Tick-spread illnesses are on the rise in Canada. Are surveillance, awareness efforts keeping up? | Canada News Media
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Tick-spread illnesses are on the rise in Canada. Are surveillance, awareness efforts keeping up?

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One morning in Sept. 2021, MaryAnn Harris felt strangely tired. She told her husband, Charles de Lint, that she needed to lie down. Then more worrisome symptoms began cropping up, from nausea to double vision.

The Ottawa couple rushed to a local emergency department.

At first, the cause of Harris’s ailment was a mystery. The ER team ran various tests, and after a few hours with no answers, they sent her husband home due to visitor restrictions put in place during the pandemic.

By the time de Lint came back the next day, his beloved partner of four decades was unresponsive and on life support in the intensive care unit.

“You don’t know what to think, what to feel,” de Lint recalled. “It was just utter panic.”

What followed was a three-year ordeal, as medical teams offered a battery of tests and treatments in hopes of bringing Harris back from the brink of death. She eventually regained consciousness, but by that point, inflammation in her brain stem had left her paralyzed. Harris never left the hospital and died in early June at the age of 71.

The cause of her devastating illness? A little-known virus that spreads through tick bites.

For years, medical experts have warned a rising number of Canadians are being exposed to ticks carrying an array of dangerous pathogens. Lyme disease is the most familiar — and by far the most common — but there’s growing concern about lesser-known threats as well, from various bacterial infections, to the rare Powassan virus that claimed Harris’s life earlier this year.

Ottawa couple MaryAnn Harris and Charles de Lint were together for four decades, sharing a love of the arts and collaborating together up until Harris fell ill from Powassan virus in 2021. She passed away three years later at the age of 71. (Supplied by Charles de Lint)

Case counts are rising, yet data remains thin, all while climate change is helping tick populations spread further north, putting even more of the population at risk. The question now, experts say, is whether awareness and surveillance efforts are keeping up with a growing threat.

“There’s probably still more of [these infections] than what’s being diagnosed … because the general public is probably not that aware of it, and healthcare providers aren’t aware of it,” said Dr. Isaac Bogoch, an infectious diseases specialist with the University Health Network in Toronto.

“The more you look, the more you find.”

Patchwork surveillance for tick-borne illnesses

Actually finding evidence of these emerging health threats is a tricky business, given the patchwork approach to tracking various tick-spread diseases in Canada.

Lyme disease, a potentially serious illness spread through black-legged ticks, has been nationally reportable in Canada since 2009.

Since then, human cases have shot up. While there were only a few hundred country-wide infections identified in the first few years after provinces started reporting data, the annual count in recent years regularly hit more than 2,500, likely due to both increased awareness and higher numbers of bacteria-carrying ticks.

Numbers are hazier, however, for tick-borne pathogens like Powassan, which is known for causing life-altering neurological symptoms and brain inflammation in roughly 10 per cent of cases.

That viral infection, along with the bacterial infection anaplasmosis and the parasitic infection babesiosis, was recently deemed nationally notifiable — but hard data from the provinces remains hard to come by.

Canada’s first locally recorded case of anaplasmosis was back in 2009 in Alberta. For more than a decade afterwards, Manitoba was the only province tracking its spread, while some others, including Ontario and Nova Scotia, followed suit last year by broadening out their tracking beyond just Lyme disease.

In 2023, Ontario had 40 confirmed or suspected anaplasmosis cases, the majority occurring from June to August, plus 15 cases of babesiosis. Both infections can cause flu-like symptoms, or more serious illness. (Manitoba’s figures suggest there are just a handful of infections in any given year, including few if any cases of babesiosis.)

But those provincial figures don’t capture the full situation.

Diseases carried by insects that infect humans, like Lyme disease and West Nile virus, are on the rise in Canada. The shorter, less severe winters due to climate change have allowed those insects to expand their range.

“We are seeing a lot more victims, especially in those high-tick areas, specifically if you’re looking at Ontario, Quebec, and Nova Scotia,” said Heather Coatsworth, one of the Public Health Agency of Canada’s (PHAC) top tick experts, in an interview with CBC News.

