Uh Oh.

So far, Manitoba has been (relatively) lucky compared to its neighbouring provinces, with only 11 confirmed cases of H1N1, more popularly known as swine flu.  Looks like our luck has run out, though, with a sudden increase in cases from 11 to 38.  From this morning's Winipeg Free Press, all highlighting is my own:

Swine flu surge hits reserve: Extra doctors, drugs sent to help H1N1 patients in St. Theresa Point

By: Jen Skerritt, Winnipeg Free Press, June 4th, 2009.

A spike in the number of Manitobans sick with H1N1 influenza has left Winnipeg hospitals facing a rush for intensive-care beds while extra doctors and drugs are being rushed to an isolated First Nation that seems particularly hard hit.

Dr. Elise Weiss, Manitoba's acting chief medical officer, confirmed Wednesday 27 new cases of H1N1 influenza have been reported across the province -- including three in the northern health region that includes St. Theresa Point First Nation.

Another 19 new cases were reported in Winnipeg, including at least one person hospitalized for severe flu symptoms.

To date, a total of 38 cases of H1N1, also known as swine flu, have been reported in Manitoba.

St. Theresa Point Chief David McDougall said 20 residents have recently been flown to Winnipeg hospitals suffering with flu symptoms, including 12 people who were medevaced in the last week.

Ten children have been hospitalized, along with two pregnant women in critical condition at St. Boniface General Hospital. One woman lost her baby as a result of the illness.

It's still unknown whether everyone who has fallen ill with a respiratory virus in the remote fly-in community is infected with swine flu, and health officials say there are still many tests that must be completed at Manitoba laboratories.

Meanwhile, McDougall said residents continue to wear masks and avoid public gatherings to prevent the spread of the disease. The province has sent three additional physicians and antiviral drugs from their pandemic stockpile to St. Theresa Point, located about 500 kilometres north of Winnipeg. At least six federal health officials arrived in the community on Wednesday to address the situation, which McDougall said included a presentation about influenza on the reserve's local TV station.

"We are taking these precautions," McDougall said. "We're doing the best we can."

The surge in new cases has put a strain on Winnipeg emergency rooms and intensive-care units, which have seen a big influx of patients reporting respiratory problems in the last week.

Winnipeg Regional Health Authority chief nursing officer Jan Currie said visits to city emergency rooms jumped to 1,000 visits a day this week -- up from the usual 800. She said hundreds of Winnipeggers are reporting flu-like symptoms at a time of year when influenza has usually fizzled out.

Staff have been asked to work overtime to handle the extra cases and every hospital is trying to move patients to personal-care homes to free up beds. Currie said the WRHA has purchased more ventilators and plans to put suspected H1N1 patients in emergency-room beds if they run out of intensive-care beds.

"Some of the staff are working overtime to staff the beds," Currie said. "We're very full and we want to be able to predict if we need more (beds) to manage it."

While public health officials have been bracing for additional cases since swine flu incited a worldwide pandemic scare in April, the latest cases have some communities worried they aren't ready for an outbreak.

Red Sucker Lake Chief Larry Knott is watching the outbreak of respiratory illness in St. Theresa Point closely, and said he worries his community won't be able to heed much of the preventative advice from public health practitioners. Handwashing is key to preventing the spread of influenza, but Knott said many residents don't have running water and must get fresh water in a pail from the lake.

First Nations leaders have warned crowded homes and impoverished conditions leave reserves inadequately equipped to deal with a widespread disease outbreak.

Red Sucker Lake is about 100 kilometres north of St. Theresa Point.

"If it hits us, I'm pretty sure it'll hit us pretty hard," Knott said.

In other words, even this small number of H1N1 cases, added to an existing workload, has "put a strain" on our healthcare system. Not a very good sign, especially as the number of swine flu cases is likely to rise as has been the case in other provinces.

And, reading between the lines, I get the sense that the outbreak in St. Theresa Point is a little more severe, perhaps?  The two pregnant women in critical care is especially worrisome; are pregnant women more at risk from this virus than other groups?

Questions, questions.  Hopefully soon we'll have answers.

Comments

[Jaismine Bourne]

This is a horrible outbreak, My prayers go out the communities of Manitoba. Will the swine flu not permit travel into Manitoba?

[cr]

Hi - yes, pregnant women are more at risk, especially in the 2nd and 3rd Trimesters

(and antivirals should be started at symptom onset -don't go by rapid, "flu "tests they are very poor at detecting PanFlu H1N1. Treatment should not be delayed waiting for lab tests, or denied by a neg. 'rapid' swab, or by lack of Fever. Some 'confirmed' cases did not present with Fever.)

During Spanish flu, pregnant women infected had fatality rates that ranged from 23% to 71%.
US CDC says (to itself) that 8% of the confirmed reported US H1N1 dead were pregnant.

Many other health problems, even including obesity, put people at worse risk of 'complications' or death,
and this being the first Pandemic in 41 years,
(attacking and killing the ages 'Spanish' Flu did, 91 years ago)
too many officials chose not to prepare communities to be able to cope, despite years of Pandemic Alert,
(because the H5N1 threat was, "too hard")
-govts also want, "the economy" be be at, 'status quo' for as long as possible,
(oh, and the PRC getting in charge of the WHO after Karo in 2006 did Not help world Preparedness, either).

US CDC Director's Update Brief, July 17, (hat-tip to JerryH at the "PFI Pandemic Flu Information Forum")
has US CFR by Age groups: pdf p29 http://cryptome.org/h1n1/cdc-071709.pdf
and other information you won't hear in the media.
"Underlying conditions" in Deaths 'reported' pdf p30
(Some dead from this Firstwave had No health problems at all.)

Have you seen GetPandemicReady.org ?