The Ahousaht First Nation, a small native community off the coast of Vancouver Island, is known for being the home of Shawn Atleo, the chief of the Assembly of First Nations. But yesterday it earned a dubious distinction: the home of what some medical experts say is Canada's first H1N1 pandemic outbreak of the fall flu season.
The virus disproportionately affected aboriginal people in the spring, and the most recent cluster of cases not only signals the toll it could take on natives but also that the flu season may have arrived early in Canada.
The influenza cluster on the Ahousaht First Nation sickened more than 100 residents of the remote reserve, north of Tofino. Roughly 10 per cent of the reserve's population had flu-like symptoms late last month. The local chief's one-year-old grandson was so ill, he could barely breathe.
A physician told the Canadian Medical Association Journal that the province's public health lab in Vancouver instructed him to stop sending swabs.
The lab had confirmed that all of the samples he forwarded were positive for the H1N1 virus.
"We weren't expecting [the virus] till October," Curtis Dick, deputy chief counsellor and emergency co-ordinator for the Ahousaht First Nation, said yesterday. "I was very surprised."
Mr. Atleo commended his community in its handling of the outbreak and the execution of its pandemic plan. "However, there is an immediate need to ensure all first nations across Canada have the information, tools and human resources needed," he said in a statement.
Native leaders fear their communities are among the least prepared for a resurgence of the H1N1 flu virus, and have criticized the federal government for not properly responding to their needs. Tensions flared this week when remote Manitoba reserves received a shipment of body bags from Health Canada, a dire prediction, leaders said, of what Ottawa expects will happen to natives during this flu season.
The Vancouver Island Health Authority said the cases in Ahousaht were mild, but the reserve's chief councillor, John Frank, said that after watching his grandson get sick 10 days ago, more help is needed.
The hospital in Tofino had no room, he said. And the reserve's nursing station is closed on weekends. His grandson pulled through, but he fears the virus could get stronger and infect more people in his community.
"We need infrastructure that's going to be there to look after us," Mr. Frank said yesterday. "We need to be vigilant and make sure we're open and supporting one another the way we need to do."
Health authorities say there were six laboratory-confirmed H1N1 cases in Ahousaht, a reserve accessible only by water or air.
They say the cases were mild, which conflicts with a CMAJ article yesterday that said an infant and an adult over 50 required hospitalization.
The journal article concluded that remote aboriginal communities on Vancouver Island, including Ahousaht, were suffering the first pandemic outbreak of the coming flu season.
Health officials yesterday disagreed, saying they have been seeing sporadic cases all summer long.
Charmaine Enns, the northern island medical health officer and the medical director for aboriginal health for the Vancouver Island Health Authority, said the flu cases on the Ahousaht reserve have plateaued.
"Ahousaht is doing very well. Ahousaht has had excellent leadership. They have a pandemic plan. Their response has been robust," Dr. Enns said in a news conference yesterday.
But the public health authority may have another cluster on its hands, this time in Beecher Bay, a native community just outside of Victoria.
An aboriginal woman was taken to hospital Sept. 12 with the H1N1 virus and died Wednesday. She had underlying health conditions. A child from the community remains in hospital. Public health authorities have taken samples from people in the community, but they suspect the pandemic virus is circulating on the reserve.
"H1N1 started in British Columbia with an individual who arrived from Mexico back in April. It has not left us. We have had lots of cases through the summer," said Richard Stanwick, chief medical health officer for the Vancouver Island Health Authority. "We really don't have a recurrence of it. It's just that we're seeing increased numbers as anticipated by Dr. Kendall [Perry Kendall, British Columbia's chief medical officer] with school coming back."
