Sublingual vaccine for urinary tract infections is awaiting approval by Health Canada – iHeartRadio.ca
Canadians who experience chronic urinary tract infections may soon have another option than antibiotics — a vaccine is awaiting approval by Health Canada.
Urinary tract infections, known as UTIs, are one of the most common infections across the globe.
They cause extreme discomfort in patients, and require antibiotics in order to clear the infection. Dr. Marla Shapiro, CTV’s medical contributor, explained the two main symptoms to CTV News Channel on Friday.
“The hallmark really is that urgency, that you’ve gotta get to the washroom in time,” she said. “There can be burning either initiating the urination or at the end of it.”
There might also be blood in the urine, or it could be cloudy, and often the odour of the urine will have changed. Some sufferers of UTIs have even reported pelvic pain.
“But it’s usually that razorblade burning that women talk about,” Shapiro said.
“Because it’s so common, the idea of finding a vaccine is particularly appealing.”
Although men also contract UTIs, they are far more common among women and other people with vaginas, partly due to a shorter urethra, which makes it easier for bacteria to enter the urinary tract.
“Also varies around the time of our estrogen. If we have less estrogen, for example, in post-menopausal women, we’re more likely to see (UTIs) because of the change in the microbiome,” Shapiro said.
Between 50 and 60 per cent of women will develop more than one UTI in their lifetime, but as many as one in four women may also develop a recurrent urinary tract infection, defined as three or more UTIs in a 12-month period.
It is this condition that the new vaccine aims to tackle.
MV140 is a sublingual bacterial vaccine developed in Spain by Inmunotek, and has been approved for use there since 2010.
Since its development, it has been used for patients in several European countries through special access programs, including in the U.K., Sweden, Australia and New Zealand, among others.
Now, it is heading to Canada.
Red Leaf Medical, which owns the licence for Uromune (MV140) in Canada, filed a new drug submission with Health Canada a year ago.
Health Canada’s drug approval process can take one to two years.
“Uromune offers hope to women suffering from recurrent urinary tract infections who currently rely on multiple courses of antibiotics to treat their condition,” Charles Ko, managing director of Red Leaf Medical Inc., said in a press release at the time. “In addition to improving UTI management, Uromune has the potential to improve antibiotic stewardship and decrease the overall risk of antibiotic resistance.”
So will UTIs soon become a thing of the past?
Well, not with MV140 — the drug doesn’t provide full immunity against contracting a UTI, but does lessen the chances for those who have chronic infections. In a trial performed in Spain, described in a study published in 2022, the drug showed a 56 to 60 per cent efficacy in preventing UTIs in a nine-month study period.
A review published in the Canadian Urological Association Journal in 2020 found that Uromune had superior outcomes over other sublingual vaccines for UTIs.
Shapiro explained that this new drug doesn’t align with the typical concept of a vaccine as one or two shots that convey a lasting immunity.
It’s a sublingual vaccine, a type of vaccine which doesn’t use needles, but enters the body through tablets taken orally, or through a spray.
“They’re made of inactivated bacteria, and the notion is that if you put (a tablet-based sublingual vaccine) under your tongue and it was daily for three months, your body would recognize these dead bacteria, mount an immune response at the level of where it should be … so that when you had an infection, you would mount your own immune response, not needing an antibiotic,” Shapiro said.
Uromune is a sublingual spray.
“It wouldn’t be a universal vaccine,” she said. “It’s something that would be used in women who are really having frequent urinary tract infections.”
For most of the population, a UTI is an uncomfortable experience that can be solved relatively quickly through antibiotics. But when a person has recurrent UTIs, the antibiotics start to become a problem.
“We worry about this because of antibiotic resistance, which we’re beginning to see, and many women end up being put on antibiotics on an ongoing basis if they have that criteria of ongoing chronic urinary tract infections,” Shapiro explained.
Antibiotic resistance occurs when bacteria learns how to fight against the antibiotics that have been developed in order to treat bacterial infections. The World Health Organization classifies it as “one of the biggest threats to global health” today, as a growing number of infections are becoming harder and harder to treat due to antibiotic resistance.
