Severe Flu Cases Surge in Manitoba - Aboriginal Community Hit Hard

[HenryN]

Re: Novel H1N1 flu outbreak hits isolated First Nations reserve

Re: Novel H1N1 flu outbreak hits isolated First Nations reserve

Is this a snapshot of what could happen when this 'mild' virus establishes itself in communities or nations with marginalized populations? WHO is right - severity is localized and relative.

New York and Boston are not homogenoeus. Cases there are exploding.

 

[Snicklefritz]

Re: Novel H1N1 flu outbreak hits isolated First Nations reserve

Re: Novel H1N1 flu outbreak hits isolated First Nations reserve

And, thank you. Are they shipping additional ventilators and epidemiologists to Boston? Is there an excess, above seasonal influenza, of severe cases in New York?

 

[HenryN]

Re: Novel H1N1 flu outbreak hits isolated First Nations reserve

Re: Novel H1N1 flu outbreak hits isolated First Nations reserve

And, thank you. Are they shipping additional ventilators and epidemiologists to Boston? Is there an excess, above seasonal influenza, of severe cases in New York?

New York has had 8 deaths, all under 65. Boston and NY have massive outbreaks among students (many other areas have outbreaks, but don't test / report).

 

[Snicklefritz]

Re: Novel H1N1 flu outbreak hits isolated First Nations reserve

Re: Novel H1N1 flu outbreak hits isolated First Nations reserve

I understand, in my own layman's way, the frustration at the way testing is being conducted. But, the number of cases is different than the severity of disease for those cases that are tested in Manitoba and the US. My post, stated as a quesiton, was whether the situation in a local community in Canada will be similar in developing nations, and in local communities in developed nations ( US included), when the virus gets a foothold. (Perhaps we can agree that it's really just beginning now?)

It seems to this layman, that the majority of cases in the US that have led to severe disease are associated with those with 'underlying conditions' which are far more common in 'marginalized' communities than in the general US population, young healthy victims notwithstanding.

 

[blacknail]

Re: Novel H1N1 flu outbreak hits isolated First Nations reserve

Re: Novel H1N1 flu outbreak hits isolated First Nations reserve

Florida1 - What we need to focus on is improving the living conditions and the health on the reserves both now and into the future. We as Canadians have to work together with the band leaders, and with everyone living on the reserves. The status quo is not working, and the political games are not useful. Maybe we can start a thread on ideas on this topic, how to overcome barriers and make a real difference to the health of people living on reserves in Canada and around the World.

 

[Diane Morin]

Re: Novel H1N1 flu outbreak hits isolated First Nations reserve

Re: Novel H1N1 flu outbreak hits isolated First Nations reserve

Severe flu cases surge in Manitoba aboriginal community

Last Updated: Monday, June 8, 2009 | 4:05 PM CT Comments0Recommend3

CBC News


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.
The Winnipeg Regional Health Authority is taking steps to provide enough support to intensive-care units and prioritizing patients for personal-care home beds. The WRHA has also acquired 15 additional ventilators that will be put to use as needed, officials said.
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.
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.
As well, the Public Health Agency of Canada has provided three epidemiologists to Manitoba to assist in assessing cases of influenza-like illness.
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.
Illnesses afflict communities of St. Theresa Point and Dauphin

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.
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.

http://www.cbc.ca/canada/manitoba/story/2009/06/08/mb-influenza-winnipeg.html

 

[HenryN]

Re: Novel H1N1 flu outbreak hits isolated First Nations reserve

Re: Novel H1N1 flu outbreak hits isolated First Nations reserve

<a rel="nofollow" href="http://www.recombinomics.com/News/06080901/H1N1_MB_Vents.html">Commentary</a>

 

[sharon sanders]

Re: Novel H1N1 flu outbreak hits isolated First Nations reserve

Re: Novel H1N1 flu outbreak hits isolated First Nations reserve

Florida1 - What we need to focus on is improving the living conditions and the health on the reserves both now and into the future. We as Canadians have to work together with the band leaders, and with everyone living on the reserves. The status quo is not working, and the political games are not useful. Maybe we can start a thread on ideas on this topic, how to overcome barriers and make a real difference to the health of people living on reserves in Canada and around the World.

