Ontario health officials are investigating seven probable cases of severe acute hepatitis in children — including one child who was sent from CHEO to SickKids hospital in Toronto for urgent treatment last December — amid reports of clusters of cases in some parts of the world.
Officials say it is too soon to say whether there has been an increase in such cases in Canada.
“More information is needed to assess the situation and any potential risks to people in Canada,” Chief Public Health Officer Dr. Theresa Tam said in a tweet this week.
Both CHEO and SickKids are monitoring any cases of severe hepatitis of unknown origin. The seven reported this week meet the case definition and timing from Public Health Ontario for cases that require further investigation.
The World Health Organization reported this week that there are now 348 probable cases of acute hepatitis of unknown origin among children across five regions of the world. One hundred and sixty three of those cases are in the UK and the U.S. has said recently it was investigating 109 probable cases.
Spokesperson Jessamine Luck of SickKids in Toronto said the hospital treats children with severe acute hepatitis of unknown origin every year and it remains to be seen whether the cases between Oct. 1, 2021 and April 30, 2022 under investigation represent an increase compared to previous years or whether any will be confirmed to be caused by a “novel clinical entity”.
In Ottawa, spokesman Patrick Moore said the December case, one of the seven cases reported by SickKids, is CHEO’s only suspect case.
“CHEO experts continue to work with their colleagues across the province and around the world and will report any probable cases treated locally to Ontario’s public health authorities.”
Tam said those and other cases will be reviewed by health authorities and may become part of the national investigation into the global issue.
The issue has raised concern because of the severity of the illness and apparent clusters of cases in some parts of the world. Some children have required liver transplants and there is at least one reported death.
In the U.S., where there has been a cluster of such cases in Alabama, the Centers for Disease Control and Prevention is looking at a common virus, adenovirus, as a possible cause, but has not yet reached any conclusions. Some have criticized the CDC for not looking more closely at COVID-19 as a cause, given the phenomenon is occurring during an unprecedented global pandemic when many children are not eligible to be vaccinated.
Experts in Ontario say there are still plenty of questions to be answered about the cases, but there is no reason for parents to panic. The cases, while serious, are extremely rare and what has been seen in Ontario in recent months does not necessarily represent anything distinctive.
Dr. Alison McGeer, an infectious disease specialist at Sinai Health in Toronto, said the clusters of cases seen in Alabama and the number of cases seen in Scotland look distinctive from what has been seen in the rest of the world. She said the cases elsewhere are not “obviously so different from baseline” although information is evolving quickly.
“There is a lot of work to be done before we have a clear idea of what is actually happening in different places in the world,” she said.
“What I am hearing about Canada so far is there is nothing that stands out as different or unusual at the moment. That doesn’t mean we haven’t had cases, it just means if we have had cases it looks like a really small number.”
Although it is early in the investigations, she said there has been a lot of adenovirus activity in recent months.
McGeer also said it is too early to rule out a connection with COVID-19, although the illnesses are clearly not related to the vaccine because most of the children affected are too young to be vaccinated.
She said it could possibly be directly related to COVID-19, adding that there doesn’t appear to be much evidence so far that it has been a factor. But it could also be connected to the pandemic in that some viruses were largely suppressed during the pandemic because of public health measures and are coming back stronger as people increase contact.
University of Ottawa virologist Earl Brown agreed that the cause remains an open question, although adenovirus 41 has been found in many of the affected children.
He speculated that the link with COVID-19 could be that it sets the groundwork for worse disease from other infections, but said there are still too many unanswered questions to point to a cause.
Physicians, meanwhile, are being told to be on the lookout for patients with signs and symptoms of hepatitis, such as recent onset jaundice, dark urine or pale stool that require further testing.
MILWAUKEE (AP) — Whooping cough is at its highest level in a decade for this time of year, U.S. health officials reported Thursday.
There have been 18,506 cases of whooping cough reported so far, the Centers for Disease Control and Prevention said. That’s the most at this point in the year since 2014, when cases topped 21,800.
