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Measles infections pose far more risks than most realize, including a fatal neurological complication – NBC News

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Erica Finkelstein-Parker planned her daughter’s 8th birthday party with love.

Because Emmalee adored airplanes, Finkelstein-Parker chose the theme “Flying High with Emmalee.” Finkelstein-Parker filled nearly two dozen brightly colored goody bags for Emmalee’s friends — one for every child in her class, so no one would feel left out.

Months later, the treat bags remained unopened in Finkelstein-Parker’s bedroom, reminders of a birthday party that was never held.

Emmalee, who developed a rare complication of measles that can strike years after infection, spent her 8th birthday in hospice care at her family’s home. Her parents adopted Emmalee from an orphanage in India when she was 2 ½ years old. The orphanage staff didn’t tell them she had been infected with measles.

Emmalee Madeline Snehal Parker. Emmalee was otherwise healthy when she developed a devastating complication after apparently recovering from measles.Erica Finkelstein-Parker

“There are some things that a parent should never have to do,” said Finkelstein-Parker, of Littlestown, Pennsylvania. “I had to call the birthday venue and explain that we were canceling the party because our daughter was dying.”

Emmalee died on Jan. 2, 2011.

“People think these diseases are ancient history, but they’re still around,” said Finkelstein-Parker. “Measles is a stealth virus. It may look like it has cleared your body, but it can hide in your nervous system.”

The massive resurgence of measles around the world — attributed to pandemic-related declines in immunizations and rising rates of vaccine hesitancy among parents — raises the risk of more serious complications and deaths, said Dr. James Cherry, a professor of pediatrics and an infectious disease expert at the David Geffen School of Medicine at UCLA.

In the past two months, doctors in the U.S. have diagnosed dozens of measles cases related to unvaccinated travelers who arrived at international airports, then exposed others at hospitals and day care centers. State health departments have reported measles cases in California, Georgia, Missouri, New Jersey, Pennsylvania, Washington, Ohio, Maryland and Minnesota. The Centers for Disease Control and Prevention has issued a warning to health providers, warning them to be on alert for more cases.

“All it takes is one infected traveler to spark an outbreak,” said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security. “It’s coming from people who are getting off airplanes.”

Measles is so contagious that even one case is considered an outbreak. Each measles patient infects an average of 12 to 18 people who lack immunity from vaccines or natural infection. In comparison, each Covid-19 patient infects about two other people, said Dr. Paul Offit, the director of the Vaccine Education Center at Children’s Hospital of Philadelphia.

“Measles is much, much more contagious than Covid or the flu,” Offit said.

Although two doses of the measles vaccine protect 97% of children, the airborne virus spreads so quickly that 95% of children in a community need to be vaccinated in order to stop outbreaks. About 93% of children were up to date on the measles vaccine in 2022-23, according to the CDC.

All states mandate vaccinations for children in public schools, but a growing number of families are taking advantage of exemptions for religious, philosophical or medical reasons. About 3% of students are now exempt from vaccine mandates. In 10 states, more than 5% of schoolchildren are exempt, a rate that makes it harder to contain outbreaks.

People who decline to vaccinate their children against measles are taking large and unnecessary risks, Dr. Peter Hotez, co-director of the Center for Vaccine Development at Texas Children’s Hospital, said. Measles vaccines have repeatedly been shown to be safe.

Long-term effects of measles

For every 10,000 children infected with measles, 2,000 will be hospitalized; 1,000 will develop ear infections with the potential for permanent hearing loss; 500 will develop pneumonia; and 10 to 30 will die, said Hotez, who is also dean of the National School of Tropical Medicine at Baylor College of Medicine.

Ariel Loop was shocked when her 4-month-old son, who had received all recommended vaccines, became sick with measles after visiting Disneyland in 2015. Babies are vulnerable to measles because they aren’t routinely vaccinated against the virus until age 12 to 15 months.

Loop took her son to the emergency room after he developed red spots, itchy eyes and a fever of 102 degrees that acetaminophen didn’t help. Loop, a nurse, was especially worried about her son because he was born prematurely and suffered a stroke while in utero.

Mobius was 4 months old when he became sick with measles after visiting Disneyland in 2015. Babies are vulnerable because they aren’t routinely vaccinated against the virus until 12 to 15 months.Ariel Loop

“He was my first baby, and I didn’t know how dangerous measles was,” said Loop, who lives in Pasadena, California.

Measles often leaves patients vulnerable to secondary bacterial infections, such as pneumonia, one of the most common causes of death in measles patients, said Patricia Stinchfield, president of the National Foundation for Infectious Diseases.

