Superbug outbreak reports at Canadian hospitals not shared

A potentially deadly class of superbug has some Canadian hospitals stepping up screening, as infectious disease experts call for a reliable national warning system to report outbreaks.

At Fraser Health in B.C.'s Lower Mainland, hospitals have intermittently found cases of multidrug-resistant bacteria called Carbapenem resistant enterobacteriaceae or CRE. From summer 2012 until the end of 2013, 41 affected patients have been identified.

David Ricci, who picked up a superbug infection in Calcutta, says doctors had to resort to surgical treatment from the pre-antibiotic era. (Courtesy David Ricci)

The overall group of bacteria normally live in the human digestive system. If those bacteria get into the wrong areas of the body, such as the blood or bladder, severe infections can occur. Some of these bacteria also have enzymes that give them resistance to last-resort antibiotics called carbapenems. The director of the U.S. Centers for Disease Control last year called the superbugs "nightmare bacteria."

"To reduce the risk of the organism spreading, Fraser Health is currently implementing a screening process for all patients admitted into our hospitals, particularly those being treated in our intensive care units," a spokeswoman for Fraser Health said in an email to CBC News on Thursday.

"The screening process will involve asking whether or not patients have been admitted into a hospital or received renal dialysis outside of Canada within the past six months. Anyone who answers yes to the screening question will be tested for CRE."

The screening is important in treating patients such as David Ricci, 22, of Seattle, who was infected with CRE in 2011. Ricci was taking a shortcut to his volunteer job at an HIV/AIDS clinic in Calcutta when his leg was pinched under a train in an accident, severing the arteries.

After he was airlifted home for treatment, doctors were in the dark about how to treat the thigh infection once they discovered he tested positive for CRE.

"The antibiotics that they did have didn't do anything. The only way to remove the infection was to surgically cut it out," Ricci said. He now has a prosthetic leg and is studying with the goal of going to medical school for a career in infectious disease.

In the U.S, the CDC maps states with confirmed cases of CRE.

"There's not a lot of apparent and transparent information available in Canada yet," said Dr. Lynora Saxinger, an infectious diseases specialist at the University of Alberta in Edmonton. "Perhaps because of fear of alienating the public and creating a crisis of confidence in the public, there is a bit of a tendency to try and minimize issues like this and try to avoid widespread knowledge about such outbreaks."

To have a culture of safety, information about outbreaks and how the risks are being managed needs to be communicated, Saxinger said.

"Often these outbreaks may be occurring and we don't even know about them," said Dr. Michael Gardam, an infectious disease specialist at Toronto General Hospital.

When hospitals across Canada are left unaware of cases at other Canadian hospitals, they don't screen for CRE, and people who are colonized and not ill can spread the resistant bacteria to other patients and health-care workers, Gardam said.

"We're looking at potentially expanding that [beyond travellers] and starting to screen all patients coming to certain parts of the hospital," such as the ICU, he said, since travel history alone may no longer reflect the risk. The goal is to stay one step ahead of resistant

The Public Health Agency of Canada has limited surveillance of 57 mainly teaching hospitals. The agency's latest published data shows three deaths where CRE was the main or contributing cause of death between 2010 and 2012. There were 160 cases reported during that period.

The national information doesn't provide real-time information that doctors want, Gardam said.

In the U.S., several states have CRE surveillance set up and Europe is a little farther ahead, Saxinger said. 

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Sports drinks unnecessary, counterproductive for most people

If you're grabbing a sports drink to replenish your electrolytes after exercise, you could actually be working against your workout.

A CBC Marketplace investigation found that the vast majority of Canadians don't exercise hard enough to need the colourful drinks, and an average workout does not deplete the body enough to require additional energy and electrolytes.

"The benefit of getting physically active – [which] improves your body composition, makes you healthier, makes you fitter and all that – that's fantastic, but unfortunately, drinking sugary, salty drinks actually does the opposite to the average person," sports physiologist Dr. Greg Wells told Marketplace co-host Tom Harrington.

WATCH 

Marketplace's episode Farther, Faster, Fitter? airs Friday at 8 p.m. (8:30 p.m. in N.L.). Follow the conversation on Twitter by using the hashtag #sportperformance.

What's more, sports drinks can be high in sugar and sodium. Gatorade's Glacier Cherry Perform drink contains 41 g of sugar per serving -- more than 10 teaspoons of sugar -- and 330 mg of sodium, more than a McDonald's medium fries and more than a serving of Doritos Cool Ranch chips.

Marketplace teamed up with Canadian Olympians Clara Hughes and Simon Whitfield to investigate popular products -- including sports drinks, protein bars and high-tech running shoes -- that promise to enhance athletic performance. The full investigation, Farther, Faster, Fitter? airs Friday at 8 p.m. (8:30 p.m. NL) on CBC Television.

Performance product trials

Sports drinks promise to rehydrate, provide energy to muscles in the form of sugar and replenish electrolytes lost during exercise. Canadians guzzle more than $450 million in sports drinks every year.

Popular choices such as Gatorade are extensively promoted for their ability to help athletes refuel. Gatorade boasts their beverage is "scientifically formulated" and will "provide optimal quantities of sodium, potassium and carbohydrate to support exercise." Powerade promises an "advanced electrolyte system designed to help replenish four electrolytes lost in sweat."

Electrolytes are minerals, such as potassium and sodium, that carry an electrical charge and are important for body function. They can be depleted through sweat during intense exercise over a long period of time or in the hot sun.

Canadian Olympic medallist Simon Whitfield joined CBC Marketplace's investigation on sports performance products, including sports drinks, protein bars and high-tech running shoes. (CBC)

To test how many electrolytes are actually lost during exercise, Marketplace recruited a team of recreational runners and tested their blood before and after a 45-minute run. None of the runners depleted either their glucose or electrolyte levels enough to require a sports drink to replenish them. In many cases, electrolyte and glucose levels increased in the blood. The test revealed that they could have benefited from water alone.

Wells, who is a researcher with the Human Physiology Research Unit at the University of Toronto and has worked with elite athletes, says that the body is very good at providing itself with what it needs to fuel moderate exercise.

"Your body is very, very good at making the changes it needs to make in order to keep you exercising safely all on its own," he says.

Marketplace also tested the blood of an elite triathlete during intense cycling and discovered that it would take about two hours of strenuous activity before she would benefit from the electrolytes in a sports drink.

Sports drinks popular with kids

Promoted by professional sports stars such as Sidney Crosby and LeBron James, sports drinks are a popular choice among young athletes.

The Canadian Paediatric Society recommends the use of sports drinks for young athletes when they are exercising in intense heat and humidity or for longer than 60 minutes, but it also cautions against overuse.

"For non-athletes, routine ingestion of carbohydrate-containing sports drinks can result in consumption of excessive calories," the group warns, "increasing the risks of overweight and obesity, as well as dental caries and, therefore, should be avoided."

Wells cautions that younger kids shouldn't be using sports drinks for normal sports activities. "We know that children don't sweat as much as adults do," he says. "So, they don't actually need it as much as adults do. And kids' events are typically shorter and not long enough to require them. We're giving our kids a lot of sugar, lots of salt, so we need to be very, very careful with that."

Helpful for intense exercise only

"Sports drinks are marketed as beverages formulated for athletes and those who are physically active," the Canadian Beverage Association (CBA) wrote in a statement to Marketplace.

"Hydration is essential for good health, and science shows that the water, carbohydrates and electrolytes in sports drinks provide significant hydration and athletic performance benefits for active individuals."

Canadian Olympic medallist Clara Hughes teamed up with Marketplace to investigate the claims behind popular sports performance products. (CBC)

The CBA also notes that sodium in sports drinks is an electrolyte that helps enhance fluid absorption, and while many drinks do contain sugar to fuel muscles, many companies "also provide a wide variety of low and no calorie hydrating beverages so that consumers can choose the product that is right for them depending on activity levels and caloric needs."

Wells agrees, to a point. "Sports drinks are fantastic for keeping electrolytes levels well, rehydrating you and giving you sugar that you need to exercise," he says. "But the average person, in a gym, typical spin class, yoga class, going to lift some weights, you need water."

Wells says that while sports drinks are widely available, they're only really helpful to a small minority of athletes. "Eighty-five per cent of Canadians don't get enough exercise to begin with, so they don't need sports drinks. The remaining 15 per cent that actually do exercise, you probably have one or two per cent exercising really hard, really intensely enough to really need those sports drinks. In that group, probably a small subset of them are exercising long enough to need it."

"In the scientific community, we generally don't recommend sport drinks for anything less than 90 minutes, if you are exercising really intensely, if you are exercising in the heat, if you are exercising for a very long period of time."

Wells says most of us are better off with water. "An average person like you, during a workout, you need to be drinking a lot of water; that's pretty much all your body needs. That's what your body needs for your muscles to work really, really well. That's what your blood needs to circulate really well."

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'I'm dying:' Woman seeks $60K online for eating disorder care

Canadians with eating disorders can face such long wait times for publicly funded treatment spots that many patients depend on personal assets and private funding to get access to facilities.

Many end up with deep debt after emerging from treatment for psychological disorders. So Ingrid Davidson has turned to online fundraising at Indiegogo to generate cash to pay for her care.

