Put down that soda, junior — it could affect your memory

If former New York City mayor Michael Bloomberg had waited just a bit longer to wage his public health battle against soda drinks, he could have had more ammunition.

Bloomberg had cited the well-known risks of obesity and diabetes that are associated with excess consumption of sugary drinks when he tried to ban oversized soda pop from being sold at some venues in the city. 

But new research indicates drinking too much soda could also negatively affect the brain, especially for teenagers.

Researchers at the University of Southern California found that drinking beverages sweetened with high-fructose corn syrup or sucrose (that is, soda) every day can impair the ability to learn and remember information.

The research will be presented at the annual meeting of the Society for the Study of Ingestive Behavior in Seattle this week. 

"It's no secret that refined carbohydrates, particularly when consumed in soft drinks and other beverages, can lead to metabolic disturbances," said Dr. Scott Kanoski, the lead author of the study, in a release.

"However, our findings reveal that consuming sugar-sweetened drinks is also interfering with our brain's ability to function normally and remember critical information about our environment, at least when consumed in excess before adulthood."

The researchers gave adult and adolescent rats daily access to sweetened beverages that matched the sugar content found in common soda drinks for 30 days.

At the end of the month, the researchers tested the rats on their cognitive functions using mazes.

They noticed that the adolescent rats had trouble with their spatial learning, which has to do with navigating the surrounding environment. The drinks also led to a glucose intolerance.

Adult rats, on the other hand, performed the tests normally.

Researchers discovered that when the teen rats drank those sugary beverages every day, it led to inflammation of the hippocampus part of their brains. The hippocampus controls memory and spatial sense. The inflammation is seen to be the reason behind the rats' learning impairment, according to the researchers.

"In many ways this region is a canary in the coal mine, as it is particularly sensitive to insult by various environmental factors, including eating foods that are high in saturated fat and processed sugar," said Kanoski.

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Ebola virus: What you need to know to protect yourself

A Toronto doctor who specializes in the treatment of tropical diseases says it's unlikely a recent outbreak of the deadly Ebola virus in West Africa could spread to North America.

Dr. Jay Keystone, who works in the tropical diseases unit of Toronto General Hospital, was interviewed Wednesday on CBC Radio's Metro Morning.

A woman puts on a protective mask to protect against SARS at a wash station at the entrance to North York General Hospital in Toronto in May 2003. (Kevin Frayer/Canadian Press)

He said the SARS outbreak in 2003 that killed more than 40 people in Toronto helped improve how we identify, treat and contain infectious diseases. He said such measures are lacking in countries affected by the current Ebola outbreak: Guinea, Liberia and Sierra Leone

As of July 23, the number of Ebola cases in West Africa reached 1,201, with 672 deaths, according to the World Health Organization.

As of July 27, there were more than 1,300 cases of the Ebola virus in the West African countries of Liberia, Guinea, Sierra Leone and Nigeria and as many as 729 deaths, according to the World Health Organization. 

The fast-acting Ebola virus, which first appeared in 1976, produces a violent hemorrhagic fever that leads to internal and external bleeding. The infection is transmitted by direct contact with blood, bodily fluids, and tissues of infected people or animals.

Though there is no vaccine and no specific treatment for Ebola, Keystone said there are a number of measures travellers to the region can take to protect themselves.

Here's what Keystone told Metro Morning guest host David Common:

How does a person contract Ebola?

"They usually acquire it from close contact with blood and body fluids, and that means someone coughs in your face, you handle a body or you look after someone and don't have ideal infection-control methods. You get the virus on your hands, you touch your nose, your mouth."

What symptoms do Ebola patients show?

"It looks like the flu: fever, headache, sore throat, muscle aches and pains. That's in the first few days. And then vomiting, diarrhea and the really serious part of the illness — that is the hemorrhage part — really doesn't occur until toward the end of the first week."

Once a patient is hemorrhaging, can he or she be saved?

"It all depends on the quality of medical care. Most Ebola outbreaks have occurred in villages, in mission hospitals where essentially they have a very poor level of health care and very poor infection control methods. The mortality rate in this outbreak ... is about 60 per cent. So you can survive. The better the care, more likely you are to survive but there's no antibiotic or anti-viral agent to treat this disease."

Why has this outbreak been so bad?

"First, there's a lot of cross-border travel. Whereas most other outbreaks have been isolated in the middle of virtually nowhere. Also, people in these countries don't trust the government. They don't believe in the infection. They hide their cases. If someone dies, they take [the body] home. And unfortunately the funeral procedures where you touch the body, and handle the body, markedly increases your risk. These cases are now more in central areas, cities rather than tiny villages. All of those reasons I think have compounded to make this a much greater outbreak."

Doctors treating patients in Africa have died. Foreign doctors have been infected. Should we be worried about Ebola making its way to Canada?

"I don't think we need to be worried. Health-care providers, paramedics, the people who deal with the situation first-hand, I think we're the ones who have greatest risk. You have to remember since 1976 when this virus was first described, there are less than a handful of cases of [patients] who've gone to North American or European countries and very rarely is there secondary transmission. And that's because we have much better public health, infrastructure and certainly better methods of isolating [patients]. SARS was a perfect wake-up call and Ebola is following that ... our health-care system improved dramatically after SARS."

What do doctors in West Africa need to do to control the outbreak now?

"Mostly it's case finding. And that's the biggest problem. Someone comes in ill, they go back to their village and other people are infected but no one knows about it. The problem is they don't have enough personnel to follow up carefully and also people are hiding cases. It's all about case finding, surveillance, making the diagnosis, isolating the individuals and using appropriate isolation procedures. That will help, but it's going to take a long time given what's going on there.

What should people travelling to West Africa know and do to protect themselves?

"The most important thing is to try and stay away from people who are ill. You won't get Ebola unless the individual you're in contact with is sick. So if someone is well, you're not going to get it. So you just need to have a heightened awareness that this is going on and wash your hands frequently, certainly before meals. [Ebola is spread through] direct contact, it's not someone walking into a room with someone with Ebola and getting the infection. Ebola generally is not aerosolized, meaning it doesn't go well into the air."

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Ebola outbreak: West African death toll tops 700, WHO says

The deadliest recorded Ebola outbreak surpassed 700 deaths across West Africa on Thursday as the World Health Organization announced dozens of new deaths reported in the last several days.

In Sierra Leone, President Ernest Bai Koroma declared a public health emergency. He vowed to quarantine sick patients at home and have authorities conduct house-to-house searches for others who may have been exposed as the country struggles with families resisting treatment at isolation centres. Some have kept loved ones at home given the high death rates at clinics where Ebola patients are quarantined.

His announcement late Wednesday came as neighbouring Liberia also ramped up its efforts to slow the virulent disease's spread, shutting down schools and ordering most public servants to stay home from work.

eEbola now has been blamed for 729 deaths in four West African countries this year, and has shown no signs of slowing down, particularly in Liberia and Sierra Leone. It has also reached Nigeria's biggest city Lagos, where authorities said on Friday a man had died of the virus. 

On Thursday, the WHO announced 57 new deaths — 27 in Liberia, 20 in Guinea, nine in Sierra Leone and one in Nigeria.

'Sierra Leone is in a great fight ... Failure is not an option.'- Ernest Bai Koroma, Sierra Leone president

Among the dead was the chief doctor treating Ebola in Sierra Leone, who was to be buried Thursday. 

The government said Dr. Sheik Umar Khan's death was "an irreparable loss of this son of the soil." The 39-year-old was a leading doctor on hemorrhagic fevers in a nation with very few medical resources.

In a measure of rising international concern, Britain on Wednesday held a government meeting on Ebola, which it said was a threat it needed to respond to.

But international airlines association IATA said the WHO was not recommending any travel restrictions or border closures due to the outbreak, and there would be a low risk to other passengers if an Ebola patient flew.

The outbreak of the hemorrhagic fever, for which there is no known cure, began in the forests of remote eastern Guinea in February, but Sierra Leone now has the highest number of cases.

Sierra Leone's Koroma said he would meet with the leaders of Liberia and Guinea in Conakry on Friday to discuss the epidemic and that he was cancelling a visit to Washington for a U.S.-Africa summit next week.

U.S. Peace Corps withdraw

"Sierra Leone is in a great fight ... Failure is not an option," Koroma said in a speech late on Wednesday, adding that the state of emergency would initially last between 60 and 90 days. "Extraordinary challenges require extraordinary measures."

Ebola's symptoms include external bleeding, massive internal bleeding, vomiting and diarrhea in its final stages. The disease kills up to 90 percent of those infected, though the fatality rate in the current epidemic is running at around 60 percent. 

Medical personnel work at the Doctors Without Borders facility in Kailahun, Sierra Leone where Dr. Sheik Umar Khan died. (Youssouf Bah/Associated Press)

The president said police and the military would enforce a quarantine on all epicentres of the disease, and would provide support to health officers and NGOs to do their work unhindered, following a number of attacks on health workers by local communities.

House-to-house searches would be implemented to trace Ebola victims and homes where the disease was identified would be quarantined until cleared by medical teams, he said, announcing a ban on all public meetings except those related to Ebola.

Liberia on Wednesday announced the closure of all schools across the country and said it was considering quarantining affected communities.

The U.S. Peace Corps said it was withdrawing 340 volunteers from Liberia, Sierra Leone and Guinea after two of them came in contact with a person who later died of the virus.

New airport controls

Sierra Leone, a former British colony, said passengers arriving and departing Lungi International Airport would be subject to new protocols, including body temperature scans.