Measles also causes “immune amnesia,” in which the immune system loses its ability to fight infections that a patient was previously immune to, Cherry said. The virus wipes out 11% to 73% of a person’s antibodies — both those acquired through infection and vaccination — which can leave patients at increased risk from viruses such as the flu and bacteria that cause pneumonia and skin infections.

Early symptoms of measles

In addition to the well-known red spots on the skin, measles usually causes white spots in the mouth, which can make it painful for children to eat or drink, Stinchfield said. Many kids with measles become dehydrated and malnourished during their illness.

About 20% of measles patients are hospitalized, often because they need intravenous fluids, she said.

“These kids come in, slung over their parents’ shoulders, barely able to hold the head up,” Stinchfield said. “They’re like little rag dolls. They won’t even take a popsicle.”

In the days before children develop a red measles rash, symptoms include:

  • Cough
  • Lethargy
  • Runny nose
  • Pink eye
  • Fever  

Many become so sensitive to light that ordinary room lights hurt their eyes.

“It might look like the common cold except for the degree of misery they have,” Offit said.

People with measles can spread the virus for nine days — from four days before they develop spots until four days after, Stinchfield said.

Because the virus spreads through aerosols, it can infect people up to two hours after a sick person has left the room.

A fatal long-term complication

Although Emmalee was always tiny for her size — topping out at a weight of 39 pounds — she was otherwise healthy, Finkelstein-Parker said.

The first signs of serious illness occurred when Emmalee was 7 and began tripping over her feet, Finkelstein-Parker said. At first, her mother said she wondered if Emmalee’s new shoes were too big. The next day, Emmalee’s chin dropped onto her chest, as if she couldn’t hold up her head. While sitting in a chair, Emmalee listed to one side, without enough muscle control to remain upright.

A pediatrician at Children’s Hospital of Philadelphia who was trained in India quickly recognized the early signs of a devastating long-term complication of measles called subacute sclerosing panencephalitis, which is more common in countries where the virus remains endemic. The fatal condition can cause memory loss, irritability, disturbances in movement, seizures and blindness, and can develop six to eight years after a child has apparently recovered from measles. Although anti-seizure drugs can sometimes ease symptoms, they don’t cure the disease.

Recent research shows the complication is more common than previously believed, striking about 1 in 600 infants with measles.

Emmalee began having uncontrollable seizures. After four months, Emmalee slipped into a coma while at home, Finkelstein-Parker said.

“My father couldn’t understand why she wouldn’t wake up,” Finkelstein-Parker said. “He tried everything, including playing music from her favorite music box.”

Emmalee spent five weeks in home hospice, passing away five months after symptoms began, Finkelstein-Parker said.

After Emmalee died, Finkelstein-Parker took the goody bags to school as presents for her daughter’s classmates. The children, who were also grieving, shared their favorite stories about Emmalee, and made a hanging mobile decorated with drawings and notes.

“Their teacher said they needed closure,” Finkelstein-Parker said. “They handled that day a whole lot better than I did.”

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Health Canada approves updated Moderna COVID-19 vaccine

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TORONTO – Health Canada has authorized Moderna’s updated COVID-19 vaccine that protects against currently circulating variants of the virus.

The mRNA vaccine, called Spikevax, has been reformulated to target the KP.2 subvariant of Omicron.

It will replace the previous version of the vaccine that was released a year ago, which targeted the XBB.1.5 subvariant of Omicron.

Health Canada recently asked provinces and territories to get rid of their older COVID-19 vaccines to ensure the most current vaccine will be used during this fall’s respiratory virus season.

Health Canada is also reviewing two other updated COVID-19 vaccines but has not yet authorized them.

They are Pfizer’s Comirnaty, which is also an mRNA vaccine, as well as Novavax’s protein-based vaccine.

This report by The Canadian Press was first published Sept. 17, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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These people say they got listeria after drinking recalled plant-based milks

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TORONTO – Sanniah Jabeen holds a sonogram of the unborn baby she lost after contracting listeria last December. Beneath, it says “love at first sight.”

Jabeen says she believes she and her baby were poisoned by a listeria outbreak linked to some plant-based milks and wants answers. An investigation continues into the recall declared July 8 of several Silk and Great Value plant-based beverages.

“I don’t even have the words. I’m still processing that,” Jabeen says of her loss. She was 18 weeks pregnant when she went into preterm labour.

The first infection linked to the recall was traced back to August 2023. One year later on Aug. 12, 2024, the Public Health Agency of Canada said three people had died and 20 were infected.

