Sunday, June 21, 2009

Flu spotlight turns to Canada, as H1N1 swine flu sweeps First Nations and Inuit communities

Left: The 1918 Spanish flu, another A/H1N1 swine flu, devastated Inuit and indigenous communities throughout North America

Inuit Territories, Canada--For a flu that thus far has produced mostly mild disease, the high number and severity of A/H1N1 influenza in Canada’s aboriginal and First Nations communities is sobering.

Canada, which to date has 5,710 confirmed H1N1 flu cases and 11 deaths, has given no indication 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. WHO senior official Keiji Fukuda announced that disproportionate numbers of serious cases in Nunavut and northern Manitoba communities was cause for concern.

Fukuda warned that past pandemics had hit Inuit populations "very severely."

Nunavut’s chief medical officer Dr. Isaac Sobol downplayed WHO’s report saying he didn’t see a disproportionate number of serious cases in Inuit communities--even as cases in Nunavut doubled from 25 to 53.

The next day the number of confirmed cases jumped to 96. The number has since risen to 204. The Nunavut Health Department has reported that outbreaks are spreading to communities throughout the entire region.

Northern Ontario's Sandy Lake First Nation is reporting more than 120 new cases.
Northeast Manitoba has 226 confirmed cases and two deaths in their small aboriginal communities.

Over two-thirds of the seriously ill and those airlifted to hospital 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 said that a disproportionate number of Manitobans from First Nations appear to have a severe form of the flu, and aboriginals and people aged 20 to 60 are among the groups most at risk of H1N1 flu infection.

The 1918 Spanish flu, another 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 blame poor health and living conditions and accuse federal and provincial governments of leaving them with few resources. Poor nutrition, overcrowding, and substandard housing makes it harder to prevent the disease from spreading. In some 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.

There is some fear that the virus may travel throughout Canada's Indian country and still be active as a possible second or third H1N1 wave hits this fall and winter. While most people recover without taking 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, putting an emphasis on the importance of its availability in indigenous communities.

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. Here's pandemic preparedness: And here’s advice for Parents on Talking to Children about H1N1 flu: Families and friends can stay in touch on the Safe and Well Registry:

The CDC, and the federal government’s pandemic website are good sources of information. The CDC’s toll-free hotline is 1-800-CDC-INFO (1-800-232-4636). The line for the hearing impaired is 1-800-232-6348.