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Trench fever, rare disease that afflicted WWI soldiers, detected in homeless Winnipeggers – CBC.ca

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An infectious diseases specialist is calling on doctors to be aware of the signs of a rare illness he recently diagnosed four times among homeless people in Winnipeg — one that commonly afflicted soldiers during the First World War.

Dr. Carl Boodman says trench fever is also known to infect people in crowded refugee camps, but he treated four patients within a couple of months, and they had all lived in shelters.

The disease is transmitted through the feces of body lice, which can be left on clothing and trigger an itchy reaction, causing people to scratch their skin to the point that they end up with abrasions, Boodman said.

That is one of the telltale signs of the misunderstood infectious disease, which can also cause fever, shin pain and a potentially fatal heart infection called endocarditis.

The four cases this year are the only ones known to have occurred in Canada since the mid-1990s, said Boodman, who is also training in medical microbiology at the University of Manitoba.

However, cases may go undiagnosed because doctors are unlikely to be aware of what to look for and therefore don’t order specific lab tests to detect a bacterium called Bartonella quintana, which was first linked to the condition a century ago, he said.

Dr. Carl Boodman says trench fever is a neglected and preventable disease of poverty that impacts people who are homeless and have little access to medical care. (Jeff Stapleton/CBC)

Boodman, who is the lead author of an article highlighting trench fever in Monday’s edition of the Canadian Medical Association Journal, said the neglected and preventable disease of poverty is known to strike people who are homeless and have little access to medical care.

“It’s a disease associated with wartime conditions and refugee camps and it’s found in Canada. If we didn’t have this degree of poverty in Canada, we wouldn’t have this disease,” he said.

People living in shelters may share clothing on which the dried feces of body lice can survive for weeks, Boodman said, noting there’s a public health need for access to laundry facilities and showers as well as affordable housing to prevent spread of disease in general among people who are under-housed across Canada.

You don’t know anything about it for 20 years or so and then you have this succession of cases.– Dr. Carl Boodman

He treated his first case of trench fever in February when a patient visited an emergency department in Winnipeg.

The 48-year-old man with shortness of breath and chest pain had repeatedly sought medical care in the previous year and a half for episodes of chest pain and body lice infestation, Boodman said about the patient, who was in ICU and spent a month in hospital following heart surgery for endocarditis. He has since recovered.

About two weeks after starting to treat that patient, Boodman was so “baffled” when he saw a second patient with what appeared to be trench fever that he had the lab tests repeated twice before confirming the diagnosis.

He treated a third patient for the same disease at a different hospital about a month later, before a colleague mentioned a mysterious case involving a man who had endocarditis. Lab tests confirmed he, too, had trench fever.

“You don’t know anything about it for 20 years or so and then you have this succession of cases,” Boodman said, adding some patients may have the bacterium associated with body lice in their bloodstream for months and be asymptomatic for the disease that could become serious, requiring surgery to replace a heart valve.

This is one of two large homeless camps that were erected in the summer near the Disraeli Freeway in Winnipeg. (Justin Fraser/CBC)

A combination of antibiotics is often prescribed but there is debate on treatment of the disease, and its prevalence is unknown because it is not reported to public health officials in Canada and the United States, Boodman said.

Small studies from cases in the south of France and cities in the United States, including Seattle and San Francisco, have estimated that up to 20 per cent of homeless people with body lice could have been exposed to the bacterium that causes trench fever, Boodman said.

Dr. Stephen Hwang, who holds a research chair in homelessness, housing and health at St. Michael’s Hospital and the University of Toronto, said that while there is a need to recognize the rare but potentially deadly trench fever, other conditions such as skin infections, respiratory illnesses, poorly controlled diabetes and high blood pressure are common among under-housed populations.

Hwang treats homeless people in Toronto’s shelters and encampments once a week as a member of a group called the Inner City Health Associates, the largest such organization in Canada, with 100 physicians as well as nurses providing care to the under-housed in multiple locations including respite centres and hotels.

The aim is to provide better primary care to people who also experience more mental health and addictions issues, he said, noting secure housing is key to better health, especially as more families and seniors are becoming homeless.

