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Spike in severe illness caused by strep A bacteria is ‘global phenomenon’ — including in Canada



As various countries continue to report high levels of invasive group A streptococcal (iGAS) infections — which cause severe illness, and in rare cases death within days — Canadian physicians are also raising alarms over a rise in serious cases this season.

The infections are linked to a common, often-harmless bacteria known as group A streptococcus. Usually it’s known for milder illnesses like strep throat or scarlet fever, which are typically treated with antibiotics.

But when bacteria enter the blood or deep tissue, people can develop more invasive, life-threatening conditions such as necrotizing fasciitis or toxic shock syndrome. In those dire cases, complications can involve massive damage to the skin and soft tissues, leading to amputations or even death, sometimes in as little as 12 to 24 hours after infection.

In Quebec, the number of iGAS infections recently spiked 56 per cent compared to the pre-pandemic average for the same time period, according to data collected by the province’s Ministry of Health and Social Services (MSSS).


A total of 327 cases were reported between the end of August 2022 and Feb. 11, 2023, compared to an average of 223 for the same period between 2015 and 2019, before widespread public health measures during the COVID-19 pandemic kept a variety of infectious diseases at bay.


Concerning rise in cases of invasive form of strep A


Doctors are seeing an increase in the number of patients experiencing an invasive form of group A strep. The illness is common but can be serious when bacteria spreads to the blood or deep tissue, and needs to be treated quickly.

The province has also reported multiple deaths among both seniors and children.

While cases peaked late last year, infected children are still coming in at a “steady pace” to Sainte-Justine University Health Centre in Montreal, said pediatric infectious diseases specialist Dr. Fatima Kakkar.

It’s the most stressed the hospital has been during a strep A season than any point in the last decade, she added.

Kakkar points to a lack of immunity among children, with more kids now catching strep recently after avoiding the bacteria over the last few years, coupled with a similar return of influenza in late 2022 after a lengthy lull.

“What usually happens is a few weeks after [having influenza] or other virus, that’s when that strep that might be there in the throat becomes invasive,” she explained.

A doctor with long brown hair, wearing a white lab coat and a yellow shirt, with a stethoscope around her neck, stands in a hospital hallway.
Dr. Fatima Kakkar, a pediatric infectious diseases specialist at Sainte-Justine University Health Center in Montreal, continues to see young patients suffering from invasive Strep A infections. (Alison Northcott/CBC)

Surges in multiple countries

The latest available Ontario data showed this has been a challenging strep season in that province as well, with more than 500 cases reported by the end of February and a higher incidence rate across all age groups than during the same period in the last five years before COVID-19 hit.

Early findings provided by the Public Health Agency of Canada (PHAC) also suggest a rise in country-wide iGAS cases last November among children under 15, compared to pre-pandemic — though the cases have since returned to typical levels.

And the challenges go beyond any one province or country.

“I will say it’s actually a global phenomenon,” said Dr. Susy Hota, the medical director of infection prevention and control with the University Health Network in Toronto. “This is not just a North American thing.”

The U.K. was among the first countries to warn of a rise in invasive strep A infections this season and has since reported more than 2,651 cases across all age groups, compared to the final tally of roughly 2,900 across the whole of the “last comparably high season” in 2017 and 2018.

This season has hit 355 deaths, already one more than the final 2017 to 2018 count.

Researchers also recently reported on 2022 surges in iGAS in France and Denmark, while the U.S. Centers for Disease Control and Prevention (CDC) said cases this year have “remained high in children in some areas of the country even after respiratory viruses decreased in those areas.”


Quebec takes control of private seniors’ homes after 4 deaths

Quebec has taken control of two private Montreal seniors’ homes where outbreaks of streptococcus A led to the deaths of four residents. The province has also been alerted of abuse allegations at both homes.

Antibiotic shortage

The CDC noted an added wrinkle: An ongoing shortage of liquid amoxicillin, which is often prescribed to children to treat early, milder group A strep infections.

That common antibiotic has also been on Health Canada’s tier three shortage list since mid-November, which refers to shortages “that have the greatest potential impact on Canada’s drug supply and health-care system.”

A spokesperson for Health Canada told CBC News that there are signals the supply is improving, though overall demand remains higher than normal, which could impact supply at some pharmacies.

The department is working with the provinces and territories, manufacturers, and stakeholders across the supply chain and health-care system to “conserve existing supply, closely monitor planned resupplies to ensure that all available supply is released and distributed without delay to pharmacies and hospitals, and access foreign-authorized supply or alternatives, where possible,” according to an emailed statement.

For iGAS infections, however, which require extensive medical treatment, amoxicillin isn’t actually part of the arsenal, said Hota, but rather a slate of other antibiotics that are typically given intravenously.

Group A streptococcus has been in the headlines recently after 15 kids died in the U.K. Dr. Joanne Langley, a pediatrician specializing in infectious diseases, discussed what guardians and adults should know about this bacteria that can cause a range of illnesses.