Great idea! How about here?

We have an entire forum dedicated to this. Go ahead and start the thread. :applause:

World's Indigenous Peoples - Health & Humanitarian Issues

http://www.flutrackers.com/forum/forumdisplay.php?f=1407

 

[pflu]

Re: Novel H1N1 flu outbreak hits isolated First Nations reserve

Re: Novel H1N1 flu outbreak hits isolated First Nations reserve

The First Nations had a meningitis outbreak just 2 weeks before Swine Flu was made public. 1 baby died, another was critical. The chief said another baby had died the week before with similar symptoms...

http://www.theprovince.com/opinion/Manitoba+First+Nations+baby+dies+meningitis/1445119/story.html
http://www.firstperspective.ca/inde...w=article&id=30:baby-dies&catid=1:latest-news

I uncovered these stories earlier while writing an article that I posted today which included a lot of research on meningitis being induced by influenza. I didn't use the material in the article, but the article covers a lot about the meningitis influenza links...

http://www.opencube.com/h1n1/origin_missouri.htm

I'm not saying these babies had the flu, but this does point out just how vulnerable the First Nation population is to any type of outbreak.

 

[Snicklefritz]

Re: Novel H1N1 flu outbreak hits isolated First Nations reserve

Re: Novel H1N1 flu outbreak hits isolated First Nations reserve

Commentary

Manitoba Ventilator Request Raises H1N1 Pandemic Concerns
Recombinomics Commentary 23:51
June 8, 2009


Manitoba has experienced an increased concentration of severe respiratory illness admitted to the intensive-care units, which is higher in number than previous influenza outbreaks. The majority of the cases are in people of Aboriginal descent.

The Public Health Agency of Canada has provided three epidemiologists to Manitoba to assist in assessing Manitoba's cases of influenza-like illness.

The Winnipeg Regional Health Authority (WRHA) is taking steps to provide enough support in intensive-care units (ICUs) and prioritizing patients for personal-care home beds. There are also 15 additional ventilators that have arrived and will be put to use as needed. The WRHA may also defer non-urgent surgical procedures that would normally require ICU care.

The above comment from a Manitoba press release today describes an increasing problem of severe disease in First Nation residents. The increase in number of cases began 1-2 weeks ago and is evident in multiple provinces (see updated map). Last week the medevacing of patients to Winnipeg was detailed this afternoon's press release strongly suggests the problem is growing.

Although it is unclear if these more severe cases are linked to poor health conditions and overcrowding, of if there is a genetic component in the target population or circulating swine H1N1 that is exacerbating the problem, but it is a growing problem and many expand as swine H1N1 spreeads through less developed areas of Asia and Africa.

The circulation of a swine H1N1 in a heterogeneous human population is likely to cause problems, which can grow as the virus adapts to its new host or the virus spreads through populations at greater risk.

Although many local agencies in the United States and Canada have limited testing of mild cases and have begun focusing on the more severe hospitalized cases, the number of frequency of positives continues to grow, even though the flu seasonal has ended in the northern hemisphere.

The spread of the swine H1N1 during the off season may be linked to an avan PB2, which optimizes viral replication at 41C, which may contribute to the rapid spread of the virus.

Most cases have been mild, and the spread of the virus has been largely silent. However, deaths are beginning to mount with three announced today (PA, OK, QB), in addition to three on Friday (TX, WA, NY), six on Thursday (AZ, PA, UT, IL, CA, WI) and seven on Wednesday (3 NY, MI, CT,VA).

These increase in fatalities among a population that is largely under 65, and the increasing admissions to hospitals and ICU's, continue to increase pandemic concerns.