Coatsworth, the chief research scientist for the National Microbiology Laboratory’s field studies section, said there are now “hundreds and hundreds” of anaplasmosis infections occurring across the country every year, along with “sputtering” reports of babesiosis.

As for Powassan — named after the Ontario town where it was first discovered in a young boy who died of his illness back in 1958 — infections remain rare and localized to certain regions, Coatsworth noted.

What’s concerning, she added, is that the virus transmits through tick bites in as little as 15 minutes, and is a “much harder hitter” when it comes to human symptoms.

New U.S. surveillance data, published in the journal Clinical Microbiology and Infection in June, also shows a four-fold spike in the number of American cases, partially thanks to the broader spread of the black-legged ticks that carry both Powassan and Lyme. From 2004 to 2013, 64 human Powassan cases were reported to U.S. officials, but that tally jumped to nearly 300 cases in the decade after.

A similar spike in Canada isn’t out of the question, given rising annual temperatures that are providing ticks more warm days to circulate far beyond their historic habitats.

“Climate change is the main driver,” Coatsworth said, noting that the increased range of ticks means these various health threats are now appearing in more animal species and urban, downtown areas.

“And once those pathogens get to a higher level, they kind of spill over naturally into the human population.”



Prompt treatment can be crucial

Despite spiking case counts of these lesser-known infections, limited awareness means a growing cohort of patients may face hurdles in getting a diagnosis and treatment.

Many health-care providers aren’t yet aware that these infections even exist, which can mean medical teams don’t always conduct the right diagnostic tests, warned Bogoch, the infectious diseases specialist in Toronto.

Those delays matter given the time-sensitive nature of tick-borne illnesses, which aren’t yet preventable through any approved vaccines.

When it comes to bacterial infections, prompt antibiotic treatments can be crucial to ensure someone’s infection doesn’t progress into dangerous territory. (In some cases, mild illness resolves on its own. There’s also no specific treatment for Powassan virus, but rather supportive care to manage its range of symptoms, including pain control for headaches, or rehydration for vomiting.)

Ottawa resident MaryAnn Harris during her lengthy hospital stay, which lasted from Sept. 2021 to her death from Powassan virus in June 2024. (Supplied by Charles de Lint)

Ottawa-area resident Mary Raths considers herself lucky for getting a prompt anaplasmosis diagnosis and treatment when she fell ill with a headache, nausea, and fever, not long after a camping trip in 2021.

Raths first tested herself for COVID-19, and when that came back negative, she went to a nearby hospital. After being admitted, she soon felt like “one of those mystery patients.”

“They did so many tests…. I don’t even remember a lot of the things they did, because I was that ill, but they did so many different blood tests, they did X-rays, they did a CT scan,” she recalled.

Thankfully, said Raths, her attending physician had previously treated an anaplasmosis patient and knew to consider the tick-borne disease. Within 24 hours she was given heavy-duty antibiotics as a precaution, and after five days in hospital, she ended up making a full recovery.

It wasn’t until later on that blood tests confirmed she had indeed caught the bacterial infection, likely from a tick bite on her recent camping trip.

“They made their best guess, and treated me for that, and confirmed it later,” she explained. “If I hadn’t recovered so quickly, it would’ve been scary.”

‘We’re behind the 8-ball’

Not all patients are that fortunate, and limited awareness remains a challenge, Bogoch stressed. “We’re behind the 8-ball,” he said, “and we definitely have a lot of catching up to do.”

In a statement, PHAC told CBC News a new national tick-borne disease surveillance dashboard is under development and could be up-and-running by this fall. It’s meant to give Canadians a picture of case counts over time, broken down by geographic, demographic, and seasonal factors, with a focus on Lyme disease.

But the first provincial data for that trio of additional infections — anaplasmosis, babesiosis, and Powassan — isn’t expected until summer 2025, the agency said.

Timing aside, Coatsworth is hopeful that more data-sharing will give Canadians a better sense of where they’re most at risk, so people can try to prevent tick bites from happening in the first place.

“As you enjoy the outdoors, it’s probably going to be a new reality,” she warned.

A warming climate means a greater tick population and more tick-borne illnesses in Canada. Ontario already tracks cases of lyme disease, but starting now, it will also track three other tick-borne illnesses, including anaplasmosis, babesiosis and powassan virus disease.

