logo
Alberta's measles outbreaks surpass case counts reported for entire U.S.

Alberta's measles outbreaks surpass case counts reported for entire U.S.

Yahoo15 hours ago
Alberta has now confirmed more measles cases than the entire United States has reported this year.
The province has been battling outbreaks since March and as of noon Monday, total case counts in the province had ballooned to 1,314.
The latest update from the U.S. Centers for Disease Control and Prevention shows that country has amassed 1,288 cases this year.
"Looking at the numbers it saddens me," said Dr. Sam Wong, the president of the section of pediatrics with the Alberta Medical Association.
"I think if we had gotten to it sooner — and taken it more seriously sooner — then maybe we would not have reached this milestone where one province actually exceeds the entire case count for the United States, which has got 10 times the population as Canada."
Thirty new cases were reported between midday Friday and noon Monday.
"It's absolutely terrible," said Dr. Lynora Saxinger, an infectious diseases specialist with the University of Alberta.
"It is really a massive scale of spread that's going on right now."
It is widely believed by experts and health officials that Alberta's case counts are higher than the confirmed numbers reflect. A standing exposure advisory remains in effect for the entire south zone and parts of the north due to widespread transmission.
And the Alberta government's measles website says cases are likely going unreported and undetected.
Saxinger worries about the impact of large summer gatherings such as the Calgary Stampede, which just ended on Sunday.
"I don't think we've seen a suggestion of things levelling off and now there's large meetings of people and after that school will be back in. So I think there's still a period of serious vulnerability to increasing numbers for a while," said Saxinger.
"As an infectious diseases specialist I never would have guessed this was going to happen because measles is supposed to be eradicated."
The south, north and central health zones have been the hardest hit by outbreaks.
According to provincial data, there had been 102 hospitalizations, including 15 ICU admissions, as of July 5. No deaths have been reported.
The latest national statistics show 58 per cent of the new cases reported during the week of June 22 to June 28 were in Alberta.
"We know that per capita we have more measles cases in Alberta than really anywhere else in North America," said Craig Jenne, a professor in the department of microbiology, immunology and infectious diseases at the University of Calgary.
"We have heard stories that there may be underreporting in the U.S. but even the fact that we're close to those numbers is quite concerning given we have almost a hundredth the population."
The latest case breakdown shows there have been a total of 774 cases in the south zone, 35 in Calgary zone, 107 in central zone, 13 in the Edmonton zone and 385 in the north.
"Perhaps the more concerning aspect, at least for me, is not the total number of cases, it's how quickly we've gotten here," said Jenne, who is also the deputy director of the Snyder Institute for Chronic Diseases.
Alberta's measles outbreaks have snowballed more quickly than Ontario's, which started in October, according to Jenne.
That province, which has three times the population of Alberta, had confirmed 1,934 as of July 8, with another 310 probable cases.
"It is growing much more rapidly here…[The] rate of transmission is very concerning."
Measles is highly contagious and can lead to serious complications, including pneumonia, brain inflammation, premature delivery and even death.
Young children, pregnant individuals and those with weakened immune systems are at highest risk.
"I'm really afraid that we're going to see terrible outcomes in babies and kids under five because that's the most vulnerable group across the board," said Saxinger.
She's calling on the provincial government to take key steps to rein in the outbreaks, including setting up mass vaccination clinics and campaigns.
"I think there can be a lot of unintended barriers for people who even want to get their vaccines updated…It can be really hard to book actually getting it," she said.
Saxinger also wants the province to target school-aged children for vaccination before they head back to school in the fall.
And, like other physicians, Saxinger is calling on the province to offer an early and extra vaccine dose to babies as young as six months old in all regions. The extra shot is only being offered in the south, central and north zones.
CBC News asked the government for a response but did not immediately hear back.
Pregnant Albertans, who are at high risk as well, need to know they should seek help if they've potentially been exposed, according to Saxinger, and vaccine messaging in general needs to be improved.
"I think it really has to be a big priority for elected officials to remind people, because not everyone watches the news [and] not everyone gets the same information."
The Alberta government is defending its measles response, saying it's working to limit further spread and support those impacted.
"Expanded vaccination clinics, targeted outreach, and clear public health guidance are already in place and showing positive results," an emailed statement from the Ministry of Primary and Preventative Health Services read in part.
Measles clinics hours and locations have been expanded in higher risk areas, according to the spokesperson, particularly in southern Alberta.
"Comparisons to the United States can be misleading, as most U.S. cases this year are concentrated in a single state —Texas ... Measles is increasing at different times in various regions as it's introduced by travellers, as seen in both Texas and Ontario."
The CDC website shows most states are reporting some measles cases. Texas has reported 753 cases since late January.
"As of now, there are two [Alberta] patients in hospital, and at no point have more than three or four patients been hospitalized at once," the Alberta government spokesperson said.
"There are currently 13 active cases across the province, and that number has remained stable for several weeks. Three of the five health zones have not seen any significant recent increase in cases. Weekly case numbers have now declined for four consecutive weeks and are roughly half of what they were at the recent peak."
The Alberta government's own website explains the "active" case count is an estimate and does not reflect the risk level because it doesn't account for those who are undiagnosed or who have been exposed.
The Alberta government has also extended its Don't Get Measles, Get Immunized ad campaign into mid-August and public health teams are calling parents of young babies in the hardest hit zones to let them know their infants are eligible for an early vaccine dose.
The ministry said its efforts are working and between mid-March and early June, the number of vaccine doses administered across Alberta increased by 57 per cent.
Orange background

