The city’s public health unit and doctors are urging people to get vaccinated against a potentially fatal bacterial disease amid a rise in cases.
Toronto Public Health (TPH) has reported 14 confirmed cases of invasive meningococcal disease (IMD) so far this year, more than double the previous average of six cases per year.
“This is a substantial increase and we’re not even halfway through the year already,” Toronto’s associate medical officer of health Dr. Vinita Dubey said in an interview.
She also noted that a strain of the disease called W-135, which is not usually common in Canada, has already proven deadly.
“We’ve had one child and one adult who have died. These are very tragic deaths,” Dubey said.
IMD is a rare but life-threatening bacterial infection that can infect the brain and spinal cord, causing meningitis, and the bloodstream, causing septicemia. Teens and infants are most likely to become infected and up to 10 per cent of all patients with IMD die, according to Health Canada.
The spread of IMD is of particular concern for health agencies right now, as summer travel gears up and large, densely populated events kick off. Doctors also note that many kids are still behind on vaccinations they missed while learning remotely during the COVID-19 pandemic.
Ontario issues warning: update kids’ vax records or face school suspension
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W-135 strain causing hospitalizations
Dubey said all five strains of IMD — A, B, C, Y and W-135 — tend to spread in Canada, but the W-135 variant in particular has hospitalized everyone who has had it recently in Toronto.
“The strain is called a hypervirulent strain, meaning that it can make you very sick,” she said. “It comes on quickly and it progresses quickly.”
The W-135 strain usually makes up 20 per cent of all cases in Toronto, but that’s increased to half this year, according to TPH.
Dr. Allison McGeer, an infectious diseases specialist at Toronto’s Mount Sinai Hospital, said the W-135 variant is commonly found in Saudi Arabia, which causes concern among health providers before and after the Hajj pilgrimage every year.
Muslims perform the Eid al-Adha morning prayer in Saudi Arabia’s holy city of Mecca, on the first day of the holiday marking the end of the Hajj pilgrimage, on June 16, 2024. The W-135 strain of IMD is common in Saudi Arabia and can be spread at crowded events, such as the annual Hajj pilgrimage, says one infectious diseases doctor. (AFP/Getty Images)
“The Hajj has so many people grouped together and meningococcal vaccines have been relatively expensive, and so they’re out of reach of many countries in the world,” McGeer said.
TPH is encouraging people returning from Saudi Arabia to watch for IMD symptoms, such as fever and headache, and to avoid sharing food and drinks as a precaution.
Dubey said someone may carry the bacteria for weeks or months before it causes severe disease.
Vaccine for B strain not publicly-funded: doctor
Ontario residents aged 18 to 38, including newcomers, who have not received IWD vaccines when they were in school, are eligible for a publicly funded meningococcal vaccine that protects against most strains of the disease.
Toronto-based family physician Dr. Vivien Brown, who also sits on the board of Immunize Canada, said the vaccine that protects against meningococcal B is not publicly funded.
“It’s not as simple as, ‘Just get your vaccine from public health,'” Brown said.
She recommends that vulnerable age groups, especially teenagers going into university this year, should consult their doctor about whether they should receive a B vaccine.
“It’s those adolescents leaving high school, getting into university, where, unfortunately, we see this killer disease,” she said.
Ontario residents aged 18 to 38 are eligible for a publicly funded meningococcal vaccine that protects against most strains of the disease. (Evan Mitsui/CBC)
Newcomers encouraged to get shot
The city’s public health unit is also encouraging newcomers to get vaccinated, as IMD shots aren’t common in many of their home countries.
“We had an outbreak of meningococcal C strain in our city in 2022 that was hitting young adults and most of those were newcomers,” Dubey said.
Those who don’t know whether they’ve received any of the IMD vaccines, should get vaccinated just in case, Brown said.
“It’s safer to get a second shot than to have missed the shot altogether,” Brown said.
Infectious disease specialist Dr. Dick Zoutman said some newcomers may not know they’re able to receive a vaccine or could be sceptical about getting one due to mistrust or misinformation.
“The critical element there is to look at providing as much information [as possible] that is appropriately developed for the audience,” Zoutman said.
He said it’s important that informational campaigns are in people’s native language and promote education.
“Many people have a very significant misunderstanding about what vaccines can do and what they can’t do and what the risks are,” he said.
“Overall, vaccines have saved an enormous number of human lives.“
Some Ontario doctors have started offering a free shot that can protect babies from respiratory syncytial virus while Quebec will begin its immunization program next month.
