Canada is facing its largest measles outbreak in over a decade and health experts have suggested that wastewater surveillance, which is a tool used widely during the COVID-19 pandemic could actually help control the virus.

What Is Wastewater Surveillance?

Wastewater surveillance is a process that involves testing sewage samples for viral pathogens. It has previously played a crucial role in tracking COVID-19. The data also helped health officials monitor the virus's trajectory and predict case surges. Many experts now argue that the same approach could be useful in identifying measles outbreaks before they escalate.

Despite this, public health officials have not implemented wastewater testing for measles. In Ontario, a measles hotspot, wastewater monitoring was discontinued last summer, leaving the province reliant on the Public Health Agency of Canada (PHAC). However, PHAC's national dashboard does not currently track measles. Instead, it monitors reported case counts but has no plans to include measles in wastewater analysis.

Detecting Measles Before Symptoms Appear

Like COVID-19, measles can be transmitted by asymptomatic carriers, meaning reported case numbers may be underestimated. This is where wastewater surveillance could provide early warnings.

"We could identify wastewater catchment areas where the measles virus is spreading and implement targeted public health measures," said Eric Arts, a microbiology professor at Western University. Increased vaccinations and public education efforts in high-risk areas could make a significant impact.

A recent study from Ottawa confirmed that monitoring measles in wastewater complements other public health strategies. Mike McKay, director of the Great Lakes Institute for Environmental Research (GLIER), has been testing wastewater for COVID-19 since the early pandemic days. His team also began testing for measles in southwestern Ontario earlier this year, mirroring an approach adopted in Detroit.

"Measles is an ideal candidate for wastewater detection because infected individuals shed the virus days before showing symptoms," McKay explained. However, PHAC has not requested measles testing, so McKay has been conducting it through informal agreements with municipalities and hospitals.

Overcoming Testing Challenges

One challenge with wastewater testing for measles is differentiating between the virus and its live-attenuated vaccine. When individuals receive the vaccine, they can shed a weakened form of the virus, which could be misinterpreted as an active infection. Sequencing the viral signal is necessary to distinguish between the two, adding a few days to the testing process.

Insufficient Testing Sites Leave Gaps

Both Arts and McKay emphasize the need for more wastewater testing sites for effective surveillance. PHAC currently operates 74 wastewater reporting sites across Canada, primarily focused on COVID-19, covering only about 37% of the population.

Given Ontario's ongoing outbreak, Arts criticized the decision to scale back wastewater surveillance. "The rationale for canceling these programs made no sense," he said, pointing out that wastewater testing is a cost-effective alternative to labor-intensive contact tracing.

A memo from Ontario's Chief Medical Officer of Health confirmed that the current outbreak originated from a large gathering in the Mennonite community of New Brunswick. Many cases in Ontario’s southwestern region, as well as in Manitoba, are linked to this event.

The Need for Immediate Action

Measles is spreading rapidly, particularly among under-immunized communities such as Mennonite, Amish, and other Anabaptist groups. Unfortunately, these regions lack active wastewater monitoring, leaving public health officials with limited data to track the outbreak's progression.

"The public health units in these areas don’t have access to real-time data. They don’t know when the outbreak has plateaued," McKay noted.

Experts argue that reinstating and expanding wastewater surveillance could help contain future outbreaks and improve public health response.

"Round 2 for me." Tahira Kashyap, a filmmaker, an author, and a breast cancer survivor, has recently shared a personal update on breast cancer relapse. Her breast cancer has returned after seven years. She is married to Bollywood actor Ayushmann Khurrana and was first diagnosed with breast cancer in 2018. Her update on her cancer relapse came on World Health Day, where she posted on her Instagram about her "Round 2".

What Is Cancer Relapse?

Often called cancer recurrence, it is the condition when, even after removal and treatment, cancer returns. It may resurface in the same area where it was first found or turn up at another spot in the body.

