BRIEF—New FDA label approval for Wegovy - The Pharma Letter

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1. BRIEF—New FDA label approval for Wegovy  The Pharma Letter
2. Semaglutide Effective for Weight Loss in Adolescents: STEP TEENS  TCTMD
3. Wegovy approved to help teens with obesity lose weight - STAT  STAT
4. A Weight-Loss Drug Has Been Approved For Obese Children 12 And Up  IFLScience
5. 'We're not addressing the actual problem': Doctors raise concerns after Wegovy approved for kids  Daily Mail
6. View Full Coverage on Google News

BRIEF—New FDA label approval for Wegovy - The Pharma Letter
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Patients undergoing cancer treatment at greater risk of contracting breakthrough Covid infections: Study - Deccan Herald

Patients with hematologic cancer, which begins in blood-forming tissue, and those receiving active treatment for any kind of cancer are at a greater risk of contracting breakthrough Covid-19 infections, particularly those who receive anti-CD20 therapy, according to a study.

Scientists also found that the third Covid-19 vaccine dose was associated with lower infection rate and coronavirus complications, except for patients receiving anti-CD20 therapy.

The study conducted by University of Toronto, Institute for Clinical Evaluative Sciences, St Michael's Hospital-Unity Health and Sunnybrook Health Sciences Centre, Toronto, Canada has been published in the Journal of the American Medical Association (JAMA) Oncology.

Also Read: Caught between cancer & Covid-19

Patients receiving cancer treatment and those with hematologic cancer, regardless of the treatment status, should be prioritised for booster vaccination, pre-exposure prophylaxis and, in the event of SARS-CoV-2 infection, early antiviral therapy, the study said.

Patients with cancer are known to have an increased risk of COVID-19 complications including death.

According to the study, a total of 2,89,400 vaccinated patients with cancer, 39,880 hematologic and 2,49,520 solid, with 11,57,600 matched non-cancer controls were identified. The cohort was 65.4 per cent female and the mean age was 66 years.

SARS-CoV-2 breakthrough infection was higher in patients with hematologic cancer, but not in patients with solid cancer.

Covid-related severe outcomes, including hospitalisation and death, were significantly higher in patients with cancer compared to patients without cancer. The risk of severe outcomes was higher among patients with hematologic cancer than patients with solid cancer, the study said.

The objective of the study was to determine the association of Covid-19 vaccination with breakthrough infections and complications in patients with cancer compared to non-cancer controls, it said.

Also Read: China insists official Covid data is transparent

The study was a retrospective population-based cohort study using linked administrative databases in Ontario, Canada, in residents aged 18 and above who received Covid-19 vaccines.

Three matched groups were identified based on age, sex, and type and date of vaccine.

There was a 1:4 match for patients with hematologic and solid cancer to non-cancer controls with hematologic and solid cancers separately analysed. There was a 1:1 match between patients with hematologic and patients with solid cancer, the study said.

Outcomes occurring 14 days after the second COVID-19 vaccine dose were taken into account. The primary outcome was SARS-CoV-2 breakthrough infection and secondary outcomes were emergency department visit, hospitalisation and death within four weeks of SARS-CoV-2 infection with the end of the follow-up period being March 31, 2022.

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Respiratory viruses still spiking admissions at Winnipeg's children's hospital - CBC.ca

Respiratory viruses circulating in Manitoba are continuing to cause high numbers of critically ill pediatric patients to be admitted to the intensive care unit at Winnipeg's children's hospital.

There were 21 pediatric ICU patients in the hospital at the Health Sciences Centre as of Thursday morning, according to a news release from Shared Health.

The normal baseline capacity for the unit is nine.

The majority of those patients were infants or toddlers experiencing severe respiratory symptoms associated with Influenza A and RSV bronchiolitis.

One elective surgery was postponed this month, after HSC reduced ts pediatric surgical slate to focus on emergency surgeries.

A Shared Health spokesperson says staff are taking steps to ensure patients' elective surgeries aren't delayed.

There were 50 patients in the neonatal ICU (NICU) as of Thursday morning, which is exactly the baseline capacity. That's a slight increase from the 48 about two weeks ago.

Despite the strain on the system, patient visits to the children's emergency department are down from the record pace of November.

The department is averaging 131.5 patients per day in December, compared with 170.3 in November.

Nearly half of the pediatric patients visiting the children's ED on Wednesday — 63 of 131 — had influenza or were experiencing flu-like symptoms. The province's weekly data on RSV-related illness was not available Thursday.

Most pediatric patients attending the emergency department are being treated and then leaving, but the acuity and level of sickness of the children being brought in for care remains very high, Shared Health said.

Of the 131 patients on Wednesday, 74 were triaged as high- to mid-acuity. Those patients require greater levels of care, which slows patient flow and impacts wait times, according to the release.

Advice for parents on how to treat their sick or injured child, as well as when and where to take them for care, is available on the Shared Health website.

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Researchers develop blood test that can reliably detect Alzheimer’s disease - Yahoo Movies Canada

When doctors need to confirm an Alzheimer's diagnosis, they often turn to a combination of brain imaging and cell analysis. Both have their downsides. The latter involves a lumbar puncture, an invasive and painful procedure that’s more commonly known as a spinal tap. A doctor will insert a needle into the lower back to extract a sample of the patient’s cerebrospinal fluid. A lab technician then tests the sample for signs of progressive nerve cell loss and excessive amyloid and tau protein accumulation. MRI scans are less invasive but they’re often expensive and accessibility is an issue; not every community has access to the technology.

The next best tool for diagnosing Alzheimer’s disease is a blood test. While some can detect abnormal tau protein counts, they’re less effective at spotting the telltale signs of neurodegeneration. But that could soon change. This week, in the journal Brain, a multinational team made up of researchers from Sweden, Italy, the UK and US detailed a new antibody-based blood test they recently developed. The new test can detect brain-derived tau proteins, which are specific to Alzheimer’s disease. Following a study of 600 patients, the team found their test could reliably distinguish the illness from other neurodegenerative diseases.

Dr. Thomas Karikari, a professor of psychiatry at the University of Pittsburgh and one of the co-authors of the study, told The Guardian he hopes the breakthrough could help other researchers design better clinical trials for Alzheimer’s treatments. “A blood test is cheaper, safer and easier to administer, and it can improve clinical confidence in diagnosing Alzheimer’s and selecting participants for clinical trial and disease monitoring,” he said. There’s more work to be done before the test makes its way to your local hospital. To start, the team needs to validate that it works for a wide variety of patients, including those who come from different ethnic backgrounds.