"I'm dying ... and there's no help," says Ingrid Davidson, a 23-year-old diagnosed with anorexia, depression and an anxiety disorder. 

"It makes me so upset that so many people are suffering so greatly, and there is no help — unless they're able to wait for months for funded treatment or they're able to pay."

According to the National Eating Disorder Information Centre, the prevalence of anorexia (self-starvation) and bulimia (binging and purging) is estimated to be 0.3 per cent and one per cent among adolescent and young women, respectively.

"Prevalence rates of anorexia and bulimia appear to increase during the transition from adolescence to young adulthood," says the centre, a non-profit organization that raises awareness about the different types of eating disorders, including through its Eating Disorder Awareness Week that starts Feb. 2 this year.

Davidson, who has relapsed into an eating disorder first diagnosed in 2009, is now living in a Hamilton hospital and hopes to use the campaign to generate $60,000 for specialized private in-patient treatment before the disorder kills her.

Davidson admitted herself to the hospital when she learned a publicly funded outpatient program couldn't accept her until March. While she didn't want her precise weight revealed, her body mass index dropped below what is considered a healthy range.

She is enrolled in the hospital's mood disorders inpatient program, which helps patients control mood disorder symptoms. But, she says it is not equipped to deal with her severe eating disorder. St. Joseph's Healthcare only has an outpatient eating disorder program, which offers weekly group therapy sessions.

Davidson says she's accustomed to long waits for publicly funded spaces. It once took about a year and a half for her name to move to the top of Homewood Health Centre's wait list for an in-patient eating disorders treatment program. At Homewood, patients get weighed regularly, eat supervised meals in a communal dining hall and attend multiple therapy groups daily.

Scarcity of publicly funded spaces

Homewood, Canada's largest in-patient treatment centre for people with eating disorders, has 21 beds allotted for patients struggling with eating issues, centre spokesman Ric Ament wrote in an email.

Ward beds are fully funded by OHIP, Ontario's health insurance program​. Beds in semi-private or private rooms carry additional costs of $260 a day and $310 a day, respectively, for Ontario patients, who must pay the added costs or have their supplementary health insurance plans do so, Ament wrote.

Ingrid Davidson's struggle with her eating disorder started during her first year of university when she searched for something to make her feel in control. (Ingrid Davidson)

Ament declined to specify how many of each bed exist in the program, but said there were more semi-private and private beds than publicly supported ward beds.

The waiting list both for privately and publicly funded beds is generally long, he wrote.

In Manitoba, CBC News has learned, patients can wait up to a year for publicly funded treatment — even in an outpatient program.

The Ontario Ministry of Health and Long-Term Care has made steps towards improving wait times. It has almost tripled its investment in eating disorders treatment since 2003-04, wrote ministry spokesman David Jensen in an email.

Thanks to the funding, the province will have the most publicly funded beds for in-patient treatment in Canada, he wrote — 24 adult beds and 24 pediatric beds. Jensen did not say how many beds currently exist or when the new beds will be available.

Private treatment costs thousands

The scarcity of beds makes long wait times, like Davidson's, "very typical," said Aziza Kajan, an employee at Hope's Garden, a support centre in London, Ont., for people with eating disorders.

The centre's site lists average wait times for various programs across Canada, ranging from several weeks to years depending on the intensity of treatment.

Patients willing to pay out of pocket or with supplementary health insurance for treatment at Homewood wait about two to five months before being admitted, according to the centre's site, while patients relying on OHIP wait between two and three years.

Kajan explains this discrepancy by saying fewer people can afford to pay privately, so the queue is shorter, while there's a backlog for in-demand publicly funded spaces.

Long wait times for publicly funded spots mean people who need treatment but can't afford to pay for it themselves don't get the help they need, said Kajan.

$35K of debt for 1st bout of treatment

In 2012, when Homewood finally offered Davidson a spot after about 18 months of waiting, she learned it was not for one of the coveted OHIP-funded beds.

Davidson's mother, 55-year-old home-care worker Susan Nelson, acquired a nearly $35,000 line of credit to pay for her daughter's treatment.

"It was at the point where I was dying and we had no option," Davidson says of her mother's sacrifice. Her mother is now "seriously in debt."

Davidson spent 3-1/2 months at Homewood, and left the healthiest she had ever been.

"My head was in such a different place," she recalls, explaining how she was no longer constantly preoccupied with food. "It was so different, so different. It was amazing."

But she quickly relapsed, unable to find enough support from services after Homewood's 24/7 care.

Ingrid Davidson now weighs less than she ever has since her eating disorder started in 2009. She fears she won't survive until a spot in a publicly funded treatment program opens up for her. (Ingrid Davidson)

While she waited two months for another bed to open up at Homewood, Davidson's eating disorder escalated. Sometimes she would go as long as 72 hours without eating.

"I was almost dead," she explains. "I could have had a heart attack really easily."

She spent December 2012 in Homewood's care, but her mother couldn't afford to pay for further treatment.

After she left, she continued seeing a psychologist, but wasn't making much progress. She moved to Toronto and was put on a wait list for an outpatient program at a hospital. The program can't accommodate her until March, she says.

"I honestly don't think I would make it," she says. "I really, really don't think that I would make it until March."

$60K fundraiser a last resort

Even if she did, Davidson is convinced the outpatient day program won't be enough support for the severity of her illness and that another extended stay is her best chance for a full recovery.

'This is one of the worst feelings any parent can imagine.'- Susan Nelson, Ingrid Davidson's mother

Homewood has told Davidson and her mother that a spot could become available in the next several weeks.

"This is one of the worst feelings any parent can imagine," Nelson wrote on Indiegogo for the fundraising campaign, which she hopes raises $60,000 by Feb. 27. So far, nearly $33,000 has been raised.

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Vodka to blame for high death risk in Russian men

Russian men who down large amounts of vodka — and too many do — have an "extraordinarily" high risk of an early death, a new study says.

Researchers tracked about 151,000 adult men in the Russian cities of Barnaul, Byisk and Tomsk from 1999 to 2010. They interviewed them about their drinking habits and, when about 8,000 later died, followed up to monitor their causes of death.

The risk of dying before age 55 for those who said they drank three or more half-litre bottles of vodka a week was a shocking 35 per cent.

Male life expectancy is 64

Overall, a quarter of Russian men die before reaching 55, compared with 7 per cent of men in the United Kingdom and less than 1 per cent in the United States. The life expectancy for men in Russia is 64 years — placing it among the lowest 50 countries in the world in that category.

'It's this pattern of getting really smashed on vodka and then continuing to drink that is dangerous.'- Sir Richard Peto, lead researcher

It's not clear how many Russian men drink three bottles or more a week. Lead researcher Sir Richard Peto of Oxford University said the average Russian adult drinks 20 litres of vodka per year while the average Briton drinks about three litres of spirits.

"Russians clearly drink a lot, but it's this pattern of getting really smashed on vodka and then continuing to drink that is dangerous," Peto said.

"The rate of men dying prematurely in Russia is totally out of line with the rest of Europe," he said. "There's also a heavy drinking culture in Finland and Poland, but they still have nothing like Russia's risk of death."

Alcohol has long been a top killer in Russia and vodka is often the drink of choice, available cheaply and often homemade in small villages. Previous studies have estimated that more than 40 per cent of working-age men in Russia die because they drink too much, including using alcohol that is not meant to be consumed like that in colognes and antiseptics.

Drinking is so ingrained in Russian culture there's a word that describes a drinking binge that lasts several days: "zapoi."

Hard liquor particularly dangerous

Peto said there was some evidence of a similar effect in Russian women who also drank heavily but there was not enough data to draw a broad conclusion.

'It's not considered out-of-order to drink until you can't function in Russia.'- David Leon, epidemiology professor

The study was paid for by the U.K. Medical Research Council and others. It was published online Thursday in the journal Lancet.

Other experts said the Russian preference for hard liquor was particularly dangerous.

"If you're drinking vodka, you get a lot more ethanol in that than if you were drinking something like lager," said David Leon, a professor of epidemiology at the London School of Hygiene and Tropical Medicine, who has also studied the impact of alcohol in Russia but was not part of the Lancet study.

He said changing drinking patterns in Russia to combat the problem was possible but that it would take a significant cultural adjustments.

"It's not considered out-of-order to drink until you can't function in Russia," Leon said. "It just seems to be part of being a guy in Russia that you are expected to drink heavily."

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Peanut allergy in children reduced in experiment

Some children with peanut allergies who were given small doses of peanut product were able to build up their tolerance and improve their quality of life after participating in a carefully controlled experiment.  

British researchers followed 96 children and teens with varying degrees of documented peanut allergy. After six month of treatment with increasing doses of peanut protein, most of the participants could safely tolerate the equivalent of about five peanuts — a reassuring change for families worried about accidental exposures.

Hanna Carter of Roanoke, Va., takes a dose of peanut protein as part of an experiment to retrain the immune system. A new British study shows the approach can work under carefully controlled conditions. (Gerry Broome/Associated Press)

"This study shows that peanut immunotherapy is an effective and well-tolerated treatment in this age group" of seven to 16 year olds, study leader Dr. Andrew Clark from Cambridge University Hospitals and his co-authors conclude in Wednesday's online issue of the medical journal The Lancet.

