(Reuters Health) – Pregnant air travelers face a higher risk of blood clots, but they can reduce their risks by walking airplane aisles, drinking water and doing calf exercises, according to a new review.
For women with additional risk, doctors may recommend compression stockings and injectable blood thinners while traveling, the authors write in the Journal of Travel Medicine.
“Both pregnancy and air travel are risk factors for venous thromboembolism, or a blood clot in the legs or lungs,” said senior author Dr. Leslie Skeith of the University of Calgary, a member of the CanVECTOR Canadian thrombosis research network.
Blood clots affect about one to two per 1,000 nonpregnant people each year and are the third leading cause of vascular death after heart attacks and strokes, the authors note. With more than two billion passengers flying each year, about 150,000 cases of travel-related blood clots are diagnosed annually.
Long-distance flights tend to increase the risk by three-fold, yet travel-related studies either don’t include pregnant women or only include a small number and don’t directly investigate how pregnancy increases the risk.
“There is very little evidence to guide what pregnant and postpartum women should do to prevent blood clots while traveling,” Skeith told Reuters Health by email.
Skeith and her colleagues review the many factors that play into an individual’s risk for a blood clot, including height, weight, recent surgery, pregnancy, use of oral contraceptives, hormone replacement therapy and a family history of clots or diseases that promote clotting.
With pregnancy in particular, they write, the risk is higher because of physiological changes, such as slower blood flow and blood vessel dilation. Pelvic blood vessels may also be compressed as the uterus grows. Starting in early pregnancy, the body starts to become hypercoagulable, or more likely to form blood clots. These risks remain higher until about 12 weeks after giving birth.
Although the average pregnant or postpartum air traveler faces an increased risk of clots, the absolute risk estimate is low at less than 1%, the study found.
Pregnant women with other risk factors, such as inherited blood problems, obesity and recent surgery, may face a higher blood clot risk, however. Although the risk depends on individual factors, women with a history of blood clots tend to have a 4% higher risk while pregnant, and those with hormonal-associated blood clots tend to have a 6% higher risk while pregnant.
For most women with a history of blood clots, the risk during air travel still remains low at just over 1%. At the same time, pregnant women who face these higher risks should consider using more extensive blood clot prevention measures while traveling, such as the injectable blood thinner low-molecular-weight heparin (LMWH).
“It is known that LMWH prophylaxis lowers the risk of recurrent thrombosis in women with previous venous thromboembolism,” said Dr. Ida Martinelli of the University of Milan, who wasn’t involved in the study.
However, some studies show that certain blood conditions and blood thinners can lead to complications during delivery, so it’s best to consult a doctor for individual recommendations.
Skeith and colleagues are now studying whether aspirin can prevent blood clots in postpartum women with risk factors for clots. The pilot randomized trial, called PARTUM, is expected to start in 2020.
“We desperately need more research to better prevent blood clots in pregnant and postpartum women,” Skeith said. “We recommend talking to your doctor about different options.”
SOURCE: https://bit.ly/34YV2cm Journal of Travel Medicine, online December 11, 2019.
DeMille Anticipates Broader Rollout Of 4th Dose Vaccination – Country 105
The Thunder Bay District Health Unit (TBDHU) is getting ready for the annual flu shot campaign, as well as a broader ask for arms to get the fourth dose of a COVID-19 vaccine.
The province expanded the second booster dose eligibility on April 7th to those who are 60 and over as well as First Nation, Inuit and Métis individuals and their non-Indigenous household members aged 18 and over.
“At this time, I’m not hearing any indication of the province opening up (eligibility) to the broader population, and I’m not sure really we would have evidence that would be needed at this time,” DeMille told Acadia News Monday. “We are much lower in terms of the amount of COVID-19 (cases) in the province of Ontario. With the summertime, we see overall less spread (of the virus).”
DeMille did mention that the District anticipates the call will get broader in the fall.
As of June 21st, 133,334 people within the TBDHU have received one dose of a COVID-19 vaccine and 80,719 have received three doses.
Officials have given fourth doses to 18,687 individuals as of the last update.
DeMille was also asked about a return to school in September, and what that might look like after Canada’s Chief Public Health Officer Dr. Theresa Tam told Federal MPs on June 8th that there is a real threat of the seventh wave of COVID-19.
The Medical Officer says it’s hard to look into the crystal ball and pinpoint what will happen based on the fact that right now a majority of the new infections are the Omicron variant.
