Public health authorities are investigating 17 suspected cases of monkeypox in the Montreal area. It is the only known outbreak in Canada of the rare disease, which can cause painful pustules and scabs to break out. Recent outbreaks have been reported in Europe and the United States.
Montreal public health director Dr. Mylène Drouin said authorities will put protective measures in place, but stressed that all cases so far have been minor and there is no cause for alarm.
“We do not have to panic at this time. It’s not something that is going to go to sustained community transmission,” she said at a hastily organized news conference Thursday, the day after Radio-Canada reported there were several suspected cases in the city.
“It’s not something you can acquire if you go to the grocery store or go on public transportation.”
The disease is spread primarily through close, sustained contact, which includes but is not limited to sexual contact, Drouin said. Contacts considered at risk are those who live in the same household with an infected person, or who have had sexual relations with someone who has had the disease.
To date, 15 suspected cases have been identified in Montreal, as well as one on the South Shore and one on the North Shore. The infected are mainly men who had sexual relations with other men, between the ages of 30 and 55.
Drouin stressed that monkeypox is not a sexually transmitted disease and warned against stigmatizing a particular segment of the community, as anyone can catch the virus.
The first cases were declared on May 12 from clinics specializing in sexually transmitted diseases. The cases were initially thought to be chancroid, a rare sexually transmitted disease that causes painful genital ulcers.
It wasn’t until Tuesday, when authorities learned of a suspected case from the United States who had travelled to Montreal, that monkeypox was suspected. Several of the cases in Montreal have been linked to a traveller who came from Boston.
Montreal’s cases have not yet been confirmed by a laboratory, but Drouin said recent outbreaks in Europe and a case reported in the United States suggest they are likely cases of the virus.
Monkeypox is typically limited to Africa, and rare cases in the United States and elsewhere are usually linked to travel there. A small number of confirmed or suspected cases have been reported this month in the United Kingdom, Portugal and Spain.
Drouin said the disease is transmitted by close contact and droplets.
Monkeypox typically begins with such symptoms as fever, headache, backache and fatigue, then progresses to a rash on the face and body. The Public Health Agency of Canada says the swelling or enlargement of lymph nodes that accompanies monkeypox distinguishes it from smallpox.
The incubation period is seven to 17 days and most infections of monkeypox last two to four weeks, the agency says. Montreal officials said there is no treatment at this time.
The first symptoms of the disease that were identified in Montreal have been traced back to April 29. People who have been in contact with a suspected case will not have to isolate, but they are asked to monitor for symptoms and go to a doctor if they suspect they have contracted the disease. Health workers in contact with possible cases are advised to wear full protective gear, including a gown, N95 mask and gloves.
The Public Health Agency of Canada notes that the smallpox vaccine, which was routinely administered to Canadians born before 1972, protects against monkeypox. Smallpox was eradicated in 1977.
Some people who have been in contact with cases in the U.K. have received a smallpox vaccine as protection. Drouin said the decision on whether similar actions will be taken here depend on availability of the vaccine, and will be decided on a provincial and federal level.
The Massachusetts Department of Public Health reported Wednesday that it had confirmed the first U.S. case of monkeypox virus infection of 2022. The individual is an adult male who recently travelled to Canada. The agency didn’t indicate what province or provinces he visited and did not respond to questions.
This story will be updated.
Feeling vexed by long COVID? Treatment may soon be available – North Shore News
Grace Parraga’s phone has been ringing off the hook since Tuesday with calls from long COVID patients from across Canada, the U.S. and the U.K.
Parraga is the lead researcher of a new study that’s identified a minuscule abnormality in the lungs of long COVID patients that can contribute to the prolonged breathing difficulty they may experience post-infection.
Following the announcement of their findings, Parraga said people have been reaching out to her, excitedly seeking further clarification on their long COVID symptoms. Parraga, a professor at Western University’s Schulich School of Medicine and Dentistry and Tier 1 Canada Research Chair in Lung Imaging, said the response has been very humbling.
“We do this as scientists with the hope of helping people,” she said.
