Severe flu cases surge in Manitoba aboriginal community

The Manitoba government is reporting a surge in the number of people requiring intensive care for influenza-like illnesses, particularly among a relatively young aboriginal population.

The vast majority of people reporting flu-like illnesses this spring are experiencing relatively mild cases and have not required hospitalization, Manitoba's chief medical officer of health, Dr. Joel Kettner, said at a press conference Monday afternoon.

'It's important to recognize that what we have observed is really more severe than what we would expect to see or what we have seen with typical seasonal influenza in the past.' —Dr. Joel Kettner, Manitoba's chief medical officer of health

However, there has been "an increased concentration of severe respiratory illness admitted to the intensive care units, which is higher in number than previous influenza outbreaks," officials with Manitoba Health and Healthy Living stated at the press conference.

As of Sunday night, 26 people were in the intensive care units on ventilators for flu-related reasons. It is expected many of them will be confirmed as cases of swine flu, or the H1N1 influenza A virus, officials said, noting more than half of the people are of aboriginal descent with an average age of 35, said Kettner.

"Our hope is that, most, of course we hope all, but we have to be realistic that if all these people survive it would be wonderful. It would also be beating the odds," said Kettner.

Overcrowded housing a "breeding ground" for flu

Glen Sanderson, a policy analyst for Manitoba's northern First Nation communities, said he is not surprised that aboriginal people are among those most affected by the illness.

"The overcrowding that exists on reserves, it's really quite high. It's a breeding ground for the virus to spread," he said. "It's an airborne virus — people cough and people are walking around in the house. When you've got as many as 11 people walking around the house, it really will spread to everybody."

'It's an airborne virus — people cough and people are walking around in the house. When you've got as many as 11 people walking around the house, it really will spread to everybody.' —Mike Moose, Split Lake Cree First Nation

Mike Moose, health director for the Split Lake Cree First Nation, about 120 kilometres north of Winnipeg, said that community's clinics are packed and so many children are sick with flu that the school has had to be closed.

He said the community wasn't prepared to deal with the outbreak.

"[Manitoba Health officials] gave us a binder…and said, 'This is what you have to have done.' We pretty much had no resources to get these plans in place."

As well, more than 200 people from St. Theresa Point First Nation, located about 500 kilometres from Winnipeg, reported being ill last week. Of those, 21 were transported to Winnipeg hospitals and two were confirmed to have swine flu. The majority of the ill are being treated in the community.

Also, a flu-like outbreak kept hundreds of students away from schools in Dauphin, Man., last week.

More ventilators brought into Winnipeg health region

The Winnipeg Regional Health Authority is taking steps to provide enough support to intensive-care units and prioritizing patients for personal-care home beds in Winnipeg. The WRHA has also acquired 15 additional ventilators that will be put to use as needed, officials said. 

'It's important to recognize that what we have observed is really more severe than what we would expect to see or what we have seen with typical seasonal influenza in the past.' —Dr. Joel Kettner, Manitoba's chief medical officer of health

Normally at this time of year, there are 30-35 patients using hospital ventilators for various reasons. The 26 people requiring the devices due to flu-like illnesses are in addition to those patients.

Typically, at this time of year, there are very few — if any — cases of severe flu.

"It's important to recognize that what we have observed is really more severe than what we would expect to see or what we have seen with typical seasonal influenza in the past," said Kettner.

And the illness is striking an unusual age distribution. Those affected are mostly in the age range of 20 to 55, as opposed to the very young and the very elderly, said Jan Currie, WRHA chief of nursing.

Non-urgent surgeries may be postponed

The WRHA authority may also defer non-urgent surgical procedures that would normally require ICU care, said health officials.

The problem lies in the lack of intensive care space. Health care workers in Winnipeg, for example, are already being forced to treat patients in recovery rooms, said Currie.

Currie said health officials in Manitoba may have to move patients to other jurisdictions across the country if local hospitals are overwhelmed.

"We know that the first patients who came in stayed on a ventilator for three to four weeks, so it's not a short-term problem," she said. "It's something where we should anticipate that these who are coming in now will require intensive care for a considerable period of time."

As well, the Public Health Agency of Canada has provided three epidemiologists to Manitoba to assist in assessing cases of influenza-like illness.

40 swine flu cases in Manitoba

There are 40 people in Manitoba with confirmed cases of swine flu. There were no new cases announced Monday.

Health authorities announced last week 27 new cases of the H1N1 virus in Manitoba, affecting people between the ages of one month and 56 years. Of the new cases, three patients required treatment in hospital.

The provincial government is encouraging the public to maintain their immune systems by making healthy food choices, being physically active and getting enough sleep.

Other tips to prevent the spread of any germs include:

• Covering a cough or sneeze, using a tissue or the inside of the elbow.
• Washing hands often with soap and water, especially after a cough or sneeze.
• Avoiding touching eyes, nose or mouth.

Those with flu-like symptoms, such as fever, cough, aches and fatigue, are most contagious for about one week. During that time, people are encouraged to stay home from school or work and limit contact with others to reduce the chance of spreading the virus.

Anyone seeking advice or care can call Health Links at 204-788-8200 or 1-888-315-9257.