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Nunavut baby in Edmonton hospital battling respiratory virus

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An infant from Kugluktuk, Nunavut, remains on a respirator in an Edmonton hospital weeks after she first developed a fever and cough.

Tanya Napayok, the mother of six-month-old Gemma, said her daughter is fighting RSV, respiratory syncytial virus, and another lung infection.

“She’s my fighting queen,” Napayok said, speaking from the Larga Edmonton patient residence.

Napayok has stayed by her baby’s side since early August, when Gemma first developed symptoms.

Then, “she just got worse,” Napayok said.

They were medevaced first to Yellowknife and, from there, to Edmonton for more intensive care.

Gemma, the six-month-old daughter of Tanya Napayok, is attached to various wires and a respirator in an Edmonton hospital where she is in intensive care for RSV. (Submitted by Tanya Napayok)

Fighting the two infections, Gemma needed to be on a respirator to help her breathe. That tube was removed recently, but was put back on because Gemma was still struggling.

Napayok’s mother is now in Edmonton with her baby but her two-year-old son, who also came down with a less-severe case of RSV, is waiting back home in Kugluktuk.

High RSV rates

Research has shown that Nunavut has among the highest rates of hospitalizations for RSV in the world.

Napayok’s two children were among 13 residents in Kugluktuk, a hamlet of roughly 1,600 people, who were diagnosed with the virus between the last week of July and beginning of August, said Dr. Michael Patterson, the chief medical officer of Nunavut.

“The number of individuals who contracted or were diagnosed with RSV was higher than what we typically see in August,” Patterson said.

This higher-than-usual number of infections could be due to improved testing for RSV or it could be a result of the relaxation of COVID-19 prevention measures in Nunavut, he said.

Nunavut Chief Public Health Officer Dr. Michael Patterson gives an update on public health measures on Jan. 13. (Steve Silva/CBC)

“We do recognize that the public health measures that we used as a response to COVID 19 also prevented a significant RSV spread for quite some time,” Patterson said.

“We know that when we relaxed measures in the spring, that could have contributed to the abnormal spread of RSV in the summer because we didn’t have any in the winter.”

Nunavut typically runs an immunization program throughout the RSV season, which generally lasts from November to April, but Patterson said the health department started to see RSV numbers increase in late April.

By mid-May, the numbers were “much more noticeable in much of the territory,” said Patterson.

That’s when the government decided to restart its immunization program “to protect young infants at highest risk of severe infection,” he said.

The program which typically provides up to five monthly doses of Palivizumab, better known as Synagis, throughout the RSV season, ended Aug. 15.

But Palivizumab was only earmarked for those at high risk.

Dr. Anna Banerji, an expert in Indigenous health, pediatrics and infectious disease at the University of Toronto’s Dalla Lana School of Public Health, has urged Palivizumab to be given to all Inuit babies.

Banerji studied respiratory infections in Inuit babies for decades, and found they occur 20 to 40 times as often as in non-Inuit, even when controlling for environmental factors.

Dr. Anna Banerji is an expert in Indigenous health, pediatrics and infectious disease at the University of Toronto’s Dalla Lana School of Public Health. (Michael Cooper/University of Toronto)

Banerji said even Inuit infants who are not high-risk have 10 times the rates of hospital admission with RSV compared to the high-risk infants, and the symptoms are often more severe.

In 2019, Banerji started an online petition, which now has more than 200,000 signatures, asking Patterson and the Nunavut government to expand the immunization program to all infants.

That hasn’t happened yet.

Banerji said the Kitikmeot region’s most westerly community, Kugluktuk, “is one of the worst regions (or perhaps is the worst) region as far as RSV” but that the community tends to get overlooked by the Nunavut Government.

Banerji appears to be in agreement on one point with Patterson — that “the public health measures from COVID also protected people from RSV.”

Patterson continues to still advise similar measures to keep RSV from spreading, by avoiding contact with others when they are sick.

Meanwhile, programs for new mothers and babies in Kugluktuk are now suspended.

“It makes sense if you have an infection that’s spreading in the community and know the highest risk is among infants, bringing mothers and infants together as a group, to me, [does] more harm than good,” Patterson said.

To limit the spread of RSV, Napayok has urged people back home in Kugluktuk not to gather for popular card games, to wash their hands and keep their homes clean.

“It’s heartbreaking to see babies so sick,” she said.

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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.

The Canadian Press. All rights reserved.

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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.

The Canadian Press. All rights reserved.

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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

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ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.

Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.

Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.

Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.

The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.

“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.

Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.

Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.

Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.

A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.

This report by The Canadian Press was first published Sept. 10, 2024.

The Canadian Press. All rights reserved.

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