3 tick-borne diseases, mpox added to list of notifiable diseases, illnesses in N.S. - Yahoo Canada Shine On

Nova Scotia is adding three tick-borne diseases to its list of notifiable diseases and conditions, along with Mpox. (CBC - image credit)

Nova Scotia is adding four diseases — three related to tick bites — to the list of illnesses and conditions that health-care professionals and lab staff must report to Public Health upon observation.

The tick-borne diseases anaplasmosis, babesiosis and Powassan virus, along with mpox, are being added to a list that includes other diseases and conditions such as cholera, Ebola, measles, rabies, shellfish poisoning and typhoid.

Jennifer Heatley, executive director of Public Health, said the most recent additions come because they're viewed as emerging issues. There is also a clause in the Reporting of Notifiable Diseases and Conditions Regulations that requires any unusual incidents of disease to be reported to Public Health.

Mpox, previously known as monkey pox, is something that previously fit the latter category because, although it's a known disease, it had not previously been seen in Canada.

"Now that we know it's here, we don't want to forever rely upon that unusual-incidence category," she said.

"We want to actually build it into the regulations and that helps it be clear for health-care providers what their responsibilities are in terms of reporting."

National Institute of Allergy and Infectious Diseases/The Canadian Press

Heatley said the tick-borne diseases are being added on the advice of epidemiologists and Public Health staff.

"It's something we want to watch for," she said.

"We know that the blacklegged tick population is endemic. It's here to stay. It's not going away. So, I think with that knowledge we want to make sure that we're monitoring the situation."

Shift in focus

Although Lyme disease is most associated with tick bites, Heatley said Public Health is shifting its education away from being specific to Lyme. Instead, it is focusing on tick-borne diseases because the main goal is to help people avoid any kind of tick bite and the symptoms of the respective illnesses are not all the same.

The QEII Health Sciences Centre laboratory is now testing all samples submitted for Lyme disease for anaplasmosis because it was emerging as a disease of unusual occurrence in Nova Scotia, according to a Health Department spokesperson. There have been no reported human cases of Powassan virus.

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HIV stigma index researchers look for Manitobans with positive diagnoses to share experience - CBC.ca

Manitoba researchers looking for people to take part in a national HIV Stigma Index project are only about halfway to their goal of hearing from at least 75 people living with a positive diagnosis.

The international peer-driven research project helps understand the stigma associated with HIV and supports those living with a diagnosis.

"I wouldn't say that anybody ran out and said 'I'm gonna go get HIV today and see how that happens.' Things happen to people and it's our duty as human beings to support people no matter what they're going through," research co-ordinator Arthur Miller told CBC Information Radio Wednesday.

The Canadian HIV Stigma Index is a community-led and community-based research study, part of the international implementation of the People Living with HIV Stigma Index project

Participants are interviewed by another person living with a positive diagnosis. Interviews are about an hour-and-a-half long and can be done in person, by phone or through a video conferencing platform, said Miller, a Mi'kmaw HIV activist based out of Nova Scotia and research co-ordinator of the project with REACH Nexus, under the MAP Centre for Urban Health Solutions at Unity Health Toronto.

The national project has been done in Ontario, Quebec, Atlantic Canada and British Columbia, and this is the second time it's being done in Manitoba, with an updated survey.

Researchers collect information related to stigma, discrimination and human rights, with the aim of better understanding the social determinants and stigma across systems like health care, schools and legal fields. The research aims to help people develop supports and policies at both local and national levels.

Peer-driven aspect crucial

Jared Star, a research manager at Winnipeg's Nine Circles Community Health Centre, which specializes in HIV prevention and care, said the HIV Stigma Index's peer-driven aspect is crucial for participants.

"They know that they won't be judged," he said. "They won't have to explain situations and details that come naturally for them, because they're talking to somebody with the same experience."

Star is also a research consultant and PhD student with expertise in sexual health, alongside his work with Nine Circles, which is working closely with Miller on the project.

"It's better for the study if we can collect the data in a shorter period of time, but because it's qualitative research, it tends to take longer than a survey," said Star. "But the more we can get up front and faster, the better."

Jared Star is a research manager for Nine Circles Community Health in Winnipeg. (Submitted by Jared Star)

Star said the information gained from the project will help people move from a place of supporting and sustaining stigma to actively challenging and resisting it.

"I think if we do a good job and we're able to get that information and then develop interventions that target stigma, we will be able to contribute to a reduction in HIV infections in Manitoba," he said. 

Education key to understanding 

Much more is known about HIV now than 30 years ago — like how to prevent transmission and that it's no longer a death sentence.

