Montreal's Heat Wave Action Plan

High Heat and Humidity Put Some Montrealers at Risk for Heat Stroke or Worse

Central Canada has been suffering from the heat for days, and with temperatures now reaching the mid-30s and the humidex (humidity index) tipping over 40ºC (104ºF) the city of Montreal is taking action to prevent heat-related illness and deaths.

Defining a heat wave

The American Meteorological Society defines a heat wave as a "period of abnormally and uncomfortably hot and usually humid weather." A standard application of that definition is a period of at least three days where heat reaches or exceeds 32ºC, but because weather patterns vary from one country or region to another, standards for an official heat wave will also vary. Quebec has a definition that uses a 30ºC minimum temperature, which means Montreal's heat wave started some days ago.

Health risks associated with heat waves

Anyone can suffer from heat stroke during weather extremes such as we are currently experiencing in central Canada at the moment, but certain people have an elevated risk and should take extra precautions. The elderly, children under age 5, and people suffering from any chronic cardiac or respiratory condition including asthma are in the population at elevated risk. Also a concern are people who spend a lot of time out in the sun: those who work outdoors, the homeless, and athletes who spend time training or competing outdoors. Even adolescents can be at risk, as they tend to be active outdoors.

People who take certain medications may be at elevated risk for sun burn during a heat wave, or may be more susceptible to heat stroke. The high heat and humidity can aggravate existing conditions such as high blood pressure or asthma. It can also result in fatigue or dehydration, or in heat stroke. Smog warnings should also be taken into consideration when evaluating risk levels.

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Image: Kilom691 (Wikimedia Commons)

Heat Wave Survival Tips

Avoid the summer sun during peak hours
Most of us realize the sun's effects are strongest around noon, but do really know what "peak hours" are? The Canadian Dermatology Association defines it as the time from 11 am to 4 pm. When ultraviolet readings are high (UV index 6-7) you should reduce exposure to the sun during this time, and take full precautions by wearing sunscreen, a shirt and a wide-brimmed hat. If the UV index reading is very high (8-10) or extreme (11+) it is best to avoid the sun as much as possible from 11 am to 4 pm. Remember, UV readings can be high even if the heat or sun don't seem strong!

Slip, Slop and Slap!
Never leave home without your protection, especially in summer's heat! Even when the UV reading is moderate (UV index 3-5) everyone should wear protection if they expect to be outside for more than 30 minutes. Slip on a shirt, slip on some sunscreen, and slap on a hat! Remember that sunscreen or sunblock are not intended to be your only protection against the sun: it's just one of the tools you should be using every day. Apply according to the label - that means using roughly enough to fill a shot glass, giving it 20 to 30 minutes to absorb into your skin before heading out the door, and re-applying as needed. Even on moderate UV days, seek shade at noon. Bringing along a bottle of water when you step out won't hurt, either.

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Deep Pressure Vests for Sensory Integration

Sensory integration is our ability to process all the inputs coming from our various senses and - well, make sense of them.

Sensory integration disorder is a neurological condition that is characterized by the inability to deal with all that sensory information. People with the disorder may only be able to cope with input from one or two
senses at a time. They tend to become easily irritated or confused, and simply cannot cope with ordinary daily experiences. The disorder can manifest in a number of ways, for example uncontrollable tantrums, very limited eating preferences, or unusual discomfort when wearing certain types of clothing.

Sensory integration disorder (SID) can cause a person to avoid or seek certain stimuli - or sometimes both in alternation. An inability to process sensory data can involve one or more senses, including the so-called "near senses" - tactile, vestibular and proprioceptive - that most of us take for granted.

Sensory integration disorder can occur alone, but it is not uncommon for a person to have both SID and autism. It can also occur in combination with such conditions as cerebral palsy or ADHD. The disorder should be diagnosed by an occupational therapist.

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Autism Elopement and Summer Vacations

Autism elopement, a special needs child wandering off unsupervised, is a frightening ordeal. Unfortunately, it is also fairly common with both children and adults. And it can be all the more terrifying if elopement occurs when the family is away from home. Planning for an emergency before it happens is one of the best ways to prevent it.

