2 die of swine flu in Manitoba as Canadian toll hits 11

Two people in Manitoba have died after contracting swine flu virus, including a man who had no underlying medical conditions, provincial health officials said Tuesday.

The man, who was in his 40s, was from the Winnipeg area, health officials said at a press conference. He had been admitted to hospital prior to his death.

The second person is a woman in her 40s from the Nor-Man health region, in north central Manitoba. She had also been admitted to hospital but had significant underlying conditions, said officials.

"We fully expected that we would have deaths, as we do every year from influenza," said Manitoba health officer Joel Kettner. "It's particularly concerning, of course, when they occur in people in their 40s, because this is a premature death by anyone's test."

No additional information on the victims was provided by the government.

News of the deaths came as health officials announced that 74 new cases of swine flu have emerged in Manitoba, bringing the total number of confirmed cases in the province to 226.

While most swine flu cases are mild, there were at least 31 people in Manitoba's intensive care units with severe symptoms, said Kettner.

"These are very critically ill people. They're on ventilators. They cannot sustain their lives without very, very active life-support help .… It is not unreasonable to expect that we will have more deaths to announce as this epidemic goes through this phase of its course."

11 deaths in Canada

Quebec also reported two deaths related to swine flu on Tuesday, bringing the total number of reported deaths in Canada to at least 11.

The Quebec victims, a man and a woman who were between 30 and 50, had underlying medical conditions that made them susceptible to infection, health officials in that province reported.

In total, six Quebecers who had swine flu have died, along with two Ontarians and one Albertan. Prior to Tuesday, no deaths related to swine flu had been reported in Manitoba.

Responding to need in Manitoba's north

In Manitoba, the most severe cases of swine flu have involved aboriginal patients. Many patients have been airlifted from a cluster of reserves in a remote area 500 kilometres northeast of Winnipeg. Aboriginal leaders have said that poor living conditions, including cramped housing and a lack of clean water, have made some reserves a breeding ground for the flu.

Manitoba health officials say extra support is being sent to northern Manitoba.

"Two additional nurse practitioners have been working in a northern community [and] three additional doctors will travel north this week," stated a news release issued by the province.

Additional staff travelling north this week include two more nurse practitioners, 13 nurses and 10 medical residents, the release stated.

Medical professionals who are interested in temporarily working in the remote northern communities where swine flu, or H1N1 influenza A, has hit particularly hard are asked to go to the Manitoba website where there is a "Physicians and Nurses Needed" button.

"All Manitobans are at risk for exposure to the H1N1 virus. The influenza outbreak is provincewide and it is likely that H1N1 is present in every community in Manitoba," the news release stated. "Although there has been an increase in the number of people with severe respiratory illness, this has been a small proportion of the people who have had 'the flu' in Manitoba in the last two months.

"The majority of people in Manitoba who have become ill have not required hospitalization."

No need to restrict travel, close schools

In Manitoba, there continues to be no public health reason to close schools, community centres or other public gathering places, or to avoid travel to any community, the government release stated.

There is also no public health reason to exclude people from any public setting based on their ethnic background or home community.

"The same basic precautions are still the best defence against H1N1 influenza, no matter where you are or who you are with," the release stated.

Anyone who has symptoms of flu-like illness, such as fever, cough, aches and tiredness, is most contagious for three to four days, but it is possible to spread the disease for up to a week once symptoms start to appear, provincial health officials said.

They advise anyone exhibiting symptoms to:

• Stay home from school or work while ill and limit unnecessary contact with others.
• Contact a health-care provider or visit the nearest health-care centre if concerned about advice or care, or especially if symptoms are severe or worsening (i.e. shortness of breath, dehydration, worsening fever, cough or weakness).

Manitobans should continue to take the following precautions:

• Cover a cough or sneeze by coughing or sneezing into your elbow or sleeve or using a tissue to cover your nose and mouth.
• Wash your hands often with soap and water, especially after you cough or sneeze. Hand sanitizers are also effective.
• Limit touching of your eyes, nose or mouth.
• Take steps to maintain your health by taking care of yourself and those in your care, including eating a healthy, balanced diet, avoiding cigarette smoke and other harmful substances, being active and getting enough rest and sleep.

Manitobans seeking advice or care can call Health Links at 204-788-8200 or 1-888-315-9257. The telephone information service is staffed by registered nurses 24 hours, seven days a week, who can provide answers to health-care questions.

The demand for the service has spiked in the past week, with close to 200 calls taken on the weekend alone. The government has increased staff to manage the calls.