<a rel="nofollow" href="http://www.recombinomics.com/News/06080901/H1N1_MB_Vents.html">Commentary</a>

I see we've come to an agreement, Dr. Niman. That's good news for all :applause:

 

[Diane Morin]

Re: Novel H1N1 flu outbreak hits isolated First Nations reserve

Re: Novel H1N1 flu outbreak hits isolated First Nations reserve

Nunavut : 19 new cases 25 total

http://www.phac-aspc.gc.ca/alert-alerte/swine-porcine/surveillance-eng.php

Nunavut with the smallest population and least dense of Canada: 31.152 inhabitants (2008)<SUP></SUP>disseminated on a surface similar to that of Western Europe. Its population is to 85% Inuit.

http://www.phac-aspc.gc.ca/alert-alerte/swine-porcine/surveillance-eng.php

 

[theforeigner]

CANADA:Manitoba; 26 people on ventilators for flu-related reasons

CANADA:Manitoba; 26 people on ventilators for flu-related reasons

http://www.cbc.ca/canada/manitoba/story/2009/06/08/mb-influenza-winnipeg.html

Severe flu cases surge in Manitoba aboriginal community

Last Updated: Monday, June 8, 2009 | 4:05 PM CT
CBC News

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.

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

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.

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.

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

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.
Illnesses afflict communities of St. Theresa Point and Dauphin
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.

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.

 

[theforeigner]

Re: CANADA:Manitoba; 26 people on ventilators for flu-related reasons

Re: CANADA:Manitoba; 26 people on ventilators for flu-related reasons

Newreport 3 days ago:

http://www.calgaryherald.com/Health/Health+ministers+clash+over+swine+response/1667116/story.html

Health ministers clash over swine flu response

By Jordana Huber and Mia Rabson, Canwest News Service and Winnipeg

Free PressJune 5, 2009


Minister of Health Leona Aglukkaq is heading a delegation of Canadian health officials and while in Geneva for the World Health Assembly she plans to meet with WHO Director-General Margaret Chan, as well as her U.S. and Mexican counterparts, in a file photo.Photograph by: Blair Gable, ReutersTORONTO ? As a remote Manitoba reserve struggles to deal with a possible outbreak of swine flu, political tensions flared Friday over pandemic flu planning for Canada's First Nations.


Federal Health Minister Leona Aglukkaq denied a claim by Manitoba's health minister that the province had repeatedly offered to help Ottawa with pandemic plans for First Nations but had been ignored until the current scare on a northern Manitoba reserve.


Aboriginal leaders have said many impoverished reserves do not have the resources to deal with an outbreak, and are susceptible to a fast-spreading virus due to overcrowded homes.


St. Theresa Point First Nation has confirmed three cases of swine flu and more than 20 residents of the community have been flown to Winnipeg hospital suffering from flu-like symptoms.


Hundreds more have reported symptoms in the community of 3,200.


Aglukkaq said she has daily conversations about the swine flu virus with health ministers across the country, but that Manitoba Health Minister Theresa Oswald never brought up the matter.


"Last week, I spoke to her and this was never raised," Aglukkaq said. "She has never made this offer to me or expressed concerns in regards to what's written in the papers today."


The province quickly responded that it wasn't help offered on the ministerial level but by officials on the ground, as established crisis response procedures dictate.


On Thursday, Oswald said the Manitoba government had offered Ottawa help with pandemic planning on First Nations 13 times since May 4 but was repeatedly turned down.


She expressed frustration at the federal government's response to the H1N1 flu outbreak when it comes to First Nations, saying the province had been prevented from doing more because it doesn't have jurisdiction.


Oswald said Friday she said she hadn't meant to start a "fist fight" over the issue or imply the federal health officials in Manitoba were doing a bad job.


"The team on the ground is doing a good job," she said.


Later Friday, the two ministers spoke by phone, and seemed to have put aside their differences.


"She agreed we have to do more joint communications," said Oswald. "I am happy with that."


Aglukkaq also announced Friday $10.8 million in funding over three years for a national influenza research network.


The funds will support the work of 80 scientists from 30 research and public-health institutions across Canada who will test the safety and effectiveness of new vaccines against the H1N1 flu virus, Aglukkaq said.


Funding for the research network comes from a $1-billion commitment in the 2006 federal budget for pandemic preparedness.


As of Wednesday, a total of 1,795 laboratory-confirmed cases of H1N1 flu virus have been reported in nine provinces and three territories in Canada. Three deaths ? two in Ontario and one in northern Alberta ? have been linked to swine flu.


Meanwhile, Manitoba's acting chief public health officer on Friday warned hoteliers not to bar flu sufferers from renting rooms.


"There is currently no public health reason to turn away guests from any community in Manitoba or elsewhere across the world," wrote Dr. Elise Weiss in a letter issued Friday.