The number of cases is likely much higher, says Lawrence Goodridge, Canada Research Chair in foodborne pathogen dynamics at the University of Guelph: “For every person known, generally speaking, there’s typically 20 to 25 or maybe 30 people that are unknown.”

The case count has remained unchanged over the last month, but the Public Health Agency of Canada says it won’t declare the outbreak over until early October because of listeria’s 70-day incubation period and the reporting delays that accompany it.

Danone Canada’s head of communications said in an email Wednesday that the company is still investigating the “root cause” of the outbreak, which has been linked to a production line at a Pickering, Ont., packaging facility.

Pregnant people, adults over 60, and those with weakened immune systems are most at risk of becoming sick with severe listeriosis. If the infection spreads to an unborn baby, Health Canada says it can cause miscarriage, stillbirth, premature birth or life-threatening illness in a newborn.

The Canadian Press spoke to 10 people, from the parents of a toddler to an 89-year-old senior, who say they became sick with listeria after drinking from cartons of plant-based milk stamped with the recalled product code. Here’s a look at some of their experiences.

Sanniah Jabeen, 32, Toronto

Jabeen says she regularly drank Silk oat and almond milk in smoothies while pregnant, and began vomiting seven times a day and shivering at night in December 2023. She had “the worst headache of (her) life” when she went to the emergency room on Dec. 15.

“I just wasn’t functioning like a normal human being,” Jabeen says.

Told she was dehydrated, Jabeen was given fluids and a blood test and sent home. Four days later, she returned to hospital.

“They told me that since you’re 18 weeks, there’s nothing you can do to save your baby,” says Jabeen, who moved to Toronto from Pakistan five years ago.

Jabeen later learned she had listeriosis and an autopsy revealed her baby was infected, too.

“It broke my heart to read that report because I was just imagining my baby drinking poisoned amniotic fluid inside of me. The womb is a place where your baby is supposed to be the safest,” Jabeen said.

Jabeen’s case is likely not included in PHAC’s count. Jabeen says she was called by Health Canada and asked what dairy and fresh produce she ate – foods more commonly associated with listeria – but not asked about plant-based beverages.

She’s pregnant again, and is due in several months. At first, she was scared to eat, not knowing what caused the infection during her last pregnancy.

“Ever since I learned about the almond, oat milk situation, I’ve been feeling a bit better knowing that it wasn’t something that I did. It was something else that caused it. It wasn’t my fault,” Jabeen said.

She’s since joined a proposed class action lawsuit launched by LPC Avocates against the manufacturers and sellers of Silk and Great Value plant-based beverages. The lawsuit has not yet been certified by a judge.

Natalie Grant and her seven year-old daughter, Bowmanville, Ont.

Natalie Grant says she was in a hospital waiting room when she saw a television news report about the recall. She wondered if the dark chocolate almond milk her daughter drank daily was contaminated.

She had brought the girl to hospital because she was vomiting every half hour, constantly on the toilet with diarrhea, and had severe pain in her abdomen.

“I’m definitely thinking that this is a pretty solid chance that she’s got listeria at this point because I knew she had all the symptoms,” Grant says of seeing the news report.

Once her daughter could hold fluids, they went home and Grant cross-checked the recalled product code – 7825 – with the one on her carton. They matched.

“I called the emerg and I said I’m pretty confident she’s been exposed,” Grant said. She was told to return to the hospital if her daughter’s symptoms worsened. An hour and a half later, her fever spiked, the vomiting returned, her face flushed and her energy plummeted.

Grant says they were sent to a hospital in Ajax, Ont. and stayed two weeks while her daughter received antibiotics four times a day until she was discharged July 23.

“Knowing that my little one was just so affected and how it affected us as a family alone, there’s a bitterness left behind,” Grant said. She’s also joined the proposed class action.

Thelma Feldman, 89, Toronto

Thelma Feldman says she regularly taught yoga to friends in her condo building before getting sickened by listeria on July 2. Now, she has a walker and her body aches. She has headaches and digestive problems.

“I’m kind of depressed,” she says.

“It’s caused me a lot of physical and emotional pain.”

Much of the early days of her illness are a blur. She knows she boarded an ambulance with profuse diarrhea on July 2 and spent five days at North York General Hospital. Afterwards, she remembers Health Canada officials entering her apartment and removing Silk almond milk from her fridge, and volunteers from a community organization giving her sponge baths.

“At my age, 89, I’m not a kid anymore and healing takes longer,” Feldman says.

“I don’t even feel like being with people. I just sit at home.”