Two regional airlines, Nigeria's Arik and Togo's Asky, have cancelled all flights to Freetown and Monrovia after a U.S. citizen died in Nigeria after contracting the disease in Liberia.

Nigeria's civil aviation authority (NCAA) said on Thursday it had started temperature screening passengers arriving from places at risk from Ebola and had suspended pan-African airline Asky for bringing the first case to Lagos. 

Patrick Sawyer, the first recorded case of Ebola in Nigeria, took an Asky flight that stopped in Ghana and Togo, raising questions over how a person whose sister had died of the disease three weeks before was able to board an international flight.

Ghana also said it was immediately introducing body temperature screening of all travellers from West African countries at Accra airport and other major entry points, with isolation centres being set up in three towns.

Kyei Faried, deputy director in charge of disease control, told a news conference that authorities had a list of 11 passengers who disembarked from Sawyer's flight and were monitoring them. The government is considering whether to ban flights from affected countries.

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Soccer goal death of Ontario teen adds to calls for tip-proof nets

At first it sounds like a freak accident: A soccer net topples, killing a young person on a playing field, a place where kids are supposed to be safe.

But accidents involving soccer goals like the one that killed a 15-year-old girl Wednesday afternoon in Bradford, Ont., north of Toronto have happened before.

The girl was playing on the field with a friend when she became trapped under the crossbar of an overturned soccer net, according to South Simcoe police.

Unable to lift the heavy net, her friend called 911. The girl was rushed to hospital, where she died.

Police are investigating what caused the net to tip over but other — almost identical — accidents have prompted a push in some jurisdictions for laws requiring that soccer nets be anchored to the ground or switched out in favour of safer, tip-proof designs.

Soccer nets are often made of metal and can weigh a few hundred pounds, and their design often makes them top heavy and prone to falling forward onto the field of play.

This soccer goal killed a five-year-old girl in Watson Lake, Yukon in 2012. (CBC)

In July 2012, a five-year-old girl died in Watson Lake, Yukon, when a soccer net tipped over on her as her parents stood nearby.

A CBC.ca story about the Watson Lake accident quoted Toronto-based neurosurgeon Dr. Charles Tator, founder of Think First Canada, a brain and spinal cord prevention agency.

"It's been recognized for a long period of time that goal posts that are improperly anchored can cause injury, and in fact there are several recorded fatalities from falling goal posts," he said.

A coroner's report into the Watson Lake death found that the net was in poor condition at the time of the accident.

In Montreal 2001, a 14-year-old boy was killed after an unsecured soccer net fell on him causing a fatal head wound. The Quebec coroner's inquest recommended all park soccer nets be anchored to the ground.

In October 2003, six-year-old Zachary Tran died when a goal fell on him during soccer practice in the north Chicago suburb of Vernon Hills, Ill. The 180-pound net tipped forward, striking Zachary on the back of the head. He died of cardiac arrest caused by massive head injuries.

Six-year-old Zachary Tran died in 2003 when a soccer net fell on him during a practice. His death prompted his parents to raise awareness about the dangers posed by unsecured soccer nets. (Tran Family)

Tran's parents made it their mission to raise awareness about the dangers of soccer goals and to prevent similar deaths. They pushed for an Illinois law — which passed in 2011 is named after their son — that bans the manufacture or sale of new movable soccer goals that are not tip-resistant. Older goals in Illinois must be properly anchored to the field and schools and soccer organizations in the state are required to have safety plans for movable goals.

Zachary's parents also started a website called Anchored for Safety, which chronicles soccer-net deaths. According to statistics compiled on their website, soccer nets have caused 38 deaths since 1979. Each incident is listed here.

Through the website, the family argues that in the short term, all soccer goals should be secured to the ground so they can't tip over. A long-term goal is to promote tip-proof designs for soccer nets.

The Tran family says other jurisdictions, including Canada, have not passed similar legislation, and that thousands of unsafe soccer goals remain in use across North America.

A YouTube video, posted on the channel of the family's law firm, tells Zachary's story.

In the video, Zachary's mother Michelle Tran said that when her son's accident happened, she was shocked to learn that his death was the 27th time someone in the U.S. was killed by a soccer goal that tips over.

"We didn't know that these structures were unsafe," she said.

Zachary's father Jayson Tran said parents should be on the lookout for any soccer goal that is not anchored to the ground.

"Keep your children away from it or make sure that it is properly secured," he says on the video.

"We want parents to know that an unanchored soccer goal is ... dangerous. When parents see a soccer goal … they need to check it. To make sure that goals are properly anchored. Parents need to report an unanchored goal to whoever owns that goal."

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Ebola virus: What you need to know to protect yourself

A Toronto doctor who specializes in the treatment of tropical diseases says it's unlikely a recent outbreak of the deadly Ebola virus in West Africa could spread to North America.

Dr. Jay Keystone, who works in the tropical diseases unit of Toronto General Hospital, was interviewed Wednesday on CBC Radio's Metro Morning.

A woman puts on a protective mask to protect against SARS at a wash station at the entrance to North York General Hospital in Toronto in May 2003. (Kevin Frayer/Canadian Press)

He said the SARS outbreak in 2003 that killed more than 40 people in Toronto helped improve how we identify, treat and contain infectious diseases. He said such measures are lacking in countries affected by the current Ebola outbreak: Guinea, Liberia and Sierra Leone

As of July 23, the number of Ebola cases in West Africa reached 1,201, with 672 deaths, according to the World Health Organization.

The fast-acting Ebola virus, which first appeared in 1976, produces a violent hemorrhagic fever that leads to internal and external bleeding. The infection is transmitted by direct contact with blood, bodily fluids, and tissues of infected people or animals.

Though there is no vaccine and no specific treatment for Ebola, Keystone said there are a number of measures travellers to the region can take to protect themselves.

Here's what Keystone told Metro Morning guest host David Common:

How does a person contract Ebola?

"They usually acquire it from close contact with blood and body fluids, and that means someone coughs in your face, you handle a body or you look after someone and don't have ideal infection-control methods. You get the virus on your hands, you touch your nose, your mouth."

What symptoms do Ebola patients show?

"It looks like the flu: fever, headache, sore throat, muscle aches and pains. That's in the first few days. And then vomiting, diarrhea and the really serious part of the illness — that is the hemorrhage part — really doesn't occur until toward the end of the first week."

Once a patient is hemorrhaging, can they be saved?

"It all depends on the quality of medical care. Most Ebola outbreaks have occurred in villages, in mission hospitals where essentially they have a very poor level of health care and very poor infection control methods. The mortality rate in this outbreak ... is about 60 per cent. So you can survive. The better the care, more likely you are to survive but there's no antibiotic or anti-viral agent to treat this disease."

Why has this outbreak been so bad?

"First, there's a lot of cross-border travel. Whereas most other outbreaks have been isolated in the middle of virtually nowhere. Also, people in these countries don't trust the government. They don't believe in the infection. They hide their cases. If someone dies, they take [the body] home. And unfortunately the funeral procedures where you touch the body, and handle the body, markedly increases your risk. These cases are now more in central areas, cities rather than tiny villages. All of those reasons I think have compounded to make this a much greater outbreak."

Doctors treating patients in Africa have died. Foreign doctors have been infected. Should we be worried about Ebola making its way to Canada?

"I don't think we need to be worried. Health-care providers, paramedics, the people who deal with the situation first-hand, I think we're the ones who have greatest risk. You have to remember since 1976 when this virus was first described, there are less than a handful of cases of [patients] who've gone to North American or European countries and very rarely is there secondary transmission. And that's because we have much better public health, infrastructure and certainly better methods of isolating [patients]. SARS was a perfect wake-up call and Ebola is following that ... our health-care system improved dramatically after SARS."

What do doctors in West Africa need to do to control the outbreak now?

"Mostly it's case finding. And that's the biggest problem. Someone comes in ill, they go back to their village and other people are infected but no one knows about it. The problem is they don't have enough personnel to follow up carefully and also people are hiding cases. It's all about case finding, surveillance, making the diagnosis, isolating the individuals and using appropriate isolation procedures. That will help, but it's going to take a long time given what's going on there.

What should people travelling to West Africa know and do to protect themselves?

"The most important thing is to try and stay away from people who are ill. You won't get Ebola unless the individual you're in contact with is sick. So if someone is well, you're not going to get it. So you just need to have a heightened awareness that this is going on and wash your hands frequently, certainly before meals. [Ebola is spread through] direct contact, it's not someone walking into a room with someone with Ebola and getting the infection. Ebola generally is not aerosolized, meaning it doesn't go well into the air."

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Sheik Umar Khan, top Ebola doctor, dies from virus after treating dozens

A leading virologist who risked his own life to treat dozens of Ebola patients died Tuesday from the disease, officials said, as a major regional airline announced it was suspending flights to the cities hardest hit by an outbreak that has killed more than 670 people.

Dr. Sheik Umar Khan, who was praised as a national hero for treating the disease in Sierra Leone, was confirmed dead by health ministry officials there. He had been hospitalized in quarantine.

Health workers have been especially vulnerable to contracting Ebola, which is spread through bodily fluids such as saliva, sweat, blood and urine. Two American health workers are currently hospitalized with Ebola in neighbouring Liberia. 

The Ebola outbreak is the largest in history with deaths blamed on the disease not only in Sierra Leone and Liberia, but also Guinea and Nigeria. The disease has no vaccine and no specific treatment, with a fatality rate of at least 60 percent. 