Human lungs, the organ under examination in this research, pack 2,400 kilometres of airways within them, Parraga explained. Stretched out across Canada, those airways would be long enough to start in Vancouver and reach all the way to Thunder Bay.
“That’s what’s packed inside of you to allow you to live,” Parraga said.
At the end of those airways are 500 million air sacs. When you inhale, oxygen moves into those tiny air sacs and hops onto your red blood cells. As you exhale, carbon dioxide hops off of those cells and is sent out of your body.
Using a very high spatial resolution MRI method, the research team was able to measure the function at the tip of those 500 million air sacs.
What they found, is an abnormally low red blood cell signal in the lungs of these long COVID patients that’s affecting their ability to breathe.
Parraga said it’s likely the lungs’ blood vessel tree is blocked by tiny, microscopic clots.
“That’s something that you can’t see with chest X-rays or CT scans, or any other method,” she said.
The study was conducted at five centres across Ontario that house this specific MRI technology and observed 34 long COVID patients.
Parraga said her team is now focusing on translating their work to other centres across Canada that also have this technology, such as BC Children’s Hospital and St. Paul’s Hospital in Vancouver.
Until now, Parraga said long COVID has been a vexing infection to have. Standard clinical tests are unable to pick up on this tiny piece of evidence that indicates something is wrong.
“Folks [with long COVID] look normal. The chest X-ray looks normal, the CT scan looks normal,” she said.
“This is the first evidence that something is not normal.”
The study’s findings serve as a relief, Parraga said. As researchers, she said it’s encouraging to find something that they understand and is consistent with their previous understanding of lung infections.
“If you’re not feeling well, you can’t walk to the mailbox and think straight, you do start to wonder if it’s in your head,” she said. “I think that physicians were concerned and that really started us on this hunt.”
Parraga said she thinks the study is providing people with hope, knowing that this abnormality is something physicians can understand and treat.
Next steps: treatment
The discovery is only the first step in the journey to treating long COVID patients experiencing difficulty breathing. Following the release of the study, Parraga said her focus is now shifting to determine the why and how factors of the infection.
“We’ve identified the what, the where, and the when. [Now], the clinical folks are going to be using that information to target treatments,” she said.
Parraga said she plans to continue following the study’s participants “for as long as they want to come to the lab.” With their participation, she hopes to answer questions such as why certain people are susceptible to long COVID and what’s going to happen to these patients in the long term.
In the meantime, Parraga and her team are taking a moment to reflect upon their success in a unique way, after sharing their results with the study’s participants.
“We created a word cloud from their emails back to us… [with] words like understanding, thank you, congratulations, thoughtful,” she said. “It was very humbling and fulfilling to see that.”
“That’s why we do this. To help people.”
COVID-19 boosters recommended for the fall, Canada's vaccine advisory body says – CBC News
People at high risk of severe disease from COVID-19 infection should be offered a booster shot this fall, regardless of how many boosters they’ve previously received, the National Advisory Committee on Immunization (NACI) said on Wednesday.
That group includes everyone age 65 and older, NACI’s updated guidance said.
Everyone else — age 12 to 64 — “may be offered” the additional doses in the fall, NACI said.
NACI said it will provide recommendations on the type of booster to be given when evidence about multivalent vaccines — which prime the body’s defences against multiple variants, including Omicron and its subvariants — becomes available.
“Manufacturers are working on new COVID-19 vaccines, including multivalent vaccines and vaccines specifically targeting VOCs [variants of concern], although their exact characteristics and timing of availability in Canada are not yet known,” NACI said.
World Health Organization Director General Tedros Adhanom Ghebreyesus said in a statement on Wednesday that Omicron subvariants BA.4 and BA.5 have caused COVID-19 case numbers to rise in 110 countries, “causing overall global cases to increase by 20 per cent.”
Dr. Theresa Tam, Canada’s chief public health officer, has also said those Omicron subvariants appear to be on the rise in this country.
2/3 However, some areas are reporting increases in some of these activity indicators. At the same time, the overall proportion of BA.4 and BA.5 among sequenced <a href=”https://twitter.com/hashtag/COVID19?src=hash&ref_src=twsrc%5Etfw”>#COVID19</a> variants is increasing as we continue to closely monitor circulating viruses.