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New Alzheimer’s disease blood test could make diagnosis easier - CTV News

A new test developed by neuroscientists at the University of Pittsburgh can detect signs of Alzheimer’s disease in a blood sample more accurately than previous tests, by spotting an elusive sign of the disease.

The test works by detecting a novel biomarker of Alzheimer's called brain-derived tau, according to a study by the team published in the medical journal Brain on Monday.

Tau is a protein that supports neurons, or nerve cells, in the brain. The abnormal accumulation of tau, especially in tangles of the protein, is a hallmark of Alzheimer's disease. While tau is associated mostly with brain cells, cells outside the body can produce a variation the study calls "big tau."

By figuring out how to detect brain-derived tau in blood, the team has created a method for diagnosing Alzheimer's that is more accessible than existing methods.

“At present, diagnosing Alzheimer’s disease requires neuroimaging,” senior author Thomas Karikari said in a media release issued on Monday. “Those tests are expensive and take a long time to schedule, and a lot of patients, even in the U.S., don’t have access to MRI and PET scanners."

The current framework for detecting Alzheimer's, set by the U.S. National Institute on Aging and the Alzheimer's Association, is called the amyloid, tau and neurodegeneration (ATN) method.

This method requires scientists to detect three components, or biomarkers, of Alzheimer’s disease – amyloid plaques, tau tangles and neurodegeneration – in the brain. It can be achieved either through imaging or by analyzing cerebrospinal fluid samples, but Karikari said these methods are costly and require a lot of resources.

Thomas Karikari is an assistant professor of psychiatry at the University of Pittsburgh and lead author of a study out of the university outlining a new method for detecting markers of Alzheimer's disease in blood. (Thomas Karikari)

So Karikari's team set out to develop a simple, minimally-invasive and cost-effective blood test that could detect the same biomarkers.

“The most important utility of blood biomarkers is to make people’s lives better and to improve clinical confidence and risk prediction in Alzheimer’s disease diagnosis,” Karikari said.

Up until now, blood diagnostic methods have been able to detect two out of three of the biomarkers needed to diagnose Alzheimer's – amyloid and a version of tau. However, they've struggled to detect the third component – neurodegeneration markers specific to Alzheimer’s. So the team developed a technique to distinguish brain-derived tau in blood from free-floating big tau using a special antibody that selectively binds to brain-derived tau.

Karikari and his team hope this new, more accessible blood diagnostic technique can improve clinical trial design and expand trial enrolment to include patients from populations that have historically been overlooked by such trials. To that end, they are planning to conduct large-scale clinical blood screening for brain-derived tau in a wide range of participants from diverse racial and ethnic backgrounds, memory clinics and the community.

“There is a huge need for diversity in clinical research, not just by skin colour but also by socioeconomic background,” Karikari said.

“To develop better drugs, trials need to enrol people from varied backgrounds and not just those who live close to academic medical centres. A blood test is cheaper, safer and easier to administer, and it can improve clinical confidence in diagnosing Alzheimer’s and selecting participants for clinical trial and disease monitoring.”  

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'We don't have the freedom to mislead': Colby addresses vaccine claims - Chatham-Kent This Week

Dr. David Colby is Chatham-Kent's acting medical officer of health. He's shown in a file photograph from September 2019. Tom Morrison/Chatham This Week SunMedia

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Responding to delegations from a recent council meeting, Chatham-Kent’s acting medical officer of health has said he wants people to have correct information about COVID-19 vaccines.

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Dr. David Colby, speaking at the Chatham-Kent Board of Health meeting on Dec. 21, said several false allegations were made that needed to be addressed.

“We don’t have the freedom to mislead, in my opinion, and we don’t have the freedom to infect others. All of our actions in public health really kind of boil down to keeping everybody as safe and protected as we possibly can,” he said.

“It’s very, very difficult when people come up with factoids about alleged and theoretical dangers of vaccines based on a misunderstanding of molecular genetics, particularly if they happen to hold some type of professional designation.”

One of the allegations was that COVID-19 vaccines have not been tested properly. Colby said Health Canada’s “rigorous procedures” for testing drugs are recognized around the world for their high standards.

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“Approval decisions are based on scientific and medical evidence that vaccines are safe, effective and in good quality, and, most importantly, that the benefits must also outweigh any risks that are present,” he said.

Colby said every drug or vaccine has side effects. However, he said dismissing vaccines because of side effects “is the intellectual equivalent of reading a report that somebody has choked on a sandwich and concluding that eating is a hazardous undertaking and that nobody should do it.”

The COVID-19 vaccines got to market “relatively quickly” for several reasons, Colby said, including technological improvements and the higher number of COVID-19 cases compared to rarer diseases.

“The COVID vaccines had four to five times the usual numbers of subject studies that any other vaccines would get,” Colby said. “To cast doubt on the approval process of our entire country just because vaccines appeared relatively quickly, that’s just not keeping up with modern technology.”

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Another allegation was that people who are vaccinated are put at a higher risk of dying.

Colby cited a report from peer-reviewed medical journal The Lancet which found 20 million deaths were prevented by vaccination in the first year COVID-19 vaccines were available.

He noted the study excluded one of the largest countries, China, so the number is probably “far greater” than 20 million people.

Colby said there were also statements that vaccines are not effective because of the need for booster shots, or revaccinations. He said the immune response to coronaviruses, including COVID-19, is short-lived.

“Even in a very healthy person with a robust immune response, the immunity starts to wane around four months after infection or after vaccination,” Colby said.

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“Until this pandemic is completely done, and it isn’t, we’re going to see revaccination every five or six months continue to be recommended.”

Other claims, such as the vaccine product monographs not being publicly available and the adverse effects of the vaccine being hidden, can be disproven by accessing the publicly available documents on the federal government’s website, Colby said.

“People who are trying to argue that vaccination is a bad idea sometimes lean on questionable facts and at some level somewhere people are actually making up facts,” Colby said.

“The planting of deliberate misinformation to either mislead people or to increase the number of mouse clicks and to make money is a real problem in today’s society.”

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CDC Issues Warning Over Invasive Strep a Cases After at Least 2 Kids Die in US - NBC Chicago

The U.S. Centers for Disease Control and Prevention have issued a warning about a recent increase in invasive infections of strep A in children after at least two kids in the U.S. and 15 in the U.K. have died.