Sheik Umar Khan, who was the head doctor fighting the Ebola virus in Sierra Leone, had treated more than 100 victims before getting the deadly disease himself. He died July 29. (Umaru Fofana/Reuters)

Binyah Kesselly, chairman of the Liberia Airport Authority board, said police are now present at the airport in Monrovia to enforce screening of passengers.

"So if you have a flight and you are not complying with the rules, we will not allow you to board."

In a statement released Tuesday, Asky Airlines said it was temporarily halting flights not only to Monrovia — the capital of Liberia — but also to Freetown, Sierra Leone. Flights will continue to the capital of the third major country where people have died — Guinea — though passengers departing from there will be "screened for signs of the virus."

Passengers at the airline's hub in Lome, Togo also will be screened by medical teams, it said. 

"Asky is determined to keep its passengers and staff safe during this unsettling time," the statement said.

The suspension comes after Patrick Sawyer, a 40-year-old American man of Liberian descent who worked for the West African nation's Finance Ministry, died Friday in Nigeria after taking several flights on Asky Airlines. At the time, Liberian authorities said they had not been requiring health checks of departing passengers in Monrovia.

His travels have caused widespread fear at a time when the outbreak shows no signs of slowing in West Africa, where medical facilities are scarce and where some affected communities have in panic attacked the international health workers trying to help them. 

Health workers scrambling

Sawyer's sister had died of Ebola though he maintained he had not had close physical contact with her when she was sick. He took an Asky Airlines flight from Liberia to Ghana, then on to Togo and eventually to Nigeria where he was immediately taken into quarantine until his death.

Now, health workers are scrambling to trace those who may have been exposed to Sawyer across West Africa, including flight attendants and fellow passengers. 

Ebola has killed 632 people across Guinea, Liberia and Sierra Leone since an outbreak began in February, putting strain on a string of weak health systems facing one of the world's deadliest diseases. (Tommy Trenchard/Reuters)

At the Finance Ministry where Sawyer worked, officials announced they were temporarily shutting down operations. All employees who came into contact with Sawyer before he left for Nigeria were being placed under surveillance, it said.

Health experts say it is unlikely he could have infected others with the virus that can cause victims to bleed from the eyes, mouth and ears. Still, unsettling questions remain: how could a man whose sister recently died from Ebola manage to board a plane leaving the country? And worse: could Ebola become the latest disease to be spread by international air travel?

The World Health Organization is awaiting laboratory confirmation after Nigerian health authorities said Sawyer tested positive for Ebola, WHO spokesman Gregory Hartl said. The WHO has not recommended any travel restrictions since the outbreak came to light.

"We would have to consider any travel recommendations very carefully, but the best way to stop this outbreak is to put the necessary measures in place at the source of infection," Hartl said. Closing borders "might help, but it won't be exhaustive or foolproof."

Risk to travellers low

Medical staff working with Doctors Without Borders prepare to bring food to patients kept in an isolation area at an Ebola treatment centre in Kailahun, Sierra Leone. The Ebola outbreak has killed almost 700 people. (Tommy Trenchard/Reuters)

The U.S. Centers for Disease Control and Prevention has issued a Level 2 travel alert, warning travellers to Liberia, Sierra Leone and Guinea to "avoid contact with blood and body fluids of infected people to protect themselves."

The risk of travellers contracting Ebola is considered low because it requires direct contact with bodily fluids or secretions such as urine, blood, sweat or saliva, experts say. Ebola can't be spread like flu through casual contact or breathing in the same air.

Patients are contagious only once the disease has progressed to the point they show symptoms, according to the WHO. And the most vulnerable are health care workers and relatives who come in much closer contact with the sick.

Still, witnesses say Sawyer was vomiting and had diarrhea aboard at least one of his flights with some 50 other passengers aboard. Ebola can be contracted from traces of feces or vomit, experts say.

Sawyer was immediately quarantined upon arrival in Lagos — a city of 21 million people — and Nigerian authorities say his fellow travellers were advised of Ebola's symptoms and then were allowed to leave. The incubation period can be as long as 21 days, meaning anyone infected may not fall ill for several weeks.

'Contact tracing'

Health officials rely on "contact tracing" — locating anyone who may have been exposed, and then anyone who may have come into contact with that person. That may prove impossible, given that other passengers journeyed on to dozens of other cities.

Patrick Sawyer had planned to visit his family in Minnesota next month to attend two of his three daughters' birthdays, his wife, Decontee Sawyer, told KSTP-TV in Minnesota.

Two American aid workers in Liberia have tested positive for the virus and are being treated there. Both had been working with a Christian group, and are described as being in "grave" condition.

Nigerians on edge

Meanwhile, the mere prospect of Ebola in Africa's most populous nation has Nigerians on edge.

It's an unprecedented public health scenario. Since 1976, when the virus was first discovered, Ebola outbreaks were limited to remote corners of Congo and Uganda, far from urban centres, and stayed within the borders of a single country. This time, cases first emerged in Guinea, and before long hundreds of others were stricken in Liberia and Sierra Leone.

The deadly Ebola outbreak has spread to Africa's most populous nation after Liberian official Patrick Sawyer vomited aboard an airplane to Nigeria and then died there, officials said Friday. (Sunday Alamba/Associated Press)

Those are some of the poorest countries in the world, with few doctors and nurses to treat sick patients let alone determine who is well enough to travel. In Sawyer's case, it appears nothing was done to question him until he fell sick on his second flight with Asky Airlines. An airline spokesman would not comment on what precautions were being taken in the aftermath of Sawyer's journey.

International travellers departing from the capitals of Sierra Leone and Guinea are also being checked for signs of fever, airport officials said. Buckets of chlorine are also on hand at Sierra Leone's airport in Freetown for disinfection, authorities said.

Still, detecting Ebola in departing passengers might be tricky, since its initial symptoms are similar to many other diseases, including malaria and typhoid fever.

"It will be very difficult now to contain this outbreak because it's spread," Heymann said. "The chance to stop it quickly was months ago before it crossed borders ... but this can still be stopped if there is good hospital infection control, contact tracing and collaboration between countries."

Nigerian authorities so far have identified 59 people who came into contact with Sawyer and have tested 20, said Lagos State Health Commissioner Jide Idris. He said there have been no new cases of the disease.

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Montreal hospital seeks bariatric patients for HIV tests after sterilization scare

The Lachine Hospital in Montreal is testing patients who underwent bariatric surgery between 2012 and 2014 for possible HIV or hepatitis infection, after a review found a tool used in the procedure hadn't been thoroughly cleaned.

About 150 people received letters last February informing them they should undergo tests as a precaution.

The McGill University Health Centre's medical director of infection prevention, Dr. Charles Frenette, told CBC News that 89 per cent of the patients have responded to the notices, and all have tested negative.

The hospital is trying to track down the remaining 11 per cent of patients by letter and by phone to ensure they get tested.

Frenette said a routine review of cleaning and sterilization procedures found that the tool hadn't been completely disassembled during past cleanings.

The tool — a liver retractor — is used to lift the liver to allow the surgeon a better view of the stomach.

Frenette said surgical debris was discovered in a connection point that hadn't been unscrewed.

"It might have been old dust. It could have been old blood, which is why we recalled all the patients," he said.

The risk of infection was minimal, said Frenette.

"But in circumstances like that, we take no chances and do a recall," he said.

Health Canada and Montreal's public health agency have also been notified of the problem to ensure other hospitals are made aware of the proper cleaning procedure for the tool.

Bariatric surgery encompasses a range of surgical procedures that help with weight loss.

Paul Brunet, chair of the Council for Patient Protection, criticized the use of letters to notify patients of the recall. 

He said it's important that patients be notified by phone, so they can ask questions and be given more information.

"This is not a car recall. You don't send a letter to patients — you call them," he said. "It doesn't cost a lot to talk to someone. You made a mistake — don't have the patients suffer more by getting a letter in the mail."

Brunet said lawsuits are possible in such circumstances.

"If patients can prove that there was a specific and direct impact on their health, yes [monetary compensation is possible]. Sometimes stress and anxiety can cause a lot of damage to your health," he said.

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B.C. doctor on Ebola team not in 'self-imposed quarantine'

Dr. Azaria Marthyman, a Victoria doctor who was part of a medical group that travelled to Liberia earlier this month to treat victims of the Ebola virus has returned home, while two of his U.S. colleagues infected with the deadly virus fight for their lives.

Marthyman was part of a 14-member team sent by Christian relief agency Samaritan's Purse to provide clinical care following a renewed outbreak of Ebola in West Africa.

On Saturday, the charity issued a news release saying that one of Marthyman's colleagues, Dr. Kent Brantly of the U.S., had tested positive for the virus and was being treated in isolation in Liberia.

On Sunday, Serving In Mission (SIM) — another charity that works closely with Samaritan's Purse — said that Nancy Writebol, an American who was part of the joint SIM/Samaritan's Purse team, had also tested positive for Ebola and was being treated in the same isolation centre as Brantly.

Earlier, Samaritan's Purse had told media that Marthyman voluntarily placed himself under quarantine at home as a precaution upon his return.

But spokesman Jeff Adams said Tuesday afternoon that information was incorrect, and that Marthyman is just taking some time off with his family to decompress from his trip.

Marthyman is healthy and has no symptoms, he said.

Dr. Azaria Marthyman wore protective medical clothing as part of his work with Ebola patients. (samaritanspurse.ca)

Both charities announced Tuesday that they have now ordered the evacuation of their non-essential personnel from Liberia after an upsurge in the number of Ebola cases in the country.