Reduce autism elopement through predictability

Autism elopement may be related to curiosity about new surroundings, or to anxiety brought on by the change in locale and routine. Help your child to regain control by keeping things as predictable as possible. Discuss vacations before leaving, and if possible allow your child to see photos or maps of places you will be going. Take advantage of the opportunity to associate places with specific events in the daily routine ("We'll have breakfast in our room, but we'll eat lunch and supper with the other guests in the dining room.") and to talk about rules that will keep your special needs child safe ("It's important to be with a grownup if you want to use the elevator or go to the pool.")

People with autism tend to rely heavily on routine. Establish a bare bones routine that can be followed wherever you are. Draw up a daily schedule for your child to follow, as well as a calendar or itinerary that highlights special occasions or places you will be on certain days. If your child uses a visual schedule be sure to update it for your vacation, and bring it along.

Create social stories to introduce any aspects of your vacation that may be difficult for your autistic child to understand. It can also be helpful to read books or watch movies that deal with a similar type of vacation (road trip, camping, visiting family, staying in a hotel, sight seeing, etc.) to help your child get a feel for what your summer holiday will be like.

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Photo by sideshowmom of morguefile.com

Lyme Disease Steadily Increasing

North American Tick Populations Spreading

Deer ticks and Lyme disease

Lyme disease is a condition transmitted through the bite of an infected tick. The species most often involved in North America is Ixodes scapularis, the black legged or deer tick. It can be found mostly in the northern Midwest and the eastern American states, and in Canada from southeastern Manitoba through Nova Scotia. In British Columbia and the Pacific Northwest the western black legged tick, Ixodes pacificus is known to spread Lyme disease.

Lyme disease has been a concern in the United States for years, but in Canada both governmental surveillance and public awareness of the problem have been lacking until very recently. Much of the population was unaware the disease spreading ticks were present in our country, including medical practitioners. Lyme disease was not reportable in Canada until this year, and health ministries are only now beginning to put out public service announcements about the condition.

In the United States Lyme disease is subject to voluntary reporting, and the Centers for Disease Control and Prevention have noted a steady increase of the number of cases. Over a 15-year period the number of cases rose by 101 percent. The CDC states these figures, "underscore the continued emergence of Lyme disease and the need for tick avoidance and early treatment interventions."

Research in Canada over roughly the same period has similarly shown expansion of known tick populations. Migrating birds have also been linked to transporting infected ticks from established populations to regions where ticks and Lyme disease had previously been unknown. This suggests a need for increased public awareness and training of medical personnel, even in areas previously considered at low risk.

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What is a Pandemic?

Classifying Infectious Diseases as Pandemics
 
The word pandemic comes to us from the Greeks. Pan- means "all" and demos means "the people," so a pandemic is an infectious disease outbreak with the potential to affect all people over a large geographic region, or even worldwide. In epidemiology, a pandemic is distinguished from an endemic (a stable but communicable disease like chickenpox in North America) and from an epidemic (an infectious disease spreading more than expected, but restricted to a smaller geographic region.)

Classification of a pandemic

The World Health Organization (WHO) uses a 6-phase pandemic classification index. Risk is low in phase 1 (animal infections only) and phase 2 (limited animal-to-human transmission) of an infectious disease outbreak. At phase 3 there may also be limited human-to-human transmission. Phase 4 sees human-to-human transmission in a "community-level outbreak." Phase 5 sees the disease spread to at least two countries within a single WHO administrative region. Only at phase 6, which involves spread to a second geographic region, is a pandemic officially declared.

A misunderstanding of what constitutes a pandemic has led to criticism over how the WHO handled the 2009 H1N1 global pandemic. The American Centers for Disease Control and Prevention (CDC) have developed a 5-category Pandemic Severity Index (PSI) that responds to the public's desire for information on severity of individual cases of a disease. All infectious disease outbreaks measured on the PSI are pandemics, however the scale puts into perspective the destructive potential of a disease. It allows comparison of a new pandemic, like the 2009 swine flu, with past ones such as the much more deadly 1918 Spanish flu.

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