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Soaring RSV rates in parts of Quebec lead national cases, strain hospital staff

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MONTREAL — Soaring cases of respiratory syncytial virus in Quebec have pushed the positivity rate to 15 per cent in Montreal and Quebec City.

Weekly provincial surveillance data ending Oct. 22 show positivity rates of the childhood illness hover just over 13 per cent provincewide, with slightly higher rates in the two cities and wide variation among smaller communities.

It’s several times the most recent federal positivity rate of 3.5 per cent, although that data is a week behind and covers the week ending Oct. 15.

The head of the pediatric emergency department at Montreal’s CHU Sainte-Justine said Tuesday his emergency rooms “are completely jammed with patients” with respiratory viruses, largely driven by RSV.

“There’s just so much more — a larger wave with sicker patients therefore more hospitalizations, and our hospitals are just full to the brim,” Dr. Antonio D’Angelo said Tuesday.

“In the emergency rooms, well, they’re just all over the place — they’re in our respiratory unit in the emergency room but they’re also in sort of a makeshift corridor for a temporary unit there. And then we had to open up another corridor with patients with respiratory cases that needed treatments.

“And that’s very, very unusual. In fact, we’ve never had it this bad.”

A pediatric infectious disease specialist at the Montreal Children’s Hospital reported similar spikes there, noting that admissions suggest Quebec is already in the middle of a very bad RSV season when normally it shouldn’t have even started yet.

Dr. Jesse Papenburg explained the early onset as the legacy of a similarly early and intense RSV season last year. He said it began in September 2021 and “was over” by January, when other provinces hadn’t even yet reached their peak.

As for why Montreal saw the early spike, he said France and New York City each saw springtime RSV outbreaks in 2021. Since both regions attract a lot of travel from Montreal, it’s possible that importation combined with a susceptible population and easing pandemic measures created the right circumstances for a summer surge.

Further adding to the burden this year is the fact RSV seems to be hitting more than just babies and toddlers to include three- and four-year-olds, who are getting the virus for the first time because they had been shielded by now-lifted pandemic precautions, said D’Angelo.

D’Angelo said he expected similar rates to emerge in other Canadian centres, acknowledging that other hospitals are already seeing increasing numbers of respiratory patients, as well as strained resources and staff.

The national figures show a positivity rate of two per cent in Ontario and 3.4 in Atlantic Canada. The lowest rates were 1.4 per cent in British Columbia, one per cent on the Prairies and two per cent in the Territories.

Ottawa pediatric hospital CHEO said for the week ending Oct. 15, out of 298 RSV tests 30 were positive — about 10 per cent.

A CHEO spokesperson said 12 patients were hospitalized for RSV last month — the same record-high number as last year, and much higher than the pre-pandemic average of about one to two hospitalizations for September.

D’Angelo said RSV typically spreads by community, and does not generally emerge at the same time across the country.

“It often happens where there’ll be one sort of epicentre where everything sort of starts to occur, and then it sort of spreads out,” he said.

D’Angelo said strain at his hospital was compounded by the fact that about 30 per cent of patients there don’t have a family physician and end up going to emergency with minor ailments that otherwise could be treated elsewhere.

“Now everything’s sort of by appointment instead of just walk-in,” he said, believing more walk-in clinics could address hospital demand.

“With the amount of viruses that we’re seeing, a lot of these docs don’t have any more time available for their own patients, which is kind of sad.”

While only a small percentage of RSV cases result in hospitalization, the illness is common among children. By age two, 90 per cent of kids will have had an RSV infection, said Papenburg.

However, some infants are at greater risk of severe illness and that’s when it’s important to be have a predictable viral season, he said.

The RSV season typically runs from November to March but Quebec experts noticed a five per cent positivity rate in August, said Papenburg.

He said that prompted the province to move a preventive campaign for high-risk babies to mid-September, instead of the usual November.

A monoclonal antibody injected monthly to very high risk infants can cut their risk of hospitalizations by half, he said. These may include children younger than one year of age who were born very prematurely, or who have congenital cardiac disease or chronic lung conditions.

— With files from Cassandra Szklarski in Toronto.

This report by The Canadian Press was first published Oct. 25, 2022.

The Canadian Press

Note to readers: This is a corrected story. A previous version stated Quebec’s provincial RSV rates were nearly 14 per cent. In fact, they were slightly over 13 per cent.

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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.

The Canadian Press. All rights reserved.

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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.

The Canadian Press. All rights reserved.

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