Try Our AI Features

Explore what Daily8 AI can do for you:

Comments

No comments yet...

Related Articles

Kidney Function Tests
Kidney Function Tests

Health Line

timean hour ago

  • Health Line

Kidney Function Tests

Key takeaways Kidney function tests are simple blood and urine tests that can identify problems with your kidneys. These tests can estimate your glomerular filtration rate (GFR), which indicates how quickly your kidneys are clearing waste from your body. Your doctor will focus on treating the underlying condition if your tests show early kidney disease. This may include medications, lifestyle changes, or seeing a specialist. Overview of kidney function tests You have two kidneys on either side of your spine that are each approximately the size of a human fist. They're located posterior to your abdomen and below your rib cage. Your kidneys play several vital roles in maintaining your health. One of their most important jobs is to filter waste materials from the blood and expel them from the body as urine. The kidneys also help control the levels of water and various essential minerals in the body. In addition, they're critical to the production of: vitamin D red blood cells hormones that regulate blood pressure If your doctor thinks your kidneys may not be working properly, you may need kidney function tests. These are simple blood and urine tests that can identify problems with your kidneys. You may also need kidney function testing done if you have other conditions that can harm the kidneys, such as diabetes or high blood pressure. They can help doctors monitor these conditions. Symptoms of kidney problems Symptoms that may indicate a problem with your kidneys include: high blood pressure blood in the urine frequent urges to urinate difficulty beginning urination painful urination swelling of the hands and feet due to a buildup of fluids in the body A single symptom may not mean something serious. However, when occurring simultaneously, these symptoms suggest that your kidneys aren't working properly. Kidney function tests can help determine the reason. Types of kidney function tests To test your kidney function, your doctor will order a set of tests that can estimate your glomerular filtration rate (GFR). Your GFR tells your doctor how quickly your kidneys are clearing waste from your body. Urinalysis A urinalysis screens for the presence of protein and blood in the urine. There are many possible reasons for protein in your urine, not all of which are related to disease. Infection increases urine protein, but so does a heavy physical workout. Your doctor may want to repeat this test after a few weeks to see if the results are similar. Your doctor may also ask you to provide a 24-hour urine collection sample. This can help doctors see how fast a waste product called creatinine is clearing from your body. Creatinine is a breakdown product of muscle tissue. Serum creatinine test This blood test examines whether creatinine is building up in your blood. The kidneys usually completely filter creatinine from the blood. A high level of creatinine suggests a kidney problem. According to the National Kidney Foundation (NKF), a creatinine level higher than 1.2 milligrams/deciliter (mg/dL) for women and 1.4 mg/dL for men is a sign of a kidney problem. Blood urea nitrogen (BUN) The blood urea nitrogen (BUN) test also checks for waste products in your blood. BUN tests measure the amount of nitrogen in the blood. Urea nitrogen is a breakdown product of protein. However, not all elevated BUN tests are due to kidney damage. Common medications, including large doses of aspirin and some types of antibiotics, can also increase your BUN. It's important to tell your doctor about any medications or supplements that you take regularly. You may need to stop certain drugs for a few days before the test. A normal BUN level is between 7 and 20 mg/dL. A higher value could suggest several