In the British study, one patient had to administer epinephrine twice for symptoms and dropped out. About 20 per cent had reactions involving wheezing that was mild in most cases and responded to a standard puffer. Others complained about itchy mouth and abdominal pain, which also weren't severe enough to require hospital care.

Peanut allergy is the most common cause of severe and life-threatening allergic reactions related to food, affecting between 0.5 per cent and 1.4 per cent of children in high-income countries, according to the journal.

Dr. Susan Waserman, an allergist and immunologist at McMaster University in Hamilton, is conducting a similar clinical trial of 32 children aged five to 10 who are taking protein powder or a placebo in jam or pudding.

Dr. Susan Waserman says the British findings show that children with all degrees of peanut allergy severity can be successfully desensitized. (McMaster University)

Waserman said the British findings cast the approach in a good light.

"In a disease where we teach everybody that even a trace amount of peanut can be fatal, this is actually quite good news, and pretty revolutionary," Waserman said.

Being able to tolerate 800 milligrams of peanut protein or about five peanuts is going to "increase their quality of life and just make them less anxious about having this whole condition," Waserman said.

So far, some of Waserman's own participants have had similar success, and other trials are under way in other countries.

The approach isn't ready for use by families and their doctors, Waserman cautioned. It's also not a cure that allows people to enjoy peanut butter sandwiches freely. Rather, researchers still need to determine the minimum amount of peanut needed to maintain the tolerance. Otherwise, the allergy sensitivity seems to creep back.

A larger and broader range of people need to be followed for longer to see if "oral immunotherapy" remains safe and is cost-effective, Matthew Greenhawt from the University of Michigan Food Allergy Centre in Ann Arbor said in a journal commentary published with the study.

It would be naive to view oral immunotherapy as a one-size-fits-all treatment for food allergy, Greenhawt said.

The study was funded by the Medical Research Council.

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Concussions plague Quebec's young football players

For more than 30,000 young Quebecers, football is both a passion and a major risk for serious head injuries.

But neither Football Quebec nor the Quebec Student Sport Federation (better known in the province by the acronym RSEQ) have any idea just how many players are getting concussions on the field.

The RSEQ, which counts approximately 186,000 student athletes among its ranks in all sports, currently has no one in charge of safety.

As for Football Quebec, its safety regulations do not contain a single line about the obligation for teams to implement any kind of protocol regarding the detection and management of concussions, not to mention a protocol on returning to the game after being on the receiving end of a head injury.

That information comes from an investigation by Radio-Canada's Enquête investigative journalism team.

'I felt a flash in my head'

Last October, the star running back for Montreal's Collège Notre-Dame football team experienced his second concussion in a month.

François Rocheleau, a football player for Collège Notre-Dame, said he received two concussions in a single month. "I really felt a flash in my head at the moment of the hit, and after that I was all disoriented," he says. (Radio-Canada)

"I really felt a flash in my head at the moment of the hit, and after that I was all disoriented," says François Rocheleau.

Rocheleau received proper medical treatment and follow-up for his injury, but as the Enquête team discovered, some young football players in Quebec aren't so lucky.

Members of Enquête's investigative team spent the fall on Quebec football fields, and they observed between five and 10 concussions per team in a single season — nearly one player in five.

When Enquête asked Alain Roy, the director of the Quebec Student Sport Federation (better known by its French name, the Réseau du Sport étudiant du Québec), for the exact number of concussions afflicting young football players last year, he wasn't able to provide a number.

"We don't currently have the tools in place for this kind of census," Roy told Radio-Canada.

No protocol for concussions

The danger of concussions in football recently came to light when 4,500 National Football League players and their families successfully sued the league for $765 million.

'Our young people are risking their lives.'- Dr. Dave Ellemberg, specialist in head injuries

The settlement was reached late last summer after the players alleged that the NFL knew more than it divulged to players about the danger of repeated hits to the head.

But, according to Enquête, the risk of head injury is higher for the 14,000 young high school football players in Quebec than it is for professional football players.

Football Quebec is responsible for the sport's development and safety in the province.

High schools are supposed to submit incident reports for every concussion to Football Quebec.

However, the organization's director Jean-Charles Meffe also seemed unaware of the extent of the problem.

When asked whether he thought Enquête's observation of between five and 10 concussions per team was a realistic number of injuries, he said he'd be surprised if it were true.

"That doesn't make sense," he said.

Meffe said he rarely gets reports of concussions, and when he does, Football Quebec doesn't follow up — and that's fine by him.

"We're happy to not receive them, honestly. Well, no, it's because I'm telling you that we're two in this federation," Meffe said, referring to the organization being short-staffed.

After a shock, the brain hits the inner walls of the skull, causing it to get deformed and causing its nerve fibres to break. The chemical and electrical brain activity is then disrupted for several days, and sometimes weeks. (Radio-Canada)

No school rules

Although youth football is rapidly expanding in Quebec, the measures taken to protect players have not been expanding in tandem.

Enquête made access to information requests to 30 schools with football teams — 20 teams from divisions 1 and 1b which, in principle, are made up of the best Quebec student athletes -- with the intention of understanding what information schools have on managing head injuries.

From the documentation received, Collège Notre-Dame was actually one of the better-equipped schools in the province. The documents also showed that the better a school's football team was, the more risk of concussions there was.

However, Enquête's team concluded that this probably actually means that schools with the better teams were also better at documenting players' injuries — not that their players were getting injured more frequently.

"We are easily 10 years behind in Quebec, and also in Canada, on the management of concussions. This means that our young people are risking their lives in playing these sports," said Dr. Dave Ellemberg, a specialist in head injuries who wrote a book on concussions in sports.

Visit Radio-Canada's special feature page (in French) for more on their investigative journalists' look at football-related injuries among Quebec's youth.

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Nearly half of obese 8th graders were overweight in preschool

Those efforts to fight obesity in schools? Think younger. A new U.S. study finds that much of a child's "weight fate" is set by age 5, and that nearly half of kids who became obese by the eighth grade were already overweight when they started kindergarten.

The prevalence of weight problems has long been known — about a third of U.S. kids are overweight or obese. But surprisingly little is known about which kids will develop obesity, and at what age.

Researchers think there may be a window of opportunity to prevent childhood obesity. (Seth Wenig/Associated Press)

Researchers think there may be a window of opportunity to prevent it, and "we keep pushing our critical window earlier and earlier on," said Solveig Cunningham, a scientist at Emory University. "A lot of the risk of obesity seems to be set, to some extent, really early in life."

She led the new study, which was published in this week's New England Journal of Medicine and paid for by the federal government.

It tracked a nationwide sample of more than 7,700 children through grade school. When they started kindergarten, 12 per cent were obese and 15 per cent were overweight. By eighth grade, 21 per cent were obese and 17 per cent were overweight.

Besides how common obesity was at various ages, researchers focused on the 6,807 children who were not obese when the study started, at kindergarten entry. Here are some things they found:

WHO BECAME OBESE: Between ages 5 and 14, nearly 12 per cent of children developed obesity  10 per cent of girls and nearly 14 per cent of boys.

Nearly half of kids who started kindergarten overweight became obese teens. Overweight 5-year-olds were four times as likely as normal-weight children to become obese (32 per cent versus 8 per cent).

GRADE LEVELS: Most of the shift occurred in the younger grades. During the kindergarten year, about 5 per cent of kids who had not been obese at the start became that way by the end. The greatest increase in the prevalence of obesity was between first and third grades; it changed little from ages 11 to 14.

RACE: From kindergarten through eighth grade, the prevalence of obesity increased by 65 per cent among whites, 50 per cent among Hispanics, almost 120 per cent among blacks and more than 40 per cent among others — Asians, Pacific Islanders and Native Americans and mixed-race children.

By eighth grade, 17 per cent of black children had become obese, compared to 14 per cent of Hispanics and 10 per cent of whites and children of other races.

INCOME: Obesity was least common among children from the wealthiest families and most prevalent among kids in the
next-to-lowest income category. The highest rate of children developing obesity during the study years was among middle-income families.

BIRTHWEIGHT: At all ages, obesity was more common among children who weighed a lot at birth — roughly 9 pounds or more. About 36 per cent of kids who became obese during grade school had been large at birth.

The study's findings do not mean that it's too late for schools to act, but their best tactic may be to focus on kids who are overweight and try to encourage exercise and healthy eating, Cunningham said.

The work also shows the need for parents, doctors, preschools and even day care centres to be involved, said Dr. Stephen Daniels, a University of Colorado pediatrician and a spokesman for the American Heart Association.

"You can change your fate by things that you do early in life," with more exercise and eating a healthy diet, he said. "Once it occurs, obesity is really hard to treat. So the idea is we should really work hard to prevent it."
 

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Michael Schumacher, former F1 champ, being brought out of coma

Michael Schumacher's doctors have started the process of bringing the former Formula One champion out of the coma he has been in since a skiing accident a month ago, his manager said Thursday.

The 45-year-old Schumacher suffered serious head injuries when he fell and hit the right side of his helmet on a rock in the French resort of Meribel on Dec. 29. The seven-time F1 champion has been in an induced coma in Grenoble University Hospital since then, although his condition stabilized following surgery after initially being described as critical.

And now doctors are slowly trying to wake him up.

Former F1 driver Michael Schumacher, shown here in 2006, fell while skiing and struck his head on a rock in December 2013. (Ferrari/Associated Press)

"Michael's sedation is being reduced in order to allow the start of the waking up process which may take a long time," Schumacher's manager, Sabine Kehm, said in a statement.

