Dr. Theresa Tam’s comments come as Canada has now confirmed 77 cases of monkeypox, with 71 in Quebec, five in Ontario and one in Alberta.
OTTAWA — Canada’s chief public health officer says the world must erect better defences against transmissible viruses as climate change and other factors raise the risk we will see more emerging infectious diseases in the years to come.
Dr. Theresa Tam’s comments come as Canada has now confirmed 77 cases of monkeypox, with 71 in Quebec, five in Ontario and one in Alberta.
Globally, there are at least 550 confirmed cases in 30 non-endemic countries where the virus has not usually been found. It is the largest outbreak ever outside West and Central Africa, where it is endemic now in at least 10 countries.
The World Health Organization has not pinpointed where this current outbreak began, but WHO director general Tedros Adhanom Ghebreyesus said Wednesday “the sudden appearance of monkeypox in many countries at the same time suggests there may have been undetected transmission for some time.”
Tam said the cases in Canada currently involve a specific group of individuals that have close, intimate sexual contact, but that could change.
“At the moment it hasn’t gone much beyond the initial risk groups, but it could happen and we need to be ready for that,” she said.
Public health officials have said while everyone is susceptible to the virus, clusters of cases have been reported among men who have sex with men.
Tam’s deputy, Dr. Howard Njoo, has said he’s mindful of the potential for stigma and discrimination and emphasized that the virus’s spread isn’t limited to any specific group.
Tam said from a broader perspective, Canada and the rest of the world need to be better equipped when outbreaks like this occur.
“Emerging infectious disease can always hit us,” she said. “And we should be as prepared as we can, which means reinforcing the global public health capacity.”
Tam said improving capacity in every country “is really important” because with climate change and other factors there is more human and animal interaction, which is often how animal-borne viruses turn into human pandemics.
“I think we’ll see an increase in numbers of these types of emerging infectious diseases, and with good capacity, not just in Canada, but globally we can help to manage them and reduce their impact as much as possible,” Tam said.
The first non-endemic cases of monkeypox were confirmed in the United Kingdom in early May. The first cases were confirmed in Canada May 19.
African scientists and doctors are weary about the sudden interest in monkeypox as it infects western countries, which largely have ignored the virus as it spread around parts of Africa.
Tam on Friday called it a “neglected tropical disease.”
“We need to have better international collaboration and support in order to collectively learn together globally,” she said.
Monkeypox got its name because it was first found in monkeys in a laboratory in Denmark in 1958, but in the wild it is found mainly in small rodents such as rats, squirrels and shrews.
A global population exhausted following two years of the COVID-19 pandemic view the arrival of monkeypox with alarm and fear, though the virus does not spread through the air like the one that causes COVID-19 does.
Instead, the monkeypox virus spreads mainly through close contact with the virus on other humans or objects such as bed linens. While it can be fatal, it is most often not, causing symptoms such as fever, headache and muscle aches, and pox-like lesions on the skin.
It can take one to two weeks for an infected person to show symptoms, and Tam warned that while we know a lot about how the monkeypox virus behaves in countries where it is endemic, we know little about how it may behave in populations that are both mostly unvaccinated against it and have no natural levels of immunity.
A vaccine created for smallpox is also approved for use against monkeypox and Canada has a supply of the vaccine. Some doses were already sent to Quebec to vaccine close contacts of known cases, and Tam said conversations with every province are ongoing to determine whether some should be “prepositioned” all over the country.
She said contact tracing is proving difficult and while there is no expectation of a wide-scale public vaccination campaign for monkeypox, the existing campaign may be expanded to try and bring the outbreak in Canada to a close.
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 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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HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
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ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
The Canadian Press. All rights reserved.
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