“The schools overall did fairly well,” DeMille stated. “We know that a lot of people did get infected, which can cause a lot of disruption because people still need to isolate so that they are not spreading (the virus) to others. Likely a lot of spread happened in the schools when we re-opened in January and through the last few waves.”
DeMille noted that the schools took a lot of measures that helped in previous waves, including improving ventilation.
“I anticipate that (masking) will always be optional, but when the Omicron variant is spreading, it’s always helpful when people are masking in indoor spaces when they are interacting with others,” said DeMille. “(Down the road) we might recommend that people wear masks in schools, but that advice will really depend on what we see circulating, how much it is circulating and what the impact is on schools.”
DeMille mentioned whether it is the school, the workplace, or any other indoor space, the goal is to return to as normal as possible in an eventual post-pandemic world.
Monkeypox is not yet a global health emergency, says WHO – Global News
Monkeypox is not yet a global health emergency, the World Health Organization (WHO) ruled on Saturday, although WHO Director-General Tedros Adhanom Ghebreyesus said he was deeply concerned about the outbreak.
“I am deeply concerned about the monkeypox outbreak, this is clearly an evolving health threat that my colleagues and I in the WHO Secretariat are following extremely closely,” Tedros said.
The “global emergency” label currently only applies to the coronavirus pandemic and ongoing efforts to eradicate polio, and the U.N. agency has stepped back from applying it to the monkeypox outbreak after advice from a meeting of international experts.
There have been more than 3,200 confirmed cases of monkeypox and one death reported in the last six weeks from 48 countries where it does not usually spread, according to WHO.
So far this year almost 1,500 cases and 70 deaths in central Africa, where the disease is more common, have also been reported, chiefly in the Democratic Republic of Congo.
Monkeypox, a viral illness causing flu-like symptoms and skin lesions, has been spreading largely in men who have sex with men outside the countries where it is endemic.
It has two clades – the West African strain, which is believed to have a fatality rate of around 1% and which is the strain spreading in Europe and elsewhere, and the Congo Basin strain, which has a fatality rate closer to 10%, according to WHO.
More than half of Canadians confident in monkeypox response, but 55% worried about spread: poll
There are vaccines and treatments available for monkeypox, although they are in limited supply.
The WHO decision is likely to be met with some criticism from global health experts, who said ahead of the meeting that the outbreak met the criteria to be called an emergency.
However, others pointed out that the WHO is in a difficult position after COVID-19. Its January 2020 declaration that the new coronavirus represented a public health emergency was largely ignored by many governments until around six weeks later, when the agency used the word “pandemic” and countries took action.
(Reporting by Jennifer Rigby; additional reporting by Mrinmay Dey; Editing by Sandra Maler)
© 2022 Reuters
Kingston, Ont., area health officials examining future of local vaccination efforts – Global News
More than 455,000 people in the Kingston region have been vaccinated against COVID-19.
Now health officials say they’re using the summer months, with low infection rates, to look ahead to what fall might bring, urging those who are still eligible to get vaccinated do so.
“Large, mass immunization clinics, mobile clinics, drive-thru clinics and small primary care clinics doing their own vaccine,” said Brian Larkin with KFL&A Public Health.
Infectious disease expert Dr. Gerald Evans says those who are still eligible for a third and fourth dose should take advantage and roll up their sleeves during the low-infection summer months.
“Now in 2022, although you still might get COVID, you’re probably not going to be very sick. You are less likely to transmit and ultimately that’s one of the ways we’re going to control the pandemic,” added Evans.
He expects another wave of COVID-19 to hit in late October to early November and that a booster may be made available for those younger than 60 who still aren’t eligible for a fourth dose.
“The best case scenario is a few more years of watching rises in cases, getting boosters to control things and ultimately getting out of it with this being just another coronavirus that just tends to cause a respiratory infection and worst-case scenario is a new variant where all the potential possibilities exist to have a big surge in cases and hopefully not a lot more serious illness,” said Evans.
Public Health says they’re still waiting for direction from the province on what’s to come this fall.
“We’re expecting that we would see more age groups and younger age groups be eligible for more doses or boosters but about when those ages start, we have yet to have that confirmed,” said Larkin.
The last 18 months of vaccines paving the way for the new normal could mean a yearly COVID booster alongside the annual flu shot.
© 2022 Global News, a division of Corus Entertainment Inc.
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