Skip to main content

Main menu

  • Home
  • COVID-19
    • Articles & podcasts
    • Blog posts
    • Collection
    • News
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • Classified ads
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
    • Career Ad Discount
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN

User menu

Search

  • Advanced search
CMAJ
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN
CMAJ

Advanced Search

  • Home
  • COVID-19
    • Articles & podcasts
    • Blog posts
    • Collection
    • News
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • Classified ads
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
    • Career Ad Discount
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
  • Visit CMAJ on Facebook
  • Follow CMAJ on Twitter
  • Follow CMAJ on Pinterest
  • Follow CMAJ on Youtube
  • Follow CMAJ on Instagram
News

Swine flu breaks out on Vancouver Island

Wayne Kondro
CMAJ October 27, 2009 181 (9) E202; DOI: https://doi.org/10.1503/cmaj.109-3054
Wayne Kondro
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Tables
  • Responses
  • Metrics
  • PDF
Loading

The first pandemic (H1N1) 2009 outbreak of Canada’s fall flu season has occurred within remote Aboriginal communities on Vancouver Island in British Columbia, CMAJ has learned.

Tofino, BC, family physician Dr. John Armstong says he has treated “dozens” of people infected with the virus, while the outbreak is such that the province’s public health lab in Vancouver recently instructed him to stop sending swabs, having confirmed that all of the samples he had already forwarded were, in fact, positive for the H1N1 virus.

“We’ve reduced our swabbing because we know that everyone who has flu-like illness in this area right now has H1N1,” Armstrong says. BC public health officials “more or less told us to stop taking swabs because the lab is getting swamped in Vancouver.”

Armstrong says most of the cases he’s handled have been “fairly mild” and treatable with oseltamivir (Tami-flu), with only two patients — an infant and an adult over 50 years of age —requiring hospitalization. “Most of the people I have been seeing are younger adults, between 20 and 40, some teenagers.”

The largest outbreak occurred in Ahousat, the principal settlement on Flores Island, which is accessible only by water or air. Ahousat is also one of the main settlements of the Ahousaht First Nations led by hereditary chief Shawn Atleo, who was recently elected national chief of the Assembly of First Nations.

But a “big community effort kept a lid on that,” as Aboriginal leaders and health officials held public meetings and urged measures to contain the spread, Armstrong says. “But now that school is starting, it’s changed again. We’re also seeing the same flu patterns in other communities.”

Armstrong says there has not been a flu-related death within the area he serves: Tofino and the nearby communities of Hot Springs Cove and Ahousat. But another BC doctor says privately that one Vancouver Island death is “suspected” as being caused by H1N1, although “it is not yet officially confirmed by health authorities in Vancouver.”

Figure1
  • Download figure
  • Open in new tab
  • Download powerpoint

The centre of the pandemic (H1N1) 2009 flu outbreak has occurred in a community that is only accessible by water or air. Image courtesy of ©2009 Jupiterimages Corp.

Although it has been argued that federal and provincial public health officials must loosen restrictions on distributing oseltamivir in remote communities where no physician or registered nurse is readily available on a daily basis, Armstrong says there’s a balance to be struck.

“Somebody has to make the clinical diagnosis in time,” he says. “Who is going to make that clinical diagnosis? The problem is that flu symptoms can look an awful lot like some other things. One of them is kidney infection. You get fever, chills, aches and pains with that. Or tonsillitis, sore throat, fever, aches and pains, headaches. Those are things that you get with influenza. The danger is that you give Tamiflu to somebody when they should be treated for appendicitis, or kidney infection, and actually causes harm because you’ve deferred proper diagnosis.”

“On the other hand, when there’s a high epidemiological likelihood of that person having the flu, it’s running through the household, I don’t see there’s any reason why community health nurses can’t be dispensing it. This really brings up the issue of access to care for people in remote places.”

The outbreak also raises concerns about the availability of a pandemic (H1N1) 2009 flu vaccine. The US Food and Drug Administration approved a vaccine, clearing the way for vaccinations to commence in early October. In Europe, vaccinations commenced in September.

Canadian health officials, meanwhile, have provided no indication whatsoever of when a vaccine might actually be available north of the 49th parallel, beyond saying it “might” be available in mid-November. The Public Health Agency of Canada did, however, announced that pregnant women, health workers, residents of remote area and adults with chronic conditions will be given “priority” access to a vaccine when it becomes available.

Given that a vaccine isn’t available, Armstrong says, it’s important that Tamiflu be “prepositioned” and readily available to those infected with the virus.

PreviousNext
Back to top

In this issue

Canadian Medical Association Journal: 181 (9)
CMAJ
Vol. 181, Issue 9
27 Oct 2009
  • Table of Contents
  • Index by author

Article tools

Respond to this article
Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Swine flu breaks out on Vancouver Island
(Your Name) has sent you a message from CMAJ
(Your Name) thought you would like to see the CMAJ web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Swine flu breaks out on Vancouver Island
Wayne Kondro
CMAJ Oct 2009, 181 (9) E202; DOI: 10.1503/cmaj.109-3054

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
‍ Request Permissions
Share
Swine flu breaks out on Vancouver Island
Wayne Kondro
CMAJ Oct 2009, 181 (9) E202; DOI: 10.1503/cmaj.109-3054
Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
  • Figures & Tables
  • Responses
  • Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • What’s important to know about the new COVID-19 variants?
  • Women experts underrepresented in pandemic coverage
  • Feds update immunization advice with Moderna vaccine approval
Show more News

Similar Articles

Collections

  • Topics
    • Infectious diseases

Content

  • Current issue
  • Past issues
  • Collections
  • Sections
  • Blog
  • Podcasts
  • Alerts
  • RSS
  • Early releases

Information for

  • Advertisers
  • Authors
  • Reviewers
  • CMA Members
  • Media
  • Reprint requests
  • Subscribers

About

  • General Information
  • Journal staff
  • Editorial Board
  • Governance Council
  • Journal Oversight
  • Careers
  • Contact
  • Copyright and Permissions

Copyright 2021, Joule Inc. or its licensors. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p)

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

Powered by HighWire