With proper care, people who are HIV positive can lead long, healthy lives. 

Miller said education is key and pointed to the fact that many don't understand somebody with an undetectable viral load who adheres to treatment can't transmit HIV through sexual intercourse. 

"This is big for people with HIV," he said. "For me, it felt like I got part of my life back."

Manitobans willing to share their experiences through the HIV Stigma Index project can contact Miller at arthur.miller@unityhealth.to or by phone at 1-877-347-1175 to begin the process. 

"The great thing about this study is we're building this network of people living with HIV," Miller said. "You're going to be talking with someone living with HIV, so they can relate and share some experiences."

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Meet Dr. Medhi Aloosh, Windsor and Essex County's new medical officer of health - CBC.ca

The Windsor Essex County Health Unit (WECHU) has a new medical officer of health in Dr. Mehdi Aloosh.

Dr. Aloosh takes the reins from former acting Medical Officer of Health Dr. Shanker Nesathurai, who held the position for more than a year. Dr. Aloosh comes to Windsor and WECHU from Hamilton, where he obtained his training in public health as well as preventative and family medicine at McMaster University. He also has a Master's degree in epidemiology from McGill University.

Prior to joining WECHU, he was a physician at Public Health Ontario, a practising family doctor and involved in research and teaching at McMaster University. 

Dr. Aloosh joined CBC Windsor's Katerina Georgieva to discuss why he chose Windsor and his priorities for public health in the region. 

Thanks for being here, Dr. Aloosh. This is a really great opportunity for people to get to know you a little bit better. So tell us why you wanted to take on this role.

When this opportunity arose in Windsor Essex county, I contacted [former medical officer of health] Dr. Ahmed and Dr. Nesathurai, who I knew in the past and I asked their opinion. They gave me very good information in terms of how the organization is working, the culture in the organization and Windsor-Essex County.

I learned that there are excited workers, very knowledgeable people working in the health unit also I learned about the collaboration with the university which brings research into public health work. Also knowing about the socioeconomics of the region. There are lots of things happening: the mega hospital, lots of new Canadians will come to the region. So all of those things led to that decision. 

We know that COVID-19 has been at the forefront for the last few years. For you now in this role moving forward, what is the biggest health issue for you?

As you mentioned COVID-19 has affected all of the individuals, businesses, all of the people and communities. Going forward making sure that COVID is under control. I think there are other priorities: sexually transmitted diseases are on the rise in Ontario and Windsor-Essex County, we are seeing things that we were not seeing in the past. We see the opioid crisis and also mental health issues, vaccinations. All of those sorts of things are some examples of my priorities going forward. 

Dr. Mehdi Aloosh is the Windsor-Essex County Health Unit's new Medical Officer of Health. (Windsor-Essex County Health Unit)

During your first board of health meeting, you spoke at length about (human papillomavirus) HPV. Can you talk about why that's so important for you to get that message out there?

HPV can several types of cancer — cervical cancer, oral cancer, penile cancer, lots of different cancers. We have a vaccine for that and we can eliminate those cancers and we can protect our kids and our young adults by vaccination in a school year that's free and I think that we should invest in that, we should work together to do that vaccination and protect population.

There are other aspects to this conversation, which is doing safe sexual behaviour, doing screening, pap smear, those sort of things. So these are other discussions that we can have beside a vaccination.

What is the uptake on the vaccine for HPV in our region? 

It's around 60 per cent, which is really good for our school age. But the evidence and some of the research shows that if we keep that over 90 per cent besides other activities like screening and treatment we can save 200 lives just for cervical cancer in Ontario and other issues like genital warts.

It's not just cancer, it's lots of things around it and we can prevent that. 

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Halton Region reports COVID-19 death in Burlington, hospitalizations up - The Independent & Free Press

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Halton Region reports COVID-19 death in Burlington, hospitalizations up  The Independent & Free PressView Full Coverage on Google News
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The dark side of the weight-loss-drug craze: eating disorders, medication shortages, dangerous knockoffs - Morningstar

By Eleanor Laise

Teens and older adults at risk, say doctors and researchers, as Novo Nordisk's Wegovy and Ozempic are hyped heavily online

A national obsession with a new class of weight-loss drugs is turning dangerous, doctors and researchers say, as many patients are inappropriately prescribed Wegovy, Ozempic and similar medications and supply shortages generate a market for unauthorized, potentially risky copycat versions of these drugs.

