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Sask. Health Authority declares syphilis outbreak – Prince Albert Daily Herald

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Dr. Khami Chokani, a medical health officer in Prince Albert for the SHA, speaks to media on Dec. 19, 2019. (Jayda Noyes/Daily Herald)

The Saskatchewan
Health Authority (SHA) has declared a syphilis outbreak in
north-central Saskatchewan, including in the Prince Albert area.

According to a press
release issued Thursday, an outbreak has been declared for the area
that includes Prince Abert, Big River, Shellbrook, Spiritwood, Birch
Hills, Christopher lake and surrounding communities. Syphilis is a
sexually-transmitted infection (STI) spread from person to person
through direct contact with a syphilis sore.

The outbreak was
declared because, in the four months from August to November, 21
cases were confirmed. The average number of annual cases in the
region is seven or fewer.

“That has prompted
us to declare an outbreak so that we can pull our resources together
(and) work together with other health care professionals,” said Dr.
Khami Chokani, medical health officer Prince Albert with the SHA.

The aim, he said, is
to investigate why the outbreak has occurred and identify what gaps
might exist or challenges people might be facing.

“We want people to
be safe,” he said.

“It is primarily
spread through person-to-person contact. It is also spread from the
mother to an unborn baby. That is what is driving us more than
anything else because the age group that is predominately affected is
that reproductive age group. It puts… our unborn population at
risk.”

The outbreak is the
third declared in Saskatchewan this year. One was declared int the
North Battleford-Lloydminster area in June, and Indigenous Services
Canada reported 83 new cases across the province’s 82 Indigenous
communities this year, a 2,000 per cent increase since 2017.

The local outbreak
has hit people of all ages, from 25 right up to 65, Chokani said.

“It’s a whole
spectrum. It’s hitting anybody who is sexually active.”

One thing many of
the cases here and elsewhere have in common is it is increasing in
young people and women of child-bearing age having unprotected sex
with multiple partners.

According to a
report from the Saskatoon StarPhoenix from just one week ago, 43 per
cent of syphilis cases this year were women, compared to just seven
per cent in 2017.

The leading risk
factor in new cases in the province is a previous STI. But Dr.
Ibrahim Khan

said he’s worried
by a newer trend driving syphilis infections: sex fuelled by crystal
meth.

“We also saw
crystal meth play a role,” Khan said. “When you use meth, you
usually aren’t too worried about using a condom.”

Some of those trends
are playing out in Prince Albert too.

Chokani said that in
over 90 per cent of cases, the person infected did not use a condom.
About 46 per cent had been using a drug.

“We do know that
some drugs — the side effect is inhibitions are lowered,” he
said.

“We’re going to be
doing a look back. Us having an outbreak will allow us to investigate
what has been going on and what has caused this. Because we just
don’t go from six cases in a year to 21 in four months.”

Saskatchewan’s
outbreak follows similar trends across Canada and in the United
States. The Public Health Agency of Canada estimates syphilis rates
in Alberta, for example, increased by more than 800 per cent this
year.

It’s also not the
only STI on the rise; rates of gonorrhea in Saskatchewan have
increased by more than 80 per cent since 2016. In the 2017-18 federal
budget, $4.3 million was allotted to fight the spread of STIs in
Saskatchewan.

Heather Hale,
executive director of Saskatoon Sexual Health, said the silver lining
of the rising figures is that more people are getting tested and
catching the illness early. Her centre has seen a 72 per cent
increase in the number of tests conducted compared to the same period
last year.

“If you’re doing
more testing, that usually means you’re going to have more
incidents,” Hale said.

For people at risk,
the best step is to seek medical advice — either from a local
physician or any sexual health clinic.

Getting tested is
important, Chokani said, as for many people, Syphilis can be
asymptomatic.

“It can remain
like that for decades and only reappear several decades later. A
feature of infectious syphilis is a sore, and it is painless and
disappears in seven to ten days whether you put treatment on it or
not,” he said

“Because it
disappears does not mean you don’t have an infection. now the
infection has the opportunity to spread and stay within your body.”

Chokani said a
frustration is that even when people do get tested, they sometimes
aren’t available for a follow-up. Tracking down people who have
gotten tested has also reportedly been difficult in other
jurisdictions.

Syphilis is
treatable, Chokani said, but you have to know you have it. The
testing is a simple blood test, and treatment is a pair of
injections. It can take 21 days after treatment to be cured of the
infection.

He added that the
health authority estimates that each positive case had at least four
other contacts, meaning the current 21 cases could have impacted as
many as 84 people.