“Without that stability it’s very difficult to deal with any of the acute or chronic conditions that they’re dealing with. We really do need to invest in creating affordable housing or else we’ll have to pay with the cost of the health consequences of that.”

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How many lives have coronavirus vaccines saved? We used state data on deaths and vaccination rates to find out – Devdiscourse

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By Sumedha GuptaAssociate Professor of Economics, IUPUI Indianapolis, Oct 17 (The Conversation) More than 200 million US residents have gotten at least one shot of a COVID-19 vaccine with the expectation that the vaccines slow virus transmission and save lives.

Researchers know the efficacy of the vaccines from large-scale clinical trials, the gold standard for medical research. The studies found the vaccines to be very effective at preventing severe COVID–19 and especially good at preventing death. But it’s important to track any new treatment in the real world as the population-level benefits of vaccines could differ from the efficacy found in clinical trials.

For instance, some people in the US have only been getting the first shot of a two-shot vaccine and are therefore less protected than a fully vaccinated person. Alternatively, vaccinated people are much less likely to transmit COVID-19 to others, including those who are not vaccinated. This could make vaccines more effective at a population level than in the clinical trials.

I am a health economist, and my team and I have been studying the effects of public policy interventions like vaccination have had on the pandemic. We wanted to know how many lives vaccines may have saved due to the states’ COVID-19 vaccination campaigns in the US.

In March 2021, when weekly data on state COVID-19 vaccinations started to become reliably available from state agencies, my team began to analyze the association between state vaccination rates and the subsequent COVID-19 cases and deaths in each state. Our goal was to build a model that was accurate enough to measure the effect of vaccination within the complicated web of factors that influence COVID–19 deaths.

To do this, our model compares COVID-19 incidence in states with high vaccination rates against states with low vaccination rates. As part of the analysis, we controlled for things that influence the spread of the coronavirus, like state–by–state differences in weather and population density, seasonally driven changes in social behaviour and non-pharmaceutical interventions like stay-at-home orders, mask mandates and overnight business closures. We also accounted for the fact that there is a delay between when a person is first vaccinated and when their immune system has built up protection.

To check the strength of our model before playing with variables, we first compared reported deaths with an estimate that our model produced.

When we fed it all of the information available – including vaccination rates – the model calculated that by May 9, 2021, there should have been 569,193 COVID-19 deaths in the US. The reported death count by that date was 578,862, less than a 2 per cent difference from our model’s prediction.

Equipped with our well-working statistical model, we were then able to “turn off” the vaccination effect and see how much of a difference vaccines made.

Using near real-time data of state vaccination rates, coronavirus cases and deaths in our model, we found that in the absence of vaccines, 708,586 people would have died by May 9, 2021. We then compared that to our model estimate of deaths with vaccines: 569,193. The difference between those two numbers is just under 140,000. Our model suggests that vaccines saved 140,000 lives by May 9, 2021.

Our study only looked at the few months just after vaccination began. Even in that short time frame, COVID-19 vaccinations saved many thousands of lives despite vaccination rates still being fairly low in several states by the end of our study period. I can say with certainty that vaccines have since then saved many more lives – and will continue to do so as long as the coronavirus is still around.(The Conversation) RUP

(This story has not been edited by Devdiscourse staff and is auto-generated from a syndicated feed.)

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Week five without LRT service and Canada's women's soccer team plays in Ottawa: Five stories to watch this week – CTV Edmonton

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OTTAWA —
A fifth week begins without LRT service, Ottawa’s top doctor has ‘cautious optimism’ for fall during the COVID-19 pandemic, and Canada’s Olympic champion women’s soccer team takes the pitch at TD Place.

CTVNewsOttawa.ca looks at five stories to watch in Ottawa this week

ALL ABOARD? CITY REVIEWS RETURN TO SERVICE PLAN FOR LRT

Ottawa transit riders could find out this week when service will resume on the Confederation Line.

City staff spent the weekend reviewing the return-to-service plan submitted by Rideau Transit Group following the LRT car derailment near Tremblay Station on Sept. 19.

