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Rapid tests deployed to curb growing syphilis outbreak in N.W.T. – CBC.ca

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Public health officials in the N.W.T. are rolling out a limited supply of rapid syphilis tests to try and bring a growing outbreak of the disease under control and to prevent it from being passed on to babies. 

Dr. Kami Kandola, the territory’s public health officer, said syphilis rates have “far exceeded” what they were when she declared an outbreak in 2019. There were 98 cases in 2021 she said, and 47 cases within the first three months of this year. 

The Public Health Agency of Canada says infectious syphilis rates have gone up substantially across the country over the past decade, and many outbreaks have been reported in the past five years.

The sexually transmitted disease can first appear as painless open sores usually in the genital area and can be cured with antibiotics. Left untreated, the infection can lead to permanent neurological issues and death. 

Kelly Fredericks, a nurse at the Frame Lake Clinic in Yellowknife, draws blood from Kristan Boucher, a public health nurse, during a training session on how to use the rapid syphilis testing kits on Tuesday. (Liny Lamberink/CBC)

It can also cause severe health problems in newborns when passed on from pregnant women to their babies — which is why Kandola said catching the infection during prenatal care is her highest priority. 

“If a baby is born with congenital syphilis, that’s a lifetime of heartache and pain,” she said during a media briefing Tuesday, noting the majority of cases in the N.W.T. are in residents who can have children. 

So far, only two babies have been diagnosed with congenital syphilis in the N.W.T. said Kandola.

Dr. Ameeta Singh is an infectious disease specialist in Alberta, the only other jurisdiction where the rapid tests have been used in Canada. She came to help train N.W.T. nurses how to do the tests, and said congenital syphilis in an infant can cause the liver or spleen to be too big, severe anemia, a “very nasty, shedding” rash, and death. 

Dr. Ameeta Singh, an infectious disease specialist in Alberta, came to help train N.W.T. nurses how to do the tests. (Liny Lamberink/CBC)

Singh oversaw a 19-month clinical trial which used a rapid test that detects syphilis and HIV on 1,500 participants in Alberta with more than 90 per cent accuracy. Singh calls the tests a game changer, but they still need Health Canada approval — she expects that’ll come by the end of the year — which means the N.W.T. needed special approval for 1,100 of them. 

It’s better than none, said Kandola, but she expects they’ll be “swallowed up very quickly” and is hoping for more. 

Kandola said syphilis rates in the N.W.T. grew by more than 1,100 per cent in women and 484 per cent in men between 2018 and 2021, and she wants to test as many people as possible in a short period of time. The rates are highest in the Dehcho, the Yellowknife region and Hay River, followed by Fort Smith and the Sahtu region, she said. 

The Northwest Territories Health and Social Services Authority (NTHSSA) is still in the process of procuring the 1,100 tests from Biolytical Laboratories, said Kandola, and she hopes they’ll arrive in the coming weeks. 

The test involves pricking a person’s finger, drawing blood, mixing it in a series of solutions and putting a few drops in a plastic sample collector that’ll deliver results within 15 minutes.

The test involves pricking a person’s finger, drawing blood, mixing it in a series of liquids and putting a few drops in a plastic sample collector that’ll deliver results with a pattern of circles in 15 minutes. (Liny Lamberink/CBC)

The quick results will allow health-care staff to immediately start tracing the contacts of a person who tests positive. Without the rapid test, Kandola said it can take days to get results from a lab. She estimates they’ve lost contact with five per cent of patients during the followup process. 

Stephanie Gilbert, a territorial public health specialist for the health authority who will lead the rollout, said the tests will be used in places with the highest risk of syphilis infection. 

The rollout plan is still in the development stages and will be tailored to individual communities, she said. 

“There is no cookie cutter approach to surveillance and contact tracing. If there was, we wouldn’t have outbreaks across the country,” said Gilbert.

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Whooping cough is at a decade-high level in US

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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.

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Scientists show how sperm and egg come together like a key in a lock

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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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Older patients, non-English speakers more likely to be harmed in hospital: report

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Patients who are older, don’t speak English, and don’t have a high school education are more likely to experience harm during a hospital stay in Canada, according to new research.

The Canadian Institute for Health Information measured preventableharmful events from 2023 to 2024, such as bed sores and medication errors,experienced by patients who received acute care in hospital.

The research published Thursday shows patients who don’t speak English or French are 30 per cent more likely to experience harm. Patients without a high school education are 20 per cent more likely to endure harm compared to those with higher education levels.

The report also found that patients 85 and older are five times more likely to experience harm during a hospital stay compared to those under 20.

“The goal of this report is to get folks thinking about equity as being a key dimension of the patient safety effort within a hospital,” says Dana Riley, an author of the report and a program lead on CIHI’s population health team.

When a health-care provider and a patient don’t speak the same language, that can result in the administration of a wrong test or procedure, research shows. Similarly, Riley says a lower level of education is associated with a lower level of health literacy, which can result in increased vulnerability to communication errors.

“It’s fairly costly to the patient and it’s costly to the system,” says Riley, noting the average hospital stay for a patient who experiences harm is four times more expensive than the cost of a hospital stay without a harmful event – $42,558 compared to $9,072.

“I think there are a variety of different reasons why we might start to think about patient safety, think about equity, as key interconnected dimensions of health-care quality,” says Riley.

The analysis doesn’t include data on racialized patients because Riley says pan-Canadian data was not available for their research. Data from Quebec and some mental health patients was also excluded due to differences in data collection.

Efforts to reduce patient injuries at one Ontario hospital network appears to have resulted in less harm. Patient falls at Mackenzie Health causing injury are down 40 per cent, pressure injuries have decreased 51 per cent, and central line-associated bloodstream infections, such as IV therapy, have been reduced 34 per cent.

The hospital created a “zero harm” plan in 2019 to reduce errors after a hospital survey revealed low safety scores. They integrated principles used in aviation and nuclear industries, which prioritize safety in complex high-risk environments.

“The premise is first driven by a cultural shift where people feel comfortable actually calling out these events,” says Mackenzie Health President and Chief Executive Officer Altaf Stationwala.

They introduced harm reduction training and daily meetings to discuss risks in the hospital. Mackenzie partnered with virtual interpreters that speak 240 languages and understand medical jargon. Geriatric care nurses serve the nearly 70 per cent of patients over the age of 75, and staff are encouraged to communicate as frequently as possible, and in plain language, says Stationwala.

“What we do in health care is we take control away from patients and families, and what we know is we need to empower patients and families and that ultimately results in better health care.”

This report by The Canadian Press was first published Oct. 17, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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