’s one of the more robust studies yet on a potential preventative aimed at long COVID.
“I think it’s a significant start to having a better understanding of the role of metformin in reducing the risk of long COVID,” said Dr. Isaac Bogoch, an infectious diseases specialist with the University Health Network in Toronto. “There’s been hints of data over the last couple of years … this furthers that discussion.”
If confirmed, the findings are “profound and potentially landmark on two distinct counts,” wrote Dr. Jeremy Faust, from Harvard Medical School, in an accompanying commentary in the Lancet.
The paper offers the “first high-quality evidence” showing incidence of long COVID can be reduced through a medical intervention, he wrote, and offers an important medical contribution regarding the very existence of the condition, since “a treatment can only be effective if there is something to treat.”
In a statement, Dr. Frances Williams, professor of genetic epidemiology at King’s College London, cautioned there would need to be extensive use of metformin to realize the study’s seemingly impressive outcomes.
“In total, 564 people were exposed to the drug metformin to prevent 23 hypothetical cases. This means 24 people would need to take metformin to prevent one case of [long COVID].”
Fatigue, ‘brain fog’
Marked by a variety of lingering symptoms such as fatigue, shortness of breath and feelings of ‘brain fog’, and formally known as post COVID-19 condition, long COVID is thought to be less common by this point in the pandemic, largely thanks to widespread protection from vaccinations.
But the condition can still be debilitating for some, including millions of people around the world — including many in Canada — who became infected with earlier SARS-CoV-2 variants before the arrival of vaccines.
While physicians are hopeful the new research may fuel additional study and potentially help bring down long COVID rates even further, there were some key limitations.
For one thing, it only focused on adults between age 30 and 85 who were overweight or had obesity — so the drug’s impact on individuals of other body weights isn’t yet known.
“It’s not entirely clear how generalizable this will be,” Bogoch said.
In his comment for the Lancet, Faust also noted that since the participants were given a diabetes drug, there may be reduced symptoms linked to undiagnosed diabetes among the patients. “Furthermore, the mechanism of action by which metformin might reduce the incidence of long COVID remains unclear,” he wrote.
Dr. Lynora Saxinger, a professor in the division of infectious diseases at the University of Alberta, noted the study didn’t follow long COVID patients using any “standardized criteria.”
But, she said in an email to CBC News, “it still is really positive and encouraging that a treatment in early COVID could reduce risk of prolonged symptoms: additional studies in other patient groups and with more specific long COVID symptom followup will be really helpful.”
Bogoch stressed that, while the drug shows potential, it wouldn’t “solve all of our issues with long COVID.” However, it could become an important tool given its decades-old safety profile, he said.
“If this is something that, indeed, pans out, and if metformin truly has some properties that reduce the risk of developing long COVID, that’s wonderful because it’s a cheap, widely available [drug].”
Hair loss can be difficult, cancer patients say — and some want better access to options – CBC.ca
White Coat Black Art26:30Hair Loss Part I: The trouble with wigs
Cairo Gregory doesn’t think about her hair too often — anymore.
For much of her life, she says she didn’t have the “greatest” relationship with her hair. Gregory, a 16-year-old student in Toronto, had at one point straightened her hair so much, it ended up damaged. So she cut it short — “I hated it,” she said.
But eventually, as she learned to style her hair, she grew to love it. So last year, when her hair started falling out in her second week of chemotherapy for ovarian cancer, she says she found the loss difficult. Like many of those going through chemotherapy, she made the decision to completely shave her head as she started shedding.
“I think that was probably the most upsetting part for me,” she told White Coat, Black Art host Dr. Brian Goldman.
“When it fell out, it was like my entire Instagram [timeline] was just hair videos, like new hairstyles because I’d gotten really into that at that point. So it really sucked when it was like something that actually really, really became important to me at that period of time.”
Despite advances in cancer treatment, little has changed with respect to its effects on hair. Chemotherapy attacks fast-growing cells in the body — including hair. For many patients, that means losing their locks during treatment.
That can have an impact on a person’s self-confidence and how they feel about themselves during treatment. But alternatives, like wigs and cold-capping procedures that can protect a patient’s hair, are out of reach for many patients due to price and availability.
For Gregory, the problem was compounded by a lack of hospital resources and alternative hair options for people of colour, she said.
“There isn’t a pamphlet that they hand out for people with curly hair to go find wigs. There should be one,” she said.
Wigs can be pricey, but free alternatives exist
Losing hair during cancer treatment can be a shocking experience. Some patients say losing hair can make the psychological burden of chemotherapy feel heavier, given they don’t look like themselves.