The new shot called Nirsevimab gives babies antibodies that provide passive immunity to RSV, a major cause of serious lower respiratory tract infections for infants and seniors, which can cause bronchiolitis or pneumonia.
Ontario’s ministry of health says the shot is already available at some doctor’s offices in Ontario with the province’s remaining supply set to arrive by the end of the month.
Quebec will begin administering the shots on Nov. 4 to babies born in hospitals and delivery centers.
Parents in Quebec with babies under six months or those who are older but more vulnerable to infection can also book immunization appointments online.
The injection will be available in Nunavut and Yukon this fall and winter, though administration start dates have not yet been announced.
This report by The Canadian Press was first published Oct. 21, 2024.
-With files from Nicole Ireland
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
ISLAMABAD (AP) — Polio cases are rising ahead of a new vaccination campaign in Pakistan, where violence targeting health workers and the police protecting them has hampered years of efforts toward making the country polio-free.
Since January, health officials have confirmed 39 new polio cases in Pakistan, compared to only six last year, said Anwarul Haq of the National Emergency Operation Center for Polio Eradication.
The new nationwide drive starts Oct. 28 with the aim to vaccinate at least 32 million children. “The whole purpose of these campaigns is to achieve the target of making Pakistan a polio-free state,” he said.
Pakistan regularly launches campaigns against polio despite attacks on the workers and police assigned to the inoculation drives. Militants falsely claim the vaccination campaigns are a Western conspiracy to sterilize children.
Most of the new polio cases were reported in the southwestern Balochistan and southern Sindh province, following by Khyber Pakhtunkhwa province and eastern Punjab province.
The locations are worrying authorities since previous cases were from the restive northwest bordering Afghanistan, where the Taliban government in September suddenly stopped a door-to-door vaccination campaign.
Afghanistan and Pakistan are the two countries in which the spread of the potentially fatal, paralyzing disease has never been stopped. Authorities in Pakistan have said that the Taliban’s decision will have major repercussions beyond the Afghan border, as people from both sides frequently travel to each other’s country.
The World Health Organization has confirmed 18 polio cases in Afghanistan this year, all but two in the south of the country. That’s up from six cases in 2023. Afghanistan used a house-to-house vaccination strategy this June for the first time in five years, a tactic that helped to reach the majority of children targeted, according to WHO.
Health officials in Pakistan say they want the both sides to conduct anti-polio drives simultaneously.
WASHINGTON (AP) — Millions of people with private health insurance would be able to pick up over-the-counter methods like condoms, the “morning after” pill and birth control pills for free under a new rule the White House proposed on Monday.
Right now, health insurers must cover the cost of prescribed contraception, including prescription birth control or even condoms that doctors have issued a prescription for. But the new rule would expand that coverage, allowing millions of people on private health insurance to pick up free condoms, birth control pills, or “morning after” pills from local storefronts without a prescription.
The proposal comes days before Election Day, as Vice President Kamala Harris affixes her presidential campaign to a promise of expanding women’s health care access in the wake of the U.S. Supreme Court’s decision to undo nationwide abortion rights two years ago. Harris has sought to craft a distinct contrast from her Republican challenger, Donald Trump, who appointed some of the judges who issued that ruling.
“The proposed rule we announce today would expand access to birth control at no additional cost for millions of consumers,” Health and Human Services Secretary Xavier Becerra said in a statement. “Bottom line: women should have control over their personal health care decisions. And issuers and providers have an obligation to comply with the law.”
The emergency contraceptives that people on private insurance would be able to access without costs include levonorgestrel, a pill that needs to be taken immediately after sex to prevent pregnancy and is more commonly known by the brand name “Plan B.”
Without a doctor’s prescription, women may pay as much as $50 for a pack of the pills. And women who delay buying the medication in order to get a doctor’s prescription could jeopardize the pill’s effectiveness, since it is most likely to prevent a pregnancy within 72 hours after sex.
If implemented, the new rule would also require insurers to fully bear the cost of the once-a-day Opill, a new over-the-counter birth control pill that the U.S. Food and Drug Administration approved last year. A one-month supply of the pills costs $20.
Federal mandates for private health insurance to cover contraceptive care were first introduced with the Affordable Care Act, which required plans to pick up the cost of FDA-approved birth control that had been prescribed by a doctor as a preventative service.
The proposed rule would not impact those on Medicaid, the insurance program for the poorest Americans. States are largely left to design their own rules around Medicaid coverage for contraception, and few cover over-the-counter methods like Plan B or condoms.
