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‘We’re holding up a floodgate’: B.C. fights off superbugs brought home by medical tourists

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The risks involved in medical tourism aren’t just personal. Having surgery abroad could also mean bringing back a drug-resistant superbug and putting people in this country at risk, B.C. officials warn.

That alert comes after the recent discovery that two patients at New Westminster’s Royal Columbian Hospital had been colonized with the multidrug-resistant yeast Candida auris. Though neither patient is infected with the bug, the two join just a handful of cases that have been identified in B.C. since 2017.

Dr. Linda Hoang, medical co-director for the Provincial Infection Control Network (PICNet), said most of these cases have come from travellers who have had treatment overseas, including medical tourists.

It means patients need to do serious research on the facilities they’re considering for surgeries or other treatments abroad, including looking for objective information about the presence of any drug-resistant microorganisms.

“It’s not only a problem in India or Southeast Asia. It is endemic in parts of the U.S. and parts of Europe,” Hoang told CBC News.

“It [antibiotic-resistant superbugs] is a global problem, and the only way to to be aware of them is to make sure that health-care professionals are informed and our residents are informed when they’re seeking health care outside of British Columbia.”

It’s a sobering reminder for those who travel abroad for medical treatments, whether it’s to skip the surgery wait list in B.C., access therapies that aren’t approved in Canada or save money on cosmetic therapy. Some of the top destinations for medical tourists from around the world include India, Mexico, Southeast Asia, Brazil and Turkey, according to the Medical Tourism Association.

But facilities in other countries can sometimes take a more haphazard approach to prescribing antibiotics, and overuse can trigger the evolution of resistance to these crucial drugs.

India a major source of bug

The two colonized patients at Royal Columbian were isolated after the bug was discovered, and the hospital has been aggressively cleaning all areas they had visited, using UV light for disinfection, according to Fraser Health.

C. auris was first identified in Japan in 2009, but it has popped up since then in countries around the world.

It acts much like any other yeast species, causing infections in wounds, the bloodstream and the ears, but the real problem is how to treat it.

“The only real reason why we’re concerned or interested in monitoring Candida auris is because of that potential resistance profile, making it difficult to treat with the anti-fungal agent that we have,” Hoang said.

The biggest risk of infection right now seems to come from Indian facilities, Hoang said.

A microscopic image, at left, shows Candida auris cells. At right is a culture of the yeast in a petri dish. (The Journal of Infection in Developing Countries)

The bug was confirmed for the first time in B.C. in July 2017 in a patient who’d been treated in India. As it turned out, that traveller also came back with infections from multiple other drug-resistant organisms.

B.C. doesn’t track whether infected people travelled abroad as medical tourists or simply required medical treatment because of an emergency during their voyages.

But patients who have had medical treatment outside B.C. for any reason are a major source of these superbugs, she said.

They include so-called CPOs — carbapenemase-producing organisms like Klebsiella, E. coli and Pseudomonas that have become resistant to broad-spectrum antibiotics, which Hoang describes as the “last resort” for treatment.

In 2017-2018, PICNet recorded more CPO cases than ever before, and more than half of them were from people who had accessed health care overseas, Hoang said.

‘There’s only so much we can do’

The key for anyone who chooses to have surgery abroad —​ and anyone who needs medical attention while travelling —​ is to let your B.C. doctor know when you return. That way, the doctor can check you for any drug-resistant bugs you may have picked up and give you the appropriate medication if you get sick.

Being open with that information protects everyone around you.

“If you require health care in British Columbia, you are running the risk of spreading that into our facilities. And that’s not a good thing for your neighbouring patients, who might be very sick and vulnerable,” Hoang said.

She said B.C. is aggressively monitoring returning travellers for drug-resistant superbugs, but the real key to stopping their spread will be eliminating the excessive use of antibiotics that allows these micro-organisms to evolve resistance.

“We’re basically holding up a floodgate, and unless the problems are addressed in these countries where antibiotics are used with minimal regulation and control, there’s only so much we can do,” Hoang said.

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List of Tourist Attractions Open Now in Ottawa

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With Ontario now in Step 3 of 2021 three-step plan for reopening, museums and other indoor attractions are allowed to reopen with capacity limited to not exceed 50 per cent capacity indoors and 75 per cent capacity outdoors.