A statement from SIM says no symptoms of Ebola are present in any of the evacuees, who are being monitored continually.

According to the World Health Organization, the incubation period for the virus is two to 21 days.

The fast-acting Ebola virus, which first appeared in 1976, produces a violent hemorrhagic fever that leads to internal and external bleeding. The infection is transmitted by direct contact with blood, body fluids and tissues of infected people or animals.

As of July 23, the number of Ebola cases in West Africa reached 1,201, with 672 deaths, according to the World Health Organization.

This Ebola outbreak is the largest in history, with deaths in Sierra Leone, Liberia, Guinea and Nigeria blamed on the virus. There is no vaccine and no specific treatment.

CBC News sought to interview Martyman by email about his experiences in Liberia fighting Ebola, but he declined.

"I regret to inform you that I am declining all requests for media interviews," the email reads. "The situation in Liberia is changing rapidly, and I don't have the most up-to-date information. Therefore, to avoid giving out any information that might not be accurate, I am referring all interview requests to our international headquarters, because staff there are closest to the situation in Liberia."

Marthyman posted many updates on the Samaritan's Purse blog while he was in Liberia. On July 24, he posted that he was headed home.

"I am doing very well physically and emotionally, having worked every day since my arrival in Liberia, and today having to say goodbye to so many people," the post read.

Mostly, though, Marthyman used his blog post to tell the story of a young boy named William, the doctor's first Ebola patient in Liberia, who needed to find a home.

"William now needs a home to go to," Marthyman wrote. "He does not have any family to care for him and will be under the ministry's care. I pray that he will have a loving home to go to. Meeting William today seems to bring some closure to my stay here in Liberia, as I prepare myself to come home to my wife and family."

At least two other British Columbians have travelled to Liberia this month with Samaritan's Purse to fight Ebola. They include a nurse from Vancouver and a nursing student, who is also an emergency medical responder, from Squamish.

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Ebola outbreak: West African airline suspends flights amid widespread fear

Police officers are being deployed to Liberia's international airport to ensure passengers are screened for Ebola symptoms as a major regional airline announced Tuesday it was suspending flights to the cities hardest hit by an outbreak that has killed more than 670 people in West Africa.

"We have a presence of the police at the airport to enforce what we're doing," said Binyah Kesselly, chairman of the Liberia Airport Authority board. "So if you have a flight and you are not complying with the rules, we will not allow you to board."

In a statement, ASKY Airlines said it was temporarily halting flights not only to Monrovia — the capital of Liberia — but also to Freetown, Sierra Leone. Flights will continue to the capital of the third major country where people have died — Guinea — though passengers departing from there will be "screened for signs of the virus."

Passengers at the airline's hub in Lome, Togo also will be screened by medical teams, it said. 

"ASKY is determined to keep its passengers and staff safe during this unsettling time," the statement said.

The suspension comes after Patrick Sawyer, a 40-year-old American man of Liberian descent who worked for the West African nation's Finance Ministry, died Friday in Nigeria after taking several flights on ASKY Airlines. At the time, Liberian authorities said they had not been requiring health checks of departing passengers in Monrovia.

His travels have caused widespread fear at a time when the outbreak shows no signs of slowing in West Africa, where medical facilities are scarce and where some affected communities have in panic attacked the international health workers trying to help them.

Health workers scrambling

Sawyer's sister had died of Ebola though he maintained he had not had close physical contact with her when she was sick. He took an ASKY Airlines flight from Liberia to Ghana, then on to Togo and eventually to Nigeria where he was immediately taken into quarantine until his death.

Now, health workers are scrambling to trace those who may have been exposed to Sawyer across West Africa, including flight attendants and fellow passengers.

At the Finance Ministry where Sawyer worked, officials announced they were temporarily shutting down operations. All employees who came into contact with Sawyer before he left for Nigeria were being placed under surveillance, it said.

Health experts say it is unlikely he could have infected others with the virus that can cause victims to bleed from the eyes, mouth and ears. Still, unsettling questions remain: how could a man whose sister recently died from Ebola manage to board a plane leaving the country? And worse: could Ebola become the latest disease to be spread by international air travel?

The World Health Organization is awaiting laboratory confirmation after Nigerian health authorities said Sawyer tested positive for Ebola, WHO spokesman Gregory Hartl said. The WHO has not recommended any travel restrictions since the outbreak came to light.

"We would have to consider any travel recommendations very carefully, but the best way to stop this outbreak is to put the necessary measures in place at the source of infection," Hartl said. Closing borders "might help, but it won't be exhaustive or foolproof."

Risk to travellers low

The U.S. Centers for Disease Control and Prevention has issued a Level 2 travel alert, warning travellers to Liberia, Sierra Leone and Guinea to "avoid contact with blood and body fluids of infected people to protect themselves."

The risk of travellers contracting Ebola is considered low because it requires direct contact with bodily fluids or secretions such as urine, blood, sweat or saliva, experts say. Ebola can't be spread like flu through casual contact or breathing in the same air.

Patients are contagious only once the disease has progressed to the point they show symptoms, according to the WHO. And the most vulnerable are health care workers and relatives who come in much closer contact with the sick.

Still, witnesses say Sawyer was vomiting and had diarrhea aboard at least one of his flights with some 50 other passengers aboard. Ebola can be contracted from traces of feces or vomit, experts say.

Sawyer was immediately quarantined upon arrival in Lagos — a city of 21 million people — and Nigerian authorities say his fellow travellers were advised of Ebola's symptoms and then were allowed to leave. The incubation period can be as long as 21 days, meaning anyone infected may not fall ill for several weeks.

'Contact tracing'

Health officials rely on "contact tracing" — locating anyone who may have been exposed, and then anyone who may have come into contact with that person. That may prove impossible, given that other passengers journeyed on to dozens of other cities.

Patrick Sawyer had planned to visit his family in Minnesota next month to attend two of his three daughters' birthdays, his wife, Decontee Sawyer, told KSTP-TV in Minnesota.

Two American aid workers in Liberia have tested positive for the virus and are being treated there. Both had been working with a Christian group, and are described as being in "grave" condition.

Nigerians on edge

Meanwhile, the mere prospect of Ebola in Africa's most populous nation has Nigerians on edge.

It's an unprecedented public health scenario. Since 1976, when the virus was first discovered, Ebola outbreaks were limited to remote corners of Congo and Uganda, far from urban centres, and stayed within the borders of a single country. This time, cases first emerged in Guinea, and before long hundreds of others were stricken in Liberia and Sierra Leone.

Medical staff working with Doctors Without Borders prepare to bring food to patients kept in an isolation area at an Ebola treatment centre in Kailahun, Sierra Leone. The disease outbreak has killed almost 700 people. (Tommy Trenchard/Reuters)

Those are some of the poorest countries in the world, with few doctors and nurses to treat sick patients let alone determine who is well enough to travel. In Sawyer's case, it appears nothing was done to question him until he fell sick on his second flight with Asky Airlines. An airline spokesman would not comment on what precautions were being taken in the aftermath of Sawyer's journey.

International travellers departing from the capitals of Sierra Leone and Guinea are also being checked for signs of fever, airport officials said. Buckets of chlorine are also on hand at Sierra Leone's airport in Freetown for disinfection, authorities said.

Still, detecting Ebola in departing passengers might be tricky, since its initial symptoms are similar to many other diseases, including malaria and typhoid fever.

"It will be very difficult now to contain this outbreak because it's spread," Heymann said. "The chance to stop it quickly was months ago before it crossed borders ... but this can still be stopped if there is good hospital infection control, contact tracing and collaboration between countries."

Nigerian authorities so far have identified 59 people who came into contact with Sawyer and have tested 20, said Lagos State Health Commissioner Jide Idris. He said there have been no new cases of the disease.

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More than doctors needed to contain 'unprecedented' Ebola outbreak

Doctors alone aren't enough to contain West Africa's deadly Ebola outbreak, which has already infected, and in some instances killed, key medical personnel, including prominent Western and local physicians.

Quebec doctor Marc Forget, who has been on the front lines of the epidemic in Guinea for seven weeks, told CBC News that past Ebola outbreaks were contained quite quickly with the intervention of international groups such as Doctors Without Borders working in conjunction with a country's ministry of health.

This time, he says, "the magnitude of the disease is unprecedented," and a stronger response is required, both in resources and personnel — including water, sanitation and logistics specialists, as well as medical staff.

Dr. Anthony Fauci, the director of the U.S. National Institute of Allergy and Infectious Diseases, says one of the big challenges facing the three West African countries fighting the epidemic is that "people are not seeming to even admit, in some cases, that there is a problem, not believing that Ebola is there.

The unprecedented Ebola outbreak in West Africa requires a stronger response in both resources and personnel, those fighting the outbreak say. Medical staff working with Doctors Without Borders prepare to bring food to Ebola patients kept in an isolation area at a treatment centre in Kailahun, Sierra Leone on July 20. (Tommy Trenchard/Reuters)

"There have been some very unusual perceptions that it's the health workers that are actually bringing the Ebola in," Fauci said in an interview with TV2Africa.

He also cited the lack of resources for appropriate care and treatment, and noted that another challenge is that the disease is no longer clustered in small, underpopulated regions, but is now showing up in larger centres "where there's a high density of population."

The fast-acting Ebola virus produces a violent hemorrhagic fever that leads to internal and external bleeding, and has already killed over half those infected in the current outbreak, according to the World Health Organization.

As of July 23, the number of Ebola cases in West Africa reached 1,201, with 672 deaths.

