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Infants in Northern Canada Face the Highest Rates of Respiratory Infection in the World

October 18, 2016

Providing antibody to infants could prove lifesaving

Toron­to, ON – Infants in Canada’s north are fac­ing alarm­ing rates of res­pi­ra­to­ry infec­tion, but pro­vid­ing an anti­body to all infants will pre­vent hun­dreds of hos­pi­tal­iza­tions of babies in the Arc­tic and save hun­dreds of thou­sands of dol­lars a year.

In a paper pub­lished today in CMAJ Open, researchers con­duct­ed the largest study ever of infant admis­sion due to low­er res­pi­ra­to­ry tract infec­tions. They focused on admis­sions to health facil­i­ties by chil­dren under 12 months old in the North­west Ter­ri­to­ries, Nunavut and Nunavik – the north­ern region of Que­bec. The research uncov­ered wide dis­par­i­ty in admis­sion rates, rang­ing from 3.9 per cent in the North­west Ter­ri­to­ries to 45.6 per cent in Nunavik, which is the high­est rate ever report­ed in the world. By com­par­i­son, the rate of res­pi­ra­to­ry infec­tion in the first year of life in North Amer­i­ca is esti­mat­ed to be between one and three per cent. More than 40 per cent were diag­nosed specif­i­cal­ly with res­pi­ra­to­ry syn­cy­tial virus (RSV), either alone or with oth­er virus­es.

“The like­ly rea­sons for these high rates may include liv­ing in over­crowd­ed con­di­tions, expo­sure to cig­a­rette smoke as well as the asso­ci­at­ed chal­lenges of liv­ing in remote areas and pover­ty. But, there could be a genet­ic risk spe­cif­ic to Inu­it. The fact is, nobody knows for sure,” said Pro­fes­sor Anna Baner­ji, Fac­ul­ty Lead of Indige­nous and Refugee Health in the Uni­ver­si­ty of Toronto’s Temer­ty Temer­ty Fac­ul­ty of Med­i­cine. Baner­ji was lead author on the paper that includ­ed co-authors from across the coun­try and was based in five north­ern hos­pi­tals and four ter­tiary hos­pi­tals.

“What real­ly stands out is that in cer­tain areas, two to three per cent of all babies born are put on life sup­port. As a result of the infec­tions, many babies are evac­u­at­ed by air to south­ern health cen­tres in Edmon­ton, Win­nipeg, Ottawa and Mon­tre­al, where they receive inten­sive care. They’re young babies – on aver­age three months old – and gen­er­al­ly don’t have any under­ly­ing risk fac­tors, but they’re often at death’s door. In addi­tion to long peri­ods of hos­pi­tal­iza­tion, they can be placed on life sup­port for extend­ed peri­ods of time and fre­quent­ly suf­fer from com­pli­ca­tions, some of those hav­ing long-term con­se­quences” said Baner­ji.

In a sec­ond paper also pub­lished in CMAJ Open, researchers found that by pro­vid­ing uni­ver­sal access to the RSV anti­body palivizum­ab in regions of Nunavut and Nunavik, the rates of hos­pi­tal­iza­tion could be sub­stan­tial­ly reduced and in cer­tain areas it would actu­al­ly save mon­ey. Cur­rent­ly, palivizum­ab is giv­en by month­ly injec­tions dur­ing the RSV sea­son to infants con­sid­ered at high risk for severe dis­ease exclud­ing most Inu­it infants. But the researchers found that by giv­ing the anti­body to all healthy babies under six months of age at the start of the RSV sea­son, some north­ern health sys­tems can save $35,000 to $50,000 per RSV infec­tion avoid­ed. The region­al Gov­ern­ment of Nunavik has just announced that will be pro­vid­ing palivizum­ab to all term Inu­it infants.

“It’s a very cost effec­tive to give this anti­body to healthy term Inu­it babies in regions of Nunavut and Nunavik. It’s much cheap­er to pre­vent RSV with this anti­body than to pay for hos­pi­tal treat­ment. We’d save mon­ey and pre­vent suf­fer­ing and long term suf­fer­ing,” said Baner­ji.


For More Infor­ma­tion:

Liam Mitchell
Asso­ciate Direc­tor, Office of Com­mu­ni­ca­tions
Temer­ty Temer­ty Fac­ul­ty of Med­i­cine, Uni­ver­si­ty of Toron­to
416–978-4672 (office)
647–522-2513 (mobile)