There are three types of cancer relapses or recurrence:

Local Recurrence: This happens when the cancer returns in the same spot.

Region Recurrence: This refers to the original cancer that shows up in tissue or lymph nodes near the original site.

Distance Recurrence: This refers to the cancer that has been found in tissue away from the original location.

Why Do Cancers Come Back?

As per Cancer Research UK, cancer may come back some time after the first treatment for different reasons.

The original treatment may not have gotten rid of all the cancer cells, and those left behind may have grown into a new tumor. In some cases, some cancer cells could also spread elsewhere in the body and start growing there to form a tumor.

Cancer can also come back after surgery because some cancer cells could have been left behind during the operation. In many cases, some cancer cells which had already broken away from the primary cancer could be too small to see to be removed. They are called micro metastases.

Can Cancer Recurrence Be Treated?

Many local or regional cancer recurrences can be treated successfully. Even if a cure isn’t possible, treatment can often shrink the cancer, slowing its growth. This may relieve symptoms, reduce pain, and potentially extend your life.

Your treatment choices will depend on many of the same factors you considered during your initial treatment—your goals, what you hope to achieve, and the side effects you're prepared to manage. Your doctor will also look at the treatments you've had before and how your body responded to them.

You might also want to explore clinical trials, which can give you access to the latest or experimental therapies. Talk to your healthcare provider to find out if any trials are available and suitable for you.

How To Know If Your Cancer Is Back?

As per the American Cancer Society, cancer care does not end when you finish treatment. You continue to see your health care team and follow up for care. It is important that you plan your follow-up care after cancer to ensure that your cancer recurrence can be diagnosed within time.

A follow-up care plan is usually based on the medical guidelines for your specific type and stage of cancer. It can also help you feel more in control as you go back to your everyday life after the treatment.

For Tahira, too, the follow-up is what ensured that her recurrence of cancer was detected. In her Instagram post, she wrote: "Seven year itch or the power of regular screening- it is a perspective, I had like to go with the latter and suggest the same for everyone who needs to get regular mammograms. Round 2 for me... I still got this."

World Health Day 2025 just went by, which touched upon the theme of "Healthy beginnings, hopeful future." On this occasion, Minister of State for Health and Family Welfare Anupriya Patel in an interview with the News Services Division of Akashvani talked about India's strides in improving maternal and child health.

With this year's global theme, which had been centered on "ending preventable maternal and newborn deaths", the minister detailed targeted efforts and achievements that India has made in reducing mortality rates.

As per Patel, India has successfully outpaced global averages in reducing maternal and child mortality. The maternal mortality rate has dropped by 83% in India. This, when compared with global drop is at 42%. Similarly, the country's infant mortality rate has also fallen by 69%, whereas the global rate is at 55%. The mortality rate for under five has also reduced by 75%, whereas globally, it stands at 58%.

She attributed this access to the Reproductive Maternal Neonatal Child and Adolescent Health (RMNCHA) strategy and associated government schemes. These included:

Janani Suraksha Yojana: Promotes institutional deliveries.

Janani Shishu Suraksha Karyakram: Offers free deliveries at public health centres.

Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA): Enables access to specialist antenatal care.

Lakshya initiative: Focuses on quality care in labour rooms and maternity OTs.

Comprehensive abortion care: Ensures safe, legal, and affordable abortions for various medical and social reasons.

Ensuring Nutrition For The Mother And Child

Patel also noted the efforts made to end malnutrition and obesity. The Ministry of Women and Child Development is also looking after the Saksham Anganwadi and Poshan 2.0. These focus on maternal nutrition, child feeding practices, and treatment of severe and moderate acute malnutrition. These schemes ensure that children aged 0 to 6 are regularly screened at Anganwadi centers. Malnourished children are referred to Nutrition Rehabilitation Centers (NRCs). Lastly, the Poshan Tracker, which is a digital platform, must monitor the real-time data on service delivery and health outcomes.