The outbreak is devastating large areas of three countries. Guinea has had the most deaths, 319; Sierra Leone has had the most cases, 525; and hundreds are affected in Liberia as well.

Physicians infected

Sheik Umar Khan, head doctor fighting the Ebola virus in Sierra Leone, had treated more than 100 Ebola victims before getting the deadly disease himself. (Umaru Fofana/Reuters)

Currently, two Americans, Dr. Kent Brantly and missionary Nancy Writebol, are receiving treatment for Ebola in Monrovia, Liberia's capital. They are both with the American medical charity Samaritan's Purse.

Ugandan doctor Samuel Muhumuza Mutoro died from the virus on July 1 in Liberia.

So did Liberian government official Patrick Sawyer, who died July 25 in Nigeria, becoming that country's first Ebola case. (The hospital where he was treated is now under quarantine.)

On Saturday, Dr. Samuel Brisbane, one of Liberia's most high-profile doctors, died from the disease.

And in Sierra Leone, the top Ebola doctor, Sheik Umar Khan, is receiving treatment.

While these high-profile cases garner media attention, the World Health Organization says "stepping up outbreak containment measures, especially effective contact tracing," is what's now needed.

Quebec doctor returns from the battlefront

Quebec's Forget agrees. He left Africa on July 9, after working in Guinea for seven weeks with Doctors Without Borders, the main aid organization in that battle.

Dr. Marc Forget returned to Canada in July after seven weeks in Guinea with Doctors Without Borders, fighting the unprecedented Ebola outbreak in West Africa. (MSF)

At night, Forget treated patients at the group's clinic in Guéckédou, the epicentre of the epidemic, then during the day he did outreach.

That requires responding to alerts when someone is sick in a village. Everyone who has been in contact with an infected person displaying symptoms is at risk, so Forget and his team needed to check the patient, do contact tracing and then follow up with those people.

For the patient, "If we have any suspicion, we bring him back in a special ambulance so he's isolated, and we explain to his family and the community why he needs to come to the centre," Forget told CBC News during a telephone interview from Montreal.

Outreach also requires that whenever someone tests positive for Ebola, it's essential to decontaminate their home. "We burn, for example, the mattresses, decontaminate the walls and everything with chlorine solution, so people can go back home safely," Forget explains.

Certificate of recovery provides reassurance

The Doctors Without Borders team also takes the few survivors back to their villages and give them a certificate of recovery to fight the stigma toward cured patients.

Saa Simbiano, along with his mother, shows off his certificate of recovery after receiving treatment for Ebola from Dr. Marc Forget at the Doctors without Borders centre in Guéckédou, Guinea. (MSF)

"If we don't give them any certificate of recovery, then it's sometimes very difficult. They are cured but then they are rejected from the community because people don't understand what's going on."

Forget says that in Guinea, "there's so much misunderstanding and fear about the disease" that community education is critical. "There's a lot of paranoia" about Ebola and even about the outreach programs.

Sometimes people "think it's a foreigner thing that was brought by Médecins Sans Frontières [Doctors Without Borders] and we're spraying the houses and we give them Ebola," he says.

"We faced resistance, we faced hostility. In some villages they completely shut down, they're throwing rocks at us, at ministry of health authorities, Red Cross workers."

Safe burial

Another challenge in trying to contain Ebola is the very strong cultural beliefs in that area of Africa.

A nurse receives a suspected Ebola patient inside the high-risk area at the Doctors Without Borders treatment centre in Kailahun, Sierra Leone, on July 9. (Sylvain Cherkaoui/Cosmos/MSF)

As Forget explains, the No. 1 contamination risk is touching the body around the time someone has died from Ebola.

"They do rituals before they bury the body that involves washing the bodies and even, sometimes, sleeping with them, the dead person."

So after someone dies at a treatment centre, the Doctors Without Borders staff bring the family to the centre and do what they call a safe burial.

"We wash the body and we put them in a body bag, but with the zipper open so they can see the face, and we bring the body to the village," in conjunction with the Guinea Red Cross, Forget says.

"People can still do a burial process but in a safe way so they don't touch the body … they can still pray and perform ceremonies but without touching the body.

"When that is understood, things get easier for us," he notes.

Forget says he may return to Africa in October after working in Northern Canada, and hopes others will volunteer.

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Montreal hospital seeks bariatric patients for HIV tests after sterilization scare

The Lachine Hospital in Montreal is testing patients who underwent bariatric surgery between 2012 and 2014 for possible HIV or hepatitis infection, after a review found a tool used in the procedure hadn't been thoroughly cleaned.

About 150 people received notices last February informing them they should undergo tests as a precaution.

The McGill University Health Centre's medical director of infection prevention, Dr. Charles Frenette, told CBC News that 89 per cent of the patients have responded to the notices, and all have tested negative.

The hospital is trying to track down the remaining 11 per cent of patients to ensure they get tested.

Frenette said a routine review of cleaning and sterilization procedures found that the tool hadn't been completely disassembled during past cleanings.

The tool — a liver retractor — is used to lift the liver to allow the surgeon a better view of the stomach.

Frenette said surgical debris was discovered in a connection point that hadn't been unscrewed.

"It might have been old dust. It could have been old blood, which is why we recalled all the patients," he said.

The risk of infection was minimal, said Frenette.

"But in circumstances like that, we take no chances and do a recall," he said.

Health Canada and Montreal's public health agency have also been notified of the problem to ensure other hospitals are made aware of the proper cleaning procedure for the tool.

Bariatric surgery encompasses a range of surgical procedures that help with weight loss.

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Alissa Chavez's Hot Seat alarm aims to prevent child hot car deaths

A 17-year-old girl from New Mexico has invented a device that alerts parents —and passersby —  if a child is left in their car.

The invention by Alissa Chavez of Albuquerque aims to reduce the chance that a child will die in an overheated car.

The teen has been working with engineers to perfect the design of the device, called Hot Seat, and is now raising money on the crowdfunding site Indiegogo to develop a prototype so it can be manufactured.

The device consists of a pad that senses if a child is in the car seat and communicates wirelessly with a fob attached to a parent's key chain.

If the parent walks more than 10 metres away without the child, it will trigger alarms on:

• The fob.
• The parent's smartphone, via an app.
• The car itself.

"If the parent doesn't have the key fob or the cellphone, the people around the vehicle will still be able to hear the alarm," Chavez told CBC's As It Happens.

Chavez hopes to raise $10,000 US on Indiegogo to build a prototype that manufacturers can use to mass produce the device, perhaps as soon as the end of this summer. As of Tuesday morning, she had raised $9,000, with less than three days left to go in the campaign.

Chavez said her mother runs a home daycare, so she was really affected by stories about children dying in hot cars after being forgotten by accident.

"I couldn't imagine losing any of the kids we work with."

A few years ago, that inspired her to create the earliest version of Hot Seat for her Grade 8 science fair project. She won the regional competition and went on to the state and national competitions.

Chavez said she has received a lot of positive feedback about the device from people who feel the invention needs to be out there.

"So many people have accidentally left their children in their car, and it didn't turn out to be a tragedy," she said, "but it still did scare them, that that can happen to anybody."

The Canada Safety Council estimates between four and six children die from being left unattended in vehicles every year.

According to the advocacy group Kidsandcars.org, in the U.S., 44 children died of heat stroke after being left in cars in 2013. 

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ReWalk Robotics exoskeleton helps paraplegics to walk

A robotic exoskeleton that allows some people with spinal cord injuries to walk upright has been approved for use by Health Canada and the U.S. Federal Drug Administration.

The ReWalk was designed by a paraplegic inventor, Dr. Amit Goffer, who was seeking a better solution to life in a wheelchair, says Larry Jasinski, CEO of ReWalk Robotics.

Dr. Goffer's invention was an exoskeleton that provides powered hip and knee motion to enable individuals with a spinal cord injury to stand upright and walk, Jasinski explained in an interview with CBC's The Lang & O'Leary Exchange.

"Given that he was paralyzed himself, I think his understanding of what he was creating was greater than any of us would have developed independently," he said.

Improvements in motion sensing technology and the advent of improved computers and batteries helped create a more natural form of motion that is not so difficult to learn for paraplegic users, Jasinski said.

A man in Germany demonstrates walking with a ReWalk robotic exoskeleton. (Argo Technologies)

"What Dr. Goffer did, he took the concept of using a motion sensor where the person can use their own body to tell this thing how to walk," he said.

"It's the combination of the sensor which communicates to the very elaborate software program that mimics human walking., When you take a step it's heel to toe, just like you and I walk down the hallway and this natural motion is important because it is efficient ...and it is also better for your body to use your joints in natural motion."

The ReWalk is already approved for use in Asia and Europe, received Health Canada approval for home use at the beginning of the year and FDA approval in May.

It sells for about $69,500 US, a cost ReWalk Robotics hopes both public and private sector insurers will eventually agree to shoulder.

"We believe the reduction in medications, as users and patients get healthier and reduced complications for someone who might be confined to a wheelchair will allow this system to pay for itself," Jasinski said.

ReWalk, based in Massachusetts and a unit of Argo Technologies, has competitors in creating robotics for paraplegics, among them Ekso Bionics.

The next step for the company is to establish training centres in Canada and the U.S. where potential users can try the device and train on it if they believe it is a good fit for them.

There are some limitations – people aren't able to walk on snow, ice or soft sand – but they can take on stairs and uneven ground.

