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What Canadians should know about the coronavirus

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Concerns about a viral outbreak in China have put global health officials on alert, but how much of a threat is the coronavirus to Canadians?

The World Health Organization stopped short of calling it a global health emergency, while officials here have said Canadians are at low risk of contracting the illness.

Nevertheless, experts stress the need to be vigilant and prepared for signs of infection. Here are key things to know:

WHAT IS IT?

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Coronaviruses are a large family of viruses that most often cause mild-to-moderate upper respiratory tract illnesses including the common cold, but they can also lead to severe diseases. Some coronaviruses spread between animals, some pass between animals and people, and others go from people to people.

This new virus is different from the coronaviruses that cause Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS).

WHAT ARE COMMON SYMPTOMS?

This new virus has non-specific symptoms including fever, cough and difficulty breathing.

Typically, coronavirus infections manifest as the common cold. Symptoms can include runny nose, headache, cough, sore throat and fever. Young babies may contract gastrointestinal disease.

Severe cases involve pneumonia, kidney failure and even death.

WHAT SHOULD I DO IF I SUSPECT INFECTION?

Consult your health care provider as soon as possible if you are worried about symptoms or have travelled to a region where severe coronaviruses are known to occur.

If you have mild cold-like symptoms, health officials encourage you to stay home while sick and avoid close contact to help protect others. Cover your mouth and nose with a tissue when you cough or sneeze, and be sure to throw used tissues in the trash and wash your hands. Clean and disinfect objects and surfaces.

— Sources: Health Canada, Public Health Ontario, World Health Organization

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COVID-19 Outbreak Declared at Southbridge Roseview

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November 28, 2022 – The Thunder Bay District Health Unit (TBDHU) and Southbridge Care Homes confirm that the COVID-19 outbreak previously declared at Southbridge Roseview has been updated to include Cheshire and Renaissance Units only, Primrose Unit has been resolved.

TBDHU has initiated a thorough assessment of the situation. Further measures will be taken as needed to manage this situation.

Prior to the outbreak, significant measures were already in place to reduce likelihood of transmission of the virus within the facility. For additional information about COVID-19 and the TBDHU area, please see the TBDHU Website.

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For more information – Health Unit Media: news@tbdhu.com.

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COVID-19

Diseases & Infections

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Monkeypox vaccine modelling study provides road map for vaccination

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A modelling study to explore optimal allocation of vaccine against monkeypox virus (MPXV) provides a road map for public health to maximize the impact of a limited supply of vaccines.

The article, led by Unity Health Toronto researchers and published in CMAJ (Canadian Medical Association Journal), confirms that prioritizing vaccines to larger networks with more initial infections and greater potential for spread is best.

“We hope that these insights can then be applied by policy makers across diverse and dynamic epidemic contexts across Canada and beyond, to maximize infections averted early in an epidemic with limited vaccine supply,” writes Dr. Sharmistha Mishra, MAP Centre for Urban Health Solutions, Unity Health Toronto.

As of November 4, 2022, there were 1,444 cases of MPXV in Canada. Early in the epidemic, a very limited supply of smallpox vaccines was available to vaccinate in populations experiencing disproportionate risks, including gay, bisexual and other men who have sex with men (GBMSM).

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Researchers modelled two hypothetical cities as interconnected networks with a combined GBMSM community size of 100,000. The team then varied the characteristics of the two cities across a range of plausible settings, and simulated roll-out of 5,000 vaccine doses shortly after the first detected case of MPXV.

They found that the strongest factors for optimal vaccine allocation between the cities were the relative reproduction number (epidemic potential) in each city, share of initial cases, and city (or network) size. If a larger city had greater epidemic potential and most of the initial cases, it was best to allocate the majority of vaccines to that city. The team varied the reproduction number with a single parameter, but they highlight how many factors could influence local epidemic potential, including the density and characteristics of the sexual network, access to prevention and care, and the underlying social and structural contexts that shape sexual networks and shape access.

Jesse Knight

“Under our modelling assumptions, we found that vaccines could generally avert more infections when prioritized to a larger network, a network with more initial infections, and a network with greater epidemic potential. Our findings further highlight the importance of global vaccine equity in responding to outbreaks, and also in preventing them in the first place” writes Jesse Knight, lead author and PhD candidate at University of Toronto and MAP Centre for Urban Health Solutions, Unity Health Toronto.

The study emphasizes the interconnectedness of regions and that a population-level perspective is necessary.

“Strategic prioritization of a limited vaccine supply by network-level risk factors can maximize infections averted over short time horizons in the context of an emerging epidemic, such as the current global monkeypox outbreak,” conclude the authors.

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Researchers identify biomarkers that could help diagnose Lyme disease

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Researchers say they’ve identified a set of biomarkers that could make an early diagnosis of Lyme disease easier.

Lyme disease is a tick-borne infectious disease caused by the bacterium Borrelia burgdorferi and rarely, Borrelia mayonii. Left untreated, the infection spreads and can cause neurological, cardiac, and dermatological problems.

In the United States, an estimated 476,000 Americans are diagnosed and treated for Lyme disease annually, according to the Centers for Disease Control and Prevention (CDC).

Current testing to diagnose the disease is based on laboratory tests, which lack sensitivity, and clinical presentation, which varies between patients. Testing is flawed and false-negative results are common.

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Some patients do not respond to treatment and develop more symptoms. This is called post-treatment or long-term Lyme disease, reports Frontline Genomics.

Patients usually get better over time, but it can take many months to feel completely well. Up to 20 percent of patients suffer from such long-term symptoms.

Using darkfield microscopy technique, this photomicrograph, magnified 400x, reveals the presence of spirochaete, or “corkscrew-shaped” bacteria known as Borrelia burgdorferi, which is the pathogen that causes Lyme disease. Source CDC, Public Domain

In a study published in Cell Reports Medicine, researchers at the Icahn School of Medicine at Mount Sinai in New York, explain how they pinpointed a specific set of genes that are activated in people with long-term Lyme disease.

According to the Washington Post, the scientists sequenced the RNA of 152 patients with post-treatment Lyme disease. The condition’s symptoms vary, but they can include fatigue, brain fog, and pain for those who have received antibiotic treatment for Lyme disease.

They compared the data with RNA sequenced from 72 patients with acute Lyme disease — earlier symptoms, such as a rash or facial paralysis — and 44 controls without the infection.

Two interesting things stood out when the researchers analyzed the results. First,  there was a distinct immune response in post-treatment Lyme disease compared to acute Lyme disease, which may provide insight into the disease’s underlying mechanism

Secondly, 35 genes were highly expressed in patients with long-term Lyme disease. And now that those 35 distinctive biomarkers have been identified, researchers say they plan to use the biomarkers to develop a diagnostic test that could identify the condition in other patients.

Professor Avi Ma’ayan, senior author of the paper said, “A diagnostic test for Lyme disease may not be a panacea but could represent meaningful progress toward a more reliable diagnosis and, as a result, potentially better management of this disease.”

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