On Tuesday, advisers to the U.S. Food and Drug Administration recommended that the next wave in COVID-19 booster shots should include a component that targets Omicron to combat the more recently circulating subvariants.
NACI recommended that booster shots happen in the fall because, as with other respiratory viruses, “incidence of COVID-19 may increase in the later fall and winter seasons,” and new variants of concern could emerge.
In addition to those 65 years and older, NACI strongly recommends a fall booster for:
- Long-term care residents.
- People with underlying medical conditions, including cardiac disease, diabetes, cancer and kidney disease.
- People who are immunocompromised.
- People who are pregnant.
- Adults who are disproportionately affected by COVID-19 (including racialized communities).
- Adults who are marginalized (including people with disabilities).
- Adults from First Nations, Inuit and Métis communities.
- Residents of congregate living settings, including group homes, shelters, correctional facilities and quarters for migrant workers.
Health officials emphasize that three doses of the current approved vaccines continue to provide good protection against severe COVID-19 illness, hospitalization and death.
Quebec COVID-19 hospitalizations rising as new variants gaining ground
MONTREAL — Quebec is seeing an increase in COVID-19 cases and hospitalizations driven by new Omicron subvariants that account for about 75 per cent of infections, the province’s public health director said Wednesday.
Dr. Luc Boileau said the subvariants, such as BA2.12.1, BA.5 and BA.4, appear to be more transmissible than previous strains but not necessarily more severe. The rise in cases was “expected,” though it came earlier than authorities had thought, he said, adding that the number of new infections should continue to rise in the coming days or weeks before declining.
Boileau said the province doesn’t plan on reimposing any broad-level public health restrictions, but he recommended that people who are over 65 or medically vulnerable take precautions such as wearing a mask. He was firm in his advice against a new provincewide masking order, insisting that such a measure was not “realistic” or necessary at this point.
“We’re not at all on a path to reimpose population-level measures such as mask-wearing, or other measures that needed to be taken in the last two years,” he said.
“We’re not there, and we’re not heading in that direction with the current variants.”
He said people who are over the age of 60, who are immunocompromised or who have chronic illnesses should seek a second booster shot if they haven’t had one or if their last shot was more than three months ago. As well, he said those who want to wear masks should be “encouraged” to do so, especially in crowded places.
His update came as COVID-19 hospitalizations rose by 34 in the previous 24 hours, after a 113-patient rise the day before. There were 1,260 people in hospital with COVID-19 in Quebec, including 35 in intensive care. Health officials also reported four more deaths associated with the novel coronavirus.
Dr. Don Vinh of the McGill University Health Centre says Quebec is facing a “perfect storm” of factors that include the emergence of new variants, waning immunity from vaccination or previous infection, and the removal of public health restrictions.
The new Omicron subvariants BA.4 and BA.5, he said in an interview Tuesday, appear to be gaining ground and finding vulnerable people to infect, especially since the mutations seem to be better able to evade immunity compared with previous strains.
“You put the two together, the new variants and waning immunity from either infection, immunization or a hybrid, and what happens is you have a renewed pool of susceptible people with an emerging variant,” he said.
The rise in hospitalizations, he added, comes at a time when the health system is least prepared to handle it.
Hospital workers at “all levels” are overwhelmed, he said, from paramedics and ambulance drivers to ER staff and the community and home care workers who need to be present to care for frail people leaving hospital.
COVID-19 is also putting increased pressure on the system by forcing sick health-care workers to stay home at a time when they’re most needed, he said. “This a catastrophic, systemic failure being unmasked and perhaps even exacerbated by unmitigated community transmission.”
On Wednesday, Boileau said he was concerned with the impact the increase in cases will have on the system, adding that authorities were working with hospitals to readjust services when necessary. He said, however, that he didn’t expect the new rise in cases to get “very, very high” and that the numbers should begin to decline in the next few weeks.
This report by The Canadian Press was first published June 29, 2022.
Morgan Lowrie, The Canadian Press
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