With a staggering global surge in dengue fever cases over the past years, health experts are warning Canadian travellers about the risks when journeying to warmer climates, including popular destinations in the southern United States.
Over the last 20 years, there has been a tenfold surge in dengue fever cases globally, according to the World Health Organization (WHO). The number of reported infections, which are transmitted to humans from mosquitoes, increased dramatically from 500,000 in the year 2000 to 5.2 million in 2019.
And with a warming climate, Michael Libman, a specialist in infectious disease and a professor at McGill University, cautions that there could be a continued rise in cases, particularly in warmer regions popular among Canadians seeking refuge during the winter.
“People have to be aware that when they go to any part of the world that’s warm, there is pretty much some risk of picking up a disease like dengue,” Libman said.
“Canadians love to leave Canada in the winter and go to places that are warmer, and almost all of those places have mosquitoes.”
The warning comes after European climate agency Copernicus on Tuesday said in its annual report that 2023 was the hottest year on record. Last year, the global average temperature was 14.98 C — the highest ever recorded since data collection began in 1850. The previous warmest year was 2016, when the average temperature recorded globally was 14.81 C.
The report also found that July and August 2023 were the hottest months ever recorded globally.
The dengue virus is not present in mosquitoes in Canada, but Libman warned that ongoing global warming, attributed to climate change, creates favourable conditions for mosquitoes that carry the virus.
“The risk of dengue does seem to be going up (in tropical regions), and climate change seems to be playing a role in this, which is very important because climate change doesn’t seem to be going away anytime soon,” he said. “I think the risk is increasing and people probably need to be a little bit more cautious.”
What is dengue fever?
Dengue is a disease spread to humans by female mosquito bites and can cause severe flu-like symptoms and in severe cases can be fatal, according to the Canadian government.
The disease is commonly found in tropical and subtropical parts of the world, like Africa, Central and South America, the Caribbean, the Eastern Mediterranean, South and Southeast Asia.
“We’re most concerned about the fact that areas like the southern United States and Europe, as they get warmer and warmer each year, we are seeing that the kinds of mosquitoes that are able to carry dengue are being found more and more in those areas,” Libman said.
The symptoms of dengue fever typically include a sudden onset of high fever, severe headache, pain behind the eyes, joint and muscle pain, rash and mild bleeding. In some cases, dengue infection can progress to a more severe form known as dengue hemorrhagic fever or dengue shock syndrome, which can be life-threatening. It presents more severe symptoms such as persistent vomiting and difficulty breathing.
But most people who get infected have little or no symptoms, he said. And a very small portion who “get very sick” may develop fatal complications, he said. People can get tested for the virus if they have it.
“The thing about dengue, there’s nothing that will tell you automatically, ‘Oh, I’ve got dengue.’ The main thing … is just fever,” he explained. “Some people describe it as having an achy general malaise that they feel like a bus hit them. But not everybody gets sick.”
There are currently no treatment options for dengue.
A hotter planet means more dengue fever
The current El Niño cycle, which causes increased humidity and rainfall, has contributed to the proliferation of mosquitoes and dengue cases, Libman said.
However, he added that another, more worrisome reason is climate change.
“Over the last decades, climate change itself made more parts of the world more hospitable to mosquitoes,” he warned.
“We’re seeing dengue is going up in many parts of the world and appearing pretty regularly in parts of the world that didn’t used to have dengue at all because they weren’t really that hospitable to this type of mosquito.”
Are there travel advisories related to dengue?
The Canadian government does not have a travel advisory in place for dengue fever, but states on its website that “all travellers are at risk in areas where dengue occurs.”
The risk is also higher during the daytime, particularly around sunrise and sunset. Mosquitoes can transmit dengue even in shady areas, when it is overcast, or if you are indoors, it warned.
Unlike malaria, which is very regional to certain parts of the world, Libman explained that dengue is spread throughout the entire globe — mainly in warmer places that have mosquitoes.
“There’s no particular travel advisory because there’s no one area of the world where it’s really much more of a risk than another part of the world,” he explained. “Dengue is present where mosquito control is maybe not that good.”
How to stay safe
Although there are some vaccines available in parts of the world that are endemic to dengue as Thailand, Libman said that currently there are not any available for Canadians.
Several emerging options are in the development pipeline, including one vaccine that is currently undergoing Health Canada’s review, he said. It is anticipated this may potentially be on the market by the end of 2024.
In the meantime, it is all about prevention methods when staying safe in tropical and subtropical regions.
“Dengue is mostly a question of protecting yourself from mosquito bites,” Libman said.
He recommended using mosquito repellants, wearing long clothing, staying in air-conditioned or screened accommodations, and avoiding areas with standing water.
“If you happen to be living in an area where there’s no air conditioning and there’s no screening, then you want to be using mosquito nets around your bed,” Libman recommended.
“But that’s kind of all we have for the moment,” he said. “We are looking forward to having vaccines that are reasonably effective. But for the moment, we don’t have that yet.”
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.
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.
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