One reason for reducing the sedation is to see if the swelling has gone down in the patient's brain and to assess what level of functions has been retained.

Kehm said she was only providing an update now on Schumacher's condition to clarify media leaks, and that no further details would be provided. French newspaper l'Equipe first reported on Wednesday that doctors had started waking Schumacher.

"The family of Michael Schumacher is again requesting to respect its privacy and the medical secret, and to not disturb the doctors treating Michael in their work," Kehm said. "At the same time, the family wishes to express sincere appreciation for the worldwide sympathy. ... For the protection of the family, it was originally agreed by the interested parties to communicate this information only once this process was consolidated. Please note that no further updates will be given."

Schumacher was being kept artificially sedated and his body temperature was lowered to between 34 and 35 degrees Celsius, to reduce swelling in the brain, reduce its energy consumption and allow it to rest.

Schumacher earned universal acclaim for his uncommon and sometimes ruthless driving talent, which led to a record 91 race wins. He retired from Formula One in 2012 after garnering an unmatched seven world titles.

Schumi, as his fans affectionately call him, was famously aggressive on the track and no less intense away from driving. In retirement, he remained an avid skydiver, horseback rider, and skier.

The accident happened on a family vacation in the Alps as Schumacher was skiing with his 14-year-old son.

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Amnesiac Henry Molaison's brain undergoes digital post-mortem

A detailed post-mortem look at the brain of a famous amnesiac is revealing new clues to his memory.

Henry G. Molaison, known in the medical literature as H.M., had parts of the hippocampus in his brain removed in 1953 at the age of 27, following increasingly severe seizures from epilepsy that couldn't be treated effectively with medications.

H.M.'s frozen brain at the level of the frontal lobes during the post-mortem cutting procedure. (Courtesy Annese et al/Nature)

"During life, H.M. was the best-known and possibly the most studied patient in modern neuroscience," Jacopo Annese of the University of California, San Diego, and his co-authors conclude in Tuesday's issue of the journal Nature Communications.

After the surgery, the Connecticut-born man had difficulty forming long-term memories of facts, faces and experiences. His willingness to participate in testing led to a range of contributions to science during his life and after his death in 2008 at the age of 82 from respiratory failure.

The latest is a digital 3D reconstruction of his brain based on thin tissue slices of his brain that Annese and his team at the Brain Observatory in San Diego began preparing in 2009. The slicing was livestreamed.

Annese said the 3D model uses virtual dissection to examine the original surgery. In the study, the researchers say the reconstruction revealed several findings, including pathology in the deep white matter and a small lesion with clearly defined edges in a frontal lobe that hadn't been described before.

Jacopo Annese examines final brain tissue slides that were also digitized for study by researchers worldwide. (University of California, San Diego)

They say neurosurgeon William Beecher Scoville "reached beyond and below the posterior hippocampus." A circuit that acts as a gateway to the hippocampus from the brain's outer layer to support the consolidation of long-term memories was also likely severely compromised during treatment.

For years, Montreal-based McGill University neuroscientist Brenda Milner travelled to Hartford to visit Molaison and test his abilities to learn tasks.

For example, Milner found that Molaison improved his performance at a co-ordination task over three days, despite his inability to recall previous attempts. Annese said a detailed survey of three brain areas could validate Milner's observations and give clues about how Molaison's brain was wired to perform tasks.

Microscopic studies of his remaining tissue in the hippocampus raise questions about how well it functioned.

Pathology observations of his white matter suggest changes acquired from medical conditions, including hypertension.

The researchers said closer study is needed to learn more about aging-related abnormalities that happened independently of Molaison's surgery.

Molaison also lacked the ability to report internal states such as pain, hunger or thirst, which was attributed to the removal of his amygdala.

The study was funded by the U.S. National Science Foundation, the Dana Foundation Brain and Immuno-Imaging Award, and by contributions from viewers of the web broadcast of the dissection.

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What works and doesn't to prevent and treat the common cold

People sick with a runny nose, sore throat and cough from the common cold will try myriad remedies, but only a few have proved to get results, a Canadian doctor says. 

Colds are common, affecting adults about two to three times a year and children under age two about six times a year.

Dr. Michael Allan, of the department of family medicine at the University of Alberta in Edmonton, reviewed and summarized the sometimes conflicting research on treatment and prevention of colds in Monday's issue of the Canadian Medical Association Journal.

Desperation will lead people with a cold to try just about anything but few treatments have evidence to support their use. (Shutterstock)

The bottom line? "For treatment of common cold, what you'd be looking at are things like fever and pain control, so acetaminophen or ibuprofen, again kids are a little bit better with ibuprofen for fever," Allan said in an interview.

"For adults, you could consider some of the over-the-counter remedies, particularly the antihistamine combinations can make you feel a little bit better if you're desperate, but remember at best one in five will feel better on those."

For children, Allan suggests honey at bedtime for those troubled with cough. Honey should not be given to infants because of the risk of botulism.

"If you give the two to five age group a single dose at bedtime of either half a teaspoon or two teaspoons, what's been shown is reduction or improvement in sleep scores."

Over-the-counter cough remedies and combination products are clearly associated with bad events in children under the age of six, he cautioned.

For prevention at all ages, the review suggests that frequent washing of hands as well as alcohol disinfectants and gloves for health-care workers can be effective.

Zinc may work to prevent colds in children and possibly adults, based on the findings of two randomized trials that pointed to lower rates of colds and fewer absences from school. There's also some evidence that zinc lozenges may shorten the duration of a cold, although Allan noted many people complain about the bad taste and zinc can cause nausea.

Antihistamines combined with decongestants or pain medications like acetaminophen and ibuprofen appear to be somewhat or moderately effective in treating colds in children over the age of five and adults.

For non-traditional treatments, the role of ginseng in preventing colds is questionable, Allan and co-author Dr. Bruce Arroll of the University of Auckland in New Zealand concluded.

Results were so inconsistent or small effects for other non-traditional treatments, such as vitamin C, that Allan says it "just not worth it." He also recommended against Chinese remedies, which were "batting one out of 17" in the studies on benefits with no information on potential side-effects.

"Desperation will lead to just about anything," Allan said with a laugh. "When people are sick, they'll try everything, from a spoonful of cayenne pepper, etcetera. Of course there's very little research, or no research, on any of those kind of things."

Warm soup falls into that category. It's warm and gentle on the throat, but improbable that a can of soup will help you get rid of a cold any sooner, Allan said.

Some commuters in Toronto pointed to herbal teas as a soothing option.

"I swear by ginger. Freshly grated ginger tea in the morning sets me right for the whole day," said Prati Vaidya. "The other is a warm glass of milk with tumeric and a little bit of jaggery," [sugar]. 

Others use Dr. Mom's advice: Rest is best.

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Ontario to spend $20M to help treat mental, physical illness

The province says it is joining forces with several partners to help people get treatment for mental and physical illness.

Health Minister Deb Matthews announced Tuesday the newly created Medical Psychiatry Alliance which will offer support across the province.

She says the government will spend up to $20 million over the next six years to lead the initiative.

The Centre for Addiction and Mental Health, The Hospital for Sick Children, Trillium Health Partners, the University of Toronto and a private donor are putting in the rest of the money, for a total of $60 million to create the alliance.

The initiative involves developing new screening and diagnostic tools, ensuring physical and mental illnesses are treated simultaneously and developing specialized clinical training for medical students.

The province says more than 1.3 million Ontarians experience physical illness combined with mental illness.

The announcement comes on Bell Canada's Let's Talk Day, which raises funds for mental health awareness across the country.

"The reality is lots of people with mental illness also have serious physical illness, and if they aren't treated together, we just don't provide the highest quality care," Matthews said.

Researching and testing new ways to deliver psychiatric care at home is also part of the initiative.

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4 Canadian Olympians share their favourite snacks

With an array of sports performance products on the market designed to help you refuel, recharge and recover, it can be hard to know what advice to swallow.

To help sort out the science behind products that promise to make you a better athlete, CBC Marketplace took some popular choices and put them through performance trials. This Friday's show will reveal some products that miss the podium.

Join sports physiologist Dr. Greg Wells and Marketplace co-host Tom Harrington for a web chat about sports performance products, and which ones are winners when it comes to sports nutrition, tonight at 7pm.

As Canada's top athletes head to Sochi, we asked some past and present Canadian Olympians about the sports snacks that help keep them strong.

WATCH

Marketplace puts sports performance products to the test on Farther, Faster, Fitter?, which airs Friday, Jan. 31 at 8pm (8:30pm N.L.) on CBC Television.

Clara Hughes

One of the greatest Olympic athletes of all time, Clara Hughes is the only athlete to win multiple medals at both summer and winter Olympics, competing in cycling and speed skating. After competing in six Olympic games (three summer and three winter), Clara is a special analyst for CBC's coverage in Sochi.

What's her go-to snack or recipe while training?

Clara likes to make her own rice cakes with ingredients such as chopped dates and almond meal. The rice gives her much needed carbs, the dates deliver sugar and the almonds are packed with protein. "And they actually taste pretty good, too."