In fact, from April 8 the Poshan Pakhwada campaign, which aims to fight malnutrition in India, titled Swast Suposhit Bachche, Samriddh Bharat Ki Neeyat” has started to mobilise community participation and promote behavioural changes in dietary habits. This will go on till April 22.

Obesity and Promoting Healthy Lifestyles

Highlighting rising childhood obesity, Patel noted initiatives by FSSAI and the Ministry of Youth Affairs and Sports. The Eat Right India campaign encourages reduced intake of salt, sugar, and fat. The Fit India Movement and the School Health Programme advocate nutrition education, obesity screening, and lifestyle counselling in schools.

Additionally, school canteens are being regulated to limit unhealthy food options, ensuring children grow up with healthier habits.

Combating Anemia in Women and Children

India’s long-standing battle with anemia continues through widespread distribution of Iron and Folic Acid (IFA) supplements. Pregnant and lactating women receive IFA tablets for 180 days, while children get IFA syrups. Routine monitoring of haemoglobin levels helps track progress. Patel expressed confidence in achieving the goal of Anemia Mukt Bharat soon.

Ensuring Equitable Healthcare Access

Patel concluded by emphasizing the government’s focus on equitable and quality healthcare access, especially in underserved and rural regions. She reiterated the need for a collective approach—government, community, and stakeholders—to ensure sustainable improvements in public health outcomes, particularly for women and children.

Melatonin is a crucial hormone that promotes sleep by signaling the brain that it is nighttime. Beyond sleep, melatonin also acts as an antioxidant and has anti-inflammatory properties. This crucial hormone is produced by the pineal gland in the brain. While consuming certain fruits and vegetables can stimulate its production, melatonin supplements are also widely used by people struggling with insomnia or jet lag and are available over the counter in many countries.

How Does Melatonin Work?

Melatonin works hand-in-hand with your body’s internal clock, known as your circadian rhythm. This rhythm tells you when to sleep, wake, and even eat. Besides sleep regulation, melatonin also plays a role in managing your body temperature, blood pressure, glucose levels, and some hormones.

At night, as it gets darker, melatonin levels rise, signalling that it’s time to rest. In the morning, exposure to light lowers melatonin levels, helping you feel alert and awake. It interacts with receptors in your brain to slow down nerve activity and reduce dopamine, the hormone that keeps you awake.

7 Habits That Can Boost Melatonin Production

1. Get Morning Sunlight

Exposure to natural light early in the day helps regulate your internal clock and tells your body when to produce melatonin later. According to experts, Natural light in the morning helps regulate your internal clock and signals to your body when it’s time to produce melatonin later.

2. Limit Blue Light at Night

There is empirical evidence that screens from phones, tablets, and TVs suppress melatonin. Adjusting your phone to filter blue light or avoiding screens before bed can help.

3. Eat Melatonin-Rich Foods

Many fruits and vegetables boost melatonin production:

Tart cherries

Bananas

Oats

Walnuts

Almonds

Milk

Tomatoes

Fatty fish (like salmon)

Eggs

Grapes

4. Include Tryptophan in Your Diet

Tryptophan, found in turkey, eggs, nuts, and seeds, helps produce serotonin, which converts into melatonin. Several other nutrients, including magnesium, calcium, vitamin D, zinc and several types of vitamin B.

5. Maintain a Consistent Sleep Schedule

Going to bed and waking up at the same time daily trains your body to produce melatonin more effectively.

6. Avoid Late Meals

Finish eating at least two hours before bed to avoid disrupting your sleep with digestion-related issues. Digestion keeps your body active when it should be winding down and can lead to sleep-disturbing side effects such as heartburn and acid reflux.

7. Manage Stress

Stress raises cortisol, which interferes with melatonin. Meditation, breathwork, and warm baths can promote relaxation. Other healthy bedtime rituals include journaling, reading and listening to a podcast — whatever you need to do to let your muscles relax so that you sleep easily.