Group A streptococcus is a type of bacteria that can cause a range of illness, from strep throat and scarlet fever to skin infections. An invasive case of strep A refers to when the bacteria spread to parts of the body that they don't normally reach, like the bloodstream. This can cause severe and even fatal illness and requires immediate treatment with antibiotics, according to the CDC warning.

The CDC said it was first notified about a rise in infections in the U.S. in November 2022, when a hospital in Colorado saw a possible increase strep A cases, followed by a potential increase "in other states," per the warning. It did not specify which states. The agency added that in some parts of the country, the increase in strep A is occurring at the same time as "increased circulation" of respiratory syncytial virus, influenza, COVID-19 and other respiratory viruses.

"While the overall number of cases has remained relatively low and (invasive Group A strep) infections remain rare in children, CDC is investigating these reports," the agency said.

NBC News previously reported that hospitals in Arizona, Colorado, Texas and Washington confirmed that they've seen more cases than usual of invasive Group A strep. In Colorado, two children, who were less than school age, have died from the infection since Nov. 1; the last time anyone in the state died from strep A was in 2018. The Denver Health Department told NBC News it has received reports of 11 cases — all in children between 10 months and 6 years old — since Nov. 1. In Texas, one hospital has seen an increase of four times in the number cases of invasive strep A this year, NBC News reported.

The CDC estimates that there are several million cases of noninvasive strep A in the U.S. every year — which includes strep throat, scarlet fever and the bacterial skin infection impetigo. Over the past five years, there have been between 14,000 and 25,000 cases of invasive strep per year and 1,500 to 2,300 deaths per year.

In the U.K., at least 21 children have died from invasive strep A since September, per the U.K. Health Security Agency. According to the World Health Organization, at least five countries in Europe (U.K., France, Ireland, the Netherlands, Sweden) have seen an increase in invasive strep A cases, primarily in kids under 10.

What is invasive strep A?

Strep A refers to the diseases that come from being infected with the bacteria called Group A streptococcus. Noninvasive illnesses from strep A, according to the CDC, include:

• Strep throat, which causes sore throat, pain with swallowing and fever. It's “a mild and common condition that can be easily treated,” according to the Colorado Department of Public Health and Environment.
• Scarlet fever, which commonly causes rash and fever.
• Impetigo, a highly contagious bacterial skin infection that starts as raised bumps on the skin followed by blisters containing pus followed by crusty lesions.

An invasive strep A infection — which is what the CDC is currently investigating — refers to when the bacteria spread outside the throat or skin (where they tend to cause only mild symptoms) and into the bloodstream, lungs, fluid in the spinal cord or "other places inside the body they would not typically live," per the Colorado health department.

Conditions that result from an invasive strep A infection include:

• Cellulitis (a bacterial infection in the tissue under the skin) with a blood infection.
• Pneumonia, an infection in the lungs.
• Necrotizing fasciitis, popularly known as flesh-eating disease.
• Streptococcal toxic shock syndrome (STSS), "which can develop very quickly into low blood pressure, multiple organ failure, and even death," per the CDC.

Strep A is spread through contact with droplets from an infected person when they cough, sneeze or talk. Cases of Group A strep tend to follow a seasonal pattern, peaking between December and April in the U.S. It's most common in kids 5 to 15 years old.

Why is strep A causing more severe infections?

It’s not currently known whether the spike in cases is due to one specific Group A strep strain, Dr. Michael Green, medical director of infection prevention and antimicrobial stewardship at the UPMC Children’s Hospital of Pittsburgh and a professor of pediatrics and surgery at the University of Pittsburgh, tells TODAY.com.

There are several hundred strains of Group A strep, and it’s possible that “a particularly nasty strain” has become more prominent in the parts of the country reporting increases, Green says, adding that until all the information on the strains from those places has been analyzed we won’t know.

Unlike COVID-19, where one variant can become dominant, “different areas of the country can have different strains of Group A in circulation,” Green says. “You can have a nasty Group A strep in Ohio, but not in Pittsburgh. But you worry that it might get here from people who are traveling.”

Green says the Children’s Hospital of Pittsburgh has not seen a bump in the number of cases this year as compared to those 2014 to 2017, but there may be an increase in the severity of this year’s cases.

It’s likely that the rise in cases in some locations is tied to the increase in viral illnesses — the flu, RSV and possibly COVID-19, Green says. Viruses like the flu can damage the small airways and make them more vulnerable to bacterial infections, he explains.

“Whenever we see a huge amount of respiratory viruses, we know we are going to see a bump up in bacterial infections,” Green says.

A factor that has confused the issue is that viruses such as RSV and influenza have sparked early this year, says Dr. Jason Zucker, an assistant professor of medicine at the Columbia University Vagelos College of Physicians and Surgeons in New York City.

“We’re seeing a lot of things in different seasons this year than we normally would,” Zucker tells TODAY.com. “So it’s not clear if there’s a change in the epidemiological pattern.”

The CDC noted in its warning that, in the past, the U.S. has seen increased rates of invasive strep A when flu activity has also been high. The current U.S. flu season is one of the worst in recent years.

Currently there doesn’t seem to be an increase in invasive Group A strep in New York City hospitals, Dr. Ethan Wiener, chief of emergency medicine at NYU Langone Health Hassenfeld Children’s Hospital, tells TODAY.com. “In speaking to people locally, there have been only sporadic cases that I am aware of."

Signs of severe strep A infections

Because a viral infection can make a bacterial infection more likely, parents of kids who recently had a viral illness should be vigilant about possible Group A strep infections, Dr. Ishminder Kaur, a specialist in pediatric infectious diseases at the UCLA, David Geffen School of Medicine, tells TODAY.com.

Signs of a Group A strep infection, per the Colorado health department, include:

• Sore throat
• Fever
• Chills
• New rashes
• Skin bumps
• Painful red patches on the skin

High fever and labored breathing, as well as "difficulty coordinating swallowing with breathing" in young kids, "should trigger parents to call their provider or to seek emergency care, depending on the seriousness of the situation," Kaur says.

Wiener adds that a high fever by itself doesn't signal Group A strep and is "in no way harmful or dangerous." Parents should remember that if a child is very sick, it could be the flu, he says.

