Severe Flu Cases Surge in Manitoba - Aboriginal Community Hit Hard

[Shiloh]

Source: http://www.winnipegfreepress.com/bre...-46706707.html


Suspected H1N1 flu outbreak hits reserve
By: Jen Skerritt
2/06/2009 1:00 AM |

AN isolated First Nations community is scrambling to retool its pandemic plan after a suspected outbreak of H1N1 influenza sent five children and two pregnant women to hospital with a severe respiratory illness.

St. Theresa Point First Nation Chief David McDougall said seven people suffering from severe flu-like symptoms were medivaced to Winnipeg in the last week, including two pregnant women who were sent to St. Boniface Hospital's intensive care unit. McDougall said one woman lost her child as a result of the illness.

Health officials have flown in at least two additional nurses and two doctors to deal with the emerging respiratory crisis in the remote community, located 500 kilometres northeast of Winnipeg.

McDougall said lab tests haven't confirmed the cause of the illness, but public health officials haven't ruled out swine flu (H1N1).

Residents have been told to avoid public gatherings and stay home if they're sick to stop the spread of the disease. "There was a spike in the number of cases brought to the nurses' station with flu-like symptoms," McDougall said. "It was a red flag."

St. Theresa Point community leaders held a meeting Monday afternoon to discuss how to pull together a pandemic plan.

McDougall said the community lacks the infrastructure to deal with a full-scale outbreak and that a potential pandemic could spread quickly since residents live in overcrowded homes.

He said community leaders are trying to quell public fear and keep residents from panicking. "There's a respiratory problem and of course that's always a concern," McDougall said. "We're trying to figure out what the best response is."

McDougall said Health Canada and Manitoba Health are working with St. Theresa Point to investigate the spike in illnesses.

A spokeswoman from Manitoba Health said there are no new confirmed cases of swine flu. Unlike other provinces, Manitoba doesn't comment on the number of suspected swine flu cases under review.

News reports late Monday night said a third Canadian -- an unidentified person from Ontario -- died from swine flu on Sunday.

jen.skerritt@freepress.mb.ca

[alert]

Re: Suspected H1N1 flu outbreak hits isolated First Nations reserve

This one bears closer watching. Seven cases of illness severe enough to reuqire a 500 km evacuation seems a little severe for the current H1N1. While the fact that the seven are children and pregnant women makes other milder cases likely (in say, healthy adults), it would require a lot of milder cases to statistically bring this into line with the current H1N1. Also, don't forget that the NML is located in Winnipeg. This laboratory is among the best in the world an should be able to diagnose any known illness rather quickly, including the novel H1N1. But this outbreak remains undiagnosed. Of course, who knows when the cases got to Winnipeg? We know they were there this morning. If this outbreak is not diagnosed in two days, that would be a bad sign. It seems from the article that some of the cases have been in Winnipeg for nearly a week.

Further information from knowledgable sources is requested, including:

The numbers of milder cases.

The population of the remote settlement.

Any diagnostic tests run.

The acutal symptoms involved.

Onset and evacuation dates.

Any familiar or epidemological links between the seven severe cases (siblings, parents, etc.)

Any bizarre exposures any of these cases might have had (i.e. ate a sick animal).

This is North America, and there really shouldn't be undiagnosed repsiratory illnesses here.

[alert]

Re: Suspected H1N1 flu outbreak hits isolated First Nations reserve

They are sending more doctors and nurses to the reservation. Hopefully, more information will be forthcoming.

http://www.upi.com/Top_News/2009/06/02/H1N1-outbreak-feared-in-Canadian-Indians/UPI-68121243950059/

H1N1 outbreak feared in Canadian Indians

WINNIPEG, Manitoba, June 2 (UPI) -- Canadian health officials in Manitoba Tuesday were investigating whether an outbreak of respiratory illnesses on an isolated Indian reservation is H1N1 flu.

Provincial officials have flown two additional doctors and two more nurses from Winnipeg to the St. Theresa Point First Nation, 350 miles northeast, the Winnipeg Free Press reported.

