Discoveries and Innovations
FOR THE FIRST TIME, RESEARCHERS DEMONSTRATE THAT THE VIRUS THAT CAUSE GASTROENTERITIS CAN SPREAD THROUGH AIR
Noroviruses are responsible for at least 50% of all gastroenteritis outbreaks worldwide. A virus can infect humans via multiple routes including direct contact with an infected person, fecal matter, or vomitus, and contact with contaminated surfaces. Although norovirus is an intestinal pathogen, aerosols could, if inhaled, settle in the pharynx and later be swallowed. In order to better understand the potential transmission routes, Caroline Duchaine’s team (Laetitia Bonifait, Marc Veillette, Nathalie Turgeon, Rémi Charlebois) wanted to study the presence of this virus in air of healthcare settings, whose consequences are difficult to mitigate. They, the team members, conducted a study to evaluate its resistance to various stresses thanks to aerosolization systems. This was achieved by selecting a mouse norovirus as a surrogate since the human virus cannot be grown in vitro so far.
A total of 48 air samples were collected during norovirus outbreaks in 8 healthcare facilities. They were taken about a meter away from each patient, in front of his bedroom or at the nurses’ station. The norovirus was detected in 6 of 8 healthcare centres, 47% of samples were positive and its concentrations reached 2300 particles by cubic meter of air. This study has also demonstrated that this virus definitely resists to aerosolization stress, which leads us to believe that it was still infectious when aerosolized. This research was cited as one of the five most important studies in infection control during the European Congress on Clinical Microbiology and Infectious Diseases (ECCMID); the attention of several hundred organizations around the world was drawn by it. Caroline Duchaine’s team is currently investigating innovative approaches aimed at destroying this norovirus when present in the air, and also developing some strategies in order to study the spread of the gastroenteritis virus via aerosols from animals.
Caroline Duchaine, Ph. D.
HOW CAN WE DO THINGS BETTER? THE QUEBEC EXPERIENCE, IN A MODE OF PROMOTING HEALTHY LIFESTYLE CHOICES AND PREVENTING OBESITY: 50 POSSIBLE ACTIONS TO IMPROVE POPULATION HEALTH
For many years, prevention of societal chronic diseases remains a priority at the Institute. Introduced in 2012, the Evaluation Platform on Obesity Prevention (EPOP) is partnering in those efforts. Working together with scientists specializing in epidemiology, public health, land-use planning and also communication, our team focuses on assessing policies, programs and interventions by fostering physical activity as well as healthy diets in Quebec. If adopting healthy lifestyle choices remains essential at an early age, it continues to be a challenge to apply. According to different surveys achieved over the last few years, about 40% of children and 60% of adolescents would not meet the weekly recommended recreational physical activity level. As well, about two thirds of adolescents would not consume the daily minimum recommended servings of fruits and vegetables.
In recent years, the Government of Quebec has worked hard to deal with this situation. But, the Plan d’action gouvernemental de promotion des saines habitudes de vie et de prévention des problèmes reliés au poids came to a close in 2012, the partnership between the Government and Québec en Forme expires in 2017 and a new Programme national de santé publique has been recently established. So, in this context, how could Quebec do things better? Thus, in 2014, the EPOP and the Institut national de santé publique du Québec (INSPQ) have proposed the project “Comment faire mieux?” in an attempt to inform the stakeholders. On the one hand, it was intended to compare to international scientific recommendations the macroscopic portrait of provincial existing initiatives (2006-2014) which promote physical activity, healthy diets as well as prevent obesity. On the other hand, a deliberative process that identifies the context-specific needs and opportunities to Quebec, it lasted two days bringing together approximately twenty stakeholders involved in development, implementation or assessment of interventions.