Signs a child's strep A infection may be invasive include:

• A change in mental status. "Maybe you’re not able to arouse the child, or the child may not be responding normally,” Wiener says. “That’s different from the child feeling blah or lying on the couch all day.”
• Early signs of necrotizing fasciitis, which, per the CDC, include: a red, warm or swollen area of skin that spreads quickly; severe pain, including pain beyond the area of the skin that is red, warm, or swollen; fever. Later-stage signs are: ulcers, blisters, or black spots on the skin; changes in the color of the skin; pus or oozing from the infected area; dizziness; fatigue; diarrhea or nausea.
• Early signs of streptococcal toxic shock syndrome, which, per the CDC, include: fever and chills, muscle aches, nausea and vomiting. Later signs, which usually develop 24 to 48 hours after the first symptoms, include: low blood pressure; faster than normal heart rate; rapid breathing; signs of organ failure, such as inability to produce urine or yellowing eyes.

While both necrotizing fasciitis and streptococcal toxic shock syndrome are rare, their symptoms can get worse quickly. So, in light of the strep A investigation, the CDC is urging parents to know the symptoms of both diseases and seek medical care quickly if they think their child has either.

Parents should also contact a health care provider right away if their child develops new or worsening symptoms during a viral infection, the Colorado health department advised.

How to prevent strep A infections

The CDC is also urging parents to make sure their children get chickenpox vaccines and flu shot, as a strep A infection can be a complication of both viruses. Group A strep infections had been going down since 1995, when the chickenpox vaccine became available, Wiener says.

Some children might need to flu shots this year, and it's not too late in the season to get them, TODAY.com previously reported.

In addition to getting vaccinated, to prevent strep A infections, the CDC recommends washing your hands often for at least 20 seconds or using an alcohol-based hand sanitizer, especially after coughing or sneezing and before preparing food or eating. You should also cover your coughs and sneezes with a tissue and dispose of it right away. If you don't have a tissue, use your upper sleeve or elbow and not your hands.

When in doubt about your child's condition, seek medical care. Even if it turns out it wasn't necessary, “it’s better than having a bad outcome,” Wiener says.

This story first appeared on TODAY.com. More from TODAY:

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The scientists tracking new COVID-19 variants — before it's too late - CBC News: The National

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Flu vaccination during 2021-2022 season significantly reduced outpatient visits - Healio

NeurologyLive® Year in Review 2022: Top Stories in Sleep Disorders - Neurology Live

In 2022, the NeurologyLive^® staff was a busy bunch, covering clinical news and data readouts from around the world across a number of key neurology subspecialty areas. From major study publications and FDA decisions to societal conference sessions and expert interviews, the team spent all year bringing the latest information to the website's front page.

Among our key focus areas is sleep disorders. Sleep medicine specialists experienced a number of FDA decisions in the past 12 months, among other progress in the existing knowledge of sleep pathology. Although major news items often appear among the top pieces our team produces, sometimes smaller stories reach those heights for other reasons—clinical impact and interest, or concerns about the small- or big-picture parts of care, for example. Whatever the reason for the attention these stories got, their place here helps provide an understanding of the themes in this field over the course of 2022.

Here, we'll highlight some of the most-read content on NeurologyLive^® this year. Click the buttons to read further into these stories.

1. Insomnia-Related Symptoms Possibly Linked to Frequency of Alcohol and Cannabis Use in Late Adolescence

In a recent longitudinal latent class analysis study conducted by Wendy Troxel, PhD, and colleagues, of 2995 late-growing adolescents, consistently poor sleep health was associated with higher levels of alcohol and cannabis use, as well as higher health consequences from substance use. The data were published in Addiction Behaviors.

2. Severe COVID-19 Could Potentially Lead to Obstructive Sleep Apnea

In an analysis done by Xiang Gao, MD, et al published in Sleep Medicine, data showed a relationship between severe COVID-19 and obstructive sleep apnea, marking this as the first study that clarifies the relationship between OSA and the risk of COVID-19 using a bidirectional, 2-sample Mendelian randomization analysis, providing a better understanding of OSA and COVID-19.

3. Presence of Insomnia Symptoms Associated With Alcohol-Related Harm

New data from a survey study of 461 college students showed that symptoms of insomnia were associated with alcohol-related harm, with the associations between drinking and acute physiological consequences from the alcohol’s effects possibly buffered by the presence of insomnia symptoms, according to Angelo M. DiBello, PhD, and colleagues, who published the findings in Addiction Behaviors.

4. Jazz Acquires Narcolepsy Hopeful DSP-0187 in Agreement With Sumitomo Pharma

According to an announcement in late spring, Jazz Pharmaceuticals and Sumitomo Pharma entered into an agreement to codevelop and cocommercialize Sumitomo’s investigational sleep disorder treatment, DSP-0187, which will be referred to as JZP441 by Jazz. The treatment has shown potential application as a therapy for narcolepsy, as well as idiopathic hypersomnia and other sleep disorders, and is initially expected to be evaluated in narcolepsy.

5. FDA Approves Daridorexant for Insomnia Treatment

In January, the FDA approved Idorsia’s daridorexant, a dual orexin receptor antagonist, for the treatment of insomnia in adults, to be marketed under the name Quviviq. The medication, which was recommended as a controlled substance by the FDA, became available in May 2022 following scheduling by the US Drug Enforcement Administration.

6. Improvements in Treating Narcolepsy, Idiopathic Hypersomnia Through Xywav

To learn more about findings presented at SLEEP 2022, as well as some of the therapeutic advantages JZP-258 brings to sleep disorders, Richard Bogan, MD, FCCP, FAASM, provided insight on the clinical management of both idiopathic hypersomnia and narcolepsy and the approach to treating them going forward.

7. FT218 Receives Tentative Approval for EDS, Cataplexy in Adults With Narcolepsy

This summer, the FDA granted tentative approval to Avadel Pharmaceuticals’ extended-release oral suspension formulation of sodium oxybate, marketed as Lumryz, for the treatment of excessive daytime sleepiness or cataplexy in adults with narcolepsy. Previously, the therapy was known as FT218.

8. IDSIQ Instrument Sensitive to Daytime Changes Experienced in Insomnia

Using a randomized, double-blind, placebo-controlled phase 3 trial (NCT03545191) of daridorexant (Quviviq; Idorsia) in adults with insomnia, the incorporation of the Insomnia Daytime Symptoms and Impacts Questionnaire, a patient-reported outcome instrument, was found to be sensitive to changes in patients who experience daytime impacts of insomnia in data presented at SLEEP 2022 by Dalma S. Kinter, PhD.

