Serious H1N1 cases in Canadian Inuits raise concern

first_imgEditor’s note: CIDRAP News learned on Jun 10 that some of the Canadian indigenous groups that have been hit by serious cases of H1N1 influenza are not Inuit, but rather are among the groups known in Canada as First Nations or aboriginals. In particular, a Canwest News Service report referred to hundreds of cases and 20 hospitalizations at St. Theresa Point, a First Nation in northern Manitoba. Jun 9, 2009 (CIDRAP News) – An official from the World Health Organization (WHO) said today that health experts are closely monitoring novel H1N1 influenza infections in Canada’s Inuit populations, following reports that the communities are seeing more than their share of severe cases.Keiji Fukuda, MD, told reporters at a press briefing, “We can say now that we know a larger number than expected of young Inuit people developed serious illnesses and had to get hospitalized.”He added that the WHO doesn’t know if the trend is linked to socioeconomic factors, genetic factors, or chronic underlying diseases, and commented that Inuit groups were hit hard in some earlier pandemics. Fukuda is the WHO’s assistant director-general for health security and the environment.Yesterday, Joel Kettner, MD, Manitoba’s chief medical officer, told reporters that 26 people were being treated in intensive care units for suspected novel influenza infections, which is unusual for an influenza outbreak, the Canadian Broadcasting Corporation (CBC) reported. He said more than half of the patients are of aboriginal descent, with an average age of 35.Manitoba’s health department said in a statement yesterday that 15 extra ventilators have arrived at the province’s ICUs and that the Winnipeg Regional Health Authority is helping the departments prioritize patients and was considering deferring non-urgent surgical procedures that would normally require use of the units.As of yesterday, Manitoba said it had confirmed 40 novel flu cases in 6 of its 11 health regions.Meanwhile, health officials in Canada’s Nunavut territory today said the number of confirmed novel flu cases has jumped from 25 to 53, with six patients in the hospital, the CBC reported. Nunavut’s population is primarily Inuit.Donald R. Olson, MPH, research director for the International Society for Disease Surveillance, based in New York City, told CIDRAP News that the severe cases in Canada’s Inuit populations are puzzling. However, he added that among remote populations, the 1918 pandemic influenza was more severe and didn’t follow the age patterns seen in the rest of the world.”Inuit groups didn’t show the same apparent sparing of the elderly, so possibly the older proportion of the population had not been exposed” to previous viruses related to the pandemic strain, he said.The medical literature tells of “flu orphans” from remote Alaskan villages who survived the 1918-19 pandemic, though their parents and grandparents died, presumably because they had not been exposed to earlier H1-like viruses.In 2006 at a state summit in Alaska, former US Health and Human Services Secretary Mike Leavitt described the impact of the 1918 pandemic virus on Alaska’s native populations. “The Alaska native population in Nome was decimated—176 of the 300 Alaska Natives in the region died,” he said in comments posted on the HHS pandemic flu Web site. “The pandemic swept through communities, killing whole villages.”Preexisting health conditions may also have contributed to the severity of the 1918 pandemic in Inuit populations, which also had high tuberculosis rates in the early 20th century, Olson said.Officials don’t know if higher rates of chronic illnesses in today’s Inuit populations are playing a role in the high number of severe cases. However, Health Canada reports that when compared to the rest of the nation, First Nations and Inuit people have 1.5 times the rate of heart disease, 3 to 5 times the rate of type 2 diabetes, and 8 to 10 times the rate of tuberculosis infection.Yesterday, an Australian health expert from Darwin warned that the country’s indigenous populations might be at greater risk for novel H1N1 infections.Besides citing lack of exposure to similar virus and underlying conditions as possible risk factors, experts have also theorized that remote populations might have a genetic predisposition that makes them more susceptible to the virus, Olson said. But he expressed doubt that the factor is playing a role in Canada’s current outbreak.The signals coming out of Canada are worrying, he said. “The less developed world may have a terrible experience with this, though there is a lot of coughing and sneezing in the rest of the world,” Olson said.Danuta Skowronski, MD, a physician and epidemiologist at the University of British Columbia, told CIDRAP News that over the past few years, circulation of seasonal H1N1 viruses in North America has been patchy, and people in remote communities are likely to have had less exposure to the viruses than have people living in urban settings.There’s still much that researchers don’t know about possible cross-protection against the novel H1N1 virus from exposure to previous H1N1 strains, she said. Though researchers have identified antibody markers and determined that seasonal vaccination offers little protection, they still haven’t gauged the cell-mediated response—which can offer protection during severe infections—afforded by exposure to previous H1N1 strains, Skowronski added.Public health officials will also be looking for environmental factors that might be contributing to the infections in the First Nations and Inuit groups, she said. For example, large numbers of people living in one household may have greater exposure to the virus. “This all needs to be assessed, because we’re picking up possible signals of concern,” Skowronski said.See also:Jun 8 Manitoba press releaseHealth Canada disease and health condition statisticsAhmed R, Oldstone MBA, Palese P. Protective immunity and susceptibility to infectious diseases: lessons from the 1918 influenza pandemic. Nature Immunol 2007 Nov;18(11):1188-93 [Abstract]last_img read more