“Voila – that is a
challenge. When you go see your family physician or nurse
practitioner, give them some contact information you know you can be
gotten ahold of at because it’s really, really important,” he said.

Chokani believes
part of the reason it can be so hard to track people down is because
they don’t want to know their results.

“Even when they’re given their results, they’re not coming back for their treatment,” Chokani said.

“We’re not saying don’t have sex, have it, but be safe take all the precautions that are necessary for you to be safe.”

“We are humans, it is difficult to expect that people will always be abstinent. but what we can ask is people always be safe. if there is a doubt, a question, go get yourself tested. There’s nothing better than knowing what it is and getting yourself treated. When you have it treated, great, you’re good to go.”

— With Daily Herald files from Jayda Noyes and StarPhoenix files from Zak Vescera

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Transplant programs reviewing policy on recipients being vaccinated against COVID-19 – Squamish Chief

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Transplant centres in Western Canada have stopped short of requiring organ recipients to be fully vaccinated against COVID-19, but they say conversations about such a policy are ongoing.

Some centres in other parts of the country, including Ontario, are requiring proof of vaccination before a patient is approved for the life-saving surgery.

BC Transplant, located in Vancouver, said COVID-19 vaccination is not required to be eligible for a transplant, but programs in the province are actively reviewing it.

“The transplant programs are strongly encouraging all pre-transplant patients to be vaccinated against COVID-19, as they do with many other vaccine-preventable infections,” the agency said in a statement.

Similarly, Alberta Health Services told The Canadian Press it has long been a requirement that patients preparing for transplant have all vaccines to help maximize their chances of success post-transplant. It notes, however, it’s only a practice guideline at this point.

Saskatchewan has also not made any changes.

“Saskatchewan’s organ transplant teams are strongly supportive of all recipients and donors having COVID vaccinations, and the issue of requiring these vaccinations in recipients is actively being discussed,” Lisa Thomson, a spokeswoman for the Saskatchewan Health Authority, said in a statement. 

The Ajmera Transplant Centre at Toronto’s University Health Network recently announced its decision to implement a policy that requires patients who may benefit from receiving a transplant be fully vaccinated against COVID-19 before they are listed for solid organ transplant.

However, there may be exemptions for medical reasons or in cases of urgent need of a transplant.

“We all recognize that (COVID-19) is a massive, massive risk factor. The prudent and ethical thing to do to protect patients and to protect each other, and show fidelity and respect to those organ donors, is to require this (policy) to be a price of pass and go,” UHN president and chief executive officer Kevin Smith said in an interview. 

The decision to enact the policy is based on a few factors, according to the organization. 

It said transplant patients are severely immunocompromised because of lifelong treatment to prevent rejection of a new organ. If someone who is immunocompromised gets COVID-19, they are at a very high risk of being hospitalized or placed on ventilation.

Unvaccinated recipients could also pose a risk to other patients post-surgery. Transplant recipients have high health needs after their transplants and require frequent visits to a hospital. These individuals may pose a greater risk of spreading illness, should they get infected, to other immunocompromised patients in an inpatient or outpatient setting.

“Thinking about an outbreak in an environment like that would be just a massacre,” Smith said. 

Infectious disease experts noted this type of policy isn’t new.

“There’s just requirements pre-transplant in order to be eligible for listing. Some of it is complying with some of the medical measures to see if patients would be eligible,” said Dr. Dima Kabbani, an assistant professor in the division of infectious diseases at the University of Alberta. 

Kabbani added pre-transplant vaccine recommendations are already in place for hepatitis B, pneumococcal disease and influenza. 

Manitoba’s Shared Health said there is no requirement for Manitobans awaiting a transplant to be vaccinated for COVID-19, but noted patients may be required to show proof of vaccinationif there are requirements elsewhere.Kidney transplants are performed in the province while all other organ transplants take place in other provinces. 

Jessica Bailey, 35, is living with stage five kidney disease and awaiting a transplant in Saskatoon. 

The government has postponed surgeries as the province deals with a devastating fourth wave of COVID-19.

Bailey said she is not in favour of requiring recipients to be vaccinated against COVID-19. She said she is double vaccinated but believes recipients should still have the choice on whether they want the vaccine. 

She does encourage patients who may be on the fence to look at the bigger picture.

“If you can get a transplant just by getting the vaccine, go and do it. Pick and choose your battles,” Bailey said. 

This report by The Canadian Press was first published on Oct. 15, 2021.

— 

This story was produced with the financial assistance of the Facebook and Canadian Press News Fellowship. 