Here is a list of Ottawa attractions you can visit starting July 16th.

Do remember to wear masks and buy tickets in advance.

Parliament Hill

Parliament’s Centre Block and Peace Tower are closed for renovation.

You can join for tours of the Senate of Canada Building (2 Rideau Street), House of Commons at West Block (111 Wellington Street) on Parliament Hill, and East Block at East Block (111 Wellington Street) on Parliament Hill.

When: Grounds open; guided tours of Parliament are suspended through the summer of 2021.
Where: 111 Wellington Street, Downtown Ottawa

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Ottawa performer leapfrogs from gymnastics to Broadway to TV

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A new AppleTV+ series set in a magical town that’s stuck in a neverending 1940s musical includes a pair of Ottawa siblings in the cast. 

Warren Yang and his sister, Ericka Hunter, play two of the singing, dancing residents of the village portrayed in Schmigadoon!, a small-screen series that takes its cues from classic musicals like Brigadoon, Wizard of Oz and Sound of Music, and skewers them with the offbeat comedic mastery of Saturday Night Live. 

In fact, you’ll recognize many of the names from SNL, starting with executive producer Lorne Michaels, creator of the late-night, live-comedy sketch show. Schmigadoon! also stars SNL cast member Cecily Strong and comedian Keegan-Michael Key, who hosted SNL in May. They play a New York couple who get lost on a hike and stumble into a strange town where everyone sings and dances. 

For Yang, a relative newcomer to show-biz, the series marks his television debut. For Hunter, the younger of his two older sisters, it’s the latest in a career path that began with dance lessons as a child more than 30 years ago. She attended Canterbury High School, Ottawa’s arts-focused secondary school. 

“Her dream was always to perform,” said Yang, 34, in an interview. “But that was never the path I thought was an option for me.” 

While his sister studied dance, Yang did gymnastics. He was an elite gymnast throughout his youth, ultimately leaving Merivale High School at 16 to train in Montreal, finishing high school through correspondence courses. He was a member of the Canadian National Team and received a scholarship to study at Penn State, majoring in marketing. 

A few years after graduation, Yang was working at an advertising agency in Toronto when he got a call from a Manhattan number. To his astonishment, they asked if he would be interested in auditioning for a Broadway revival of Miss Saigon.

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COVID-19: uOttawa to require vaccination for students living in residence

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Vaccination will be mandatory for students who want to live in residence at the University of Ottawa this year, with proof of vaccination and at least one dose required before move-in, or within two weeks of doing so if they can’t secure a shot before arriving.

Those who can’t receive a vaccine for “health-related reasons or other grounds protected under the Ontario Human Rights Code” will be able to submit a request for accommodation through the university’s housing portal, according to information on the university’s website.

Students with one dose living in residence will also have to receive their second dose “within the timeframe recommended by Ottawa Public Health.”

People who haven’t been granted an exemption and don’t get vaccinated or submit proof of having done so by the deadlines set out by the school will have their residence agreements terminated, uOttawa warns.

“Medical and health professionals are clear that vaccination is the most (effective) means of protecting people and those around them,” reads a statement provided to this newspaper by uOttawa’s director of strategic communications, Patrick Charette.

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“It is precisely for this reason that the University of Ottawa is requiring all students living in residence for the 2021-2022 academic year to be fully vaccinated. The University recognizes that some students may require accommodations for a variety of reasons and will be treating exceptions appropriately.”

Faculty, staff and students are also strongly encouraged to get vaccinated, the statement notes.

“Ensuring a high vaccine coverage in all communities is critical to ensuring an ongoing decline in cases and ending the pandemic. This will be especially important with the return of students to post-secondary institutions in our region in the fall of 2021.”

Neither Carleton University nor Algonquin College is currently mandating vaccination for students living in residence, according to the websites for both schools. But uOttawa isn’t alone in its policy – Western University, Trent University, Durham College and Fanshawe College have all implemented similar requirements. Seneca College, in the GTA, is going even further, making vaccination mandatory for students and staff to come to campus, in-person, for the fall term.

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