Sources tell CTV News Ottawa the RTM return to service plan has a specific date, but staff must review the entire plan to assess if it’s possible. Officials expect that when the trains resume, it will be a gradual return to service.

City Manager Steve Kanellakos told council last week that Rideau Transit Group has identified a loose gearbox as the issue that caused the derailment.

The Transit Commission is scheduled to receive an update on the Confederation Line on Wednesday, which could include details on the derailment and return to service plan.

Meantime, the new boss of OC Transpo arrives on Monday.

Renee Amilcar replaces John Manconi as Transportation Services General Manager after Manconi retired last month. Amilcar worked with Montreal’s transit system as the director of bus maintenance.

QR CODES FOR COVID-19 VACCINE PASSPORT

Ontario’s new COVID-19 vaccine verification app and QR code system will roll out this week for people to access non-essential restaurants and services.

Individuals can download their QR codes through the Ontario government’s website, while businesses can download an app to check a vaccination status.

When a proof of vaccination QR code is scanned in the app, it will respond with either a green check, yellow caution sign or a red “X,” which means the certificate is invalid.

The yellow caution sign could be issued because the vaccine certificate being scanned was issued outside of Canada, the app says.

You will still need to show a piece of ID with the QR code.

Verify Ontario app

‘CAUTIOUS OPTIMSIM’ ON COVID-19 SITUATION IN OTTAWA

With Ottawa approaching a first dose vaccination rate of 90 per cent, medical officer of health Dr. Vera Etches says her outlook for fall is “one of cautious optimism.”

However, Dr. Etches is concerned about the number of close contacts unvaccinated children under 12 currently have.

“The most common source of COVID-19 infections for children and youth are household members.”

Etches is asking parents to limit extra curricular activities, sleepovers and other social activities outside of school for unvaccinated school to limit cases and help keep schools open.

Currently 89 per cent of Ottawa residents 12 and older have received one dose of a COVID-19 vaccine, while 85 per cent of residents are fully vaccinated. Dr. Etches has set a goal of over 90 per cent of residents fully vaccinated to limit the spread of the virus.

As of Sunday, there are five outbreaks in Ottawa elementary schools. The number of active cases is at 258, and hospitalizations remain low.

COVID-19 vaccine in Ottawa

MORE MONEY FOR THE OTTAWA PUBLIC LIBRARY

Ottawa’s finance and economic development committee and the Ottawa Public Library Board will vote Tuesday on spending more money to build the new super-library at LeBreton Flats.

The price-tag for the new joint library between the Ottawa Public Library and Library and Archives Canada jumped by $131 million, plus another $10 million for the parking garage.

A report says the increase from the initial estimate of $193 million (including the parking garage) to $334 million can be directly attributed to an escalation in the construction market.

“Canada is experiencing a significant increase in construction costs due to COVID-19 impacts,” said staff. “A combination of material shortages and commodity escalation, supply chain slowdowns and pressures, labour implications and a superheated construction market, have all been described by the Ottawa Construction Association and observed in recent city tenders.”

The city of Ottawa must spend an extra $65 million for the new super library, which will be covered through borrowing, using surplus funds and development charges.

Ottawa Public Library

CANADA’S WOMEN’S SOCCER TEAM PLAYS IN OTTAWA

Canada’s Olympic champion women’s soccer team will play in Ottawa next weekend, the first match since winning a historic Gold medal at the Summer Games in Tokyo.

Canada faces New Zealand at TD Place as part of the Women’s National Team Celebration Tour.  Game time 3 p.m. Saturday.

The team includes Ottawa’s Vanessa Gilles, who scored the decisive penalty shootout goal for Canada in the quarterfinals against Brazil.

For tickets, visit canadasoccer.com

canada women's soccer

EVENTS HAPPENING IN OTTAWA THIS WEEK

Tuesday

Ottawa Finance and Economic Development Committee meeting – 9 a.m.

Standing Committee on Environmental Protection, Water and Waste Management meeting – 1 p.m.

Ottawa Public Library Board meeting – 5 p.m.

Wednesday

Ottawa Transit Commission meeting – 9:30 a.m.