Weiss's letter was prompted by reports that residents of St. Theresa Point First Nation were kicked out of the St. Regis Hotel earlier this week because they could have been infected with the same strain now gripping the reserve, which is located about 500 kilometres northeast of Winnipeg.


Globally, 21,940 people are infected with the H1N1 flu virus and 125 have died according to the World Health Organization.


On Friday, the agency's pandemic alert level remained at 5, its second-highest level on a scale of 1 to 6.


In a statement, WHO said future changes to its alert level would include an assessment of how severe an outbreak was as well as how widespread.


The UN agency has been weighing how to revamp its pandemic alert scale to reflect both the severity of the flu as well as its geographic spread around the world.


This follows criticism that it may have caused undue panic about the new strain, whose effects have been mainly mild apart from in Mexico, where it is known to have killed more than 100 people.

? Copyright (c) Canwest News Service

 

[theforeigner]

Re: CANADA:Manitoba; 26 people on ventilators for flu-related reasons

Re: CANADA:Manitoba; 26 people on ventilators for flu-related reasons

http://www.cbc.ca/canada/manitoba/story/2009/06/08/mb-influenza-winnipeg.html

Severe flu cases surge in Manitoba aboriginal community

Last Updated: Monday, June 8, 2009 | 4:05 PM CT
CBC News

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.

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

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.

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.

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

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.
Illnesses afflict communities of St. Theresa Point and Dauphin
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.

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.

WHY!!! was this EXSTREAMY important news report moved into this thread?

It REALLY should have a thread of it own.

This newsreport IMO point to a VERY serious development.

 

[sharon sanders]

Re: Novel H1N1 flu outbreak hits isolated First Nations reserve

Re: Novel H1N1 flu outbreak hits isolated First Nations reserve

Thanks Foreigner!

I think this development will receive more attention on this thread where many have already established a direct link into FT.

I have also changed the title of the thread to reflect this.

 

[HenryN]

Re: Severe Flu Cases Surge in Manitoba - 26 on Ventilators Since June 7 - Aboriginal Community Hit Hard

Re: Severe Flu Cases Surge in Manitoba - 26 on Ventilators Since June 7 - Aboriginal Community Hit Hard

Surge in people needing intensive care for flu

By: Larry Kusch
8/06/2009 7:20 PM | Comments: 2

<!--startclickprintexclude-->

• Print
• E?mail
• <SCRIPT type=text/javascript src="http://w.sharethis.com/button/sharethis.js#publisher=36749a9c-cc10-4042-8c29-84e0c435a633&type=website&buttonText=Share%20This&post_services=facebook%2Ctwitter%2Cdigg%2Cdelicious%2Cstumbleupon%2Creddit%2Cnewsvine%2Ctechnorati%2Cmixx%2Cblogger%2Ctypepad%2Cwordpress%2Cfriendfeed%2Cgoogle_bmarks%2Cwindows_live%2Cmyspace%2Cybuzz%2Cfark%2Cpropeller%2Cbus_exchange%2Clinkedin%2Cfriendster%2Cslashdot%2Cyahoo_bmarks&headerbg=%23296391&headerTitle=Share%20it%20with%20your%20friends"></SCRIPT>Share This

<!--endclickprintexclude-->WINNIPEG ? There has been a "surge" in the number of people requiring intensive care in Manitoba hospitals with flu-like illnesses, the province said today.

As of Sunday night, there were 26 such persons in hospital ? more than half of them aboriginal. All were or had been on ventilators due to influenza or of an influenza-like illness.

Eight persons with severe cases required hospitalization in the past week alone.

Joel Kettner, chief provincial public health officer, told reporters Monday that "most if not all" of the cases are expected to be later confirmed as the new H1N1 influenza.

"I expect that there will be many more confirmed cases of H1N1," he told a news conference at the Legislative Building.

Kettner said the number of severely ill persons with flu-like symptoms is greater than what health officials would normally see in a typical flu season.

And he said Manitoba seems to be harder hit than other provinces.

"At this point in time I?m not aware of rates of severe illness of this magnitude in other parts of Canada."

Yet, he stressed that only a tiny percentage ? maybe one in 5,000 ? of those who have likely been exposed to the H1N1 flu virus in Manitoba have become severely ill.