"Right now the primary limitations are people learning to use it properly and we have enough users now in the U.S. and starting in Canada, Europe and Asia.  The rewalkers as we call them, they learn from each other about how to use it better," Jasinski said.

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E-cigarette market on fire while scientists wage heated debate

Electronic cigarette use is skyrocketing, revenue has reached the billions of dollars, legislators are talking about — and enacting — regulations, and more and more research is published every month.

But the jury is still out on their safety, and whether they are a gateway to smoking.

Earlier this week, the New York Times highlighted a growing concern that the tobacco industry is taking over the business and targeting kids with flavours that sound like candy as well as advertisements featuring cartoon characters or celebrities.

Meanwhile, the less reliable Daily Mirror in Britain focussed on the danger of explosions when e-cigarettes are plugged into the wrong charger, citing half a dozen examples to back up its worries.

For those not up on this newest trend, an e-cigarette includes a battery, heating coil and a cartridge containing e-juice. That's the liquid that may or may not contain nicotine and which gets vaporized when the battery powers the coil to heat up the liquid.

The vapor gets drawn up by the wick when someone inhales, and there is no smoke, so it's called vaping.

The pros and cons of vaping are hotly debated by scientists, and there is a wide range of experience among those who have tried it.

Vaping may increase smoking

For some, like Anna Camara, it may even lead to increased smoking.

Some smokers have successfully turned to e-cigarettes to help them stop smoking, while others blame e-cigarettes for an increase in the amount they smoke. (Richard Vogel/Associated Press)

Last year, an acquaintance she would see at the off-leash area for dogs in a Toronto park persuaded Camara, an eight-cigarette-a-day smoker, to follow her example and abandon smoking for vaping.

Camara invested $80 in the technology and the e-juice, with nicotine, but felt that vaping wasn't delivering enough nicotine to satisfy her need. So she would also smoke a cigarette.

She calculated that vaping would be cheaper than smoking, but it didn't help her to quit, and it also irritated her throat. (She had tried to quit before by using a nicotine patch, but found it too strong.)

In the end, she blames the vaping experience for doubling the number of cigarettes she smokes to about 16 a day.

On the other hand

E-cigarette proponents claim that because the physical act of vaping more closely resembles smoking, and because the nicotine intake can be adjusted, it should be a better tool to help a smoker quit the habit.

That's what Winnipegger Matt Clinch found. He says e-cigarettes are "fantastic."

In 20 years of puffing, he was up to a pack a day. But then he tried e-cigarettes and hasn't had a smoke in seven weeks.

He says he feels better, he isn't out of breath as much as he was and food is starting to taste better.

"It's as close to smoking as you can get without lighting up and smelling like an ashtray."

He says the battery charge lasts him until dinner time and then he has to charge the unit for four hours, which he calls "a good thing, because it keeps me from over-using it."

Cheaper than cigarettes

Clinch also likes the fact that the juice comes in a variety of flavours and levels of nicotine, because "it makes cutting back your nicotine intake easier, without really realizing that you're cutting back."

The e-juice in e-cigarettes comes in a variety of flavours and levels of nicotine. (CBC)

He estimates the start-up costs of vaping as equivalent to a carton of cigarettes. But now he's down from spending $17 a day on cigarettes to 75-80 per cent less buying e-juice.

Nick Cooke, a Canadian living in Nicaragua, is discovering the same thing.
He has been using a vaporizer for a little more than a year and says vaping is "way less worse for me than the 30 to 40 cigarettes I used to smoke each day.

"It's odourless and smokeless for the people around me, so it's no problem to have a puff in a restaurant or bar or airport boarding lounge."

Cooke also can have just one or two drags on the e-cigarette and then set it aside.

He says that even in Nicaragua, where cigarettes are cheap ($1.75 for a pack of 20), he's saving money by vaping.

"The only disadvantage is not always having a lighter in my pocket, which comes in handy during power outages."

Doubts about safety

In Canada, selling e-cigarettes with nicotine or those with a health claim is not authorized, though selling e-cigarettes or e-juice without nicotine is legal.

In an email to CBC News, Health Canada said, "To date there is not sufficient evidence that the potential benefits of e-cigarettes in helping Canadians quit smoking outweigh the potential risks."

Some manufacturers design their e-cigarettes to look like the real thing. (CBC)

In order to get a vaping product authorized, Health Canada requires a company "to provide evidence of safety, quality and effectiveness" - a regulatory hurdle that is "among the most restrictive in the world," according to an editorial last year in the Canadian Medical Association Journal. (It wants e-cigarettes to be regulated as pharmaceutical rather than tobacco products.)

Winnipeg-based Theravape Inc. is one of about a dozen established juice-makers in Canada.

It is just Eden Sorrell and two friends working there and they manufacture and sell wholesale at least 13 different flavours of e-juice.

Their best sellers include lychee, menthol and tobacco. Sorrell describes the tobacco flavor as "transitional."

E-juice containing nicotine gets poured into a vaping device at the Henley Vaporium in New York. (Frank Franklin II/Associated Press)

All their flavours can come with or without nicotine, and the nicotine can come in different strengths. Theravape e-juice sells for about $1 a millilitre.

Asked about Health Canada's policy, Sorrell explains that e-cigarettes with nicotine are "not authorized for sale but not prohibited. It's a grey market item."

He says his company doesn't get hassled by Health Canada "because it's actually marketed as a chemical consumer product, not as a health-care product."

Sorrell, who also works as a nurse, and is a non-smoker, explains that "it takes longer for nicotine to hit your bloodstream from a vape than it does from a cigarette, because it's being absorbed through the mucous membranes in the mouth, not within the lungs."

Tobacco industry dominates

One of the issues under debate among scientists is whether vaping could serve as a so-called gateway to smoking.

Sorrell says Theravape is "not here to start new habits" and he is unaware of any non-smokers trying their product.

Nevertheless a concern in the medical community is that e-cigarettes will be "a Trojan horse that will allow the tobacco industry to reverse decades of global progress in reducing smoking prevalence," says the CMAJ editorial.

"The tobacco industry sees a future where e-cigarettes accompany and perpetuate, rather than supplant tobacco use," the editorial adds.

The tobacco industry dominates the e-cigarette industry. In the U.S., a company called Blu eCigs accounts for almost half of all e-cigarettes sold, and it is in the process of being acquired by Imperial Tobacco.

Tobacco industry-owned Blu eCigs accounts for almost half of all e-cigarettes sold in the U.S. (AFP/Getty Images)

The tobacco industry also dominates the e-cigarette industry in Europe, where vaping is more popular.

In the British documentary, "The Rise of the E-cigarette," Kingsley Wheaton, a director at British American Tobacco (which sells Vype e-cigarettes), says e-cigarettes "provide a substantially safer alternative to smoking a traditional cigarette."

Although that may sound like a good reason to stop smoking, there is intense debate among scientists around the world about whether vaping will lead to smoking cessation.

In May, 53 public health specialists wrote to the World Health Organization, arguing that e-cigarettes could provide what they called tobacco harm reduction because, in vaping, nicotine is consumed in a low-risk, non-combustible form and doesn't draw tar and toxic gases into the lungs the way smoking tobacco does.

That started a vigorous scientific exchange, starting with a rebuttal from 129 other public health and medical authorities, then a reply from the first group.

Reading those three letters gives an understanding of the debate, and its intensity.

The points in contention include the safety of the liquid, the safety of the second-hand vapor, and whether e-cigarettes are just another way of perpetuating smoking.

They don't debate the harms of the nicotine. By now that's pretty well understood.

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Liberian man who died in Nigeria tests positive for Ebola

A Liberian man who died in Nigeria's megacity of Lagos on Friday has tested positive for the deadly Ebola virus, the country's health minister has confirmed.

The man, who was in his 40s, collapsed on arrival in Lagos, a city of 21 million people, on Sunday, and was taken from the airport and put in isolation in a local hospital.

Nigerian Health Minister Onyebuchi Chukwu said all ports of entry in the country are now on "red alert" and health officials are investigating all people who had contact with the deceased.​

Earlier on Friday, a Nigerian official in Geneva said the man died while under quarantine.

"The Liberian came in and he was quarantined at the airport and not allowed to go to the city. While he was quarantined he passed away. Everyone who has had contact with him has been quarantined," he told Reuters.

Ebola, one of the world's deadliest diseases, has killed 660 people across Guinea, Liberia and Sierra Leone since it was first diagnosed in February. There have been 1,093 cases to date in West Africa's first outbreak, according to the UN health agency.

The Liberian man is the first case on record of Ebola in Nigeria, Africa's biggest economy and, with 170 million people, its most populous country. 

"He departed on the plane initially with no symptoms, he reported being symptomatic on arrival. I understand that he was vomiting and he then turned himself over basically, he made it known that he wasn't feeling well. Nigerian health authorities took him and put him in isolation," World Health Organization spokesman Paul Garwood said earlier on Friday. 

Ebola victim from Sierra Leone on the run

Also on Friday, Sierra Leone officials appealed for help to trace the first known resident in the capital with Ebola whose family forcibly removed her from a Freetown hospital after testing positive for the deadly disease.

Radio stations in Freetown, a city of around 1 million inhabitants, broadcast the appeal on Friday to locate the woman.

"Saudatu Koroma of 25 Old Railway Line, Brima Lane, Wellington," the announcement said. "She is a positive case and her being out there is a risk to all. We need the public to help us locate her."

Koroma, 32, a resident of the densely populated Wellington neighbourhood, had been admitted to an isolation ward while blood samples were tested for the virus, said health ministry spokesman Sidi Yahya Tunis. The results came back on Thursday.