Atletico Ottawa vs. Valour FC. 7 p.m. at TD Place (TSN 1200)

Thursday

Ottawa Community and Protective Services Committee meeting – 9:30 a.m.

Ottawa Senators vs. San Jose Sharks. 7 p.m. at Canadian Tire Centre (TSN 1200 and TSN 5)

Saturday

Ottawa Senators vs New York Rangers. 1 p.m. at Canadian Tire Centre (TSN 5 and TSN 1200)

Canada’s women’s soccer team vs. New Zealand. 3 p.m. at TD Place

Ottawa Redblacks at Hamilton. 4 p.m. (TSN 1200 and TSN)

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Three more COVID-19 related deaths, 58 new cases, in New Brunswick Sunday – CTV News Atlantic

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New Brunswick is reporting three more COVID-19 related deaths on Sunday, bringing the total number in the province to 90. 

All three deaths occurred in Zone 5 (Campbellton region). Two people were aged 40-49 and one person was aged 80-89.

“My thoughts are with the loved ones of the people who have passed away today,”Premier Blaine Higgs said in a release.

“We all have a role to play in slowing the spread of the virus. I want to thank the businesses that have taken steps to motivate employees to get vaccinated and I encourage other businesses to do the same. COVID-19 can pose a serious risk in the workplace and may impact a business’s operations, especially if an unvaccinated employee contracts the disease.”

There are 57 people hospitalized due to the virus, with 18 in an intensive care unit.

“Of the 18 in an intensive care unit, none are fully vaccinated (16 are unvaccinated and two are partially vaccinated). Of the total of all hospitalized, 29 are unvaccinated, six are partially vaccinated and 22 are fully vaccinated,” says the release.

58 NEW CASES

Public health is also reporting 58 new cases of COVID-19 Sunday and 117 recoveries, dropping the number of active cases to 935.

Of the new cases, 35 – or 60 per cent – are unvaccinated, five – or nine per cent – are partially vaccinated, and 20 – or 34 per cent – are fully vaccinated.

RAPID-TESTING PROGRAM EXPANDS

Beginning Monday, Oct. 18, people who are not a positive COVID-19 case will be able to pick up free rapid-test kits which they can administer at home.

Public Health has doubled the number of rapid test kits for each pick-up location Monday and throughout this week to help meet the initial high demand.

All the pick-up centres will be open during their scheduled hours or until the daily supply has been given out.

“We’re grateful for the high interest in these tests as people clearly want to do what they can to help fight the COVID-19 virus,” Dr. Jennifer Russell, chief medical officer of health, said in a release.

“Thank you for your patience with staff at the centres as they work as quickly as possible to distribute the tests.”

The kits will be available to the public at large at the following locations provincewide:

  • Moncton: Greater Moncton Health Centre, 150 Edmonton Ave., (3 p.m. to 9 p.m. Monday to Thursday, 1 p.m. to 5 p.m. Friday, and 9 a.m. to noon Saturday)
  • Cocagne: Cocagne Health Clinic, 4813 Rte. 134, (8 a.m. to 10 a.m. and 2 p.m. to 4 p.m. Monday to Thursday, and 8 a.m. to noon Friday)
  • Moncton: 380 MacNaughton Ave. (10 a.m. to 6 p.m. Monday to Friday)
  • Edmundston: Edmundston Regional Hospital, 275 Hébert Blvd., (2 p.m. to 4 p.m. Monday to Friday)
  • Clair: Haut-Madawaska Medical Clinic, 809 Principale St., (1 p.m. to 3:30 p.m. Tuesday, Wednesday and Thursday)
  • Grand Falls: Grand Falls General Hospital, 625 Everard H. Daigle Blvd., (8 a.m. to 4 p.m. Monday to Friday)
  • Saint-Quentin: Hôtel-Dieu Saint-Joseph de Saint-Quentin, 21 Canada St., (2 p.m. to 5 p.m. daily)
  • Campbellton: E.L. Murray Medical Clinic, 3 Stanley St., (2 p.m. to 4 p.m. Monday to Friday)
  • Dalhousie: St. Joseph Community Health Centre, 280 Victoria St., (noon to 3 p.m. Monday to Friday)
  • Shediac: Shediac Regional Medical Centre, 419 Main St., (8:30 a.m. to 4:30 p.m. Monday to Friday)
  • Belledune: Jacquet River Health Centre, 41 Mack St., (1 p.m. to 3:30 p.m. Monday to Friday)
  • Bathurst: Chaleur Regional Hospital, 1750 Sunset Blvd., (12:30 p.m. to 1:30 p.m. Monday to Saturday)
  • Caraquet: Enfant-Jésus RHSJ Hospital, 1 Saint-Pierre Blvd. W., (1 p.m. to 4 p.m. Monday to Friday)
  • Tracadie: Tracadie Hospital, 400 Des Hospitalières St., (1 p.m. to 3 p.m. daily)
  • Lamèque: Lamèque Hospital and Community Health Centre, 29 De l’Hôpital St., (noon to 3 p.m. Monday to Friday)
  • Paquetville: Paquetville Health Centre, 1096 Du Parc St., (8 a.m. to 4 p.m. Monday, Tuesday, Thursday and Friday, 1 p.m. to 4 p.m. Wednesday)
  • Saint-Isidore: Saint-Isidore Community Health Centre, 3973-1 Des Fondateurs Blvd., (12:30 p.m. to 3 p.m. Monday to Friday)
  • Saint John: Diamond Jubilee Cruise Terminal, (10 a.m. to 6 p.m. Monday to Friday)
  • Fredericton: Exhibition Grounds, 361 Smythe St., (10 a.m. to 6 p.m. Monday to Friday)
  • Miramichi: 365 Wellington St. (10 a.m. to 6 p.m. Monday to Friday)

The rapid test screening program is aimed at people two and older who are not a confirmed positive COVID-19 case. A kit has five tests to be used over a 10-day period. People 16 and under must be accompanied by an adult to acquire a testing kit.

VACCINATION UPDATE

Public Health reported today that 82.4 per cent of eligible New Brunswickers are fully vaccinated against COVID-19 and 91.5 per cent have received their first dose of a vaccine.

All eligible New Brunswickers can book their second-dose appointments for a date that is at least 28 days after their first dose.

Those attending a vaccination clinic are asked to bring their Medicare card, a signed consent form and, for those receiving their second dose, a copy of the record of immunization provided after receiving their first dose.

REGIONAL BREAKDOWN OF NEW CASES

The 15 new cases in Zone 1 (Moncton region) are as follows:

  • four people 19 and under;
  • four people 20-29;
  • two people 30-39;
  • two people 40-49;
  • one person 60-69;
  • one person 70-79; and
  • one person 80-89.

Thirteen cases are under investigation and two cases are contacts of previously confirmed cases.

The three new cases in Zone 2 (Saint John region) are as follows:

  • a person 20-29; and
  • two people 50-59.

All three cases are under investigation.

The ten new cases in Zone 3 (Fredericton region) are as follows:

  • one person 19 and under;
  • a person 20-29;
  • two people 30-39;
  • a person 40-49;
  • a person 50-59; and
  • four people 60-69.

All ten cases are under investigation.

The 13 new cases in Zone 4 (Edmundston region) are as follows:

  • five people 19 and under;
  • three people 20-29
  • a person 30-39;
  • a person 40-49;
  • a person 60-69; and
  • two people 70-79.

Twelve cases are under investigation and one case is a contact of previously confirmed cases.

The 14 new cases in Zone 5 (Campbellton region) are as follows:

  • four people 19 and under;
  • three people 30-39;
  • three people 40-49;
  • two people 50-59;
  • a person 70-79; and
  • a person 80-89.

Twelve cases are under investigation and two cases are contacts of previously confirmed cases.

The two cases in Zone 6 (Bathurst region) are as follows:

  • a person 50-59; and
  • a person 60-69.

Both cases are under investigation.

The one new case in Zone 7 (Miramichi region) is a person 80-89 and the case is under investigation.

Additional information is available on the COVID-19 dashboard.

POTENTIAL PUBLIC EXPOSURES

Anyone with symptoms of the virus, as well as anyone who has been at the site of a possible public exposure, is urged to request a test online to get an appointment.

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