different health problems. Estimated GFR This test estimates how well your kidneys are filtering waste. The test determines the rate by looking at factors, such as: test results, specifically creatinine levels age gender race height weight Any result lower than 60 milliliters/minute/1.73m 2 may be a warning sign of kidney disease. How the tests are performed Kidney function tests usually require a 24-hour urine sample and a blood test. 24-hour urine sample A 24-hour urine sample is a creatinine clearance test. It gives your doctor an idea of how much creatinine your body expels over a single day. On the day that you start the test, urinate into the toilet as you normally would when you wake up. For the rest of the day and night, urinate into a special container provided by your doctor. Keep the container capped and refrigerated during the collection process. Make sure to label the container clearly and to tell other family members why it's in the refrigerator. On the morning of the second day, urinate into the container when you get up. This completes the 24-hour collection process. Follow your doctor's instructions about where to drop the sample off. You may need to return it either to your doctor's office or a laboratory. Blood samples BUN and serum creatinine tests require blood samples taken in a lab or doctor's office. The technician drawing the blood first ties an elastic band around your upper arm. This makes the veins stand out. The technician then cleans the area over the vein. They slip a hollow needle through your skin and into the vein. The blood will flow back into a test tube that will be sent for analysis. You may feel a sharp pinch or prick when the needle enters your arm. The technician will place gauze and a bandage over the puncture site after the test. The area around the puncture may develop a bruise over the next few days. However, you shouldn't feel severe or long-term pain. Treatment of early kidney disease Your doctor will focus on treating the underlying condition if the tests show early kidney disease. Your doctor will prescribe medications to control blood pressure if the tests indicate hypertension. They'll also suggest lifestyle and dietary modifications. If you have diabetes, your doctor may want you to see an endocrinologist. This type of doctor specializes in metabolic diseases and can help ensure that you have the best blood glucose control possible. If there are other causes of your abnormal kidney function tests, such as kidney stones and excessive use of painkillers, your doctor will take appropriate measures to manage those disorders.

How to Recognize Burnout During Medical School, Residency
How to Recognize Burnout During Medical School, Residency

Medscape

timean hour ago

  • Medscape

How to Recognize Burnout During Medical School, Residency

This transcript has been edited for clarity. Let's be real. Medical school and residency are demanding jobs, and we are going to be working way more hours than some of our peers. It is super important to take care of not only our physical health, but also our mental health during this time. Let's talk about signs of burnout and some signs that you might need to take a mental reset. Number one is chronic fatigue and poor sleep. If you're noticing that you're tossing and turning in your sleep or you are staying up with anxious thoughts and worries, this could be a sign that you are experiencing burnout. Also, if you suddenly find yourself getting sick more often than usual, it could be your body's way of telling you that you are stressed, you are in a high cortisol state, and as a result, your immune system isn't able to fight off illness as best as it can. Then, of course, there are emotional signs, too, like feeling sad, lonely, and can all be signs of early-onset depression. It is super important to recognize signs of burnout during residency and medical school because there is help if you need it.