He estimated that perhaps five or 10 per cent of Manitobans have been exposed to H1N1 in the past six weeks.

"This isn?t a cause for panic," Kettner said. "It?s not a cause for really any change in the advice or the approach to this problem that we have been talking about for the last six weeks. If you?re healthy and well it?s perfectly fine to go to work, to stay at a hotel, to travel anywhere in Manitoba that you choose to for business or pleasure."

There have been no deaths reported yet in Manitoba as a result of H1N1. The number of confirmed cases of the virus in the province on Monday remained at 40. They come from six different health regions.

Kettner said the 26 people on ventilators in hospital are "very ill."

"Some of them have been on ventilators for several weeks, and in most of these situations it?s not expected that this will be a quick and short illness requiring just a couple of days of support. The pattern has been so far that many of these patients have required several weeks of intensive care before they have recovered."

He said that in the first week of June the rate at which people became severely ill with what is suspected as H1N1 was far higher than it was in April or May.

More than half of those in intensive care are First Nation people ? status or non-status as well as Inuit. A variety of other ethnic or racial groups have also been affected including caucasian, black and Filipino, Kettner said.

So far, unlike SARS, no one has become ill because they work in the health care system, he said.

Jan Currie, vice-president and chief nursing officer with the Winnipeg Regional Health Authority, said there are normally 30 to 35 people on ventilators in Winnipeg hospitals at any one time for a variety of reasons.

The 26 listed by Kettner are in addition to that, she said. The WRHA has acquired 15 extra ventilators and may defer non-urgent procedures that would normally require ICU care.

It is also taking steps to provide enough support in intensive-care units (ICU) and prioritizing patients for personal-care home beds, the province said in a release.

Meanwhile, the Public Health Agency of Canada has provided three epidemiologists to Manitoba to help assess the province?s cases of flu-like illness.

Kettner said only two of the 26 persons in intensive care are of school age. Questioned by reporters, he said he saw no reason to recommend that any school be closed due to H1N1, adding that this would not stop kids from gathering and potentially spreading the virus.

Jim Wolfe, the federal regional director for First Nations and Inuit Health, said Ottawa is working with the province to ensure there are enough doctors and nurses in First Nation communities to deal with an outbreak.

Government officials would not say how many First Nations have had reported or suspected cases of H1N1. Health authorities believe First Nations people may be at greater risk because of cramped housing conditions and poorer water quality among other reasons.

<!--1 $item-->larry.kusch@freepress.mb.ca

 

[the doctor]

Re: Severe Flu Cases Surge in Manitoba - 26 on Ventilators Since June 7 - Aboriginal Community Hit Hard

Re: Severe Flu Cases Surge in Manitoba - 26 on Ventilators Since June 7 - Aboriginal Community Hit Hard

This re-named thread relates to the surge in LIL among the indigenous people living in Canada.

As of 7Jun2009, there were 26 people on ventilators in Manitoba; presumably most or all of these severely ill people were among those transferred from the First Nations reservation over the last week or so.

Obviously these patients are critically ill. Based upon the track record with patients this ill due H5N1, their chances of surviving is pretty low but H1N1 is not H5N1.

Based upon our track record for people on ventilators due to Adult Respiratory Distress Syndrome which is a medical condition with many causes that in some respects simulates the pulmonary failure seen in patients with widespread influenza pneumonia, the chances of survival is in question irrespective of what ICU they are hospitalized in.

Since these people have H1N1 and do not have H5N1 or ARDS, it is not possible to say what their chances of survival are. It would be very helpful if the Mexican Ministry of Health provided the medical community with this type of information since they are the only ones with this information given that >100 of their citizens died from H1N1, many of whom suffered respiratory failure similar to these people in Canada.

Providing clinical information about those who died in Mexico of H1N1 would be a great service to the world since it would enable those responsible for the care of critically ill H1N1 patients to have the benefit of the Mexican past experience. It is certain that the Mexican MOH has collected this data given their considerable professionalism and expertize.

While 26 people on ventilators is a large number, the local health authorities have requested an addition 15 vents be flown in and these are on the way. That all their available vents are occupied suggests that there may well have been some patients needing vents who could not be accommodated given the drastic rise in the need over such a short time. This pattern is typical of a severe influenza epidemic.