9. Pediatric Sleep Disorders: Assessment and Treatment

Yolanda A. Yu, DO, and Alon Y. Avidan, MD, MPH, provide an in-depth overview of the long-term consequences of untreated—and prevalent—sleep disorders in children and adolescents and explain how they point to a need to focus on this field of care. In this review, they discuss common pediatric sleep disorders and provide epidemiology background, clinical presentation, diagnostic evaluation, and management opportunities.

10. Pitolisant to be Evaluated in Idiopathic Hypersomnia Phase 3 Study

A newly initiated phase 3 study, dubbed INTUNE (NCT05156047), will evaluate the efficacy and safety of pitolisant (Wakix) in patients with idiopathic hypersomnia, a condition that currently has only 1 FDA-approved medication, Harmony Biosciences announced this past spring. Pitolisant, a selective histamine 3 receptor antagonist/inverse agonist, is already FDA-approved to treat excessive daytime sleepiness and cataplexy in adults with narcolepsy.

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The future of COVID-19: What we learned in 2022 and what we can expect in the new year - Denver 7 Colorado News

DENVER — Another year is putting us further from the start of the COVID-19 pandemic, as 2022 provided additional solutions. Chief medical officer Dr. Jaya Kumar at Denver's Swedish Medical Center has been at the forefront of this virus since its inception.

"We've seen an evolution, not just in the virus itself, but in the way we think of COVID-19 as an illness and the way we treat it, the way we diagnose it and how we look forward to the new year," Kumar said. "Now we have rapid sequencing of viral genomes. So any virus you see, you could sequence it, duplicate it, make a treatment or a vaccine against it; that is huge."

She points to some of the biggest advances made in 2022.

"We saw a new antiretroviral drug come in like paxlovid, which is a pill which you can give as an outpatient," Kumar said.

That is something Dr. Scott Joy, the chief medical officer of HealthOne's Physician Services Group, says has kept patients out of the hospital.

"On a weekly basis, we're doing, myself personally, about six to 10 prescriptions of paxlovid a week, and I have yet to see a patient whose been admitted really in the last six months of 2022," Joy said.

The last year has also expanded experts' knowledge.

"So, for example, so we are seeing an RSV or Flu serge. Things have become like a piece of cake for us. We know what to do," Kumar said. "And we had our surge protocol ready in 30 minutes while this would have taken us hours and hours of hard work two years ago."

However, while these successes are worth celebrating, both doctors say it's essential to acknowledge the hurdles.

"I think one of the challenges moving forward after the pandemic is patients' trust in the vaccines," Joy said. "I'm just a little concerned that vaccines are the tip of the iceberg and are going to start getting questions about data around cancer screenings and questioning about cholesterol medicines to reduce risk of heart attack and stroke and I think we've opened up a little bit of a pandora's box."

Health care staffing has become an issue too.

"I think the biggest challenge we have moving forward is really the workforce. I think that's going to be a big challenge for us in the next year or two," Joy said.

These experts emphasize that people are still not caught up on necessary medical exams and screenings, which could lead to more significant health complications.

"I do think we've held back, and we are still seeing people come in with advance stages of illnesses. We still see people in the hospitals who have postponed medical care," Kumar said. "I think we need to do a lot of catching up in the next few years."

We must pinpoint where we currently stand with COVID-19 to understand what is next.

"The concept of never getting COVID is something that we need to get over," Joy said.

"We could potentially enter into an endemic stage, but that'll take some time. An endemic stage is where you see predictable surges like flu," Kumar said. "But for now, I think people still need to be on their watch and make sure you are getting your vaccines."

The years to come will allow us to be more informed on the effects of the COVID-19 virus.

"We're still in the infancy stages of this pandemic. Although it seems like it's been years but long-term effects are still unknown," Kumar said. "So the next few years, we'll be building upon the technology, investing more in basic science research, and be better prepared for any more pandemics that we may see in the future."

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The Last Word: Can You Actually 'Boost' Your Immune System? - Everyday Health

The immune system is a network of cells, tissues, and organs that help your body fight infections, illnesses, and diseases. It works to recognize and protect against these foreign invaders that can make you sick.

When your immune system is functioning properly, it’s able to stop or fight off germs or foreign cells that can cause you harm, according to the Cleveland Clinic. So, it makes sense to want to know how to keep your immune system at peak function.

But is there anything you can do to boost your immune system, or is boosting the immune system just a concept created to market wellness products such as packaged foods, drinks, and supplements?

The Claim About Boosting Your Immune System

You’ve probably seen ads for things like supplements that claim the ingredients will boost your immune system. And in an atmosphere where we’ve seen multiple respiratory viruses (think COVID-19, RSV, and the flu) spreading at once, it can be tempting to buy into those types of claims — especially if the promise is you won’t get sick or you’ll recover from illness faster.

“The concept of boosting or strengthening the immune system is problematic because it highlights the idea that immunity is like a muscle we can strengthen and train with supplements,” says Christine Kingsley, advanced practice registered nurse and health and wellness director at the Lung Institute in Manchester, Connecticut.

The Scientific Research on Healthy Immune Systems

This belief that you can strengthen the immune system is a key reason people use nutritional supplements, according to research, but some marketing claims can be misleading.

“The immune system is a highly complex, tightly regulated system, so it’s challenging for a particular supplement or food to have a significant effect in ‘boosting’ the immune system,” says Megan Meyer, PhD, a science communications consultant based in Durham, North Carolina. She also explains that an overactive immune system shouldn’t be a goal.

Your immune system is made up of several different elements, and each plays a role in defending the body against harmful invaders that can make you ill or cause damage. According to the Cleveland Clinic, the main parts of the immune system include:

• White blood cells
• Lymph nodes
• Spleen
• Tonsils and adenoids
• Thymus
• Bone marrow
• Skin and mucus membranes
• Stomach and bowels

While you want this system to function well, you don’t necessarily need to “boost” it. And there isn’t really evidence to prove that certain actions or nutrients can boost the immune system. Kingsley says she prefers to use the term nurture the immune system, which is more in line with what we currently know about how nutrition and healthy habits impact the body’s various systems, including immunity.

The Centers for Disease Control and Prevention (CDC) and Cleveland Clinic recommend these tips to help immune system function:

The Top Nutrients for Immunity

“There are a few micro and macronutrients that can support immune health,” says Meyer.