A book published in April 2016 have compiled fifty possible actions to adopt in order to “do things better”, including twelve inevitable. In particular, these propose to take advantage of the upcoming wave to renovate Quebec schools in order to develop infrastructure that will pave the way for preparing friendly meals and performing physical activity. They also point out the ongoing revised government policies regarding land use planning, which remain opportunities not to be missed stimulating the adoption of sketches and plans both at large scale to foster sporting and recreational physical activity as well as the active transportation. In addition, the scope includes a better monitoring of food and beverage nutritional quality, an awareness-raising to healthy eating from easy and positive reference points, an increase of time spent in physical activity over school and extracurricular activities as well as many other proposals of special interests.
The whole book and its summary (in French only) are available at: IUCPQ.qc.ca/comment-faire-mieux. We warmly thank all partners and collaborators involved in this project, we hope that these results will inspire at different jurisdictions as well as a wide range of backgrounds.
Yann Le Bodo, M. Sc.
FIGHTING MORE EFFICIENTLY AORTIC STENOSIS
Several types of valvular heart disease (VHD) are affecting approximately 800,000 Canadians (2.5% of the population). They are responsible in Canada of about 2500 deaths, 15,000 surgeries and other annually cardiac procedures. Contrasting with the magnitude of the problem, the mechanisms of VHD still remain widely unknown and no medical treatment currently available for it. Aortic stenosis (AS), the most common VHD, a progressive illness leads to the calcification or the stricture of the corresponding valve. Once an AS becomes severe and a patient develops symptoms, the only treatment available at the moment remains to perform an aortic valve replacement.
Over the last 20 years, Dr. Philippe Pibarot established an extensive multidisciplinary research program at the Institute’s Research Centre. It aims to develop new technologies and pharmacotherapy in order to improve the diagnosis, the prevention as well as the treatment of patients suffering from the AS. Discoveries stemming from this program have already significantly influenced in many ways the medical practice around the world.
Dr. Pibarot, in collaboration with several researchers working at the Institute, including Drs. Patrick Mathieu, Yohan Bossé, Benoit Arsenault and Jean-Pierre Després, conducts studies from the cell to the patient’s level in order to elucidate the mechanisms involved in aortic valve stenosis. The ultimate goal focuses on development, and testing afterwards new drugs in order to slow down the progression of this illness, thus avoiding an aortic valve replacement procedure. In that behalf, Dr. Pibarot’s team became the first to establish the link between abdominal obesity and AS. This breakthrough forged promising new directions in regard to the prevention and medical treatment of this illness. According to recent findings, Institute’s researchers focus on lipoprotein (a) that would play a key role in AS development. Led by Dr. Pibarot and his team, a clinical trial will start soon in several countries around the world to determine the effectiveness of a drug reducing lipoprotein (a) blood level in order to slow down the AS progression.
Working with several researchers from the Institute, including Drs. Jean Dumesnil, Marie-Annick Clavel, Éric Larose, Jonathan Beaudoin, Marie Arsenault, Mathieu Bernier and Kim O’Connor, Dr. Pibarot conducted research leading up to significant progress in the diagnosis of the AS. More specifically, this team highlighted the “Paradoxical Low-Flow, Low-Gradient aortic stenosis”, an atypical form which severity was before seriously underestimated, leading to an underutilized treatment and therefore an impaired prognosis.
At the present time, the aortic valve replacement remains the only treatment available for the stenosis. In that behalf, the research conducted by Dr. Pibarot contributed to developing new strategies in order to select type and size of the most appropriate prosthetic valves for any given patient, thus ensuring an optimal outcome for the replacement surgery. In collaboration with Drs. Josep Rodés-Cabau, François Dagenais and Éric Dumont, Dr. Pibarot is currently investigating new minimally invasive procedures in order to implant prosthetic valves through a catheter inserted into an artery. This advanced technology constitutes nothing short of a revolution in AS treatment, this research group working at the Institute is considered worldwide as one of the best in this field. In this respect, Dr. Pibarot established at the Institute an echocardiography core lab which assesses in a standardized way performed examinations obtained from more than 50 hospitals, as a part of clinical trials aimed at evaluating this new technology safety and effectiveness.
DVM, Ph. D., FAHA, FACC, FESC, FASE