A life cut short

That reality is one de Lint hopes others won’t have to face, given the suffering and high level of paralysis his wife endured following her Powassan infection. The couple doesn’t even know where she got bit, he added, since Harris hadn’t spent time beyond their own Ottawa neighbourhood leading up to her illness.

“I really hope that doctors, especially the ER docs, are more educated and given more data and information so they can recognize this kind of thing when it comes across them,” he said.

The Ottawa resident recounted four decades of memories with Harris, prior to her illness. From the couple’s meet-cute while de Lint was working in a record shop and Harris was searching for a mandolin player, to “years and years” of playing music together, to their longtime creative collaborations through Harris’s work as an artist and de Lint’s career as a writer and novelist — all of it, he said, was cut short.

“It was terrible what happened to MaryAnn, but she had 70 years,” de Lint added. “Imagine this happening to a kid? Their life would be over.”

How to avoid tick bites

Prevent bites

  • Wear light coloured long-sleeved shirts and pants.
  • Tuck your shirt into your pants, and your pants into your socks.
  • Wear closed-toe shoes.
  • Use bug spray with DEET or icaridin.
  • Walk on cleared paths or walkways.
  • You can also wear permethrin-treated clothing, now available in Canada.

Check for ticks

  • Shower or bathe as soon as possible after being outdoors.
  • Do a daily full body tick check on yourself, your children, your pets and your gear.
  • Put your clothes in a dryer on high heat for at least 10 minutes.

Take action if bitten

  • If you spot a tick, use clean fine-point tweezers to immediately remove it from your skin.
  • Keep the tick in a closed container and bring it with you if you go see your health care provider.
  • Contact your health care provider if you’re not feeling well or if you are concerned after being bitten by a tick.

Source: Public Health Agency of Canada

 

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Health Canada approves updated Moderna COVID-19 vaccine

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TORONTO – Health Canada has authorized Moderna’s updated COVID-19 vaccine that protects against currently circulating variants of the virus.

The mRNA vaccine, called Spikevax, has been reformulated to target the KP.2 subvariant of Omicron.

It will replace the previous version of the vaccine that was released a year ago, which targeted the XBB.1.5 subvariant of Omicron.

Health Canada recently asked provinces and territories to get rid of their older COVID-19 vaccines to ensure the most current vaccine will be used during this fall’s respiratory virus season.

Health Canada is also reviewing two other updated COVID-19 vaccines but has not yet authorized them.

They are Pfizer’s Comirnaty, which is also an mRNA vaccine, as well as Novavax’s protein-based vaccine.

This report by The Canadian Press was first published Sept. 17, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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These people say they got listeria after drinking recalled plant-based milks

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TORONTO – Sanniah Jabeen holds a sonogram of the unborn baby she lost after contracting listeria last December. Beneath, it says “love at first sight.”

Jabeen says she believes she and her baby were poisoned by a listeria outbreak linked to some plant-based milks and wants answers. An investigation continues into the recall declared July 8 of several Silk and Great Value plant-based beverages.

“I don’t even have the words. I’m still processing that,” Jabeen says of her loss. She was 18 weeks pregnant when she went into preterm labour.

The first infection linked to the recall was traced back to August 2023. One year later on Aug. 12, 2024, the Public Health Agency of Canada said three people had died and 20 were infected.

The number of cases is likely much higher, says Lawrence Goodridge, Canada Research Chair in foodborne pathogen dynamics at the University of Guelph: “For every person known, generally speaking, there’s typically 20 to 25 or maybe 30 people that are unknown.”

The case count has remained unchanged over the last month, but the Public Health Agency of Canada says it won’t declare the outbreak over until early October because of listeria’s 70-day incubation period and the reporting delays that accompany it.

Danone Canada’s head of communications said in an email Wednesday that the company is still investigating the “root cause” of the outbreak, which has been linked to a production line at a Pickering, Ont., packaging facility.

Pregnant people, adults over 60, and those with weakened immune systems are most at risk of becoming sick with severe listeriosis. If the infection spreads to an unborn baby, Health Canada says it can cause miscarriage, stillbirth, premature birth or life-threatening illness in a newborn.