Brittany Hobson, The Canadian Press

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Health Unit Gearing Up For Flu Shot Program – ckdr.net

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With the colder months not far away, the Northwestern Health Unit is preparing for their annual flu shot program.

“The Northwestern Health Unit will begin to offer the flu vaccine in November and we will inform the public when they can start booking appointments,” says Medical Officer of Health Dr. Kit Young Hoon. “As always the influenza vaccine will also be available at many pharmacies and from other health care providers.”

The Public Health Agency of Canada only reported 79 lab confirmed cases of influenza in 2020 compared to 54-thousand cases just the year before.

The drop is largely attributed to strong public health measures and lockdowns due to COVID-19, but officials say there could be more documented cases this year.

“Influenza vaccination were relatively high last year so we’re working off a similar assumption for this year that they will be high,” says Dr. Young Hoon. “I believe we will have enough vaccine to provide to whoever wants to be vaccinated and we’re prepping to have a relatively high rate this year.”

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U.S. to lift curbs from Nov. 8 for vaccinated foreign travelers – White House

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The White House on Friday said it will lift COVID-19 travel restrictions for fully vaccinated foreign nationals effective Nov. 8, ending historic restrictions that barred much of the world from the United States.

 Restrictions on non-U.S. citizens were first imposed on air travelers from China in January 2020 by then-President Donald Trump and then extended to dozens of other countries, without any clear metrics for how and when to lift them.

Curbs on non-essential travelers at land borders with Mexico and Canada have been in place since March 2020 to address the COVID-19 pandemic.

Reuters first reported Friday’s announcement of the Nov. 8 starting date earlier in the day.

U.S. airline, hotel and cruise industry stocks rose on the news, including American Airlines, up 1.9%; Marriott International Inc, up 2.2%; and Carnival Corp, up 1.3%.

The United States had lagged many other countries in lifting such restrictions, and allies welcomed the move. The U.S. restrictions have barred travelers from most of the world, including tens of thousands of foreign nationals with relatives or business links in the United States.

The White House on Tuesday announced it would lift restrictions at its land borders and ferry crossings with Canada and Mexico for fully vaccinated foreign nationals in early November. They are similar but not identical to requirements announced last month for international air travelers.

Unvaccinated visitors will still be barred from entering the United States from Canada or Mexico at land borders.

Canada on Aug. 9 began allowing fully vaccinated U.S. visitors for non-essential travel.

The Centers for Disease Control and Prevention (CDC) told Reuters last week the United States will accept the use by international visitors of COVID-19 vaccines authorized by U.S. regulators or the World Health Organization.

The White House, which held a meeting late Thursday to finalize the Nov. 8 date, still faces some remaining questions, including how and what exemptions the Biden administration will grant to the vaccine requirements. Children under 18, for example, are largely expected to be exempt from the requirements, an official said.

U.S. Travel Association Chief Executive Roger Dow said in a statement that the Nov. 8 date “is critically important for planning – for airlines, for travel-supported businesses, and for millions of travelers worldwide who will now advance plans to visit the United States once again.”

The White House announced on Sept. 20 that the United States would lift restrictions on air travelers from 33 countries in early November. It did not specify the date at the time.

Starting Nov. 8, the United States will admit fully vaccinated foreign air travelers from the 26 so-called Schengen countries in Europe, including France, Germany, Italy, Spain, Switzerland and Greece, as well as Britain, Ireland, China, India, South Africa, Iran and Brazil. The unprecedented U.S. restrictions have barred non-U.S. citizens who were in those countries within the past 14 days.

The United States has allowed foreign air travelers from more than 150 countries throughout the pandemic, a policy that critics said made little sense because some countries with high COVID-19 rates were not on the restricted list, while some on the list had the pandemic more under control.

The White House said last month it would apply vaccine requirements to foreign nationals traveling from all other countries.

Non-U.S. air travelers will need to show proof of vaccination before boarding a flight, and will need to show proof of a recent negative COVID-19 test. Foreign visitors crossing a land border will not need to show proof of a recent negative COVID-19 test.

The new rules do not require foreign visitors or Americans entering the country to go into quarantine.

Americans traveling overseas must still show proof of a recent negative COVID-19, and unvaccinated Americans will face stricter COVID-19 testing requirements. They will also be subject to restrictions in the countries they plan to visit, which may include quarantines.

The CDC plans to soon issue new rules on contact tracing for international air travelers.

 

(Reporting by David Shepardson; editing by John Stonestreet, Nick Zieminski and Jonathan Oatis)

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