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Measles spreading in Ontario, Quebec with cases of unknown origin

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Luc Boileau, Quebec director of National Public Health during a news conference on the COVID-19 pandemic, in Quebec City, on Nov. 3, 2022.Jacques Boissinot/The Canadian Press

Community transmission of measles may be occurring in at least two provinces, a development that could have significant public-health ramifications. Health officials in both Ontario and Quebec said this week they had confirmed cases with no links to international travel or people infected with the virus.

Quebec’s health director, Luc Boileau, said in a notice to health professionals Thursday he is concerned the virus is spreading in the community after officials identified a case of measles in an individual in Laval, a Montreal suburb, who does not know how the infection occurred.

Also on Thursday, health officials in York region, in the Greater Toronto Area, said they had identified a case in a male in his 30s with no known exposure.

Measles is no longer endemic in Canada, meaning the virus is typically introduced through international travel. The fact these individuals don’t know how they got sick “implies that there are additional cases of measles that haven’t been detected or diagnosed,” said Danny Chen, physician lead of infection prevention and control at Mackenzie Health, based in York region.

Last month, the country’s Chief Public Health Officer, Theresa Tam, issued a statement in advance of March break saying she is concerned that an uptick in measles cases around the world combined with lower vaccination rates in Canada could result in transmission of the virus in communities here.

Nearly a dozen cases of measles have been confirmed in Canada so far this year, compared with 12 during all of 2023. Earlier this week, officials in Ontario’s Brant County confirmed a case of measles in a Brantford-area child who recently returned from Europe.

Information released by the Brant County Health Unit seems to indicate the child was taken directly to the Brantford General Hospital’s emergency department from Toronto’s Pearson International Airport on Feb. 23, followed early the next morning by a trip to the emergency department at McMaster Children’s Hospital in Hamilton. Anyone who was on the child’s flight from London’s Heathrow Airport, or in either emergency rooms at the same time, could have been exposed to the virus.

Hospitals typically have processes in place to isolate individuals who may be infected with measles or another communicable virus, Dr. Chen said. But it can be challenging to identify measles early on, as the virus’s trademark rash typically doesn’t appear until a few days after the onset of illness.

Measles is one of the most contagious viruses in existence. Almost everyone who comes into contact with it will get sick as a result if they aren’t vaccinated or don’t have prior exposure. Complications can be severe. About one in five people will require hospital admission, Dr. Chen said, while one in 10 will develop a complicating infection, such as pneumonia. About one in 1,000 will experience encephalitis, a dangerous swelling of the brain that can lead to deafness, blindness or intellectual disability.

To keep the virus at bay in a community, 95 per cent of people need to have received two doses of the measles, mumps and rubella vaccine. While Canada doesn’t have a national vaccine registry, the data that are available point to significant declines in MMR vaccination rates since the pandemic.

For example, as of 2022, only 74 per cent of children in Alberta had received two doses of the MMR vaccine by age seven, a decrease from 80 per cent in 2019, according to a provincial database.

People who are pregnant, those with compromised immune systems, and children under 5, particularly babies, face heightened risks of complications.

 

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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

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Canada to donate up to 200,000 vaccine doses to combat mpox outbreaks in Africa

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The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.

It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.

Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”

Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.

Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.

A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.

On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.

Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”

But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”

“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.

Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.

Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.

Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.

“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.

“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”

This report by The Canadian Press was first published Sept. 13, 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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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

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HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.

The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.

Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.

“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”

The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.

A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.

Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.

“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.

Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.

The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.

“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.

This report by The Canadian Press was first published Sept. 11, 2024.

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