Rethinking GI Prophylaxis for the Critically Ill
Rethinking GI Prophylaxis for the Critically Ill

Medscape

time2 hours ago

  • Medscape

Rethinking GI Prophylaxis for the Critically Ill

Prevention doesn't come easy. The bar is high. The decision to act medically because an untoward outcome could occur means creating intervention side-effect risk that's otherwise absent. Large patient numbers must be subjected to that side-effect risk to obtain net benefit. Last, your bedside modeling must be tight, and in medicine it never is. The story of gastrointestinal (GI) prophylaxis in ICU highlights these challenges. It is best told by Deborah Cook, the godmother of ICU research. It's told through her work. She's randomized more patients than a sequence generator. Her name is the most critical MeSH term for your systematic review. If Churg, Strauss, and Wegener hadn't ruined the disease eponym practice, she'd have several to her name. Just as well; we're all transgressing some currently unidentified but soon-to-be-coined "-ism." Cook's work has dominated the GI prophylaxis space since the early 1990s. If you're new to it, start with her New England Journal of Medicine (NEJM) review from 2018. It was published on the heels of the latest randomized control trial on GI prophylaxis in the ICU. The SUP-ICU trial, which randomized patients to pantoprazole vs placebo and was also published in NEJM, had equivocal results. The accompanying editorial provided a tepid endorsement of continued prophylaxis with proton pump inhibitors (PPI), but only for those at high risk for bleeding. Two years later, a systematic review and another randomized trial (PEPTIC) found a mortality signal with PPIs, but in the wrong direction. This drove some back to H2 blockers even though they are less effective than PPI for preventing bleeding. Where I practice I see an equal number of ICU patients on PPI or H2 blockers. There seems to be no clear preference or consensus. The indomitable Dr Cook just investigated the mortality difference in the REVISE trial, published last year. She and her colleagues also produced an updated systematic review. REVISE made me feel better. I've been a PPI-for-prophylaxis guy for anyone on mechanical ventilation. I held on after PEPTIC and SUP-ICU created doubt, and REVISE seemed to vindicate my practice. REVISE found that PPI decreased bleeding without increasing mortality. PPI didn't increase pneumonia or Clostridioides difficile infections either. Unfortunately, it's never that simple. The mortality signal was still present in the updated systematic review. The mortality "noise" is dependent on severity of illness. It's the sicker patients who have a higher mortality when given PPI for prophylaxis. Why? I'm not sure. The pneumonia and C diff associations were absent in SUP-ICU, REVISE, and the updated systematic review. The systematic review authors list multiple possible explanations, given that PPI are associated with an altered microbiome, endothelial changes, and delirium. If there is a causal mechanism affecting mortality, it's not clear why the direction is discordant across levels of illness severity. Conclusions drawn by the editorials accompanying SUP-ICU and REVISE are also discordant. Seven years ago, the idea was that PPIs were most beneficial in those who are 'seriously ill with a high risk of complications.' Fast-forward and the REVISE editorial suggests PPI for those on mechanical ventilation and an APACHE II score of less than 25. Figure 2 in Dr Cook's 2018 review lists risk factors for bleeding— lots of overlap with the APACHE and other illness severity scores. Can a patient be at high bleeding risk but have an APACHE II score less than 25? I'm sure they can, but that needle won't be easy to thread at the bedside. Can Dr Cook snatch clarity from the jaws of this data quagmire? Perhaps. Her group just published another paper on GI bleeding in the ICU. The focus was on bleeding events that are considered important by ICU survivors and family members. This was a preplanned analysis of data from the REVISE trial. PPI shined again, reducing patient-important events regardless of illness severity. They used a proportional hazards model, that accounts for the competing risk for death, to analyze their primary outcome. Not sure if this provides clarity per se but it does make me feel better about continuing to use prophylactic PPI for my mechanically ventilated patients.

DOWNLOAD THE APP

Get Started Now: Download the App

Ready to dive into a world of global content with local flavor? Download Daily8 app today from your preferred app store and start exploring.
app-storeplay-store