Certain symptoms should ‘ring an alarm’

Those severe strep infections, several medical experts stressed, do remain quite rare. The bacteria spreads easily through respiratory droplets, but most people experience milder illness, while others aren’t even aware they’re infected.

“It’s a very common bacteria, actually,” said microbiologist Dr. Cécile Tremblay, a professor in the Department of Microbiology and Immunology at the Université de Montréal. “Many people in the population carry it, and often it does us no harm.”

And while anyone can get hit by iGAS, the worst infections usually strike the most vulnerable — those individuals who are already battling another virus, or suffering from multiple comorbidities, or experiencing an open wound.

Dr. Donald Vinh, an infectious diseases specialist with McGill University, said fever, headaches, confusion and a decreased level of consciousness during a strep infection all signal a shift to more serious disease.

“Those constellations of symptoms usually should ring an alarm bell,” he said.



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Flavanols are linked to better memory and heart health – here’s what foods you can eat to get these benefits – Yahoo Canada Sports



<img class="caas-img has-preview" alt="Two-and-a-half cups of green tea contain the recommended daily amount of flavanols. granata68/ Shutterstock” src=”–/YXBwaWQ9aGlnaGxhbmRlcjt3PTk2MDtoPTYzOQ–/″ data-src=”–/YXBwaWQ9aGlnaGxhbmRlcjt3PTk2MDtoPTYzOQ–/″>

There are plenty of good reasons to make sure you’re eating enough fruit and vegetables each day. Not only do fruit and vegetables contain many of the important vitamins and minerals our body needs to function at its best, they also keep our gut healthy and may even help maintain a healthy weight.

But some plant foods may be more beneficial for health than others, thanks to a group of compounds called flavanols.

For instance, a recent study I helped conduct showed that people who eat a diet high in flavanol-rich foods may have better memory compared to those who have a low intake. A previous study also found that people with a low intake of flavanols were at higher risk of heart disease. Overall, there’s convincing evidence that consuming enough flavanols has health benefits.


But while research shows that flavanols have many health benefits, it’s important for consumers to know that not all flavanol-rich foods contain the same amount of flavanols – meaning some may be more beneficial to health than others.

Plant compounds

Flavanols are a group of compounds that are found in many plants – including apples, berries, plums and even beverages such as tea.

There are two main groups of flavanols, with many different subgroups. Each plant will contain different combinations of flavanols, as well. These compounds each have different structures and different effects on the body. That means that not all flavanols are created equal.

For example, a portion of blueberries and a cup of tea may contain the same amount of total flavanols – but they are made up of completely different types of flavanols, which may have completely different health effects.

So in order to investigate the health effects of flavanols, it’s therefore important to use a source which includes a wide range of different types. This is why flavanols extracted from cocoa are an ideal model, as they contain the two main types of flavanols. It also allows researchers to calculate which other foods are likely to have benefits based on how similar the compounds they contain are to cocoa flavanols.

Since foods such as cocoa, berries and tea contain a combination of many types of flavanols, it’s currently not clear which individual compounds generate health benefits. But some research has linked the specific flavanol epicatechin with better vascular function. Cocoa and tea both contain epicatechin.

Many different types

Another thing to know is that even if a food contains flavanols, it may contain lower amounts compared to others.

To better understand how flavanol intake affects health, a few years ago we developed a test that uses urine to measure flavanol intake. The test is based on the way the human body processes flavanols and tells us whether someone has eaten large amounts, small amounts or no flavanols at all.

Using this test, we were able to show that people with high flavanol intake had lower blood pressure and better memory than those with lower intake.

When we developed the urine test, we also investigated how it is affected by different types of flavanols and foods. This allowed us to estimate what amount of different flavanol-rich foods a person needs to consume to achieve approximately 500mg of flavanols per day – similar to the amount used in studies, which has been shown to have clinical benefit.

A table showing the number of servings of certain foods which are needed to get 500mg of flavanols a day.

Number of servings needed from different flavanol-containing foods to obtain 500 mg per day. Gunter Kuhnle, Author provided

According to our research, only two-and-a-half cups of green tea are needed daily to get the recommended 500mg of flavanols. Just under a cup of millet (sorghum grain) can also provide you with the recommended daily amount.

But if you were to try and get your flavanols from one type of fruit and vegetable, our research shows you’d need to consume large amounts of each to achieve the recommended amount. For example, you’d need to consume nearly 15 cups of raspberries alone to get 500mg of flavanols.

As such, the best way to get enough flavanols daily is by consuming a combination of different fruits and vegetables. For example two apples, a portion of pecan nuts and a large portion of strawberries can achieve the 500mg target – or a salad made with millet and fava beans.