Jasmine Jiles and three-year-old Max, Kahnawake Mohawk Territory, Que.

Jasmine Jiles says her three-year-old son Max came down with flu-like symptoms and cradled his ears in what she interpreted as a sign of pain, like the one pounding in her own head, around early July.

When Jiles heard about the recall soon after, she called Danone Canada, the plant-based milk manufacturer, to find out if their Silk coconut milk was in the contaminated batch. It was, she says.

“My son is very small, he’s very young, so I asked what we do in terms of overall monitoring and she said someone from the company would get in touch within 24 to 48 hours,” Jiles says from a First Nations reserve near Montreal.

“I never got a call back. I never got an email”

At home, her son’s fever broke after three days, but gas pains stuck with him, she says. It took a couple weeks for him to get back to normal.

“In hindsight, I should have taken him (to the hospital) but we just tried to see if we could nurse him at home because wait times are pretty extreme,” Jiles says, “and I don’t have child care at the moment.”

Joseph Desmond, 50, Sydney, N.S.

Joseph Desmond says he suffered a seizure and fell off his sofa on July 9. He went to the emergency room, where they ran an electroencephalogram (EEG) test, and then returned home. Within hours, he had a second seizure and went back to hospital.

His third seizure happened the next morning while walking to the nurse’s station.

In severe cases of listeriosis, bacteria can spread to the central nervous system and cause seizures, according to Health Canada.

“The last two months have really been a nightmare,” says Desmond, who has joined the proposed lawsuit.

When he returned home from the hospital, his daughter took a carton of Silk dark chocolate almond milk out of the fridge and asked if he had heard about the recall. By that point, Desmond says he was on his second two-litre carton after finishing the first in June.

“It was pretty scary. Terrifying. I honestly thought I was going to die.”

Cheryl McCombe, 63, Haliburton, Ont.

The morning after suffering a second episode of vomiting, feverish sweats and diarrhea in the middle of the night in early July, Cheryl McCombe scrolled through the news on her phone and came across the recall.

A few years earlier, McCombe says she started drinking plant-based milks because it seemed like a healthier choice to splash in her morning coffee. On June 30, she bought two cartons of Silk cashew almond milk.

“It was on the (recall) list. I thought, ‘Oh my God, I got listeria,’” McCombe says. She called her doctor’s office and visited an urgent care clinic hoping to get tested and confirm her suspicion, but she says, “I was basically shut down at the door.”

Public Health Ontario does not recommend listeria testing for infected individuals with mild symptoms unless they are at risk of developing severe illness, such as people who are immunocompromised, elderly, pregnant or newborn.

“No wonder they couldn’t connect the dots,” she adds, referencing that it took close to a year for public health officials to find the source of the outbreak.

“I am a woman in my 60s and sometimes these signs are of, you know, when you’re vomiting and things like that, it can be a sign in women of a bigger issue,” McCombe says. She was seeking confirmation that wasn’t the case.

Disappointed, with her stomach still feeling off, she says she decided to boost her gut health with probiotics. After a couple weeks she started to feel like herself.

But since then, McCombe says, “I’m back on Kawartha Dairy cream in my coffee.”

This report by The Canadian Press was first published Sept. 16, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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B.C. mayors seek ‘immediate action’ from federal government on mental health crisis

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VANCOUVER – Mayors and other leaders from several British Columbia communities say the provincial and federal governments need to take “immediate action” to tackle mental health and public safety issues that have reached crisis levels.

Vancouver Mayor Ken Sim says it’s become “abundantly clear” that mental health and addiction issues and public safety have caused crises that are “gripping” Vancouver, and he and other politicians, First Nations leaders and law enforcement officials are pleading for federal and provincial help.

In a letter to Prime Minister Justin Trudeau and Premier David Eby, mayors say there are “three critical fronts” that require action including “mandatory care” for people with severe mental health and addiction issues.

The letter says senior governments also need to bring in “meaningful bail reform” for repeat offenders, and the federal government must improve policing at Metro Vancouver ports to stop illicit drugs from coming in and stolen vehicles from being exported.

Sim says the “current system” has failed British Columbians, and the number of people dealing with severe mental health and addiction issues due to lack of proper care has “reached a critical point.”

Vancouver Police Chief Adam Palmer says repeat violent offenders are too often released on bail due to a “revolving door of justice,” and a new approach is needed to deal with mentally ill people who “pose a serious and immediate danger to themselves and others.”

This report by The Canadian Press was first published Sept. 16, 2024

The Canadian Press. All rights reserved.

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