The Canadian Press spoke to 10 people, from the parents of a toddler to an 89-year-old senior, who say they became sick with listeria after drinking from cartons of plant-based milk stamped with the recalled product code. Here’s a look at some of their experiences.

Sanniah Jabeen, 32, Toronto

Jabeen says she regularly drank Silk oat and almond milk in smoothies while pregnant, and began vomiting seven times a day and shivering at night in December 2023. She had “the worst headache of (her) life” when she went to the emergency room on Dec. 15.

“I just wasn’t functioning like a normal human being,” Jabeen says.

Told she was dehydrated, Jabeen was given fluids and a blood test and sent home. Four days later, she returned to hospital.

“They told me that since you’re 18 weeks, there’s nothing you can do to save your baby,” says Jabeen, who moved to Toronto from Pakistan five years ago.

Jabeen later learned she had listeriosis and an autopsy revealed her baby was infected, too.

“It broke my heart to read that report because I was just imagining my baby drinking poisoned amniotic fluid inside of me. The womb is a place where your baby is supposed to be the safest,” Jabeen said.

Jabeen’s case is likely not included in PHAC’s count. Jabeen says she was called by Health Canada and asked what dairy and fresh produce she ate – foods more commonly associated with listeria – but not asked about plant-based beverages.

She’s pregnant again, and is due in several months. At first, she was scared to eat, not knowing what caused the infection during her last pregnancy.

“Ever since I learned about the almond, oat milk situation, I’ve been feeling a bit better knowing that it wasn’t something that I did. It was something else that caused it. It wasn’t my fault,” Jabeen said.

She’s since joined a proposed class action lawsuit launched by LPC Avocates against the manufacturers and sellers of Silk and Great Value plant-based beverages. The lawsuit has not yet been certified by a judge.

Natalie Grant and her seven year-old daughter, Bowmanville, Ont.

Natalie Grant says she was in a hospital waiting room when she saw a television news report about the recall. She wondered if the dark chocolate almond milk her daughter drank daily was contaminated.

She had brought the girl to hospital because she was vomiting every half hour, constantly on the toilet with diarrhea, and had severe pain in her abdomen.

“I’m definitely thinking that this is a pretty solid chance that she’s got listeria at this point because I knew she had all the symptoms,” Grant says of seeing the news report.

Once her daughter could hold fluids, they went home and Grant cross-checked the recalled product code – 7825 – with the one on her carton. They matched.

“I called the emerg and I said I’m pretty confident she’s been exposed,” Grant said. She was told to return to the hospital if her daughter’s symptoms worsened. An hour and a half later, her fever spiked, the vomiting returned, her face flushed and her energy plummeted.

Grant says they were sent to a hospital in Ajax, Ont. and stayed two weeks while her daughter received antibiotics four times a day until she was discharged July 23.

“Knowing that my little one was just so affected and how it affected us as a family alone, there’s a bitterness left behind,” Grant said. She’s also joined the proposed class action.

Thelma Feldman, 89, Toronto

Thelma Feldman says she regularly taught yoga to friends in her condo building before getting sickened by listeria on July 2. Now, she has a walker and her body aches. She has headaches and digestive problems.

“I’m kind of depressed,” she says.

“It’s caused me a lot of physical and emotional pain.”

Much of the early days of her illness are a blur. She knows she boarded an ambulance with profuse diarrhea on July 2 and spent five days at North York General Hospital. Afterwards, she remembers Health Canada officials entering her apartment and removing Silk almond milk from her fridge, and volunteers from a community organization giving her sponge baths.

“At my age, 89, I’m not a kid anymore and healing takes longer,” Feldman says.

“I don’t even feel like being with people. I just sit at home.”

Jasmine Jiles and three-year-old Max, Kahnawake Mohawk Territory, Que.

Jasmine Jiles says her three-year-old son Max came down with flu-like symptoms and cradled his ears in what she interpreted as a sign of pain, like the one pounding in her own head, around early July.

When Jiles heard about the recall soon after, she called Danone Canada, the plant-based milk manufacturer, to find out if their Silk coconut milk was in the contaminated batch. It was, she says.