What will come next are the death announcements. Given the news reports provided in this thread beginning from the beginning, it is very clear that there have already been many deaths. A good percentage of those in critical condition in Manitoba who were placed on ventilators will be among those who are already dead. Others died before they could be flown out of the First Nations village.

The Canadian government is not to blame for this in my view. What we are seeing is the affect of a flu pandemic. The mortality and morbidity experienced by the residents of the First Nation village is much more severe than seen in Toronto, Chicago or NYC. The reason for this is of interest.

Previously on this thread I posted a theory exploring why the outcomes for these people might be as severe as they were for those in Mexico during April and May of 2009. Regrettably this guess may well be proven true. Even if it is that does not mean that the reason given by me previously for why it may be so is by any means proven.

IMO, the outcomes we are seeing now simply support the proposition that there is some relationship between these people and those in Mexico that explains why this novel H1N1 in its present form affects some more severely than others.

I reject the notion that either Mexican or First Nation people are less healthy that European North Americans. When it comes to influenza treatment, those in Mexico, indigenous peoples of Canada, and wealthy EuroAmericans in Huston, TX or Manitoba sick with an ILI are all receiving similar care.

Basically, the acute care provided for those sick with an ILI is the same across north America. OK, the ICU might be better in Huston but by the time the patient reaches the ICU with pulmonary failure from flu their chances of survival have already dropped significantly irrespective of where they are hospitalized.

So, what I am saying is that it appears the death rates among indigenous peoples living in Canada is going to be much higher than seen among EuroCanadians ill with flu. It is also likely to be higher than that of EuroAmericans living in the US and rather similar to that seen in Mexicans living in Mexico. If this prediction proves true then it is something that needs closer scrutiny.

Grattan Woodson, MD

 

[HenryN]

Re: Severe Flu Cases Surge in Manitoba - 26 on Ventilators Since June 7 - Aboriginal Community Hit Hard

Re: Severe Flu Cases Surge in Manitoba - 26 on Ventilators Since June 7 - Aboriginal Community Hit Hard

'Toba aboriginals hardest hit by flu, says Kettner

By JASON HALSTEAD, SUN MEDIA

Last Updated: 9th June 2009, 2:58am
Influenza-like illness is hitting aboriginal Manitobans especially hard as health officials are reporting a spike in intensive care treatment for what they believe will prove to be more serious cases of the H1N1 virus.
Manitoba's chief medical officer of health Dr. Joel Kettner said 26 people -- more than half of aboriginal descent -- are currently in Manitoba intensive care units with confirmed cases of H1N1 or serious influenza-like illness.
"This pattern we're seeing in terms of severe illness in people in their 20s, 30s, 40s and 50s is more severe than what we see with a typical seasonal influenza," he said. "This is unusual in this period of time, to see this many cases in those age groups requiring intensive care."
To deal with the surge of more serious cases, the Winnipeg Regional Health Authority is increasing support for ICUs, prioritizing patients for personal-care home beds and has brought in 15 additional ventilators.
"We are expecting the majority of these cases that are in intensive care to be confirmed as new H1N1 cases," Kettner said. "Pretty much all of the influenza now is looking like it's going to be the new H1N1."
As of yesterday there were 40 confirmed cases of H1N1 in Manitoba. No new cases were announced yesterday and no one has died from the virus yet.
"It's not unusual to see a pattern where illness rates are higher amongst our First Nations and other aboriginal peoples, or amongst others that are disadvantaged by living, social and economic conditions," Kettner said.
Kettner tried to put the serious cases in perspective by stressing the vast majority of Manitobans exposed to the H1N1 virus will not become seriously ill.
"It's way more than dozens (who will be exposed to H1N1)," Kettner said. "We're talking about tens of thousands -- if not hundreds of thousands -- of Manitobans. It's only a small proportion of people exposed to this virus who are becoming ill enough to require hospital care.
"This isn't a cause for panic or for really any change in the approach to this problem."
jason.halstead@sunmedia.ca

http://www.winnipegsun.com/news/manitoba/2009/06/09/9733651-sun.html

 

[HenryN]

Re: Severe Flu Cases Surge in Manitoba - 26 on Ventilators Since June 7 - Aboriginal Community Hit Hard