Adam van Koeverden

Kayaker and four-time Olympic medallist Adam van Koeverden was Canada's flag bearer at the opening ceremony of the 2008 Olympic Games in Beijing. Adam has won 22 World Cup titles and an astonishing 67 Canadian championships. He is also a special analyst for CBC's coverage in Sochi.

What's his go-to snack or recipe while training?

"I rely on unpackaged, unprocessed foods as much as possible," Adam says. "If it grew out of the ground, then it is really good for you." Protein is very important for recovery, but Adam doesn't eat meat, so he carries nuts and dried fruit wherever he goes for a hit of protein and sugar. To replenish after a workout, one of Adam's go-to snacks is a glass of water and a banana. Bananas are "portable and delicious and come in their own biodegradable wrapper."

Jennifer Heil

Freestyle mogul skier Jennifer Heil has participated in three winter Olympics, taking home gold and silver medals, including Canada's first medal at the 2006 Winter Olympics in Turin. For the Sochi games, Jennifer will be sharing her expertise as part of CBC's Olympics broadcast team as a freestyle skiing analyst.

What's her go-to snack or recipe while training?

"Right now I am loving my homemade vegan peanut butter cookies, but a bag of nuts will do the trick, too," she says. "I make a smoothie because it is important to replace nutrients and to rehydrate after a workout. The best time to have a smoothie is within thirty minutes of finishing a workout. When I was training for the Olympics my shakes had protein powder, but today I just put in almond milk, sometimes a scoop of natural peanut butter, hemp hearts and whatever fresh and frozen mix of fruits and vegetables I am in the mood for."

Kaya Turski

Heading to Russia for her first Olympics, Kaya Turski is one of the top-ranked women's slopestyle skiers in the world, a sport that is also making its debut in Sochi.

What's her go-to snack or recipe while training?

"One of my favourite things to eat after a morning on the slopes is very simple - a turkey sandwich on rye bread with an apple," says Kaya. "I also love hard boiled eggs." Whether she's in training or at a competition, Kaya also relies on nuts and granola bars to give her a boost.

Cheer on all the athletes starting Feb. 6, as CBC begins the largest Olympic Winter Games broadcast in history, including 12 live sports feeds, a mobile app and more at olympics.cbc.ca.

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What works and doesn't to prevent and treat the common cold

People sick with a runny nose, sore throat and cough from the common cold will try myriad remedies, but only a few have proved to get results, a Canadian doctor says. 

Colds are so common, affecting adults about two to three times a year and children under age two about six times a year.

Dr. Michael Allan, of the department of family medicine at the University of Alberta in Edmonton, reviewed and summarized the sometimes conflicting research on treatment and prevention of colds in Monday's issue of the Canadian Medical Association Journal.

Desperation will lead people with a cold to try just about anything but few treatments have evidence to support their use. (Shutterstock)

The bottom line? "For treatment of common cold, what you'd be looking at are things like fever and pain control, so acetaminophen or ibuprofen, again kids are a little bit better with ibuprofen for fever," Allan said in an interview.

"For adults, you could consider some of the over-the-counter remedies, particularly the antihistamine combinations can make you feel a little bit better if you're desperate, but remember at best one in five will feel better on those."

For children, Allan suggests honey at bedtime for those troubled with cough. Honey should not be given to infants because of the risk of botulism.

"If you give the two to five age group a single dose at bedtime of either half a teaspoon or two teaspoons, what's been shown is reduction or improvement in sleep scores."

Over-the-counter cough remedies and combination products are clearly associated with bad events in children under the age of six, he cautioned.

For prevention at all ages, the review suggests that frequent washing of hands as well as alcohol disinfectants and gloves for health-care workers can be effective.

Zinc may work to prevent colds in children and possibly adults, based on the findings of two randomized trials that pointed to lower rates of colds and fewer absences from school. There's also some evidence that zinc lozenges may shorten the duration of a cold, although Allan noted many people complain about the bad taste and zinc can cause nausea.

Antihistamines combined with decongestants or pain medications like acetaminophen and ibuprofen appear to be somewhat or moderately effective in treating colds in children over the age of five and adults.

For non-traditional treatments, the role of ginseng in preventing colds is questionable, Allan and co-author Dr. Bruce Arroll of the University of Auckland in New Zealand concluded.

Results were so inconsistent or small effects for other non-traditional treatments, such as vitamin C, that Allan says it "just not worth it." He also recommended against Chinese remedies, which were "batting one out of 17" in the studies on benefits with no information on potential side-effects.

"Desperation will lead to just about anything," Allan said with a laugh. "When people are sick, they'll try everything, from a spoonful of cayenne pepper, etcetera. Of course there's very little research, or no research, on any of those kind of things."

Warm soup falls into that category. It's warm and gentle on the throat, but improbable that a can of soup will help you get rid of a cold any sooner, Allan said.

Some commuters in Toronto pointed to herbal teas as a soothing option.

"I swear by by ginger. Freshly grated ginger tea in the morning sets me right for the whole day," said Prati Vaidya. "The other is a warm glass of milk with tumeric and a little bit of jaggery," [sugar]. 

Others use Dr. Mom's advice: Rest is best.

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Alkaline diet's scientific basis 'taken out of context'

The alkaline diet touted by Hollywood celebrities for weight loss and to avoid diseases such as cancer and osteoporosis promotes eating more vegetables, but the premise behind it is junk science, some experts say.

Proponents of the alkaline diet claim that when eating foods that lead the body to produce acids, such as meat, dairy and refined sugars, the mineral stores in our bones can become depleted and lead to illness.

In general, the diet advocates eating more of most fruits and vegetables, nuts and legumes instead of meat or grains.

There's no science behind the alkaline diet, a dietitian and chemist say. (Czarek Sokolowski/Associated Press)

"If it's green, high water content you can pretty much say it's alkaline," said Julie Cove of Victoria, who runs a website  promoting the diet. "The key is add way more greens into your diet."

Hydration is another pillar of the diet some companies are profiting from. A $60 water pitcher, for example, claims to make water alkaline by adding minerals.

But our bodies don't need help to do that. Moreover, the digestive system treats all foods the same way, said Joe Schwarcz, a chemist at McGill University

Since you cannot change the pH of your blood, "drinking alkaline water makes zero sense whatsoever," Schwarcz said.

In a Petri dish, cancer cells have been shown to multiply more in an acidic environment. But that can't be extrapolated  to the body.

"What has happened in this case is a bit of scientific fact was taken completely out of context and woven into a fabric of nonsense," Schwarcz said.

Christy Brissette, a registered dietitian at the Princess Margaret Cancer Centre in Toronto, is concerned that the diet doesn't work and could hurt some patients by putting them at risk of malnutrition.

"Some of the healthy foods that this diet limits are things like mushrooms, tropical fruits and berries," Brissette said. "I'd encourage people to pick the foods that they eat based on the nutrition in them, rather than looking at every single item and questioning is it acid, is it alkaline?"

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Flu volunteers sniffle for scientists

Forget being sneezed on: U.S. government scientists are deliberately giving dozens of volunteers the flu by squirting the live virus straight up their noses.

It may sound bizarre, but the rare type of research is a step in the quest for better flu vaccines. It turns out that how the body fends off influenza remains something of a mystery.

"Vaccines are working, but we could do better," said Dr. Matthew Memoli of the U.S. National Institutes of Health, who is leading the study that aims to infect up to 100 adults over the next year.

Wait a minute: Flu is sweeping the country, so why not just study the already sick? That wouldn't let scientists measure how the immune system reacts through each step of infection, starting with that first exposure to the virus.

It's not an experiment to be taken lightly. After all, the flu kills thousands of Americans a year. For safety, Memoli chose a dose that produces mild to moderate symptoms — and accepts only volunteers who are healthy and no older than 50.

Daniel Bennett sits in isolation as he remains quarantined to avoid spreading flu germs. His health is closely monitored before release. (Charles Dharapak/Associated Press)

And to avoid spreading the germs, participants must spend at least nine days quarantined inside a special isolation ward at the NIH hospital, their health closely monitored. They're not released until nasal tests prove they're no longer contagious.

The incentive: About $3,000 US to compensate for their time.

"I received a very scolding email from my mother" about signing up, Daniel Bennett, 26, said with a grin.

"Their standards are so high, I don't believe I'm in danger," added Bennett, a restaurant worker from College Park, Md. "I don't get sick that often."

A masked and gloved Memoli had Bennett lie flat for about a minute.

"It will taste salty. Some will drip down the back of your throat," Memoli said, before squeezing a syringe filled with millions of microscopic virus particles, floating in salt water, into each nostril.

Sure enough, a few days later Bennett had the runny nose and achiness of mild flu.

The best defense against influenza is a yearly vaccine, but it's far from perfect. In fact, the vaccine is least effective in people age 65 and older — the group most susceptible to flu — probably because the immune system weakens with age.

Understanding how younger adults' bodies fight flu may help scientists determine what the more vulnerable elderly are missing, clues to help develop more protective vaccines for everyone, Memoli explained.

Here's the issue: The vaccine is designed to raise people's levels of a particular flu-fighting antibody. It targets a protein that acts like the virus' coat, called hemagglutinin — the "H" in H1N1, the strain that caused the 2009 pandemic and that is causing the most illness so far this winter, too.

But it's not clear what antibody level is best to aim for — or whether a certain amount means you're protected against getting sick at all, or that you'd get a mild case instead of a severe one.