Social media buzz about the drugs has promoted the mistaken perception that the medications are appropriate for a broad swath of people who may want to shed a few pounds--with disastrous consequences for some patients, doctors say. Patients who previously recovered from eating disorders, for example, are coming in for treatment because they "have had their eating disorder reactivated by use of these medications," said Dr. Elizabeth Wassenaar, a regional medical director at the Eating Recovery Center, which specializes in treating the disorders. Some patients have wound up in the hospital, she said, and in some cases the providers who prescribed the drugs were unaware of the patients' eating-disorder history. "It's a real warning to people who prescribe these medications that it's not without risk," she said.

Some doctors also question whether the safety of the drugs has been adequately studied in older adults, who may have an undesirable loss of lean muscle mass when taking the medications. That complicates an ongoing debate about whether Medicare should cover these drugs for weight loss.

And patients of all types are put at risk, experts say, by the illegal production of knock-off versions of the medications. The Food and Drug Administration and several state pharmacy boards in recent weeks have warned that some compounding pharmacies are producing unauthorized versions of the drugs--which poses particular safety concerns for injectable drugs such as Wegovy, said David Margraf, a pharmaceutical research scientist with the Resilient Drug Supply Project at the University of Minnesota's Center for Infectious Disease Research and Policy. "It's not just a victimless crime," he said. "People can be severely injured."

Novo Nordisk (NOVO-B.KO), the maker of Wegovy and Ozempic, itself sought to tap the brakes on the craze around these drugs in a statement posted on its website this month, saying it's concerned about reports of the drugs being used "for purely cosmetic or aesthetic weight loss," unauthorized versions of the drugs hitting the market, and "insufficient clinical evaluations by some telehealth providers" promoting the drugs.

Drugs such as Novo Nordisk's Wegovy, Ozempic and Rybelsus and Eli Lilly's (LLY) Mounjaro mimic the effects of a gut hormone known as GLP-1, which can help control blood-sugar levels and reduce appetite. (Mounjaro also affects another hormone called GIP.) Ozempic, Rybelsus and Mounjaro are FDA-approved for treatment of type 2 diabetes, while Wegovy is approved for people with obesity and certain people with excess weight combined with weight-related medical problems.

Billions of dollars in drug sales hinge on the breadth of the patient population prescribed these medications. Last year, more than 5 million prescriptions for Ozempic, Mounjaro, Rybelsus or Wegovy were written for weight management, up from just 230,000 in 2019, according to data and analytics firm Komodo Health. Obesity drugs could be a $54 billion market by 2030, up from $2.4 billion in 2022, Morgan Stanley said in a report last year. Reports of GLP-1 drug users seeing improvements in addictive behaviors such as smoking and drinking have lately amplified interest in the medications.

The drugs have become such a cultural phenomenon that Walmart during its quarterly earnings call last week blamed the medications for a shift in consumer-spending patterns that pressured its margins. In the first quarter, the company saw "a shift to health and wellness," John Rainey, Walmart Inc.'s (WMT) executive vice president and chief financial officer, said on the call with analysts. "And part of that is related to these GLP-1 drugs that are to treat diabetes," he said, adding that the shift "comes at a lower margin, and so that has some impact on our business as well."

Noom, a digital health company that for years has emphasized a behavioral approach to weight management, this week announced a new program that will make Ozempic, Wegovy, Mounjaro and other medications available to eligible patients. "Prescriptions are not the goal of our program. They're very much an adjunct," Dr. Linda Anegawa, Noom's chief of medicine, told MarketWatch. Medical professionals will review patients' entire health history, order labs to assess their metabolic health, and engage in video visits with patients as they determine what treatments might be appropriate, she said.

Telling your brain you're not hungry

The reason GLP-1 drugs help control weight is pretty straightforward, said Dr. Daniel Drucker, who helped discover GLP-1 and is senior scientist at Lunenfeld-Tanenbaum Research Institute in Toronto. When people take these drugs, he said, they simply eat less because they feel more full. "GLP-1 will tell your brain that you're not hungry," he said, and people taking these medications may feel less stressed about food or find themselves thinking less about food. And the effects may go beyond eating, he said, as some people also see improvements in smoking, drinking, and other addictive or compulsive behaviors. "These are really interesting areas for further investigation," he said. Drucker has been a consultant or speaker for Novo Nordisk, Pfizer (PFE) and other pharmaceutical companies.

Novo Nordisk said in a statement to MarketWatch that it is not conducting any dedicated clinical studies to evaluate Ozempic, Rybelsus or Wegovy in patients with substance-use disorders or addiction-related illnesses, and Eli Lilly said it does not have any studies planned for investigating tirzepatide--the active ingredient in Mounjaro--for treatment of addiction.

