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Long COVID and children: expert panel agrees on definition, study says – CTV News

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Scientists and medical experts from around the world have agreed on a research definition for “long COVID” in children, according to a U.K.-based study, the first such consensus for young people.

The peer-reviewed paper, published in BMJ’s Archives of Disease in Childhood journal, defines long COVID, or post-COVID-19 condition, as an illness that “occurs in young people with a history of confirmed SARS CoV-2 infection, with at least one persisting physical symptom for a minimum duration of 12 weeks after initial testing that cannot be explained by an alternative diagnosis. The symptoms have an impact on everyday functioning, may continue or develop after COVID-19 infection, and may fluctuate or relapse over time.”

There are more than 200 symptoms associated with Long COVID in adults, researchers said, but the most common symptoms in both adults and children are similar, especially fatigue and headache. But less is known about long COVID in children. There are also differences including early data that suggested a higher proportion of younger patients were asymptomatic at the time of their initial infection, making a separate definition useful, researchers said.

“It is currently unclear whether long COVID represents one or many different conditions and it has consequently been difficult to derive a universally accepted definition for the condition,” the authors wrote.

“Research into the prevalence and impact of long COVID has consequently been hampered, thereby delaying the implementation of policies and services that could help affected [children and young people].”

The definition was agreed upon by a panel of participants with relevant expertise, knowledge and lived experience. Among those invited to participate, a total of 120 people registered. In addition, children between the ages of 11 and 17 were also included in the final review.

The definition aligns closely with the clinical case definition proposed for adults by the World Health Organization (WHO), and if widely adopted, could help researchers get a more accurate account of the condition and its impact on patients, the study’s authors say.

The WHO defines long COVID in adults as “people with a history of probable or confirmed SARS CoV-2 infection, usually three months from the onset of COVID-19, with symptoms that last for at least two months and cannot be explained by alternative diagnoses.”

With no formal definition for children who have post-COVID-19 condition – the preferred term by the WHO – comparison and evaluation of different studies is challenging. Definitions vary in terms of the number, type and duration of symptoms, resulting in estimates between one per cent and 51 per cent in terms of how common long COVID is in children, researchers said.

In order to reach a consensus, panel participants had to give a score between one and nine on 49 statements related to long COVID. A score of one to three meant the statement was not important, while a score of four to six meant it was important. A score of seven to nine meant it was very important.

The statements were developed based on existing literature, guidelines by the U.K.’s National Institute for Health and Care Excellence (NICE) on managing the effects of long COVID, COVID-19 advice by the U.K.’s National Health Service (NHS), and other sources. They were then pruned down in three phases with 10 final statements discussed in a consensus meeting and finalized down to five. The final statements were also reviewed by a group of eight children aged eleven to 17 to make sure their voices were heard as well.

The final statements included defining the condition as having:

• impacted a patient’s physical, mental, or social wellbeing

• interfered with some aspect of their daily living, such as school, work, home life, or relationships

• lasted for at least 12 weeks after testing positive for COVID-19, even if symptoms “waxed and waned” over that period

The authors noted some limitations and caveats to the study, including the fact that it was conducted in English. The authors noted that having representation from non-English speaking countries and less developed countries would have been preferred since the goal of the study was to provide a definition that would allow comparison between studies from around the world.

Researchers also highlighted the importance of distinguishing between their research definition and a clinical case definition.

“It is understandable that the patient groups representing people with Long COVID are concerned about a definition that could restrict access to services that are needed,” researchers said.

“In our view, the decision whether a child or young person can see a healthcare professional, access any support needed, or be referred, investigated or treated for Long COVID should be a shared decision involving the young person, their [care givers] and clinicians.”

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Peel Region reports its first confirmed case of monkeypox – CP24 Toronto's Breaking News

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Peel Region has its first confirmed case of monkeypox.

According to Peel Public Health, the person infected is an adult male in his 30s who lives in Mississauga.

The heath unit said the risk to the public remains low.

Monkeypox, which comes from the same virus family as smallpox, spreads though close contact with an infected individual. Most transmission happens through close contact with the skin lesions of monkeypox, but the virus can also be spread by large droplets or by sharing contaminated items.

To reduce risk of infection, people are advised to be cautious when engaging in intimate activities with others. Vaccination is available for high-risk contacts of cases and for those deemed at high risk of exposure to monkeypox.

Symptoms can include fever, headache, fatigue, swollen lymph nodes, and a rash/lesions, which could appear on the face or genitals and then spread to other areas.

Anyone who develops these symptoms should contact their healthcare provider and avoid close contact with others until they have improved and rash/lesions have healed.

While most people recover on their own without treatment, those who have been in close contact with someone who has tested positive for monkeypox should self-monitor for symptoms, and contact PPH to see if they are eligible for vaccination.

The Mississauga case is at least the 34th confirmed case of the disease in Ontario, with dozens more under investigation.

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Monkeypox case count rises to more than 3400 globally, WHO says – The Globe and Mail

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More than 3,400 confirmed monkeypox cases and one death were reported to the World Health Organization as of last Wednesday, with a majority of them from Europe, the agency said in an update on Monday.

WHO said that since June 17, 1,310 new cases were reported to the agency, with eight new countries reporting monkeypox cases.

Monkeypox is not yet a global health emergency, WHO ruled last week, although WHO Director-General Tedros Adhanom Ghebreyesus said he was deeply concerned about the outbreak.

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Sudbury news: Northern agencies highlight national HIV testing day | CTV News – CTV News Northern Ontario

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Monday was national HIV testing day. Officials say this year’s theme surrounds how getting tested is an act of self-care.

From clinics to self-testing kits, groups in the north say there are many options to get tested and everyone should use whichever way works best for them.

Just more than a year ago, Reseau Access Network in Sudbury teamed with Ready to Know and Get a Kit, groups that provide HIV self-testing kits at a pickup location.

Officials said it has been a huge success.

“We get a consistent number throughout each month and I can’t really divulge those figures, unfortunately, but as part of the overall study I can tell you the pickup of self-tests is a fraction of the amount of tests being ordered,” said Angel Riess, of Reseau Access Network.

“There’s actually a lot of tests being shipped to homes directly but I can confirm that they have been active and there’s a significant number of people who have chosen to engage in both programs.”

Elsewhere, the Aids Committee of North Bay and Area held a point-of-care testing clinic to mark the day.

“It’s an opportunity for us to remind everyone that getting tested is essential. If you don’t know you have HIV, you can’t take the steps to try to mitigate the possibility of spread,” said executive director Stacey Mayhall.

In addition to stopping the spread, knowing whether you are positive sooner rather than later can allow for a better quality of life.

“HIV is not a death sentence that it used to be,” said Riess.

“There have been advances in testing and medication and people can live long, healthy lives living with HIV.”

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