It’s also important to note that while the flavanols used in many studies were extracted from cocoa, unfortunately chocolate (even dark chocolate) is a very poor source of flavanols – despite what some headlines might claim. This is because these flavanols are lost during processing.

Although there’s still much we don’t know about flavanols – such as why they have the effect they do on so many aspects of our health – it’s clear from the research we do have that they are very likely beneficial to both memory and heart health.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

The ConversationThe Conversation

The Conversation

Gunter Kuhnle has received research funding from Mars, Inc., a company engaged in flavanol research and flavanol-related commercial activities.

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‘Social deprivation’ speeds up aging, and death: McMaster study



We are dying every day, wrote Seneca, a stoic philosopher in ancient Rome.

And if you struggle living alone or have weak familial bonds, you risk speeding up death by as much as one year, according to findings published by McMaster University on Monday.

The new study shows that biological clocks tick faster for those dwelling in an environment of social deprivation (a dearth of family or community network resources) or material poverty, such as lacking access to quality housing, healthy food and recreation.

McMaster’s Divya Joshi, the study’s first author, said the findings indicate that living in a “deprived urban neighbourhood” marked by either form of deprivation is associated with “premature biological aging.”


Joshi is a research associate in the university’s Department of Health Research Methods, Evidence and Impact.

“If your (biological) systems are aging faster than your chronological age, then you will have more poor health outcomes, or quicker health outcomes, than someone who is aging slower biologically,” she told The Spectator.

The study analyzed DNA from the blood samples of 1,445 participants across Canada, who are part of the Canadian Longitudinal Study on Aging that is following 50,000 people between age 45 to 85.


“Epigenetic clocks” studied in the samples — also called “DNA methylation-based estimators” — indicated aging at the cellular level, she said.

“To be able to see that living in a socially or materially deprived neighbourhood impacts your healthy aging; that it increases your risk of epigenetic age acceleration by almost a year, beyond your individual health status — I think that is just remarkable,” she said.

When your biological age outpaces your calendar age, she said you have a greater risk of cardiovascular disease, respiratory conditions and neurological disorders that present a “greater risk of premature mortality.”

The findings fit their research hypothesis, she said, but what didn’t fit was the assumption that depression in the test subjects would further “amplify” the rapid aging effect.

In fact, while depression symptoms also contributed to epigenetic aging, environmental factors impacted aging acceleration regardless of depression symptoms.

The findings were published June 5 in “The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences.”

McMaster professor Parminder Raina led the research team, which included investigators from the Netherlands, Norway and Switzerland, according to a news release.

While the presentation of the findings focused on the connection to disadvantaged neighbourhoods, Joshi agreed that an individual will age more rapidly when deprived of familial or social bonds, regardless of where they live.


“That is true, there is evidence that those people who have poor social networks or broken family units have a greater risk of higher epigenetic age acceleration … It is aging you, and that is so relevant coming out of the pandemic, and the isolation many people experienced, especially the toll it had on our older populations.”



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Sudbury health unit offers advice about West Nile Virus –



The Sudbury health unit is warning area residents to be wary of the possibility of being infected with West Nile Virus.

“Whether you are spending time in your backyard, exploring local trails, or vacationing in Ontario, getting bitten by mosquitos puts you at risk of being infected with West Nile virus,” said the release from Public Health Sudbury and Districts. 

The release also said the risk is low, but it is still possible.


“Although the overall risk of becoming infected with West Nile virus is low, everyone is at risk and preventing bites is important to protect yourself and your family,” said Ashley DeRocchis, an environmental support officer with Public Health Sudbury & Districts.

Citizens are advised to use an insect repellent approved by Health Canada and follow the application recommendations on the package.

Also, during the times of day when mosquitoes are most active — during dusk and dawn — people might choose to stay indoors if possible.  

The health unit also advised that people can wear light-coloured clothing, including long sleeves, long pants, socks, and a hat whenever they are outdoors. Consider the use of mesh “bug jackets” or “bug hats,” the news release said.

At home, people can check their window and door screens to ensure that there are no tears or holes for mosquitoes to get through. Also, don’t give the bugs a place to lay eggs.  

Mosquitoes need only a small amount of calm, standing water to lay their eggs and for larvae to hatch, said PHSD. 

Reduce mosquito breeding areas by changing or removing standing water at least once a week from areas such as bird baths. old tires, containers, barrels, flower pot saucers, swimming pool covers, wading pools, clogged gutters and eavestroughs, clogged drainage ditches, small containers like cans or bottle tops and unused children’s toys, said the release.

The health unit said symptoms of West Nile virus can range from mild to severe, from flu-like symptoms to severe nausea and even loss of consciousness.

Public Health Sudbury & Districts will be trapping and testing mosquitoes again this year starting in mid-June and continuing into the fall of 2023, said the release. For more information on West Nile virus, visit the website at or call Public Health Sudbury & Districts at 705-522-9200, ext. 464 (toll-free 1-866-522-9200).

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