Chief David McDougall told the newspaper five children and two pregnant women came down with severe breathing problems in the past week and had to be airlifted to Winnipeg hospitals. One of the women miscarried as a result of her illness, he said.

Public health officials have not determined the virus was H1N1, originally called swine flu, the report said.

McDougall said residents have been told to stay home if they're sick.

[alert]

Re: Suspected H1N1 flu outbreak hits isolated First Nations reserve

Some background information about this commmunity from Wikipedia. This is a very small community, and essentially the entire community would need to be sick to bring the numbers into line with the current H1N1.

St. Theresa Point, Manitoba
From Wikipedia, the free encyclopedia
Jump to: navigation, search
Coordinates: 53?49′10″N 94?53′0″W / 53.81944?N 94.88333?W / 53.81944; -94.88333 St. Theresa Point is a remote community of approximately 2,184 people in Manitoba, Canada. The community is located on the southern shore of Island Lake, the sixth largest lake in the province. More than 5,400 people live in the area within 40-kilometre (25-mile) radius. There are 478 housing units within the community[1].

There is also the St. Theresa Point Indian Reserve of 2,735 people located near the community[2].

The community is only accessible by airplane or winter ice roads (which continue north towards Garden Hill, and southwest towards Manigotagan, with a branch leading towards Berens River). The community is served by the nearby St. Theresa Point Airport. It has a local educational institution, St Theresa Point Regional Centre, with courses offered by the University College of the North and Assiniboine Community College.

[tropical]

Re: Suspected H1N1 flu outbreak hits isolated First Nations reserve

#1/#3/../ "Isolated ... reservation"


It could be realy isolated if there were instaurated previously the quarantines.

So, the idea of prepping for a month, two, is not enaugh good, because from somewhere, somebody, would infect us after this timeline.

If this virus remains, as it seems, at least to the next season, an than could be switched by a worst one, the possibility of escape it without vaccines, would be esigue.

Now it is visible that it also cause devastations in pregnancy.

How this going on, it seems an more and more serious flu.

[alert]

Re: Suspected H1N1 flu outbreak hits isolated First Nations reserve

http://sttheresapoint.com/

This site has lots of background information on this community (but unfortunately, no mention of the outbreak). It is definitely worth checking out to get some kind of perspective. Of special note is the following statement, which indicates that the community is not completely isolated:

The nearest accessible service centre is Winnipeg, Manitoba, located 467 air kilometres to the southwest and Thompson, Manitoba, located 290 air kilometres to the northwest. Although, Winnipeg is further in distance, there is passenger service scheduled three times a day, Monday to Friday and twice a day on weekends and some holidays. Perimeter Aviation is the only airline company flying in to St. Theresa Point from Winnipeg.

[alert]

Re: Suspected H1N1 flu outbreak hits isolated First Nations reserve

http://sttheresapoint.com/

This site has lots of background information on this community (but unfortunately, no mention of the outbreak). It is definitely worth checking out to get some kind of perspective. Of special note is the following statement, which indicates that the community is not completely isolated:

The nearest accessible service centre is Winnipeg, Manitoba, located 467 air kilometres to the southwest and Thompson, Manitoba, located 290 air kilometres to the northwest. Although, Winnipeg is further in distance, there is passenger service scheduled three times a day, Monday to Friday and twice a day on weekends and some holidays. Perimeter Aviation is the only airline company flying in to St. Theresa Point from Winnipeg.

Of special note is that this site does have a phone number for the St. Theresa's Point Nurses Station, so if things start going sour (which I hope it won't) and information becomes hard to get, FT members in Canada (and I know there are some) will still have a direct line.

[hornblower]

Re: Suspected H1N1 flu outbreak hits isolated First Nations reserve

The overall health status of people living on the reserves is often appallingly poor for Western standards. For one thing, Type 2 diabetes is hitting the population at a rate 3-5 times greater than the general population. Anyone looking for 'underlying conditions' will surely find them among cases from a reserve.

It is a very vulnerable population.