The stronger bacteria created by antibiotic resistance aren’t only a problem for the person who is being prescribed antibiotics that are no longer working — that stronger bacteria can also infect others and cause these more difficult infections to spread.
If Uromune is approved for use in Canada, it could help combat some of the antibiotic resistance that those with recurrent UTIs are at a risk of.
'Pandora's Box': Doctors Warn of Rising Plant Fungus Infections in People After 'First of Its Kind' Case – VICE
A man in India is the first human known to be infected by a fungus called Chondrostereum purpureum, a pathogen that is most well-known for causing a disease called silver leaf in plants, reports a new study.
The patient, who was 61 at the time of the diagnosis, made a full recovery and has not experienced any recurrence of the infection after two years of follow-up observations. However, this “first of its kind” case study exemplifies the risks that fungal pathogens pose for humans, especially now that climate change and other human activities like rampant urbanization, have opened a “Pandora’s Box for newer fungal diseases” by contributing to their spread, according to the study.
Fungal pathogens are having a pop culture moment because they are the source of a fictional disease depicted in apocalyptic game The Last of Us, which was recently adapted into the acclaimed HBO series of the same name. But these microbes are also a real-life scourge that infect about 150 million people every year, resulting in about 1.7 million deaths.
Though millions of fungal species exist, only a very small fraction of them are able to infect animals, including humans, because our bodies present challenges to these invaders such as high temperatures and sophisticated immune systems.
Soma Dutta and Ujjwayini Ray, doctors at Apollo Multispecialty Hospitals in Kolkata, India, have now added one more fungus to that small list of human invaders with their unprecedented report of a C. purpureum infection. The patient, a plant mycologist, had suffered from cough, fatigue, anorexia, and a throat abscess for months before his hospital visit, and was probably exposed to the fungus as a result of his profession.
When conventional techniques failed to diagnose the disease, the pathogen was sent to a World Health Organization center based in India where it was finally identified using DNA sequencing. The case “highlights the potential of environmental plant fungi to cause disease in humans and stresses the importance of molecular techniques to identify the causative fungal species,” according to their recent study in the journal Medical Mycology Case Reports.
“This is a first of its kind of a case wherein this plant fungus caused disease in a human,” Dutta and Ray said in the study. “This case report demonstrates the crossover of plant pathogens into humans when working in close contact with plant fungi. The cross-kingdom pathogenicity demands much work to be done in order to explore insights of the mechanisms involved, thus leading to possible recommendations to control and contain these infections.”
C. purpureum can infect a variety of different plants with silver leaf disease, an often fatal condition that is named after the color that the pathogen induces on the leaves on the hosts. It is the latest in a growing number of fungal pathogens that have infected humans, which are buoyed on in part by human activities, such as urbanization, travel, and commerce.
Human-driven climate change is also accelerating the spread of infectious diseases, including fungal pathogens, by allowing microbes to adapt to higher temperatures (like those in mammal bodies), expand their range, and interact with new hosts in the aftermath of extreme weather events. And though fungal diseases have maintained a lower profile in epidemiology compared to other pathogens, they may be more dangerous than viruses or bacteria in some contexts.
“While viral and bacterial diseases receive most attention as the potential cause of plagues and pandemics, fungi can arguably pose equal or even greater threats,” according to a 2021 study in PLoS Pathogens. “There are no vaccines available yet for fungal pathogens, the arsenal of antifungal agents is extremely limited, and fungi can live saprotrophically, producing large quantities of infectious spores and do not require host-to-host contact to establish infection. Indeed, fungi seem to be uniquely capable of causing complete host extinction.”
In addition to avoiding the spread of new fungal pathogens that can directly infect humans, researchers also point to the damage these diseases can deal to crops and ecosystems that people depend on. For this reason, Dutta and Ray recommend more research into the nature of these infections and strategies to mitigate their spread.