Zinc is a nutrient found in the body that helps the immune system and metabolism function, according to Mayo Clinic. If you get enough zinc through your diet, you usually don’t need a supplement. But there is some research to suggest zinc supplements can be used to potentially prevent or decrease symptoms in a variety of health issues, including the common cold and pneumonia. Meyer recommends taking zinc supplements or using zinc lozenges at the first sign of a cold. As the National Center for Complementary and Integrative Health notes, avoid intranasal zinc, which is associated with loss of smell.

Vitamin D, which the body gets from food and direct sun exposure, also plays a role in immune system function. One study examined the potential benefits of vitamin D supplementation in U.S. veterans in reducing infection and mortality rates from COVID-19. Researchers found an association between vitamin D and reduced severity of infection and the spread of COVID-19. Study participants with low vitamin D levels had received a higher benefit from supplementation than those who had higher vitamin D levels before getting the supplement.

Omega-3 fatty acids, also known as healthy fats, are found in certain plants and fatty fish and are essential in helping the body’s cells function properly, according to Cleveland Clinic. Meyer says omega-3s may also be helpful for supporting immune health, and one review suggests omega-3 supplementation may reduce the risk COVID-19 infection and decrease the duration of symptoms.

Sleep, or lack of sleep, can also have an impact on immune function. Meyer says lack of sleep has been shown to decrease key immune cells and increase inflammation, leading to a higher risk for infection. Research supports this notion. So, if you’re not getting enough consistent quality sleep, aiming to improve sleep habits can help your body’s immune system function better.

The Final Word on Whether You Can Boost Your Immune System

Healthy habits for your body and mind, as well as certain nutrients, help your immune system do its work, but they don’t necessarily boost it — and that’s not a bad thing.

Giving your body the fuel it needs to maintain immune system function by meeting nutritional requirements should be the goal, says Kingsley. She notes that supplements are most helpful when there’s a vitamin deficiency because the body will discard excess vitamins and minerals as waste.

“The tried-and-true foods — think a variety of fruits and veggies, whole grains, lean protein, and unsaturated fats [and] oils — are going to be your best bet for keeping your immune system healthy,” says Meyer.

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Long COVID: Could mono virus or fat cells be playing roles? - CTV News

A British historian, an Italian archeologist and an American preschool teacher have never met in person, but they share a prominent pandemic bond.

Plagued by eerily similar symptoms, the three women are credited with describing, naming and helping bring long COVID into the public's consciousness in early 2020.

Rachel Pope, of Liverpool, took to Twitter in late March 2020 to describe her bedeviling symptoms, then unnamed, after a coronavirus infection. Elisa Perego in Italy first used the term "long COVID," in a May tweet that year. Amy Watson in Portland, Oregon, got inspiration in naming her Facebook support group from the trucker cap she'd been wearing, and "long hauler" soon became part of the pandemic lexicon.

Nearly three years into the pandemic, scientists are still trying to figure out why some people get long COVID and why a small portion -- including the three women -- have lasting symptoms.

Millions of people worldwide have had long COVID, reporting various symptoms including fatigue, lung problems, and brain fog and other neurological symptoms. Evidence suggests most recover substantially within a year, but recent data show that it has contributed to more than 3,500 U.S. deaths.

Here's some of the latest evidence:

WOMEN MORE AT RISK?

Many studies and anecdotal evidence suggest that women are more likely than men to develop long COVID.

There could be biological reasons.

Women's immune systems generally mount stronger reactions to viruses, bacteria, parasites and other germs, noted Sabra Klein, a Johns Hopkins professor who studies immunity.

Women are also much more likely than men to have autoimmune diseases, where the body mistakenly attacks its own healthy cells. Some scientists believe long COVID could result from an autoimmune response triggered by the virus.

Women's bodies also tend to have more fat tissue and emerging research suggests the coronavirus may hide in fat after infection. Scientists also are studying whether women's fluctuating hormone levels may increase the risks.

Another possible factor: Women are more likely than men to seek health care and often more attuned to changes in their bodies, Klein noted.

"I don't think we should ignore that," she said. Biology and behavior are probably both at play, Klein said.

It may thus be no coincidence that it was three women who helped shine the first light on long COVID.

Pope, 46, started chronicling what she was experiencing in March 2020: flu-like symptoms, then her lungs, heart and joints were affected. After a month she started having some "OK" days, but symptoms persisted.

She and some similarly ill colleagues connected with Perego on Twitter. "We started sort of coming together because it was literally the only place where we could do that," Pope said. "In 2020, we would joke that we'd get together for Christmas and have a party," Pope said. "Then obviously it went on, and I think we stopped joking."

Watson started her virtual long haulers group that April. The others soon learned of that nickname and embraced it.

MONO VIRUS

Several studies suggest the ubiquitous Epstein-Barr virus could play a role in some cases of long COVID.

Inflammation caused by coronavirus infection can activate herpes viruses, which remain in the body after causing an acute infection, said Dr. Timothy Henrich, a virus expert at the University of California, San Francisco.

Epstein-Barr virus is among the most common of these herpes viruses: An estimated 90% of the U.S. population has been infected with it. The virus can cause mononucleosis or symptoms that may be dismissed as a cold.

Henrich is among researchers who have found immune markers signaling Epstein-Barr reactivation in the blood of long COVID patients, particularly those with fatigue.

Not all long COVID patients have these markers. But it's possible that Epstein-Barr is causing symptoms in those who do, although scientists say more study is needed.

Some scientists also believe that Epstein-Barr triggers chronic fatigue syndrome, a condition that bears many similarities to long COVID, but that also is unproven.

OBESITY

Obesity is a risk factor for severe COVID-19 infections and scientists are trying to understand why.

Stanford University researchers are among those who have found evidence that the coronavirus can infect fat cells. In a recent study, they found the virus and signs of inflammation in fat tissue taken from people who had died from COVID.

Lab tests showed that the virus can reproduce in fat tissue. That raises the possibility that fat tissue could serve as a "reservoir," potentially fueling long COVID.

Could removing fat tissue treat or prevent some cases of long COVID? It's a tantalizing question, but the research is preliminary, said Dr. Catherine Blish, a Stanford infectious diseases professor and a senior author of the study.

Scientists at the University of Texas Southwestern Medical Center are studying leptin, a hormone produced by fat cells that can influence the body's immune response and promote inflammation.

They plan to study whether injections of a manufactured antibody could reduce leptin levels -- and in turn inflammation from coronavirus infections or long COVID.

"We have a good scientific basis together with some preliminary data to argue that we might be on the right track," said Dr. Philipp Scherer.

