Flu spotlights Canada as H1N1 sweeps First Nations and Inuit communities

By Terri Hansen
Environment and Science Reporter
Inuit Territory, Canada

For a flu that has thus far produced mostly mild disease, the high number and severity of A/H1N1 infection in Canada’s aboriginal and First Nation communities is sobering. Canada, which to date has 5,710 confirmed H1N1 flu cases and 11 deaths, has given no indication of why the surge is occurring in indigenous communities.

The sharp spike of outbreaks in the predominantly Inuit territories drew alarm from the World Health Organization last week, with senior official Keiji Fukuda saying a disproportionate numbers of serious cases had unfolded in Nunavut and northern Manitoba communities. Fukuda warned that past pandemics had hit Inuit populations "very severely."

Nunavut’s chief medical officer Dr. Isaac Sobol downplayed WHO’s report, but even as he said he didn’t see a disproportionate number of serious cases in Inuit communities, cases in Nunavut doubled from 25 to 53. The next day cases in Nunavut jumped to 96. The number has since risen to 204, and the Nunavut Health Department reported that outbreaks were spreading to communities throughout the entire region. Northeast Manitoba reported 226 cases and two deaths in their small aboriginal communities. Northern Ontario’s Sandy Lake First Nation is reporting more than 120 new cases. Over two-thirds of the seriously ill and those airlifted to hospital intensive care in need of ventilators and intensive care are aboriginals.

“I suspect, by the time this virus has worked its way through Manitoba, as many as half, if not more, Manitobans will have been infected," chief provincial public health officer Dr. Joel Kettner said. He also said that a disproportionate number of Manitobans from First Nations appear to have a severe form of the flu, and aboriginals and people aged between 20 and 60 are among the groups most at risk of H1N1 flu infection. First Nation chiefs say their communities are in full pandemic mode. The Canadian government is denying their requests to set up emergency field hospitals. Manitoba officials issued a plea asking doctors and nurses to volunteer in the remote communities. Three doctors are en route to the region, and 13 nurses, 10 medical residents and two nurse practitioners have indicated their interest. The 1918 Spanish flu pandemic caused by A/H1N1 swine flu, devastated not only Inuit communities in Canada and Alaska, but other North American indigenous communities as well, and caused extremely high mortality rates among indigenous peoples. WHO’s Fukuda said any speculation as to causes such as genetic, environmental or due to underlying diseases is premature. Aboriginal leaders in Canada blame the poor health and crowded living conditions in their communities and accuse federal and provincial governments of leaving them with little help. Poor nutrition, overcrowding, and poor housing make it harder to prevent the disease from spreading. In some First Nation communities, as many as a dozen people squeeze into two-bedroom homes, and over half have no running water. They also lack full-scale medical clinics. Canada’s provincial governments are responding differently to outbreaks in aboriginal communities.

Saskatchewan First Nations, as Status Indians, must have pre-authorization before the Canadian government will authorize payment for the anti-viral drug Tamiflu. The process usually takes a week, and Tamiflu is only effective if taken during the first one or two days. While most people recover from the flu without using anti-virals, WHO said the anti-viral Tamiflu may reduce the symptoms and duration of illness, and may contribute to preventing severe disease and death. There is some fear now that the virus may travel throughout Canada’s Indian country and still active as a possible second and third wave of H1N1 hit this fall and winter.

The message to protect your family and yourself is as important as ever. Stop its spread by washing your hands thoroughly, or use alcohol-based hand sanitizers; both kill the virus. Turn your head and cough into the crook of your arm. Keep a healthy distance from sick people. And stay home from work or school when you’re sick, so you don’t infect others. The Obama administration has put out a plea for understanding from employers.

The Red Cross website counsels worried families that knowing what to expect, how to prepare and where to find needed information and support will increase your resilience, decrease your stress and minimize the impact on you and your loved ones. Information on pandemic preparedness is available at http://www.pandemicfluandyou.org/. And here’s advice for Parents on Talking to Children about H1N1 Flu: http://bit.ly/7NNCU.

The CDC, www.cdc.org/swineflu, and the federal government’s pandemic website, www.pandemicflu.gov/, are good sources of information. Or call the CDC’s toll-free hotline: 1-800-CDC-INFO (1-800-232-4636). The line for the hearing impaired is 1-800-232-6348.

Compiled from news reports and other sources.