"The family of the patient stormed the hospital and forcefully removed her and took her away," Tunis said. "We are searching for her."

Fighting one of the world's deadliest diseases is straining the region's weak health systems, while a lack of information and suspicion of medical staff has led many to shun treatment.

Dozens with Ebola unaccounted for

Earlier this year, a man in Freetown tested positive for Ebola although he is believed to have caught it elsewhere.

According to health ministry data and officials, dozens of people confirmed by laboratory tests to have Ebola are now unaccounted for in Sierra Leone, where the majority of cases have been recorded in the country's east.

While international medical organizations have deployed experts to the field in an attempt to contain the outbreak, WHO said poor health infrastructure and a lack of manpower were hindering their efforts.

"We're seeing many of these facilities simply don't have enough people to provide the constant level of care needed," Garwood told a news briefing in Geneva on Friday.

There is no cure or vaccine for Ebola, which causes diarrhea, vomiting and internal and external bleeding. It can kill up to 90 per cent of those infected, although the mortality rate of the current outbreak is around 60 per cent.

The West African outbreak is the first time that Ebola, which was first discovered in what is now Democratic Republic of Congo in 1976, has appeared in heavily populated urban areas and international travel hubs.

Cases have already been confirmed in Conakry and Monrovia, the capital cities of Guinea and Liberia.

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Liberia's president orders strict anti-Ebola measures

Liberia's president has closed all but three land border crossings, restricted public gatherings and quarantined communities heavily affected by the Ebola outbreak in the West African nation.

President Ellen Johnson Sirleaf described the measures late Sunday after the first meeting of a new task force she created and is chairing to contain the disease, which has killed 129 people in the country and more than 670 across the region.

A top Liberian doctor working at Liberia's largest hospital died on Saturday, and two American aid workers have fallen ill, underscoring the dangers facing those charged with bringing the outbreak under control.

Last week a Liberian official flew to Nigeria via Lome, Togo, and died of the disease at a Lagos hospital. The fact that the official, Patrick Sawyer, was able to board an international flight despite being ill raised fears that the disease could spread beyond the three countries already affected — Liberia, Guinea and Sierra Leone.

There is no known cure for Ebola, which begins with symptoms including fever and sore throat and escalates to vomiting, diarrhea and internal bleeding. The disease spreads through direct contact with blood and other bodily fluids as well as indirect contact with "environments contaminated with such fluids," according to the World Health Organization.

Health workers teach people about the Ebola virus and how to prevent infection, in Conakry, Guinea, earlier this year. (Youssouf Bah/Associated Press)

"No doubt, the Ebola virus is a national health problem," Sirleaf said. "And as we have also begun to see, it attacks our way of life, with serious economic and social consequences."

Sirleaf said all borders would be closed except for three — one of which crosses into Sierra Leone, one that cross into Guinea and another that crosses into both. Experts believe the outbreak originated in southeast Guinea as far back as January, though the first cases weren't confirmed until March. That country has recorded the most deaths, with 319. Sierra Leone has recorded more of the recent cases, however, and has seen 224 deaths in total.

Liberia will keep open Roberts International Airport outside Monrovia and James Spriggs Payne Airport, which is in the city.

Sirleaf said "preventive and testing centers will be established" at the airports and open border crossings, and that "stringent preventive measures to be announced will be scrupulously adhered to."

Other measures include restricting demonstrations and marches and requiring restaurants and other public venues to screen a five-minute film on Ebola.

Sirleaf also empowered the security forces to commandeer vehicles to aide in the public health response and ordered them to enforce the new regulations.

In Sierra Leone, President Ernest Bai Koroma announced Monday he was heading to the east of the country to visit the country's top Ebola doctor who became infected with the disease last week. Officials have said the doctor, Sheik Humarr Khan, has been responding well to treatment at a center run by Doctors Without Borders in the town of Kailahun. Khan has been described as a national hero for his work fighting the outbreak.

Koroma made the announcement at the National Stadium in Freetown, where he joined Muslims in prayers to mark the Eid el-Fitr holiday.

Health Minister Miatta Kargbo also left Monday morning for Kailahun, said Sidie Yayah Tunis, a ministry spokesman.

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Liberian man who died in Nigeria tests positive for Ebola

A Liberian man who died in Nigeria's megacity of Lagos on Friday has tested positive for the deadly Ebola virus, the country's health minister has confirmed.

The man, who was in his 40s, collapsed on arrival in Lagos, a city of 21 million people, on Sunday, and was taken from the airport and put in isolation in a local hospital.

Nigerian Health Minister Onyebuchi Chukwu said all ports of entry in the country are now on "red alert" and health officials are investigating all people who had contact with the deceased.​

Earlier on Friday, a Nigerian official in Geneva said the man died while under quarantine.

"The Liberian came in and he was quarantined at the airport and not allowed to go to the city. While he was quarantined he passed away. Everyone who has had contact with him has been quarantined," he told Reuters.

Ebola, one of the world's deadliest diseases, has killed 660 people across Guinea, Liberia and Sierra Leone since it was first diagnosed in February. There have been 1,093 cases to date in West Africa's first outbreak, according to the UN health agency.

The Liberian man is the first case on record of Ebola in Nigeria, Africa's biggest economy and, with 170 million people, its most populous country. 

"He departed on the plane initially with no symptoms, he reported being symptomatic on arrival. I understand that he was vomiting and he then turned himself over basically, he made it known that he wasn't feeling well. Nigerian health authorities took him and put him in isolation," World Health Organization spokesman Paul Garwood said earlier on Friday. 

Ebola victim from Sierra Leone on the run

Also on Friday, Sierra Leone officials appealed for help to trace the first known resident in the capital with Ebola whose family forcibly removed her from a Freetown hospital after testing positive for the deadly disease.

Radio stations in Freetown, a city of around 1 million inhabitants, broadcast the appeal on Friday to locate the woman.

"Saudatu Koroma of 25 Old Railway Line, Brima Lane, Wellington," the announcement said. "She is a positive case and her being out there is a risk to all. We need the public to help us locate her."

Koroma, 32, a resident of the densely populated Wellington neighbourhood, had been admitted to an isolation ward while blood samples were tested for the virus, said health ministry spokesman Sidi Yahya Tunis. The results came back on Thursday.

"The family of the patient stormed the hospital and forcefully removed her and took her away," Tunis said. "We are searching for her."

Fighting one of the world's deadliest diseases is straining the region's weak health systems, while a lack of information and suspicion of medical staff has led many to shun treatment.

Dozens with Ebola unaccounted for

Earlier this year, a man in Freetown tested positive for Ebola although he is believed to have caught it elsewhere.

According to health ministry data and officials, dozens of people confirmed by laboratory tests to have Ebola are now unaccounted for in Sierra Leone, where the majority of cases have been recorded in the country's east.

While international medical organizations have deployed experts to the field in an attempt to contain the outbreak, WHO said poor health infrastructure and a lack of manpower were hindering their efforts.

"We're seeing many of these facilities simply don't have enough people to provide the constant level of care needed," Garwood told a news briefing in Geneva on Friday.

There is no cure or vaccine for Ebola, which causes diarrhea, vomiting and internal and external bleeding. It can kill up to 90 per cent of those infected, although the mortality rate of the current outbreak is around 60 per cent.

The West African outbreak is the first time that Ebola, which was first discovered in what is now Democratic Republic of Congo in 1976, has appeared in heavily populated urban areas and international travel hubs.

Cases have already been confirmed in Conakry and Monrovia, the capital cities of Guinea and Liberia.

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Vancouver street youth face 'alarmingly' high risk of hepatitis C

A drug user prepares heroin bought on the street at a supervised injection clinic in Vancouver. (Darryl Dyck/Canadian Press)

Vancouver street youth face an alarmingly high risk of hepatitis C infection because of a high incidence of injection drug use, according to a new study published in the British Medical Journal.

The B.C. Centre for Excellence in HIV/AIDS tracked youth aged 14 to 26 over the course of six years.

Of 940 people recruited between September 2005 and November 2011, 100 tested positive for the disease at the outset.

Of the people 512 who tested negative at the beginning and showed up for at least one subsequent visit, 56 were positive in follow-up tests — 10.9 per cent.

And of those 512 youth, 166 — about 32 per cent — reported prior use of injection drugs.

"We found that the risk for (hepatitis C virus) acquisition among street youth in this setting was alarmingly high, and that intravenous drug injection remains a primary risk factor," said the study, led by Dr. Scott Hadland.

The study was also the first to look at the risk of hepatitis infection from injecting opioids like oxycodone and morphine, which is on the rise throughout North America.

It found that while the risk of infection is elevated by the injection use of heroin, cocaine and crystal meth, it does not appear to increase with opioid injection.

The researchers acknowledged that there was a relatively small number of youth in the study who engaged in prescription opioid misuse, which could have limited the ability to measure risk in opioid users.

It is also possible, the study said, that opioid users may not be as entrenched in the local drug scene and, therefore, may not associate frequently with hepatitis-positive drug users.

Either way, the excessive risk of infection among street youth requires specific prevention and mitigation strategies, the study found.

The street youth are a marginalized and difficult-to-reach population, Hadland wrote.

There are challenges to providing maintenance programs such as methadone to the population, and harm reduction services such as needle exchanges and safe injection sites may not effectively target younger users, he said in the study.

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E-cigarette market on fire while scientists wage heated debate

Electronic cigarette use is skyrocketing, revenue has reached the billions of dollars, legislators are talking about — and enacting — regulations, and more and more research is published every month.