“My son is very small, he’s very young, so I asked what we do in terms of overall monitoring and she said someone from the company would get in touch within 24 to 48 hours,” Jiles says from a First Nations reserve near Montreal.

“I never got a call back. I never got an email”

At home, her son’s fever broke after three days, but gas pains stuck with him, she says. It took a couple weeks for him to get back to normal.

“In hindsight, I should have taken him (to the hospital) but we just tried to see if we could nurse him at home because wait times are pretty extreme,” Jiles says, “and I don’t have child care at the moment.”

Joseph Desmond, 50, Sydney, N.S.

Joseph Desmond says he suffered a seizure and fell off his sofa on July 9. He went to the emergency room, where they ran an electroencephalogram (EEG) test, and then returned home. Within hours, he had a second seizure and went back to hospital.

His third seizure happened the next morning while walking to the nurse’s station.

In severe cases of listeriosis, bacteria can spread to the central nervous system and cause seizures, according to Health Canada.

“The last two months have really been a nightmare,” says Desmond, who has joined the proposed lawsuit.

When he returned home from the hospital, his daughter took a carton of Silk dark chocolate almond milk out of the fridge and asked if he had heard about the recall. By that point, Desmond says he was on his second two-litre carton after finishing the first in June.

“It was pretty scary. Terrifying. I honestly thought I was going to die.”

Cheryl McCombe, 63, Haliburton, Ont.

The morning after suffering a second episode of vomiting, feverish sweats and diarrhea in the middle of the night in early July, Cheryl McCombe scrolled through the news on her phone and came across the recall.

A few years earlier, McCombe says she started drinking plant-based milks because it seemed like a healthier choice to splash in her morning coffee. On June 30, she bought two cartons of Silk cashew almond milk.

“It was on the (recall) list. I thought, ‘Oh my God, I got listeria,’” McCombe says. She called her doctor’s office and visited an urgent care clinic hoping to get tested and confirm her suspicion, but she says, “I was basically shut down at the door.”

Public Health Ontario does not recommend listeria testing for infected individuals with mild symptoms unless they are at risk of developing severe illness, such as people who are immunocompromised, elderly, pregnant or newborn.

“No wonder they couldn’t connect the dots,” she adds, referencing that it took close to a year for public health officials to find the source of the outbreak.

“I am a woman in my 60s and sometimes these signs are of, you know, when you’re vomiting and things like that, it can be a sign in women of a bigger issue,” McCombe says. She was seeking confirmation that wasn’t the case.

Disappointed, with her stomach still feeling off, she says she decided to boost her gut health with probiotics. After a couple weeks she started to feel like herself.

But since then, McCombe says, “I’m back on Kawartha Dairy cream in my coffee.”

This report by The Canadian Press was first published Sept. 16, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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B.C. mayors seek ‘immediate action’ from federal government on mental health crisis

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VANCOUVER – Mayors and other leaders from several British Columbia communities say the provincial and federal governments need to take “immediate action” to tackle mental health and public safety issues that have reached crisis levels.

Vancouver Mayor Ken Sim says it’s become “abundantly clear” that mental health and addiction issues and public safety have caused crises that are “gripping” Vancouver, and he and other politicians, First Nations leaders and law enforcement officials are pleading for federal and provincial help.

In a letter to Prime Minister Justin Trudeau and Premier David Eby, mayors say there are “three critical fronts” that require action including “mandatory care” for people with severe mental health and addiction issues.

The letter says senior governments also need to bring in “meaningful bail reform” for repeat offenders, and the federal government must improve policing at Metro Vancouver ports to stop illicit drugs from coming in and stolen vehicles from being exported.

Sim says the “current system” has failed British Columbians, and the number of people dealing with severe mental health and addiction issues due to lack of proper care has “reached a critical point.”

Vancouver Police Chief Adam Palmer says repeat violent offenders are too often released on bail due to a “revolving door of justice,” and a new approach is needed to deal with mentally ill people who “pose a serious and immediate danger to themselves and others.”

This report by The Canadian Press was first published Sept. 16, 2024

The Canadian Press. All rights reserved.

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