[alert]

Re: Suspected H1N1 flu outbreak hits isolated First Nations reserve

The overall health status of people living on the reserves is often appallingly poor for Western standards. For one thing, Type 2 diabetes is hitting the population at a rate 3-5 times greater than the general population. Anyone looking for 'underlying conditions' will surely find them among cases from a reserve.

It is a very vulnerable population.

I fully agree. Manitoba in general has only reported 11 confirmed cases of H1N1 though, and just 6 of them in Winnipeg, the only real link this town has to the outside world. I think it would be a serious issue to figure out how that virus got to this town. Then again, this could certainly be Adenovirus 14 or some other pathogen. I think laboratory studies at NML would have only started today.

I'm not anywhere near pushing the "novel virus" panic button yet; I'm willing to give this a couple days to see what turns up. I will continue to follow this story though and appreciate anything else anyone can find.

I wonder if the word "isolated" in the title should be changed to remote. "Isolated" also can have two other meanings, neither of which seem to apply here.

[alert]

Re: Suspected H1N1 flu outbreak hits isolated First Nations reserve

http://www.cjob.com/News/Local/Story.aspx?ID=1099117

Respiratory outbreak on Manitoba First Nation
CJOB News Team reporting
6/2/2009


Public health officials have not ruled out H1N1 influenza as the cause of a severe respiratory illness outbreak in a remote Manitoba First Nations community.

Health officials have flown in at least two nurses and two doctors to deal with the crisis in St. Theresa Point First Nation, 500 kms. northeast of Winnipeg.

Five children and two pregnant women have been medivac'd to hospitals in Winnipeg in the last week.

One woman has lost her child due to the illness.

Lab tests haven't yet confirmed the cause.

[cartski]

Re: Suspected H1N1 flu outbreak hits isolated First Nations reserve

Background...

Mounties to commute from Winnipeg to northern reserve
Last Updated: Wednesday, April 16, 2008 | 9:50 AM CT Comments29Recommend30CBC News
The RCMP is sending six officers to the troubled community of St. Teresa Point, Man., but they won't live on the remote reserve.

The isolated reserve is served by the Island Lake RCMP detachment, located 20 kilometres away on Stevenson Island. The detachment also serves the nearby Red Sucker Lake, Wasagamack and Garden Hill reserves.

"They would have to use boats, quads, snowmobiles, chartered helicopters to attend the calls, depending on the season," said spokeswoman Sgt. Line Karpish. "It's definitely posed some challenges in terms of responding to sometimes very serious incidents in a timely fashion."

The new officers won't be stationed in the remote reserve; they will be based in Winnipeg and flown in and out every few days.

Karpish said it's not unusual for officers not to live full-time in more isolated communities.

"Many of the communities don't have very many amenities and definitely pose challenges for the members that have families: school, some of the spouses have careers. You know, just on a human-resource basis it poses some challenges."

Officers are expected to being working on the reserve in the summer under the pilot project, which is partly funded by the province.

[alert]

Re: Suspected H1N1 flu outbreak hits isolated First Nations reserve

This link is the same as the first article in this thread, but it now contains the boldfaced text below. My reading of this story is that the two pregnant women had been admitted to hospital over the past week, but the five kids didn't get there until Monday night, which would help explain why there is no diagnosis yet. I don't think these are five additional cases.

http://www.winnipegfreepress.com/breakingnews/suspected-h1n1-flu-outbreak-hits-reserve-46706707.html

A remote First Nations community has shut down its school over heightened concern a severe flu is spreading among area residents.

St. Theresa Point First Nation Chief David McDougall saidtoday an additional five children suffering from severe flu-like symptoms were flown to Winnipeg on Monday night.

Over the last week, seven people suffering from severe flu-like symptoms were medivaced to Winnipeg in the last week, including two pregnant women who were sent to St. Boniface Hospital’s intensive care unit. One woman lost her child as a result of the illness.

Health officials have flown in at least two additional nurses and two doctors to deal with the emerging respiratory crisis in the remote community, located 500 kilometres northeast of Winnipeg.

Lab tests haven’t confirmed the cause of the illness, but public health officials suspect the respiratory virus could be H1N1 influenza, also known as swine flu.