“Cross-kingdom human pathogens, and their potential plant reservoirs, have important implications for the emergence of infectious diseases,” Dutta and Ray said. “Fungi are also responsible for various infections in plants that cause destruction of millions of plants and crops” and “produce toxins that contaminate food and cause acute toxicity.”
“Over the past several decades multiple new pathogenic fungi have emerged,” they concluded. “A notable emergence of the multidrug resistant fungus Candida auris has spread all over the world and has become a significant threat. The worsening of global warming and other civilization activities opens Pandora’s Box for newer fungal diseases.”
Staff reassigned to children’s ICU in Winnipeg, some surgeries postponed: Shared Health – Global News
An influx of kids sick with respiratory illness at the children’s pediatric intensive care unit (PICU) in Winnipeg has forced a staff shakeup that may result in the postponement of some non-urgent surgeries, health officials say.
Shared Health says roughly 10 staff — including some from pediatric surgical and recovery units — are being temporarily reassigned to help at Health Sciences Centre Children’s ICU.
Children’s ER seeing ‘unprecedented’ patient levels in Winnipeg as feds secure more pain medications
Officials say a resurgence in respiratory illness circulating in the province is to blame for an uptick in kids ending up in the hospital’s ICU.
There were 17 kids receiving intensive care in the PICU as of Thursday morning. The PICU’s normal baseline capacity is nine.
Update on COVID-19 boosters
“A significant number of these patients were experiencing medically complex cases that were further complicated by respiratory illness, including infants and young children,” Shared Health said in an online statement.
There were 51 patients in the hospital’s neonatal ICU Thursday morning. The normal baseline capacity there is 50.
Meanwhile, Shared Health says the number of kids visiting the ER with influenza-like symptoms has increased from a low of 22 on March 18 to 47 on Wednesday.
Children’s ER seeing ‘unprecedented’ patient levels in Winnipeg as feds secure more pain medications
Shared Health didn’t say how long it expects the latest staff reassignments will be in place.
While all urgent and life-threatening surgeries will continue to be performed, Shared Health said some non-urgent procedures will be postponed.
Families of affected patients will be contacted, officials said.
New downtown exhibit compares Winnipeg’s COVID-19 response to the Spanish Flu
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Syphilis In Babies Skyrockets In Canada Amid Rising Drug Use – NDTV
The numbers of babies born with syphilis in Canada are rising at a far faster rate than recorded in the United States or Europe, an increase public health experts said is driven by increased methamphetamine use and lack of access to the public health system for Indigenous people.
While syphilis has made a global resurgence over the last five years, Canada is an outlier among wealthy nations in its rate of increase: 13-fold over five years, according to Health Canada. The incidence of babies born with syphilis reached 26 per 100,000 live births in 2021, the most recent year available, up from 2 in 2017, according to the Health Canada data.
That total is on track to increase further in 2022, according to the preliminary government data obtained by Reuters.
Babies with congenital syphilis are at higher risk of low birthweight, bone malformations and sensory difficulties, according to the World Health Organization (WHO).
Syphilis in pregnancy is the second-leading cause of stillbirth worldwide, the WHO said.
Yet congenital syphilis is easily preventable if an infected person gets access to penicillin during their pregnancy.
Among the G7 group of wealthier nations for which data is available, only the United States had a higher incidence of syphilis at birth: 74 per 100,000 live births in 2021, triple the rate in 2017, according to preliminary figures from the U.S. Centers for Disease Control and Prevention (CDC).
There were 2,677 cases of congenital syphilis in the U.S. in 2021 for a population of 332 million, according to preliminary CDC data. Canada had 96 cases for a population of 38 million, according to Health Canada.
People experiencing poverty, homelessness and drug use, and those with inadequate access to the health system, are more likely to contract syphilis through unsafe sex and pass it to their babies, public health researchers said.
“In high-income countries you see it in pockets of disadvantaged populations,” said Teodora Elvira Wi, who works in the WHO’s HIV, Hepatitis and sexually transmitted infection program.
“It’s a marker of inequality. It’s a marker of low-quality prenatal care.”
