While federal officials say there’s still no sign of a dangerous form of bird flu in Canadian dairy cows, scientists warn limited surveillance means Canada might not be staying ahead of an explosive H5N1 outbreak among dairy cattle south of the border.
So far, dozens of herds across various U.S. states have been infected with this form of influenza A. While it appears to cause milder infections in cows, H5N1 has also been linked to stunning death rates of 50 per cent or more in other species, including various birds, cats and even humans, though more data and research is needed to fully understand the risks.
“I think we’re way behind the virus,” warned Matthew Miller, an immunologist and vaccine developer with McMaster University, who’s among the Canadians working on H5N1 research.
Without a “robust national surveillance program, there’s no way to know if there are infections here or not.”
The Canadian Food Inspection Agency (CFIA) told CBC News on Monday it has not detected this form of bird flu yet in dairy cattle — or any other livestock — in Canada. (In birds, however, the disease is already widespreadacrossthe country, impacting an estimated 11 million farmed birds to date.)
The disease is federally reportable in any species, cattle included, the CFIA said. The agency requires dairy producers to monitor for signs of infection, follow biosecurity measures, and contact their local CFIA office if there is a “high degree of suspicion” of the disease.
The CFIA says it has not detected this form of bird flu yet in dairy cattle — or any other livestock — in Canada. (Jeff McIntosh/The Canadian Press)
It appears that cross-country trade is still allowed. Asked whether dairy cattle can currently be transported between the U.S. and Canada, the CFIA said the World Organisation of Animal Health “does not recommend restrictions on the movement of healthy cattle and their products at this time.”
As well, following a U.S. federal order last Wednesday requiring H5N1 testing for many dairy cattle moving between states, “Canada will also require testing for [avian flu] on imported lactating dairy cattle from the U.S.,” the CFIA said.
When asked about testing milk samples, the agency said if H5N1 is detected in Canadian cattle, it will help provide testing support.
(The agency was more clear in an earlier statement on social media, saying it is “not currently testing raw or pasteurized milk,” adding that the virus isn’t a food safety concern.)
Multiple Canadian scientists, however, stress that widespread testing and surveillance efforts should already be underway rather than set to ramp up after a first detection.
Canada needs ‘active surveillance’
Canada should “absolutely be doing active surveillance for H5N1 in cattle,” other animals and humans who are in close contact with them, said Dr. Isaac Bogoch, an infectious diseases expert with the University Health Network in Toronto, in correspondence with CBC News.
He said those efforts could include a range of approaches such as wastewater surveillance, blood sample studies and nasal swabs.
The goal should be going “all-in on prevention,” Miller said, adding “pandemics always have the highest risk of happening when we have a virus in animals that humans are heavily exposed to.”
Given H5N1’s unprecedented leap into cattle, followed by explosive cow-to-cow spread across the U.S. in mere weeks, the potential for human-to-human transmission seems more likely as the virus adapts to more mammals, he warned.
“If we see more human infections, cat’s out of the bag, it’s way too late,” Miller said. “We need to be sparing no amount of effort, and no amount of expense, in doing absolutely everything to prevent even those initial infections in humans — because the stakes are just too high.”
The U.S. has reported one human infection linked to the cattle outbreaks so far, in an individual whose only symptom was eye inflammation. However, some scientists have warned there are likely more that aren’t being detected, amid growing calls for mass testing on farms.
WATCH | Texan contracts bird flu:
Human bird flu case linked to U.S. dairy cattle outbreaks
27 days ago
Duration 2:32
A person in Texas who had close contact with infected dairy cattle has been diagnosed with bird flu. It’s the country’s second known human case after the virus was discovered circulating among dairy cows across at least four U.S. states for the first time.
“Since the issue in the [U.S.] seems to be bigger than we thought and was brewing before it was recognized, and since we have a plausible route for exposure here, we should be proactive,” said Dr. Scott Weese, a professor at the Ontario Veterinary College and director of the University of Guelph’s Centre for Public Health and Zoonoses.
At a minimum, he added, that would involve milk surveillance. It may not be particularly sensitive — the milk supply is diluted because it comes from so many farms, Weese said.
“But if there are positives, we know we have it and then need to look more aggressively at the farm level.”
Despite sick cows being pulled from production lines, U.S. Food and Drug Administration officials said its recent nationwide survey of milk sold on store shelves found viral remnants of H5N1 in one in five samples. (More reassuringly, federal tests suggest pasteurization — a heating process meant to neutralize harmful pathogens — does ensure milk is safe to drink.)
On Monday, the U.S. Department of Agriculture (USDA) also announced there will be testing of ground beef in states with bird flu outbreaks, and recently warned the virus may be passing back and forth between cattle and poultry farms.
Outbreak officially spread to 34 herds, 9 states
The first known cattle infected with H5N1 were reported in late March. Since then, at least 34 herds across nine U.S. states have been impacted, and scientists suspect the outbreak is already far bigger than official figures suggest.
Newly released research from the U.S. Centers for Disease Control and Prevention also showed profound impacts on farm cats — with a death rate of around 50 per cent among those fed raw milk products from infected cows.
The study raises “new concerns regarding the potential for virus spread within mammal populations,” the team continued.
WATCH | Quebec poultry industry suffers avian flu outbreaks:
Avian flu outbreaks shake Quebec poultry industry
12 months ago
Duration 2:02
A Quebec poultry farmer is taking extra precautions to protect his livelihood and livestock as the province grapples with avian flu outbreaks that have killed almost one million birds in the past year.
On Monday, other U.S. researchers shared a preprint — research not yet formally published or peer-reviewed — outlining efforts to monitor influenza A at dozens of wastewater sites this spring.
The team tested samples from three plants where spring rises in influenza A were observed, and found a marker for the H5 gene at all three facilities. Those plants were also located in an unnamed state with confirmed H5N1 outbreaks among dairy cattle, and two of the facilities discharged animal waste and milk byproducts into sewers, the researchers noted.
It all paints a picture of a fast-spreading outbreak that’s impacting new species, appearing in new areas, and is likely past the point of containing, several outside scientists agreed.
Funding, support for testing needed
Here in Canada, funding and support for veterinarians and farmers to test needs to be clear, stressed Weese.
“If farmers have to pay for sampling and testing, and don’t know what will happen if there’s a positive, and have no direct personal gain from it, why would they do it voluntarily?” he questioned. “We need a clear program that supports good testing and supports farms.”
Toronto-based infectious diseases specialist Dr. Allison McGeer, from Sinai Health System, said she’s “personally hoping we are not going to get caught off guard” here in Canada.
What’s reassuring, McGeer added, is that Canada does have robust human testing in place to catch severe flu infections. Typically, she says, Canadian hospitals use combined viral testing — for COVID, influenza and RSV — which can pick up a certain protein that is stable across all strains of influenza A.
If a human infection of avian flu showed up in a hospital, the test would label it along the lines of “influenza A, subtype not detected,” she explained. And, if the patient had also been in contact with poultry or wildlife, that combination of factors could trigger extra lab work to pinpoint the specific type of influenza — including H5N1.
But that’s only if someone is sick enough to visit a healthcare facility.
“It’s not a perfect system,” McGeer acknowledged, “but it’s [a sensitive system] for detecting severe disease from H5N1.”
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