DURATION

It has been estimated that about 30% of people infected with the coronavirus will develop long COVID, based on data from earlier in the pandemic.

Most people who have lingering, recurrent or new symptoms after infection will recover after about three months. Among those with symptoms at three months, about 15% will continue to have symptoms for at least nine more months, according to a recent study in the Journal of the American Medical Association.

Figuring out who's at risk for years-long symptoms "is such a complicated question," said Dr. Lawrence Purpura, an infectious disease expert at Columbia University.

Those with severe infections seem to be more at risk for long COVID, although it can also affect people with mild infections. Those whose infections cause severe lung damage including scarring may experience breathlessness, coughing or fatigue for more than a year. And a smaller group of patients with mild initial COVID-19 infections may develop neurologic symptoms for more than a year, including chronic fatigue and brain fog, Purpura said.

"The majority of patients will eventually recover," he said. "It's important for people to know that."

It's small consolation for the three women who helped the world recognize long COVID.

Perego, 44, developed heart, lung and neurologic problems and remains seriously ill.

She knows that scientists have learned a lot in a short time, but she says "there is a gap" between long COVID research and medical care.

"We need to translate scientific knowledge into better treatment and policy," she said.

Watson, approaching 50, says she has "never had any kind of recovery." She has had severe migraines, plus digestive, nerve and foot problems. Recently she developed severe anemia.

She wishes the medical community had a more organized approach to treating long COVID. Doctors say not knowing the underlying cause or causes makes that difficult.

"I just want my life back," Watson said, "and it's not looking like that's all that possible."

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute's Science and Educational Media Group. The AP is solely responsible for all content

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Healthy Diet Tips: 5 Foods To Avoid To Prevent Inflammation And Boost Immunity - NDTV Food

Pandemic has been a wake-up call in so many ways. We have neglected our health for far too long; and now, there's no scope to make any error. In fact, it won't be an exaggeration to say that this period has managed to put plenty of things into perspective. Today, health and overall nourishment are our main focus. From our diet to our lifestyle - we plan everything mindfully to prevent the looming risk of infections. As per consultant nutritionist Rupali Datta, immunity is not built in a day; it needs time and dedicated efforts. A strong immune-health can help build resistance against many diseases, especially the seasonal ones.

Also Read: Eat Walnut To Prevent Inflammation: 5 Delicious Recipes To Add More Walnuts To Your Diet

_{Photo Credit: iStock}

Importance Of Immunity | Why Is It Important To Build Strong Immunity:

Winter is upon us and several people are complaining of cold, cough and flu now-a-days. Hence, we must take all measures to keep ourselves warm and cosy. Food has a major role to play in this scenario. Experts suggest, it is time to tweak our diet to make it seasonal and healthy. While much has been spoken about what to eat to build immunity, we hardly talk about the foods that need to be avoided.

Celebrity nutritionist Nmami Agarwal recently took to Instagram to share about the foods that one must avoid to prevent inflammation and build strong immunity.

Relation Between Inflammation And Immunity: Does Inflammation Affects Immunity:

Poor lifestyle choices, unhealthy diet, exposure to toxins and the accumulation of other daily habits are the biggest influencers of inflammation. This affects body's defense mechanism, further reducing immunity. Hence, experts suggest maintaining a healthy lifestyle to boost overall immune health and prevent inflammation in the body.

Also Read: 7 Best Anti-Inflammatory Foods You Must Add to Your Diet

5 Foods To Avoid To Prevent Inflammation In Body | 5 Foods To Avoid To Boost Immunity:

Sugar:

According to a study by Harvard, consuming too much added sugar can raise blood pressure and increase chronic inflammation. Both these factors are pathological pathways to heart disease. Nmami Agarwal states, "Sugar should be avoided or restricted in our diet. It also includes natural form of sugar (like jaggery)."

Salt:

A study, published in the journal Pediatrics, suggests that too much salt affects the immune system, which can result in tissue inflammation. People who already have hypertension or heart problems have an increased inflammatory response when they have too much salt. Nmami Agarwal recommends that a person should not consume more than one teaspoon of salt in a day.

_{Photo Credit: iStock}

Read Meat:

A study published in the Public Health Nutrition states that higher intake of red meat may cause heart problems, increase cholesterol and lead to several chronic diseases - all of which go hand-in-hand with inflammation. Hence, Nmami Agarwal suggests avoiding red meat as much as possible for overall healthy living.

Alcohol:

According to a report in the World Journal of Gastroenterology, alcohol causes inflammation in the intestines and impairs the body's ability to regulate that inflammation. Hence, it is always advised to avoid excessive consumption of alcohol to prevent several health issues.

Processed Food:

Processed food like cookies, chocolate, pizza and more are loaded with trans-fat that increase cholesterol in the body, affecting several organs including heart. These factors further affect body's defense mechanism, boosting inflammation. Hence, Nmami Agarwal strictly recommends avoided any processed food in your diet to keep it clean and healthy.

Now that you got the list of foods to avoid to prevent inflammation, we suggest make a conscious decision while planning your next meal. Eat healthy, stay fit!

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.

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About Somdatta SahaExplorer- this is what Somdatta likes to call herself. Be it in terms of food, people or places, all she craves for is to know the unknown. A simple aglio olio pasta or daal-chawal and a good movie can make her day.

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Surprising New Research: Drinking Tea or Coffee Could Reduce Your Risk of a Hip Fracture - SciTechDaily

Hip fractures are a common and serious injury that can occur in both men and women, but they are more common and have a higher impact on the health and quality of life of older women. Hip fractures often occur as a result of falls, and women are more prone to falls due to factors such as osteoporosis, which is more common in women and can cause bones to weaken and break more easily.

A new study reveals how women can reduce the risk their risk of hip fracture. 

According to a new study conducted by food scientists at the University of Leeds, increasing protein intake and consuming regular cups of tea or coffee may help reduce the risk of hip fractures in women.

The research found that an increase of 25g of protein per day was associated with a 14% reduction in the risk of hip fractures on average. Additionally, the study revealed that every additional cup of tea or coffee consumed was linked to a 4% decrease in the risk of suffering a hip fracture.

Writing in the journal Clinical Nutrition, the researchers noted that the protective benefits were greater for women who were underweight, with a 25g/day increase in protein reducing their risk by 45%.

The protein could come in any form: meat, dairy, or eggs; and for people on a plant-based diet, from beans, nuts, or legumes. Three to four eggs would provide around 25g of protein as would a steak or piece of salmon. 100g of tofu would provide about 17g of protein.