Adolescents' use of the drugs for weight loss is a particular concern for some doctors. Wegovy is approved for treatment of obesity in children 12 and older. "The adolescent mental health crisis is unprecedented," said Wassenaar, with many teens suffering severe mood disorders, eating disorders, and suicidality, and teens struggling with depression may think, "if I lose weight, I'll feel better and people will like me. There's this magic drug, and all I have to do is inject it." And if patients can start taking these drugs as early as 12 years of age, "we just don't know what that's going to do to them in 10 or 20 years," she said, because there's not enough long-term data.

Novo Nordisk said in a statement to MarketWatch that "teenage obesity is linked to weight-related health problems such as high blood pressure, high cholesterol and type 2 diabetes," and that cutting calories and increasing physical activity may not be enough for some patients. "The decision to prescribe an anti-obesity medication is at the discretion of the physician and the patient/parents," the company said.

Eli Lilly said that tirzepatide is not currently being studied for chronic weight management in children or adolescents.

Some doctors are also concerned about broad use of the drugs among older adults. Many older adults have sarcopenia, an age-related loss of muscle mass and strength that can contribute to frailty and fall risk later in life--and losing weight can mean an additional loss of muscle mass that may not be advisable for some patients, doctors and researchers say.

While "there's a huge push to get Medicare to cover these drugs, it's not really certain whether they would be helpful in this population or actually more harmful," said Judy Butler, a research fellow at PharmedOut, a research and education project at Georgetown University Medical Center. Noom is not enrolling patients over age 60 in its new program, Anegawa said, partly because "we really don't have enough data yet with many of these drugs in the geriatric population."

In the pivotal clinical trials for Wegovy, 9% of the Wegovy-treated patients were between 65 and 75 years of age, and 1% were 75 and older, Novo Nordisk said in a statement. "No overall differences in safety or effectiveness have been observed between patients 65 years of age and older and younger adult patients," the company said. In an ongoing cardiovascular outcomes trial, about 38% of patients are 65 or older, the company said.

By law, Medicare generally does not cover drugs prescribed for weight loss--although some drugmakers and industry groups are pushing to change that. Some of the drugs now generating intense demand also come with a hefty sticker price: Wegovy, for example, has an estimated annual net cost of about $13,600, according to the Institute for Clinical and Economic Review. If Medicare coverage rules changed and 10% of beneficiaries with obesity used Wegovy, total annual Medicare Part D spending on the drug could be as much as $26.8 billion, according to a recent study published in the New England Journal of Medicine. That's more than 18% of the net total Part D spending by beneficiaries and the Medicare program in 2019.

Dangerous copycats

There are potential physical as well as financial costs. Side effects of the drugs can range from nausea and vomiting to gallbladder problems, inflammation of the pancreas, and thyroid cancer.

More broadly, some doctors question the prescribing of drugs solely based on obesity, absent other risk factors. "If somebody is obese and has diabetes, high blood pressure, and high cholesterol, losing weight may improve those parameters, but obesity on its own does not need to be treated," said Dr. Adriane Fugh-Berman, a professor at Georgetown University Medical Center and director of PharmedOut. "It's cardiovascular fitness that is important, no matter what weight you are," she said. "We should stop focusing on the weight itself as a risk factor."

(MORE TO FOLLOW) Dow Jones Newswires

05-27-23 1108ET

Copyright (c) 2023 Dow Jones & Company, Inc.

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Tracking the COVID vaccine rollout in Halton Region - Waterloo Region Record

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As Halton Region began COVID-19 vaccination programs, we're tracking every dose administered. More than 1.5 million doses have been administered, according to the most up-to-date data publicly available.

A total of 1,562,131 doses of vaccine have been administered in the region, with 85 per cent of Halton's total population (including children under 12) receiving at least two doses.

The graph lists the most up-to-date information of doses administered in Halton thus far. Doses administered may include health care workers who work in Halton but do not live here.

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Halton Region reports COVID-19 death in Burlington, hospitalizations up - Waterloo Region Record

Halton Region reported the COVID-19 related death of a Burlington resident.

The region also reported a rise in hospitalizations and lab-confirmed case.

There are currently 12 people being treated for COVID-19 in Halton’s hospitals, up from 10 the previous week. Of those, three were admitted for COVID-19 and nine were admitted for other reasons but later tested positive. Hospital occupancy rose slightly to 106 per cent for acute care beds and 71 per cent for intensive care unit beds, up from 103 and 69 per cent last week.

The number of lab-confirmed cases rose from an average of 7.9 per day last week to 12.8 this week. The positive test rate also jumped from 7.8 per cent to 18.4 per cent.

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