"As mind-boggling as it is, we don't know the answer to that," said Dr. Anthony Fauci, chief of NIH's National Institute of Allergy and Infectious Diseases. "We made some assumptions that we knew everything about flu."

Just targeting hemagglutinin probably isn't enough, Memoli added. Already, some people in his study didn't get sick, despite remarkably low antibody levels, meaning something else must be protecting them.

Could it be antibodies against the "N" in flu's name, the neuraminidase protein? Specific T cells that are activated to fight infection? Genes that switch on and off when a virus invades?

To begin finding out, Memoli first developed a laboratory-grown copy of the H1N1 flu strain and sprayed different amounts into volunteers' noses until he found the right dose to trigger mild flu. He hopes eventually to test the harsher H3N2 strain, too.

Now he's infecting two groups — people with low antibody levels and those with high levels. Some were recently vaccinated, and some weren't. He'll compare how sick they get, how long they're contagious and how the immune system jumps into action.

Called a human challenge study, this kind of research hasn't been performed with flu viruses in the U.S. for more than a decade, before scientists had ways as sophisticated to measure what happens.

"It's all going to add up to a better understanding of what you need to have to be protected against the flu," said Dr. John Treanor, a flu specialist at the University of Rochester Medical Center who is closely watching the work.

So far, Memoli's patients are becoming contagious a day or two before they start feeling bad, one reason the flu spreads so easily. He sees a range of symptoms, from sniffles to a few days of moderate fever, fatigue and congestion.

Bennett's flu was pretty mild, and he passed the time studying, watching TV and playing games with the four other study participants infected this month.

"All I had to do was read and watch movies, so it wasn't that terrible," Bennett said. "It was a really cool experience" to see how research is done.

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Black Death mysteries unlocked by McMaster scientists

Two devastating plagues that decimated much of Europe hundreds of years ago were actually caused by distinct strains of the same pathogen, new research suggests — and scientists say it's not impossible for a new strain of the plague to emerge in humans in the future.

These findings mark the apex of McMaster University scientist Hendrik Poinar's quest to do something no other scientist has ever done — crack the code of an ancient killer and change the way we fight disease in the 21st century.

'The pathogen only represents one half of the equation. We're the other half.'- Hendrik Poinar, director of the McMaster University Ancient DNA Centre

The Hamilton university scientist is part of an international team studying the Plague of Justinian and the Black Death — a fourteenth century killer disease that wiped out more than 50 million people. The results are currently published in the online edition of The Lancet Infectious Diseases. 

"The research is both fascinating and perplexing. It generates new questions which need to be explored," said Poinar, an associate professor and director of the McMaster Ancient DNA Centre and an investigator with the Michael G. DeGroote Institute for Infectious Disease Research.

"Why did this pandemic, which killed somewhere between 50 and 100 million people, die out?" he asked.  

Poinar is an evolutionary biologist, which means he studies the nature of how humans got here and where we're going. Until now, little was known about the origins or cause of the Justinian plague — which helped bring an end to the Roman Empire — and its relationship to the Black Death, which came about some 800 years later.

Secrets pulled from ancient teeth

Researchers from McMaster, Northern Arizona University and the University of Sydney have isolated minuscule DNA fragments from the 1,500-year-old teeth of two victims of the Justinian plague that were buried in Bavaria, Germany. These are the oldest pathogen genomes scientists have obtained.

It's from these short fragments that scientists have reconstructed the genome of the oldest Yersinia pestis, which is the bacterium responsible for the plague, and compared it to a database of hundreds of contemporary disease strains.

Scientists studied remains taken from two victims of the Justinian plague. They believe the victims died in the latter stages of the epidemic when it had reached southern Bavaria, likely sometime between 541 and 543. (Courtesy McMaster University)

Pulling DNA from century-old skeletal remains was akin to finding a "needle in the proverbial haystack," Poinar said.

"These are tiny little DNA fragments. We managed again using these novel technologies to pull all these little tiny pieces out and stitch them together to be able to access and understand these genomes of the past.

"That's quite a challenge from a technological standpoint, but it allows us really to go deeper and deeper and deeper into the past."

The Plague of Justinian struck in the sixth century and is estimated to have killed between 30 and 50 million people, virtually half the world's population, as it spread across Asia, North Africa, Arabia and Europe.

The Black Death erupted about 800 years later with similar force, killing 50 million Europeans between 1347 and 1351.

'A massive pandemic'

These new findings suggest the strain of the pathogen responsible for the Justinian outbreak was an evolutionary "dead-end" that was distinct from strains involved later in the Black Death and other pandemics.

"We know the bacterium Y. pestis has jumped from rodents into humans throughout history and rodent reservoirs of plague still exist today in many parts of the world," said Dave Wagner, an associate professor in the Center for Microbial Genetics and Genomics at Northern Arizona University.

Researchers used this tooth to extract DNA information about plagues that ravaged Europe centuries ago. (Courtesy McMaster University)

"If the Justinian plague could erupt in the human population, cause a massive pandemic, and then die out, it suggests it could happen again," he said. "Fortunately we now have antibiotics that could be used to effectively treat plague, which lessens the chances of another large scale human pandemic."

Scientists say they hope this research will lead to a better understanding of the dynamics of modern infectious disease, including a form of the plague that still kills thousands every year.

The disease remains a threat today in parts of Africa and Asia. Just last month, the bubonic plague killed 20 people in Madagascar. A squirrel was also found carrying a strain of the plague that is a descendent of the Black Death in a Los Angeles park last year.

All it takes for the disease to spread are fleas that feed on rodents infected with the plague to then feed on humans, Poinar said — though thanks to much cleaner cities than fourteenth-century Europe and modern antibiotics, a widespread plague like the one that swept across Europe is unlikely, Poinar said.

In studying the human genome before and after these epidemics struck, scientists can really start to understand what is inherent in the human genetic makeup that made some so susceptible to the plague and others resistant.

"The pathogen only represents one half of the equation," Poinar said. "We're the other half."

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L'Isle-Verte fire prompts calls to end 'patchwork' safety rules

As rescue crews continue to comb through the frozen rubble at a seniors' home in eastern Quebec after deadly fire, many people are reflecting on fire safety of seniors' homes across the country.

The Canadian Association of Retired Persons, an organization that advocates for older Canadians, is calling for an end to what it describes as Canada's patchwork safety rules for seniors' homes.

Susan Eng, vice-president for advocacy at CARP, said that although there is a wide range of fire regulations on new homes, only a few provinces have regulations on retrofitting.

"When you say that the newly built homes have to have fire doors, safety zones, fire drills etc., why don't the older homes have to have that?" she told CBC News.

"The worst thing is we, actually, not only know what we should be doing, we have the technology to do it and it's not outrageously expensive."

An early-morning fire ripped through a seniors' home in the small Quebec community of L'Isle-Verte Thursday, killing at least 10 people. Twenty two people are still considered missing, officials said Saturday.

Much of the destruction took place in the older wing of the residence, where it was reported that there were no sprinklers.

Eng said fire safety for seniors' homes needs to be a coast-to-coast initiative led by the federal government, with coordination among the provinces and territories.

Watch the full interview with Susan Eng by clicking the video.

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Flu volunteers sniffle for scientists

Forget being sneezed on: U.S. government scientists are deliberately giving dozens of volunteers the flu by squirting the live virus straight up their noses.

It may sound bizarre, but the rare type of research is a step in the quest for better flu vaccines. It turns out that how the body fends off influenza remains something of a mystery.

"Vaccines are working, but we could do better," said Dr. Matthew Memoli of the U.S. National Institutes of Health, who is leading the study that aims to infect up to 100 adults over the next year.

Wait a minute: Flu is sweeping the country, so why not just study the already sick? That wouldn't let scientists measure how the immune system reacts through each step of infection, starting with that first exposure to the virus.

It's not an experiment to be taken lightly. After all, the flu kills thousands of Americans a year. For safety, Memoli chose a dose that produces mild to moderate symptoms — and accepts only volunteers who are healthy and no older than 50.

Daniel Bennett sits in isolation as he remains quarantined to avoid spreading flu germs. His health is closely monitored before release. (Charles Dharapak/Associated Press)

And to avoid spreading the germs, participants must spend at least nine days quarantined inside a special isolation ward at the NIH hospital, their health closely monitored. They're not released until nasal tests prove they're no longer contagious.

The incentive: About $3,000 US to compensate for their time.

"I received a very scolding email from my mother" about signing up, Daniel Bennett, 26, said with a grin.

"Their standards are so high, I don't believe I'm in danger," added Bennett, a restaurant worker from College Park, Md. "I don't get sick that often."

A masked and gloved Memoli had Bennett lie flat for about a minute.

"It will taste salty. Some will drip down the back of your throat," Memoli said, before squeezing a syringe filled with millions of microscopic virus particles, floating in salt water, into each nostril.

Sure enough, a few days later Bennett had the runny nose and achiness of mild flu.

The best defense against influenza is a yearly vaccine, but it's far from perfect. In fact, the vaccine is least effective in people age 65 and older — the group most susceptible to flu — probably because the immune system weakens with age.

Understanding how younger adults' bodies fight flu may help scientists determine what the more vulnerable elderly are missing, clues to help develop more protective vaccines for everyone, Memoli explained.