But the jury is still out on their safety, and whether they are a gateway to smoking.

Earlier this week, the New York Times highlighted a growing concern that the tobacco industry is taking over the business and targeting kids with flavours that sound like candy as well as advertisements featuring cartoon characters or celebrities.

Meanwhile, the less reliable Daily Mirror in Britain focussed on the danger of explosions when e-cigarettes are plugged into the wrong charger, citing half a dozen examples to back up its worries.

For those not up on this newest trend, an e-cigarette includes a battery, heating coil and a cartridge containing e-juice. That's the liquid that may or may not contain nicotine and which gets vaporized when the battery powers the coil to heat up the liquid.

The vapor gets drawn up by the wick when someone inhales, and there is no smoke, so it's called vaping.

The pros and cons of vaping are hotly debated by scientists, and there is a wide range of experience among those who have tried it.

Vaping may increase smoking

For some, like Anna Camara, it may even lead to increased smoking.

Some smokers have successfully turned to e-cigarettes to help them stop smoking, while others blame e-cigarettes for an increase in the amount they smoke. (Richard Vogel/Associated Press)

Last year, an acquaintance she would see at the off-leash area for dogs in a Toronto park persuaded Camara, an eight-cigarette-a-day smoker, to follow her example and abandon smoking for vaping.

Camara invested $80 in the technology and the e-juice, with nicotine, but felt that vaping wasn't delivering enough nicotine to satisfy her need. So she would also smoke a cigarette.

She calculated that vaping would be cheaper than smoking, but it didn't help her to quit, and it also irritated her throat. (She had tried to quit before by using a nicotine patch, but found it too strong.)

In the end, she blames the vaping experience for doubling the number of cigarettes she smokes to about 16 a day.

On the other hand

E-cigarette proponents claim that because the physical act of vaping more closely resembles smoking, and because the nicotine intake can be adjusted, it should be a better tool to help a smoker quit the habit.

That's what Winnipegger Matt Clinch found. He says e-cigarettes are "fantastic."

In 20 years of puffing, he was up to a pack a day. But then he tried e-cigarettes and hasn't had a smoke in seven weeks.

He says he feels better, he isn't out of breath as much as he was and food is starting to taste better.

"It's as close to smoking as you can get without lighting up and smelling like an ashtray."

He says the battery charge lasts him until dinner time and then he has to charge the unit for four hours, which he calls "a good thing, because it keeps me from over-using it."

Cheaper than cigarettes

Clinch also likes the fact that the juice comes in a variety of flavours and levels of nicotine, because "it makes cutting back your nicotine intake easier, without really realizing that you're cutting back."

The e-juice in e-cigarettes comes in a variety of flavours and levels of nicotine. (CBC)

He estimates the start-up costs of vaping as equivalent to a carton of cigarettes. But now he's down from spending $17 a day on cigarettes to 75-80 per cent less buying e-juice.

Nick Cooke, a Canadian living in Nicaragua, is discovering the same thing.
He has been using a vaporizer for a little more than a year and says vaping is "way less worse for me than the 30 to 40 cigarettes I used to smoke each day.

"It's odourless and smokeless for the people around me, so it's no problem to have a puff in a restaurant or bar or airport boarding lounge."

Cooke also can have just one or two drags on the e-cigarette and then set it aside.

He says that even in Nicaragua, where cigarettes are cheap ($1.75 for a pack of 20), he's saving money by vaping.

"The only disadvantage is not always having a lighter in my pocket, which comes in handy during power outages."

Doubts about safety

In Canada, selling e-cigarettes with nicotine or those with a health claim is not authorized, though selling e-cigarettes or e-juice without nicotine is legal.

In an email to CBC News, Health Canada said, "To date there is not sufficient evidence that the potential benefits of e-cigarettes in helping Canadians quit smoking outweigh the potential risks."

Some manufacturers design their e-cigarettes to look like the real thing. (CBC)

In order to get a vaping product authorized, Health Canada requires a company "to provide evidence of safety, quality and effectiveness" - a regulatory hurdle that is "among the most restrictive in the world," according to an editorial last year in the Canadian Medical Association Journal. (It wants e-cigarettes to be regulated as pharmaceutical rather than tobacco products.)

Winnipeg-based Theravape Inc. is one of about a dozen established juice-makers in Canada.

It is just Eden Sorrell and two friends working there and they manufacture and sell wholesale at least 13 different flavours of e-juice.

Their best sellers include lychee, menthol and tobacco. Sorrell describes the tobacco flavor as "transitional."

E-juice containing nicotine gets poured into a vaping device at the Henley Vaporium in New York. (Frank Franklin II/Associated Press)

All their flavours can come with or without nicotine, and the nicotine can come in different strengths. Theravape e-juice sells for about $1 a millilitre.

Asked about Health Canada's policy, Sorrell explains that e-cigarettes with nicotine are "not authorized for sale but not prohibited. It's a grey market item."

He says his company doesn't get hassled by Health Canada "because it's actually marketed as a chemical consumer product, not as a health-care product."

Sorrell, who also works as a nurse, and is a non-smoker, explains that "it takes longer for nicotine to hit your bloodstream from a vape than it does from a cigarette, because it's being absorbed through the mucous membranes in the mouth, not within the lungs."

Tobacco industry dominates

One of the issues under debate among scientists is whether vaping could serve as a so-called gateway to smoking.

Sorrell says Theravape is "not here to start new habits" and he is unaware of any non-smokers trying their product.

Nevertheless a concern in the medical community is that e-cigarettes will be "a Trojan horse that will allow the tobacco industry to reverse decades of global progress in reducing smoking prevalence," says the CMAJ editorial.

"The tobacco industry sees a future where e-cigarettes accompany and perpetuate, rather than supplant tobacco use," the editorial adds.

The tobacco industry dominates the e-cigarette industry. In the U.S., a company called Blu eCigs accounts for almost half of all e-cigarettes sold, and it is in the process of being acquired by Imperial Tobacco.

Tobacco industry-owned Blu eCigs accounts for almost half of all e-cigarettes sold in the U.S. (AFP/Getty Images)

The tobacco industry also dominates the e-cigarette industry in Europe, where vaping is more popular.

In the British documentary, "The Rise of the E-cigarette," Kingsley Wheaton, a director at British American Tobacco (which sells Vype e-cigarettes), says e-cigarettes "provide a substantially safer alternative to smoking a traditional cigarette."

Although that may sound like a good reason to stop smoking, there is intense debate among scientists around the world about whether vaping will lead to smoking cessation.

In May, 53 public health specialists wrote to the World Health Organization, arguing that e-cigarettes could provide what they called tobacco harm reduction because, in vaping, nicotine is consumed in a low-risk, non-combustible form and doesn't draw tar and toxic gases into the lungs the way smoking tobacco does.

That started a vigorous scientific exchange, starting with a rebuttal from 129 other public health and medical authorities, then a reply from the first group.

Reading those three letters gives an understanding of the debate, and its intensity.

The points in contention include the safety of the liquid, the safety of the second-hand vapor, and whether e-cigarettes are just another way of perpetuating smoking.

They don't debate the harms of the nicotine. By now that's pretty well understood.

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ReWalk Robotics exoskeleton helps paraplegics to walk

A robotic exoskeleton that allows some people with spinal cord injuries to walk upright has been approved for use by Health Canada and the U.S. Federal Drug Administration.

The ReWalk was designed by a paraplegic inventor, Dr. Amit Goffer, who was seeking a better solution to life in a wheelchair, says Larry Jasinski, CEO of ReWalk Robotics.

Dr. Goffer's invention was an exoskeleton that provides powered hip and knee motion to enable individuals with a spinal cord injury to stand upright and walk, Jasinski explained in an interview with CBC's The Lang & O'Leary Exchange.

"Given that he was paralyzed himself, I think his understanding of what he was creating was greater than any of us would have developed independently," he said.

Improvements in motion sensing technology and the advent of improved computers and batteries helped create a more natural form of motion that is not so difficult to learn for paraplegic users, Jasinski said.

A man in Germany demonstrates walking with a ReWalk robotic exoskeleton. (Argo Technologies)

"What Dr. Goffer did, he took the concept of using a motion sensor where the person can use their own body to tell this thing how to walk," he said.

"It's the combination of the sensor which communicates to the very elaborate software program that mimics human walking., When you take a step it's heel to toe, just like you and I walk down the hallway and this natural motion is important because it is efficient ...and it is also better for your body to use your joints in natural motion."

The ReWalk is already approved for use in Asia and Europe, received Health Canada approval for home use at the beginning of the year and FDA approval in May.

It sells for about $69,500 US, a cost ReWalk Robotics hopes both public and private sector insurers will eventually agree to shoulder.

"We believe the reduction in medications, as users and patients get healthier and reduced complications for someone who might be confined to a wheelchair will allow this system to pay for itself," Jasinski said.

ReWalk, based in Massachusetts and a unit of Argo Technologies, has competitors in creating robotics for paraplegics, among them Ekso Bionics.

The next step for the company is to establish training centres in Canada and the U.S. where potential users can try the device and train on it if they believe it is a good fit for them.

There are some limitations – people aren't able to walk on snow, ice or soft sand – but they can take on stairs and uneven ground.

"Right now the primary limitations are people learning to use it properly and we have enough users now in the U.S. and starting in Canada, Europe and Asia.  The rewalkers as we call them, they learn from each other about how to use it better," Jasinski said.

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