Re: Severe Flu Cases Surge in Manitoba - 26 on Ventilators Since June 7 - Aboriginal Community Hit Hard

<!-- google_ad_section_start(name=article) -->Flu cases requiring intensive care spike in Manitoba, first death in Quebec
By Steve Lambert ? 9 hours ago
WINNIPEG ? Manitoba health officials were investigating a sudden spike in the number of people requiring intensive care for flu-like illnesses Monday, while Quebec reported its first death related to swine flu.
There were 26 Manitobans on ventilators due to flu as of Monday, and that's in addition to the 30 or so people who are on ventilators on an average day for a wide variety of illnesses. The spike prompted the Winnipeg Regional Health Authority to order 15 additional machines.
"We're seeing a number of severe cases of influenza-like illness," said Dr. Joel Kettner, Manitoba's chief public health officer.
"What we've observed is really more severe than what we would expect to see or have seen with typical seasonal influenza in the past."
While the vast majority of people who have contracted the flu have not required hospitalization, the new swine flu seems to be hitting certain groups hard - aboriginals and people between 20 and 60, Kettner said.
Manitoba did not confirm any new cases of swine flu Monday. The provincial total remains at 40, none of which has been fatal. But Kettner said he expects most, if not all, of the recent serious cases will test positive for swine flu.
More than half of those on ventilators as of Monday were aboriginal. Native leaders have warned that poor housing conditions make it hard to prevent a contagious disease from spreading. One of the hardest-hit communities is St. Theresa Point - a fly-in reserve 500 kilometres northeast of Winnipeg where some two-bedroom homes house 10 or more people.
More than a dozen reserve residents have been hospitalized in recent weeks, including a pregnant woman who lost her child.
A flu outbreak in Dauphin, Man., forced about one-third of the 280 students at Mackenzie Middle School to stay home last week. Many students were bedridden for a few days, but most have recovered and were back in class Monday.
"We were encouraging students who felt ill to stay at home, (and) hoped that this thing would maybe run its course," said Jack Sullivan, superintendent of the region's school division.
"We put in extra cleaning staff on Friday and really did a thorough cleaning of the school - you know, hand rails and sinks and fountains."
Quebec health officials, meanwhile, reported the death of a woman over the age of 65. The unidentified woman from Quebec City is the province's first death from swine flu and Canada's fourth.
Dr. Alain Poirier, Quebec's chief public health officer, said the woman had been in fairly good health before she checked into a Quebec City hospital with breathing problems last week. She was treated for bacterial pneumonia.
"She was apparently in good shape and she turned up with an acute respiratory problem," Poirier said, adding he did not know how she became infected with swine flu. She had not travelled recently to Mexico.
Poirier said it was not yet clear whether the virus caused her death or contributed to it.
Quebec has reported 547 cases of swine flu.
The Public Health Agency of Canada has reported more than 2,446 confirmed swine flu cases across the country since early April.

http://www.google.com/hostednews/canadianpress/article/ALeqM5jQlDvm7Yp_tamq1Y-zhRSquOWhAQ

 

[HenryN]

Re: Severe Flu Cases Surge in Manitoba - 26 on Ventilators Since June 7 - Aboriginal Community Hit Hard

Re: Severe Flu Cases Surge in Manitoba - 26 on Ventilators Since June 7 - Aboriginal Community Hit Hard

<!-- google_ad_section_start(name=article) -->Flu cases requiring intensive care spike in Manitoba, first death in Quebec

"She was apparently in good shape and she turned up with an acute respiratory problem," Poirier said, adding he did not know how she became infected with swine flu. She had not travelled recently to Mexico.
Poirier said it was not yet clear whether the virus caused her death or contributed to it.
Quebec has reported 547 cases of swine flu.
The Public Health Agency of Canada has reported more than 2,446 confirmed swine flu cases across the country since early April.

http://www.google.com/hostednews/canadianpress/article/ALeqM5jQlDvm7Yp_tamq1Y-zhRSquOWhAQ

The above comments on lack of travel to Mexico are becoming increasingly annoying, especially in countries like Canada or the US, where H1N1 is widespread and obviously transmitting efficiently from person to person within the United States and Canada.