Here's the issue: The vaccine is designed to raise people's levels of a particular flu-fighting antibody. It targets a protein that acts like the virus' coat, called hemagglutinin — the "H" in H1N1, the strain that caused the 2009 pandemic and that is causing the most illness so far this winter, too.

But it's not clear what antibody level is best to aim for — or whether a certain amount means you're protected against getting sick at all, or that you'd get a mild case instead of a severe one.

"As mind-boggling as it is, we don't know the answer to that," said Dr. Anthony Fauci, chief of NIH's National Institute of Allergy and Infectious Diseases. "We made some assumptions that we knew everything about flu."

Just targeting hemagglutinin probably isn't enough, Memoli added. Already, some people in his study didn't get sick, despite remarkably low antibody levels, meaning something else must be protecting them.

Could it be antibodies against the "N" in flu's name, the neuraminidase protein? Specific T cells that are activated to fight infection? Genes that switch on and off when a virus invades?

To begin finding out, Memoli first developed a laboratory-grown copy of the H1N1 flu strain and sprayed different amounts into volunteers' noses until he found the right dose to trigger mild flu. He hopes eventually to test the harsher H3N2 strain, too.

Now he's infecting two groups — people with low antibody levels and those with high levels. Some were recently vaccinated, and some weren't. He'll compare how sick they get, how long they're contagious and how the immune system jumps into action.

Called a human challenge study, this kind of research hasn't been performed with flu viruses in the U.S. for more than a decade, before scientists had ways as sophisticated to measure what happens.

"It's all going to add up to a better understanding of what you need to have to be protected against the flu," said Dr. John Treanor, a flu specialist at the University of Rochester Medical Center who is closely watching the work.

So far, Memoli's patients are becoming contagious a day or two before they start feeling bad, one reason the flu spreads so easily. He sees a range of symptoms, from sniffles to a few days of moderate fever, fatigue and congestion.

Bennett's flu was pretty mild, and he passed the time studying, watching TV and playing games with the four other study participants infected this month.

"All I had to do was read and watch movies, so it wasn't that terrible," Bennett said. "It was a really cool experience" to see how research is done.

22.46 | 0 komentar | Read More

Vitamin D supplements' benefits panned in review of studies

Taking vitamin D supplements to prevent cancer, heart disease, fractures and premature death provide few if any benefits, a new review of studies says.

Vitamin D, the sunshine vitamin, has been supplemented in foods like milk for decades to prevent rickets in Canada and northern Europe. 

Vitamin D pills became popular after observational studies linked its use to a reduced risk of multiple sclerosis, diabetes and breast and prostate cancers. But more rigorous randomized control trials don't support a cause-and-effect relationship between taking the vitamin and gaining health benefits.

There is little justification for prescribing vitamin D supplements in the general population, a new review of trials concludes. (Shutterstock)

Now a review and analysis pooling findings from 40 trials on the effect of vitamin D supplements concludes the pills likely provide few, if any, health benefits.

"In view of our findings, there is little justification for prescribing vitamin D supplements to prevent myocardial infarction or ischaemic heart disease, stroke or cerebrovascular disease, cancer or fractures, or to reduce the risk of death in unselected community-dwelling individuals," in the general population, Dr. Mark Bolland, of the University of Auckland in New Zealand, and his co-authors concluded in Friday's online issue of the Lancet Diabetes & Endocrinology.

Critics claim certain people could still benefit from vitamin D supplements, said Glenville Jones, a biochemistry professor at Queen's University in Kingston, Ont.

Jones was part of the Institute of Medicine's panel in 2011 that concluded the majority of Canadians and Americans are getting enough vitamin D based on national surveys of blood tests.

Vitamin D supplements continue to be important for people living close to the North Pole, those who suffered rickets in childhood and adulthood, osteoporosis or chronic kidney disease, he said.

Jones suggested that people consult their doctor to determine whether their vitamin D levels are low.

"Remember that Canadians can't make vitamin D between October and April, so if we're vulnerable at all it would be at this time of the year. But most of us are probably not vulnerable."

The scientific and medical debate about vitamin D is driven in part by differences in defining vitamin D deficiency and insufficiency, Jones said. A current U.S. government-funded trial of 20,000 people should provide more definitive answers.

The Institute of Medicine's recommendation to the Canadian and U.S. governments is for 600 IU to 800 IU of vitamin D from foods such as salmon, fortified foods or supplements, depending on age.

In a journal editorial on multivitamins last December, Dr. Edgar Miller, a professor of medicine and epidemiology at Johns Hopkins University in Baltimore, Md., wrote that proponents of supplements, including vitamin D, hope the pills will overcome poor diet or behaviour, but the latest research isn't supporting that.

"Unfortunately, consumers continue to take supplements and it's hard to turn that ship even in the face of strong evidence from trials," Miller said in an interview.

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Alkaline diet's scientific basis 'taken out of context'

The alkaline diet touted by Hollywood celebrities for weight loss and to avoid diseases such as cancer and osteoporosis promotes eating more vegetables, but the premise behind it is junk science, some experts say.

Proponents of the alkaline diet claim that when eating foods that lead the body to produce acids, such as meat, dairy and refined sugars, the mineral stores in our bones can become depleted and lead to illness.

In general, the diet advocates eating more of most fruits and vegetables, nuts and legumes instead of meat or grains.

There's no science behind the alkaline diet, a dietitian and chemist say. (Czarek Sokolowski/Associated Press)

"If it's green, high water content you can pretty much say it's alkaline," said Julie Cove of Victoria, who runs a website  promoting the diet. "The key is add way more greens into your diet."

Hydration is another pillar of the diet some companies are profiting from. A $60 water pitcher, for example, claims to make water alkaline by adding minerals.

But our bodies don't need help to do that. Moreover, the digestive system treats all foods the same way, said Joe Schwarcz, a chemist at McGill University

Since you cannot change the pH of your blood, "drinking alkaline water makes zero sense whatsoever," Schwarcz said.

In a Petri dish, cancer cells have been shown to multiply more in an acidic environment. But that can't be extrapolated  to the body.

"What has happened in this case is a bit of scientific fact was taken completely out of context and woven into a fabric of nonsense," Schwarcz said.

Christy Brissette, a registered dietitian at the Princess Margaret Cancer Centre in Toronto, is concerned that the diet doesn't work and could hurt some patients by putting them at risk of malnutrition.

"Some of the healthy foods that this diet limits are things like mushrooms, tropical fruits and berries," Brissette said. "I'd encourage people to pick the foods that they eat based on the nutrition in them, rather than looking at every single item and questioning is it acid, is it alkaline?"

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Vitamin D supplements' benefits panned in review of studies

Taking vitamin D supplements to prevent cancer, heart disease, fractures and premature death provide few if any benefits, a new review of studies says.

Vitamin D, the sunshine vitamin, has been supplemented in foods like milk for decades to prevent rickets in Canada and northern Europe. 

Vitamin D pills became popular after observational studies linked its use to a reduced risk of multiple sclerosis, diabetes and breast and prostate cancers. But more rigorous randomized control trials don't support a cause-and-effect relationship between taking the vitamin and gaining health benefits.

There is little justification for prescribing vitamin D supplements in the general population, a new review of trials concludes. (Shutterstock)

Now a review and analysis pooling findings from 40 trials on the effect of vitamin D supplements concludes the pills likely provide few, if any, health benefits.

"In view of our findings, there is little justification for prescribing vitamin D supplements to prevent myocardial infarction or ischaemic heart disease, stroke or cerebrovascular disease, cancer or fractures, or to reduce the risk of death in unselected community-dwelling individuals," in the general population, Dr. Mark Bolland, of the University of Auckland in New Zealand, and his co-authors concluded in Friday's online issue of the Lancet Diabetes & Endocrinology.

Critics claim certain people could still benefit from vitamin D supplements, said Glenville Jones, a biochemistry professor at Queen's University in Kingston, Ont.

Jones was part of the Institute of Medicine's panel in 2011 that concluded the majority of Canadians and Americans are getting enough vitamin D based on national surveys of blood tests.

Vitamin D supplements continue to be important for people living close to the North Pole, those who suffered rickets in childhood and adulthood, osteoporosis or chronic kidney disease, he said.

Jones suggested that people consult their doctor to determine whether their vitamin D levels are low.

"Remember that Canadians can't make vitamin D between October and April, so if we're vulnerable at all it would be at this time of the year. But most of us are probably not vulnerable."

The scientific and medical debate about vitamin D is driven in part by differences in defining vitamin D deficiency and insufficiency, Jones said. A current U.S. government-funded trial of 20,000 people should provide more definitive answers.

The Institute of Medicine's recommendation to the Canadian and U.S. governments is for 600 IU to 800 IU of vitamin D from foods such as salmon, fortified foods or supplements, depending on age.

In a journal editorial on multivitamins last December, Dr. Edgar Miller, a professor of medicine and epidemiology at Johns Hopkins University in Baltimore, Md., wrote that proponents of supplements, including vitamin D, hope the pills will overcome poor diet or behaviour, but the latest research isn't supporting that.

"Unfortunately, consumers continue to take supplements and it's hard to turn that ship even in the face of strong evidence from trials," Miller said in an interview.

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Health-care tool shows quality of care comparisons

Canadians can now get a snapshot of how the quality of health care in each province compares with other countries.