Residents have been told to avoid public gatherings and stay home if they're sick to stop the spread of the disease. "There was a spike in the number of cases brought to the nurses' station with flu-like symptoms," McDougall said. "It was a red flag."

St. Theresa Point community leaders held a meeting Monday afternoon to discuss how to pull together a pandemic plan.

McDougall said the community lacks the infrastructure to deal with a full-scale outbreak and that a potential pandemic could spread quickly since residents live in overcrowded homes.

He said community leaders are trying to quell public fear and keep residents from panicking. "There's a respiratory problem and of course that's always a concern," McDougall said. "We're trying to figure out what the best response is."

McDougall said Health Canada and Manitoba Health are working with St. Theresa Point to investigate the spike in illnesses.

[alert]

Re: Suspected H1N1 flu outbreak hits isolated First Nations reserve

Actually, I'm not so sure now that I think about it. I don't know if these are five more (twelve total) or the original five. Any idea? I now think it might be five additional hospitalizations for a total of 12.

Ten hospitalized children in this community would be outside the range of H1N1 (the link indicates the elementary school has 300 students), even if every student is infected. I anxiously await lab results. I'm getting a little nervous...

[cartski]

Re: Suspected H1N1 flu outbreak hits isolated First Nations reserve

This one bears closer watching. Seven cases of illness severe enough to reuqire a 500 km evacuation seems a little severe for the current H1N1. .

Sorry, but I would disagree. The amount of air transport from Winnipeg to the north is amazing. 500kms is a stone throw away. Perimeter Airways is thriving.

Also, don't forget that the NML is located in Winnipeg. This laboratory is among the best in the world an should be able to diagnose any known illness rather quickly, including the novel H1N1. .

Yes, NML is world class. But therein lies the rub. There's no reason why NML would nor should give preferential treatment to local outbreaks. All samples would likely be prioritized in some other method than by jurisdiction, but that's my assumption. As well, do we know that the samples went to NML? They could have gone to a local lab - maybe Cadham next to HSC. Typically medi-vac patients go to the Health Sciences Center, the main, overcrowded hospital here in Winnipeg.

This is North America, and there really shouldn't be undiagnosed repsiratory illnesses here.

True, but we're talking about the far north. Think Outback, or desert, but with muskeg. St. Theresa Point is in the Burntwood Regional Health Authority - the big yellow section in the map:

http://www.gov.mb.ca/health/population/3/burntwood.pdf

and look a the huge area and small villages in the population figures.

And on the east side of Lake Winnipeg - the roads stop at a latitude approximately 1/4 up the small basin of the Lake. St. Theresa Point is about the same latitude as the top of the Lake, but farther east.

http://maps.google.ca/maps?hl=en&um=1&q=st.%20theresa%20point%20manitoba&ndsp=18&ie=UTF-8&sa=N&tab=il

To follow the confirmed cases, watch the Burntwood number in this (although the press will likely have faster info):

http://www.gov.mb.ca/health/publichealth/sri/cases.html

J.

[alert]

Re: Suspected H1N1 flu outbreak hits isolated First Nations reserve

Yes, NML is world class. But therein lies the rub. There's no reason why NML would nor should give preferential treatment to local outbreaks. All samples would likely be prioritized in some other method than by jurisdiction, but that's my assumption. As well, do we know that the samples went to NML? They could have gone to a local lab - maybe Cadham next to HSC. Typically medi-vac patients go to the Health Sciences Center, the main, overcrowded hospital here in Winnipeg.

J.[/QUOTE]

We don't know that the samples went to NML, but I would think that with an undiagnosed severe respiratory illness in the province, that would get first priority. I hope.

We know that the two pregnant women are in the ICU at St. Boniface's Hospital. We don't know where the 5-10 children are (and I suspect it isn't all the same hospital).

Nice to see we have FT memebers in Winnipeg. You might have information the rest of us don't, and certainly you would know if there starts to be panic. Post anything you know or find. You could be a very valuable source if this thing goes sour.