Justyn Knight, arguably the greatest SU runner of all time, is looking for his first individual national championship

first_img Published on November 15, 2017 at 9:48 pm Contact Matt: mdliberm@syr.edu In 2016, Knight missed qualifying for the Olympics by 0.1 seconds, his mother Jennifer said. That November, Tiernan beat Knight at the national championship. Come 2017, he qualified for the World Championships in the 5,000-meter. When it turned to race time, a familiar face lurked in the finals. It was Tiernan.With five laps to go, Tiernan moved into the lead, quickening the pace by two seconds. But Knight didn’t budge. He stayed with the pack, gradually chasing down the man that beat him a year earlier.Tiernan couldn’t maintain his pace, and Knight only sped up, inching closer and closer. Knight finished in ninth place in his first appearance on the world stage. Tiernan took 11th.“If he doesn’t win,” former SU runner Martin Hehir said, “he’s just going to come back with a vengeance.Knight’s talent matches his flare to make him one of the most well-known runners in the world. As one of the nation’s most dominant athletes, he’s commanded attention from everyone, including his teammates. They want to run with him.Everyone’s always wanted to run with him.When the St. Michael Catholic (Ontario, Canada) High School runner was just beginning to rise to local stardom, his head coach, Frank Bergin, found him waiting at the track after practice. Everyone else was gone, and Bergin was on his way out, but Knight was waiting for two kids from the nearby elementary school, who couldn’t have been older than 11, Bergin said. The two had seen Knight run and asked him to run a lap with them after school. So Knight waited and ran with them.“I remember just going ‘wow.’” Bergin said. “That’s Justyn.”Once Knight arrived on Syracuse’s campus two years later, he made an immediate impact, running in the national championship his true freshman season.By his sophomore season in 2015, Knight emerged as one of the best runners in the country. Hehir had always been the runner that teammates modeled themselves after. Soon, even for Hehir, that runner became Knight.Andy Mendes | Digital Design EditorOne of the reasons that Hehir excelled so much as a senior, Smith said, was because Knight took the pressure off Hehir and let him run freely.“Justin’s transformed the program and he’s taken us to a place where we couldn’t have been without him,” Hehir said. “That’s meant a lot for the program and for the future of the program.”The pair, along with emerging star Colin Bennie, led Syracuse to its first national championship in 64 years. When Bennie arrived at campus, like many, he copied Hehir’s model. But in 2015, he mimicked Knight.“Justyn being the guy to keep with,” Bennie’s mother Lisa said, “is the best training situation Colin could be in.”The entire time Knight trained for worlds, he checked on his teammate’s summer training, Jennifer said. In between workouts this summer in Vaughan, Ontario, Knight’s phone would be littered with messages from younger runners asking how his training was going, but also asking questions about their own training and how to prepare for the fall.Syracuse head coach Chris Fox traveled to London this summer for Knight’s race. As soon as it was over, Knight found his coach.“‘Let’s get ready for cross-country,’” he said to Fox.Throughout this season, Knight has worked to ensure his teammates are ready to battle at NCAAs. He sets the tones in workouts, checks in on how his teammates train and recover and takes on his own coaching responsibilities as the team’s leader. All his preparations have lined up for this Saturday, when Knight has one final attempt at a cross-country crown. “I think it’s a pretty fitting final chapter for him to put his mark on,” Hehir said. “The fact that he hasn’t won a title yet chomps this up to make it even sweeter. It could be a storybook ending.”Knight loves the pressure and the spotlight, but he’s had to adjust to it. Being the favorite is something he’s struggled with in the past. After he rose to prominence in 2015, the lights shined brighter and the microphones in his face multiplied. He felt overwhelmed. But he’s learned to embrace it and use the added attention to take the pressure off of his team.No matter the finish, Saturday’s race will bring an end to the greatest cross-country career a Syracuse runner has ever had.“I’m 30 years old and I don’t think that I will ever have another Justyn in my coaching career,” Smith said. “He is a once in a lifetime talent.”And on Saturday afternoon, he can capture the one thing that’s eluded him. Comments For two years, across three seasons, Justyn Knight couldn’t beat Oregon’s Edward Cheserek. No one could. Cheserek, or “the King” as he was called, finished his college career as a 17-time national champion in 21 possible events. But, at the cross-country national championship last year, Knight finished ahead of him.Then he ran into another problem: Villanova’s Patrick Tiernan. Knight prefers a sit-and-kick type race, where the runners don’t burn themselves out during the race, but then sprint ahead at the end. Tiernan set the pace that day, and made sure he didn’t let Knight kick. Instead, he burned the last mile, forcing Knight to chase, preventing a strong kick.“Sometimes you have your day,” Syracuse assistant coach Adam Smith said, “and that day was Tiernan’s day.”Cheserek and Tiernan were both experienced runners in their last year of eligibility. Knight was one of the favorites, but not the favorite. In all cross-country disciplines, outdoor and indoor track, Knight has had his share of chances to claim an individual national title, but hasn’t won one yet.Knight is the best runner in Syracuse history, with two top-five finishes in three years at the national championship. When Knight began his college career, Syracuse was a middle-of-the-pack finisher at nationals, unable to get over the hump. Knight turned the team into a perennial top-three team and national champion in 2015. He has carried the program on his back while making his teammates better. But he has never captured an individual cross-country championship. On Saturday, he has one final opportunity to do it.AdvertisementThis is placeholder text“I don’t go into any race racing for second,” Knight said.center_img Facebook Twitter Google+last_img read more