Just over 3% of the women in the study group experienced a hip fracture.

Observational study

The investigation – Foods, nutrients, and hip fracture risk: A prospective study of middle-aged women – is based on a large observational analysis of more than 26,000 women.

As an observational study, the researchers were able to identify associations between factors in diet and health. They could not single out direct cause and effect.

James Webster, a doctoral researcher in the School of Food Science and Nutrition at Leeds who led the study, said: “Across the world, the costs to individuals and societies caused by hip fracture are enormous.

“Hip fracture can often lead to other chronic illnesses, loss of independence, and premature death. In the UK, the annual cost to the NHS is between £2 to £3 billion.

“Diet is a factor that people can modify to protect themselves by maintaining healthy bones and muscles. This study is one of the first to investigate relationships between food and nutrient intakes and the risk of hip fracture, with hip fractures accurately identified through hospital records.

“The results highlight which aspects of diet may be useful tools in reducing hip fracture risk in women, with evidence of links between higher protein, tea, and coffee intakes and a reduced risk.”

Proteins are the basic building blocks of life and are needed to keep cells, tissues, and muscles working properly as well as contribute to bone health.

The recommended protein intake in the UK is 0.8g per kilogram of body weight per day, a limit some nutritional experts believe is too low. As the study revealed, people who had a higher protein consumption had a reduction in the risk of hip fracture. However, intakes of protein that are very high – where intake is greater than 2 to 3g of protein/kg body weight/day – can have negative health effects. The study was not able to explore these very high protein intake levels.

Professor Janet Cade, who leads the Nutritional Epidemiology Group at Leeds and supervised the research, said: “In the UK most people eat an adequate amount of protein, however, certain groups, such as vegetarians or vegans need to check that their protein intakes are high enough for good health.”

Why underweight women may see greater risk reductions

Women who are underweight may be more likely to have reduced bone mineral density and muscle mass. Increasing intakes of several foods and nutrients, especially protein, may help reduce hip fracture risk more in underweight women than in healthy or overweight women by helping to establish or restore bone and muscle health. However, the researchers note that this finding needs further research to confirm this.

Tea and coffee both contain biologically active compounds called polyphenols and phytoestrogens which may help to maintain bone health.

Professor Cade added: “This is an interesting finding given that tea and coffee are the UK’s favorite drinks. We still need to know more about how these drinks could affect bone health but it might be through promoting the amount of calcium present in our bones.”

Reference: “Foods, nutrients and hip fracture risk: A prospective study of middle-aged women” by James Webster, Darren C. Greenwood and Janet E. Cade, 8 November 2022, Clinical Nutrition.
DOI: 10.1016/j.clnu.2022.11.008

The data used in the study came from the UK Women’s Cohort Study, which recruited participants between 1995 and 1998. At the time they entered the study, the women ranged between 35 and 69 years of age.

At recruitment, they were asked to fill out questionnaires about their diet and lifestyle. This information was then linked with hospital records over the following two decades, which revealed how many had suffered a hip fracture or had a hip replaced.

Of the 26,318 women involved in the study, 822 cases of hip fracture were identified, that is 3.1%.

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Geisinger offers COVID-19 boosters for children 6 months and older - Geisinger

DANVILLE, Pa. – Following recent guidance from the Centers for Disease Control and Prevention and the Food and Drug Administration, Geisinger is now offering booster doses of the updated (bivalent) Pfizer/BioNTech COVID-19 vaccines for children 6 months and older. 

Data continues to show the effectiveness of the COVID-19 vaccine, and the updated booster dose for kids will increase their protection. As the virus has changed and immunity from previous COVID-19 vaccination wanes, there is more benefit for individuals and public health to keep up to date on vaccinations.

The following outlines how children can receive the new booster:

• Children 6 months through 4 years old who have never had the vaccine would receive a three-dose series with the third dose including protection against newer variants.
• Children in progress of getting the series will receive the third dose covering new variants.
• Children who have completed the three-dose series can get a booster that covers the new variants at least two months after their third dose.

If you're unsure if your child qualifies for a booster or have any questions, contact your pediatrician. Geisinger pediatric clinics are accepting appointments for booster shots for those who are eligible. You can make an appointment at Geisinger through MyGeisinger, the MyChart mobile app, or by calling 570-284-3657.

Remember to bring your child's COVID-19 vaccine card or proof of having received their vaccine to their appointment. More information about the COVID-19 vaccine is available at geisinger.org/covidvax.

About Geisinger

Geisinger serves more than 1 million people in central and northeastern Pennsylvania. We’ve been nationally recognized for innovative practices in quality, delivery models such as ProvenCare® and the use of an award-winning electronic medical record, Epic®. Our physician-led system has about 24,000 employees, including nearly 1,700 physicians, 10 hospital campuses, two research centers and a health plan with more than half a million members, all of which boost our hometown economies by $8 billion annually.

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Flu Cases Reportedly Fall As Hospitals Continue To Battle 'Tripledemic' - TODAY

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CDC warns of a rise in severe strep A infections among children - BOL News

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Emergency department visits jump as flu, RSV, and COVID strike - BayToday.ca

Influenza A, RSV, COVID-19, and other respiratory viruses are sweeping through the area.

Between December 18 and 20, the region had 156 emergency department visits for respiratory symptoms says the North Bay Parry Sound District Health Unit.

"That makes it extremely important that people use layers of protection to help prevent themselves and those around them from getting ill this holiday season," says a release.

Layers of protection include: 

• Staying home when you or someone you live with is unwell
• Receiving your flu shot and COVID-19 booster – which are safe to receive at the same time
• Washing your hands often with soap and water or use an alcohol-based hand sanitizer
• Wearing a well-fitted mask in all public settings
• Covering your coughs and sneezes with your arm or a tissue
• Frequently disinfecting high-touch surfaces
• Being mindful of your distance from others when out in public.

“The holidays are a great opportunity to spend time with family and friends. However, it is important that when attending holiday gatherings people consider the well-being of others by using a layer of protection and staying home if they or someone they live with is unwell,” explains Dr. Carol Zimbalatti, Associate Medical Officer of Health.

“It can be difficult to make the decision to stay home, but exposing a child, older person, or someone who is immunocompromised to a respiratory virus could lead to a severe respiratory infection.”

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Do you really need to put your bird feeder away to stop avian flu? - cenlanow.com

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