The increase is not unexpected — whooping cough peaks every three to five years, health experts said. And the numbers indicate a return to levels before the coronavirus pandemic, when whooping cough and other contagious illnesses plummeted.
Still, the tally has some state health officials concerned, including those in Wisconsin, where there have been about 1,000 cases so far this year, compared to a total of 51 last year.
Nationwide, CDC has reported that kindergarten vaccination rates dipped last year and vaccine exemptions are at an all-time high. Thursday, it released state figures, showing that about 86% of kindergartners in Wisconsin got the whooping cough vaccine, compared to more than 92% nationally.
Whooping cough, also called pertussis, usually starts out like a cold, with a runny nose and other common symptoms, before turning into a prolonged cough. It is treated with antibiotics. Whooping cough used to be very common until a vaccine was introduced in the 1950s, which is now part of routine childhood vaccinations. It is in a shot along with tetanus and diphtheria vaccines. The combo shot is recommended for adults every 10 years.
“They used to call it the 100-day cough because it literally lasts for 100 days,” said Joyce Knestrick, a family nurse practitioner in Wheeling, West Virginia.
Whooping cough is usually seen mostly in infants and young children, who can develop serious complications. That’s why the vaccine is recommended during pregnancy, to pass along protection to the newborn, and for those who spend a lot of time with infants.
But public health workers say outbreaks this year are hitting older kids and teens. In Pennsylvania, most outbreaks have been in middle school, high school and college settings, an official said. Nearly all the cases in Douglas County, Nebraska, are schoolkids and teens, said Justin Frederick, deputy director of the health department.
That includes his own teenage daughter.
“It’s a horrible disease. She still wakes up — after being treated with her antibiotics — in a panic because she’s coughing so much she can’t breathe,” he said.
It’s important to get tested and treated with antibiotics early, said Dr. Kris Bryant, who specializes in pediatric infectious diseases at Norton Children’s in Louisville, Kentucky. People exposed to the bacteria can also take antibiotics to stop the spread.
“Pertussis is worth preventing,” Bryant said. “The good news is that we have safe and effective vaccines.”
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AP data journalist Kasturi Pananjady contributed to this report.
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The Associated Press Health and Science Department receives support from the Robert Wood Johnson Foundation. The AP is solely responsible for all content.
The Canadian Press. All rights reserved.
How a sperm and egg fuse together has long been a mystery.
New research by scientists in Austria provides tantalizing clues, showing fertilization works like a lock and key across the animal kingdom, from fish to people.
“We discovered this mechanism that’s really fundamental across all vertebrates as far as we can tell,” said co-author Andrea Pauli at the Research Institute of Molecular Pathology in Vienna.
The team found that three proteins on the sperm join to form a sort of key that unlocks the egg, allowing the sperm to attach. Their findings, drawn from studies in zebrafish, mice, and human cells, show how this process has persisted over millions of years of evolution. Results were published Thursday in the journal Cell.
Scientists had previously known about two proteins, one on the surface of the sperm and another on the egg’s membrane. Working with international collaborators, Pauli’s lab used Google DeepMind’s artificial intelligence tool AlphaFold — whose developers were awarded a Nobel Prize earlier this month — to help them identify a new protein that allows the first molecular connection between sperm and egg. They also demonstrated how it functions in living things.
It wasn’t previously known how the proteins “worked together as a team in order to allow sperm and egg to recognize each other,” Pauli said.
Scientists still don’t know how the sperm actually gets inside the egg after it attaches and hope to delve into that next.
Eventually, Pauli said, such work could help other scientists understand infertility better or develop new birth control methods.
The work provides targets for the development of male contraceptives in particular, said David Greenstein, a genetics and cell biology expert at the University of Minnesota who was not involved in the study.
The latest study “also underscores the importance of this year’s Nobel Prize in chemistry,” he said in an email.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.
The Canadian Press. All rights reserved.
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