The Canadian Institute for Health Information (CIHI) launched a new interactive tool on Thursday that displays how provincial results stand up against the average for all member countries in the Organization for Economic Co-operation and Development (OECD) and those with developed economies.

In a companion report, CIHI said the results of the comparisons are mixed, with no province being consistently the best or worst on measures such as health spending, acute-care beds per 1,000 population and self-reported smoking, compared with OECD countries.

Canada performs well compared with other countries on several measures of effectiveness of care, such as avoidable admissions, but falls behind on patient expectations, a new report says.

The indicators include:

• Avoidable admissions for asthma and diabetes.
• Breast cancer and colorectal cancer survival and mortality.
• Cervical cancer screening.
• Foreign bodies such as sponges left in after surgery.

"Canada performs well compared with other countries on several measures of effectiveness of care, including avoidable admissions, influenza vaccinations, cancer care and certain acute care outcomes," such as the number
of deaths that occur in hospital within 30 days of being admitted for a heart attack.

"Canada falls behind other countries on measures of patient experience and safety," such as having a doctor spend enough time during a consultation and preventing infections at surgical sites.

More Canadian mothers are injured by tears during childbirth without a C-section or help of forceps and other instruments than in many other OECD countries, CIHI said. About three women out of 100 experience a third- or fourth-degree tear when their babies are delivered without instruments, twice the OECD average of 1.6 per 100 births.

"Canada's high rate may be due to many factors, including stricter follow-up procedures after childbirth,
which allows more of these incidents to be coded."

22.45 | 0 komentar | Read More

Hospital parking tax break proposed for patients, visitors

But 2013 budget's end to tax exemption for lots run by charities, public institutions will go ahead

The Canadian Press Posted: Jan 24, 2014 11:57 AM ET Last Updated: Jan 24, 2014 11:57 AM ET

External Links

(Note: CBC does not endorse and is not responsible for the content of external links.)

The federal Finance Department is proposing to soften part of the 2013 budget and exempt hospital parking fees from the GST or HST.

Last year's budget ended a special tax break on parking fees at public institutions where the parking lot was run by a non-profit partner.

The government said the change was intended to ensure consistent tax treatment.

Now, however, Finance is proposing a new loophole for parking fees paid by hospital patients and visitors.

It will go ahead with amendments to eliminate the tax exemption for parking provided by a charity set up or used by a municipality, university, public college or school.

The department says it will accept public comments on the proposal until Feb. 24.

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The House

• Tragedy in L'Isle-Verte raises questions on seniors' homes standards Jan. 25, 2014 6:47 AM This week on The House, following the tragedy in the small Quebec town of L'Isle-Verte, we ask whether seniors' homes require national safety standards? Quebec Public Security Minister Stéphane Bergeron joins us to discuss. Then, we get ready for Parliament's return on Monday.

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L'Isle-Verte fire prompts calls to end 'patchwork' safety rules

As rescue crews continue to comb through the frozen rubble at a seniors' home in eastern Quebec after deadly fire, many people are reflecting on fire safety of seniors' homes across the country.

The Canadian Association of Retired Persons, an organization that advocates for older Canadians, is calling for an end to what it describes as Canada's patchwork safety rules for seniors' homes.

Susan Eng, vice-president for advocacy at CARP, said that although there is a wide range of fire regulations on new homes, only a few provinces have regulations on retrofitting.

"When you say that the newly built homes have to have fire doors, safety zones, fire drills etc., why don't the older homes have to have that?" she told CBC News.

"The worst thing is we, actually, not only know what we should be doing, we have the technology to do it and it's not outrageously expensive."

An early-morning fire ripped through a seniors' home in the small Quebec community of L'Isle-Verte Thursday, killing at least 10 people. Twenty two people are still considered missing, officials said Saturday.

Much of the destruction took place in the older wing of the residence, where it was reported that there were no sprinklers.

Eng said fire safety for seniors' homes needs to be a coast-to-coast initiative led by the federal government, with coordination among the provinces and territories.

Watch the full interview with Susan Eng by clicking the video.

22.45 | 0 komentar | Read More

Health-care tool shows quality of care comparisons

Canadians can now get a snapshot of how the quality of health care in each province compares with other countries.

The Canadian Institute for Health Information (CIHI) launched a new interactive tool on Thursday that displays how provincial results stand up against the average for all member countries in the Organization for Economic Co-operation and Development (OECD) and those with developed economies.

In a companion report, CIHI said the results of the comparisons are mixed, with no province being consistently the best or worst on measures such as health spending, acute-care beds per 1,000 population and self-reported smoking, compared with OECD countries.

Canada performs well compared with other countries on several measures of effectiveness of care, such as avoidable admissions, but falls behind on patient expectations, a new report says.

The indicators include:

• Avoidable admissions for asthma and diabetes.
• Breast cancer and colorectal cancer survival and mortality.
• Cervical cancer screening.
• Foreign bodies such as sponges left in after surgery.

"Canada performs well compared with other countries on several measures of effectiveness of care, including avoidable admissions, influenza vaccinations, cancer care and certain acute care outcomes," such as the number
of deaths that occur in hospital within 30 days of being admitted for a heart attack.

"Canada falls behind other countries on measures of patient experience and safety," such as having a doctor spend enough time during a consultation and preventing infections at surgical sites.

More Canadian mothers are injured by tears during childbirth without a C-section or help of forceps and other instruments than in many other OECD countries, CIHI said. About three women out of 100 experience a third- or fourth-degree tear when their babies are delivered without instruments, twice the OECD average of 1.6 per 100 births.

"Canada's high rate may be due to many factors, including stricter follow-up procedures after childbirth,
which allows more of these incidents to be coded."

22.46 | 0 komentar | Read More

Hospital parking tax break proposed for patients, visitors

But 2013 budget's end to tax exemption for lots run by charities, public institutions will go ahead

The Canadian Press Posted: Jan 24, 2014 11:57 AM ET Last Updated: Jan 24, 2014 11:57 AM ET

External Links

(Note: CBC does not endorse and is not responsible for the content of external links.)

The federal Finance Department is proposing to soften part of the 2013 budget and exempt hospital parking fees from the GST or HST.

Last year's budget ended a special tax break on parking fees at public institutions where the parking lot was run by a non-profit partner.

The government said the change was intended to ensure consistent tax treatment.

Now, however, Finance is proposing a new loophole for parking fees paid by hospital patients and visitors.

It will go ahead with amendments to eliminate the tax exemption for parking provided by a charity set up or used by a municipality, university, public college or school.

The department says it will accept public comments on the proposal until Feb. 24.

22.46 | 0 komentar | Read More

Vitamin D supplements' benefits panned in review of studies

Taking vitamin D supplements to prevent cancer, heart disease, fractures and premature death provide few if any benefits, a new review of studies says.

Vitamin D, the sunshine vitamin, has been supplemented in foods like milk for decades to prevent rickets in Canada and northern Europe. 

Vitamin D pills became popular after observational studies linked its use to a reduced risk of multiple sclerosis, diabetes and breast and prostate cancers. But more rigorous randomized control trials don't support a cause-and-effect relationship between taking the vitamin and gaining health benefits.

There is little justification for prescribing vitamin D supplements in the general population, a new review of trials concludes. (Shutterstock)

Now a review and analysis pooling findings from 40 trials on the effect of vitamin D supplements concludes the pills likely provide few, if any, health benefits.

"In view of our findings, there is little justification for prescribing vitamin D supplements to prevent myocardial infarction or ischaemic heart disease, stroke or cerebrovascular disease, cancer or fractures, or to reduce the risk of death in unselected community-dwelling individuals," in the general population, Dr. Mark Bolland, of the University of Auckland in New Zealand, and his co-authors concluded in Friday's online issue of the Lancet Diabetes & Endocrinology.

Critics claim certain people could still benefit from vitamin D supplements, said Glenville Jones, a biochemistry professor at Queen's University in Kingston, Ont.

Jones was part of the Institute of Medicine's panel in 2011 that concluded the majority of Canadians and Americans are getting enough vitamin D based on national surveys of blood tests.

Vitamin D supplements continue to be important for people living close to the North Pole, those who suffered rickets in childhood and adulthood, osteoporosis or chronic kidney disease, he said.

Jones suggested that people consult their doctor to determine whether their vitamin D levels are low.

"Remember that Canadians can't make vitamin D between October and April, so if we're vulnerable at all it would be at this time of the year. But most of us are probably not vulnerable."

The scientific and medical debate about vitamin D is driven in part by differences in defining vitamin D deficiency and insufficiency, Jones said. A current U.S. government-funded trial of 20,000 people should provide more definitive answers.

The Institute of Medicine's recommendation to the Canadian and U.S. governments is for 600 IU to 800 IU of vitamin D from foods such as salmon, fortified foods or supplements, depending on age.

In a journal editorial on multivitamins last December, Dr. Edgar Miller, a professor of medicine and epidemiology at Johns Hopkins University in Baltimore, Md., wrote that proponents of supplements, including vitamin D, hope the pills will overcome poor diet or behaviour, but the latest research isn't supporting that.

"Unfortunately, consumers continue to take supplements and it's hard to turn that ship even in the face of strong evidence from trials," Miller said in an interview.

22.46 | 0 komentar | Read More