What sets Canada apart are its Indigenous populations who experience discrimination and often have poor access to health and social services, said Sean Rourke, a scientist with the Li Ka Shing Knowledge Institute at St. Michael’s Hospital in Toronto, who focuses on prevention of sexually transmitted disease.
“It’s just the whole system, and all the things that we’ve done in bad ways not to support Indigenous communities,” he said.
Health Canada told Reuters it has dispatched epidemiologists to help provinces contain the increase in congenital syphilis. Spokesperson Joshua Coke said the federal government is expanding testing and treatment access in Indigenous communities.
Tessa, an Indigenous 28-year-old woman who asked to be identified only by her middle name, said she had a years-long crystal meth addiction and was homeless when she got pregnant in Saskatoon, Saskatchewan.
“I would be walking down the street just crying: ‘Why am I living like this?'” she told Reuters.
She said she received no prenatal care until she went into labor in November, which is when she tested positive for HIV and syphilis during a routine test.
Her daughter was prescribed a 10-day course of antibiotics, administered by IV, and is now healthy, Tessa said. But she still thinks about the difficulties she experienced in accessing prenatal care.
“Having transportation, maybe, and a place to live, and being sober, probably would have helped, big time,” she said.
Susanne Nicolay, nurse lead at Wellness Wheel clinic in Regina, Saskatchewan, which serves Indigenous and vulnerable populations, said providers needed to do more to expand access to health care. “The system always talks about patients that are hard to reach. But I think it’s health providers that are hard to reach,” she said.
A lot needs to go wrong for a baby to be born with syphilis, said Jared Bullard, a Manitoba pediatrician who has been researching babies born with syphilis since 2021 in an ongoing study for the Public Health Agency of Canada.
“It’s pointing at multiple failures along the path,” he said.
In Canada, the rise in babies born with syphilis is concentrated in the three prairie provinces: Manitoba, Saskatchewan and Alberta.
Prairie provinces have higher crystal meth use and remote populations and Indigenous populations who may have trouble accessing health care, Bullard said.
Manitoba recorded the highest rate, with about 371 cases per 100,000 live births in 2021.
The province said in an emailed statement that it is expanding training for health care providers in addressing sexually transmitted infections, encouraging frequent testing and early treatment. It is digitizing its records of STI infections.
Saskatchewan has launched a public awareness campaign urging people to practice safe sex and get tested, said Dale Hunter, a spokesperson for the provincial health ministry. The province had an incidence of 185 cases of congenital syphilis per 100,00 live births in 2021.
Alberta said women aged 15-29 made up more than half of what it called a “significant increase” in syphilis rates. “The reasons for the increase are not fully known, but it is likely that a variety of factors have contributed to this rise,” Alberta Health Services spokesperson James Wood said.
In preliminary results of a study of 165 infants exposed to syphilis, Bullard and fellow pediatrician Carsten Krueger found at least two-thirds were born to women reporting a history of substance abuse.
About 45% of the women identified as Indigenous and another 40% had no ethnicity recorded. Indigenous people make up about 5% of the Canadian population, according to census data.
About a quarter of the people in the study did not get tested because they got no prenatal care; about one-fifth of those who tested positive did not get treated. Bullard said he has also seen people get treated early in pregnancy and then get re-infected.
Public health researchers and clinicians said the rates of congenital syphilis began increasing before the pandemic and worsened as public health agencies diverted resources to COVID-19 testing and other pandemic-related health measures.
“All of the social circumstances that contributed to this have just gotten worse over the pandemic,” said Ameeta Singh, an infectious diseases specialist with an HIV/STI practice in Edmonton, Alberta.
This month Health Canada approved a syphilis and HIV test that can provide results in less than a minute, allowing providers to begin treatment right away.
Some public health researchers and providers are urging the Canadian government to buy and distribute the tests.
“We probably need a million tests to get out there around the country,” Rourke said. “The solution’s right in front of us.”
Health Canada did not respond when asked about purchasing test kits.
(Except for the headline, this story has not been edited by NDTV staff and is published from a syndicated feed.)
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