“Obviously nobody wants to feel sick, but I didn’t want to look sick,” said Tammy Wegener, who was treated for breast cancer in 2022. “I wanted to feel that I had some peace of mind, that my kids had some peace of mind going through all this.”
That’s something Mona Rozdale says she hears often.
“At the end of the day, everybody wants to feel like themselves, and when you strip something that you’re so used to having, you don’t know life without it,” she said.
Rozdale is responsible for the Canadian Cancer Society’s wig and breast prosthetics bank lending program, which is free.
She says wigs can be a helpful solution to those facing hair loss. But they can also be pricey. On average, a good quality wig made from human hair can cost around $2,500, according to Rozdale. But cheaper synthetic wigs are starting to look more realistic.
When Gregory couldn’t find a wig that fit her style — or budget of around $500 — at a hospital boutique, she opted to have her mother’s hairdresser make her one at a discount.
Scalp cooling is resource-intensive
Some people being treated for cancer have kept their natural hair with a process known as scalp cooling or cold capping.
Patients wear an intensely cold helmet before, during and after chemotherapy that constricts blood vessels in the scalp. It involves chilled caps that are swapped out regularly, or a machine that pumps cold liquid through an attached cap. In doing so, chemotherapy is less likely to reach and damage hair follicles, potentially reducing hair loss.
With limited data on its efficacy and a high price tag, however, cold capping is not widely available across Canada.
“The greatest limitation is chair time. It is a resource-rich type of use of the machine,” said Dr. Shannon Salvador, gynecologic oncologist at the Jewish General Hospital in Montreal and an associate professor at McGill University.
“When you have a patient who has to come for chemo every single week, that’s a great deal of time for them and a lot of time in the hospital to be able to come and use the machine.”
But Salvador, who has studied the effectiveness of scalp cooling, says there is evidence it does work for some patients.
In a 2021 study she co-authored, published in the journal Gynecologic Oncology Reports, over half of patients who were on a smaller weekly dose of a chemotherapy drug retained about 50 per cent of their hair when using a cold cap. The cold cap treatment didn’t work for those on a larger dose.
Cold caps limited at Canadian hospitals
Cold capping is not available to people with certain types of cancer, such as blood cancers, and those being treated with certain types of chemotherapy.
White Coat, Black Art reached out to several cancer centres in Canada, and found scalp cooling offered at just a handful of hospitals, often at the patient’s expense.
Wegener, 49, was able to access the treatment for free at Saint John Regional Hospital after a scalp cooling machine was donated by a nurse at the institution.
26:30Hair Loss Part II: Cold Capping
Salvador says she expects hospitals will still rely on donations and external support for scalp cooling technology, rather than funding them directly.
“We need to acknowledge that, in Canada, we are in a socialized health-care system where we need to place the money where it’s going to do the most benefit,” she said.
“Unfortunately that does mean turning away things that are of great emotional benefit to patients, but may not play a great deal in their actual clinical care.”
Cold capping was a success for Wegener, who says during her chemotherapy treatment she noticed only some thinning of her hair and eyebrows. Based on her own experience, she hopes to see it in more places.
“Not that it’s for everybody and not everybody sees the results I saw with mine,” Wegener said. “But I think it still should be an option for everyone.”
Gregory, the Toronto student who is still anxious about her cancer potentially returning, has become more comfortable with — and without — her wig.
She went to class bald for the first three months of the school year, in part because she also lost hair on and around her face, making the wig look unnatural. But she has since confidently worn wigs to school, and now has enough of her natural hair to add in braids.
“That took a year. It’s almost been a year since my hair started going back,” she said.
“I think by next summer I could probably wear a ponytail wig and then hopefully, like maybe a few summers after that, I won’t wear wigs anymore at all.”
Addictions counselling services expanded for Vancouver Islanders
People struggling with mental health and substance abuse can access up to 12 free counselling sessions per year in a new Island Health program.
Leah Hollins, Island Health Board Chair, says “This represents a significant expansion and investment in community-based counselling services to improve access to these services on Vancouver Island.”
Virtual Island-wide services will be available through Cognito Health, and Trafalgar Addiction Treatment Centre. Services are also available in Port Hardy through North Island Crisis and Counselling Services and in Nanaimo through EHN Outpatient Services and Tillicum Lelum Aboriginal Society.
The publicly-funded, community-based counselling is intended for people with moderate challenges. The new partnership with Island health will meet the counselling needs of at least 1,500 people per year.
Access to the counselling services is via referral or self-referral through Island Health Mental Health and Substance Use locations.
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